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Home My WebLink AboutRBPR-07-2013-17714.TIFTHIS IS NOT A PERMIT Case # RBPR-07-2013-17714 CATAWBA COUNTY HEALTH DEPARTMENT PLAN REVIEW APPLICATION FOR ENVIRONMENTAL SERVICES Residential Building Plan Review - Modular IMPROVEMENT- AUTH_CONST - NEW WELL w�rl Applicant MICHAEL VAUGHN, 2204 QUARTER CREST DR, NEWTON NC 28658 C.7043250153 Contractor CMH HOMES INC DBA CLAYTON HOMES # 72, 2026 NORTHSIDE DR, STATESVILLE NC 28625 B.704-873-2547 C:7042393693F:704-872-1166 Land Owner HAROLD SCARLETT, 32685 E ALBEMARLE CI', N41LLSBORO NC 19966 Owner BRANDON EDMONDSON, 3771 MAIN AVE DR NW, HICKORY NC 28601 0:8286388386 Paid By *ABEE'S CLEARING 3 GRADING (DEENAABEE), 2381 US HWY 64 W, MOCKSVILLE NC 2702 C:7042393693 ABEESCG@AOL.COM NAME TO APPEAR ON PERMIT Michael Vaughn SITE ADDRESS: 1019 HEATHER GLEN DR, CATAWBA NC 28609 PIN # 470003039875 NAME of SUBDIVISION: MAPLE GLEN Lot 4 5 Section/Block PROPERTY SIZE: Square Fect Acres 092 DIRECTIONS: 10E/ RT MURRAY'S MILL RD/ LEFT SHERRILLS FORD RD/ LEFT LONG ISLAND RD/ RT MAPLE GLEN/ RT HEATHER GLEN / PROPERTY ON RIGHT IN CUL-DE-SAC PRIMARY CONTACT: Contractor SEWER TYPE: Septic Tank GALLONS PER D WATER SUPPLY: Private Well DESCRIBE WOR : RPvisP_ .d 7_ /�16 -Changed Owners to Brandon Edmondson **AC Now Voided, Reprinted Well Permit to reflect new owner on frame modular 28 x 70 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? No 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: 4 PROPOSED CONSTRUCTION NEW STRUCTURE DIM:: 28 x 70 # OF NEW BEDROOMS:: 3 BASEMENT? No BASEMENT FIXTURES? No Desired system types (Improvement Permit or Authorization to Construct). ACCEPTED: ALTERNATIVE OTHER: INNOVATIVE. Other described. PLUMBING REQUIRED? CONVENTIONAL: ANY: YES E9-chupphcntu11 07/122016 15 08 Page 1 44 nA CATAWBA COUNTY Case a RBPR-07-2013-17714 Public Health Department Subdivision MAPLE GLEN Environmental Health Division PINtI 470003039875 / PO Box 389, 100-A Southwest Blvd. Newton. NC 28658 Igg2 :u NAME ON PERMIT: ( MICHAEL VAUGHN), 2204 QUAR'T'ER CREST DR, NEWTON NC 28658 ( Michael Vaughn) Site Address: 1019 HEATHER GLEN DR, CATAWBA NC 28609 Property Size: Square Fect Acres 0.92 Directions: 10E/ RT MURRAY'S MILL RD/ LEFT SHERRILLS FORD RD/ LEFT LONG ISLAND RD/ RT MAPLE GLEN/ RT HEATHER GLEN / PROPERTY ON RIGHT IN CUL-DE-SAC APPLICATION FOR WELL CONSTRUCTION PROPOSED WELL TYPE: Individual Well REPLACE WELL?: NO 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 Emtronmental Health Specialist will contact you within 5 working days of application date. If you need further infomtation or assistance please call 828-466-7291 AREA1 '"illlilltin'15ayi'�(?�`..,., �� ,'I jl5 J:,'ir:' d"i{, q'illi I it dt l: , :iii:...'�, tN' t :ijoi"t 1% C+FEENA'ME {.,1:,° n,,,:'tC,gntn�'i j p 7%"i'.yl�:l%DATE FEEA'DiOUNT'. : ...._-. ____:;.Wf.%�::Z.,d�;:..,_..16dc,::.:,uLl.ialal ., 1�.a1:.,,.%hLB::'�L+14.u�!zi.11;.. _. . _ Authorization to Construct Fee (New/Expansion) 07/23/2013 $15000 Fee Improvement Permit Fee Well Permit & Inspection Fee 07/23/2013 5150.00 07/23/2013 5300 00 M. .n4�1 n'! 1,i':; ::r'i'll I 1-ATS600!00 r'IwojITOTAL FEESIlis�'d;" '�"ij,{l�l��.I.', ' ':;Il�j{�{!i(';. ,. i,. ,. 