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Home My WebLink AboutCBPR-10-2023-45680.TIF �A �G THIS IS NOT A PERMIT Case# CBPR 10 2023-45680 rr,, CATAWBA COUNTY HEALTH DEPARTMENT v v PLAN REVIEW APPLICATION FOR ENVIRONMENTAL SERVICES 18 2 su Commercial Building Plan Review- Building Alteration • IMPROVEMENT )111)3k LW- Owner DONNIE IIASEN,7923 STILLWATER DR,SHERRILLS FORD NC 28673 C:7043082826 THEDENTREMOVER@GMAIL.COM NAME TO APPEAR ON PERMIT Donnie Hasen SITE ADDRESS: 2612 S NC 16 HWY,NEWTON NC 28658 PIN# 365915641213 NAME of SUBDIVISION: Lot Section/Block PROPERTY SIZE: Square Feet 37,461.60 Acres 0.86 DIRECTIONS: PRIMARY CONTACT: Owner SEWER TYPE: Septic Tank GALLON PER DAY: 370 WATER SUPPLY: Public Water SCRIBE WORK: 11/29/23 REVISED. OFFICE SPACE FOR REALTY COMPANY, PHOTO COPYING/PRINTING SERVICE AND 1000 SQ FT RETAIL SPACE. 4 EMPLOYEES TOTAL FOR ALL USES. NO FOOD SERVICE. IMPROVEMENT PERMIT TO DESIGNATE REPAIR AREA 11/28/23 Revise to 1000 SQ FT retail space only no food service 4 employees. 10/14/2023 REVISE TO NO SEATS, 91 SQ FT FOOD STAND SPACE WITH 500 SQ FT RETAIL SPACE 3 EMPLOYEES Change of use from Convenience store to 5 seat restaurant. Improvement Permit to designate repair, Authorization to Construct to install grease trap. 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: Existing Structure STRUCTURE TYPE: *"NO STRUCTURE SELECTED** FACILITY TYPE: Restaurant OTHER DESCRIPTION: DESCRIPTION OF EXISTING STRUCTURES ON SITE(IF ANY) DIM EXISTING STRUCTURE: 45 x 54 NUMBER OF EXISTING BEDROOMS: #OF OCCUPANTS: PROPOSED CONSTRUCTION EMPLOYEES PER SHIFT: 4 NUMBER OF SHIFTS: 1 TOTAL EMPLOYEES: 4 SEATING CAPACITY: TOTAL FLOOR SPACE(SQ FT): RETAIL FLOOR SPACE(SQ FT): 1,000 DINING AREA FLOOR SPACE(SQ FT): DAYCARE OCCUPANCY: KITCHEN: Yes Desired system types(Improvement Permit or Authorization to Construct): ACCEPTED: ALTERNATIVE: CONVENTIONAL: OTHER: INNOVATIVE: ANY: Other described: eha1 pIkau,ai 11/29/2023 08:30 Page I of3 CATAWBA COUNTY Case# CBPR-10-2023-45680 365915641213 Public Health Department Subdivision .n -. Environmental Health Division PIN# PO Box 389,100-A Southwest Blvd,Newton,NC 28658 �. sr NAME ON PERMIT: (DONNIE HASEN),7923 STILLWATER DR,SHERRILLS FORD NC 28673 ( Donnie Hasen) Site Address: 2612 S NC 16 HWY,NEWTON NC 28658 Property Size: Square Feet 37,461.60 Acres 0.86 Directions: 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: ( 1 �� ,U)-3 Signature of Applicant or Agent ._ . ---- +� If you need further information or assistance please call 828-465-8270 AREA2 FEENAME DATE FEE AMOUNT Authorization to Construct Fee(New/Expansion) 10/05/2023 S150.00 Fee Improvement Permit Fee I0/05/2023 S150.00 Food and Lodging Review Fee 10/17/2023 $75.00 TOTAL