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Home My WebLink AboutRBPR-07-2014-19468.TIFTHIS IS NOT A PERMIT Case # RBPR-07-2014-19468 CATAWBA COUNTY HEALTH DEPARTMENT PLAN REVIEW APPLICATION FOR ENVIRONMENTAL SERVICES Residential Building Plan Review - Building Addition IMPROVEMENT D Ls F21 0 Owner JAMES COOK, 3825 SWANSON RD, SHERRILLS FORD NC 28673-8329 NAME TO APPEAR ON PERMIT James Cook SITE ADDRESS: 3825 SWANSON RD, SHERRILLS FORD NC 28673 PIN # 460702559264 NAME of SUBDIVISION: CRESCENT LAND AND TIMBER CORP Lot # 169 Section/Block PROPERTY SIZE: Square Feet Acres 0.97 DIRECTIONS: SHERRILLS FORD RD TOWARD TERRELL/ RT ON BEATTY RD/ LT ON REID CIRI RT ON SWANSON RD/ HOUSE ON RT PRIMARY CONTACT: Owner SEWER TYPE: Septic Tank GALLONS PER DAY: WATER SUPPLY: Private Well DESCRIBE WORK: adding 20 x 28 attached garage 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: STRUCTURE TYPE: Existing Structure PRIMARY RESIDENCE FACILITY TYPE: Single Family Residence OTHER DESCRIPTION: DESCRIPTION OF single family EXISTING STRUCTURES ON SITE (IF ANY) DIM EXISTING STRUCTURE: 86 x 80 NUMBER OF EXISTING BEDROOMS: 3 # OF OCCUPANTS: 2 PROPOSED CONSTRUCTION NEW STRUCTURE DIM:: 20 x 28 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: 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. 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 AREA1 MINIMUM SETBACKS FRONT: 30 SIDE: 15 REAR: 30 MAX HEIGHT: D) chappliratxm 07/11/2014 15:18 Page 1 of �yX�A CATAWBA COUNTY Case # RBPR-07-2014-19468 Public Health Department Subdivision CRESCENT LAND AND TIMBE Environmental Health Division PIN# 460702559264 PO Boa 389, 100-A Southwest Blvd, Newton, NC 28658 1842 NAME ON PERMIT: ( JAMES COOK), 3825 SWANSON RD, SHERRILLS FORD NC 28673-8329 ( James Cook) Site Address: 3825 SWANSON RD, SHERRILLS FORD NC 28673 Property Size: Square Feet Acres 0.97 Directions: SHERRILLS FORD RD TOWARD TERRELL/ RT ON BEATTY RD/ LT ON REID CIR/ RT ON SWANSON RD/ HOUSE ON RT FEENAME Improvement Permit Fee TOTAL FEES DATE FEE AMOUNT 07/11/2014 $150.00 $150.00 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) CQ - chapplicalion 07/11/2014 15:18 Page 2 of THIS IS NOT A PERMIT - CnUN.TY CATAWBA COUNTY HEALTH DEPARTMENT Application for Environmental Services 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 E:1 Existing Facility [:1Property Address �� l,cUY�{�� l 1'`JC Subdivision c`�" `�.VV',A�� ;:;fir ` �V�` c ot# Acres Secdon/Block/Phase Driving Directions to Property NAME TO APPEAR ON PERMIT? [v3Owner ❑ Applicant ❑ Contractor Applicant Contact Information Name Address HcaS `cel ��, �� , � er `C �� C , �l `�0 Phone <:�ag CellPhone Owner Contact Information Name —VXM� (I -=,. ( Address Phone I Cell Phone Contractor Contact Information Name Address Phone Cell Phone WHO WILL BE THE PRIMARY CONTACT? ❑ Owner ❑ Applicant ❑ Contractor �!n `+. ...,,�,,........,-.._....,, ,... ,. Des �g Structures on Site # of BedroomsStructure Dimensions To # of Occupants ..��,,. Basement ❑ Yes P'to 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. �1 �Yes eNo Does the site contain any jurisdictional wetlands? l7'1'es V No Does the site contain any existing wastewater systems? a Yes �No Is any wastewater going to be generated on the site other than domestic sewage? 9(Yes 0 No Is the site subject to approval by any other public agency? 