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Home My WebLink AboutRBPR-07-2012-15952.TIFSBA o U °vaPv '"C 4® 1842 SM THIS IS NOT A PERMIT Case # RBPR-07-2012-15952 CATAWBA COUNTY HEALTH DEPARTMENT PLAN REVIEW APPLICATION FOR ENVIRONMENTAL SERVICES Residential Building Plan Review - Accessory Structure IMPROVEMENT Applicant JERRY HOLLAR, 5327 LEE CLINE RD, CONOVER NC 28613 C:828-234-5764 Owner JERRY HOLLAR, 5327 LEE CLINE RD, CONOVER NC 28613 C:828-234-5764 NAME TO APPEAR ON PERMIT JERRY HOLLAR SITE ADDRESS: 4352 N NC 16 HWY, CONOVER NC 28613 PIN # 375310356408 NAME of SUBDIVISION: Lot # Section/Block PROPERTY SIZE: Square Feet Acres .38 DIRECTIONS: 16N / BESIDE BLACK CHAIN LINK FENCE AROUND ROCK BARN GOLF CLUB PROPERTY PRIMARY CONTACT: Owner SEWER TYPE: Septic Tank GALLONS PER DAY: 240 WATER SUPPLY : Public Water Public water is `*NOT"' available for this property. DESCRIBE WORK: ADDITION TO EXISTING ACCESSORY BUILDING / adding 24 x 20 on the rear APPLICATION FOR: Existing Structure STRUCTURE TYPE: ACCESSORY STRUCTURE FACILITY TYPE: Accessory Structure OTHER DESCRIPTION: DESCRIPTION OF SINGLE FAMILY DWELLING EXISTING STRUCTURES ON SITE (IF ANY) DIM EXISTING STRUCTURE: 43 X 30 NUMBER OF EXISTING BEDROOMS: 2 # OF OCCUPANTS: 2 PROPERTY EASEMENTS: none PROPOSED CONSTRUCTION NEW STRUCTURE DIM:: ADDING 20 X 24 BASEMENT? No BASEMENT FIXTURES? No PLUMBING REQUIRED? No 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 AgentM n-4 An Environmental Health Specialist will contact you wit n 2 workk days of application date. If you need further information or assistance please call 828-466-7291 MINIMUM SETBACKS FRONT: 30 SIDE: 10 REAR: 5 MAX HEIGHT: 45 FEENAME Improvement Permit Fee TOTAL FEES DATE FEE AMOUNT 07/06/2012 $150.00 $150.00 CHANGE WORK ORDER REQUIRING REDESIGN AND/OR RETRIP WILL INCURE AN ADDITIONAL CHARGE (SEE FEE SCHEDULE) [;9-chapplication 07/06/2012 12:48 Pagel of3 .� AyTHIS IS NOT A PERMIT C CATAWBA COUNTY HEALTH DEPARTMENT Application for Environrrental,Services Page 1 1842 spa Improvement Permit ❑ Authorization 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 .�a � q e, hv y /j Al, Subdivision O-•�l e. AW Lot # Acres 3 5( Section/Block/Phase Driving Directions to Property y �� /)/, (Y�"S ,�h�1_'10f PL/1/ / , 4 W Ca NAME TO APPEAR ON PERMIT? [✓]Owner ❑ Applicant 1:1 Contractor C Applicant Contact Information QNameLLJ T.a. rrY .0 , /•f� //AJ— m I Address �c t/,X/ Y A/' Phone ��— y _ _�'j6 �, p Cell Phone Owner Contact Information Name Address Q Phone I Cell Phone Contractor Contact Information W Name Address ILM = I Phone I Cell Phone Z WHO WILL BE THE PRIMARY CONTACT? []Owner ❑ Applicant ❑ Contractor ZDescription of Existing Structures on Site 5/-7/7/ L A� tr., F ->i 26 X 2 N Q # of Bedrooms *T Structure Dimensions ?, )e -5 b # of occupants 2. I� Basement ❑ Yes []'No Basement Fixtures ❑ Yes ❑ No Planned Future Additions or Improvements (Building Permit NOT requested at this time) CC Describe Proposed Future Structure Dimensions # of Bedrooms *'I if applicable ? Are there easements or right-of-ways recorded on this property ❑ Yes ❑ No Describe Is a public water supply available on or adjacent to the above property ** Z Yes ❑ No Check type available ❑ Comnuinity Well ❑ Semi -Public Well ❑ County/City/Township Water Line Existing water supply in use ❑ Individual Well ❑ Community Well ❑ Semi -Public Well [County/City/Township Water Line 2-1 WOULD LIKE TO SCHEDULE A COMBINED FLAGGING AND SOIL EVALUATION (SEE COMBINED EVALUATION PROCEDUES) THIS IS NOT A PERMIT CATAWBA COUNTY HEALTH DEPARTMENT Application for Envirohmental Services Page 2 842 sm Proposed Facility Type ❑ Primary Residence ❑ New Residence ❑ Addition to Residence # of New Bedrooms * j Project Description Structure Dimensions # of Occupants Basement ❑ Yes ❑ No Basement Fixtures ❑ Yes ❑ No ❑ Accessory Structure(s) Describe &-4-- 4-:b 10 4, a 'J'1' OCL e `jC 6 C # of New Bedrooms *t if applicable % Structure Di►nensions,- vL) 9"al�S # of Occupants R Accessory Dwelling ❑ Yes ❑ No C W.,'C)D�� Plumbing ❑ Yes F-1NoDescribe Plumbing Needed �J ❑ Multi -Family Residence # Units #Bedrooms per Unit* -j Total # Bedrooms *'i Structure Dimensions ❑ Food Service Specify Type # 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 I 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 permit 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 not transferable Signature of Owner or Agent ---G C)'. Printed Name of Owner or Agent , ) p �-h-y�- Date 7 -Z r /02 I inch = 40 feet 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: 3753-10-35-6408 THIS IS NOT A LEGAL DOCUMENT Prepared for: R-20 Date: 7/6/2012 r OXF Time: 12:21:19 PM CATAWBA COUNTY NC - Parcel Report Information Regarding. Selected Parcel(s) Parcel ID: 3753-10-35-6408 Name: HOLLAR JERRY LEON Name2: HOLLAR JACQUE JOLLY Address: 5327 LEE CLINE RD Address2: City: CONOVER State: NC Zip: 28613-8722 Account: 159770713 Calc Acreage: 0.38 Tax Map: 2300 00046A LRK: 65849 Deed Book: 3073 Deed Page: 0803 Subdivision Name: Subdivision Block: Lots: Plat Book: Plat Page: Building Number: 4352 Street Name: N NC 16 HWY Site Zip: 28613 Township: CLINES Fire Code: OXFORD City Code: COUNTY State Road: Total Bldgs Value: $56,900 Land Value: $9,000 Total Value: $65,900 Year Built: 1949 Year Remodeled: 1973 Last Sale Date: Last Sale Amount: Neighborhood: 67 Watershed: WS -IV Protected Area Watershed Split: NO Voter Precinct: P27 E911 District: COUNTY Zoning: R-20 Zoning2: Zoning3: Zoning Split: N Zoning Overlay: WP -O 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: R-2004-14, R-489 Census Tract 2010: 010101 Census Block 2010: 2019 Small Area Plan: ST STEPHENS/OXFORD Agricultural District: Proximity Printed: Friday, July 06, 2012 12:16 PM fo $l am ��