Loading...
HomeMy WebLinkAboutRBPR-07-2012-16035.TIFApplicant THIS IS NOT A PERMIT Case # RBPR-07-2012-16035 CATAWBA COUNTY HEALTH DEPARTMENT PLAN REVIEW APPLICATION FOR ENVIRONMENTAL SERVICES Residential Building Plan Review - Accessory Structure IMPROVEMENT JOYCE BROOKS, 2110 31 ST DR AV NE, HICKORY NC 28601 H:8282569159 Contractor SAME AS OWNER, , Owner KAREN CROUCH, 2314 20TH AVE CT NE, HICKORY NC 28601-7954 NAME TO APPEAR ON PERMIT JOYCE BROOKS SITE ADDRESS: 2110 31 ST AV DR NE, HICKORY NC 28601 PIN # 372413026508 NAME of SUBDIVISION:Lot # Section/Block PROPERTY SIZE: Square Feet Acres QR�ST DIRECTIONS: HIGHLAND AV NE/ LF 9TH ST NE/ NE/ BECOMES 8TH ST DR NE/ BECOMES 16TH ST NE/ RT 31 STAVE DR NE/ PRIMARY CONTACT: Owner SEWER TYPE: Septic Tank GALLONS PER DAY: 360 WATER SUPPLY: Private Well Public water IS available for this property. DESCRIBE WORK: 20 X 21' METAL CARPORT *'"Hickory Zoning APPLICATION FOR: New Structure STRUCTURE TYPE: FACILITY TYPE: Accessory Structure DESCRIPTION OF SW MOH EXISTING STRUCTURES ON SITE (IF ANY) DIM EXISTING STRUCTURE: 14 X 76 NUMBER OF EXISTING BEDROOMS: 3 PROPERTY EASEMENTS: NONE ACCESSORY STRUCTURE OTHER DESCRIPTION: # OF OCCUPANTS: 1 PROPOSED CONSTRUCTION NEW STRUCTURE DIM:: 20 X 21' Carport 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. Date: Signature of Applicant or Agent An Environmental Health Specialist will contact you within 2 working days of application date. If you need further informati nce please call 828-466-7291 Area 2 MINIMUM SETBACKS FRONT: 30 SIDE: 5 REAR: 5 MAX HEIGHT: FEENAME Improvement Permit Fee TOTAL FEES DATE FEE AMOUNT 07/25/2012 $150.00 5150.00 CHANGE WORK ORDER REQUIRING REDESIGN AND/OR RETRIP WILL INCURE AN ADDITIONAL CHARGE (SEE FEE SCHEDULE) E9 - ehapplication 07/25/2012 17:02 Pagel of 3 1842 SM Applicant THIS IS NOT A PERMIT Case # RBPR-07-2012-16035 CATAWBA COUNTY HEALTH DEPARTMENT PLAN REVIEW APPLICATION FOR ENVIRONMENTAL SERVICES Residential Building Plan Review - Accessory Structure IMPROVEMENT JOYCE BROOKS, 2110 31 ST DR AV NE, HICKORY NC 28601 H:8282569159 Contractor SAME AS OWNER, , Owner KAREN CROUCH, 2314 20TH AVE CT NE, HICKORY NC 28601-7954 NAME TO APPEAR ON PERMIT JOYCE BROOKS SITE ADDRESS: 2110 31 ST AV DR NE, HICKORY NC 28601 PIN # 372413026508 NAME of SUBDIVISION: PROPERTY SIZE: Square Feet Acres Lot # Section/Block DIRECTIONS: HIGHLAND AV NE/ LF 9TH ST NE/ RT 8TH ST NE/ BECOMES 8TH ST DR NE/ BECOMES 16TH ST NE/ RT 31 ST AVE DR NE/ PRIMARY CONTACT: Owner SEWER TYPE: Septic Tank GALLONS PER DAY: 360 WATER SUPPLY: Private Well Public water IS available for this property. DESCRIBE WORK: 20 X 21' METAL CARPORT **Hickory Zoning APPLICATION FOR: New Structure STRUCTURE TYPE: FACILITY TYPE: Accessory Structure DESCRIPTION OF SW MOH EXISTING STRUCTURES ON SITE (IF ANY) DIM EXISTING STRUCTURE: 14 X 76 NUMBER OF EXISTING BEDROOMS: 3 PROPERTY EASEMENTS: NONE NEW STRUCTURE DIM:: 20X21' BASEMENT? No ACCESSORY STRUCTURE OTHER DESCRIPTION:�- # OF OCCUPANTS: 1 PROPOSED CONSTRUCTION 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. Date:�n Q ®) Signature of Applicant or Agent �eing An Environmental