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) B) - rhapphtatam 07/12/2016 15 08 Pagc 2A 4 THIS IS NOT A PERMIT Case # RBPR-07-2013-17714 CATAWBA COUNTY HEALTH DEPARTMENT �❑' PLAN REVIEW APPLICATION FOR ENVIRONMENTAL SERVICES Residential Building Plan Review - Modular _ • •* T IMPROVEMENT - AUTH CONST - NEW WELL D Applicant MICHAEL VAUGHN, 2204 QUARTER CREST DR, NEWTON NC 28658 C:7043250153 Contractor CMH HOMES INC DBA CLAYTON HOMES # 72, 2026 NORTHSIDE DR, STATESVILLE NC 28625 B:704 -873-2547F:704-872-1166 _ Owner HAROLD SCARLETT, 32685 E ALBEMARLE CT, MILLSBORO NC 19966 Paid By ABEE'S CLEARING & GRADING, , C:7042393693 NAME TO APPEAR ON PERMIT Michael Vaughn SITE ADDRESS: 1019 HEATHER GLEN DR, CATAWBA NC 28609 PIN # 470003039875 NAME of SUBDIVISION: MAPLE GLEN Lot # 5 Section/Block PROPERTY SIZE: Square Feet Acres 0.92 DIRECTIONS: 10E/ RT MURRAY'S MILL RD/ LEFT SHERRILLS FORD RD/ LEFT LONG ISLAND RD/ RT MAPLE GLEN/ RT HEATHER GLEN / PROPERTY ON RIGHT IN CUL-DE-SAC PRIMARY CONTACT: Contractor SEWER TYPE: Septic Tank GALLONS PER DAY: 360 WATER SUPPLY: Private Well DESCRIBE WORK: on frame modular 28 x 70 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? No APPLICATION FOR: New Structure STRUCTURE TYPE: PRIMARY RESIDENCE FACILITY TYPE: Single Family Residence OTHER DESCRIPTION: DESCRIPTION OF EXISTING STRUCTURES ON SITE (IF ANY) DIM EXISTING STRUCTURE: NUMBER OF EXISTING BEDROOMS: # OF OCCUPANTS: 4 PROPOSED CONSTRUCTION NEW STRUCTURE DIM:: 28 x 70 # OF NEW BEDROOMS:: 3 BASEMENT? No BASEMENT FIXTURES? No PLUMBING REQUIRED? 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: %ndivI r-WCA REPLACE WELL?: NO 1-9 - ehapplicalion 07/23/2013 11:53 Page I of 4 A CATAWBA COUNTY Case # RBPR-07-2013-17714 Public Health Department Subdivision MAPLE GLEN Environmental H;.alth Division PIN# 470003039875 PO Box 389, 100-A Southwest Blvd, Newton, NC 28658 1842 sm NAME ON PERMIT: MICHAEL VAUGHN, 2204 QUARTER CREST DR, NEWTON NC 28658 Site Address: 1019 HEATHER GLEN DR, CATAWBA NC 28609 Property Size: Square Feet Acres 0.92 Directions: 10E/ RT MURRAY'S MILL RD/ LEFT SHERRILLS FORD RD/ LEFT LONG ISLAND RD/ RT MAPLE GLEN/ RT HEATHER GLEN / PROPERTY ON RIGHT IN CUL-DE-SAC 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 law n rules. I understand that I am solely responsible for the proper identificationyanf� labeling of all property lines and corners and making the site acc ssib so that a com a aluation can be performed. Date: / %3( )3 Signature of Applicant or Agent � / An Lnvironmental 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: 15 REAR: 30 MAX HEIGHT: 11101010"UV 1 N Authorization to Construct Fee (New/Expansion) Fee Improvement Permit Fee Well Permit & Inspection Fee TOTAL FEES DATE FEE AMOUNT . 07/23/2013 $150.00 07/23/2013 $150.00 07/23/2013 $300.00 $600.00 SYSTEM REDESIGN AND/OR RETRIP WILL INCUR AN ADDITIONAL CHARGE (SEE FEE SCHEDULE) F.9 - ehapplication 07/23/2013 11:53 Page 2 of CATAWBA THIS IS NOT A PERMIT CATAWBA COUNTY HEALTH DEPARTMENT Application for Environmental Services Page I wo.cn croon Improvement Permit V Authorization to Consuct EZ*' Septic Repair ❑ Septic Malfunction ❑ Septic Expansion ❑ New Well Permit LA Replacement Well ❑ Well Abandonment ❑ Well Repair ❑ Existing System Inspection (Pre -Approval Required) ❑ Application