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HomeMy WebLinkAboutRBPR-07-2013-17649.TIFTHIS IS NOT A PERMIT Case # RBPR-07-2013-17649 CATAWBA COUNTY HEALTH DEPARTMENT Ma . PLAN REVIEW APPLICATION FOR ENVIRONMENTAL SERVICES Residential Building Plan Review - Building New IMPROVEMENT - AUTH CONST f❑� Contractor BOUREANU, CONSTANTIN CLAUDIU, 5155 ORCHARD PARK DR, HICKORY NC 28602- B:(828)320 -4225F:(866)530-4588 ADVANCEDELECTRICAL@HOTMAIL.COM Owner ABERNETHY PARK LIMITED, 2850 SAINT GEORGE RD, WINSTON SALEM NC 27106 NAME TO APPEAR ON PERMIT BOUREANU, CONSTANTIN CLAUDIU SITE ADDRESS: 1530 KENSINGTON PARK CT, HICKORY NC 28602 PIN # 279008888206 NAME of SUBDIVISION: ABERNETHY PARK PH 9 Lot # 75 Section/Block PROPERTY SIZE: Square Feet Acres 0.47 DIRECTIONS: Zion Church Rd / Left Pittstown / Left Abernathy Park / right Orchard Park Dr / Right Regents Park Dr / Right Kensington Park Ct PRIMARY CONTACT: Contractor SEWER TYPE: Septic Tank GALLONS PER DAY: 480 WATER SUPPLY : Public Water DESCRIBE WORK: Single Family Dwelling / No basement / attached garage / Finished 500 sf bonus room SITE INFORMATION Do any of the following apply to the property for which this application is applied? If the answer to any of the questions below is "YES", then supporting documentation is required: Does this site contain any jurisdictional wetlands? No Does this site contain any existing wastewater systems? No Is any of the wastewater going to be generated on the site other than domestic sewage? No Is the site subject to approval by any other public agency? No Are there any easements or right-of-ways on this property? No APPLICATION FOR: New Structure STRUCTURE TYPE: PRIMARY RESIDENCE FACILITY TYPE: Single Family Residence OTHER DESCRIPTION: DESCRIPTION OF EXISTING STRUCTURES ON SITE (IF ANY) DIM EXISTING STRUCTURE: NUMBER OF EXISTING BEDROOMS: # OF OCCUPANTS: 5 PROPOSED CONSTRUCTION NEW STRUCTURE DIM:: 64 x 60 # OF NEW BEDROOMS:: 4 BASEMENT? No BASEMENT FIXTURES? No PLUMBING REQUIRED? Yes Desired system types (Improvement Permit or Authorization to Construct): ACCEPTED: YES ALTERNATIVE: CONVENTIONAL: OTHER: INNOVATIVE: ANY: Other described: I:9 - chaphlication 07/10/2013 16:57 Page I of CATAWBA COUNTY Public Health Department Environmental Health Division 110 Box 389, 100-A Southwest Blvd, Newton. NC 28658 I NAME ON PERMIT: Site Address: 1530 KENSINGTON PARK CT. 14ICKORY NC 28602 Property Size: Square Feet Acres 0A7 Directions: Zion Church Rd / Left Pittstown Left Case 4 RBPR-07-2013-17649 Subdivision ABERNETHY PARK PH 9 PIN4 279008888206 Improvement Permits issued as a result of this information are valid for 5 years or may be non -expiring under certain specified conditions. An Authorization to Construct issued by this department is valid for (5) five years from the date issued and is not transferable; Improvement Permits and Well Permits are transferrable. Permits may be revoked if the information on this application, site plans or intended use changes for the proposed facility. I have read this application and certify that the information provided herein is true, complete and correct. Authorized county and state officials are granted right of entry to conduct necessary inspections to determine compliance with applicable laws and rules. I understand that I am solely responsible for the proper identification a labeling of allproperty lines and corners and making the site aci6epsible so that p complete valuation can be performed. Date: Signature ot'Applicant or Agent -Oil 5_61cl�lv\ �4'� An Environmental Health Specialist will contact you within 2 working days of application date. If you need further infonnation or assistance please call 828-466-7291 AREA2 MINIMUM SETBACKS FRONT: 20 SIDE: REAR: 18 MAX HEIC;HT: FEENAME, DATE FEE AMOUNT Authorization to Construct Fee (New/Expansion) 07/10/2013 $300.00 Fee Improvement Permit Fee 07/10/2013 $150.00 TOTAL FEES $450.00 SYSTEM REDESIGN AND/OR RETRIP WILL INCUR AN ADDITIONAL CHARGE (SEE FEE SCHEDULE) 07/10/200 16:03 ['age 2 of4 CATAWBA nTHIS IS NOT A PERMIT COUNTY CATAWBA COUNTY HEALTH DEPARTMENT Application for Environmental