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Home My WebLink AboutRBPR-02-2023-43390.TIF r 'A* THIS IS NOT A PERMIT Case# RBPR-02-2023-43390 CATAWBA COUNTY HEALTH DEPARTMENT (1.11112y4 PLAN REVIEW APPLICATION FOR ENVIRONMENTAL SERVICES 8 - su Residential Building Plan Review- Building New A;viscci IMPROVEMENT- AUTH_CONST- NEW WELL & /u4) gamy/ S12.LJ Applicant *JOHN&SHAYNE RUTHERFORD, 114 SUN LN,MOORESVILLE NC 28115 H:7042670635 C:7049044149 HOME:7042670635 WAKEUP954a1GMAILCOM Owner *JOIIN&SHAYNE RUTHERFORD, 114 SUN LN,MOORESVILLE NC 28115 H:7042670635 C:7049044149 HOME:7042670635 WAKEUP954@GMA1L.COM NAME TO APPEAR ON PERMIT *John & Shayne Rutherford SITE ADDRESS: 2178 HOPEWELL CHURCH RD,SHERRILLS FORD NC 28673 PIN# 369904711632 NAME of SUBDIVISION: Lot# 2 Section/Block PROPERTY SIZE: Square Feet Acres 13.18 DIRECTIONS: Hwy 150 W From Mooresville Turn Right on Sherrills Fords RD,4 mi,Left on Hopewell Church RD,lot on Left beside church PRIMARY CONTACT: Applicant SEWER TYPE: Septic Tank GALLONS PER DAY: 360 WATER SUPPLY: Private Well CRIBE WORK: 6/16/2023 detached garage size changed to 30 x 46 same location 4/27/23 Revised size of the home 32x60,detached garage 28x40 location and size has changed. Revise size of home 32x60 4/19/23 pm Previous description: New 1 story 3 bedroom Modular home 30x60 with 12x20 rear deck. 20x50 detached garage. 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? No 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: Single Family Residence OTHER DESCRIPTION: DESCRIPTION OF EXISTING STRUCTURES ON SITE(IF ANY) DIM EXISTING STRUCTURE: vacant lot NUMBER OF EXISTING BEDROOMS: I OF OCCUPANTS: 2 PROPOSED CONSTRUCTION NEW STRUCTURE DIM:: 32x60; 12x20 rear deck OF NEW BEDROOMS:: 3 BASEMENT? No BASEMENT FIXTURES? PLUMBING REQUIRED? Desired system types(Improvement Permit or Authorization to Construct): ACCEPTED: ALTERNATIVE: CONVENTIONAL: YES OTHER: INNOVATIVE: ANY: Other described: APPLICATION FOR WELL CONSTRUCTION PROPOSED WELL TYPE: Individual Well REPLACE WELL?: NO ehnpphcatum 06/16/2023 09:29 Page 1 of 3 �MNd_.:-.X c':cl'AwkA(O('NTY' caw N R BPI(-02-2023-43390 i + A Public Health Department Sulxln Is+un Environmental Health Division f'INt7 369904711632 {i)' PO Box 3Ih) 1ti0-A Soutlmest Blvd.Ne+Nnn,NY' 2kfr5$ NAME ON PERMIT: i "JOIIN& SI'AVNI' RI'TII[.Rl(iRl)), 114 SIN I.N. MOORI'.SVH.I.I:NC 2X115 ( 'John&Shayne Rutherford) Site Address: 217H I IOPf.i>t'1.1.1.CI IIIRCI I RI).SI IFRRII.I.ti 1.0R1)NC 28673 PropertySize: V 13.18 S niter Pnt Acres Directions: Hwy 150 W From Mooresville Turn Right on Sherrifs Fords RD,4 mi.Leh on Hopewell Church RD,lot on Left beside church Completed appiicabons are valid for a period of 2 years Improvement Permits are valid with complete site plan=60 months(5 years),with c:ampiete plat =without expiration An Authorization to Construct will remain valid as long as the Improvement Permit is valid An Authontatton 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 lacdlty 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 identificabon 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 n I / I)ttr: 06 - 1 6 • 23 S:pat tire of Appiicunt i ir AIterit .J--'I`-1. . II you need further information or as.,Istan'c pIva>e call 828-465-827( AREA4 F-EEti:1MF; DATE. FEE AMOUNT Authorization to Construct Fee(New/Expansion) i)'%13'2023 SI 50 ix) Fee Improvement Permit Fee 02,i 3,102 3 S 150 00 Well Permit&Inspection Fee 02 13/21)23 S300 00 TOTAL FEES S600.00 FEES ARE NON-REFUNDABLE ONCE A SITE VISIT IS MADE OR WORK ON A PLAN REVIEW IIAS COMMENCED SYSTEM REDESIGN AND/OR RETRIP WILL INCUR AN ADDITIONAL CHARGE (SEE FEE SCHEDULE) • 'ib Ib;o;; i i;•i I'Iv,:,. 1P,Ac.,or.il &iQ Da-e.vz3,- Y3.390 Catawba County Environmental Health a ott-2o2.U- /Y36 7 (...)Q 0 l oY-aoz - ril6t3 TZ • 6flit gekAsed • ,i!' • a ii Q if !le 1 a 13.1an 3ix(,p 1 �� P sr .44 I or, 12%20 OuK 8-I, I e 1-...zfzi / 2s P4 e-'r Parcel:369004711632,2178 HOPEWELL 1irr=10o11 CHURCH RD SHERRILLS FORD, 28673 T tospireport produat vim praprrsd bron the estawbo Co.wdy,we c, Wmo n servtaes. C a=boo triads em,a� .1 effortsto amass eir eooteaay atlocolk rt and ieTirarI_ od on map or dam an Ws vapor.Cat &m promotes and ruin tree troiegBf�rs vt� dtel a or am m,�°iao gee an*ar lesphpport product by a'le ter.rho County ty at Cara,tk.,ha u ttploy ae,agents,and &MK and 1111110 n0t ha Fdd �D for N and d arn/vas,Ion or 6stity,vbbot tar direct it +d or oatrequential 14bit arises or miry Wee'bun fnil~opal product or Qta tleelharoof by eny person or godly. Copyright 2023 Coteike County NC 4/144202 4y'=\th.