is for New Construction C�( Existing Facility ❑ Property Address tv. Subdivision je- C I e_v-) ° Lot # J Acres , Section/Block/Phase P1- 49 - Q Driving Directions to Property fl, I,r,r,.r : i s 11/1 i 11 O n :'She re i J 15 00 Ori ). '{' eez`I4-)er- �Eu� NAME TO APPEAR ON PERMIT? ❑ Owner L Applicant ❑ Contractor Applicant Contact Information Name �h n P�� O(,l I Aghn Address A f)o Phone (rtog) S - r)1, 3 Owner Contact Information Name Address aQ iDRA� F. Phone Contractor Contact Information Name 1V911 %1Cn, /RC1 Cell Phone #E 7 /JC 1q,7,w, Cell Phone Address ( iVrk thS,c fir. z_�'tC;s s u�) Jam. Nc"". -__Q � Phone 7g7 4 �� _ / Cell Phone WHO WILL BE THE PRIMARY CONTACT? ❑ Owner ❑ ApplicantContractor Description of Existing Structures on Site # of Bedrooms *t Structure Dimensions # of Occupants Basement ❑ Yes ❑ No Basement Fixtures ❑ Yes ❑ No The Applicant shall notify the local health department upon s 11 ubmittal 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 C9'f,to Does the site contain any jurisdictional wetlands? ❑ Yes Grll o Does the site contain any existing wastewater systems? VYes B No Is any wastewater going to be generated on the site other than domestic sewage? s EOPNo Is the site subject to approval by any other public agency? ❑ Yes 2_1�0 Are there any easements or right of ways on this property? Describe Existmg water supply m use ❑Individual Well ❑ CommunityWell 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 i/ /Ay THIS IS NOT A PERMIT fSeg-o- oQV 13-1 `7 _7 1 CATAWBA COUNTY HEALTH DEPARTMENT Application for Environmental Services Page 2 Proposed Facility Type ❑ Primary Residence New Residence 0 Addition to Residence 4 of New Bedrooms *t Project Description 0&1 r- FRA nA k= IM (D L_( LAP Structure Dimensions �A K "-//-) 4 of Occupants A4 Basement n Yes [2"'No Basement Fixtures n Yes [TNo EJ Accessory Structure(s) Describe 9 of New Bedrooms *t if applicable Structure Dimensions 4 of Occupants Accessory Dwelling [:1 Yes n No Plumbing M Yes F -I No Describe Plumbing Needed Multi -Fa n' ily Residence 4"Units . I �13 edr'o'oms per Unit*t' Total 9 Bedrooms *t Structure Dimensions F] Food Service Specify Type # Seats Floor Space -Entire Food Service Facility (Sq Ft) 9 Employees per Shift 9 of Shifts Dining Area (Sq. Ft.) F] Business Specific Type of Business Retail Floor Space # of Employees per Shift 4 of Shifts ❑ Other Facility Type Specify If Church 4 of Seats Kitchen ❑ Yes ❑ No If Daycare Specify Occupancy Application far Well Construction/Abandonment/Repair Proposed Well Type ❑ Individual Well n Semi -Public Well E] Community Well Abandonment Type n Drilled El Bored M 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. t 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 Printed Name of Owner or Agent Date —//) N 1 inch = 60 feet .70 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 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: 4700-03-03-9875 10 .39 19- J (144) 0 9 zC-23 Prepared for: 206.60 9070 4 2�61y gF 9875 i 233.94 \ j231.5 0 Plat 44=1 64 Z "' 8668 (230) No� Z o� S22g� 00 "Zi co 1-845--- 36.2 �o C) N THIS IS NOT A LEGAL DOCUMENT Date: 7/23/2013 Time. 11:17:37 AM 20� 2 1 (.