Services Page I Improvement Permit i Authorization to Construct ry, Septic Repair 0 SepticlMalfunction❑ Septic Expansion R New Well Permit [I Replacement Well El Well Abandonment ❑ Well Repair 0 Existing System Inspection (Pre -Approval Required) Application is for New Construction ❑ Existing Facility ❑ Property Address l GS D kC_0Sn _61 T&,,CtSubdivision �7 ' Lot # �;- Acres ------------ Sectiort/B(ock[Phase Driving Directions to Property INAME TO APPEAR ON PERMIT? ❑Owner nApplicant [contractor Applicant Contact Information Name 1 Address Gia h C— t Phone b 0 9XIIII� Cell Phone Owner Contact Information Name Address Phone Cell Phone Contractor Contact Information 1 Name Address Phone Cell Phone WHO WILL BE THE PRINLARY CONTACT? FlOwner ❑Applicant 1Contractor Description of Existing Structures on $ite # of Bedrooms *t 14 Structure Dimensions '�,(o 0 9 of Occupants 4�-;7 Basement M Yes %,,No Basement Fixtures ❑ Yes ❑ No The Applicant shall notify the local health department upon submittal of this application if any of the following apply to the property in question. If the answer to any question is "yes", applicant must attach supporting documentation. 0 Yes KNo Does the site contain any jurisdictional wetlands? 0 Yes allo Does the site contain any existing wastewater systems? Cl Yes �Q No Is any wastewater going to be generated on the site other than domestic sewage? 0 Yes N No Is the site subject to approval by any other public agency? 0 Yes t&,No Are there any easements or right of ways on this property? Describe ' '❑ 'Individual'i' ' "❑ ... ...... . . ­ ' ' ' ' ' ' " " ' 11 Existing water supply in use M Well M Community Well 0 Semi -Public Well County/City/Township Water Line Is a public water supply available? ** Fl Yes F-1 No If applying for an Improvement Permit or Authorization to Construct, Please IndicateDesired' System Type(s). IW( stems can be ranked in order of your preference) Accepted 0 Alternative 0 Conventional 0 Innovative Cl Other 0 Any CA+"('AW A THIS IS NOT A PERMIT CC>UC+�TY L31`3 CATAWBA COUNTY HEALTH DEPARTMENT Application for Environmental Services Proposed Facility Type �} Primary Residence n New Residence ❑ Addition to Residence # of New Bedrooms *t �{ Project Description i W �)C f*) <:, Structure Dimensions K ' 0 # of Occupants ' Basement ❑ Yes K No Basement Fixtures © Yes ❑ No ❑ Accessory Structure(s) Describe # of New Bedrooms *f if applicable Structure Dimensions # of Occupants Accessory Dwelling ❑ Yes ❑ No Plumbing ❑ Yes ❑ No Describe Plumbing Needed ❑ Multi -Family Residence # Units #Bedrooms per Unit*� 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 ❑1 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 Page 2 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 confirnted 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. t 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. SYSTEM REDESIGN AND/OR RETRTP WILL INCUR AN ADDITIONAL CHARGE (SEE FEE SCHEDULE) improvement Permits issued as a result of this information are valid for S years or may be non -expiring under certain specified conditions. An Authorization to Construct issued by this department is valid for (S) five years from the date issued and is not transferable; Improvement Permits and Well Permits are transferrable. Permits may be revoked if the information on this application, site plans or intended use changes for the proposed facility. I have read this application and certify that the information provided herein is true, complete and correct. Authorized county and state officials are granted right of entry to conduct necessary inspections to determine compliance with applicable laws and rules. I understand that I am solely responsible for the proper identification and labeling of all property lines and corners and making the site accessible so that a complete site evaluation can be performed. Signature of Owner or Agent")tA31—A.'