HomeMy WebLinkAboutRBPR-07-2013-17735.TIFTHIS IS NOT A PERMIT Case # RBPR-07-2013-17735
CATAWBA COUNTY HEALTH DEPARTMENT
PLAN REVIEW APPLICATION FOR ENVIRONMENTAL SERVICES
Residential Building Plan Review - Accessory Structure
IMPROVEMENT
Applicant RODNEY LONG II, 3792 S NC 127 HWY, HICKORY NC 28602
C:828-302-8063
Owner RODNEY LONG 11, 3792 S NC 127 HWY, HICKORY NC 28602
C:828-302-8063
NAME TO APPEAR ON PERMIT
Rodney Long II
SITE ADDRESS: 3792 S NC 127 HWY, HICKORY NC 28602
PIN # 279009272104
NAME of SUBDIVISION: Lot # Section/Block
PROPERTY SIZE: Square Feet Acres 0.86
DIRECTIONS: FROM US 321/ EXIT ONTO 127S/ GO SOUTH / HOUSE ON LEFT BESIDE HOMESTEAD SIGN (HOMESTEAD
SUBDM
PRIMARY CONTACT: Owner SEWER TYPE: Public Sewer
GALLONS PER DAY: 480 WATER SUPPLY: Private Well
DESCRIBE WORK: NEW METAL ACCESSORY BUILDING 40 X 40
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?
Does this site contain any existing wastewater systems?
Is any of the wastewater going to be generated on the site other than domestic sewage?
Is the site subject to approval by any other public agency?
Are there any easements or right-of-ways on this property? No
APPLICATION FOR: New Structure
STRUCTURE TYPE: ACCESSORY STRUCTURE
FACILITY TYPE:CSingle Family Residence OTHER DESCRIPTION:
DESCRIPTION OF 6INGIE FAMILY DWELLING
EXISTING STRUCTURES
ON SITE (IF ANY)
DIM EXISTING STRUCTURE: 68 X 35
NUMBER OF EXISTING BEDROOMS: 4 # OF OCCUPANTS: 4
PROPOSED CONSTRUCTION
NEW STRUCTURE DIM:: 40 X 40
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 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 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
F9 - ehapplication 08/01/2013 IT58 Page 1 of 4
Applicant
Owner
THIS IS NOT A PERMIT Case # RBPR-07-2013-17735
CATAWBA COUNTY HEALTH DEPARTMENT
PLAN REVIEW APPLICATION FOR ENVIRONMENTAL SERVICES
Residential Building Plan Review - Accessory Structure
IMPROVEMENT
RODNEY LONG II, 3792 S NC 127 HWY, HICKORY NC 28602
C:828-302-8063
RODNEY LONG Il, 3792 S NC 127 HWY, HICKORY NC 28602
C:828-302-8063
NAME TO APPEAR ON PERMIT
Rodney Long II
SITE ADDRESS: 3792 S NC 127 HWY, HICKORY NC 28602
NAME of SUBDIVISION:
PIN # 279009272104
Lot # Section/Block
PROPERTY SIZE: Square Feet Acres 0.86
DIRECTIONS: FROM US 321/ EXIT ONTO 127S/ GO SOUTH / HOUSE ON LEFT BESIDE HOMESTEAD SIGN (HOMESTEAD
SUBDIV)
PRIMARY CONTACT: Owner SEWER TYPE: Public Sewer
GALLONS PER DAY: 480 WATER SUPPLY: Private Well
DESCRIBE WORK: NEW METAL ACCESSORY BUILDING 40 X 40
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?
Does this site contain any existing wastewater systems?
Is any of the wastewater going to be generated on the site other than domestic sewage?
Is the site subject to approval by any other public agency?
Are there any easements or right-of-ways on this property? No
APPLICATION FOR: New Structure
STRUCTURE TYPE: ACCESSORY STRUCTURE
FACILITY TYPE: Accessory Structure OTHER DESCRIPTION:
DESCRIPTION OF SINGLE FAMILY DWELLING
EXISTING STRUCTURES
ON SITE (IF ANY)
DIM EXISTING STRUCTURE: 68 X 35
NUMBER OF EXISTING BEDROOMS: 4 # OF OCCUPANTS: 4
PROPOSED CONSTRUCTION
NEW STRUCTURE DIM:: 40 X 40
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 am solely responsible for the
proper identification and labeling of all property lines and corners and making the site ac si sblo o that a co�"� fete site evaluation can be performed.
Date: ! a �c3 i Signature of Applicant or Agent 4 e ^ i�
An Environmental Health Specialist will contact you within 2 working 6a)Uof application date.
If you need further information or assistance please call 828-466-7291
AREA2
1-1) - Aapplicaiwn 07/25/2013 16:04 Page I of
vagA CATAWBA COUNTY Case # RBPR-07-2013-17735
Public Health Department Subdivision
Environmental Health bivision PIN# 279009272104
Q
u tea®
PO Box 389, 100-A Southwest Blvd, Newton, NC 28658
1842 5 -
NAME ON PERMIT: RODNEY LONG II, 3792 S NC 127 HWY, HICKORY NC 28602
Site Address: 3792 S NC 127 HWY, HICKORY NC 28602
Property Size: Square Feet Acres 0.86
Directions: FROM US 321/ EXIT ONTO 127S/ GO SOUTH / HOUSE ON LEFT BESIDE HOMESTEAD SIGN (HOMESTEAD SUBDIV)
MINIMUM SETBACKS FRONT: 30 SIDE: 10 REAR: 5 MAX HEIGHT:
FEENAME DATE FEE AMOUNT
Improvement Permit Fee 07/25/2013 $150.00
TOTAL FEES $150.00
SYSTEM REDESIGN AND/OR RETRIP WILL INCUR AN ADDITIONAL CHARGE
(SEE FEE SCHEDULE)
1-:1) - 0happifraiion 07/25/2013 16:04 Page 2 of
CATAWBA THIS IS NOT A PERMIT
COU�l`7►.V�V A CATAWBA COUNTY HEALTH DEPARTMENT
Application for Environmental Services Page 1
Improvement Permit V 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
Property Address
New Construction ❑ Existing Facility ❑
G Z.
