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HomeMy WebLinkAboutRBPR-07-2012-16027.TIFApplicant Owner THIS IS NOT A PERMIT Case # RBPR-07-2012-16027 CATAWBA COUNTY HEALTH DEPARTMENT PLAN REVIEW APPLICATION FOR ENVIRONMENTAL SERVICES Residential Building Plan Review - Accessory Structure IMPROVEMENT JIMMY PRESNELL, , C:8288510215 HELEN PRESNELL, 364 21 ST ST SE, HICKORY NC 28602 C:828-345-1271 NAME TO APPEAR ON PERMIT HELEN PRESNELL SITE ADDRESS: 364 21ST ST SE, HICKORY NC 28602 PIN # 371212862 NAME of SUBDIVISION: Lot 1 &2 Sectional cl.4A ) PROPERTY SIZE: Square Feet Acres 00.54 DIRECTIONS: SWEETWATER RD/ BESIDE CHURCH / CLOSE TO LITTLE FOLKS SCHOOL PRIMARY CONTACT: Applicant SEWER TYPE: Septic Tank GALLONS PER DAY: WATER SUPPLY: Public W er Public wat r IS -')available for this property. DESCRIBE WORK: PVT METAL CARPORT 20 X 20 APPLICATION FOR: New Structure STRUCTURE TYPE: ACCESSORY DWELLING_+ �~ FACILITY TYPE: Single Family Residence OTHER DESCRIPTION: DESCRIPTION OF SINGLE FAMILY EXISTING STRUCTURES ON SITE (IF ANY) DIM EXISTING STRUCTURE: 50 X 60 NUMBER OF EXISTING BEDROOMS: 3 # OF OCCUPANTS: 2 PROPERTY EASEMENTS: NON PROPOSED CONSTRUCTION NEW STRUCTURE DIM::( 20 X 20 CARPO 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 ance please call 828-466-7291 AREA MINIMUM SETBACKS FRONT: 30 SIDE: 5 REAR: 5 MAX HEIGHT: 15 FEENAME Improvement Permit Fee TOTAL FEES DATE FEE AMOUNT 07/24/2012 $150.00 $150.00 CHANGE WORK ORDER REQUIRING REDESIGN AND/OR RETRIP WILL INCURE AN ADDITIONAL CHARGE (SEE FEE SCHEDULE) F;9 - ehapplication 07/24/2012 16:23 Page t of 3 Applicant Owner THIS IS NOT A PERMIT Case # RBPR-07-2012-16027 CATAWBA COUNTY HEALfiH DEPARTMENT PLAN REVIEW APPLICATION FOR ENVIRONMENTAL SERVICES Residential Building Plan Review - Accessory Structure IMPROVEMENT JIMMY PRESNELL, , _C:8288510215 HELEN PRESNELL, 364 21 ST ST SE, HICKORY NC 28602 C:828-345-1271 NAME TO APPEAR ON PERMIT HELEN PRESNELL SITE ADDRESS: 364 21ST ST SE, HICKORY NC 28602 PIN # 371212862838 NAME of SUBDIVISION: Lot # Section/Block PROPERTY SIZE: Square Feet Acres DIRECTIONS: SWEETWATER RD/ BESIDE CHURCH / CLOSE TO LITTLE FOLKS SCHOOL PRIMARY CONTACT: Applicant SEWER TYPE: Septic Tank GALLONS PER DAY: 360 WATER SUPPLY: Public Water Public water is *`NOT** available for this property. DESCRIBE WORK: PVT METAL CARPORT 20 X 20 APPLICATION FOR: STRUCTURE TYPE: FACILITY TYPE: Accessory Structure DESCRIPTION OF SINGLE FAMILY EXISTING STRUCTURES ON SITE (IF ANY) DIM EXISTING STRUCTURE: 50 X 60 NUMBER OF EXISTING BEDROOMS: 3 NEW STRUCTURE DIM:: 20 X 20 New Structure ** NO STRUCTURE SELECTED ** OTHER DESCRIPTION: # OF OCCUPANTS: 2 PROPOSED CONSTRUCTION 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 thiVprope, . Any representation by you of house or structure location should conform to applicable setbacks. �����E � Date: aEl—l� Signature of Applicant or Agent r� - An Environmental Health Specialist will contact you withinff2 workii g days of application date. If you need further information or assistance please call 828-466-7291 MINIMUM SETBACKS FRONT: 30 SIDE: 5 REAR: 5 MAX HEIGHT: 15 FEENAME Improvement Permit Fee TOTALFEES DATE FEE AMOUNT 07/24/2012 $150.00 $150.00 CHANGE WORK ORDER REQUIRING REDESIGN AND/OR RETRIP WILL INCURE AN ADDITIONAL CHARGE (SEE FEE SCHEDULE) 11> - chappiicaticm 07/24/2012 15:07 Page] of 3 07/24/2012 14:34 8283226814 THIS IS NOT A PERMIT h , CATAWBA. COUNTY HEALTH DEPARTMENT Application for Environmental Services Page 1 SM Improvement Permit ❑ Authorization to Construct ❑ Septic Repair ❑ Septic Malfunction ❑ Septic Expansion ❑ New Well Permit ❑ Replacement Well ❑ Well Abandonment ❑ Well Repair C] Existing System Inspection (Pre -Approval Required) ❑ Application is for New Construction [] Existing ,Facility ❑ CATAWBA COUNTY PAGE 01/08 .Property Address„_:�kdA .�4. 