HomeMy WebLinkAboutRBPR-07-2013-17682.TIFTHIS IS NOT A PERMIT Case # RBPR-07-2013-17682
CATAWBA COUNTY HEALTH DEPARTMENT
PLAN REVIEW APPLICATION FOR ENVIRONMENTAL SERVICES
Residential Building Plan Review - Building New
IMPROVEMENT - AUTH CONST - NEW WELL
Owner CLIFF BARNES, 2146 WESTOVER RD, HICKORY NC 28602 ('�� _ S `x193 IT
11:828-409-1466 HOME:828-409-1466 KR,V 1$ eS �/�
NAME TO APPEAR ON PERMIT
Cliff Barnes
SITE ADDRESS: 2146 WESTOVER RD, HICKORY NC 28602 PIN # 279111752135
NAME of SUBDIVISION: Lot 8 2 Section/Block
PROPERTY SIZE: Square Feet Acres 10.2
Page 1 of
DIRECTIONS: 321 S, take exit 42 onto 127 W Turn right 0.3 miles turn right onto Westover Rd, property on right
PRIMARY CONTACT: Owner SEWER TYPE: Septic Tank
GALLONS PER DAY: 480 WATER Sl IPPLY : Private Well
DESCRIBE WORK<12/23/14- owner changing septic location due to grading on property. Needs to pav redraw fee. (es)
New 53x51 dwe Ing w un Ims asemen w x poo an x 0 detached garage
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? Yes
Are there any easements or right-of-ways on this properly?
APPLICATION FOR:
STRUCTURE TYPE:
FACILITY TYPE: Single Family Residence
DESCRIPTION OF
EXISTING STRUCTURES
ON SITE (IF ANY)
DIM EXISTING STRUCTURE:
NUMBER OF EXISTING BEDROOMS:
NEW STRUCTURE DIM:: 53x51
# OF NEW BEDROOMS:: 4
New Structure
PRIMARY RESIDENCE
OTHER DESCRIPTION:
# OF OCCUPANTS:
PROPOSED CONSTRUCTION
BASEMENT? Yes BASEMENT FIXTURES? Yes PLUMBING REQUIRED? Yes
Desired system types (Improvement Permit or Authorization to Construct):
ACCEPTED: ALTERNATIVE: CONVENTIONAL:
OTHER: INNOVATIVE: ANY: YES
Other described:
APPLICATION FOR WELL CONSTRUCTION
PROPOSED WELL TYPE: Individual Well REPLACE WELL?: NO
F9 - ehapplicauon 12232014 15:00
CATANBA COUNTY Case # RBPR-07-2013-17682
Public Hcahh Department Subdivision
Environmental Health Division PIN# 2 78111 7521 35
PO Box 389. 100-A Southwest Blvd, Newton, NC 28658
a
NAME ON PERMIT: ( CLIFF BARNES), 2146 WESTOVER RD, HICKORY NC 28602
(Cliff Barnes)
Site Address: 2146 WESTOVERRD, HICKORY NC28602
Property Sim: Square Fax Acres 10.2
Directions: 321 S. take exit 42 onto 127 W Turn right 0.3 miles tum right onto Westover Rd, property on right
Improvement Permits Issued as a result of this Information are valid for 5 years or may be nom -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 end Well
Permits are transferrable. Permits may be revolted if the information an this opparallon, site pians or intended use changes for the proposed facility.
I have read this application and earthy that the information provided herein is true, Complete and correA. 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 1 am solely responsible for the
proper identification end labeling of all property lines and comers and making the site accessible so that a complete site evaluation can W performed.
