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Home My WebLink AboutRBPR-07-2012-15988.tifTHIS IS NOT A PERMIT Case # RBPR-07-2012-15988 CATAWBA COUNTY HEALTH DEPARTMENT PLAN REVIEW APPLICATION FOR ENVIRONMENTAL SERVICES I Residential Building Plan Review - Building New I IMPROVEMENT - AUTH CONST Contractor DIXON CONSTRUCTION, 1706 BRENTWOOD DR, NEWTON NC 28658 B:828 -464 -5709C:828 -244-6564F:828-464-5709 SEPT23JSC@YAHOO.COM Owner JOHAN BOLICK, 1206 MAYS CHAPEL CHURCH RD, NEWTON NC 28658-9004 H:828-638-5599 NAME TO APPEAR ON PERMIT Johan Bolick SITE ADDRESS: 3031 JOE BOLICK RD, MAIDEN NC 28650 PIN # 365803230140 NAME of SUBDIVISION: Lot # Section/Block PROPERTY SIZE: Square Feet Acres C7.29) DIRECTIONS: Hwy 16 / right Providence Mill Rd / Right Joe Bolick Rd / before the Baptis Church PRIMARY CONTACT: Contractor GALLONS PER DAY: (360 SEWER TYPE WATER SUPPLY Septic Tank • Public Wate( Public watefIs vailable for this property. DESCRIBE WORK: Single Family Dwelling / Attached garage / Finished Bonus Room / No basement APPLICATION FOR: STRUCTURE TYPE: FACILITY TYPE: Single Family Residence DESCRIPTION OF EXISTING STRUCTURES ON SITE (IF ANY) DIM EXISTING STRUCTURE: NUMBER OF EXISTING BEDROOMS: PROPERTY EASEMENTS: none NEW STRUCTURE DIM:: 82 x 36 House # OF NEW BEDROOMS:: 3 BASEMENT? No New Structure PRIMARY RESIDENCE OTHER DESCRIPTION: # OF OCCUPANTS: 3 PROPOSED CONSTRUCTION BASEMENT FIXTURES? No 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 informatnoranceplease call 828-466-7291 MINIMUM SETBACKS FRONT: 80 SIDE: REAR`. 30 MAX HEIGHT: I FEENAME DATE FEE AMOUNT Authorization to Construct Fee (New/Expansion) 07/16/2012 $150.00 Fee Improvement Permit Fee 07/16/2012 $150.00 TOTAL FEES 5300.00 F9 - ehapplication 07/16/2012 18:08 Page 1 of 3 THIS IS NOT A PERMIT Case # RBPR-07-2012-15988 CATAWBA COUNTY HEALTH DEPARTMENT PLAN REVIEW APPLICATION FOR ENVIRONMENTAL SERVICES Residential Building Plan Review - Building New IMPROVEMENT - AUTH CONST Contractor DIXON CONSTRUCTION, 1706 BRENTWOOD DR, NEWTON NC 28658 B:828 -464 -5709C:828 -244-6564F:828-464-5709 SEPT23JSC@YAHOO.COM Owner JOHAN BOLICK, 1206 MAYS CHAPEL CHURCH RD, NEWTON NC 28658-9004 H:828-638-5599 NAME TO APPEAR ON PERMIT Johan Bolick SITE ADDRESS: 3031 JOE BOLICK RD, MAIDEN NC 28650 PIN # 365803230140 NAME of SUBDIVISION: Lot # Section/Block PROPERTY SIZE: Square Feet Acres DIRECTIONS: Hwy 16 / right Providence Mill Rd / Right Joe Bolick Rd / before the Baptis Church PRIMARY CONTACT: Contractor SEWER TYPE: Septic Tank GALLONS PER DAY: 360 WATER SUPPLY : Public Water Public water is **NOT** available for this property. DESCRIBE WORK: Single Family Dwelling / Attached garage / Finished Bonus Room / No basement APPLICATION FOR: STRUCTURE TYPE: FACILITY TYPE: Single Family Residence DESCRIPTION OF EXISTING STRUCTURES ON SITE (IF ANY) DIM EXISTING STRUCTURE: NUMBER OF EXISTING BEDROOMS: PROPERTY EASEMENTS: none NEW STRUCTURE DIM:: 82 x 36 # OF NEW BEDROOMS:: 3 BASEMENT? No New Structure PRIMARY RESIDENCE OTHER DESCRIPTION: # OF OCCUPANTS: 3 