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Home My WebLink AboutRBPR-07-2012-16036.TIFTHIS IS NOT A PERMIT Case # RBPR-07-2012-16036 CATAWBA COUNTY HEALTH DEPARTMENT PLAN REVIEW APPLICATION FOR ENVIRONMENTAL SERVICES Residential Building Plan Review - Building New IMPROVEMENT Contractor COMPASS BUILDING & REALTY, LLC, 3535 N HWY 16, DENVER NC 28037-8267 13:7044833633 INFO@COMPASSBANDR.COM Owner GLADYS JOSEY, 3947 ANDERSON MOUNTAIN RD, MAIDEN NC 28650 H:828-238-8864 NAME TO APPEAR ON PERMIT Gladys Josey SITE ADDRESS: 3947 ANDERSON MOUNTAIN RD, MAIDEN NC 28650 PIN # 367704539831 NAME of SUBDIVISION: Lot # Section/Block PROPERTY SIZE: Square Feet Acres DIRECTIONS: HWY 16 S, RIGHT ON ANDERSON MOUNTAIN RD, APPROX 1/2 MILE ON RIGHT PRIMARY CONTACT: Contractor SEWER TYPE: Septic Tank GALLONS PER DAY: WATER SUPPLY: Private Well Public water is **NOT** available for this property. DESCRIBE WORK: New Single Family dwelling / No basement / Attached garage (on existing slab) / No bonus Room APPLICATION FOR: New Structure STRUCTURE TYPE: PRIMARY RESIDENCE FACILITY TYPE: Single Family Residence OTHER DESCRIPTION: DESCRIPTION OF 2 bedroom home (being removed due to fire ) EXISTING STRUCTURES ON SITE (IF ANY) DIM EXISTING STRUCTURE: NUMBER OF EXISTING BEDROOMS: 2 PROPERTY EASEMENTS: None NEW STRUCTURE DIM:: 40 x 76 BASEMENT? No # OF OCCUPANTS: 1 PROPOSED CONSTRUCTION BASEMENT FIXTURES? No PLUMBING REQUIRED? Yes 1 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: -_/�) 1/Z— 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: 80 SIDE: 15 REAR: 30 MAX HEIGHT: FEENAM E Improvement Permit Fee TOTAL FEES DATE FEE AMOUNT 07/25/2012 $150.00 $150.00 CHANGE WORK ORDER REQUIRING REDESIGN AND/OR RETRIP WILL INCURE AN ADDITIONAL CHARGE (SEE FEE SCHEDULE) 12.9 - ehapplicalion 07/25/2012 14:24 Page 1 of 3 THIS IS NOT A PERMIT CATAWBA COUNTY HEALTH DEPARTMENT Application for Environmental Services Page I 18 Z SM 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) 0 Application is for New Construction ❑ Existing Facility ❑ Property Address 3947 Anderson Mt. Rd. Subdivision Maiden, NC Lot # Acres 1.88 Section/Block/Phase Driving Directions to Property HWY. 16 to west on Anderson MT. Rd. follow approximately 1 - 2 miles, property is on the right. NAME TOPEAR . AP ON PERMIT? Q Owner ❑Applicant ❑Contractor Applicant Contact Information Name Address 3535 N. HWY 16 Denver, NC 28037 Phone 704-483-3633 I Cell Phone Owner Contact Information Name Neomia Josey Address 3947 Anderson Mt. Rd. Maiden NC Phone 828-464-7575 Cell Phone Contractor Contact Information Name Compass Building & Realty Address 3535 N. Phone 704-483-3633 I Cell Phone WHO WILL BE THE PRIMARY CON'TAC'T? ❑ Owner ❑Applicant 0 Contractor Description of Existing Structures t<Lctures �o,..,n.r, rSite destroyed o„fire ti „/_preparing repariing .t.o�d,yemol ish and ybuild ynew ,,e....,,.... .a.,. ..,,...�. ,.,,.�...... ,W...