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Home My WebLink AboutRBPR-04-2023-44024.TIF r 44" ve THIS IS NOT A PERMIT Case# RBPR-04-2023-44024 �' y CATAWBA COUNTY HEALTH DEPARTMENT PLAN REVIEW APPLICATION FOR ENVIRONMENTAL SERVICES /8 2 sa Residential Building Plan Review-Building New IMPROVEMENT-AUTH CONST- NEW WELL Applicant SAME AS OWNER,, Contractor *JOHN STUBBS BUILDING CONTRACTOR LLC (JOHN STUBBS),4996 OLD SHELBY RD,VALE NC 28168 C:8285698883 JOHNISTUBS a GMAIL.COM Owner MELANIE STUBBS,4996 OLD SHELBY RD,VALE NC 28168 NAME TO APPEAR ON PERMIT Melanie Stubbs SITE ADDRESS: 4972 OLD SHELBY RD,VALE NC 28168 PIN# 267903037627 NAME of SUBDIVISION: Lot# Section/Block PROPERTY SIZE: Square Feet Acres 35.68 DIRECTIONS: Hwy 10,Turn Right onto Providence Ch Rd to end turn left Old Shelby Rd,Property on corner and left PRIMARY CONTACT: Owner SEWER TYPE: Septic Tank GALLONS PER DAY: 240 WATER SUPPLY: Private Well DESCRIBE WORK: 2 bedroom 26x25 Accessory Dwelling on crawl with rear deck 10x10 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: ACCESSORY DWELLING FACILITY TYPE: Accessory Dwelling OTHER DESCRIPTION: DESCRIPTION OF vacant lot EXISTING STRUCTURES ON SITE(IF ANY) DIM EXISTING STRUCTURE: NUMBER OF EXISTING BEDROOMS: #OF OCCUPANTS: 3 PROPOSED CONSTRUCTION NEW STRUCTURE DIM:: 26x25 #OF NEW BEDROOMS:: 2 BASEMENT? No BASEMENT FIXTURES? No PLUMBING REQUIRED? Desired system types(Improvement Permit or Authorization to Construct): ACCEPTED: ALTERNATIVE: CONVENTIONAL: OTHER: YES INNOVATIVE: ANY: Other described: 25%reduction APPLICATION FOR WELL CONSTRUCTION PROPOSED WELL TYPE: Individual Well REPLACE WELL?: NO ehapplication 04/12/2023 11:33 Page 1 of 3 A sy `• CATAWBA COUNTY Case# RBPR-04-2023-44024 ti(....I ,� Public Health Department Subdivision d -- '"1 Environmental Health Division PIN# 267903037627 PO Box 389, 100-A Southwest Blvd,Newton,NC 28658 sv NAME ON PERMIT: (MELANIE STUBBS),4996 OLD SHELBY RD,VALE NC 28168 (Melanie Stubbs) Site Address: 4972 OLD SI IELBY RD,VALE NC 28168 Property Size: Square Feet Acres 35.68 Directions: Hwy 10,Turn Right onto Providence Ch Rd to end turn left Old Shelby Rd,Property on corner and left 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: Signature of Applicant or Agent If you need further information or assistance please call 828-465-8270 AREA1 FEENAME • DATE •FEE AMOUNT Authorization to Construct Fee(New/Expansion) 04/12/2023 $150.00 Fee Well Permit& Inspection Fee 04/12/2023 $300.00 Improvement Permit Fee 04/12/2023 $150.00 TOTAL FEES $600.00 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) ehapplication 04/12/2023 11:33 Page 2 of 3 ;.+ . . catawba county public health Application for Environmental Health Services _ THIS IS NOT A PERMIT Application is for: [New Construction ❑Existing Facility ❑ Improvement Permit (sr Authorization to Construct kNew Septic ❑Septic Repair/Malfunction ❑ Septic Relocation ❑ Septic Expansion ❑ Existing System Ins ecte or Reconnection lAl New Well ylb"). t Replacement Well 11 ^--,^, ID Well Abandonment I]Well Repair Property Address � OLb Sfte Kf�4�J \kLL—t ,J L1 2 E'I 6S' Acres3 '- (pE Subdivision r �r Lot# Drivi g Directions to PropertyALAN. 1? Kl ( l� ru f CI& Ct eC��'i Tao &0 -To L � 4w �4 �� PAC-vey 0,.J (.0e.At C Describe work {J J,LC) 60 S QOI '4X7 i “ el Applicant Name <rat-ii..1 i V _ "---(i-J.rfOS Applicant Address (Mg S(tftt ( 1A1) ll"/rl.,(;f n�' C , 2 ( 6g- Phone S2& —8 $3 Email diZtaia J0nntst'ubS p &&►'& ( rCcAl Owner Name Si Pt;S lI'vM.( oa�5 Owner Address L¢Qq c, OU sf{tt3.-1 � J E rJ C-,' ( & Phone �Z� — S 6 Q `� Email J bin itT 31-0)c V NtCr(o` a (O V Contractor Name J-)A ciass S (5 Ui lA i.