PROPOSED CONSTRUCTION BASEMENT FIXTURES? No 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�0 7 ! Signature of Applicant orAgent �U/�—•. An Environmental Health Specialist will contact you withi working days of appltcatton date. If you need further information or assistance please call 828-466-7291 MINIMUM SETBACKS FRONT: 80 SIDE: 15 REAR, 30 MAX HEIGHT: FQ - ehapplicailoll 07/16/2012 16:19 Page I of �aA THIS IS NOT A PERMIT CATAWBA COUNTY HEALTH DEPARTMENT d Application for Environmental Services Page 1 1842 m 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 j 03 :LL /jd Subdivision Lot # Acres ,L f� / j Sect' /B1 WPhase Driving Directions to Property � / — [� C�)l o� IY1 /11 A—/ A.-/ /c/o X/ I Jet, CL I �c11�y� �� d - d , 0 UjW i CL NAME TO APPEAR ON PERMIT? 4 Owner ❑ Applicant ❑ Contractor C Applicant Contact Information UU Name � e mAddress L. Phone I Cell Phone Owner Contact Information Name �g�� jri ��tG. z I Address I" �2D)l Ge�,9 0 I Phone q) 9- 631- 9q I Cell Phone Contractor Contact Information LLj Name ,�lQ �Ol^S7`l�C fig Address Phone C�� ,j, y��d �, Cell Phone Z WHO WILL BE THE PRIMARY CONTACT? ❑ Owner ❑ Applicant Contractor Description of Existing Structures on Site 0 # of Bedrooms *t Structure Dimensions # of Occupants I• Basement ❑ Yes ❑ No Basement Fixtures ❑ Yes ❑ No Planned Future Additions or Improvements (Building Permit NOT requested at this time) Describe _ L4. Proposed Future Structure Dimensions # of Bedrooms *-j if applicable ? Are there easements or right-of-ways recorded on this property ❑ Yes [RNo Describe Is a public water supply available on or adjacent to the above property ** El Yes ❑ No Check type available ❑ Community Well ❑ Semi -Public Well j ❑ County/City/Township Water Line Existing water supply in use ❑ Individual Well ❑ Communityj Well ❑ Semi -Public Well 0 County/City/Township Water Line i ❑ I WOULD LIKE TO SCHEDULE A COMBINED FLAGGING AND SOIL EVALUATION (SEE COMBINED EVALUATION PROCEDUES) 0 W J Ca C 0 V W m �3A THIS IS NOT A PERMIT CATAWBA COUNTY HEALTH DEPARTMENT �iP sc Application for Environmental Services Page 2 1842 sm Proposed Facility Type ❑ Primary Residence New Residence ❑ Ad ition to Residence # of New Bedrooms * j Project Description er S'Ole C c �j d✓SL Structure Dimensions VX 36 1 # of Occupants Basement ❑ Yes n No Basement Fixtures ❑ Yes NO No ❑ Accessory Structure(s) Describe # of New Bedrooms *t if applicable Structure Dimensions Accessory Dwelling ❑ Yes ❑ No Describe Plumbing Needed #Bedrooms per Unit* j Structure Dimensions # of Occupants Plumbing ❑ Yes ❑ No ❑ Multi -Family Residence # Units Total # Bedrooms *'i ❑ 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. 'j 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 nsferable Signature of Owner or Agent Printed Name of Owner or Agents s C/��- •�� Date I 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: 3658-03-23-0140 1 inch = 120 feet Prepared for: I f ' (12 9) _ f `-� 20`2 s 4296 0 21 ?6J 7:29A 2986 4298 014'0" 180.04 ` �20 C-NI CIO -Jr co - 129 -7-6 (152) 2875 0 CD (160 ) 0`5r�y .3,313 071 Ul2794 D r �. C5 �:� (155) 3363 !