Health Specialist will contact you within days of application date. AaC;�� If you need further information or assistance please call 828-466-7291 MINIMUM SETBACKS FRONT: 30 SIDE: 5 REAR: 5 MAX HEIGHT: FEENAME Improvement Permit Fee TOTALFEES DATE FEE AMOUNT 07/25/2012 $150.00 $150.00 E9 - ehapplicauon 07/25/2012 11:40 Page 1 of 3 CATAWBA COUNTY Case # RBPR-07-2012-16035 4q �� Public Health Department Subdivision d Environmental Health Division PIN# 372413026508 PO Box 389, 100-A Southwest Blvd, Newton, NC 28658 NAME ON PERMIT: JOYCE BROOKS, 2110 31ST DR AV NE, HICKORY NC 28601 Site Address: 2110 31 ST AV DR NE, HICKORY NC 28601 Property Size: Square Feet Acres Directions: HIGHLAND AV NE/ LF 9TH ST NE/ RT 8TH ST NE/ BECOMES 8TH ST DR NE/ BECOMES 16TH ST NE/ RT 31 ST AVE DR NE/ CHANGE WORK ORDER REQUIRING REDESIGN AND/OR RETRIP WILL INCURE AN ADDITIONAL CHARGE (SEE FEE SCHEDULE) CATAWBA COUNTY, NC d rs Environmental Health Boundaries w O E E•pro�urnxn8w.can� 881Y� S l J Your application for Environmental Health (EH) services has been assigned to An Environmental Health Specialist (EHS) working in this area will contact you within two business days of receip by the EH Division. If you are not contacted within this time, or if you would like to leave a message with an EHS, please call (828) 466-7291. Be sure to first state your case number from the top right corner of your application, and clearly state, your name, area number, and a number where you can be reached during normal business hours. t 9 - ehapplication 07/25/2012 11:40 Page 2 of 3 �y�3a THIS IS NOT A PERMIT ;r CATAWBA COUNTY HEALTH DEPARTMENT �e c Application for Environmental Services Page I 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 ❑ F n Property Address 2t 10 3 5 6 Jt' 0 4 1,01 Subdivision Lot # Acres `` Section/B1ocWPha�fse Driving Directions to Property � A -VX d L4� � r� �,l <P '� c \ S i,) e 17c i1 E W a NAME TO APPEAR ON PERMIT? ©'Owner ❑ Applicant ❑ Contractor OApplicant Contact Information U I Name �u�ce 1� It Z, V-'5 m I Address 11 3 l to 1� A Phone 3 2 S i, ell -j-41 I Cell Phone Owner Contact Information Name \x � 14 m --e t Z I Address i'� S�ft,n�-2 Phone 1\ S ;�„,� Z Cell Phone Contractor Contact Information NI Name Sp,�P H I Address S 00,,,E P t' = Phone e Cell Phone Z WHO WILL BE THE PRIMARY CONTACT? © Owner ❑ Applicant ❑ Contractor Description of Existing Structures on Site Q# of Bedrooms *f 3 Structure Dimensions /t/A 7q # of Occupants j 1= Basement ❑ Yes ❑t_ -No Basement Fixtures ❑ Yes No C Planned Future Additions or Improvements (Building Permit NOT requested at this time) ODescribe %'i%" •1 t' LL. Proposed Future Structure Dimensions # of Bedrooms *f if applicable z Are there easements or right-of-ways recorded on this property ❑ Yes 2 -No Describe Is a public water supply available on or adjacent to the above property" [Yes ❑ No Check type available ❑ Community Well ❑ Semi -Public Well i] County/City/Township Water Line Existing water supply in use Q 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) 0 W ca C 0 U W m H THIS IS NOT A PERMIT r, CATAWBA COUNTY HEALTH DEPARTMENT Application