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Home My WebLink AboutRBPR-07-2012-15937.TIF~�A THIS IS NOT A PERMIT Case # RBPR-07-2012-15937 CATAWBA COUNTY HEALTH DEPARTMENT PLAN REVIEW APPLICATION FOR ENVIRONMENTAL SERVICES 1842 SM Residential Building Plan Review - Manufactured Home Revi s d J6k, (?,,h -i V947- IMPROVEMENT Contractor OAKWOOD HOMES #712,1265 HWY 70, NEWTON NC 28658 B:(828)217 -1862C:(828)464 -2662F:828-464-4301 Owner MARY JO HOUSTON, LFI, 1369 HOUSTON MILL RD, CONOVER NC 28613-8503 NAME TO APPEAR ON PERMIT Mary Jo Houston, LFI SITE ADDRESS: 1367 HOUSTON MILL RD, CONOVER NC 28613 PIN # 374413144343 NAME of SUBDIVISION: Lot # A Section/Block PROPERTY SIZE: Square Feet Acres 0.87 IRECTION� County Home Road / Right Lee Cline Rd / Left Houseton mill Road / House on Left PRIMARY CONTACT: A ' ant SEWER TYPE: Septic Tank GALLONS PER DAY: 240 WATER SUPPLY: Public Water Public water is **NOT** available for this property. DESCRIBE WORK: Change out 2000 Class B Single Wide APPLICATION FOR: STRUCTURE TYPE: FACILITY TYPE: Mobile Home DESCRIPTION OF Single Wide MOH EXISTING STRUCTURES ON SITE (IF ANY) DIM EXISTING STRUCTURE: 14 x 70 NUMBER OF EXISTING BEDROOMS: 2 PROPERTY EASEMENTS: none NEW STRUCTURE DIM:: 24 x 46 # OF NEW BEDROOMS:: 2 New Structure PRIMARY RESIDENCE OTHER DESCRIPTION: # OF OCCUPANTS: 1 PROPOSED CONSTRUCTION I understand that this is a formal application for a well permit, Improvement permit or Authorization to Construct a ground absorption sewage disposal system to serve the above described facility on this property and authorize Catawba County Health Department employees to go on this property for evaluation purposes. I certify the above information to be correct and understand that an Improvement Permit issued as a result of this information is transferable and may be eligible for a non -expiring date, but may be revoked if this information, site plans or intended use changes for the proposed facility. A Well Permit and Authorization to Construct issued by this department is valid for (5) five years from the date issued and is not transferable. Note: You must obtain Zoning Approval prior to locating a home or structure on this property. Any representation by you of house or structure location should conform to applicable setbacks. Date: Signature of Applicant or Agent An Environmental Health Specialist will contact you within 2 working days of application date. If you need further information or assistance please call 828-466-7291 AREA2 MINIMUM SETBACKS FRONT: 30 SIDE: 15 REAR: 30 MAX HEIGHT: FEENAME �f DATE FEE AMOUNT Improvement Permit Fee 07/03/2012 $150.00 .TOTAL FEES $150.00 CHANGE WORK ORDER REQUIRING REDESIGN AND/OR RETRIP WILL INCURE AN ADDITIONAL CHARGE (SEE FEE SCHEDULE) 19 - ehapnlication 07/05/2012 09:01 Page I of 3 THIS IS NOT A PERMIT Case # RBPR-07-2012-15937 CATAWBA COUNTY HEALTH DEPARTMENT PLAN REVIEW APPLICATION FOR ENVIRONMENTAL SERVICES Residential Building Plan Review - Manufactured Home IMPROVEMENT Contractor OAKWOOD HOMES #712,1265 HWY 70, NEWTON NC 28658 B:(828)217 -18620:(828)464-2662F:828-464-4301 Owner MARY JO HOUSTON, LFI, 1369 HOUSTON MILL RD, CONOVER NC 28613-8503 NAME TO APPEAR ON PERMIT Mary Jo Houston, LFI SITE ADDRESS: 1367 HOUSTON MILL RD, CONOVER NC 28613 PIN # 374413144343 NAME of SUBDIVISION: PROPERTY SIZE: Square Feet Acres 0.87 DIRECTIONS: s PRIMARY CONTACT: Applicant GALLONS PER DAY: DESCRIBE WORK: Change out 2000 Class B Single Wide APPLICATION FOR: STRUCTURE TYPE: Lot # A Section/Block SEWER TYPE: Septic Tank WATER SUPPLY: Public Water Public water is **NOT** available for this property. New Structure PRIMARY RESIDENCE FACILITY TYPE: Mobile Home OTHER DESCRIPTION: DESCRIPTION OF Single Wide MOH EXISTING STRUCTURES ON SITE (IF ANY) DIM EXISTING STRUCTURE: 14 x 70 NUMBER OF EXISTING BEDROOMS: 2 PROPERTY EASEMENTS: none NEW STRUCTURE DIM:: 24 x 46 # OF NEW BEDROOMS:: 2 # OF OCCUPANTS: 1 PROPOSED CONSTRUCTION I understand that this is a formal application for a well permit, Improvement permit or Authorization to Construct a ground absorption sewage disposal system to serve the above described facility on this property and authorize Catawba County Health Department employees to go on this property for