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Home My WebLink AboutRBPR-11-2022-42801.TIF A $ % THIS IS NOTA PERMIT Case# RBPR-1 1-2022-4280 1 `` CATAWBA COUNTY HEALTH DEPARTMENT PLAN REVIEW APPLICATION FOR ENVIRONMENTAL SERVICES /841 sM Residential Building Plan Review-Manufactured Home IMPROVEMENT-AUTH CONST- RELOCATION (k).;' .SC.C.-j n-'7').-t-- '1 Owner *SERGIO SAUCEDO SANTACRUZ,3010 34TH STREET DR NE 4,HICKORY NC 28601 C:828308304I SERGIOSANTACRUZ100 rJGMAIL.COM NAME TO APPEAR ON PERMIT *SERGIO SAUCEDO SANTACRUZ SITE ADDRESS: 5617 MTN TERRACE DR,HICKORY NC 28602 PIN# 279010379314 NAME of SUBDIVISION: MOUNTAIN SITES Lot hi 5 Section/Block C PROPERTY SIZE: Square Feet Acres •47 DIRECTIONS: NC 127,left onto Old Farm Dr,left onto Mountain Terrace Dr PRIMARY CONTACT: Owner SEWER TYPE: Septic Tank GALLONS PER DAY: 360 WATER SUPPLY: Public Water DESCRIBE WORK_,;7/7/23 Revised 12x42 back deck. 7/3/23 Revised 14x42 back deck. New site map received. 1/10/2023 FRONT OF DECK WILL BE 30' FROM FRONT AS SHOWN ON ORIGINAL SITE PLAN. CHANGE TO 3 BEDROOM SAME HOME AND DECK SIZES. EXISTING SYSTEM MUST BE RELOCATED ON TO PROPERTY, RUNS OFF PROPERTY. PREVIOUS DESCRIPTION: EXISTING SYSTEM INSP/4 BEDROOMS/480 GPD---Installation of a 70x26 double wide w/6x6 front deck and 6x8 back deck SITE INFORMATION Do any of the following apply to the property for which this application is applied? If the answer to any of the questions below is"YES",then supporting documentation is required: Does this site contain any jurisdictional wetlands? No Does this site contain any existing wastewater systems? Yes Is any of the wastewater going to be generated on the site other than domestic sewage? No Is the site subject to approval by any other public agency? Yes Are there any easements or right-of-ways on this property? No APPLICATION FOR: New Structure STRUCTURE TYPE: PRIMARY RESIDENCE FACILITY TYPE: Mobile Home OTHER DESCRIPTION: DESCRIPTION OF EXISTING STRUCTURES ON SITE(IF ANY) DIM EXISTING STRUCTURE: NUMBER OF EXISTING BEDROOMS: #OF OCCUPANTS: 5 PROPOSED CONSTRUCTION C NEW STRUCTURE DIMS 70x26 DW,6x6 front&12x42 back deck #OF NEW BEDROOMS:: 3 Desired system types(Improvement Permit or Authorization to Construct): ACCEPTED: ALTERNATIVE: CONVENTIONAL: OTHER: INNOVATIVE: ANY: YES Other described: ehapplication 07/07/2023 15:59 P,i,:c I of �$: • CATAWBACOUNTY Case# RBPR-1 1-2022-42 80 1 E. t IL x Public Health Department(....... Subdivision MOUNTAIN SITES "j Environmental Health Division PIN# 279010379314 PO Box 389,100-A Southwest Blvd,Newton,NC 28658 w NAME ON PERMIT: (*SERGIO SAUCEDO SANTACRUZ),3010 34TH STREET DR NE 4,HICKORY NC 28601 (*SERGIO SAUCEDO SANTAC Site Address: 5617 MTN TERRACE DR,HICKORY NC 28602 Property Size: Square Feet Acres 47 Directions: NC 127,left onto Old Farm Dr,left onto Mountain Terrace Dr Completed applications are valid for a period of 2 years.Improvement Permits are valid:with complete site plan=60 months(5 years);with complete plat =without expiration. An Authorization to Construct will remain valid as long as the Improvement Permit is valid.An Authorization to Construct issued for septic repair is valid for 60 months(5 years).Permits may be revoked if the information on this application/site plan changes or if the intended use for the proposed facility changes. Permits may be revoked if site conditions are altered such that they effect permit conditions or installation requirements I have read this application and certify that the information provided herein is true,complete and correct. Authorized county and state officials are granted right of entry to conduct necessary inspections to determine compliance with applicable laws and rules. I understand that I am solely responsible for the proper identification and labeling of all property lines and corners and making the site accessible so that a complete site evaluation can be performed. The