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Home My WebLink AboutRBPR-07-2013-17683.TIFTHIS IS NOT A PERMIT Case # RBPR-07-2013-17683 CATAWBA COUNTY HEALTH DEPARTMENT Fil� f0 PLAN REVIEW APPLICATION FOR ENVIRONMENTAL SERVICES f Residential Building Plan Review - Accessory Structure • • • T IMPROVEMENT Owner DILLON CROUCH, 1037 SILAS ST, NEWTON NC 28658 H:704-325-0887 HOME: 704-325-0887 NAME TO APPEAR ON PERMIT Dillon Crouch SITE ADDRESS: 1037 SILAS ST, NEWTON NC 28658 NAME of SUBDIVISION: Lot # PROPERTY SIZE: Square Feet Acres 0.98 DIRECTIONS: X PRIMARY CONTACT: Owner SEWER TYPE GALLONS PER DAY: 360 WATER SUPPLY DESCRIBE WORK: 30x48 metal garage- needs engineered drawings 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 1s 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: Accessory Structure DESCRIPTION OF EXISTING STRUCTURES ON SITE (IF ANY) DIM EXISTING STRUCTURE: 30x35 NUMBER OF EXISTING BEDROOMS: 3 ACCESSORY STRUCTURE OTHER DESCRIPTION: D❑ PIN # 375015530628 Section/Block Septic Tank Private Well # OF OCCUPANTS: 3 PROPOSED CONSTRUCTION NEW STRUCTURE DIM:: 30x48 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 identifica and I beling of a roperty lines and corners and making the site accessible so that a complete site 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 AREA1 MINIMUM SETBACKS FRONT: 30 SIDE: 10 REAR: 5 MAX HEIGHT: CSI - chapplicaUcm 07/17/2013 12:50 Page I of 4 yA CATAWBA COUNTY Public Health Department d spa 3 Environmental Health Division U odbv 'C PO Box 389, 100-A Southwest Blvd, Newton, NC 28658 Ig 2 :M NAME ON PERMIT: DILLON CROUCH, 1037 SILAS ST, NEWTON NC 28658 Site Address: 1037 SILAS ST, NEWTON NC 28658 Property Size: Square Feet Acres 0.98 Directions: X FEENAME Improvement Permit Fee TOTAL FEES Case # RBPR-07-2013-17683 Subdivision PIN# 375015530628 DATE FEE AMOUNT 07/17/2013 $150.00 $150.00 SYSTEM REDESIGN AND/OR RETRIP WILL INCUR AN ADDITIONAL CHARGE (SEE FEE SCHEDULE) L9 - chappliration 07/17/2013 12:50 Page 2 of 4 CATAWBA THIS IS NOT A PERMIT COUNTY - - CATAWBA COUNTY HEALTH DEPARTMENT Application for Environmental Services gBf V_ I1 (F9�) Page I Improvement Permit ❑ Authorization to Construct X 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 1037 Silas Street Newton NC 28658 Subdivision Lot # Acres 0.99 Section/Block/Phase Driving Directions to Property East on Hwy 10 right on Little Rd, then Right on Silas St driveway is on the end of the road. Gravel drive about 200 yards to house. NAME TO APPEAR ON PERMIT? X Owner ❑ Applicant ❑ Contractor Applicant Contact Information Name Hugh Dillon Crouch Address 1037 Silas Street Newton NC 28658 Phone 828-312-1664 I Cell Phone Owner Contact Information Name Hugh Dillon Crouch Address 1037 Silas Street Newton NC 28658 Phone 828-312-1664 I Cell Phone Contractor Contact Information Name Tarheel Metal Structures Address 8314 Business Hwy 220 Randelman NC 27317 Phone 336-476-4955 I Cell Phone WHO WILL BE THE PRIMARY CONTACT? Owner ❑ Applicant ❑ Contractor Description of Existing Structures on SitHo, w. e use # of Bedrooms *t 3 Structure Dimensions 30x35 # of Occupants 3 Basement ❑ Yes ❑■ No Basement Fixtures ❑ Yes ❑ No The Applicants tify e health department