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HomeMy WebLinkAboutRBPR-07-2012-15983.TIF$A co moi► 1842 sM THIS IS NOT A PERMIT Case # RBPR-07-2012-15983 CATAWBA COUNTY HEALTH DEPARTMENT PLAN REVIEW APPLICATION FOR ENVIRONMENTAL SERVICES Residential Building Plan Review - Building New IMPROVEMENT - AUTH_CONST - REPAIR Contractor WADE A WORKMAN, 1161 HULLS GROVE CHURCH RD, VALE NC 28168 B:704 -276-1824F:704-276-2321 WORKMANCONCO@BELLSOUTH.NET Owner DOUGLAS SMITH, 1385 STARTOWN RD, LINCOLNTON NC 28092 H:704 -735-8472C:828-234-25 57 NAME TO APPEAR ON PERMIT DOUGLAS SMITH SITE ADDRESS: 5074 WICKFORD LN, DENVER NC 28037 PIN # 460603424736 NAME of SUBDIVISION: CRESCENT LAND AND TIMBER CORP Lot # 160 Section/Block PROPERTY SIZE: Square Feet Acres 0.87 DIRECTIONS: left at Denver / at stop light left Burris Rd / RT Bankhead Rd / Rt Sally Brook/ Rt Wickford / lot 160 on left 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: )BUILDING 2 STORY DWELLING W/ ATTACHED GARAGE / UNFINISHED BASEMENT/ UNFINISHED 1)BUILDING ROOM OVER EXISTING SEPTIC. IP/AC TO MOVE EXISTING SYSTEM APPLICATION FOR: New Structure STRUCTURE TYPE: PRIMARY RESIDENCE FACILITY TYPE: Single Family Residence OTHER DESCRIPTION: DESCRIPTION OF SW MOBILE HOME EXISTING STRUCTURES ON SITE (IF ANY) DIM EXISTING STRUCTURE: 10 X 80 NUMBER OF EXISTING BEDROOMS: 2 PROPERTY EASEMENTS: NONE) NEW STRUCTURE DIM:: 75 x 40 # OF NEW BEDROOMS:: 3 BASEMENT? Yes # OF OCCUPANTS: PROPOSED CONSTRUCTION BASEMENT FIXTURES? Yes PLUMBING REQUIRED? Yes 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 AREA1 MINIMUM SETBACKS FRONT: 30 SIDE: 15 REAR: 30 MAX HEIGHT: 45 FEENAME DATE FEE AMOUNT Authorization to Construct (Repair) Fee 07/16/2012 $300.00 TOTAL FEES 5300.00 E9 - ehapplication 07/16/2012 16:53 Page 1 of 3 PAYOR SMITH, DOUGLAS PAYMENTS CATAWBA COUNTY 100A SOUTHWEST BLVD NEWTON, NORTH CAROLINA 28658 PHONE: 828.465.8399 www.catawbacountync.gov TRANSACTION NUMBER: TRC -260158-18-03-2013 PAYMENT DATE : 03/18/2013 PAYMENT TYPE: Credit Card 89330278 INVOICE NUMBER FEE NAME 03-13-294775 Re -Trip or Redesign Fee TOTAL PAYMENTS RBPR-07-2012-15983 RECEIPT Monday, March 18, 2013 FEE AMOUNT $70.00 $70.00 CASE TYPE: Residential Building Plan Review WORK CLASS: Building New SITE ADDRESS: 5074 WICKFORD LN, DENVER NC 28037 Owner DOUGLAS SMITH, 1385 STARTOWN RD, LINCOLNTON NC 28092 H:704 -735-8472C:828-234-2557 ** NO PEOPLESOFT ACCOUNT ASSIGNED ** Contractor WADE A WORKMAN, 1161 HULLS GROVE CHURCH RD, VALE NC 28168 B:704 -276-1824F:704-276-2321 WORKMANCONCO@BELLSOUTH.NET E9 - receipt 03/18/2013 15:28 Page I of 1 THIS IS NOT A PERMIT Case # RBPR-07-2012-15983 CATAWBA COUNTY PTEALTH DEPARTMENT PLAN REVIEW APPLICATION FOR ENVIRONMENTAL SERVICES Residential Building Plan Review - Building New IMPROVEMENT - AUTH CONST - REPAIR Contractor WADE A WORKMAN, 1161 HULLS GROVE CHURCH RD, VALE NC 28168 B:704 -276-1824F:704-276-2321 WORK MANCONCO@BELLSOUTH.NET Owner DOUGLAS SMITH, 1385 STARTOWN RD, LINCOLNTON NC 28092 H:704 -735-8472C:828-234-2557 NAME TO APPEAR ON PERMIT DOUGLAS SMITH SITE ADDRESS: 5074 WICKFORD LN, DENVER NC 28037 PIN # 460603424736 NAME of