�"t �v Datel I3d �+ r Printed Name of Or�vner or Agent C_lJt`t ` j A-NT1 ty> ^� t ;r N, y CATAWBA Geospatial Vl'\ Tl Information services Rea! Estate Search N w+t S Parcel: 279008888206, 1530 KENSINGTON PARK CT HICKORY, 28602 Owners: ABERNETHY PARK LIMITED, Owner Address: 2850 SAINT GEORGE RD Values - Building(s): $0, Land: $26,800, Total: $26,800 1 in=50ft 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 maptreport product or the use thereof by any person or entity. Copyright 2012 Catawba County NC 07/1012013 Catawba County, North Carolina This map product was prepared from the Catawba County, NC, Geospaual 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 "fhe Countv of Catawba, its employees, agents and E personnel disclaim, and shall not be held liable for anv and all damages, loss or liability, whether direct, indirect or consequential which arises or may arise from this map product or the use thereof be any person or entity Selected Parcel Number: 2790-08-88-8206 ; 1 inch = 79 feet 1 Prepared for: UJJI �I R-20 X44. j g3 151° a . Plait -71-123 sot f 140' O. , (5— �9J ii 74 s6 r -Cb 3j �. , 3) 76 17 l' 73 O 8384 x/75 _ Plat 70=16 i8 .. 82.06 y0 f 209, 3�j p0 3S 00 76 3 0290 C R.-40 (0ry 7184 241.91 lb 77 7 � 8 77 I - 97 ,�Ak r -- - —' 27.71 tom,, i 7047 Pla 0-16 �' ;.�j 0097 \\ LL 78 273h� �' /9589 , 0 Q` _ w O O ; 90 0- 0 690 --. �(- �� moo° \\ �;' 0040 ` ��5� Plat 71\0-11 Flat 72,-,88 �� 't . �� ( Plat 49-125 � N� .__ ,� 7; 0903 7 Date: 7/10/2013 Time: 4:48:14 PM THIS 1S NOT A LEGAL DOCUMENT,,'' CATAWBA COUNTY NC - Parcel Report Information Regarding Selected Parcel(s) ParcelID: 2790-08-88-8206 . Name: ABERNETHY PARK LIMITED Name2: Address: 2850 SAINT GEORGE RD Address2., City: WINSTON SALEM State: NC Zip: 27106-5029 Account: Calc Acreage: 0.47 Tax Map: LRK: 606778 Deed Book: 3045 Deed Page: 0183 Subdivision Name: ABERNETHY PARK PH 9 Subdivision Block: Lots: 75 Plat Book: 70 Plat Page: 16 Building Number: 1530 Street Name: KENSINGTON PARK CT Site Zip: 28602 Township: HICKORY Fire Dist: MOUNTAIN VIEW City[Tax: State Road: Total Bldgs Value: Land Value: $26,800 Total Value: $26,800 Year Built: Year Remodeled: Last Sale Date: Last Sale Amount: Neighborhood: 80 Watershed: WS-III Protected Area Watershed Split: NO Voter Precinct: P23 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: MOUNTAIN VIEW Middle School: JACOBS FORK High School: FRED T FOARD School Split: NO P&Z Case Number: Census Tract 2010: 011801 Census Block 2010: 3005 Small Area Plan: MOUNTAIN VIEW Agricultural District: Printed: Wednesday, July 10, 2013 04:48 PM ti . CATAWBA COUNTY ar �•.�����\ Publi: Health Department Case # W LS2007-00809 < v ` Environmental Health Division Subdivision ABERNETHY PARK PH 8 `d \\7 / PO Box 389, 100-A Southwest Blvd, Newton, NC 28658 SecdBUPh/Lot # 75 (828) 465-8270 FAX (828),165-8276 TDD (828) 465-8200 PIN# 911279008974976-75 Applicant/Owner ABERNETHY PARK LIMITED Site Address: 1530 KENSINGTON PARK CT pa-k—J Property Size: SF 20225 ACRES Directions: BETHEL CHURCH RD /LEFT PITTSTOW N RD/ LEFT ABERNETHY PARK DR/ RT ORCHARD PARK DR/ RT REGENTS PARK DR/ RT KENSINGTON PARK CT Q Improvement Permit Permit Valid For: Five years v No Expiration � Facility (Residential): House / House X Mobile Home Multi -Family Bedrooms _4 New? t! Addition? Projected Daily Flow Li. &0 g.p.d Water Supply Private Well? Public? �/ Semi -Public? Basement: N Basement Plumbing: HotTub/Spa: N Special Fixtures (explain): ��a.�F,�� Proposed Wastewater System: �Se7. ________ Type: Proposed Repair: Soy. ��an��l; �, I_!'P d.'sFr,b r,.. i bR�-�1 r S�<,�:r-a Permit Conditions: ' A I I �.. r� a o f Sia c M J{ 10 — e% t n,/ �• 1.<0' I S ' pr.•.� ino • 1 to ' Cr ,. Oroo,,ifY i'Tn�f<il �.�� -n Con+o✓/yJO n.+��d` i�rivt IcrF;lll o•r <vSh=•+)r7!'