for Environmental Services Page 2 1 2 SM Proposed Facility Type ❑ Primary Residence ❑ New Residence ❑ Addition to Residence # of New Bedrooms *T -� Project Description �`�,� ����^� �0 A )�l Structure Dimensions # of Occupants Basement ❑ Yes 2 -No Basement Fixtures ❑ Yes EFNo ®'Accessory Structure(s) Describe � d x ;I 1 : A- # of New Bedrooms *'I if applicable Structure Dimensions # of Occupants /� Accessory Dwelling ❑ Yes ❑TIo Plumbing ❑ Yes [DN -0 Describe Plumbing Needed ❑ Multi -Family Residence # Units #Bedrooms per Unit*T Total # Bedrooms "t 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 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. tlf 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 transferable Signature of Owner or Agent X b Printed Name of Owner or Agent Date -7 X2 5 -10'k7, I inch = 40 feet �4S 98 9 2 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: 3724-13-02-6508 N/ N 146 Prepared for: J 6508 THIS IS NOT A LEGAL DOCUMENT Date: •7/25/2012 N P Co� r%%;� 4%% r- < C%v **%j A ., 60 l CO . Time: 4:59:17 PM I his neap product «.t< prepared from the COUM1111 C,-nuxN. \(' ,r:•.I,an nlorr.nnor S\,ICIII Catas+ha Count% has made eub,tanUal effort, to en,ute the uccum, } of !,,, atmn and I ,hvIine inform.u!on ont ,it tied on this map Cataksha Counn promotes and recout i n•nds the mdependcnt seuticalion of an, data contained on this map product b) the user I he ( ount, ofe_',,;;r. ba. in cmpio}ecs, agents and personnel disclaim, and shall not he held Kahle for any and all day ase,, hos, or hahthn, %shethcr direct. mdtrcct or onsequenual Much anus or mas arise from this map produ. t nr th, u,c thereof hN am person or er nw, Selected Parcel Number: 3724-13-02-6508 I inch = 46 feet I Prepared for: - - - -- — -- - -- •rte - � - ---- -.. -_-- - - - - - - -- - - `��� \ �� m r `V,1 -6-508, 0 949 I'j 0 F .,7 T.: !+ `_,`-\- 6 8' J(I_ �' �✓ � tis" ___ �J - i r/ Lf—�-----�-� I� •,4 .. �` � ,� Date: 7/2/2012 lime: l I:00: i I :+�I > THIS is NoT LecAl. DcxT.NtEN'r' CATAWBA COUNTY NC - Parcel Report Information Regarding Selected Parcel(s) Parcel ID: 3724-13-02=6308' Name: CROUCH KAREN H Name2: Address: 2314 20TH AVENUE CT NE Address2: City: HICKORY State: NC Zip: 28601-7954 Account: 181478 Calc Acreage: 0.74 Tax Map: 155H 01062B LRK: 53582 Deed Book: 2463 Deed Page: 1444 Subdivision Name: Subdivision Block: Lots: PT 3 Plat Book: Plat Page: Building Number: 2110 Street Name: 31ST AV DR NE Site Zip: 28601 Township: HICKORY Fire Code: ST. STEPHENS City Code: COUNTY State Road: 1500 Total Bldgs Value: Land Value: $21,000 Total Value: $21,000 Year Built: Year Remodeled: Last Sale Date: Last Sale Amount: Neighborhood: 56 Watershed: Watershed Split: Voter Precinct: P30 E911 District: HICKORY Zoning: R-2 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: CLYDE CAMPBELL Middle School: ARNDT High School: ST STEPHENS School Split: NO P&Z Case Number: Census Tract 2010: 010302 Census Block 2010: 2000 Small Area Plan: Agricultural District: Printed: Wednesday, July 25, 2012 11:00 AM .�ll'� 31sk 24�) �� � ISS► Le CP 4"J (Fit T.) n ve, ca e --IPO r IYNOvt A i -D lc fo k4 V