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Home My WebLink AboutRBPR-07-2012-15974.TIFBA THIS IS NOT A PERMIT Case # RBPR-07-2012-15974 CATAWBA COUNTY HEALTH DEPARTMENT PLAN REVIEW APPLICATION FOR ENVIRONMENTAL SERVICES Ig�}2 SM Residential Building Plan Review - Building New P�o o -I Ir31►a� IMPROVEMENT - AUTH CONST - NEW WELL .Lklfl� Applicant CARMICHAEL HOMES, INC., PO BOX 878, DENVER NC 28037- H:9807225132B: (704)489-0787 F:704-489-1703 Contractor CARMICHAEL HOMES, INC., PO BOX 878, DENVER NC 28037- H:9807225132B:(704)489-0787F:704-489-1703 Owner UNITED WAY OF THE CAROLINAS INC, 301 S BREVARD ST, CHARLOTTE NC 28202 NAME TO APPEAR ON PERMIT CARMICHAEL HOMES, INC. SITE ADDRESS: 3570 LAKE BLUFF DR, SHERRI LLS FORD NC 28673 PIN # 460701493173 NAME of SUBDIVISION: Lot # Section/Block PROPERTY SIZE: Square Feet Acres 1.11 DIRECTIONS: 16S/ LEFT 150E/ LEFT SHERRILLS FORD/ LEFT BEATTY / RT LAKE BLUFF DR/ LOT ON RIGHT PRIMARY CONTACT: Contractor SEWER TYPE: Septic Tank GALLONS PER DAY: 360 WATER SUPPLY: Private Well Public water is **NOT** available for this property. DESCRIBE WORK: 1 STORY DWELLING W/ ATTACHED GARAGE / no basement APPLICATION FOR: STRUCTURE TYPE: FACILITY TYPE: Single Family Residence DESCRIPTION OF EXISTING STRUCTURES ON SITE (IF ANY) DIM EXISTING STRUCTURE: New Structure PRIMARY RESIDENCE OTHER DESCRIPTION: NUMBER OF EXISTING BEDROOMS: # OF OCCUPANTS: ***** COMBINED FLAGGING AND SOIL EVALUATION ***** PROPERTY EASEMENTS: NONE PROPOSED CONSTRUCTION NEW STRUCTURE DIM:: 55 X 50 # OF NEW BEDROOMS:: 3 BASEMENT? No BASEMENT FIXTURES? No PLUMBING REQUIRED? Yes APPLICATION -FOR WELL CONSTRUCTION r - PROPOSED WELL TYPE: Individual Well REPLACE WELL?: 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 Agent An Environmental Health Specialist will contact you within 2 working days of application date. If you need further informatio or a . tance please call 828-466-7291 Area MINIMUM SETBACKS FRONT: 30 SIDE: 15 REAR: 30 MAX HEIGHT: 45 E9 - ehapplication 07/13/2012 09:18 Page 1 of 5 1$4 ski THIS IS NOT A PERMIT Case # RBPR-07-2012-15974 CATAWBA COUNTY HEALTH DEPARTMENT PLAN REVIEW APPLICATION FOR ENVIRONMENTAL SERVICES Residential Building Plan Review - Building New IMPROVEMENT - AUTHI CONST - NEW WELL Applicant CARMICHAEL HOMES, INC., PO BOX 878, DENVER NC 28037- _ _ B:(704)489 -0787F:7_04-4_89-17_03_ NA__ Contractor CARMICHAEL HOMES, INC., PO BOX 878, DENVER NC 28037- B:(704)489 -0787F:704-489-1703 NA Owner UNITED WAY OF THE CAROLINAS INC, 301 S BREVARD ST, CHARLOTTE NC 28202 NAME TO APPEAR ON PERMIT CARMICHAEL HOMES, INC. SITE ADDRESS: 3570 LAKE BLUFF DR, SHERRILLS FORD NC 28673 PIN # 460701493173 NAME of SUBDIVISION: Lot # Section/Block PROPERTY SIZE: Square Feet Acres 1.11 DIRECTIONS: 16S/ LEFT 150E/ LEFT SHERRILLS FORD/ LEFT BEATTY / RT LAKE BLUFF DR/ LOT ON RIGHT PRIMARY CONTACT: Contractor SEWER TYPE: Septic Tank GALLONS PER DAY: 360 WATER SUPPLY: Private Well Public water is **NOT** available for this property. DESCRIBE WORK: 1 STORY DWELLING W/ ATTACHED GARAGE / no basement APPLICATION FOR: STRUCTURE TYPE: FACILITY TYPE: Single Family Residence New Structure PRIMARY RESIDENCE OTHER DESCRIPTION: DESCRIPTION OF EXISTING STRUCTURES ON SITE (IF ANY) DIM EXISTING STRUCTURE: NUMBER OF EXISTING BEDROOMS: # OF OCCUPANTS: ***** COMBINED FLAGGING AND SOIL EVALUATION ***** PROPERTY EASEMENTS: NONE PROPOSED CONSTRUCTION NEW STRUCTURE DIM:: 55 X 50 # OF NEW BEDROOMS:: 3 BASEMENT? No BASEMENT FIXTURES? No PLUMBING REQUIRED? Yes APPLICATION FOR WELL CONSTRUCTION PROPOSED WELL TYPE: REPLACE WELL?: 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: —7—1 Z —1 Z Signature of Applicant or Agert,> %�� 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 1 MINIMUM SETBACKS FRONT: 30 SIDE: 15 REAR: 30 MAX HEIGHT: 45 F.9 - chapplication 07/12/2012 16:20 Page 1 of 5 gA CATAWBA COUNTY Case # RBPR-07-2012-15974 Public Health Department Subdivision Environmental Health Division ` PIN# 460701493173 PO Boz 389, 100-A Southwest Blvd, Newton, NC 28658 Ig 2 SN NAME ON PERMIT: CARMICHAEL HOMES, INC., PO BOX 878, DENVER NC 28037 - Site Address: 3570 LAKE BLUFF DR, SHERRILLS FORD NC 28673 Property Size: Square Feet Acres 1.11 Directions: 16S/ LEFT 150E/ LEFT SHERRILLS FORD/ LEFT BEATTY / RT LAKE BLUFF DR/ LOT ON RIGHT FEENAME Authorization to Construct Fee (New/Expansion) Fee Improvement Permit Fee Well Permit & Inspection Fee TOTAL FEES DATE FEE AMOUNT 07/12/2012 $150.00 07/12/2012 $150.00 07/12/2012 $300.00 $600.00 CHANGE WORK ORDER REQUIRING REDESIGN AND/OR RETRIP WILL INCURE AN ADDITIONAL CHARGE (SEE FEE SCHEDULE) 1"9 - chapplicaixm 07/12/2012 16:20 Page 2 of 5 THIS IS NOT A PERMIT Q C CATAWBA COUNTY HEALTH DEPARTMENT Application for Environmental Service;, Page I 1842 w Improvement Permit d Authorization to Construct 2r Septic Repair ❑ Septic Malfunction ❑ Septic Expansion ❑ New Well Permit�Replacement Well ❑ Well Abandonment ❑ Well Repair [:1 Existing System Inspection (Pre -Approval Required) ❑ Application is for New Construction ❑ Existing Facility F]Property Address 3S-7® /hv /3L� �� Subdivision Lot # Acres SectionlBlock/Phase Driving Directions to Property ,V NAME TO APPEAR ON PERMIT? ❑ Owner fKApplicant ❑ Contractor Applicant Contact Information Name �.rrl�L Fh',>✓S /,--- Address j? �. ,3� 57, c-,6�-- Phone -70 C -7g7 Owner Contact Information Name U,--- , 7�15b G✓A Address Phone Contractor Contact Information Name e:::<Nz.R-r Address JG"�,,v� Phone -� n.� a,50:3 % Cell Phone �'�Po I Cell Phone I Cell Phone WHO WILL BE THE PRIMARY CONTACT? ❑ Owner NApplicant ❑ Contractor Description of Existing Structures on Site # of Bedrooms *'j Structure Dimensions # of Occupants Basement ❑ Yes ❑ No Basement Fixtures ❑ Yes ❑ No Planned Future Additions or Improvements (Building Permit NOT requested at this time) Describe Proposed Future Structure Dimensions # of Bedrooms *'r 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 ** ❑ 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 ❑ County/City/Township Water Line 0I WOULD LIKE TO SCHEDULE A COMBINED FLAGGING AND SOIL EVALUATION (SEE COMBINED EVALUATION PROCEDUES) 0 W J ca C 0 v W m H THIS IS NOT A PERMIT CATAWBA COUNTY HEALTH DEPARTMENT Application for Environmental Services Page 2 1842 sn+ Proposed Facility Type ❑ Primary Residence/New Residence F1 Addition to Residence # of New Bedrooms Project Description Structure Dimensions _�W )( Sa % of Occupants Basement ❑ Yes IR—No Basement Fixtures F-1YesRNo ❑ 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 #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 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 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 Printed Name of Owner or Agent /"/G Date 7 12, —/ 7_ 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 emplovees, 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: 4607-01-49-3173 1 inch = 60 feet Prepared for: /7L? 84-.