upon '' t pp ' y g p to . „ hall no � the 'localsubmittal of flus a hcahon if an of the following apply 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? ❑ Yes ❑ No Does the site contain any existing wastewater systems? ❑ Yes ® No Is any wastewater going to be generated on the site other than domestic sewage? ❑ Yes ---Q 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 �Indiv> dual Well ] Communi y Well Semi Public Wel L L W ty ❑ 1 ❑ 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 0 Innovative 0 Other 0 Any CATA BA THIS IS NOT A PERMIT COUNTY �_ __== _-\ CATAWBA COUNTY HEALTH DEPARTMENT Application for Environmental Services Page 2 Proposed Facility Type ❑ Primary Residence ❑ New Residence ❑ Addition to Residence # of New Bedrooms *f Project Description Structure Dimensions # of Occupants � � ❑ No V m Struc❑ture(s) El Basement Fixtures � Ye ., Yes No -Accessory e # of New Bedrooms *t if applicable U Structure D�imens'u�%, y K ' # of Occupants 1_0 Accessory Dwelling A;/ S No Plumbing ❑ Yes cg:l No Describe Plumbing Needed Multi -Family Residence # units #Bedrooms per Unit*f Total # Bedrooms *t Structure Dimensions ❑ Food Seryice S eci p fy 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 „.,, ❑ ,Other Facility T . e , 1 U.,.,: W... ,:,..:.:.: Y Yp Specify If Church # of Seats Kitchen ❑ Yes ❑ No If Daycare Specify Occupancy A.: lication for Well Co,nstructionAAbandonmentARea , .„. „„ , .: ”' " : p.:p pit .:: 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 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. f 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 0/m Ok rI fA A- Date 7-)7-/3 Printed Name of Owner or Agent Cru I_I 7 � 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 or consequential which arises or may arise from this map product or the use thereof by any person or entity. Selected Parcel Number: 3750-15-53-0628 1 inch = 60 feet Prepared for: 1.U2A 1868 1 ,moo 1 7 f ,d 1056 1.050 off J / 06:28 I 1037 , ,7 1 'ci —'' �s , THIS IS NOT A LEGAL DOCUMENT Date: 7/17/2013 Time: 12:35:51 PM CATAWBA COUNTY NC - Parcel Report Information Regarding Selected Parcel(s) Parcel ID: 3750-15-53-0628 Name: CROUCH HUGH DILLON Name2: Address: 1037 SILAS ST Address2: City: NEWTON State: NC Zip: 28658-9684 Account: Calc Acreage: 0.98 Tax Map: 062N 01020D LRK: 34746 Deed Book: 2952 Deed Page: 1031 Subdivision Name: Subdivision Block: Lots: Plat Book: Plat Page: Building Number: 1037 Street Name: SILAS ST Site Zip: 28658 Township: NEWTON Fire Dist: NEWTON RURAL City/Tax: State Road: Total Bldgs Value: $70,700 Land Value: $9,900 Total Value: $80,600 Year Built: 1955 Year Remodeled: 1993 Last Sale Date: Last Sale Amount: Neighborhood: 117 Watershed: Watershed Split: NO Voter Precinct: P22 E911 District: COUNTY Zoning: R-20 Zoning2: Zoning3: Zoning Split: N Zoning Overlay: Zoning District: COUNTY Split Zoning Dist: N Split Zoning Dist(1): 0 Split Zoning Dist(2): 0 School District: COUNTY Elementary School: BALLS CREEK Middle School: MILL CREEK High School: BANDYS School Split: NO P&Z Case Number: Census Tract 2010: 011300 Census Block 2010: 3005 Small Area Plan: BALLS CREEK Agricultural District: Printed: Wednesday, July 17, 2013 12:35 PM M