Cos_
Driving Directions to Property j= �o 0 3), I k r l
Ncv;P L S o/x LF -T Aom,- s4rk
NAME TO APPEAR ON PERMIT,
Applicant Contact Information
Name
Address 3` c) wE, I z*7 S
Phone aa� . �,Iq
Owner Contact Information
Name
Address
Phone
Contractor Contact Information
Name
Address
Phone
Subdivision
Lot # Acres
Section/Block/Phase
Owner ❑ Applicant ❑ Contractor
Cell Phone
Cell Phone
Cell Phone
WHO WILL BE THE PRIMARY CONTACT? [G] -Owner ❑ Applicant ❑ Contractor
Description of Existing Stnuctures on Site ;? .tcr, LA C L. s,— i arM
# of Bedrooms Structure Dimensions # of Occupants q
Basement ❑ Yes [� No Basement Fixtures ❑ Yes Z1 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 0 No Does the site contain any jurisdictional wetlands?
XYes , f,No Does the site contain any existing wastewater systems'?
❑ Yes O No Is any wastewater going to be generated on the site other than domestic sewage?
XYes No Is the site subject to approval by any other public agency?
❑ Yes lrNo Are there any easements or right of ways on this property? Describe
Existing water supply in use Individual Well ❑ Community Well ❑ Semi -Public Well
❑ County/City/Township Water Line Is a public water supply available? ** ❑ Yes ZNo
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)
11 Accepted 0 Alternative 0 Conventional 0 Innovative ❑ Other 0 Any
CA .A.
COUNTY
North Cnrolln
THIS IS NOT A PERMIT
CATAWBA COUNTY HEALTH DEPARTMENT '
Application for Environmental Services
Proposed Facility Type
❑ Primary Residence ❑ New Residence ❑ Addition to Residence # of New Bedrooms * j
Project Description
Structure Dimensions # of Occupants
Basement ❑ Yes ❑ No Basement Fixtures ❑ Yes ❑ No
[�
Accessory
A
of New Bedrooms applicable ory Structure(s) Describe q0 Kq0 3 C r 3A,-6q
_e_
if ' pp able Structure Dimensions
# of Occupants Accessory Dwelling ❑ Yes ❑ No
Plumbing ❑ Yes ❑ No Describe Plumbing Needed
❑ Multi -Family Residence #Units #Bedrooms per Unit*j-
Total # Bedrooms *t Structure Dimensions
F] Food Service Specify Type
# Seats Floor Space -Entire Food Service Facility (Sq Ft)
# Employees per Shift # of Shifts Ditung Area (Sq. Ft.)
❑ Business Specific Type of Business Retail Floor Space
# of Employees per Shift # of Shifts
❑ p
Other FacilityType e S ecifY
If Church # of Seats Kitchen ❑ Yes ❑ No If Daycare Specify Occupancy
Application l .
p . ., ,... 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 -� 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.
j 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 Agcnr— �4� , Date 'IT )_d `
Printed Name of Owner or Agent
Catawba County, North Carolina
w'
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: 2790-09-27-2104
1 inch = 40 feet
Prepared for:
CP
NJ N
THIS IS NOT A LEGAL DOCUMENT
Date: 7/25/2013
Time: 3:30:23 PM
32
c
CATAWBA COUNTY NC - Parcel Report
Information Regarding Selected Parcel(s)
Parcel ID:
2790O9,-27-2104
Name:
LONG RODNEYA II
Name2:
PARKER -LONG COURTNEY
Address:
3792 S NC 127 HWY
Address2:
City:
HICKORY
State:
NC
Zip:
28602-8239
Account:
Calc Acreage:
0.86
Tax Map:
175H 03026B
L R K:
59324
Deed Book:
2746
Deed Page:
1615
Subdivision Name:
Subdivision Block:
Lots:
Plat Book:
Plat Page:
Building Number:
3792
Street Name:
S NC 127 HWY
Site Zip:
28602
Township:
HICKORY
Fire Dist:
MOUNTAIN VIEW
City/Tax:
State Road:
Total Bldgs Value:
$158,700
Land Value:
$16,900
Total Value:
$175,600
Year Built:
1907
Year Remodeled:
2006
Last Sale Date:
4/28/2006
Last Sale Amount:
$160,000
Neighborhood:
81
Watershed:
WS -III Protected Area
Watershed Split:
NO
Voter Precinct:
P24
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:
MOUNTAIN VIEW
Middle School:
JACOBS FORK
High School:
FRED T FOARD
School Split:
NO
P&Z Case Number:
Census Tract 2010: 011801
Census Block 2010: 2009
Small Area Plan:
MOUNTAIN VIEW
Agricultural District:
Printed: Thursday,
July 25, 2013 03:30 PM
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