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Home My WebLink AboutRBPR-07-2014-19552.TIFTHIS IS NOT A PERMIT Case # RBPR-07-2014-19552 CATAW13A COUNTY HEALTH DEPARTMENT PLAN REVIEW APPLICATION FOR ENVIRONMENTAL SERVICES Residential Building Plan Review - Building Addition IMPROVEMENT Owner RALPH COCHRANE, 7076 ROLLING HILLS DR, SHERRILLS FORD NC 28673 C:8645080174 NAME TO APPEAR ON PERMIT Ralph Cochrane SITE ADDRESS: 7076 ROLLING HILLS DR, SHERRILLS FORD NC 28673 PIN # 460703026549 NAME of SUBDIVISION: A L ROBINSON Lot # 13 Section/Block PROPERTY SIZE: Square Feet Acres 0.46 DIRECTIONS: NC 16S to NC 150E/left onto Little Mtn Rd/ half mile turn left onto Rolling Hills Rd/ 150 yds/turn left @ stop sign/4th house on right PRIMARY CONTACT: Owner SEWER TYPE: Septic Tank GALLONS PER DAY: 240 WATER SUPPLY: Private Well DESCRIBE WORK: 21.5 x 8 addition to rear of house 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: 75 x 35 NUMBER OF EXISTING BEDROOMS: 2 NEW STRUCTURE DIM:: 21.5x8 BASEMENT? No # OF OCCUPANTS: 2 PROPOSED CONSTRUCTION BASEMENT FIXTURES? Desired system types (Improvement Permit or Authorization to Construct): ACCEPTED: ALTERNATIVE: OTHER: INNOVATIVE Other described: PLUMBING REQUIRED? CONVENTIONAL: ANY: 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 corre. Aut orized county and state officials are granted right of entry to conduct necessary inspections to determine compliance with applicable laws and ru s. I ders at I am solely responsible for the proper identificat irid latling of II property lines and corners and making the site accessib e o th co I site evaluation can be performed. Date: "� l ��J Signature of Applicant or Agent i An Environmental Health Specialist will contact you within 2 working Uays of application date. If you need further information or assistance please call 828-466-7291 AREA1 L4 - chane lication 07/21/2014 13.07 Page] of 4 vSpA CATANVBA COUNTY Case # RBPR-07-2014-19552 Public Health Department Subdivision A L ROBINSON Environmental Health Division PIN# 460703026549 ®`® PO Box 389, 100-A Southwest Blvd, Newton, NC 28658 Ig 2 sM NAME ON PERMIT: ( RALPH COCHRANE), 7076 ROLLING HILLS DR, SHERRI LLS FORD NC 28673 ( Ralph Cochrane) Site Address: 7076 ROLLING HILLS DR, SHERRILLS FORD NC 28673 Property Size: Square Feet Acres 0.46 Directions: NC 16S to NC 150E/left onto Little Mtn Rd/ half mile turn left onto Rolling Hills Rd/ 150 yds/turn left @ stop sign/4th house on right MINIMUM SETBACKS FRONT: 30 SIDE: 15 REAR: 30 MAX HEIGHT: FEENAME Improvement Permit Fee TOTAL FEES DATE FEE AMOUNT 07/21/2014 $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) FQ - chapplicaUon 07/21/2014 13:07 Page 2 of 4 pA THIS IS NOT A PERMIT u\Ti' CATAWBA COUNTY HEALTH DEPARTMENT Application for Enviromnental Services Page 1 Improvement Permit a 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] Existing Facility El Property Address / 076 6 AJ1114 / Subdivision ,Rdl,Nc, ��1 S Amb Lot # Acres 5H�Al D, /I)(- Section/Block/Phase Driving Directions to Property 1i1,f/loW�?u�N/,Sl'C#1, / T a)Td 1,401 ,,�JC9 1-1,15 h , /5Z) yaps. fr44 le-* 47— 'S -1-a 5-1G/1 y NAME TO APPEAR ON PERMIT? Q Owner ❑ Applicant ❑ Contractor Applicant Contact Information Name �.��I,fJH �kl ,7lSZ6A�1� Address Phone 5n-.9 / %q I Cell Phone 5,4/�S' Owner Contact Information I Name ,gx3j vz' I Address Phone I Cell Phone Contractor Contact Information Name Address Phone I Cell Phone WHO WILL BE THE PRIMARY CONTACT? RrOwner ❑ Applicant ❑ Contractor #lof1Bedro xist g Struch�res, on SiStructure Dimensions /6' A) ix O4fP, ' Sf/E� Des Bedrooms * oC .. '� .-' ....Vons 7.S/X �3 S # of Occupants P IZ Basement ❑ Yes [Z No Basement Fixtures 0 Yes No The Applicant shall notify'the local health department upon submittalthus of y - - application if any of the following apply t 0 the property in question. If the answer to any question is "yes", applicant must attach supporting documentation. 0 Yes 8 No Does the site contain any jurisdictional wetlands? ,Yes No Does the site contain any existing wastewater systems? 0 Yes H No Is any wastewater going to be generated on the site other than domestic sewage? Yes No Is the site subject to approval by any other public agency? 13 Yes 19 No Are there any easements or right of ways on this property? Describe Existing water su - 1 muse ��Individual Well ❑ Communi Well ❑ Serm-Pub _.....-- - -......