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Home My WebLink AboutRBPR-07-2013-17726.TIF� BA �o 1842 SM THIS IS NOT A PERMIT Case # RBPR-07-2013-17726 CATAWBA COUNTY HEALTH DEPARTMENT PLAN REVIEW APPLICATION FOR ENVIRONMENTAL SERVICES Residential Building Plan Review - Building Addition IMPROVEMENT -7J.31113 Contractor M. KEVIN BRADSHAW, 3761 OLD SHELBY RD, HICKORY NC 28602 C:828-320-9717 Owner THERESA COLEMAN, PO BOX 11341, HICKORY NC 28603 H:828-256-0174 HOME: 828-256-0174 NAME TO APPEAR ON PERMIT Theresa Coleman SITE ADDRESS: 4045 24TH ST PL NE, HICKORY NC 28601 PIN # 372406385690 NAME of SUBDIVISION: SNO-CREEK HEIGHTS Lot # 22 Section/Block PROPERTY SIZE: Square Feet Acres 0.62 DIRECTIONS: SPRINGS RD/ LEFT SULPHURS RD / LEFT SNOW CREEK / LEFT 25TH ST NE/ RT 24TH ST PL NE PRIMARY CONTACT: Contractor SEWER TYPE: Septic Tank GALLONS PER DA size changed WATER SUPPLY: Community Well DESCRIBE WORK ""7/31/13 laundry room to 6 x1�y Kevin Bradshaw LAUNDRY ROOM 8 X 9 ADDITION TO EXISTING DWtLLINh 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? No APPLICATION FOR: Existing Structure STRUCTURE TYPE: PRIMARY RESIDENCE FACILITY TYPE: Single Family Residence OTHER DESCRIPTION: DESCRIPTION OF SINGLE FAMILY DWELLING EXISTING STRUCTURES ON SITE (IF ANY) DIM EXISTING STRUCTURE: 55 X 26 NUMBER OF EXISTING BEDROOMS: 3 # OF OCCUPANTS: 3 PROPOSED CONSTRUCTION NEW STRUCTURE DIM:x 1 Desired system types (Improvement Permit or Authorization to Construct): ACCEPTED: ALTERNATIVE: CONVENTIONAL: OTHER: INNOVATIVE: ANY.- Other NY: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 labTling of property lines and corners and making the site acces so t at comple a evalu on an be _ erformed. 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 AREA2 1:9 - ehapplication 07/31/2013 16:41 Page I of 4 CATAWBA COUNTY Case # RBPR-07-2013-17726 a Public Health Department Subdivision 1 SNO-CREEK HEIGHTS Environmental Health Division PIN# 372406385690 PO Boz 389, 100-A Southwest Blvd, Newton, NC 28658 Ig42 sM NAME ON PERMIT: THERESA COLEMAN, PO BOX 11341, HICKORY NC 28603 Site Address: 4045 24TH ST PL NE, HICKORY NC 28601 Property Size: Square Feet Acres 0.62 Directions: SPRINGS RD/ LEFT SULPHURS RD / LEFT SNOW CREEK / LEFT 25TH ST NE/ RT 24TH ST PL NE MINIMUM SETBACKS FRONT: 30 SIDE: 15 REAR: 30 MAX HEIGHT: FEENAME Improvement Permit Fee TOTAL FEES DATE FEE AMOUNT 07/24/2013 $150.00 $150.00 SYSTEM REDESIGN AND/OR RETRIP WILL INCUR AN ADDITIONAL CHARGE (SEE FEE SCHEDULE) F9 - ehapphcatlon 07/31/2013 16:41 Page 2 of4 THIS IS NOT A PERMIT Case # RBPR-07-2013-17726 CATAWBA COUNTY HEALTH DEPARTMENT PLAN REVIEW APPLICATION FOR ENVIRONMENTAL SERVICES Residential Building Plan Review - Building Addition IMPROVEMENT :A 0 Contractor~ _ M. KEVIN BRADSHAW, 3761 OLD SHELBY RD, HICKORY NC 28602 C:828-320-9717 Owner THERESA COLEMAN, PO BOX 11341, HICKORY NC 28603 H:828-256-0174 HOME: 828-256-0174 NAME TO APPEAR ON PERMIT Theresa Coleman SITE ADDRESS: 4045 24TH ST PL NE, HICKORY NC 28601 PIN # 372406385690 NAME of SUBDIVISION: SNO-CREEK HEIGHTS Lot # 22 Section/Block PROPERTY SIZE: Square Feet Acres 0.62 DIRECTIONS: SPRINGS RD/ LEFT SULPHURS RD / LEFT SNOW CREEK / LEFT 25TH ST NE/ RT 24TH ST PL NE PRIMARY CONTACT: Contractor SEWER TYPE: Septic Tank GALLONS PER DAY: 360 WATER SUPPLY: Community Well DESCRIBE WORK: LAUNDRY ROOM 8 X 9 ADDITION TO EXISTING DWELLING 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? No APPLICATION FOR: Existing Structure STRUCTURE TYPE: PRIMARY RESIDENCE FACILITY TYPE: Single Family Residence OTHER DESCRIPTION: DESCRIPTION OF SINGLE FAMILY DWELLING EXISTING STRUCTURES ON SITE (IF ANY) DIM EXISTING STRUCTURE: 55 X 26 NUMBER OF EXISTING BEDROOMS: 3 # OF OCCUPANTS: 3 PROPOSED CONSTRUCTION NEW STRUCTURE DIM:: 8 X 9 Desired system types (Improvement Permit or Authorization to Construct): ACCEPTED: ALTERNATIVE: CONVENTIONAL: OTHER: INNOVATIVE: ANY: 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 a solely responsible for the proper identification and labeling of all property lines and corners and making the site acce"s/ ble,�51, at a co 't� site ation can be performed. Date: % ��_ — Signature of Applicant or Agent ` 11 o 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 69 - chapplicalion 07/24/2013 15:40 Page 1 of A CATAWBA COUNTY Case # RBPR-07-2013-17726 Public