undersigned is the owner of the property or legal agent of the owner. Date: / 2 ) 2-- Signature of Applicant or Agent-�c S+0 5- Sa Fa O(V-N---_____ If you need further information or assistance please call 828-465-8270 AREA1 FEENAME DATE` FEE AMOUNT Existing Tank Check Fee 11/16/2022 $80.00 Authorization to Construct(Relocation) 01/10/2023 $70.00 Improvement Permit Fee 01/10/2023 $150.00 Re-Trip or Redesign Fee 07/03/2023 $70.00 TOTAL FEES $370.00 FEES ARE NON-REFUNDABLE ONCE A SITE VISIT IS MADE OR WORK ON A PLAN REVIEW HAS COMMENCED SYSTEM REDESIGN AND/OR RETRIP WILL INCUR AN ADDITIONAL CHARGE (SEE FEE SCHEDULE) ehapplicauon 07/07/2023 15:59 Page 2 of 3 v. „„„initivri CATAVIRA COUNTY k `�' Polk Health Defaming Subdivision MOUNTAIN Sit`fES 'te " s Environmental Health Damon ' e* # 1'U 3ti9.I0O A SoaIIltwrat 1 27iSf310378Kit4 ir /:CY w Blvd.t NC 28155$ NAMEON�: (`SERGIO SAL)CEDO SANTACRUZ) 3010 34111 STREET DR NE 4,HICKORY NC 28601 ('SERGIO SAUCED()SANTAC Sala Address: - 5617 MTN TERRACE DR,HICKORY NC 23602 . Preipmy Slzs Square Feed Ames 47 io Dl,eufl s: NC 127,kit onto Old Farm Or,left*trio Mountain Terrace Dr ere;mad tor a period of 2 meta.Improvement Permtta are vend:van co rrw..se clan s ea a late a III law*adtt exrrlaieta Plat . .estraut mairadau:An Awn tO Cerwtrula wit retinae valid as long w IIu latNovarrna Ferrel a wed.AnAirthattaarnt ta Corm utu+ad far mc repair Is vela axed rawest to ).Permits naty Oa MOM if the trnennetion on Ms eppfer plan Menges or a the Mantled use ax Ire y atentat Permits may Oe revottad 0 site eansaions errs altered tagari that they artezt permit emrtdielara of Inagdd9on fmn sn s fi moves mad this+fin setd au awe ego*Carnation provided heroin a @us,comalete arm emsrem Auttraired=ON ant Nos*Maul" ate 1 OnRatad Vat et la mn ud r,asasey inspections to tafltivane am me mat appatam a Iowa and naea, 1 undencend dmf I tan Soler I r crane the t er berm and abeam of ell property and toners and mane Me saes ees that aanimate Bile avwwaon et The iminusianed la the owner of the property or leper opera edarocenter, Duel._ o � : Signature of Applicant a:A € Ifyou treed further information or assistance pi�tall 828�46541270 �"" AREA! '`' t M , .. ::: r .:.! : x,>:.< ,• A=M Exieng Tank Check FeefUUri" 11/16/2022 311000 Au on to Cons1ruot(Relocation) 01/10/2023 $70.00 improvement Permit Fee 01/10l2023 3150,00 Re-Trip ce Redesign Fee 07/03/2023 370,00 31 :4. f,raW,.N..sS arasa:i?r.,.G i.°.',.. .a. :5.,<..nLR"`'"a.;.r.a cMA FEES ARE NON-REFUNDABLE ONCE A SITE VISIT IS MADE OR WORK ON A PLAN REVIEW HAS COMMENCED SYSTEM REDESIGN AND/OR RETRIP WILL INCUR AN ADDITIONAL CHARGE (SEE FEE SCHEDULE) owns)11.OJ Nosors B%fie\ THIS IS NOTA PERMIT Case# RBPR-1 1-2022-42 80 1 �' �_ CATAWBA COUNTY HEALTH DEPARTMENT' �` ' PLAN REVIEW APPLICATION FOR ENVIRONMENTAL SERVICES l84 sit THIS mg Plan Review-Manu ac u IMPROVEMENT-AUTH CONST- RELOCATION 1 1 b 1D3 rRot,A 5c,d Owner SERGIO SAUCEDO SANTACRUZ,3010 34TH STREET DR NE 4,I IICKORY NC 28601 C:828308304I SERG1OSANTACRUZI00(�iGMAIL.COM NAME TO APPEAR ON PERMIT SERGIO SAUCEDO SANTACRUZ SITE ADDRESS: 5617 MTN TERRACE DR,HICKORY NC 28602 PIN# 279010379314 NAME of SUBDIVISION: MOUNTAIN SITES Lot 0 5 Section/BlockC PROPERTY SIZE: Square Feet Acres .47 DIRECTIONS: NC 127,left onto Old Farm Dr,left onto Mountain Terrace Dr PRIM__ - • Owner SEWER TYPE: Septic Tank - •LLONS PER DAY: 360 WATER SUPPLY: Public Water DESCRIBE WORK: /10/2023 FRONT OF DECK WILL BE 30' FROM FRONT AS SHOWN ON ORIGINAL SITE PLAN. CHANGE TO 3 BEDROOM SAME HOME AND DECK SIZES. EXISTING SYSTEM MUST BE RELOCATED ON TO PROPERTY, RUNS OFF PROPERTY. PREVIOUS DESCRIPTION: EXISTING SYSTEM INSP/4 BEDROOMS/480 GPD—Installation of a 70x26 double wide w/6x6 front deck and 6x8 back deck SITE INFORMATION Do any of the following apply to the property for which this application is applied? If the answer to any of the questions below is"YES",then