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Home My WebLink AboutRBPR-07-2012-15975.TIFTHIS IS NOT A PERMIT Case # RBPR-07-2012-15975 CATAWBA COUNTY HEALTH DEPARTMENT PLAN REVIEW APPLICATION FOR ENVIRONMENTAL SERVICES Residential Building Plan Review - Building New IMPROVEMENT - AUTH CONST - NEW WELL Applicant DAVID BELLAFAIRE, 484 MCKENDREE RD, MOORESVILLE NC 28117 H:7047996625C:7044002447 DBELLAFAIRE@ROADRUNNER.COM Owner DAVID BELLAFAIRE, 484 MCKENDREE RD, MOORESVILLE NC 28117 H:7047996625C:7044002447 DBELLAFAIRE@ROADRUNNER.COM NAME TO APPEAR ON PERMIT David Bellafaire SITE ADDRESS: 3765 KISER ISLAND RD, TERRELL NC 28682 PIN # 461704653068 NAME of SUBDIVISION: Lot # Section/Block PROPERTY SIZE: Square Feet Acres 13.1 DIRECTIONS: Hwy 150 Right onto Kiser Island Rd / Property is about 1 mile on right / driveway at road is stoned PRIMARY CONTACT: Owner SEWER TYPE: Septic Tank GALLONS PER DAY: 600 WATER SUPPLY: Private Well Public water is **NOT** available for this property. DESCRIBE WORK: New Dwelling APPLICATION FOR: STRUCTURE TYPE: FACILITY TYPE: Single Family Residence DESCRIPTION OF EXISTING STRUCTURES ON SITE (IF ANY) DIM EXISTING STRUCTURE: NUMBER OF EXISTING BEDROOMS: New Structure PRIMARY RESIDENCE OTHER DESCRIPTION: # OF OCCUPANTS: PROPOSED FUTURE ADDITIONS I In ground Pool 40 x 60 OR IMPROVEMENTS: ***** COMBINED FLAGGING AND SOIL EVALUATION ***** PROPERTY EASEMENTS: none PROPOSED CONSTRUCTION NEW STRUCTURE DIM:: 71 x 93 # OF NEW BEDROOMS:: 5 APPLICATION FOR WELL CONSTRUCTION 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 information or-assi tance please call 828-466-7291 AREA1 MINIMUM SETBACKS FRONT: 30 SIDE: 15 REAR: 30 MAX HEIGHT: 1-9 - ehapplication 07/13/2012 09:24 Page 1 of 5 THIS IS NOT A PERAUT Case # RBPR-07-2012-15975 CATAWBA COUNTY HEALTH DEPARTMENT PLAN REVIEW APPLICATION FOR ENVIRONMENTAL SERVICES Residential Building Plan Review - Building New IMPROVEMENT Q RUTH CONST o NEW WELL Applicant DAVID BELLAFAIRE, 484 MCKENDREE RD, MOORESVILLE NC 28117 H:7047996625C:7044002447 DBELLAFAIRE@ROADRUNNER.COM Owner DAVID BELLAFAIRE, 484 MCKENDREE RD, MOORESVILLE NC 28117 H:7047996625C:7044002447 DBELLAFAIRE@ROADRUNNER.COM NAME TO APPEAR ON PERMIT David Bellafaire SITE ADDRESS: 3765 KISER ISLAND RD, TERRELL NC 28682 PIN # 461704653068 NAME ofSUBDIVISION: Lot # Section/Block PROPERTY SIZE: Square Feet Acres DIRECTIONS: Hwy 150 Right onto Kiser Island Rd / Property is about 1 mile on right / driveway at road is stoned PRIMARY CONTACT: Owner SEWER TYPE: Septic Tank GALLONS PER DAY: him WATER SUPPLY: Private Well Public water is "NOT" available for this property. DESCRIBE WORK: New Dwelling APPLICATION FOR: New Structure STRUCTURE TYPE: PRIMARY RESIDENCE FACILITY TYPE: Single Family Residence OTHER DESCRIPTION: DESCRIPTION OF EXISTING STRUCTURES ON SITE (IF ANY) DIM EXISTING STRUCTURE: NUMBER OF EXISTING BEDROOMS: # OF OCCUPANTS: PROPOSED FUTURE ADDITIONS I In ground Pool 40 x 60 OR IMPROVEMENTS: ***** COMBINED FLAGGING AND SOIL EVALUATION PROPERTY EASEMENTS: none PROPOSED CONSTRUCTION NEW STRUCTURE DIM:: 71 x 93 # OF NEW BEDROOMS:: 5 APPLICATION FOR WELL CONSTRUCTION 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 