HomeMy WebLinkAboutRBPR-07-2013-17688.TIFTHIS IS NOT A PERMIT Case # RBPR-07-2013-17688
CATAWBA COUNTY HEALTH DEPARTMENT
PLAN REVIEW APPLICATION FOR ENVIRONMENTAL SERVICES
Residential Building Plan Review - Accessory Structure
IMPROVEMENT
Rl
Owner MARCUS ROBINSON, 7894 WINALDA AV, SHERRILLS FORD NC 28673
1-1:828-303-9260 HOME:828-303-9260
NAME TO APPEAR ON PERMIT
Marcus Robinson
SITE ADDRESS: 7894 WINALDA AV, SHERRILLS FORD NC 28673 PIN # 460702992515
NAME of SUBDIVISION: GABRIELS PINEWOOD ACRES Lot # 8 Section/Block A
PROPERTY SIZE: Square Feet Acres 0.63
DIRECTIONS: 16 S to 150 E to Terrell turn left at light on to Sherrills Ford Rd cross bridge 1 st rd on left Gregory Rd to Winalda Ave Ist
house on right white with blue trim
PRIMARY CONTACT: Owner SEWER TYPE: Septic Tank
GALLONS PER DAY: 360 WATER SUPPLY: N/A
DESCRIBE WORK: 18x21 metal carport
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:
STRUCTURE TYPE:
FACILITY TYPE: Accessory Structure
DESCRIPTION OF
EXISTING STRUCTURES
ON SITE (IF ANY)
DIM EXISTING STRUCTURE: 25x40
NUMBER OF EXISTING BEDROOMS: 3
New Structure
ACCESSORY STRUCTURE
OTHER DESCRIPTION:
# OF OCCUPANTS: 5
PROPOSED CONSTRUCTION
NEW STRUCTURE DIM:: 18x21
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 labeling of all property lines and corners and making the site accessible so that a complete site ebaluation 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
AREA1
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MINIMUM SETBACKS FRONT: 30 SIDE: 10 REAR: 5 MAX HEIGHT:
1-1) - chapplication 07/18/2013 10:29 Page I of
CATAWBA COUNTY Case # RBPR-07-2013-17688
Public Health Department Subdivision GABRIELS PINEWOOD ACRE;
v o® Environmental Health Division PIN# 460702992515
ao PO Box 389, 100-A Southwest Blvd, Newton, NC 28658
184 sM
NAME ON PERMIT: MARCUS ROBINSON, 7894 WINALDA AV, SHERRI LLS FORD NC 28673
Site Address: 7894 WINALDA AV, SHERRILLS FORD NC 28673
Property Size: Square Feet Acres 0.63
Directions: 16 S to 150 E to Terrell turn left at light on to Sherrills Ford Rd cross bridge 1 st rd on left Gregory Rd to Winalda Ave Ist
house on right white with blue trim
FEENAME
Improvement Permit Fee
TOTAL FEES
DATE FEE AMOUNT
07/18/2013 $150.00
$150.00
SYSTEM REDESIGN AND/OR RETRIP WILL INCUR AN ADDITIONAL CHARGE
(SEE FEE SCHEDULE)
L9 - chapphcatxm 07/18/2013 10:29 Page 2 of 4
CATAWBA
THIS IS NOT A PERMIT
COUNTY CATAWBA COUNTY HEALTH DEPARTMENT
North Cnroltnu Application for Environmental Services nio
FP— 1109 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 R
Property Address 7R i V c, 1 P QF , Subdivision G4--6re ' t Pine t,,� &A �crPS
5I.e tom. tis o rCa % .3 Lot # Acres
_
Section/Block/Phase
Driving Directions to Property &_5 tD l S vg. tv i-erreli -r//- r-+ +c)
5he..r:4&4 RA A�y�
W ; ,1-, \A c-, Adv . •f CX13F C;)n 12kgh � w hI k- t,., k 131 a Ie., -r,
NAME TO APPEAR ON PERMIT? �wner H -Applicant ❑ Contractor
Applicant Contact Information
Name M A (2 co, S A hi{AS
Address 2grg(/ C� ����� � A U S►SfrI �� S �� r C Z k_'6?3
Phone 12 g- 3c) 3 . 5� 2 b d Cell Phone
Owner Contact Information
Name
Address
Phone I Cell Phone
Contractor Contact Information
Name
Address
Phone I Cell Phone
WHO WILL BE THE PRIMARY CONTACT? ❑ Owner aApplicant ❑ Contractor
Description of Existing Structures on Site�a
# of Bedrooms *t 3 Structure Dimensions rQh k Lo # of Occupants
Basement ❑ Yes [A 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.
Yes 19 No Does the site contain any jurisdictional wetlands?
es ® 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 UNo Is the site subject to approval by any other public agency?
❑ Yes R No Are there any easements or right of ways on this property? Describe
Existing water supply in use ❑ Individual Well g 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 0 Innovative, 0 Other 0 Any
CATAWBA THIS IS NOT A PERMIT
COUN
CATAWBA COUNTY HEALTH DEPARTMENT .
Application for Environmental Services Page 2
Proposed Facility Type
❑ Primary Residence ❑ New Residence ❑ Addition to Residence # of New Bedrooms *t
Project Description
Structure Dimensions # of Occupants
dBasement
Accesso Structuree❑Descroibe Basement Ficx�tures Yes N
(s) PO
# of New Bedrooms *t if applicable Structure Dimensions
# of Occupants Accessory Dwelling ❑ Yes ❑ No
Plumbing ❑ Yes ❑ No Describe Plumbing Needed
❑.,,..,° Residence # Unit
Multi -Family , s #Bedrooms per Unit* j'
Total # Bedrooms * j Structure Dimensions
❑.,, Food Servicep • fj
S eci Type
# Seats Floor Space -Entire Food Service Facility (Sq Ft)
# Employees per Shift # of Shifts Dining Area (Sq. Ft.)
❑.,,.,. 1 S
Business Specific Type of Business Retail Floor pace
# of Employees per Shift # of Shifts
❑ Other Facility
„ .. , . _.d............ .