5i 'SV Subdivision Lot # Acres r Section/Block/Phase Driving Directions to Property r —,�6 o. r ,ku for, i NAME TO APPEAR ON PERMIT? O'Owner D Applicant: ❑ Contractor Applicant Contact Information Name Address -'gnu- 3 l S C 5�_ • L -�f jc,� r�y N L ��Si✓ 7 cS� Phone �`�a`�� ?N a—Cell Phone Owner Contact Information Name Address Phone I Cell Phone Contractor Contact Information Name Address Phone 1 Cell Phone WHO WILL BE THE PRIMARY CONTACT? caner [7 Applicant ❑ Contractor Description of Existing Structures on Site # of Bedrooms Structure Dimensions � #! of Occupants Basement F] Yes No Basement Fixtures ❑ Yes ©'No Planned Future Additions or improvements (Building Permit NOT requested at this time) 1Desc.ribe "Ll,*' r— Pr.oposed Future Structure Dimensions of Bedrooms *-� if applicable Are there easements or right-of-ways recorded on this property ❑ Yes Q'No Describe Is a public water supply available on or adlaccnt to the above property ** A,�Yes U No Check type available ❑ Community Well ❑ Semi -Public Well �uiity/City/Township Water Line Existingter supply in use ❑ Individual Well ❑ Community Well ❑ Semi -Public Well County/City/Township Water Line ❑ I WOULD LIKE TO SCHEDULE A COMBINED FLAGGING ANY) SOIL EVALUATION (SEE COMBINED EVALUATION PROCEDUES) 07/24/2012 14:34 8283226814 CATAWBA COUNTY PAGE 02/08 THIS IS NOT A PERMIT , CATAWBA COUNTY HEALTH DEPARTMENT Application for Environmental Services su Page 2 PrPoscd Facility Type [9 Primary Residence ❑ New Residence ❑ Addition to Residence # of New Bedrooms *t Project Description Stricture Dimensions # of Occupants Basement ❑ Yes O'No Basement Fixtures ❑ Yes ❑ No ❑,"Accessory Structure(s) Describe # of New Bedrooms *'r if applicable Structure Dimensions 2D X -'A o of Occupants Accessory.Dwelling ❑ Yes ❑ No Plumbing ❑ Yes ❑ No Describe Plumbing Needed (� C' ❑ Multi -Family Residence ## Units 4Pcdrooms per Unit*t f" Total 4 .Bedrooms *'p Stnicturc Dimensions [] .Food Service Specify Type / U//f # Seats Floor Space -Entire Food Service Facility (Sq FI) o Employees per Shift # of Shifts Dining Area (Sq. Ft.) ❑ Business Specific Type of Business e'Ulg 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 ❑ Individua.l Well ❑ Scmi-Public Well ❑ Commurtity Well Abandonment Type ❑ Drilled ❑ Bored ❑ Dug ❑ Unknown Well Repair Requested ❑ Yes ❑ No Describe Calculated Design Flow, Commercial f 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. of 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. OO CHANGE WORD ORDER .REQUIRING REDESIGN AND/OR RETRIP WILL INCURS AN W ADDITIONAL CHARGE (SEE FEE SCUEDULE) 4 I understand that this is a formal application for Environmental Services and authorize Catawba County Environmental CXHealth employccs to go on this property for evaluation proposes..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 mplans or intended use changes for the proposed facility. An Authorization to Construct issued by this department is valid for (S) five years from the date issued and is not t sferable Signature of Owner or Agent Printed Name of Owner or Agent I/ U Date 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: 3712-12-86-2838 1 inch = 50 feet Prepared for: 45,EV .�u \ •� CJ ` 344\ �. ! o 359 4\ 3 5.23 - < 24 0 I 8 = 1998 9 0-) 7 6 t �0 , 410 co 2\� r • oO /'� 3 ` 64 j N ��.. SWEETWATER Se p.0o , PRESBYTERIAN= - 454 C H.0 RC H "- _ - 3735 , SW TWATER 0 i ` PRES YTERIAN 2 CHURCH--\ 0 498 452 \ 1780 cp. r) a\ g 3 �2.00 15 THIS IS NOT A LEGAL DOCUMENT `,. Date: 7/24/2012 .Time: 2:51:13 I'M 0. R i n `, 9 C1A/� FT CATAWBA COUNTY NC - Parcel Report Information Regarding Selected Parcel(s) Parcel ID: 3712-12-86-2838 Name: PRESNELL HELEN J Name2: Address: 364 21ST ST SE Address2: City: HICKORY State: NC Zip: 28602-4427 Account: 52884550 Calc Acreage: 0.54 Tax Map: 123H 01030 LRK: 47074 Deed Book: 1230 Deed Page: 0855 Subdivision Name: Subdivision Block: A Lots: 1&2 Plat Book: 4 Plat Page: 83 Building Number: 364 Street Name: 21 ST ST SE Site Zip: 28602 Township: HICKORY L1 C i Fire Code: HICKORY RURAL City Code: COUNTY �0 State Road: Total Bldgs Value: $72,800 , (, Land Value: $11,000 Total Value: $83,800 Year Built: 1946 �', l 4 ` Year Remodeled: 1993 I Last Sale Date: 4/1/1980 Last Sale Amount: $27,500 Neighborhood: 53 Watershed: Watershed Split: Voter Precinct: P35 E911 District: HICKORY Zoning: R-4 Zoning2: Zoning3: Zoning Split: N Zoning Overlay: Zoning District: HICKORY Split Zoning Dist: N Split Zoning Dist(1): 0 Split Zoning Dist(2): 0 School District: COUNTY Elementary School: ST STEPHENS Middle School: ARNDT High School: ST STEPHENS School Split: NO P&Z Case Number: Census Tract 2010: 011000 Census Block 2010: 4016 Small Area Plan: Agricultural District: Printed: Tuesday, July 24, 2012 02:51 PM