represen ion by yo of house or structure location should conform to applicable setbacks_ - Date: '� /a2/G'/' Signature of Applicant or Age C � _'---- �-- i w' w' w r ay sofa Environmental Health Specialist ill contact you within 2 o kt da sofa tcatton date. If you need further information or assistance please cal 828-466-7291 MINIMUM SETRACUS FRONT: 30 SIDE: 15 REAR: 30 MAX HEIGHT: 1 9 -:'r.;r; l Sc:'rm 07/12/2.012 16:41 Page i or I IgA CATAWBA COUNTY Case # RBPR-07-2012-15975 Public Health Department Subdivision v oz.s Environmental Health Division PIN# 461704653068 PO Box 389, 100-A Southwest Blvd, Newton, NC 28658 1842 sm NAME ON PERMIT: DAVID BELLAFAIRE, 484 MCKENDREE RD, MOORESVILLE NC 28117 Site Address: 3765 KISER ISLAND RD, TERRELL NC 28682 Property Size: Square Feet Acres Directions: Hwy 150 Right onto Kiser Island Rd / Property is about 1 mile on right / driveway at road is stoned FEENAME DATE FEE AMOUNT Authorization to Construct Fee (New/Expansion) 07/12/2012 $300.00 Fee Improvement Permit Fee 07/12/2012 $150.00 Well Permit & Inspection Fee 07/12/2012 $300.00 TOTAL FEES $750.00 CHANGE WORK ORDER REQUIRING REDESIGN AND/OR RETRIP WILL INCURE AN ADDITIONAL CHARGE (SEE FEE SCHEDULE) F9 - ehapphcalion 07/12/2012 16:41 Page 2 of 5 THIS IS NOT A PERMIT CATAWBA COUNTY HEALTH DEPARTMENT Application for Environmental Services Page 1 1842 a, Improvement Permit V 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 37765 KISE2 T - .4,VO AOAl Subdivision AAA ? 662 Lot # Acres Section/Block/Phase Driving Directions to Property N i c,,,11i,i q /_-30 e154 n'i-in '46 ilk SPA ��G�'/rY/ / S �L�7�� 7i/t LYJ �'/J ji fG . /�� UEhJtI;•' /,�J'L %Li:ttf' iS' �Y�.�P� NAME TO APPEAR ON PERMIT? Owner Applicant ❑Contractor Applicant Contact Information Name Address Phone I Cell Phone Owner Contact Information Name DgV)o I��CLA,cAI�E �a(le PrP �J co. -d Address Phone Cell Phone 7011- `� z9 V1-117 Contractor Contact Information Name Address Phone I Cell Phone Z WHO WILL BE THE PRIMARY CONTACT? .,Owner ❑ Applicant ❑ Contractor Z Description of Existing Structures on Site Q # of Bedrooms *t 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 * j if applicable ? Are there easements or right-of-ways recorded on this property ❑ Yes .Z No Describe Is a public water supply available on or adjacent to the above pr operty ** ❑Yes 29 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 b<I 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 Environmental Services Page 2 184"L u Proposed Facility Type Primary Residence New Residence ❑ Addition to Residence # of New Bedrooms Project Description E01906IA4 Y04/5F hJ+TH 111J&_JeCV4i IG1-7.+ Structure Dimensions 93` 93' # of Occupants y Basement r" Yes ❑ No Basement Fixtures Yes ❑ No ® Accessory Structure(s) Describe i_n1&0oA%A Stru Ptc�i.