11 Yes ONo Are there any easements or right of ways on this property? Describe Exis�gCounty/City/Township �� Individual ual Well Is❑a public waters supply available? Semi-Public Yes I�SNo , water supply "muse emi e. ** 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) 13 Accepted 0 Alternative 0 Conventional 7 Innovative 11 Other RAny i CATAWBA THIS IS NOT A PERMIT COUNT]' � �= E �_:.. cCATAWBA COUNTY HEALTH DEPARTMENT Application for Enviromnental Services Page 2 Proposed Facility Type ❑ Primary Residence ❑,�Tew Residence Addition to Residence # of New Bedrooms * j' Project Description Structure Dimensions(»( # of Occupants Basement ❑ Yes No Basement Fixtures Yes No ❑ Accessory Structure(s) Describe # of New Bedrooms *t if applicable Structure Dimensions # of Occupants Accessory Dwelling ❑ Yes ❑ No Plumbing ❑ Yes ❑ No Describe Plumbing Needed U Multi -Family Residence # Units #Bedrooms per Unit*t Total # Bedrooms *t Structure Dimensions Food Service Sp ecify 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 Abandonment Type ❑ Drilled ❑ Bored Well Repair Requested ❑ Yes ❑ No Describe ❑ Community Well ❑ Dug ❑ Unknown 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 Ag nt �� Date 1 Printed Name of Owner or Agent IY 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: 4607-02-55-9264 1 inch = 60 feet Prepared for: MOv. N 2A C lat 15-11� 8-' 9'98 1 ro, 16 THIS IS NOT A LEGAL DOCUMEN'� 0 264 CO 225_..1 1 16.8. N Co, i8 60 Date Shed: 6/11/2014 i r r ^Time:4f 2M84jPM CATAWBA COUNTY NC - Parcel Report Informatidn Regarding Selected Parcel(s) Parcel ID: 4607-02-55-9264 Name: COOK JAMES CRAIG Name2: COOK SONYA G Address: 3825 SWANSON RD Address2: City: SHERRILLS FORD State: NC Zip: 28673-8329 Account: Calc Acreage: 0.97 Tax Map: 012 X 32169 LRK: 12908 Deed Book: 1885 Deed Page: 0782 Subdivision Name: CRESCENT LAND AND TIMBER CORP Subdivision Block: Lots: 169 Plat Book: 15 Plat Page: 187 Building Number: 3825 Street Name: SWANSON RD Site Zip: 28673 Township: MOUNTAIN CREEK Fire Dist: SHERRILLS FORD City/Tax: State Road: 1976 Total Bldgs Value: $261,600 Land Value: $138,700 Total Value: $400,300 Year Built: 1972 Year Remodeled: 1995 Last Sale Date: Last Sale Amount: Neighborhood: 129 Watershed: WS -IV Critical Area Watershed Split: NO Voter Precinct: P31 E911 District: COUNTY Zoning: R-30 Zoning2: Zoning3: Zoning Split: N Zoning Overlay: CRC-O,WP-O,FPM-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: 3003 Small Area Plan: SHERRILLS FORD Agricultural District: Printed: Wednesday, July 09, 2014 04:28 PM a ( rec4y Sia✓kd Vv 0ATAWBA coc%1-rY Public Health Department Case # WLS2006-01871 .: Envimunental Health Division Subdivision CRESCENT LAND AND MIE \ ' PO Box 389. 100-A Southwest Blvd. Newton, N -C 28658 Sect/BIJPh/L.ot # 69 .'828) 465-8270 FAX (528; 465-8276 TDD t82S) 465-8200 Pte# I607U255926 Applicant/Owner: CRAIG (JAMES) COOK Site Address: 3825 SWANSON RD SI IERRILLS FORD NC Property" size: SF .97 ACRES Directions: SHERRILLS FORD RD TOWARD TERRELU RT ON BEATTY RD/ LT ON REID CIR/ RT ON SWANSON RD/ HOUSE ON RT EXISTING SEPTIC SYSTEM INSPECTION REPORT Site/Svstem Diagram Type of Facility: House X Mobile Home # Bedrooms 4__ Business Specify Other Specify Proposed Additions / Accessory Structures: a/' X 3 y ` �,4l2l;,�- 75- 1 Approved --4_ Not Approved Reason Evidence of system malfunction: YES NO _ System Type/Description Authorized State Agent: / DATE: NOT FOR LOAN APPROVAL Form E A7 �nnnr:\Fo�n.V �t L.. oo.rm