�� CATAWBA COUNTY NC - Parcel Report Information Regarding Selected Parcel(s) Parcel ID: 4700-03-03-9875 Name: SCARLETT HAROLD Name2: Address: 32685 E ALBEMARLE CT #E7 Address2: City: MILLSBORO State: DE Zip: 19966-4825 Account: Calc Acreage: 0.92 Tax Map: LRK: 300927 Deed Book: 2658 Deed Page: 0650 Subdivision Name: MAPLE GLEN Subdivision Block: Lots: 5 Plat Book: 48 Plat Page: 92 Building Number: 1019 Street Name: HEATHER GLEN DR Site Zip: 28609 Township: CATAWBA Fire Dist: BANDYS City/Tax: State Road: Total Bldgs Value: Land Value: $10,400 Total Value: $10,400 Year Built: Year Remodeled: Last Sale Date: 4/27/2005 Last Sale Amount: $15,000 Neighborhood: 128 Watershed: WS -IV Protected Area Watershed Split: NO Voter Precinct: P21 E911 District: COUNTY Zoning: R-40 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: CATAWBA Middle School: MILL CREEK High School: BANDYS School Split: NO P&Z Case Number: Census Tract 2010: 011503 Census Block 2010: 1021 Small Area Plan: SHERRILLS FORD Agricultural District: Printed: Wednesday, July 24, 2013 08:24 AM Applicant Owner Paid 13), Contractor CATAWBA COUNTY PERMIT ZONING AUTHORIZATION (R) New Dwelling , IVR PIN# PERMIT NO: ZONR-07-201:3-040196 1'. 0. Box 389 Phone: 828-465-8380 APPLIED: 07/23/2013 100A SQntIMTSt Blvd FAX: 828-465-8484 ISSUED: 07/23/2013 Newton, North Carolina 28658 EXP112ES: 04/11/2014 www. cat awhacountync.gov MICHAEL VAUGHN, 2204 QUARTER CREST DR, NEWTON NC 25658 0:7043250153 HAROLD SCARLETT, 32685 E ALBEMARLE CT, MILLSBORO NC 19966 ABEE'S CLEARING & GRADING, , C:7042393693 **NO PEOPLESOFTACCOUNTASSIGNED ** CMI -I HOMES INC DBA CLAYTON HOMES /,72,2026 NORTHSIDE DR, STATESVILLE NC 28625 13:704-873-25471":704-872-11 66 PROPERTY IDs;: 470003039875 STREETADDRESS: 1019 HF_.ATHER GLEN DR, CATAWBANC 28609 PROJECT DESCRIPTION: on frame modular 28 x 70 CENSUS TRACT: 011503 LOTil: 5 FLOOD ZONE? OWNER TYPE: 100 YEAR FLOOD ZONE PLAIN? LAND OWNER: FLOOD PLAIN, STRUCTURE? No FRONT SETBACK: 30.00 SIDE SETBACK: 15 REAR SETBACK FRONT SETBACK 2: SIDE STREET SETBACK: MAX HEIGHT: SETBACK COMMENT: REQUIRED SETBACKS FRONT: 30 REAR: 30 SIDE: 15 1. 13cforc an inspection can be made by the Building Inspection 011ice, the applicant must pull a string to designate the side and real' property- lines where the structure is being placed or constructed. 2. Home shall he placed on the lot in harmony with the site-huilt structures. 01' have the front door face the road Frontage. INVOICE,,: 07-13-298794 FEE DESCRIPTION DATE FEE AMOUNT Residential Zoning Fee 07/23/2013 $25.00 TOTAL FEES 525.00 30 The applicant herebv certifies that all information and attachments to this Certificate of Zoning Compiliance are true and correct, and acknowledges that this permit was issued on the basis of the information required herein. The applicant further acknowledges that any consunuction, alteration or addition which differs from this application shall be subject to removal or alteration so as to bring said su'ucturc 11110 conformance with the specifications and standards of the Catawba County Zoning Ordinance. Such corrective action shall he at the cxpcnse of the applicant. n t APPLICANT NAtiM (PRINTED) APPLICANT SIGNAFURE /ENING AI'PROVED BY { I — ` "ZONING FEES ARE NON-REFUNDABLE ***** C0N,lPANY NA\ME " I'110"'1 07/23/2013 11:54 ISSUED BY: Pat r ucen Pace I of I