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Home My WebLink AboutRBPR-07-2013-17670.TIF1842 SM Contractor Owner THIS IS NOT A PERMIT Case # RBPR-07-2013-17670 CATAWBA COUNTY HEALTH DEPARTMENT PLAN REVIEW APPLICATION FOR ENVIRONMENTAL SERVICES Residential Building Plan Review - Accessory Structure IMPROVEMENT SMITH, TIM, 1433 RING TAIL RD, CLAREMONT NC 28610 B:828-464-2304 C:8283101909 TONY HOLLAR, 5577 RIVER BEND RD, CLAREMONT NC 28610 H:828-459-9300 HOME:828-459-9300 NAME TO APPEAR ON PERMIT TONY HOLLAR SITE ADDRESS: 5577 RIVER BEND RD, CLAREMONT NC 28610 NAME of SUBDIVISION: PIN # 376403221292 Lot # A Section/Block PROPERTY SIZE: Square Feet Acres 1.03 DIRECTIONS: 16N/ RT 1 ST RIVER BEND RD/ LAST HOUSE ON LEFT/ CLOSE TO OXFORD SCH L,RD PRIMARY CONTACT: Contractor SEWER TYPE: eptic T_anl� GALLONS PER DAY: 360 WATER SUPPLY: Private Well DESCRIBE WORK: PVT ACCESSORY BUILDING 30 X 53 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? Yes 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? Yes Are there any easements or right-of-ways on this property? No APPLICATION FOR: N.e:W StruC:tu,t'e STRUCTURE TYPE: _ (—PRIMARY RESIDENCE_._..--:�> FACILITY TYPE: Single Family Residence OTHER DESCRIPTION: DESCRIPTION OF SINGLE FAMILY DWELLING EXISTING STRUCTURES ON SITE (IF ANY) DIM EXISTING STRUCTURE: 80 X 40 NUMBER OF EXISTING BEDROOMS: 3 # OF OCCUPANTS: 2 PROPOSED CONSTRUCTION NEW STRUCTURE DIM:: 30 X 53 Desired system types (Improvement Permit or Authorization to Construct): ACCEPTED: ALTERNATIVE : CONVENTIONAL: OTHER: INNOVATIVE: ANY: Other described.- Improvement escribed: 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 MINIMUM SETBACKS FRONT: 30 SIDE: 10 REAR: 5 MAX HEIGHT: V9 - chapnlicatinn 07/15/2013 17:08 Page 1 of 4 IgA CATAWBA COUNTY Case # RBPR-07-2013-17670 nQ' Public Health Department Subdivision Environmental Health Division PIN# 376403221292 184�M PO Box 389, 100-A Southwest Blvd, Newton, NC 28658 2 NAME ON PERMIT: TONY HOLLAR, 5577 RIVER BEND RD, CLAREMONT NC 28610 Site Address: 5577 RIVER BEND RD, CLAREMONT NC 28610 Property Size: Square Feet Acres 1.03 Directions: 16N/ RT 1 ST RIVER BEND RD/ LAST HOUSE ON LEFT / CLOSE TO OXFORD SCHOOL RD FEENAME Improvement Permit Fee TOTAL FEES DATE FEE AMOUNT 07/15/2013 $150.00 $150.00 SYSTEM REDESIGN AND/OR RETRIP WILL INCUR AN ADDITIONAL CHARGE (SEE FEE SCHEDULE) 1,9 - chapplUcatiot) 07/15/2013 17:08 Page 2 of 4 THIS IS NOT A PERMIT Case # RBPR-07-2013-17670 CATAWBA COUNTY HEALTH DEPARTMENT PLAN REVIEW APPLICATION FOR ENVIRONMENTAL SERVICES Residential Building Plan Review - Accessory Structure IMPROVEMENT Contractor SMITH, TIM, 1433 RING TAIL RD, CLAREMONT NC 28610 13:828-464-2304 C:8283101909 Owner TONY HOLLAR, 5577 RIVER BEND RD, CLAREMONT NC 28610 H:828-459-9300 HOME: 828-459-9300 NAME TO APPEAR ON PERMIT TONY HOLLAR ❑'R 0 SITE ADDRESS: 5577 RIVER BEND RD, CLAREMONT NC 28610 PIN # 376403221292 NANIE of SUBDIVISION: Lot # A Section/Block PROPERTY SIZE: Square Feet Acres 1.03 DIRECTIONS: 16N/ RT 1 ST RIVER BEND RD/ LAST HOUSE ON LEFT / CLOSE TO OXFORD SCHOOL RD PRIMARY CONTACT: Contractor SEWER TYPE: Public Sewer GALLONS PER DAY: 360 WATER SUPPLY: Private Well DESCRIBE WORK: PVT ACCESSORY BUILDING 30 X 53 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? Yes 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? Yes Are there any easements or right-of-ways on this property? No APPLICATION FOR: New Structure STRUCTURE TYPE: ** NO STRUCTURE SELECTED *' FACILITY TYPE: Single Family Residence OTHER DESCRIPTION: DESCRIPTION OF SINGLE FAMILY DWELLING EXISTING STRUCTURES ON SITE (IF ANY) DIM EXISTING STRUCTURE: 80 X 40 NUMBER OF EXISTING BEDROOMS: 3 # OF OCCUPANTS: 2 PROPOSED CONSTRUCTION NEW STRUCTURE DIM:: 30 X 53 Desired system types (Improvement