�;r ++ Owner or Legal Representative Si atuW: 1 �t M/�/� /ii�JZ.tLt� Date: Authorized State Agent: `Y� Date: The issuance of this permit by the He apartment does not guarantee the issuance of other permits. It is the responsibility of the applicandproperty owner to insure that all Catawba County Planning/Zoning and Building inspections requirements are met. This Improvement Permit is subject to revocation if the site plan, plat or the intended use changes, or if site conditions are altered. The Improvement Permit is not affected by a change in ownership of the property. This permit was issued in compliance with the provisions of the North Carolina 'Laws and Rules for Sewaee Treatment and Disposal Systems' (15A NCAC 18A .1900). Neither Catawba County nor the Environmental Health Specialist warrants that the septic tank system will continue to function satisfactorily for any given period of time. Authorization to Construct Wastewater Svstem (Required for Buildinq Permit) * See site plan and additional attachments ( ). Proposed Wastewater System: Type: Wastewater Flow New Repair Expansion Soil LTAR: g.p.d.M2 Type of Facility: Basement: N Basement Plumbing: HotTub/Spa: N Special Fixtures (explain): Wastewater Svstem Requirements Tank Size: Septic Tank gal Pump Tank gal Grease Trap gal Drainfield: Total Area: sq It Total Length: ft Maximum Trench Depth Trench Width ft Minimum Soil Cover in Minimum Trench Seperation Distribution: Distribution Box Serial Distribution Pressure Manifold LPP Other Additional Specifications: Authorized State Agent: Date: Permit Expiration Date- / have read and accept the specifications and all conditions of this permit as indicated. Owner or Legal Representative Signature: r: \Tidrmurk\ronnsV WLSnoa rpt Date: in g.p.d Form B IT r -CATAWBA COUNTY / � 4 �\ Pub4 Health Department Case # W LS2007-00809 Environmental Health Division Subdivision ABERNETHY PARK PH 8 \J `/ PO Box 389. 100•A Southwest Blvd, Newton, NC 28658 Sect/BUPh/Lot # 75 i M l / (828) 465-8270 FAX (828) 465-8276 TDD (828) 465-8200 PIN# 911279008974976-75 ApplicanUOwner ABERNETHY PARK LIMITED Site Address: 1530 KENSINGTON PARK CT Property Si SF 2022 ACRES Directions: BETHEL CHURCH RD /LEFT PITTSTOW N RD/ LEFT ABERNETHY PARK DR/ RT ORCHARD PARK DR/ RT REGENTS PARK DR/ RT KENSINGTON PARK CT ® Improvement Permit Authorization To Construct SITE PLAN 0 o Sdt T M 50 ° _M � U Zn.t,�I S�/shy. as5o Q..a - i q 1So,ott M Well Permit S'/S+—M {. b, — e � ik� I1,,,_') r- k ,r 1, I = (0o Scale System components represent approximate contours only. The contractor must flag the system prior to beginning the installation to ensure that proper grade is maintained. Do not install system under wet conditions. This permit is subject of revocation if the site plan or site conditions are altered. L � I� log Authte dState A ent Date Form C r\Tidemurk\Fn m.N W LSnnn. rm DEPARTMENT OF ENVIRONMENT AND NATURAL RESOURCES Sheet—of— DIVISION OF ENVIRONMENTAL HEALTH PROPERTY ID #: ON-SITE WASTEWATER SECTION COUNTY: SOIL/SITE EVALUATION for ON-SITE WASTEWATER SYSTEM OWNER APPLICATION DATE ADDRESS: DATE EVALUATED: I -7, °V I Ir" PROPOSED FACILITY: 461Z Nol PROPOSED DESIGN FLOW (.1949): fASO PROPERTY SIZE. 2- LOCATION OF SITE: ly 9- r k Tt 1 ,5 PROPERTY RECORDED: WATER SUPPLY: 0 Private ("Public Weil 0 spring 0 Other EVALUATION METHOD: 0 Auger Boring Pit 0 cut TY PF OF WASTEWATER 9/Sewage 0 Industrial Process 0 Naed ............ ............... .............. ..... ........... ............... ............. ...... ............... ................... ................. ...... 0 Emo AOL. 00- ............. ...... ............ ............... ............ is ................ - ............... gg.. ............. .................... ..................... .......... ...... ...................... .......... .... ........ ............................ ....... ............... ................... ...... ................. ....................... ...•.......... ............... ....... ............ .... .... .... . .......... . ....... ........ .................... ............... ..................... ........... ............ ........... MOVIL $�� ............. RO 10. ........... ..... ... .......... g ST r ................... ..... . .......... ..................... ............... .... .. .... ............... ...... ....................... ............ . ......................................... ....... ........ ............. ........ .... 4t Cr LN 11 -36," is If Pi jexp I 2 I ro DESCRIPTION Available Space (.1945) BUIALSYSTEM U-PAMSYSTFM PS I OTHER FACTORS (.1946): SITE CLASSIFICATION (.1948): nr SystemType(s) A EVALUATED BY: OTHER(S) PRESENT: Site LTAR' COMMENTS: 7 6"