-4 Ct COA.72yetribc2 Contractor Address (. - fv Qck . , at264 42) t<zzC_ 2E-( (a Phone Email J p(An (S -C () EIMa t) e Cc -t Name to Appear on Permit? ,216wner ❑Applicant ❑Contractor Who will be the Primary Contact? ,,R Owner ❑Applicant ❑Contractor Proposed New Construction-Residential Primary Residence ❑ New Residence .PrAddition to Residence #of New Bedrooms*t _ #of Occupants Project Description_ , ,__, _ ,. . _ Structure Dimensions,also specify dimensions of decks&porches , , ,_ _ , _ (Choose One) 0 Basement, Crawl Space ❑ Slab If Basement,Will There Be Water Using Fixtures In Basement ❑Yes ❑ No Retaining Wall>2' 0 Yes ❑ No Accessory Dwelling #of New Bedrooms*t #of Occupants 3 Structure Dimensions 2&Fr t( 25 T (Choose One) ❑Basement ,Crawl Space ❑ Sla If Basement,Will There Be Water Using Fixtures In Basement ❑Yes ❑ No Retaining Wall>2' ❑ Yes,eNo 2 . ))&C---V-- 5 c 2 C: ( 0 ( V _ , Accessory Str cture(s)Describe Structure(s)Dimensions • • Plumbing Yes ❑No D scribe Plumbing Needed _ , (Choose One) ❑Basement Crawl Space ❑ Slab If Basement,Will There Be Water Using Fixtures In Basement ❑Yes 0 No Retaining Wall>2' ❑ Yes,,rNo Multi-Family Residence #of Apartments #Bedrooms per Apartment*t Total#Bedrooms in Stnicture*t #of Occupants Structure Dimensions (Choose One) 0 Basement 0 Crawl Space El Slab If Basement,Will There Be Water Using Fixtures In Basement ❑Yes El No Retaining Wall>2' ❑ Yes 0 No Well Construction/Abandonment/Repair Proposed Well Type Individual Well ❑ Semi-Public Well ❑ Community Well Abandonment Type ❑ Drilled Bored ❑ Dug ❑ Unknown Well Repair Requested ❑Yes ❑No Describe Will Certified Well Contractor Install Water Line or Electrical Line from Well Head to Pressure Tank? Yes ❑No Environmental Health Catawba County Government Center,25 Government Drive I PO. Box 389, Newton, NC 28658 Phone:(828)465-8270 I Fax: (828)465-8276 I EHAdmin@CatawbaCountyNC.gov Existing Structures on Site Describe Structure Dimensions #of Bedrooms* #of Occupants Basement El Ycs ❑ No Basement Plumbing El Yes ❑ No Existing Water Supply ,Individual Well ❑ Shared Well—Number of Connections El Community Well ❑ County/City/Township Water Line Is a public water supply available?** ❑ Yes ❑No Commercial El Proposed New Construction ❑Existing/Change of Use ❑ Repair Food Service Specify Type #Seats Dining Area(Sq.Ft.) #Employees per Shift #of Shifts Church #of Seats Daycare❑Yes ❑No #of Children #of Employees per Shift #of Shifts Commercial Kitchen El Yes ❑No Residential Kitchen ❑ Yes ❑No Daycare#of Children #of Employees per Shift #of Shifts Business/Other Specify Type Structure Dimensions Retail Floor Space #of Employees per Shift #of Shifts Other Information Calculated Design Flow,Commercial t (This value will be determined by EH staff) The Applicant shall notify the local health department upon submittal of this application if any of the following apply to the property in question. If the answer to any question is"yes",applicant must attach supporting documentation. ❑ Yes "ENo Does the site contain any jurisdictional wetlands? Yes OrNo Does the site contain any existing wastewater systems? ❑ Yes El No Is any wastewater going to be generated on the site other than domestic sewage? JYes gNo Is the site subject to approval by any other public agency? ❑ Yes . No Are there any easements or right of ways on this property'? Describe If applying for an Improvement Permit or Authorization to Construct,Please Indicate Desired System Type(s): (stems can be ranked in order of our preference) n Accepted 0 Alternative /,/ '`Conventional 0 Innovative Other , 5 51)(! K t1j,".❑ Any *Any room that will be intended for sleeping at the time of construction or for future consideration should be noted as a bedroom and counted on all applications.The number of bedrooms will be confirmed by rooms identified on floor plans as a bedroom at the time of building permit issuance. This may prevent the need for septic system expansion in the future. t If structure is plumbed but has no bedrooms,calculated design flow will be determined by EH Staff. ** If No,a well permit must be issued with the Authorization to Construct. RETRIP TO THE PROPERTY AND/OR SYSTEM REDESIGN WILL INCUR AN ADDITIONAL CHARGE(SEE FEE SCHEDULE) Environmental Health soil/site evaluations require digging,angering,and/or probing into the ground.Property owner/applicant is responsible for marking all underground utilities,including but not limited to:underground power,cable,telephone,gas,water lines,and irrigation systems/sprinkler systems. Catawba County Environmental Health is not responsible for damage to unmarked utilities. 