supporting documentation is required: Does this site contain any jurisdictional wetlands? No Does this site contain any existing wastewater systems? Yes Is any of the wastewater going to be generated on the site other than domestic sewage? No Is the site subject to approval by any other public agency? Yes Are there any easements or right-of-ways on this property? No APPLICATION FOR: New Structure STRUCTURE TYPE: PRIMARY RESIDENCE FACILITY TYPE: Mobile Home OTHER DESCRIPTION: DESCRIPTION OF EXISTING STRUCTURES ON SITE(IF ANY) DIM EXISTING STRUCTURE: NUMBER OF EXISTING BEDROOMS: #OF OCCUPANTS: 5 PROPOSED CONSTRUCTION NEW STRUCTURE DI 70x26 DW,6x6 front&6x8 back decks OF1f BEDROOMS:: 3 esi ysterrrtype mprovement Permit or Authorization to Construct): ACCEPTED: ALTERNATIVE: CONVENTIONAL: OTHER: INNOVATIVE: ANY: YES Other described: thapplication 01/102023 11:36 Page 1 of 3 .ty • CATAWBA COUNTY Case# RBPR-1 1-2022-4280 1 ti 4 Public Health Department �Z Subdivision MOUNTAIN SITES Q ''l Environmental Health Division '"(ll`,.�) "x'' PIN# 279010379314 PO Box 389,100-A Southwest Blvd,Newton,NC 28658 8. w NAME ON PERMIT: (SERGIO SAUCEDO SANTACRUZ),3010 34TH STREET DR NE 4,HICKORY NC 28601 (SERGIO SAUCEDO SANTACF Site Address: 5617 MTN TERRACE DR,HICKORY NC 28602 47Pro Property Size: Square FeetAcres Directions: NC 127,left onto Old Farm Dr,left onto Mountain Terrace Dr Completed applications are valid for a period of 2 years.Improvement Permits are valid:with complete site plan=60 months(5 years);with complete plat =without expiration. An Authorization to Construct will remain valid as long as the Improvement Permit is valid,An Authorization to Construct issued for septic repair is valid for 60 months(5 years).Permits may be revoked if the information on this application/site plan changes or if the intended use for the proposed facility changes, Permits may be revoked if site conditions are altered such that they effect permit conditions or installation requirements I have read this application and certify that the information provided herein is true,complete and correct. Authorized county and state officials are granted right of entry to conduct necessary inspections to determine compliance with applicable laws and rules. I understand that I am solely responsible for the proper identification and labeling of all property lines and corners and making the site accessible so that a complete site evaluation can be performed. The undersigned is the owner of the property or legal agent of the owner. /- y� Date: /— ! O' 3 Signature of Applicant or Agent FQ ,S .5ezzi tec V V -- If you need further information or assistance plAs.4 call 828-465-8270 AREA1 FEENAME DATE FEE AMOUNT Existing Tank Check Fee 11/16/2022 $80.00 Authorization to Construct(Relocation) 01/10/2023 $70.00 Improvement Permit Fee 01/10/2023 $150.00 TOTAL FEES S300.00 FEES ARE NON-REFUNDABLE ONCE A SITE VISIT IS MADE OR WORK ON A PLAN REVIEW HAS COMMENCED SYSTEM REDESIGN AND/OR RETRIP WILL INCUR AN ADDITIONAL CHARGE (SEE FEE SCHEDULE) eirvplic at nm 01/10/2023 11:36 Page 2 of 3 $A • CATAWBA COUNTY 100A SOUTHWEST BLVD 1 NEWTON,NORTH CAROLINA 28658 RECEIPT �. PHONE:828.465.8399 Tuesday,January 10,2023 www.catawbacountync.gov PAYOR: SAUCEDO SANTACRUZ,SERGIO PAYMENTS TRANSACTION NUMBER: TRC-55 152396-10-01-2023 PAYMENT DATE: 01/10/2023 PAYMENT TYPE: Credit Card 299625123 INVOICE NUMBER ACCOUNT FEE NAME FEE AMOUNT 01-23-416642 110-580200-663000 Authorization to Construct(Reloca $70.00 tion) 01-23-416642 uo-sso2oo•663000 Improvement Permit Fee $150.00 TOTAL PAYMENTS: $220.00 RBPR-1 1-2022-42801 CASE TYPE: Residential Building Plan Review WORK CLASS: Manufactured liome SITE ADDRESS: 5617 MTN TERRACE DR,HICKORY NC 28602 Owner SERGIO SAUCEDO SANTACRUZ,3010 34TII STREET DR NE 4,HICKORY NC 28601 C:828308304I SERGIOSANTACRUZIOO@GMAIL.COM **NO PEOPLESOFT ACCOUNT ASSIGNED** receipt 01/10/2023 11:41 Page 1 of 1