Date: 12,123,/201+1 Signature of Applicant or Agent B494ta0
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
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FEENAME
Authorization to Construct Fee (New/Expansion)
Fee
Improvement Permit Fee
Well Permit & Inspection Fee
Re -Trip or Redesign Fee
TOTAL FEES
D—FEEAMOUNT
07/17/2013 $300.00
07/1712013 S150.00
07/172013 5300.00
12232014 570.00
$820.00
FEES ARE NON-REFUNDABLE
ONCE A SITE VISIT IS MADE OR
WORK ON A PLAN REVIEW HAS COMMENCED
SYSTEM REDESIGN AND/OR RETRIP WILL INCUR AN ADDITIONAL CHARGE
(SEE FEE SCHEDULE)
1:0-eheppfiearron 12/2312014 13:00 Page 2 of 4
PAYOR
Barnes, Cliff
PAYMENTS
CATAWBA COUNTY
100A SOUTHWEST BLVD
NEWTON, NORTH CAROLINA 28658
PHONE: 828.465.8399
www.catawbacountync.gov
TRANSACTION NUMBER: TRC -411899-23-12-2014
PAYMENT DATE: 12/23/2014
PAYMENTTYPE: Credit Card
129855358
INVOICE NUMBER
12-14-313105
TOTAL PAYMENTS:
RBPR-07-2013-17682
FEE NAME
Re -Trip or Redesign Fee
CASE TYPE: Residential Building Plan Review WORK CLASS:
SITE ADDRESS: 2146 WESTOVER RD, HICKORY NC 28602
Owner CLIFF BARNES, 2146 WESTOVER RD, HICKORY NC 28602
H:828409-1466
** NO PEOPLESOFT ACCOUNT ASSIGNED **
RECEIPT
Tuesday, December 23, 2014
FEE AMOUNT
$70.00
870.00
Building New
E9 - receipt 12/23/2014 15:07 Page I of I
THIS IS NOT A PERMIT Case # RBPR-07-2013-17682
CATAWBA COUNTY HEALTH DEPARTMENT 0 "x,w0
PLAN REVIEW APPLICATION FOR ENVIRONMENTAL SERVICES T WIT
' � tiResidential Building Plan Review - Building New•
IMPROVEMENT -A UTHCONST - NEW WELL
Owner CLIFF BARNES, 2146 WESTOVER RD, HICKORY NC 28602
H:828-409-1466 HOME: 828-409-1466
NAME TO APPEAR ON PERMIT
Cliff Barnes
SITE ADDRESS: 2146 WESTOVER RD, HICKORY NC 28602 PIN # 279111752135
NAME of SUBDIVISION: Lot # 2 Section/Block
PROPERTY SIZE: Square Feet Acres 10.2
DIRECTIONS: 321 S, take exit 42 onto 127 W Turn right 0.3 miles turn right onto Westover Rd, property on right
PRIMARY CONTACT: Owner SEWER TYPE:
GALLONS PER DAY: 480 WATER SUPPLY:
DESCRIBE WORK: New 53x51 dwelling w unfinished basement w pool w detached garage
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? Yes
Are there any easements or right-of-ways on this property?
APPLICATION FOR: New Structure
STRUCTURE TYPE:
FACILITY TYPE: Single Family Residence
DESCRIPTION OF
EXISTING STRUCTURES
ON SITE (IF ANY)
DIM EXISTING STRUCTURE:
NUMBER OF EXISTING BEDROOMS:
PRIMARY RESIDENCE
OTHER DESCRIPTION:
# OF OCCUPANTS:
PROPOSED CONSTRUCTION
NEW STRUCTURE DIM:: 53x51
# OF NEW BEDROOMS:: 4
BASEMENT? Yes BASEMENT FIXTURES? Yes
Desired system types (Improvement Permit or Authorization to Construct):
ACCEPTED: ALTERNATIVE:
OTHER: INNOVATIVE:
Other described:
Septic Tank
Private Well
PLUMBING REQUIRED? Yes
CONVENTIONAL:
ANY: YES
APPLICATION FOR WELL CONSTRUCTION
PROPOSED WELL TYPE: i.�ct;v�dv�a� we�1 REPLACE WELL?: NO
L9 - chapplication 07/17/2013 12:27 Page I of 4
SpA C' CAJAWBA COUNTY Case # RBPR-07-2013-17682
it l Public Health Department Subdivision
d oaca Environmental Health Division PIN# 279111752135
ac PO Box 389, 100-A Southwest Blvd, Newton, NC 28658
!8 2 W
NAME ON PERMIT: CLIFF BARNES, 2146 WESTOVER RD, HICKORY NC 28602
Site Address: 2146 WESTOVER RD, HICKORY NC 28602
Property Size: Square Feet Acres 10.2
Directions: 321 S, take exit 42 onto 127 W Turn right 0.3 miles turn right onto Westover Rd, property on right
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 tat I am solely responsible for the
proper identification a d I beling of all property lines and corners and making the site accessible o tahat a compl> etg, a evaluation can be performed.