— # of New Bedrooms *-i if applicable Structure Dimensions'- � 0, X (,G>, # of Occupants Accessory Dwelling ❑ Yes ❑ No Plumbing ❑ Yes ❑ No Describe Plumbing Needed ❑ Multi -Family Residence # Units #Bedrooms per Unit* Total # Bedrooms * j Structure Dimensions ❑ Food Service S . pecify 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 Facilityyp T e Specify If Church # of Seats Kitchen [:]Yes ❑ No If Daycare Specify Occupancy Application for Well Construction/Abandon ent m /Repair Proposed Well Type F] 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. '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 Auth ization to Construct issued by this department is valid for (5) five years from the date issued and is not IT fer bl. Signature of Owner or Agent Printed Name f Owner or Agent pr Date '7141 VI1.1111'PY LEAPO WATERSHED NOTATION:FLOOD PMN NOTATION; ' ME PARCELS OF LAND AS SHOWN ON THIS PUT UFE TRE PARCELS OF LAND AS SHOWN ON THIS PLAT ARE LOCATED IN TRE WS -IV CRITICAL AREA OF THE LACENOT LOCATED IN A 100 YEAR FLOOD PLAIN PER FIRM NO;aAAN - CATA'WBA RNER WATERSHED. PMCEI.. LUP d371046170DK . EFFECTNE DATE 3/18/21108 f y --------------- - ---�rrz7�pJ%2J�8� ------------------------'� i - JaO77 f A 1 PB 71-88 R9 + S aro5'Sa•E 622.78- 592 10' zz.7a-59210' 1 1IR1A:ElVA?T,7 CY7.W..-UNK III LLC f1R..14„W. 141J P.P. 46 fu 13.1 13.35 AC.+- 1.79 *AA. '- ESIIiENC �y W �• N • • • W W .a 1 W W W W •• . W W ♦"' W W W W i . . . . . • . . . , .. . .. • . • . • • . • . • W W W W . . . , , • • • . • . . . • . • • • • W W W W W • . • . • . . • . • . . . . . . . . . . . . e • . . . . . . . . . . . . . . . . . . • _ . .. - . _ . . _ - _ . - 8.. AL -I:— AGRICULTURE EXEMPT1 F' . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .3gt.39: . . .•.•R� �Z , . . . . 11�b N THOMAS1 L[SOQND: V.D. /545, 100, A2 1't?. 35S LM 00UKMJfY Lk!£ !�� — UN��0um Pam r -e LC7T 52 �/W�MM Ov"aw unum 17 s � s >14/F-5 ............... L ............... 1 3.35 s� 17s 70.56' 1.79 AC.+- (PESIbENC\t) �--� \Y W W 4 W W 93.07' Q Y da Ma ri � Yss b dt "u ,lY Ylc Al^u u da 41 da ^u N 1 inch = 200 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: 4617-04-65-3068 Prepared for: ze .,sA 1757 i ,3068 M 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. 1 inch = 80 feet r-% i -Y-.d Selected Parcel Number: 4617-04-65-3068 Prepared for: e IN IN THIS IS NOT A LEGAL DOCUMENT_---<:�7 i ! r r r` r r' f1. l JY F� 13'11A q,. 13068 r`YY r� wG 00i Date: 7/11/2012 1 i f Y i� J �+ i IO ! ' d e IN IN THIS IS NOT A LEGAL DOCUMENT_---<:�7 i ! r r r` r r' f1. l JY F� 13'11A q,. 13068 r`YY r� wG 00i Date: 7/11/2012 1 i f Y i� J �+ i IO Time: 8:28:48 AM CATAWBA COUNTY NC - Parcel Report Information Regarding Selected Parcel(s) Parcel ID: 4617-04-65-3068 Name: THIS PARCEL IS CURRENTLY BEING PROCESSED Name2: Address: NONE Address2: City: State: Zip: Account: Calc Acreage: 13.11 Tax Map: LRK: 803825 Deed Book: Deed Page: Subdivision Name: Subdivision Block: Lots: Plat Book: 50 Plat Page: 183 Building Number: 3765 Street Name: KISER ISLAND RD Site Zip: 28682 Township: Fire Code: City Code: COUNTY State Road: 1841 Total Bldgs Value: Land Value: Total Value: Year Built: Year Remodeled: Last Sale Date: Last Sale Amount: Neighborhood: Watershed: WS -IV Critical Area Watershed Split: NO Voter Precinct: P41 E911 District: COUNTY Zoning: Zoning2: Zoning3: Zoning Split: N Zoning Overlay: Zoning District: 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: 011504 Census Block 2010: 3033 Small Area Plan: SHERRILLS FORD Agricultural District: Printed: Wednesday, July 11, 2012 08:28 AM