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Home My WebLink AboutRBPR-07-2013-17678.TIFTHIS IS NOT A PERMIT Case # RBPR-07-2013-17678 CATAWBA COUNTY HEALTH DEPARTMENT PLAN REVIEW APPLICATION FOR ENVIRONMENTAL SERVICES Residential Building Plan Review - Deck/Porch IMPROVEMENT of �Q Contractor NEW GENESIS VENTURES, INC., 939 8TH ST NE, HICKORY NC 28601 13:8282561313 C:8283120710F:8282561313 DROCK@WHITEROCKCONSTRUCTION.BIZ Owner LORENE HENRY, 3495 MAYS CHAPEL CIR, NEWTON NC 28658 NAME TO APPEAR ON PERMIT Lorene Henry SITE ADDRESS: 3495 MAYS CHAPEL CIR, NEWTON NC 28658 PIN # 364706486014 NAME of SUBDIVISION: PAUL J MCREE Lot # 8 Section/Block PROPERTY SIZE: Square Feet Acres 0.76 DIRECTIONS: Business 321 S, left on Chapel Church Rd, left on Mays Chapel Cir PRIMARY CONTACT: Contractor SEWER TYPE: Septic Tank GALLONS PER DAY: 360 WATER SUPPLY: Private Well DESCRIBE WORK: 14x16 screened porch 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? APPLICATION FOR: New Structure STRUCTURE TYPE: ACCESSORY STRUCTURE FACILITY TYPE: Accessory Structure OTHER DESCRIPTION: DESCRIPTION OF single family home with detached garage EXISTING STRUCTURES ON SITE (IF ANY) DIM EXISTING STRUCTURE: 30x60 NUMBER OF EXISTING BEDROOMS: 3 # OF OCCUPANTS: 3 PROPOSED CONSTRUCTION NEW STRUCTURE DIM:: 1416 Desired system types (Improvement Permit or Authorization to Construct): ACCEPTED: ALTERNATIVE: CONVENTIONAL: OTHER: INNOVATIVE: ANY: YES 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 labelin of all property lines and corners and making the site accessibJe-soo t a mplet�e� aluation can be performed. Date: -7._ I b, U Signature of Applicant or Agent _ (/ _ � Li An Environmental Health Specialist will contact you within 2 working da s of application date. If you need further information or assistance please call 828-466-7291 AI EA1 MINIMUM SETBACKS FRONT: SIDE: REAR: MAX HEIGHT: F9 -.happlicatuorr 07/16/2013 11:58 Page I of �4A CATAWBA COUNTY Case # Public Health Department Subdivision Q aP` Environmental Health Division PIN# PO Box 389, 100-A Southwest Blvd, Newton, NC 28658 1842 su NAME ON PERMIT: LORENE HENRY, 3495 MAYS CHAPEL CIR, NEWTON NC 28658 Site Address: 3495 MAYS CHAPEL CIR, NEWTON NC 28658 Property Size: Square Feet Acres 0.76 Directions: Business 321 S, left on Chapel Church Rd, left on Mays Chapel Cir FEENAME Improvement Permit Fee TOTAL FEES "PR -07-2013-17678 PAUL J MCREE 364706486014 DATE FEE AMOUNT 07/16/2013 $150.00 $150.00 SYSTEM REDESIGN AND/OR RETRIP WILL INCUR AN ADDITIONAL CHARGE (SEE FEE SCHEDULE) F.9 - eharphcation 07/16/2013 11:58 Page 2 of 4 CATAWBA THIS IS NOT A PERMIT c0u, n` CATAWBA COUNTY HEALTH DEPARTMENT 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 ❑ 3 i�C1eProperty Address � C i c e�Q Lot # Acres -7 (o / 7 Section/Block/Phase Driving Directions to Property rYbQ. S 7 > k -i Ak j Q (? E 0, M s.0 s UAPA NAME TO APPEAR ON PERMIT? )Q Owner ❑ Applicant ❑ Contractor Applicant Contact Information Name OWi*ra�J� I Address 9 j y fit. S + A- Phone I Cell Phone 76q- Wt Owner Contact Infor1mation Name i_ --- Address -3q �5 (`�1/}� S Gl ( C,\Ap_ Phone Cell Phone Contractor Contact Information Name Address Phone Cell Phone to WHO WILL BE THE PRIMARY CONTACT? ❑ Owner E<pplicant ❑ Contractor Description of Existing Structures on Site 6NI Iet/e ( Y ae�A, ek q:, --4Q # of Bedrooms *j' _a Structure Dimensions D Cp0 # of Occupants 3 Basement ❑ Yes No Basement Fixtures ❑ Yes Z 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. ❑ Yes )No Does the site contain any jurisdictional wetlands? ff Yes No Does the site contain any existing wastewater systems? ❑ Yes h�No is any wastewater going to be generated on the site other than domestic sewage? O'1'es —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 X1 Conventional ❑, Innovative ❑ Other 0 