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Home My WebLink AboutRBPR-07-2013-17650.TIFContractor Owner THIS IS NOT A PERMIT Case # RBPR-07-2013-17650 CATAWBA COUNTY HEALTH DEPARTMENT PLAN REVIEW APPLICATION FOR ENVIRONMENTAL SERVICES Residential Building Plan Review - Accessory Structure IMPROVEMENT L7; 'f BOUREANU, CONSTANTIN CLAUDIU, 5155 ORCHARD PARK DR, HICKORY NC 28602- B:(828)320 -4225F:(866)530-4588 ADVANCEDELECTRICAL@HOTMAIL.COM MARCHS SULLIVAN, 956 ASHTON GLEN CIR, HICKORY NC 28602-7227 NAME TO APPEAR ON PERMIT Marchs Sullivan SITE ADDRESS: 956 ASHTON GLEN CIR, HICKORY NC 28602 PIN # 360901466110 NAME of SUBDIVISION: ASHTON GLEN PH 1 Lot # 55 Section/Block PROPERTY SIZE: Square Feet Acres 0.92 DIRECTIONS: HWY 321 S/ RT RIVER RD/ LF ZION CH RD/ RT PITTSTOWN RD/ LF FINGER BRIDGE RD/ RT ASHTON S DIV/TURN UP HILL/ ON LF/ LOT 55 PRIMARY CONTACT: Contractor SEWER TYPE: Septic Tank GALLONS PER DAY: 480 WATER SUPPLY: Public Water DESCRIBE WORK: 16 x 20 wood Accessory structure with electrical 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: STRUCTURE TYPE: FACILITY TYPE: Accessory Structure DESCRIPTION OF House EXISTING STRUCTURES ON SITE (IF ANY) DIM EXISTING STRUCTURE: 35 x 60 NUMBER OF EXISTING BEDROOMS: 4 NEW STRUCTURE DIM:: 16 x 20 BASEMENT? No New Structure ACCESSORY STRUCTURE OTHER DESCRIPTION: # OF OCCUPANTS PROPOSED CONSTRUCTION BASEMENT FIXTURES? No 4 PLUMBING REQUIRED? No Desired system types (Improvement Permit or Authorization to Construct): ACCEPTED: YES ALTERNATIVE: CONVENTIONAL: OTHER: INNOVATIVE : ANY: Other described: 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 and labeling of all property lines and corners and making the site accessible so that a complete site evaluation can be performed. Date: 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 AREA2 G9 - ehapplicalion 07/10/2013 17:00 Page 1 of A CATAWBA COUNTY Public Health Department Environmental Health Division PO Box 389, 100-A Southwest Blvd, Novton, NC 28658 Case 4, RBPR-07-20131-17650 Subdivision ASHTON GLEN PH 1 PIN# 360901466110 NAME ON PERMIT: Site Address: 956 ASHTON GLEN CIR, HICKORY NC 28602 Property Size: Square Feet Acres 0.92 Directions: HWY 321 S/ RT RIVER RD/ LF ZION CH RD/ RT PITTSTOWN RD/ LF FINGER BRIDGE RD/ RTASHTON S DIV/ TURN UP HILL] ON LF/ LOT 55 Improvement Permits issued as a result of this information are valid for 5 years of 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 identificatio andrbeling of all property lines and corners and making the site acMsible sVthat 4 complete site evaluation can be performed, Date: V7 710 '2 0 C2. Signature of Applicant or Agent kfox)t�. An Environmental Health Specialist will contact you within 2 days s of application date. :M I If you need further information or assistance please call 828-466-7291 AREA2 MINIMUM SETBACKS FRONT: 30 SIDE: 10 REAR: 5 MAX HEIGHT: FEENAME DATE FEE ANIOUNT Improvement Permit Fee 0711012013 $150.00 TOTAL FEES S.150.00 SYSTEM REDESIGN AND/OR RETRIP WILL INCUR AN ADDITIONAL CHARGE (SEE FEE SCHEDULE) I:) - - cA Im" 07/10/2013 16:35 Page 2 oril GIA"A nTHIS IS NOT A PERMIT � Ak IL COUNTY CATAWBA COUNTY HEALTH DEPARTMENT Application for Environmental Services Page I Improvement Permit M Authorization to Construct [I Septic Repair M Septic Malfunction ❑ Septic Expansion 0 New Well Permit 0 Replacement Well Ej Well Abandonment ❑ Well Repair M Existing System Inspection (Pre -Approval Required) ED Application is for New Construction M Existing Facility 0 Property Address '�56 4-5�)6) Glir, n C� C, Subdivision G)�f V1, WC(i0Q,1 —hic, 2- P-,6 o L Lot # Acres Section/BlocklPhase Driving Directions to Property NAME TO APPEAR ON PERMIT? [Owner E] Applicant ❑ Contractor Applicant Contact Information Narnoc Address Phone Cell Phone Owner Contact Information I Name M OC- Ctj ili%,40 Address 95-6 44-A-0" Ort v -N _��E Phone Cell Phone Contractor Contact Information Address -Y-oQy Nc- Phone Cell Phone WHO WILL BE THE PRIMARY CONTACT? ❑ Owner R Applicant contractor Description of Existing Structures on Site # of Bedrooms *t 11 Structure Dimensions '15 X 6 D 9 of Occupants 4f Basement [Yes 0 No Basement Fixtures F Yes T4 -Vo notify �e`ith The Applicant shall the local a epa n n 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, D Yes � No Does the site contain any jurisdictional tis,etiiiids? 