=. :�. # of Bedrooms *f 2 Structure Dimensions # of Occupants 1 Basement ❑ Yes 0 No Basement Fixtures ❑ Yes ❑ No Planned Future Additions or Improvementsu (Building Permit NOT requested at this time) Describe Proposed Future Structure Dimensions # of Bedrooms *t if applicable Are there easements or right-of-ways recorded on this property ❑ Yes K No Describe Is a public water supply available on or adjacent to the ab ❑ ove property._* .�,. Yes ®No. _ ..... ... _,,. _..... ... ,-_ Check type available ❑ Community Well ❑ Semi -Public Well ❑ County/City/Township Water Line Existing water supply in use Individual Well ❑Community Well ❑ Semi -Public Well ❑ County/City/Township Water Line EJ I WOULD LIFE TO SCHEDULE A COMBINED FLAGGING AND SOIL EVALUATION (SEE COMBINED EVALUATION PROCEDUES) s�$ THIS IS NOT A PERMIT CATAWBA COUNTY HEALTH DEPARTMENT Application for Environmental Services Page 2 1842 va Proposed Facility Type Q Primary Residence X New Residence ❑ Addition to Residence # of New Bedrooms *f 2 Project Description Demolish remainder of existing structure which was destroyed by fire. Build new 2 bedroom ranch home. Structure DimensionsL10 x 76- # of Occupants 1 Basement ❑ Yes X No Basement Fixtures ❑ Yes ❑ No ❑Accessory Structure(s) Describe # of New Bedrooms *t if applicable Structure Dimensions # of Occupants Accessory Dwelling ❑ Yes ❑ No Plumbing ❑ Yes ❑ No Describe Plumbing Needed ulti-Family Residence # Units #Bedrooms per Unit* f ❑ M Total # Bedrooms Structure Dimensions [] ,Food Service ,:.Specify TYPe..,.:..,,..:..�.:,.d,�d,.,,:�:`..�m..,..,.,.:,v,,�,:.:�.,�.:,�:....n...,zs�,�., # 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 J # 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. tIf 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 WORD ORDER REQUIRING REDESIGN AND/OR RETRIP WILL INCURE AN Lu� ADDITIONAL CHARGE (SEE FEE SCHEDULE) QI 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 ferable Signature of Owner or Agent Printed Name f O ner or Agent J'4 Date �� /� i I' til I inch = 100 feet 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: 3677-04-53-9831 R-40 Prepared for: ~' (160) PT 1 1 - 1- ,� Plat 7071': - - ! N - 1 4 OO Plat 22-213 1 THIS IS NOTA LEGAL DOCUMENT Date: 7/25/2012 Time: 2:29:06 PM 1 CATAWBA COUNTY NC - Parcel Report Information Regarding Selected Parcel(s) Parcel ID: 3677-04-53-9831 Name: JOSEY GLADYS N DRUM Name2: ' Address' 3947 ANDERSON MOUNTAIN RD Address2: City: MAIDEN State: NC Zip: 28650-9017 Account: 159772594 Calc Acreage: 1.88 Tax Map: LRK: 201623 Deed Book: 1670 Deed Page: 0177 Subdivision Name: Subdivision Block: Lots: PT 1 Plat Book: 70 Plat Page: 193 Building Number: 3947 Street Name: ANDERSON MOUNTAIN RD Site Zip: 28650 Township: CALDWELL Fire Code: BANDYS City Code: COUNTY State Road: Total Bldgs Value: $72,000 Land Value: $18,700 Total Value: $90,700 Year Built: 1952 Year Remodeled: Last Sale Date: Last Sale Amount: Neighborhood: 122 Watershed: WS-IV Protected Area Watershed Split: NO Voter Precinct: P1 E911 District: COUNTY Zoning: R-40 Zoning2: Zoning3: Zoning Split: N Zoning Overlay: DWMH-O,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: 011602 Census Block 2010: 3006 Small Area Plan: BALLS CREEK Agricultural District: Proximity Printed: Wednesday, July 25, 2012 02:29 PM