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HomeMy WebLinkAboutRBPR-07-2012-15980.TIFContractor Owner THIS IS NOT A PERMIT Case # RBPR-07-2012-15980 CATAWBA COUN`I'Y' HEALTH DEPARTMENT PLAN REVIEW APPLICATION FOR ENVIRONMENTAL SERVICES Residential Building Plan Review - Building Addition IMPROVEMENT -- SAME AS OWNER, , -- -- - — - - -- — - — BILLY ISOM, 5876 LEIL RD, HICKORY NC 28602 H:704-325-3822 NAME TO APPEAR ON PERMIT BILLY ISOM SITE ADDRESS: 5876 LEIL RD, HICKORY NC 28602 NAME of SUBDIVISION: PIN # 269917107360 Lot # Section/Block PROPERTY SIZE: Square Feet Acres 2.91 DIRECTIONS: 10W/ PAST INTERSECTION AT 127 / GO 1/4 MILE/ RT LEIL RD/ 1 ST HOUSE ON RIGHT PRIMARY CONTACT: Owner SEWER TYPE: Septic Tank GALLONS PER DAY: 360 WATER SUPPLY: Private Well Public water is ""NOT`" available for this property. DESCRIBE WORK: ADDING PVT METAL CARPORT 24 X 26 / to side of existing modular dwelling - no load bearing on existing dwelling APPLICATION FOR: Existing Structure STRUCTURE TYPE: PRIMARY RESIDENCE FACILITY TYPE: Single Family Residence OTHER DESCRIPTION: DESCRIPTION OF single family modular dwelling EXISTING STRUCTURES ON SITE (IF ANY) DIM EXISTING STRUCTURE: 64 x 27 NUMBER OF EXISTING BEDROOMS: 3 # OF OCCUPANTS: 2 PROPERTY EASEMENTS: none PROPOSED CONSTRUCTION NEW STRUCTURE DIM:: 24 x 26 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. 2 Date: rl J—' � 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 MINIMUM SETBACKS FRONT: 30 SIDE: 15 REAR: 30 MAX HEIGHT: 45 FEENAME Improvement Permit Fee TOTAL FEES DATE FEE AMOUNT 07/13/2012 $150.00 $150.00 CHANGE WORK ORDER REQUIRING REDESIGN AND/OR RETRIP WILL INCURE AN ADDITIONAL CHARGE (SEE FEE SCHEDULE) C4-rhaPpli:at o❑ 07/13/2012 14:07 Page I of3 �tv THIS IS NOT A PERMIT CATAWBA COUNTY HEALTH DEPARTMENT d Application for Environmental Services Page 1 1842 ua 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 5-0 ! & LE/ L KP, Subdivision Lot # Acres A4D p g -,,o X> / % o Section/Block/Phase Driving Directions to Property IIX7 (5; 1-c) J` / t j +e- 12S�c_��rJ� v -M I le- � t f►—�'C� D p S l-OAi-�.� 0 k) 2 i' + Lei L of (A) 0 A 9-e-- 5 J ` CL NAME TO APPEAR ON PERMIT? 0,6wner ❑ Applicant ❑ Contracto►- OApplicant Contact Information V I Name la tj I W I Address (l i_e'--j' L F_G?. N G l� a r� nJ G 7,,L-9& m 1-� I Phone r-70 Lf—'3; ;1-s-- 3 &,'p� Cell Phone jOwner Contact Information 5," e, Name Address 0 I Phone I Cell Phone UContractor Contact Information LU Name Address = Phone Cell Phone Z WHO WILL BE THE PRIMARY CONTACT? ❑ Owne [:]Applicant ❑Contractor Description of Existing Structures on Site I X, (p LP Q # of Bedrooms *t � __Structure Dimensions # of Occupants �- I� Basement ❑ Yes [io---Basement Fixtures ❑ Yes © _ Planned Future Additions or Improvements (Building Permit NOT requested at this time) ODescribe 14. Proposed Future Structure Dimensions # of Bedrooms *t if applicable ? Are there easements or right-of-ways recorded on this property ❑ Yes ED-Ns� Describe Is a public water supply available on or adjacent to the above property ** ❑ Yes 0 -No J Check type available ❑ Community.,Well ❑ Semi -Public Well ❑ County/City/Township Water Line Existing water supply in use D -'Individual Well ❑ Community Well ❑ Semi -Public Well ❑ County/City/Township Water Line ❑ I WOULD LIKE TO SCHEDULE A COMBINED FLAGGING AND SOIL EVALUATION (SEE COMBINED EVALUATION PROCEDUES) A THIS IS NOT A PERMIT Q C� CATAWBA COUNTY' HEALTH DEPARTMENT Application for Environmental Services Page 2 1842 vn 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 -p1) T` YKcfoJ C'r_r" pn r l— # of New Bedrooms *i if applicable Structure Duinnensions Q "l X & # of Occupants Accessory Dwelling ❑ Yes ❑ No Plumbing ❑ Yes ❑ No Describe Plumbing Needed ❑ Multi -Family Residence # Units #Bedrooms per Unit*'i 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 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. 