evaluation purposes. I certify the above information to be correct and understand that an Improvement Permit issued as a result of this information is transferable and may be eligible for a non -expiring date, but may be revoked if this information, site plans or intended use changes for the proposed facility. A Well Permit and Authorization to Construct issued by this department is valid for (5) five years from the date issued and is not transferable. Note: You must obtain Zoning Approval prior to locating a home or structure on this property. Any representation by you of house or structure locations o60 conform to applicable setbacks. Dates -'Signature of Applicant or Agent An vironmental Health Specialist will contact you Wthi 2 wort g days of application date. �J If you need further information or assistance plsAgdcall 828-466-7291 AREA2 MINIMUM SETBACKS FRONT: 30 SIDE: 15 REAR: 30 MAX HEIGHT: FEENAME Improvement Permit Fee TOTAL FEES DATE FEE AMOUNT 07/03/2012 $150.00 $150.00 CHANGE WORK ORDER REQUIRING REDESIGN AND/OR RETRIP WILL INCURE AN ADDITIONAL CHARGE (SEE FEE SCHEDULE) 07/03/2012 13:09 Page I of 3 �13A THIS IS NOT A PERMIT CATAWBA COUNTY HEALTH DEPARTMENT J° Application for Environmental Services Page 1 184 SM Improvement Permit 1Authorization to Construct ❑ Septic Repair ❑ Septic Malfunction ❑ Septic Expansion ❑ New Well Permit ❑ Replacement Well ❑ Well Abandonment ❑ Well Repair ❑ Existing System Inspection (Pre -Approval Required) ❑ Application is for New Construction,,-��❑ Existing Facility [� Property Address I (Q� I'MI_ISM 0 M ( LL Inn,1IJftD Subdivision rO 00k) P-, Z Q(; I Lot # Acres g 7o Section/Block/Phase Driving Directions to Property `Tuvw 0 UTI) (1')t,( L3r-cf rmVV F �O ftD TZx epo —K I& T OPV) I,E E Ot tJ'�,- RD _ ` ZAW IAF i OP rtb us-fno o Aw_u kv. . A) 00 L 4 pT [._�(n 7 W C NAME TO APPEAR ON PERMIT? ( Owner ❑ Applicant ❑ Contractor OAp � ontact Information Name (I"p L HDU 5-f-6 /x$80 1l L4J m Address 3 (Q7 � 'i) USntj Vii k U _ R. -P i Co N0 U 3 C v2gCo (3 � I• I Phone Cell Phone fethmj4r Contact Information Name d / -Baa /v2S l� i �� ,„-C `.) z Address i �-6 l�`z.✓ y `7 0 {z ��/ �C - 2_p Phone �� _ (l � cP ( Z4� -Z Cell Phone 62_�>217— S UContractor Contact Information Lai I Name Address = I Phone I Cell Phone Z WHO WILL BE THE PRIMARY CONTACT? Owner ❑ Applicant ❑ Contractor Description of Existing Structures on Site j Q X -7 1 A (-s LEW L 17 E Q # of Bedrooms *t 'A' Structure Dimensions 1 4 x -D # of Occupants Basement ❑ Yes 4 No Basement Fixtures ❑ Yes ❑ No Planned Future Additions or Improvements (Building Permit NOT requested at this time) O Describe (,A0_e S ((QCT Le u) t.i) LL Proposed Future Structure Dimensions X 4 to # of Bedrooms *-j if applicable oZ ? Are there easements or right-of-ways recorded on this property ❑ Yes X No Describe Is a public water supply available on or adjacent to the above property ** Yes ❑ No Check type available ❑ Community Well ❑ Semi -Public Well [ County/City/Township Water Line Existing water supply in use ❑ Individual Well ❑ Community Well ❑ Semi -Public Well [N County/City/Township Water Line ❑ I WOULD LIKE TO SCHEDULE A COMBINED FLAGGING AND SOIL EVALUATION (SEE COMBINED EVALUATION PROCEDUES) Q LAJW j ac C V W m A THIS IS NOT A PERMIT CATAWBA COUNTY HEALTH DEPARTMENT Q° S Application for Environmental Services Page 2 I�42 SM Proposed Facility Type Primary Residence ❑ New Residence ❑ Addition to Residence # of New Bedrooms *-t Project Description �j aA) S1 PD09 Structure Dimensions y ,_4- p # of Occupants Basement ❑ Yes No Basement FiXtUres ❑ Yes L�7No ❑ Accessory Structure(s) Describe / # of New Bedrooms *t if applicable Structure Dimensions # of Occupants Accessory Dwelling ❑ Yes ❑ No Plumbing ❑ Yes ❑ No Describe Plumbing Needed ❑ Multi -Family Residence # Units Total # Bedrooms *t ❑ Food Service Specify Type #Bedrooms per Unit* I Structure Dimensions # Seats Floor Space -Entire Food Service Facility (Sq Ft) # Employees per Shift # of Shifts Dining Area (Sq. Ft.) ❑ Business Specific Type of Business Retail Floor Space # of Employees per Shift # of Shifts ❑ Other Facility Type Specify If Church # of Seats Kitchen ❑ Yes ❑ No If Daycare Specify Occupancy Application for 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 