HomeMy WebLinkAboutRBPR-02-2023-43407.TIF THIS IS NOTA PERMIT Case# RBPR-02-2023-43407
d t �M CATAWBA COUNTY HEALTH DEPARTMENT
v lig 0 PLAN REVIEW APPLICATION FOR ENVIRONMENTAL SERVICES
18 'L 5M Residential Building Plan Review-Building Addition
EXS_SYSTEM
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Contractor *DENNIS DEAL,576 SNOW CREEK RD,STATESVILLE NC 28625
C:7049023978 DENNIS.DEAL55 rr,GMAIL.COM
Owner JOI-M IIOUSNER, 1320 BENSON LN,NEWTON NC 28658
H:8288500523 I IOM E:8288500523
NAME TO APPEAR ON PERMIT
John Housner
SITE ADDRESS: 1320 BENSON LN,NEWTON NC 28658 PIN# 374006381197
NAME of SUBDIVISION: Lot# B Section/Block
PROPERTY SIZE: Square Feet Acres 0.57
DIRECTIONS: Mt.Olive Church RD, Right Thomas DR,Right E. 18th ST,changes to Benson LN ,property on the Right
PRIMARY CONTACT: Owner SEWER TYPE: Septic Tank
GALLONS ER DAY: 360 WATER SUPPLY: Private Well
DESCRIBE WORK- 3/20/23 REVISE ADDITION TO 22 X39.
PREVIOUS DESCRIPTION:Addition to consist of family room, 1 full bath&kitchenette
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: Single Family Residence OTHER DESCRIPTION:addition
DESCRIPTION OF house
EXISTING STRUCTURES
ON SITE(IF ANY)
DIM EXISTING STRUCTURE: 56x62
NUMBER OF EXISTING BEDROOMS: 3 #OF OCCUPANTS: 2
'� PROPOSED CONSTRUCTION
NEW STRUCTURE 22 X 39
Desired system types(Improvement Permit or Authorization to Construct):
ACCEPTED: ALTERNATIVE: CONVENTIONAL:
OTHER: INNOVATIVE: ANY:
Other described:
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41y,a, • CATAWBA COUNTY Case# RBPR-02-2023-43407
Public Health Department Subdivision
d -• Environmental Health Division(...,
PIN# 374006381197
PO Box 389,100-A Southwest Blvd,Newton,NC 28658
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NAME ON PERMIT: (JOHN HOUSNER), 1320 BENSON LN,NEWTON NC 28658
(John Housner)
Site Address: 1320 BENSON LN,NEWTON NC 28658
Property Size: Square Feet Acres 0.57
Directions: Mt.Olive Church RD,Right Thomas DR,Right E.18th ST,changes to Benson LN,property on the Right
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: S i a3 Signature of Applicant or Agent X/6.7 If you need further information or assistal 828-465-8270
AREA3
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FEENAME DATE FEE AMOUNT
Existing Tank Check Fee 02/14/2023 $80.00
TOTAL FEES $80.00
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)
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