0 Yes 15 No Does the site contain any existing wastewater systems? (3 Yes IS No Is any wastewater going to be generated oil the site other than domestic sewage? 0 Yes 9 No Is the site subject to approval by any other public agency? 0 Yes El No Are there any easements oi- right of ways on this property? Describe Existing water supply in use ividual Well Community WellSerni-Public Well 2'County/City/Townsbip Water Line Is a public water supply available? F1 Yes F -I No If applying for an Improvement Permit or Authorization to Construct, Please Indicate Desired System Type(s): (systems can be ranked in order of your preference) l�cceptecl 0 Alternative 0 Conventional 0 Innovative 0 Other 0 Any C ATA BA THIS IS NOT A PERMIT Cflt)NTY yY CATAWBA COUNTY HEALTH DEPARTMENT Application for Environmental Services Proposed Facility Type ❑ Primary Residence F-1 New Residence ❑ Addition to Residence # of New Bedrooms *' Project Description Structure Dimensions # of Occupants Basement ❑ Yes ❑ No Basement Fixtures ❑ Yes ❑ No {� Accessorys `rt () Describe bl#of t `1Structure New Bedrooms *t applicable Dti en%sns t # of Occupants Accessory Dwelling ❑ Yes ❑ No Plumbing ❑ Yes [,No Describe Plumbing Needed ❑ Multi -Family Residence## Units #Bedrooms per Unit*f 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 Shirt # 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 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 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. 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 RETRIP WILL YNCUR AN ADDITIONAL CHARGE (SEE FEE SCHEDULE) 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 Constrict issued by this department is valid for (5) live 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 comers and making the site accessible so that a complete site evaluation can be performed. Signature of Owner or Aget!-)'-,`> �v� �2,n v Date Po /?4,?/ 3 Printed Name of Owner or Agent Q...%" ;-_TAA, CATANN7BA Geospatial Information Services Real Estate Search N w + 1 Parcel: 360901466110, 956 ASHTON GLEN CIR HICKORY, 28602 Owners: SULLIVAN MARCUS RAY, SULLIVAN TERRI HUNT Owner Address: 956 ASHTON GLEN CIR Values - Building(s): $219,600, Land: $28,200, Total: $247,800 "--1 lin=100ft This maptreport 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 map/report product or the use thereof by any person or entity. Copyright 2012 Catawba County NC 07/10/2013 u • 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. 'rhe 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: 3609-01-46-6110 1 inch = 79 feet Prepared for: 73113' �. `.965 w 53 4 R-00. 980 18 �f i TO -N r - �' 7233 4 ! r 61 26.'24-18.76, 19 / -817&�-24.93 sz T p4 00;01 4142 20. 10') ao 55 - ,` 2 3.03,,. 54 ��- 4J� Llt 3 61 0 8&-00 • � 380.;05 25.244I 114 1 9055,,�y 44 recr.",estion lot 1 �. R-20 f C I � wn - m . �; .945 rt R-40 1 THIS IS NOT A LEGAL DOCUMENT Datet:,7/10/2013. Time: 4/38:43yyI'M CATAVVBACOUNTY NC Parcel Report Information Regarding Selenh»dPonm|(s) Farce /D: 3609'01'46'6110 Name: SULLIVAN MARCUS RAY Nomo2: ^ SULLIVAN TERR|HUNT Address: 95SAQHTONGLEN C|R Addrens2:, City: HICKORY State: NC 4p 28602-7227 Account: Calc o: 0.92 Tax Map: LRK: 700753 Deed Book: 2597 Deed 0016 5uUdw|nmn Name: ASHT0N GLEN PH 1 Subdivision Block: Lots: 55 Plat Book: 52 Plat 66 Building Number: 956 Street Name: ASHTON GLEN C|R Site Zip: 28802 Township: JACOBS FORK Fire Dist: PROPST City/Tax: State Road: Total Bldgs Value: $219,600 Land Value: $28.200 Total Value: $247.800 Year Built: 2002 Year Remodeled: Last Sale Date: 7/302004 Last Sale Amount: $250.000 Neighborhood: 80 VVohamhod: VVS'}1|Protected Area Watershed Split: NO Voter Precinct: P3 E811 District: COUNTY Zoning: R-20 Zbning2: Zoning Split: N Zoning Overlay: WP -0 Zoning District: COUNTY Split Zoning Dist: N Split Zoning Dist(l): 0 Split Zoning Dist(2): 0 School District: COUNTY Elementary School: BLACKBURN Middle School: JACOBS FORK High School: FRED TFOAND School Split: NO r&Z Case Number: LOMA2-2O-20O2 Census Tract %01D:011802 Census Block 2O1U:3OUO 8meUArnoP|on: K4OUNTA|NV|EVV Agricultural Printed: Wednesday, July 1O.2O13O4:38PyN