Calculated Design Flow, Commercial j Additional information may be required to determine design flow from certain facilities. This value will be determined during consultation with on- site staff. *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 house plans as a bedroom at the time of building permit issuance. This may prevent the need for septic system size increase in the future. i If structure is plumbed but no bedrooms, calculated design flow is required. ** If No, a well pennit must be issued with the Authorization to Construct. Note: You must obtain Zoning approval prior to locating a home or structure on this property. Any representation by you of house or structure location should conform to applicable setbacks. CHANGE WORK ORDER REQUIRING REDESIGN AND/OR RETRIP WILL INCURE AN ADDITIONAL CHARGE (SEE FEE SCHEDULE) I understand that this is a formal application for Environmental Services and authorize Catawba County Environmental Health employees to go on this property for evaluation purposes. I certify the above information to be correct and understand that an Improvement Permit issued as a result of this information is valid for 5 years or may be non -expiring under certain specified conditions. Improvement Permits and Well Permits are transferrable, but may be revoked if this information, site plans or intended use changes for the proposed facility. An Authorization -to Construct issued by this department is valid for (5) five years from the date issued and is nc` Signature of Owner or Agent Printed Name of Owner or Agent Date % - rg 2 Catawba County, North Carolina This map product was prepared from the Catawba County, NC, Geospatial Information System. N Catawba County has made substantial efforts to ensure the accuracy of location and labeling information contained on this map. Catawba County promotes and recommends the independent verification of any data contained on this map 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 product or the use thereof by any person or entity. Selected Parcel Number: 3744-13-14-4343 1 inch= 50 feet Prepared for: 4 �Y> dP "J 64 27 26 I f� (250 254,71 133 255.72 +� 1367 �•I 44 co 221 06.29 '1 150 J._ 80 40 3205 5 i AW4 c 418 N co / c) 5187 �5175 `� f ,�, �, r• 5199 07 ' h 3154 --' THIS IS NOT A LEGAL DOCUMENT Date: 713!2012 Time: 12:46:25 PAT N 1 inch = 80 feet f 2 Catawba County, North Carolina This map product was prepared from the Catawba County, NC, Geospatial Information System. Catawba County has made substantial efforts to ensure the accuracy of location and labeling information contained on this map. Catawba County promotes and recommends the independent verification of any data contained on this map 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 product or the use thereof by any person or entity. Selected Parcel Number: 3744-13-14-4343 Prepared for: ISN 02 3 c 4� `C 19 \1 lb 1/054 THIS IS NOT A LEGAL DOCUMEN' I vpv rf . - i- \ 1 28 v , 27 254.71 255.72 1367 4343 133 c� M 5184 /. Time:_ 12:45:34 PM ' 51961 CATAWBA COUNTY NC - Parcel Report Information Regarding Selected Parcel(s) Parcel ID: 3744-13-14-4343 Name: HOUSTON MARY JO S LFI Name2: Address: 1369 HOUSTON MILL RD Address2: ` City: CONOVER State: NC Zip: 28613-8503 Account: 139423 Calc Acreage: 0.87 Tax Map: LRK: 401429 Deed Book: 2160 Deed Page: 0161 Subdivision Name: Subdivision Block: Lots: A Plat Book: 41 Plat Page: 133 Building Number: 1367 Street Name: HOUSTON MILL RD Site Zip: 28613 Township: CLINES Fire Code: ST. STEPHENS City Code: COUNTY State Road: Total Bldgs Value: Land Value: $10,600 Total Value: $10,600 Year Built: Year Remodeled: Last Sale Date.- ate:Last LastSale Amount: Neighborhood: 67 Watershed: Watershed Split: Voter Precinct: P33 E911 District: COUNTY Zoning: R-20 Zoning2: Zoning3: Zoning Split: N Zoning Overlay: Zoning District: COUNTY Split Zoning Dist: N Split Zoning Dist(1): 0 Split Zoning Dist(2): 0 School District: COUNTY Elementary School: LYLE CREEK Middle School: RIVER BEND High School: BUNKER HILL School Split: NO P&Z Case Number: Census Tract 2010: 010202 Census Block 2010: 1000 Small Area Plan: ST STEP HENS/OXFORD Agricultural District: Printed: Tuesday, July 03, 2012 12:44 PM G�C YVi A "n T � Q, N