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Home My WebLink AboutEHPR-11-09-2447 (2).TIF ~A C THIS IS NOT A PERMIT Case # EHPR-I 1-09-2447 CATAWBA COUNTY HEALTH DEPARTMENT Plan Review Application for Environmental Services \1842 sM Environmental Health Plan Review - OSWP APPLICANT OWNER; - CONTIR CTOR ADRIAN BAALAN ADRIAN.BAI.AN 6004 GLEN.WOOD PL_ CT' .6004 GLENWOOD PL CT' HICKORY NC 28602 HICKORY NC 28602 828-962-6263 828-962-6263 NAME TO APPEAR ON PERMIT ADRIAN BALAN Pin#: 268902880978 SITE ADDRESS: 1359 SHADOWFAX WYND, Hickory, NC DIRECTIONS: TAKE EXIT 321 S FROM HWY 70/ RT ON NC 127 W/ CONTINUE S/ RT ON DEERFIELD LN/ CONTINUE ON FAWN TRL/ RT ON SHIREBOURN/ RT ON WILLOWBOTTOM RD/ RT ON SHADOWFAX WYND/ ON LT NAME of SUBDIVISION: DEERFIELD 4 Lot # 48 Section/Block/Phase PROPERTY SIZE: Square Feet Acres 1.23 Date Platted/Recorded TYPE OF FACILITY: House X Mobile Home Dimension of Structure Bedrooms 4 Basement: Yes Water Using Fixtures in Basement:Yes No. in Family Whirlpool Tub : Gal. Capacity: MULTIPLE FAMILY RESIDENCE: Units a 00.;, ~.x. Total Number of Bedrooms DAYCARE: Number of Children RESTAURANT: Seats Square Feet Dining Area Square Feet Foodstand/Meat Market Floor Space TYPE OF BUSINESS: Number of Employees 1st 2nd 3rd OTHER: (Specify) Do you aniticipate any additions to Facility? If so, describe: Has any grading, removal, or addition of soil.been done to this property?' If so, describe Are there easements/right-of-ways recorded on this property? No k Type of Water Supply: Individual Well X Cornmunitj %Vcll Municipal Semi-Public I understand that this is a formal application for a well permit, Improvement permit or Authorization to Construct a ground absorption sewage disposal system to serve the above described facility on this property and authorize Catawba County Health Department employees to go on this property for evaluation purposes. I certify the above information to be correct and understand that an Improvement Permit issued as a result of this information is transferable and may be eligible for a non-expiring date, but may be revoked if this information, site plans or intended use changes for the proposed facility. A Well Permit and Authorization to Construct issued by this department is valid for (5) five years from the date issued and is not transferable. Note: You must obtain Zoning Approval prior to locating a home or structure on this property. epresenta ' Phi of house or structure location should conform to applicable setbacks. Date: it 0Z 0° 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• AREA 2 (FOR OFFICE USE ONLY) Zoning Approval -Yes No Zoning Approval UDO Zoning Form A Minimum Setbacks Front 30 FEF NAME DATE- AMOUNT Imuruvuuiuijt I'u, mut Fee ltl/0272~OOy 5150:00 Side 15 Rear 30 TOTAL FEES $150.00 Max Hght *If a permit has to be redesigned and / or RETRIPS made to the property, there is an additional S60 charge 11/02/09 08:36 THIS IS NOT A PERMIT WLS # CATAWBA COUNTY HEALTH DEPARTMENT Ap 'cation for Environmental Services Improvement Permit Authorization to Construct ❑ Septic Repair El Septic Expansion ❑ Existing Tank Check E] New Well Permit E] Replacement Well ❑ Well Abandonment ❑ I . Name to Appear on Permit A- W2~ kr, i '3 A L-A a of 1) 2. Permit Requested By A-L-);L~, A:-4 7b AL Ari Business Phone 8JE 2_-6Z6 3 Address 600(3tencymA ?to - c .c ' NC a Home Phone 3. Property Owner Business Phone Address 50'~ e Home Phone _ 4. Name of Subdivision Lot #L12?_ Section/Block/Phase I y Property Address 13M 'S dawVe~-x Q Vc Z Directions to Property: 5. Property Size: Square Feet Acres o 2 Date Platted/Recorded 6. TYPE OF FACILITY: House Mobile Home Dimension of Structure 4iO,<60 Bedrooms*_ `kAm roomlh:u ill he intended ,,i ing at the time of cornstruction (,r I oi Ii illu c .onsideration should be rioted as a bedrooii) and counted on all application,. fhc'iiuunber of bedrooms will be confirmed b}7 roonisidentified on house plans-ass,d bedroom {at the time of Uuildin- permit i~ Hance This way pre ent'the need fot~system size incrziSe in the fuluie: Basement: yes no 'Water Using Fixtures in Basement: 911,0 No. in Family Whirlpool T-ub yes/no Gallon Capacity MULTIPLE FAMILY RESIDENCES: Units 2 Total Number of Bedrooms DAY CARE: Number of Children RESTAURANT: Seats Square Feet Dining Area -Square Feet Food stand/Meat Market Floor Space TYPE OF BUSINESS: Number of Employees 1 st 2nd 3rd OTHER: (Specify) 7. Do you anticipate any additions to Facility? Yes (2D If so, describe: 8. Has any grading, removal, or addition of soil been done to this property? Ye / No If so, describe: 9. Are there easements/right-of-ways recorded on this property? Yes / No 10. Is a public water supply available on or adjacent to the above property? Yes / No Check type that is available: [ ] Community well [ ] Semi-public well [ County/City/Township water line **If No, a Well Permit must be' ued with the Septic Permit.