Health Department Subdivision SNO-CREEK HEIGHTS d nava, Environmental Health Division PIN# 372406385690 PO Box 389, 100-A Southwest Blvd, Newton, NC 28658 Ig 2 SM NAME ON PERMIT: THERESA COLEMAN, PO BOX 11341, HICKORY NC 28603 Site Address: 4045 24TH ST PL NE, HICKORY NC 28601 Property Size: Square Feet Acres 0.62 Directions: SPRINGS RD/ LEFT SULPHURS RD / LEFT SNOW CREEK / LEFT 25TH ST NE/ RT 24TH ST PL NE MINIMUM SETBACKS FRONT: 30 SIDE: 15 REAR: 30 MAX HEIGHT: FEENAME Improvement Permit Fee TOTAL FEES DATE FEE AMOUNT 07/24/2013 $150.00 $150.00 SYSTEM REDESIGN AND/OR RETRIP WILL INCUR AN ADDITIONAL CHARGE (SEE FEE SCHEDULE) G9 - chapplicalion 07/24/2013 15:40 Page 2 of CATAWBA THIS IS NOT A PERMIT e COUNTY �� -� CATAWBA COUNTY HEALTH DEPARTMENT Application for Environmental Services Page 1 Improvement Permit VAuthorization 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 NewConstruction[D' Existing Facility ❑ Property Address A S� dc / �' L Subdivision Lot# Acres / Section/Block/Phase Driving Directions to Property NAME TO APPEAR ON PERMIT? ®'Owner ❑ Applicant ❑ Contractor Applicant Contact Information Name j�1 /`CS *xM Address 0 ;z ti 5 7f $Oj_ A4 Phone 5a8- �Co_ ®L►Z�t I Cell Phone Owner Contact Information Name Address Phone Cell Phone Contractor Contact Information Name j%) i Gli,9�� j�� [✓5�.�(•t Address ( t? �r S% �b �/ eL %��c' �/^�! /1�'(4 I Phone ` I Cell Phone WHO WILL BE THE PRIMARY CONTACT? ❑ Owner ❑ Applicant [L -Contractor Description of Existing Structures on Site # of Bedrooms *t 3 Structure Dimensions G15xi # of Occupants Basement ❑'l'es ❑ 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. es VNo Does the site contain any jurisdictional wetlands? 12OYes -No Does the site contain any existing wastewater systems? ❑ Yes la'No Is any wastewater going to be generated on the site other than domestic sewage? Is -fes 'No Is the site subject to approval by any other public agency? ❑ Yes PINo Are there any easements or right of ways on this property? Describe Existing water supply in use ❑ Individual Well 0Community 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 11 Alternative 0 Conventional ❑ Innovative 0 Other ❑ Any CATHWBA THIS IS NOT A PERMIT COUNTY / CATAWBA COUNTY HEALTH DEPARTMENT Application for Environmental Services Proposed Facility Type ❑ Primary Residence ❑ New ResidenceAddition to Residence # of New Bedrooms *t / Project Description 1,AJC4 � p 6 fn Structure Dimensions O kq la # of Occupants Basement aYes ❑ No Basement Fixtures DYes ❑ No ❑ Accessory Structure(s) Describe # of New Bedrooms *f if applicable Structure Dimensions # of Occupants Accessory Dwelling ❑ Yes ❑ No Plumbing ❑ Yes Ej'No Describe Plumbing Needed U Multi -Family Residence # Units #Bedrooms per Unit*i Total # Bedrooms 'I Structure Dimensions U Food Service Specify 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 Type Specify If Church # of Seats Kitchen ❑ Yes ❑ No If Daycare Specify Occupancy 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 Page 2 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 %G' /„ �v i�.i v Date �7 ' 7 Printed Name of Owner or Agent N I inch = 40 feet 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: 3724-06-38-569( Prepared for: 18.15 152.4, 4578 THIS IS NOT A LEGAL DOCUMENN. Time: 3:06:02 PM CATAWBA COUNTY NC - Parcel Report Information Regarding Selected Parcel(s) Parcel ID: 3724-06-38-5690 Name: EMANUEL THERESA COLEMAN Name2: Address: PO BOX 11341 Address2: City: HICKORY State: NC Zip: 28603-4841 Account: Calc Acreage: 0.62 Tax Map: 0718 01007 LRK: 37856 Deed Book: 3166 Deed Page: 1868 Subdivision Name: SNO-CREEK HEIGHTS Subdivision Block: Lots: 22 Plat Book: 12 Plat Page: 110 Building Number: 4045 Street Name: 24TH ST PL NE Site Zip: 28601 Township: CLINES Fire Dist: ST STEPHENS City/Tax: State Road: Total Bldgs Value: $92,700 Land Value: $17,400 Total Value: $110,100 Year Built: 1970 Year Remodeled: Last Sale Date: 9/19/2003 Last Sale Amount: $113,500 Neighborhood: 56 Watershed: Watershed Split: NO Voter Precinct: P29 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: SNOW CREEK Middle School: ARNDT High School: ST STEPHENS School Split: NO P&Z Case Number: Census Tract 2010: 010301 Census Block 2010: 2005 Small Area Plan: ST STEPHENS/OXFORD Agricultural District: Printed: Wednesday, July 24, 2013 03:06 PM J l��