Permit or Authorization to Construct): ACCEPTED: 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 identificati andoelingp. f II property lines and corners and making the site access o that a comp) site evaluati n be performed. Date:—- / Signature of Applicant orAG%/ _\ 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 I y - chapplicallo❑ 07/15/2013 0947 Page I of4 ypA CATAWBACOUNTY Case RBPR-07-2013-17670 Public Health Department Subdivision Environmental Health Division PIN# 376403221292 PO Box 389,, 100-A Southwest Blvd, Newton, NC 28658 1842 su NAME ON PERMIT: TONY HOLLAR, 5577 RIVER BEND RD, CLAREMONT NC 28610 Site Address: 5577 RIVER BEND RD, CLAREMONT NC 28610 Property Size: Square Feet Acres 1.03 Directions: 16N/ RT 1 ST RIVER BEND RD/ LAST HOUSE ON LEFT / CLOSE TO OXFORD SCHOOL RD MINIMUM SETBACKS FRONT: 30 SIDE: 10 REAR: 5 MAX HEIGHT: FEENAME Improvement Permit Fee TOTAL FEES DATE FEE AMOUNT 07/15/2013 $150.00 $150.00 SYSTEM REDESIGN AND/OR RETRIP WILL INCUR AN ADDITIONAL CHARGE (SEE FEE SCHEDULE) E9 - ehaPhliratiort 07/15/2013 09:47 Page 2 of4 CA'lAV V BA THIS IS NOT A PERMIT CO unTI y y CATAWBA COUNTY HEALTH DEPARTMENT North Cnro—� Application for Environmental Services Page 1 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 ❑ Property Address rl 'R 1 V-e<DA, • Subdivision C--Cc-r C� � h 10 Lot # Acres Section/Block/Phase Driving Directions to Property NAME TO APPEAR ON PERMIT? Owner ❑ Applicant contractor Applicant Contact Information v, Name Address I l,i ft04-r, •,�( Phone 26A -'Cell Phone Owner Contact Information Name -T-0 0, c,q ! _ cs r Address .� 51-' i 1� �C �7 ; _. y ° �� Gc rt° n) rio" Phone Hc; q— q 6 o (D I Cell Phone Contractor Contact Information Name 1 1. n-\ ,� - D� 5 -_ U__ _�.' Address / Phone f14 Cell Phone 6 1P ! 01�1 WHO WILL BE THE PRIMARY CONTACT? ❑ Owner ❑ Applicant �] Contractor )f Description of Existing Structures on Site c i CL--; ttr)cd-e_ _ , # of Bedrooms *t �j Structure Dimensionsof Occupants Basement] 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. ❑ Yys ;1 No Does the site contain any jurisdictional wetlands? 'Yes ❑ No Does the site contain any existing wastewater systems? ❑ YY s ;9 No Is any wastewater going to be generated on the site other than domestic sewage? `'Yes _0 No Is the site subject to approval by any other public agency? ❑ Yes '] No Are there any easements or right of ways on this property? Describe Existing water supply in use Individual Well ❑ Community Well ❑ Semi -Public Well ❑ County/City/Township Water Line Is a public water supply available? ** ❑ Yes ❑ 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) 0 Accepted 0 Alternative 0 Conventional ❑ Innovative ❑ Other pon(h 0 Any CATAWBA THIS IS NOT A PERMIT coin rY ,_--- - CATAWBA COUNTY HEALTH DEPARTMENT No.m c ,o Application for Environmental Services Page 2 Proposed Facility Type ❑ Primary Residence ❑ New Residence ❑ Addition to Residence # of New Bedrooms * j Project Description Structure Dimensions # of Occupants Basement ❑ Yes ❑ No Basement Fixtures ❑ Yes ❑ No ❑., Accessory Structure(s) .,, Describeb ret P h, LA I � S � � # of New Bedrooms *t if applicable Structure Dim&rasions "�i0 V 5 # of Occupants Accessory Dwelling [:]Yes O No Plumbing ❑ Yes ®,No Describe Plumbing Needed a ❑� Multi -Family Residence idence #Units #Bedrooms per Unit*'l Total # Bedrooms * j Structure Dimensions ❑J Food Servicep fy S eci 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 Floor1 Space # of Employees per Shift # of Shifts ❑ Other Facility Type f Speciy If Church # of Seats Kitchen ❑ Yes ❑ No If Daycare Specify Occupancy Application for Well Construction/Abandonment/Repair Proposed Well Type F-1 Individual Well ❑ Semi -Public Well ❑ Community Well Abandonment Type ❑ Drilled ❑ Bored ❑ Dug ❑ Unknown Well Repair Requested ❑ Yes ❑ No Describe Calculated Design Flow, Commercial j 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. 