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HomeMy WebLinkAboutRBPR-06-2023-44756.TIF $A �� THIS IS NOTA PERMIT Case# RBPR-06-2023-44756 CATAWBA COUNTY HEALTH DEPARTMENT arvO PLAN REVIEW APPLICATION FOR ENVIRONMENTAL SERVICES 184 sa Residential Building Plan Review- Building New IMPROVEMENT-AUTH CONST-NEW WELL Applicant RONALD CHAPMAN,, C:9194148972 DREW.CHAPMANI2@GMAIL.COM Contractor *BLAKE KING CONSTRUCTION,LLC (STEPHEN KING), 1373 HOMESTEAD DR,HICKORY NC 28602 C:8284090472 SBK231985 a YAHOO.COM Owner SENG LO,5455 PINE RIDGE DR,CONNELYS SPRING NC 28612 C:6127029597 SENGLO@YAHOO.COM YAHOO.COM Paid By JASON BERRY,, C:8286394533 NAME TO APPEAR ON PERMIT Ronald Chapman SITE ADDRESS: 2322 MOSS FARM RD,HICKORY NC 28602 PIN# 279110467724 NAME of SUBDIVISION: Lot# 2 Section/Block PROPERTY SIZE: Square Feet Acres 11.28 DIRECTIONS: Right 127,North on moss Farm RD,Access to the property is by a paved 25"deeded ROW off of Moss Farm RD, going to an adjoining with 2314 Moss Farm RD PRIMARY CONTACT: Applicant SEWER TYPE: Septic Tank GALLONS P Y: 480 WATER SUPPLY: Private Well DESCRIBE WORK: 8/17/23 revised to show new pool size and location 40x16/with 10'surround and well location. Revised 8/1/23 add a well. Previous Description: New 2 story 4 bedrooms w/attached garage&finished bonus room &finished basement *In-ground pool in the future 36x15 decking 10; around peri meter**Shared well with 2314 Moss Farm RD 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? Yes Property Easements Description: 25'easement APPLICATION FOR: New Structure STRUCTURE TYPE: PRIMARY RESIDENCE FACILITY TYPE: Single Family Residence OTHER DESCRIPTION: DESCRIPTION OF vacant EXISTING STRUCTURES ON SITE(IF ANY) DIM EXISTING STRUCTURE: NUMBER OF EXISTING BEDROOMS: #OF OCCUPANTS: 5 PROPOSED CONSTRUCTION NEW STRUCTURE DIM:: 71x60; 12x30 back deck, 18x7 front porch #OF NEW BEDROOMS:: 4 BASEMENT? Yes BASEMENT FIXTURES? Yes PLUMBING REQUIRED? Desired system types(Improvement Permit or Authorization to Construct): ACCEPTED: ALTERNATIVE: CONVENTIONAL: OTHER: INNOVATIVE: ANY: YES Other described: &application 08/17/2023 10:56 Page 1 of3 V)4 CATAWBA COUNTY Case y RBPR-06-2023-44756 AisPublic Health Department h "t' 'Z - "'1 Environmental Health Division PIN# 279110467724 PO Box 389,100-A Southwest Blvd,Newton,NC 28658 Subdivision NAME ON PERMIT: (RONALD CHAPMAN),, ( Ronald Chapman) Site Address: 2322 MOSS FARM RD,HICKORY NC 28602 Property Size: Square Feet Acres 11.28 Directions: Right 127, North on moss Farm RD,Access to the property is by a paved 25"deeded ROW off of Moss Farm RD, going to an adjoining with 2314 Moss Farm RD APPLICATION FOR WELL CONSTRUCTION PROPOSED WELL TYPE: Individual Well REPLACE WELL?: NO 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. l The undersigned is the owner of the property or legal agent of the owner. l \ Date: - `f 7- 9 3_ Signature of Applicant or Agent If you need further information or assistance please call 82 70 AREA1 **********************+*************************************+**+**+***************************************** FEENAME DATE FEE AMOUNT Authorization to Construct Fee(New/Expansion) 06/26/2023 $300.00 Fee Improvement Permit Fee 06/26/2023 $150.00 Well Permit&Inspection Fee 08/01/2023 $300.00 Re-Trip or Redesign Fee 08/17/2023 $70.00 TOTAL FEES S820.00 FEES ARE NON-REFUNDABLE ONCE A SITE VISIT IS MADE OR WORK ON A PLAN REVIEW HAS COMMENCED SYSTEM REDESIGN AND/OR RETRIP WILL INCUR AN ADDITIONAL CHARGE (SEE FEE SCHEDULE) ehepplicamm 08/17/2023 10:56 Page 2 of3 Q o Deed 2517, Mtge 1306 QTatalliwirmilmiaamiejalimali" -- ail AAC) A r covmcn • ID ,LZ•994 M „SO,Li.00 N fence W N N N o A N co l .a9 NV iVVv' tT a O rnNyog2 N c° C` m . �.1 -$N O /4")/V � NN -0• N V CA CA COW "Sz 1 a a z a 3 rb/ .� V W W N to UI V: �N •• o ud N. b z O co to 0 93 IJ N On Us N A O U1 nsCA o / / / 0'V, CO cvn, C c3 / W S 1+{� mn tiG�/ N ? 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