-70 .5% �s 1.11API ,y 3113 THIS IS NOT A LEGAL DOCUMENT c. -I . O O O tt O � Time: 9:21:00 AM �' I CATAWBA COUNTY NC - Parcel Report Information Regarding Selected Parcel(s) Parcel ID: 4607-01-49-3173 Name: UNITED WAY OF THE CAROLINAS INC Name2: Address: ATTN SHELLEY WHITE Address2: 301 S BREVARD ST City: CHARLOTTE State: NC Zip: 28202-2317 Account: 124399 Calc Acreage: 1.11 Tax Map: LRK: 800866 Deed Book: 2171 Deed Page: 1710 Subdivision Name: THE RETREAT Subdivision Block: Lots: 24 Plat Book: 42 Plat Page: 172 Building Number: 3570 Street Name: LAKE BLUFF DR Site Zip: 28673 Township: MOUNTAIN CREEK Fire Code: SHERRILLS FORD City Code: COUNTY State Road: Total Bldgs Value: Land Value: $51,500 Total Value: $51,500 Year Built: Year Remodeled: Last Sale Date: Last Sale Amount: Neighborhood: 129 Watershed: WS-IV Critical Area Watershed Split: NO Voter Precinct: P31 E911 District: COUNTY Zoning: R-30 Zoning2: Zoning3: Zoning Split: N Zoning Overlay: CRC-O,WP-O Zoning District: COUNTY Split Zoning Dist: N Split Zoning Dist(1): 0 Split Zoning Dist(2): 0 School District: COUNTY Elementary School: SHERRILLS FORD Middle School: MILL CREEK High School: BANDYS School Split: NO P&Z Case Number: Census Tract 2010: 011502 Census Block 2010: 3002 Small Area Plan: SHERRILLS FORD Agricultural District: Proximity Printed: Friday, July 13, 2012 09:21 AM � 5 . 4 47.09 8.29 �� . 4310 . `._1_ 77. fl`�� / f 5 r ` �bit 43.52 14.45 zo tT 19.26 i r 84.70 ' T 5-r f 374.98 / _ ff � j/ f r 2.4 Page 1 of 1 233.92 126. p 91.1b soli 21 http://www.gis.catawba.nc.us/output/Parcel cocatgisweb2l89225363820 jpg 7/11/2012 CATAWBA COUNTY PERMIT ZONING AUTHORIZATION (R) New 'Dwellinj IVR PIN# PERMIT NO: ZONR-07-201-029528 P. O. Box 389 Phone: 828-465-8380 APPLIED: 07/12/2012 I OOA Southwest Blvd FAX: 828-465-8484 ISSUED: 07/12/2012 Newton, North Carolina 28658 EXPIRES: 03/27/2013 www.catawbacountync.gov Applicant CARMICHAEL HOMES, INC., PO BOX 878, DENVER NC 28037- B:(704)489 -0787F:704-489-1703 NA O_ WAYwner-._.__.._.m....._ -. -'UNITE.....,.,.._.,..-_--._-__.___._�.....,_._.............�.__--..:_.......,_._._..._._.....,.,...-..._.._,.....__,_-_.._.-�....... ......._.._n_,--___.,.... _...._...__.. D OF THE CAROLINAS INC, 301 S BREVARD ST, CHARLOTTE NC 28202 Contractor CARMICHAEL HOMES, INC., PO BOX 878, DENVER NC 28037- B:(704)489 -0787F:704-489-1703 NA ACCOUNT: 5000400 PROPERTY ID#: 460701493173 CENSUS TRACT: 011502 STREET ADDRESS: 3570 LAKE BLUFF DR, SHERRILLS FORD NC 28673 PROJECT DESCRIPTION: 1 STORY DWELLING W/ ATTACHED GARAGE / no basement FLOOD ZONE? No OWNER TYPE: 100 YEAR FLOOD ZONE PLAIN? LAND OWNER: FLOOD PLAIN, STRUCTURE? No REQUIRED SETBACKS FRONT: 30 REAR: 30 SIDE: 15 MAX HEIGHT: 45 1. Before an inspection can be made by the Building Inspection Office, the applicant must pull a string to designate the side and rear property lines where the structure is being placed or constructed. 2. Home shall be placed on the lot in harmony with the site -built structures, or have the front door face the road frontage. INVOICE#: 07-12-288259 FEE DESCRIPTION- = -DATE - _ - FEE AMOUNT Residential Zoning Fee 07/12/2012 $25.00 TOTAL FEES - - -$25.00 The applicant herebv certifies that all information and attachments to this Certificate of Zoning Compiliance are true and correct, and acknowledges that this permit was issued on the basis of the information required herein. The applicant further acknowledges that any construction, alteration or addition which differs from this application shall be subject to removal or alterationas to bring said structure into %conformance wititc.h thespecifications and standards of the Catawba County Zoning Ordinance. Such co cti)ve action shall be at the APPLICANT NAME (PRINTED) APPLICANT SIGNATURE ZONING APPROVED BY ZONING FEES ARE NON-REFUNDABLE ***** COMPANY NAME P.9 - permit 07/12/2012 16:23 ISSUED BY: Pat Queen Page I of I