HomeMy WebLinkAboutEHPR-03-2016-23419 (2).tif hy,A �G THIS IS NOT A PERMIT Case # EHPR-03-2016-23419
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CATAWBA COUNTY HEALTH DEPARTMENT fl
f'� PLAN REVIEW APPLICATION FOR ENVIRONMENTAL SERVICES ti t
1842 sM Environmental Health Plan Review - OSWP
IMPROVEMENT
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Applicant KEVIN FULLER, 1300 HARPER LEE DR,NEWTON NC 28658
C:8282347714
NAME TO APPEAR ON PERMIT
KEVIN FULLER
SITE ADDRESS: 1322 THURBER LN, NEWTON NC 28658 PIN # 372012953881
NAME of SUBDIVISION: Avian Woods PH 3 Lot# 39&40 Section/Block
PROPERTY SIZE: Square Feet 74,923.20 Acres 1.72
DIRECTIONS: Startown Rd, left on Milton St, left on Thurber Ln, lots on right at end of cul-de-sac
PRIMARY CONTACT: Applicant SEWER TYPE: Septic Tank
GALLONS PER DAY: 480 WATER SUPPLY: Private Well
DESCRIBE WORK: Revised 3/29/16 - Changed house dimensions to be 65x85
IP Only property combination
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? No
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? No
Are there any easements or right-of-ways on this property? No
APPLICATION FOR: New Structure
STRUCTURE TYPE: PRIMARY RESIDENCE
FACILITY TYPE: House OTHER DESCRIPTION:
DESCRIPTION OF
EXISTING STRUCTURES
ON SITE (IF ANY)
DIM EXISTING STRUCTURE:
NUMBER OF EXISTING BEDROOMS: #OF OCCUPANTS: 4
PROPOSED CONSTRUCTION
NEW STRUCTURE DIM:: 65 x 85 )
#OF NEW BEDROOMS:: 4
BASEMENT? Yes BASEMENT FIXTURES? Yes PLUMBING REQUIRED?Yes
Desired system types (Improvement Permit or Authorization to Construct):
ACCEPTED: ALTERNATIVE: CONVENTIONAL: YES
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 I eling of all property lines and corners and making the site accessi le sot a com lete site evaluation can be performed.
Date: k V Signature of Applicant or Agent
An Environmental Health Specialist will contact you within 5 wor Img days of application date.
I f you need further information or assistance please call 828-466-7291
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/45:cri CATAWBA COUNTY Case it EIPR-03-2016-23419
(.7 Public Health Department Subdivision Avian Woods PH 3
-Atm ". Environmental Health Division PINII 372012953881
PO Box 389. 100-A Southwest Blvd. Newton, NC 28658
/84..-"9/
NAME ON PERMIT: ( KEVIN FULLER), 1300 HARPER LEE DR, NEWTON NC 28658
( KEVIN FULLER)
Site Address: 1322 THURBER LN, NEWTON NC 28658
Property Size: Square Feet 74,923.20 Acres 1.72
Directions: Startown Rd, left on Milton St left on Thurber Ln, lots on right at end of cul-de-sac
FTivL I Trttfl1tc-i :ItTrintn: . ttrPitic.t
FEENAME iismrsici,,,T t.- ijjr Li DATE LFrEAMOUNT
Improvement Permit Fee 03/17/2016 SI50.00
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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)
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