** 11. Well Type Applying For: ndividual well [ ] Community well [ ] Semi-Public well I understand that this is a formal application for a well permit, Improvement Permit or Authorization to Construct a ground absorption sewage disposal system to serve the above described facility on this property and authorize Catawba County Health Department employees to go on this property for evaluation purposes. I certify the above information to be correct and understand that an Improvement Permit issued as a result of this information is valid for 5 years or may be non-expiring under certain specified conditions. Improvement Permits and Well Permits are transferable, but may be revoked if this information, site plans or intended use changes for the proposed facility. An Authorization to Construct issued by this department is valid for (5) five years from the date issued and is not transferable. Note: You must obtain Zoning Approval prior to locating a home or structure on this property. Any representation by you of house or structure location should conform to applicable setbacks. **IF A PERMIT HAS TO BE REDESIGNED AND/OR RETRIPS MADE TO THE P T , THE S A DITIONAL CHARGE,** Date `~L- 0_00- Signature of Owner or Agent Catawba County, North Carolina This map product was prepared from the Catawba Caumr. NC, Geographic h formation Srstem. N Colorha Count has made substantial cff rls to ensm e the ocomoct1 of localion cmd labeling m fm matiar cooained oo this map. Colowba Counm promotes and recommends the mdependeot reriIicotio)i ojam: dato contained on this mop product btu the user. The Coumr ofCotawha, its emplorecs, ageois and personnel disclaim. and shall not be held lioblc fin" cam and all damages, loss or liobilim, whether direct, indirect or consequential which arises or moV arise fi om this mop product or the use Ihcreof big cm person or Colity. Legend Selected Parcel Number: 2639-02-88-0978 I inch = 60 feet Prepared for: F r Y, v- .f u i t i J ti n sf 7 8`19127? 1. L 3A, , 9 7, 8 . 1 i = 48 (9 U~ 0 12 57 o M 1. z6 i 5 d C. I fFIIS IS NOT A L, I' GAI D 0 C" V LIME iNT t t Monday, November 02, 2009 08:06 Ai'I ~`7 CATAWBA COUNTY NC - Parcel Report Information Regarding Selected Parcel(s) Parcel ID: 2689-02-88-0978 Name: ' ABERNETHY AVERY MARK Name2: ABERNETHY GARY JAMES Address: 825 3RD AVE NW Address2: City: HICKORY State: NC Zip: 28601-4806 Account: 161179 Calc Acreage: 1.23 Tax Map: 002AB 01048 LRK: 90705 Deed Book: 1712 Deed Page: 0151 Subdivision Name: DEERFIELD 4 Subdivision Block: Lots: 48 Plat Book: 29 Plat Page: 13 Building Number: 1359 Street Name: SHADOWFAX WYND Site Zip: 28602 Township: BANDY'S Fire Code: MOUNTAIN VIEW City Code: COUNTY State Road: Total Bldgs Value: Land Value: $27,500 Total Value: $27,500 Year Built: Year Remodeled: Last Sale Date: Last Sale Amount: Neighborhood: 82 Watershed: WS-III Protected Area Watershed Split: NO Voter Precinct: P24 E911 District: COUNTY Zoning: R-40 Zoning2: Zoning3: Zoning Split: N Zoning Overlay: WP-0 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: 1023 Small Area Plan: MOUNTAIN VIEW Agricultural District: Printed: Monday, November 02, 2009 08:00 AM ~A COQ CATAWBA COUNTY, NC C 100-A South West Blvd PLAN '~V /~~V®'CC Newton, NC 28658- V (828)465-8399 ® Monday, November 2, 2009 184 2 sM www.catawbacountync.gov Plan Case: EHPR-11-09-2447 Invoice Number: I NV-1 1-09-256808 Environmental Health Plan Review Invoice Date: 11/02/2009 Fee Name Fee Amount Improvement Permit Fee Fixed $150.00 Total Fees Due: $150.00 PAYMENTS Date Pay Type Check Number Amount Paid Change 11/02/2009 Credit Card -1 $150.00 $0.00 Total Paid: $150.00 Total Due: $0.00 plan ine't icc ;!?<<1t }.il>-f)tiy 1_ y(}_u>>il lnc;t9ce 1 b).rpt 11/02/2009 08:57