Date: � i� �// 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: 15
FEENAME
Authorization to Construct Fee (New/Expansion)
Fee
Improvement Permit Fee
Well Permit & Inspection Fee
TOTAL FEES
REAR: 30 MAX HEIGHT:
DATE FEE AMOUNT
07/17/2013 $300.00
07/17/2013 $150.00
07/17/2013 $300.00
$750.00
SYSTEM REDESIGN AND/OR RETRIP WILL INCUR AN ADDITIONAL CHARGE
(SEE FEE SCHEDULE)
CO - ehapplieauon 07/17/2013 12:27 Page 2 of 4
CATMATBA' FHIS IS NOTA PERMIT
CATAWBA COUNTY HEALTH DEPARTMENT
...„,. °,k Application for Environmental Services Page I
Improvement Permit N Authorization to CoustructJ2 Septic Repair ❑ Septic Malfunction ❑
:peptic Expansion ❑ New Well Permit Replacement Well ❑ Well :abandonment ❑
Well Repair ❑ Existing System Inspection (Pre -Approval Required) ❑
Application is for New Construction ❑ Existing I;acility ❑
Property Address__ I �o 084411,64ar RJ= _._ Subdivision 1A)6,n '2>
Lot # Acres 11),
Section/Block/Phase
Driving Directions to Property 3� l . T`aKe �: # o.%# f 7 . T” ,:^_
"%atwl #r, t.0e, , �r".........i .. t , }� icy. . -A k_..
AME TO APPEAR ON PERMIT'? El Owner ❑ Applicant ❑ contractor
Applicant Contact Information
Name
Address 4201
!''Itcinc.�I..0 1� Dr
Owner Contact Information
Name 1; "" Mesa
Address --
Phone
Contractor Contact Infor€aaatidn
Cell Phone
AJr
Cell Phone `"t �7 '..._�_l��
Name
sr€�.
Addressf�f ase l µsE ,cr 1i".1ra'�
Phone r Cel! Plt€iric. 8 17 -- e.- 8_± .
WHO WILL HE THE PRIMARY CONTACT? ❑ (Rona ❑] Applicant [�g Contractor
Description ofl xisting Structures can Site, 0t,-
!# of Bedrooms *t --i Structure. Dimensions 53 :� St ;# cifoccupants �
Basement ® Yes ❑ No Basement Fixtures P,] Yes ❑ No
rhe 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 CWNo Dos the: site contain any jurisdictional wetlands?
CI Yes E No Does the; site contain any existing wastewater systems?
Q Yes ER NET Is any wastewater going to be generated cin tht stile either than domestic sewage?
C Yes W No Is the site: subject to approval by any other public agency?
0 Yes 04 No Arc there any casements or right of ways on this; propos rty7 Describe
Existing water supply in use Individ€€al Well C`rimmunity Well Semi -Public W s11
Q C aunty/C'ity/Township Water LineIs a public wntvr supply available;'? ** Yes ❑ No
If applying; for an Improvement Permit or .Authorization to Construct, Please Indicate Desired System Typc(sT
(systems can be ranked in order of your preference)
0 Accepted 0 Alternative: KConventional 0 Innovative EJ Other Cl Any
C, THIS [S NOT A IiI;RM[T
C"ATAWBA COUNTY HEALTH DEPARTMENT
Application fior Environmental Services Page: 2
Proposed Facility Type j
Efl Primary Residence ❑ New Residence ❑ Addition to Residcnce # of Ncw Re£ireiorns *'
Project Dcscription j2-A'N1e. ra stlr owe(l; n
Structure Dimension -9,x 5 # �d of occupa€lus
Basement ❑ Yes ❑ No Basement Fixtures ❑ Yes ❑ 1',-o
Accessory Structure(s) Describe'I.G aa-<._.._._
# ol'New Bedrooms *I' if applicable Structure Dimensions ._Q,( 40 X
# of Occupants _ Accessory [)welling ❑ Yes ❑ No
Plumbing ❑ Yes ❑ No (describe Plumbing Needed
Multi -Family Residence # Units #Beadrootxis per Unit*t
Total ii Bedrooms *t Structure Dimensions
Food Service--
tf Notts f=loor Space: -Entire Food Service Facility (Sq Ft}
# Employees per Spilt # of Shifts inning Area (Sq. Ft.)___"__
Business Specific Tyke of Business Retail Floor Space,____.