Any CATAWBA THIS IS NOT A PERMIT couN_TY _ CATAWBA COUNTY ]E][]EA�ti�'lE3[ �]EPAI��'M ENT Application for Environmental Sery ices North Cnroll Proposed Facility Type Primary Residence ❑ New Residence Addition to Residence # of New Bedrooms *T Project Description $«p'pf, C.t'r,l-\ pvpf-� rr9_Ve SIR-. Structure Dimensions j 4 X / �i # of C occupants Basement ❑ Yes X No Basement Fixtures ❑ Yes [O'No ❑ Accessory Structure(s) Describe # of New Bedrooms *T if applicable St lucture Dimensions # of Occupants Plumbing ❑ Yes ❑ No ❑ Multi -Family Residence # Units Total # Bedrooms *t ❑ Food Service Specify Type Accessory Dwelling ❑ Yes ❑ No Describe Plumbing Neey ed #Bedrois per Unit* f Structure Dimen ions # Seats Floor Space -Entire Food Sery ce 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 I) ❑ Other Facility Type Specify If Church # of Seats Kitchen ❑ Yes ❑1\o If Daycare Specify Occupancy Page 2 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 deter dined during consultation with on-site staff. *Any room that will be intended for sleeping at the time of constructic I or for future consideration should be noted as a bedroom and counted on all applications. The number of bedrooms will be confirm(,d by rooms identified on house plans as a bedroom at the time of building permit issuance. This may prevent the need for septic syst m size increase in the future. t If structure is plumbed but no bedrooms, calculated design flow is iequired. ** If No, a well permit must be issued with the Authorization to Cons ruct. SYSTEM REDESIGN AND/OR RETRIP WILL INCUR �N ADDITIONAL CHARGE (SEE FEE SCHEDULE) Improvement Permits issued as a result of this information are valid ft 15 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 I officials are granted right of entry to conduct necessary inspections to understand that I am solely responsible for the proper identification ar accessible so that a complete site evaluation can be performe . JI Signature of Owner or Agent )Q// ex Printed Name of Owner or Agent ein is true, complete and correct. Authorized county and state germine compliance with applicable laws and rules. I labeling of all property lines and corners and making the site Date � _..'� N I H t 1 inch = 60 feet 36.4 7 4929 E 2j I. B ,,, , �,,, �W.,.-..... _..._ ......-.. -.,,..,,,W.,..-.,.,,,.. .,.,. , ,,,.,, ,, Catawba County, Noirth Carofina 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: 3647-06-48-6014 Prepared for: CO o 3470 _O' \ .AAAA --. I{ i•8 THIS IS NOT A LEGAL r7� 7s 1-0 Date: 7/16/201 IN 9 1.14A r- 7963 3516 7 / 275-00 'I 6 ?La.t_12=99y N 3 Time: 11:49:10 AMt 8234----- CATAWBA COUNTY NC - Parcel Report Information, Regarding Selected Parcel(s) Parcel ID.- 3647-06-48-6014 Name: HENRY LORENE M LFI Name2: Address: 3495 MAYS CHAPEL CIR Address2: City: NEWTON State: NC Zip: 28658-9011 Account: Calc Acreage: 0.76 Tax Map: 013M 04028 LRK: 14677 Deed Book: 1942 Deed Page: 0267 Subdivision Name: PAUL J MCREE Subdivision Block: Lots: 8 Plat Book: 12 Plat Page: 99 Building Number: 3495 Street Name: MAYS CHAPEL CIR Site Zip: 28658 Township: NEWTON Fire Dist: MAIDEN RURAL City/Tax: State Road: Total Bldgs Value: $140,200 Land Value: $10,700 Total Value: $150,900 Year Built: 1968 Year Remodeled: Last Sale Date: 3/1/1976 Last Sale Amount: $28,000 Neighborhood: 113 Watershed: Watershed Split: NO Voter Precinct: P20 E911 District: MAIDEN Zoning: R-15 Zoning2: Zoning3: Zoning Split: N Zoning Overlay: Zoning District: MAIDEN Split Zoning Dist: N Split Zoning Dist(1): 0 Split Zoning Dist(2): 0 School District: COUNTY Elementary School: MAIDEN Middle School: MAIDEN High School: MAIDEN School Split: NO P&Z Case Number: Census Tract 2010: 011601 Census Block 2010: 1053 Small Area Plan: Agricultural District: Proximity Printed: Tuesday, July 16, 2013 11:49 AM