' ty Type Specify
If Church # of Seats Kitchen ❑ Yes ❑ No If Daycare Specify Occupancy
"Application for Well Construction/Abandonment/Re a
p it
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.
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 Pen -nits 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.
1 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 v� Date /
Printed Name of Owner or Agent
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: 4607-02-99-2515
1 inch = 50 feet
Prepared for:
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THIS IS NOTA LEGAL DOCUMENT
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Date: 7/18/2013 Time:,10:1l9:28AM
CATAWBA COUNTY NC - Parcel Report
Information Regarding Selected Parcel(s)
Parcel ID:
4607-02-99-2515
Name:
ROBINSON MARCUS L
Name2:
Address:
7894 WINALDAAVE
Address2:
City:
SHERRILLS FORD
State:
NC
Zip:
28673-8339
Account:
Calc Acreage:
0.63
Tax Map:
007AX 03008
LRK:
7345
Deed Book:
1818
Deed Page:
1048
Subdivision Name:
GABRIELS PINEWOOD ACRES
Subdivision Block:
A
Lots:
8
Plat Book:
13
Plat Page:
112
Building Number:
7894
Street Name:
WINALDAAV
Site Zip:
28673
Township:
MOUNTAIN CREEK
Fire Dist:
SHERRILLS FORD
C ity/Tax:
State Road:
Total Bldgs Value:
$66,800
Land Value:
$9,800
Total Value:
$76,600
Year Built:
1993
Year Remodeled:
Last Sale Date:
5/1/1989
Last Sale Amount:
$4,000
Neighborhood:
128
Watershed:
WS -IV Critical Area
Watershed Split:
NO
Voter Precinct:
P31
E911 District:
COUNTY
Zoning:
R-20
Zoning2:
Zoning3:
Zoning Split:
N
Zoning Overlay: WP -O
Zoning District:
COUNTY
Split Zoning Dist:
N
Split Zoning Dist(1):
0
Split Zoning Dist(2):
0
School District:
COUNTY
Elementary School:
SHERRILLS FORD
Middle School:
MILL CREEK
High School:
BANDYS
School Split:
NO
P&Z Case Number:
Census Tract 2010: 011504
Census Block 2010: 3004
Small Area Plan:
SHERRILLS FORD
Agricultural District:
Proximity
Printed: Thursday,
July 18, 2013 10:19 AM
)(✓ N° 04665
C A T A W B A COUNTY HEALTH D E P A R T M E N T
(704) 465-8270
Lot Eval. (/Improve. Permit�Repair Permit Cert. of Comp. PermitL,-Voi�r. Permit
Owner/Agent GaeCF-- S Q06i/-ASOAl Phone
Address '7q0-2 L1 Aja LDA J2U9,. Subdivision
k RJ",S ;=�O&D A". Section/Block Lots
Lot Size Directions: A id S/ -noii .c Fp Qn R /AL I- 041
► . A
Facility: House-1.,e44obile Home Business Other: Zoning Approval no # 15- r 31
Hulti-famil�— Other 100% Repair Area yes/no
Bedrooms 1 Seats Employees GPD Flow 360 Application Rate y
Hot Tub or Spa yes® Special Fixtures REPAIR NOTICE: REPAIM M1ST BE iR'"
Basement yeses Basement Plumbing yes4i 30 DAYS OR DAYS FROM DATE OF
Nater Supply: Private_41ijiPablicPERMIT.
AAAAAAfAAAARRRARAARAAARRlAAAf R!lRAA!!!!!!!!!!!!f!!!!!!AlfA!!!lAARlfRARRARlAf RARlAAARRRARAA
Type of System: Trench ✓Bed Pump Pump/Panel Panel LPP Other
Tank Size: Septic Tank / ODY91— Pump Tank
Nitrification Field: Total Square Feet 9bi5-� Depth of Stone !a " Bed Size
Trench Width 3 Total Length of All Trenches , ;360 Number of Trenches_��
Individual Trench Length /C0//0_/_ Feet on Center_j-- Maximum Trench Depth
Distance of Nearest Well Lot Evaluation: Approved yes/no (Void After 24 months)
ftAwAAAwRRRAAAAAARAAAARAAAAIAARRRAAAAAA!!!!!!!!A!!!!lRRRARAAAAAA!!AR!!!!!!!!f!!!!!�!!!!!!!!
Topo l 0 Slope \ I Sketch of lot Evaluation Site - System Design Fin I
Texture ctgoiedx I --05�Re Vch fF'S
�l I
Structure ,licnrwe y i(3 1
IPr
I
Clay Min.
Soil Wetnessl I
Soil Depth '
�ti J/$�S I
Restric. Hoz. at l \ _,,a
Available space nol 1
Overall Class Si
l ,
Comments:
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**NO GUARANTEE OR WARRANTY IS IMPLIED OR GIVEN THROUGH THE ISSUANCE OF THIS PERMIT**
**AAAAARAAAAAAAAAAAfAAAAAfI/ARAAAAAARAAAAAAAAAAAAAAAAAAIAAAAAAAIAAAAAAAAAAAAAAAAAARRAAAAfAA
Permit Date 194 (Improvement Permit void after 60 months)
i
Owner/Agent P ,�(- Sanitarian 62- -z5,-
Installed
Installed By 47-7-v DateR.26 93 Sanitarian
(Note any'chang6s/information in red or by sketch on.Back)
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