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 .gent of the owner. joiy Signature of Owner or Legal Agent 4 Date I U 2 Z Printed Name of Owner or Legal Agent J f71-t— STA.:gS Catawba County Environmental Health 329r ' _` ` f1ti7 t�I 0138 r * 05E4* DL°SHELBY .501%ww6 - 1 ‘1_19, tt+r RD ` �f � 4945 4.3 t `O `d4 - ;a 43 3. •d> 799i# r 0 ,� .x9s8 41 73g 304.77 r , s i` / m 1. _73 �7952 c 307.48 111 4 7/ C ��j 41, 'fC 29O.6 A41/4/ s •, 14 ��' of 6 41)* A, .6 1 mo •l•`1., IC h x . Parcel: 267903037627, 4946 OLD SHELBY RD 1 in=200ft VALE, 28168 This map/report product was prepared from the Catawba County,NC Geospatial Information Services. Catawba County has made substantial efforts to ensure the accuracy of location and labeling information contained on this map or data on this report.Catawba County promotes and recommends the independent verification of any data contained on this map/report product by the user.The County of Catawba,its employees,agents,and personnel,disclaim,and shall not be held liable for any and all damages,loss or liability,whether direct,indirect or consequential which arises or may arise from this map/report product or the use thereof by any person or entity. Copyright 2023 Catawba County NC 04/10/2023 4/12/23, i0:55P�M Parcel Report Parcel Report - Catawba County NC Parcel Information: Owner Information: Parcel ID: 267903037627 Owner: STUBBS MELANIE OXENTINE Parcel Address: 4946 OLD SHELBY RD Owner2: City: VALE, 28168 Address: 4996 OLD SHELBY RD LRK(REID): 2540 Address2: Deed Book/Page: 3581/1827 City: VALE Subdivision: State/Zip: NC 28168-9573 Lots/Block: / School Information: Last Valid Sale: School District: COUNTY Plat Book/Page: Elementary School: BANOAK Legal: Middle School: JACOBS FORK Calculated Acreage: 35.680 High School: FRED T FOARD Tax Map: 003 B 07005 School Map Township: BANDYS State Road #: 1002 Tax/Value Information: Tax Rates Zoning Information: City Tax District:All in County Zoning District: COUNTY County Fire District: COOKSVILLE Zoningl: R-40 Building(s)Value: $169,500 Zoning2: Land Value: $149,700 Zoning3: Assessed Total Value: $214,600 Zoning Overlay: WP-O Deferred Value: $104,600 Small Area: PLATEAU Use Land Value: $45,100 Split Zoning Districts: / Year Built/Remodeled: 1948/ Zoning Agency Phone Numbers Tax Revaluation 2023: Info, COMPER Online Appeals Valid Sales (COMPER)for this parcel Contact Tax Dept. at 828-282-2009 Current Tax Bill Miscellaneous: Firm Panel Date: 2007-09-05 Building Permit Address Search for this parcel. Firm Panel #: 3710266800J If available, Building Permits for this parcel. Septic links 2010 Census Block: 2009 are not permits. 2010 Census Tract: 011802 Septic Final Permits prior to 08/2018, contact Agricultural District: PROXIMITY Environmental Health. Building Details J 1)/Ac Mrs SePA 1306 WaterShed: WS-III Protected Area , 1/0_ Pc' Voter Precinct: P2/Voting Map Parcel Report Data Descriptions Nettaeti 3O O List all Owners Deed History Report Assessment Report This map/report product was prepared from the Catawba County,NC Geospatial Information Services.Catawba County has made substantial efforts to ensure the accuracy of location and labeling information contained on this map or data on this report.Catawba County promotes and recommends the independent verification of any data contained on this map/report product by the user.The County of Catawba,its employees,agents,and personnel,disclaim,and shall not be held liable for any and all damages,loss or liability,whether direct,indirect or consequential which arises or may arise from this map/report product or the use thereof by any person or entity. gis.catawbacountync.gov/nomap/parcel_report.php?key=267903037627&type=u 1/2