FEES $375.00 FEES ARE NON-REFUNDABLE ONCE A SITE VISIT IS MADE OR WORK ON A PLAN REVIEW HAS COMMENCED SYSTEM REDESIGN AND/OR RETRIP WILL INCUR AN ADDITIONAL CHARGE (SEE FEE SCHEDULE) ahapplicmnn 11/29/2023 08:30 Page 2 of 3 .4.1$A •G THIS IS NOT A PERMIT Case# CBPR-I 0-2023-45680 CATAWBA COUNTY HEALTH DEPARTMENT J PLAN REVIEW APPLICATION FOR ENVIRONMENTAL SERVICES 18 . ski Commercial Building Plan Review- Building Alteration IMPROVEMENT-AUTH CONST I D p"7)-)3R& cta Owner DONNIE HASEN,7923 STILLWATER DR,SHERRILLS FORD NC 28673 C:7043082826 THEDENTREMOVER@GMAIL.COM NAME TO APPEAR ON PERMIT Donnie Hasen SITE ADDRESS: 2612 S NC 16 HWY,NEWTON NC 28658 PIN# 365915641213 NAME of SUBDIVISION: Lot{I Section/Block PROPERTY SIZE: Square Feet 37,461.60 Acres 0.86 DIRECTIONS: P Owner SEWER TYPE: Septic Tank GALLONS PER DAY: 229 WATER SUPPLY: Public Water DESCRIBE WORK: 0/14/2023 REVISE TO NO SEATS, 91 SQ FT FOOD STAND SPACE WITH 500 SQ FT RETAIL SPACE 3 EMPLOYEES Change of use from Convenience store to 5 seat restaurant. Improvement Permit to designate repair, Authorization to Construct to install grease trap. 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: Existing Structure STRUCTURE TYPE: **NO STRUCTURE SELECTED** FACILITY TYPE: Restaurant OTHER DESCRIPTION: DESCRIPTION OF EXISTING STRUCTURES ON SITE(IF ANY) DIM EXISTING STRUCTURE: 45 x 54 NUMBER OF EXISTING BEDROOMS: #OF OCCUPANTS: PROPOSED CONSTRUCTION EMPLOYEES PER SHIFT: 3 NUMBER OF SHIFTS: 1 TOTAL EMPLOYEES: 3 SEPACITY: TOTAL FLOOR SPACE(SQ FT): TAIL FLOOR SPACE(SQ FT): ) 500 DINING AREA FLOOR SPACE(SQ FT): 15AYCA KITCHEN: Yes Desired system types(Improvement Permit or Authorization to Construct): ACCEPTED: ALTERNATIVE: CONVENTIONAL: OTHER: INNOVATIVE: ANY: Other described: chapplicati,m 10/172023 11:31 Page I of3 r • CATAWBA COUNTY Case# CBPR-10-2023-45680 /r 1 1, Public Health Department Subdivision d '-'1 Environmental Health Division lil • 365915641213 PO Box 389,100-A Southwest Blvd,Newton,NC 28658 PIN# alt w NAME ON PERMIT: (DONNIE HASEN),7923 STILLWATER DR,SHERRILLS FORD NC 28673 ( Donnie Hasen) Site Address: 2612 S NC 16 HWY,NEWTON NC 28658 Property Size: Square Feet 37,461.60 Acres 0.86 Directions: 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: i i od Signature ofApplicant orAgent _-- - ` If you need further information or assistance p ease call 828-465-8270 AREA2 **s**s......rt*ss**r*t*as*s«*sr*.s.+ss*rt**+s*a*s**ss*►**s*a.*ss*******a**s***s*sr•+s.........rt*ar**sr+•srrr FEENAME DATE FEE AMOUNT Authorization to Construct Fee(New/Expansion) 10/05/2023 $150A0 Fee Improvement Permit Fee 10/05/2023 $150.00 TOTAL FEES S300.00 1 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) elapplicatnm 10/17/2023 11:31 Page 2 of 3