SUBDIVISION: CRESCENT LAND AND TIMBER CORP Lot # 160 Section/Block PROPERTY SIZE: Square Feet Acres 0.87 DIRECTIONS: left at Denver / at stop light left Burris Rd / RT Bankhead Rd / Rt Sally Brook/ Rt Wickford / lot 160 on left 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: 2 STORY DWELLING W/ ATTACHED GARAGE / UNFINISHED BASEMENT / UNFINISHED BASEMENT ROOM APPLICATION FOR: New Structure STRUCTURE TYPE: PRIMARY RESIDENCE FACILITY TYPE: Single Family Residence OTHER DESCRIPTION: DESCRIPTION OF SW MOBILE HOME EXISTING STRUCTURES ON SITE (IF ANY) DIM EXISTING STRUCTURE: 10 X 80 NUMBER OF EXISTING BEDROOMS: 2 # OF OCCUPANTS: PROPOSED CONSTRUCTION NEW STRUCTURE DIM:: 75 x 40 # OF NEW BEDROOMS:: 3 BASEMENT? Yes BASEMENT FIXTURES? Yes PLUMBING REQUIRED? Yes K) DyVe­ 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. �( _ `DateSignature of Applicant or Aged'' An Environmental Health Specialist will contact you within 2 woAg days of application date. If you need further information or assistance please call 828-466-7291 AREA1 MINIMUM SETBACKS FRONT: 30 SIDE: 15 REAR: 30 MAX HEIGHT: FEENAME DATE FEE AMOUNT Authorization to Construct (Repair) Fee 07/16/2012 $300.00 TOTAL FEES $300.00 45 CHANGE WORK ORDER REQUIRING REDESIGN AND/OR RETRIP WILL INCURE AN ADDITIONAL CHARGE (SEE FEE SCHEDULE) F-9-chapplicaiion 07/16/2012 10:28 Pagel of3 r a THIS IS NOT A PERMIT a CATAWBA COUNTY HEALTH DEPARTMENT Application for Environmental Services Page 1 1842 va Improvement Permit SJ Authorization to Construct ❑ Septic Repair'❑ Septic Malfunction ❑ Septic Expansion ❑ New Well Permit ❑ Replacement Well ❑ Well Abandonment ❑ Well Repair ❑ Existing System Inspection (Pre -Approval Required) ❑ Application is for New Construction JZ Existing Facility ❑ Property Address U%L/I /2 Subdivision Z-2`/ i %� G� � � Lot # %® Acres t� Section/Block/Pha e Driving Directions to PropertyZe-FJL 4-7` %J ely //'e-� W Q. NAME TO APPEAR ON PERMIT? Owner ❑ Applicant X Contractor OApplicant Contact Information V Name ©U mAddress Phone I Cell Phone Owner Contact I rmation Name ,/OL' �5�� T Z I Address �-- M2 W/�/ /"ry Q I Phone y C/ f7 Cell Phone y4 Contract5r Co tact Information HName fll_S"�U Address �/� r/rI 1 i .,_RQV /,gR Phone^� �. � /� Cell Phone WHO WILL BE THE PRIMARY CONTACT? Owner E] Applicant Contractor zDescription of Existing Structures on Site be - Q # of Bedrooms * j' Structure Dimensions rte - FO # of Occupants 1► Basement ❑ Yes [K No Basement Fixtures ❑ Yes �4 1 o C Planned Future Additions'or Improvements (Building Permit NOT requested at this time) O Describe�Alo Ld zmrd I��< L.L.Proposed Future Structure Dimensions of Bedrooms *'I if applicable ? Are there easements or right-of-ways recorded on this property ❑ Yes No Describe Is a public water supply available on or adjacent to the above property ** ❑ Yes eE$No Check type available ❑ Community Well ❑ Semi -Public Well ❑ County/City/Township Water Line Existing water supply in use X Individual Well ❑ Community Well ❑ Semi -Public Well ❑ County/City/Township Water Line '9I WOULD LIKE TO SCHEDULE A COMBINED FLAGGING AND SOIL EVALUATION (SEE COMBINED EVALUATION PROCEDUES) A G THIS IS NOT A PERMIT a CATAWBA COUNTY HEALTH DEPARTMENT Application for EnvironMental, Services Page 2 1842 un Proposed Facility Type ❑ Primary Residence A New Residence ❑ Addition to Residence # of New Bedrooms * j Project Description S .