{,- 1.12A l r CO O 85825 ' 30 �3316� J12Q61 �,.� 0 5-27 Date: 7/16/2012 \ Tim 1:06:13 P— THIS IS NOT A LEGAL DOCUMEN� � �� / I � / 0 ', ,/ + Print Parcel Map http://www.gis.catawba.nc.us/website/Parcel/printMap.asspp?pinc=365... �C�a0 3821rc Parcel Summary Printed Map Scale 1 inch = 200ft (Parcel ID: 365803230140 jParcel Address: 3031 JOE BOLICK RD, MAIDEN Owner: BOLICK JOHAN ERIC Address: 1206 MAYS CHAPEL City: NEWTON (CHURCH RD IOwner2: IAddress2: ,State/Zip: NC, 28658-9004 IBuilding(s) Value: (Land Value: $65,500 ITotal Value: $65,500 DISCLAIMER: This map/report product was prepared from the Catawba County, NC Geospatial Information Services. Catawba County has made substantial efforts to ensure the accuracy of location and labeling information contained on this map or data on this report. Catawba County promotes and recommends the independent verification of any data contained on this map/report 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/report product or the use thereof by any I of 2 7/16/2012 1:31 PM 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 N 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: 3658-03-23-0140 1 inch = 200 feet i Prepared for: i l6�) t � 392 5. �O Q 1.19A co 144) �0 295-j (1255) w 1977 L R-40 THIS IS NOT A LEGAL DC 9 v6 co N U 2.25A 2624 CATAWBA I ROO COUNTY BAPTIST DAMP 1 MEETWG Y,' uo f I u> j R-40 N of 27)I 3314 (129) _ 1 5.20A 5438 4296 2196r 3.43A 7.29A r 4298 0140 I 180.04. (169) I /20 10W PROVIDE BA PT ISl OF MAID 4.1: PROVIDENCE I 2.37A\ BAPTIST Ctju; ?7902 OF MAIDEN NC 3 a6N 160 6 so 65281 30 ` _ 3l 190 oi9� 0� \� 30 l6 � Plat 65-45 2 yDate:7/16/2012 R-40Time:4:28:13PM479100 R-4 �g r� G 1.35A 8554 1y2976 L� (152) 2875 0 o (160) 2794 (155; 10W PROVIDE BA PT ISl OF MAID 4.1: PROVIDENCE I 2.37A\ BAPTIST Ctju; ?7902 OF MAIDEN NC 3 a6N 160 6 so 65281 30 ` _ 3l 190 oi9� 0� \� 30 l6 � Plat 65-45 2 yDate:7/16/2012 R-40Time:4:28:13PM479100 R-4 �g r� G 1.35A 8554 CATAWBA COUNTY NC - Parcel Report Information Regarding Selected Parcel(s) Parcel ID: 3658-03-23-0140 Name: BOLICK JOHAN ERIC Name2: Address: 1206 MAYS CHAPEL CHURCH RD Address2: City: NEWTON State: NC Zip: 28658-9004 Account: 5450800 Calc Acreage: 7.29 Tax Map: LRK: 902101 Deed Book: 2133 Deed Page: 0038 Subdivision Name: Subdivision Block: Lots: Plat Book: Plat Page: Building Number: 3031 Street Name: JOE BOLICK RD Site Zip: 28650 Township: NEWTON Fire Code: MAIDEN RURAL City Code: COUNTY State Road: Total Bldgs Value: Land Value: $65,500 Total Value: $65,500 Year Built: Year Remodeled: Last Sale Date: Last Sale Amount: Neighborhood: 113 Watershed: WS-II Protected Area Watershed Split: YES Voter Precinct: P20 E911 District: COUNTY Zoning: R-40 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: TUTTLE Middle School: MAIDEN High School: MAIDEN School Split: NO P&Z Case Number: Census Tract 2010: 011601 Census Block 2010: 1049 Small Area Plan: BALLS CREEK Agricultural District: Proximity Printed: Monday, July 16, 2012 04:28 PM