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) 141 4 1 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. 1 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 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 not transferable j'Signature of Owner or Agent :>4I'rinted Name of Owner or Agent �.� (( CJ �1,°9�ril %� / )q -N �- 5:76/v� ��/Date 73��vZ 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: 2699-17-10-7360 1 inch = 100 feet Prepared for: PI to 65-9-9 4 '' X2800 4S ��60 O 1.48A 5460 A��, ,- —��-- \ Plat 65-04 �� ---� 2,91Aw 7360 'yd __ '`✓s �� 1.82A 0267N fr'/ 'V .✓ _ e. ' ! Cly` V.! 166A 9130 3o2J� �o ,00 30. p0 1- 56A �a /11 THIS IS NOTA LEGAL DOCUMENT' \�.Date: 7/13/2012 Time: 1:28:15 PMQ-�WFV I'll . ^% de t t r.r / Q7/\124?f„ I . ^ 7 11 /M f CATAWBA COUNTY NC - Parcel Report Information Regarding Selected Parcel(s) Parcel ID: 2699-17-10-7360 Name: ISOM BILLY DARRELL Name2: ISOM DIANE M Address: 5876 LEIL RD Address2: City: HICKORY State: NC Zip: 28602-7161 Account: 35551020 Calc Acreage: 2.91 Tax Map: 005AB 01003 LRK: 5210 Deed Book: 1605 Deed Page: 0061 Subdivision Name: PROPST ACRES Subdivision Block: Lots: 3 Plat Book: 15 Plat Page: 166 Building Number: 5876 Street Name: LEIL RD Site Zip: 28602 Township: BANDY'S Fire Code: PROPST City Code: COUNTY State Road: Total Bldgs Value: $66,300 Land Value: $21,400 Total Value: $87,700 Year Built: 1990 Year Remodeled: Last Sale Date: 3/1/1988 Last Sale Amount: $11,500 Neighborhood: 89 Watershed: WS -III Protected Area Watershed Split: NO Voter Precinct: P2 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: BANOAK Middle School: JACOBS FORK High School: FRED T FOARD School Split: NO P&Z Case Number: Census Tract 2010: 011802 Census Block 2010: 2000 Small Area Plan: PLATEAU Agricultural District: Proximity Printed: Friday, July 13, 2012 01:28 PM 'cam -GtJgSbb� p cc,(,; as � CG -p ya. CATAWBA COUNTY PERMIT ZONING_ AUTHORIZATION (R) Addition IVR PIN# PERMIT NO: ZONR-07-201-029553 P. O. Box 389 Phone: 828-465-8380 APPLIED: 07/13/2012 100A Southwest Blvd FAX: 828-465-8484 ISSUED: 07/13/2012 Newton, North Carolina 28658 EXPIRES: 03/28/2013 www.catawbacountync.gov _ _ . _... - .-. ...._... _.,..._ .._ .._._..... _..._..-.. - --------..._ __. - .. _ .. ---- - - Owner BILLY ISOM, 5876 LEIL RD, HICKORY NC 28602 H:704-325-3822 **NO PEOPLESOFT ACCOUNT ASSIGNED ** Contractor SAME AS OWNER,, PROPERTY ID#: 269917107360 CENSUS TRACT: 011802 STREETADDRESS: 5876 LEIL RD, HICKORY NC 28602 PROJECT DESCRIPTION: ADDING PVT METAL CARPORT 24 X 26 / to side of existing modular dwelling - no load bearing on existing dwelling FLOOD ZONE? 100 YEAR FLOOD ZONE PLAIN? FLOOD PLAIN, STRUCTURE? No OWNER TYPE: LAND OWNER: No REQUIRED SETBACKS FRONT: 30 REAR: 30 SIDE: 15 MAX HEIGHT: 45 VALUE: $49,657.92 INVOICE#: 07-12-288283 FEE "DESCRIPTION = - DATE " '- FEE AMOUNT Residential Zoning Fee 07/13/2012 $25.00 TOTALFEES . _ $25.00 FEES COLLECTED ON MAIN PERMIT The applicant herebv certifies that all information and attachments to this Certificate of Zoning Comviliance are true and correct, and acknowledges that this permit was issued on the basis of the information reauired herein. The applicant further acknowledges that any construction, alteration or addition which differs from this application shall be subject to removal or alteratio to bring said structure into conformance with the specifications and standards of the Catawba County Zonin Ordinance. Such correc ve actiti nnsshall be at the expense of the APPLICANT NAME (PRINT91)) MAPPLICANT SIGNATTZRE ZONING APPROVED BY ***** ZONING FEES ARE NON-REFUNDABLE ***** COMPANY NAME i:') - per„ t 07/13/2012 14:18 ISSUED BY: Pat Queen Page 1 of