( r Z e. -(, Structure Dimensions—'77y9� rl S X f Occupants Basement ig Yes ❑ No Basement Fixtures X Yes ❑ No ❑ Accessory Structure(s) Describe ll -e # of New Bedrooms * j .if applicable Structure Dimensions # of Occupants Accessory Dwelling ❑ Yes ❑ No Plumbing ❑ Yes ❑ No Describe Plumbing Needed ❑ Multi -Family Residence # Units #Bedrooms per Unit*t Total # Bedrooms * j 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 )V-ri7 # of Employees per Shift # of Shifts ❑ Other Facility Type Specify /T If Church # of Seats Kitchen ❑ Yes ❑ No Application for Well Construction/Abandonment/Repair Retail Floor Space If Daycare Specify Occupancy Proposed Well Type ❑ Individual Well ❑ Semi -Public Well ❑ Community Well Abandonment Type ❑ Drilled ❑ Bored ❑ Dug ❑ Unknown Well Repair Requested ❑ Yes [:]No Describes d/fP (,tJeLL �%D v Calculated Design Flow, Commercial t 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 W ADDITIONAL CHARGE (SEE FEE SCHEDULE) 4 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 0 that an Improvement Permit issued as a result of this information is valid for 5 years or may be non -expiring under certain V specified conditions. Improvement Permits and Well Permits are transferrable, but may be revoked if this information, site W plans or intended use changes for the proposed facility. An Authorization to Construct issued by this department is valid for m � (5) five years from the date issued and is n transferable Signature of Owner or Agentj Printed Name of Owner or Agent V D duo 61 .S' C_ S Date J_UJ 7 Catawba County, North Carolina This map product was prepared from the Catawba County, NC, Geospatial Information System. N CatawbaCounty 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= 60 feet Selected Parcel Number: 4606-03-42-4736 Prepared for: CATAWBA COUNTY NC - Parcel Report Information Regarding Selected Parcel(s) Parcel ID: 4606-03-42-4736 Name: SMITH DOUGLAS EDGAR Name2: SMITH LUCILLE W Address: 1385 STARTOWN RD Address2: City: LINCOLNTON State: NC Zip: 28092-8038 Account: 197693 Calc Acreage: 0.87 Tax Map: 017 X 34160 LRK: 17972 Deed Book: 2615 Deed Page: 0499 Subdivision Name: CRESCENT LAND AND TIMBER CORP Subdivision Block: Lots: 160 Plat Book: 16 Plat Page: 22 Building Number: 5074 Street Name: WICKFORD LN Site Zip: 28037 Township: MOUNTAIN CREEK Fire Code: SHERRILLS FORD City Code: COUNTY State Road: Total Bldgs Value: $2,300 Land Value: $145,300 Total Value: $147,600 Year Built: Year Remodeled: Last Sale Date: Last Sale Amount: Neighborhood: 129 Watershed: WS-IV Critical Area Watershed Split: NO Voter Precinct: P41 E911 District: COUNTY Zoning: R-30 Zoning2: Zoning3: Zoning Split: N Zoning Overlay: CRC-O,WP-O,FPM-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: 011504 Census Block 2010: 4018 Small Area Plan: SHERRILLS FORD Agricultural District: Printed: Monday, July 16, 2012 09:57 AM