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 INCUR 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 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. Signature of Owner or Agent , (Yf t , �# -;� r `%�� Date 0 Gt Printed Name of Owner or Agent ` t- j f� �' j 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 N 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: 3764-03-22-1292 I inch = 60 feet Prepared for: .1 6A 0 34 2 x ;'tl�2d 1 0'3/A �— 12-9/ Gj 1,53 10 .88/1 U S" C 13Y THIS IS NOT A LEGAL DOCUMENT Date: 7/15/2013 TG_e_9:2!:'5;AM Dots/ CATAWBA COUNTY NC - Parcel Report Information Regarding Selected Parcel(s) Parcel ID: 3764-03-22-1292 Name: HOLLAR TONY WAYNE Name2: HOLLAR LORI Y Address: 5577 RIVER BEND RD Address2: City: CLAREMONT State: NC Zip: 28610-8133 Account: Calc Acreage: 1.03 Tax Map: 1700 00130A LRK: 92142 Deed Book: 1759 Deed Page: 0768 Subdivision Name: Subdivision Block: Lots: A Plat Book: 30 Plat Page: 133 Building Number: 5577 Street Name: RIVER BEND RD Site Zip: 28610 Township: CLINES Fire Dist: OXFORD City/Tax: State Road: 1704 Total Bldgs Value: $161,500 Land Value: $13,200 Total Value: $174,700 Year Built: 1992 Year Remodeled: Last Sale Date: Last Sale Amount: Neighborhood: 67 Watershed: WS-IV Protected Area Watershed Split: NO Voter Precinct: P27 E911 District: COUNTY Zoning: R-30 Zoning2: Zoning3: Zoning Split: N Zoning Overlay: WP-0 Zoning District: COUNTY Split Zoning Dist: N Split Zoning Dist(1): 0 Split Zoning Dist(2): 0 School District: COUNTY Elementary School: OXFORD Middle School: RIVER BEND High School: BUNKER HILL School Split: NO P&Z Case Number: Census Tract 2010: 010101 Census Block 2010: 2005 Small Area Plan: ST STEPHENS/OXFORD Agricultural District: Printed: Monday, July 15, 2013 09:23 AM • a 3809 CATAWBA C;t.7LT�i+TTY g-iEALTH DEPARTMENT (704) 465-8270 Lot Eval. ,Improve. PermitRepair Permit Cert. of Comp. PermitOper. Permit —r_—, - //.4. —X- Oemer/Agent Phone Address U Subdivision / Sectio /Block Lot# Lot Size . Directio �/�J —�/�;) ��c� (1,�/� a Facility: House Mobile Home Business Other: Zoning Approvales no #� 14ulti-family_ Other 100% Repair Area yes/no Bedrooms ,3 Seats Employees GPD Flow Application Rate Hot Tub or Spa yes /}Special Fixtures REPAIR NOTICE: REPAIRS MUST BE WITHIN Basemen es/no Basement Plumbing yes se -o-- 30 DAYS OR DAYS FROM DATE OF Water Supp y: Private Public PERMIT. a,t+e,aswtw**+etteaww,►+►t,►�wffiwyrwetwffiww,t*wyewffi►twwte,r*rwtso�w:ttttffi,tit,r*tetrtww*:ffiww::rrtt+effiwfwt�astt,taa:neazt Type of System: Trench-."X—Bed Pump Pump/Panel Panel LPP Other Tank Size: Septic Tank 1000 Pump Tank //;; 7it Nitrification Field: Total Square Feet `7� o Q Depth of Stone /Ci Bed Size Trench Width 3 -C+, Total Length of All Trenches 300 Dumber of Trenches 25r Individual Trench Length �O/ M/f60/_/_ Feet on Center 7 Maximum Trench Depth.3 Z , Distance of Nearest Well Lot Evaluation: Approved yes/no (Void After 24 months) * A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A ll A A A A A A A A A A A A A A A A A ffi A Topo -5 % Slope l Sketch of lot Evaluation Site - System Design - Final Texture�� Structure_��Cti Clay 1iin. Soil Wetness _ _ — Soil Depth +-a,$ Restric. Hoz. at l ^— Available space ffe3ynol Overall Class SIJ l Comments: l i5 I 16 s I I I I **NO GUARANTEE OR WARRANTY IS I1iPLIED OR GIVEN THROUGH THE ISSUANCE OF THIS PERNIT*" AAAAAAAAAAAAAAAAAAAAAAAA AQAAAAAAAAAAAAAAfIAAfIA*AAf *A1lAAARA:AAAARAAAAA Wr Fermit Date�Z 7- %�(Improvement i oid60 months) 0%.mer/Agent ev Sanitarian/�✓ Installed By 13,11RL01 a4t,4, Date Sanitarian (Note any chaO-F� s/information in rAd or by skPtr on } r