# of Einployees per Shift
❑ Other-- --- _ -
Facility'(-ypc Specify
4 of Shifts
If'C"hunch 4 ol'Scats Klichen ❑ Yes ❑ No If Daycare Specify Occupancy
Application for Well Construction/Abandonment/Repair
Proposed Well Type ❑ Individual Well ❑ Serni-Pubic Well ❑ Community Well
Abandonment Type L) 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 he determined during consultation with on-site staff.
*Any room that will be intended fiir sleeping at the time of construction or t€ir liaure consideration should be noted as a bedroom and
counted tin all applications. The number of-bedroo ns will he confirmed by rocines itlemtified on house plans aN a hedroom at the time
of building p:nnit issuance- `ilii; may prevent, the need liar septic system size; incrcasc in the t"titurc.
-t Ifstructure is plumbed but no bedrooms, calculated desigyn flaw is required.
** If No, a well permit must be issued with the Authorization tti Construct.
SYSTEM REDESIGN AND/OR RETRIP WILL INCUR AN ADDITIONAL CHARGE (SEF: FEE SCHEDULE)
Improvement Permits issued as a result ofthis information are valid fbr 5 years or may be non -expiring under certain specified
conditions. Art t u(horization tet Construct issued by this department is valid liar (5) five, years fruits the date issued and is nett
transferable; Improvement permits and Well 11trinits are transt rrabli:. Permits may be revoked ifthe information on this application,
site shares or intended use: ehangcs for dic propos-ed facility.
I have rears this application and certify that the information provided herein is true, complete and correct. Audi ori zed county and state
ofriici3als are gi anted ii,ght of cit try to conduct necessary inspect ions to de wnititic £;t?tiiphance with :applicable laws .end rules. I
understand that I ani solely responsible for the proper idtsnuhcation and labeling of all property lines and corners and making the site
accessible so that a complete site cvaluati£iri can his performed,
Signature of (`owner or Agent � �^,� �^ l�/1✓t� Date �?
Printed Naim of Owner or AgentC t��t�2afes � �_U_�.M ►�Q .__�G _t Vl...�5
M
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. 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
Ak or consequential which arises or may arise from this map product or the use thereof by any person or entity.
Selected Parcel Number: 2791-11-75-2135
1 inch = 120 feet
Prepared for:
i
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sera ,�'' �✓/��((�� "�'.`�4 .,` ,,2135,' `'0
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THIS IS NOT A LEGAL DOCUMENT
l Plat 65-141
4
2158�
116.85,
14
Date: 7/17/2013 22o Time: 12:12:55 PM
CATAWBA COUNTY NC - Parcel Report
Information Regarding Selected Parcel(s)
Parcel ID:
2791-11-75-2135
Name:
BARNES CLIFF
Name2:
BARNES CAROLINE
Address:
964 18TH AVE CIR NW
Address2:
City:
HICKORY
State:
NC
Zip:
28601-1200
Account:
Calc Acreage:
10.2
Tax Map:
LRK:
605225
Deed Book:
3126
Deed Page:
0594
Subdivision Name:
Subdivision Block:
Lots:
2
Plat Book:
62
Plat Page:
16
Building Number:
2146
Street Name:
WESTOVER RD
Site Zip:
28602
Township:
HICKORY
Fire Dist:
MOUNTAIN VIEW
City/Tax:
State Road:
Total Bldgs Value:
Land Value:
$123,600
Total Value:
$123,600
Year Built:
Year Remodeled:
Last Sale Date:
Last Sale Amount:
Neighborhood:
79
Watershed:
Watershed Split:
NO
Voter Precinct:
P24
E911 District:
COUNTY
Zoning:
R-20
Zoning2:
R-1
Zoning3:
Zoning Split:
Y
Zoning Overlay:
Zoning District:
COUNTY
Split Zoning Dist:
Y
Split Zoning Dist(1):
0
Split Zoning Dist(2):
5
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: 011101
Census Block 2010: 2009
Small Area Plan:
MOUNTAIN VIEW
Agricultural District:
Printed: Wednesday, July 17, 2013 12:12 PM