�....,a pp y .ty . _ lic Well El I County/City/Township Water Line-� W„ Is a public watersupplyavailable : ** I,❑ -Yes .Nou+, 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) ❑ Accepted 11 Alternative ❑ Conventional 0 Innovative 11 Other 0 Any CATAWBA THIS IS NOT A PERMIT COUNTY_ CAT'AWBA COUNTY HEALTH DEPARTMENT Application for Environmental Services Page 2 Pro osed Facility Type PPrimary Residence ❑ New Residence [Addition to Residence # of New Bedrooms *t Project Description J/,1Jei1, , 6V 03, 0&-R GLS Structure Dimensions ,� ! /�� u _� # of Occupants a• Basement ❑ Yes No Basement Fixtures Yes No ❑Accessory Structure(s) ry Describe # of New Bedrooms if applicable Structure Dimensions # of Occupants Accessory Dwelling ❑ Yes ❑ No Plumbing ❑ Yes ❑ No Describe Plumbing Needed Multi -Fa Residence # Units ... #Bedrooms per Uni . U wily p t*1' Total # Bedrooms * j 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 p 'fy If Church # of Seats Kitchen ❑ Yes ❑ No If Daycare Specify Occupancy Application for Well Construction/Abando . nment/Repau• 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. 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 ��/'�''��-- Date 712 Printed Name of Owner or Agent CATAWBA COUNTY NC - Parcel Report Information Regarding Selected Parcel(s) Parcel ID: 4607-03-02-6549 Name: COCHRANE RALPH E Name2: COCHRANE APRIL S Address: 7076 ROLLING HILLS DR Address2: City: SHERRILLS FORD State: NC Zip: 28673-9759 Account: Calc Acreage: 0.46 Tax Map: 011 AX 02012 LRK: 11756 Deed Book: 3033 Deed Page: 1832 Subdivision Name: A L ROBINSON Subdivision Block: Lots: 13 Plat Book: Plat Page: Building Number: 7076 Street Name: ROLLING HILLS DR Site Zip: 28673 Township: MOUNTAIN CREEK Fire Dist: SHERRILLS FORD City/ Tax: State Road: 1941 Total Bldgs Value: $191,400 Land Value: $107,200 Total Value: $298,600 Year Built: 1967 Year Remodeled: 1971 Last Sale Date: 6/29/2010 Last Sale Amount: $315,000 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: 3039 Small Area Plan: SHERRILLS FORD Agricultural District: Printed: Monday, July 21, 2014 12:22 PM ' CATAWBA COUNTY HEALTH DEPARTMENT POW Telephone: (828) 465-8270 TDD: (828) 465-8200 WLS # Ck5r,16a IP AC Rpr. Prmt. 0 Prmt. Sys. Type Well Prmt. Replacement WellWell Rpr. Prmt. Owner/Agent ��P.� �vrt�/ Phone Address 70/l Subdivision Section/Block/Physe _ /Lot# Lot Size yZ�-4r Direc�ti/9qns: /� -S (L) iSd _ Z,-ee- �vt�iv (L% Property Address `jQ]� Kol// /f�IL.S Facility: House Mobile Home Business Multi -family . Other: Pin Number 4,17-O3 G — 6S -i -7i Other . Zoning Approval # # Bedrooms —3 # Seats # Employees . Application Rate GPD Flow Hot Tub or Spa yes/no Special Fixtures Basement yes/no 100% Repair Area yes/no Basement Plumbing yes/no Water Supply: Private Well Public Semi -Public Type of System: Trench Bed Pump Pump/Panel Panel LPP Other Septic Tank Size Pump Tank Size Nitrification Field: Total Square Feet Depth of Stone Bed Size Trench Width Total Length of All Trenches Number of Trenches Trench Length _/_/_//_J Feet on Center pMaimum Trench Depth Distance of Nearest Well *DO NOT INSTALL SEPTIC WHEN WET* / ,moi *WELL RECORD REQUIRED AT COMPLETION* Topo % Slope Texture Structure Clay Min. Soil Wetness Soil Depth Restric. Hoz. at Available space yes/no Overall Class S PS U Comments: I Q NO Filter Required Riser required when tank is more than 6 /jpC�i�'S ll�Jl? inches deep. **NO GUARANTEE OR WARRANTY IS IMPLIED OR GIVEN AS TO THE PERFORMANCE OR LENGTH OF TIME THIS SYSTEM WILL FUNCTION** *Improvement Permit has no expiration date and is transferable, but may be revoked if site plans or intended use changes for the proposed facility. An Authorization to Construct is valid for (5) five years from date issued and is not transferable. Well Permit valid for 5 years provided site conditions do not change. Well location, installation, and protection must meet state and local regulations, and must be inspected and approved by a representative of the Catawba County Health Department before any'an of the installation is put into use. The siting of the well by the Health Department staff is to provide protection from known posse e/sGr(rc of contamination. No volume of water is guaranteed at a�yy�s}te b the Health Department. Permit Date / O� �} EHS _/(/�,Cc l - �� wner/Age ��e� w �' � iv�Ztci.cr�� Septic T Installed B}� Date E Well Installed By Well Cirdu Approval Date Well Head Approval Date Date Sample Collected Date of Results Results EHS /d!(& White - Office Yellow - Owner/Agent Pink - Building Impi(ction Authorization to C