•G THIS IS NOT A PERMIT Case# RBPR-02-2023-43390 d CATAWBA COUNTY HEALTH DEPARTMENT PLAN REVIEW APPLICATION FOR ENVIRONMENTAL SERVICES Ig 2 sra Residential Building Plan Review-Building New IMPROVEMENT-AUTH CONST- NEW WELL nAlcd 44-an-43 Applicant *JOHN&SHAYNE RUTHERFORD, 114 SUN LN,MOORESVILLE NC 28115 C:7049044149 WAKEUP954@GMAIL.COM Owner *JOHN&SHAYNE RUTHERFORD, 114 SUN LN,MOORESVILLE NC 28115 C:7049044149 WAKEUP954@GMAIL.COM NAME TO APPEAR ON PERMIT *John & Shayne Rutherford SITE ADDRESS: 2178 HOPEWELL CHURCH RD,SHERRILLS FORD NC 28673 PIN# 369904711632 NAME of SUBDIVISION: Lot# 2 Section/Block PROPERTY SIZE: Square Feet Acres 13.18 DIRECTIONS: Hwy 150 W From Mooresville Turn Right on Sherrills Fords RD,4 mi,Left on Hopewell Church RD,lot on Left beside church PRIMARY CONTACT: Applicant SEWER TYPE: Septic Tank GALLONS PER DAY: 360 WATER SUPPLY: Private Well DESC WOR 4/27/23 Revised size of the home 32x60,detached garage 28x40 location and size has changed. Revise size of home 32x60 4/19/23 pm. Previous description: New 1 story 3 bedroom Modular home 30x60 with 12x20 rear deck.20x50 detached garage. 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? No 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: Single Family Residence OTHER DESCRIPTION: DESCRIPTION OF EXISTING STRUCTURES ON SITE(IF ANY) DIM EXISTING STRUCTURE: vacant lot NUMBER OF EXISTING BEDROOMS: #OF OCCUPANTS: 2 PROPOSED CONSTRUCTION W STRUCTURE DIM:: ' 32x60;12x20 rear deck Ira NEW BEDROOMS:: 3 BASEMENT? No BASEMENT FIXTURES? PLUMBING REQUIRED? Desired system types(Improvement Permit or Authorization to Construct): ACCEPTED: ALTERNATIVE: CONVENTIONAL: YES OTHER: INNOVATIVE: ANY: Other described: APPLICATION FOR WELL CONSTRUCTION PROPOSED WELL TYPE: Individual Well REPLACE WELL?: NO ehapplication 04/27/2023 12:02 Page 1 of 3 w• CATAWBA COUNTY Case/t RBPR-02-2023-43390 • .it Public Health Department Subdivision i? Environmental Health Division PINtt 369904711632 PO Box 389,100-A Southwest Blvd,Newton,NC 28658 w NAME ON PERMIT: (*JOHN&SHAYNE RUTHERFORD), 114 SUN LN,MOORESVILLE NC 28115 (*John&Shayne Rutherford) Site Address: 2178 HOPEWELL CHURCH RD,SHERRILLS FORD NC 28673 Property Size: Square Feet Acres 13.18 Directions: Hwy 150 W From Mooresville Turn Right on Sherrills Fords RD,4 mi,Left on Hopewell Church RD,lot on Left beside church 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. yy Date: Aril 7._.71 -2_0 Z3 Signature of Applicant or Agent c-k— V.. C/,J If you need further information or assi ance lease call 828-465-827 AREA4 FEENAME DATE FEE AMOUNT Authorization to Construct Fee(New/Expansion) 02/13/2023 $150.00 Fee Improvement Permit Fee 02/13/2023 $150.00 Well Permit&Inspection Fee 02/13/2023 $300.00 TOTAL lr EES . !$600 00 ;i 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) • ehapplication 04/27/2023 12:02 Page 2 of 3 Jt ►P,ac,t,JcJ &Q tn.- 2023- 'l3390 Catawba County Environmental Health Aw14 Ott-2023- MO 7 hbll oi-Jo13- /93693 u Qp r7 -..................t. / geNi;Sed S . P\(,Y^ ifiI Z7l23 v II- I 1 d •21 w s I • 1 13.18A 4. 1 s•• 1 p I 94. .4\ ) Er �4 1i, :Alf isy, ,, iiiiii. G Parcel;389904711632,2178 HOPEWELL n 11ri100ft CHURCH RD SHERRILL8 FORD,28673 N r r 11de t product was lamed from the Catawba Corm NC Geospeliel moon latiofl eervioes. Catawba County has made substantial effort' to ensure the eooaaq d Imam and 1ebalins bdamatton mimed on We map or data an this repot Cetaw=Candy promotes end rocanmende the adepandent mdlicaton of any data cantered on this naphepod product by Ore user.The Corsdy of Catawba.Its employees,agents.and personnel,dWara and anal not be held liable tow any and a1 dermas,ions or May.whether direct,balled or consequential which arises o►may ens from Ora report product or the use thereof by any person o►entity. Copydgtd 2023 Catawba County NC 04/14P2023