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HomeMy WebLinkAboutEHPR-11-09-2918 (2).TIF ~A Cp THIS IS NOT A PERMIT Case # EHPR-1 1-09-2918 CATAWBA COUNTY HEALTH DEPARTMENT U ^C Plan Review Application for Environmental Services 1842 SM Environmental Health Plan Review - OSWP EXS_SYSTEM APPLICANT OWNER CONTRACTOR FH - Frye, Randy FFi - Frye, Randy NC NC NAME TO APPEAR ON PERMIT FH - Frye, Randy Pin#: 363708981821 SITE ADDRESS: 3444 HAYNES DR, Maiden, NC DIRECTIONS: BUS 321 S/ RT ON ZEB 14AYNES RD/ RT ON HAYNES DR/ ON CORNER NAME of SUBDIVISION: HIDDEN CREEK ESTATES Lot # 30 & PT B Section/Block/Phase PROPERTY SIZE: Square Feet Acres 0.419 Date Platted/Recorded TYPE OF FACILITY: House X Mobile Home Dimension of Structure Bedrooms 3 Basement: No Water Using Fixtures in Basement:No No. in Family 3 Whirlpool Tub : Gal. Capacity: MULTIPLE FAMILY RESIDENCE: Units 1.00 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 Type of Water Supply: Individual Well X Community Well 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. An esentation by you of house or structure location should conform to applicable setbacks. Date: 12- 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 1 (FOR OFFICE USE ONLY) Zoning Approval: _Yes No Zoning Approval UDO Zoning Form A Minimum Setbacks Front 30 FEE NAME DATE AMOUNT Side 10 Existing Tank Check Fee 12/03/2009 $80.00 Rear TOTAL FEES $80.00 Max Hght *If a permit has to be redesigned and / or RETRIPS made to the property, there is an additional $60 charge 12/03/09 15:53 r THIS IS NOT A PERMIT W L S # f' &~~1~ CATAWBA COUNTY HEALTH DEPARTMENT Application for Environmental Services Improvement Permit ❑ Authorization to Construct ❑ Septic Repair ❑ Septic Expansion ❑ Existing Tank Check ewpWell Permit ❑ Replacement Well ❑ Well Abandonment ❑ 1. Name to Appear on ermit !Q IGt U) - V '.Q 2. Permit Requested By rY~ Business Phone Address e r• Home Phone l ( F" 00 i 3I Property Owner t~and'si -9 E-4Q r Business Phone Address n Home Phone 4. Name of Subdivision ~ Lot #Section/Block/Phase Property Address 3 y 1k P, ne.i r Directi is to Property: .321 h ~D YLJ Or 1st r 5. Property Size: Square Feet 1 I 1 Acres 0, (at Date Platted/Recorded l a doo 6. TYPE OF FACILITY: House Mobile Home Dimension of Structure Bedrooms* Amy 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 system size increase in the future. Basement: yeonn Water Using Fixtures in Basement: yes/ o- No. in Family Whirlpool Tub yes& Gallon Capacity MULTIPLE FAMILY RESIDENCES: Units Total Number of Bedrooms 3 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 acjlity Yes No If so, describe: ~ 'i 8. Has any grading, remova , or addition of soil een done to this property? Yes If so, describe: 9. Are there easements/right-of-ways recorded on this property? Yes o 10. Is a public water supply available on or adjacent to the above property./ No Check type that is available: [ ] Community well [ ] Semi-public we [ ] County/City/Township water line **If No, a Well Permit must be issued with the Septic Permit.** 1 l . Well Type Applying For: [ ] Individual 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 RETRIP=MDE MERER- , THER AN ADDITIONAL CHARGE" Date 3o Signature of Owner or A r ~ Catawba County, North Carolina This map product was prepared f rom the Catawba Connry, NC, Geographic 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 front this map product or the use thereof by any person or entity. Legend Selected Parcel Number: 3637-08-98-1821 1 inch = 60 feet Prepared for: 3 7 \r e 2 / O .,'092i ti 6 (b' 61 Plat 38-37 1821 (n v 6 r N. 6' f 32.75 r 1b s CO O 75.00 0,. CEMETERY Plat 38-37 2627 0 o. o 13 31.63" 75.00 9674 r THIS IS NOT A LEGAL DOCUMENT Thursday, December 03, 2009 03:39 PM CATAWBA COUNTY NC - Parcel Report Information Regarding Selected Parcel(s) Parcel ID: 3637-08-98-1821 Name: FRYE RANDY W Name2: FRYE WENDY E Address: 3444 HAYNES DR Address2: City: MAIDEN State: NC Zip: 28650-9303 Account: 159740592 Calc Acreage: 0.62 Tax Map: LRK: 900531 Deed Book: 2909 Deed Page: 0686 Subdivision Name: MEADOW SPRINGS SUBDIVISION Subdivision Block: Lots: 1 Plat Book: 38 Plat Page: 37 Building Number: 3444 Street Name: HAYNES DR Site Zip: 28650 Township: NEWTON Fire Code: MAIDEN RURAL City Code: COUNTY State Road: Total Bldgs Value: $151,100 Land Value: $16,300 Total Value: $167,400 Year Built: 2001 Year Remodeled: Last Sale Date: 8/31/2001 Last Sale Amount: $163,000 Neighborhood: 113 Watershed: Watershed Split: Voter Precinct: P20 E911 District: MAIDEN Zoning: R-15 Zoning2: Zoning3: Zoning Split: N Zoning Overlay: Zoning District: MAIDEN Split Zoning Dist: N Split Zoning Dist(1): 0 Split Zoning Dist(2): 0 School District: COUNTY Elementary School: MAIDEN Middle School: MAIDEN High School: MAIDEN School Split: NO P&Z Case Number: Census Tract 2010: 011702 Census Block 2010: 3021 Small Area Plan: Agricultural District: PROXIMITY Printed: Thursday, December 03, 2009 03:39 PM gA CMG CATAWBA COUNTY, NC 100-A South West Blvd PLAN INVOICE a Newton, NC 28658- 0 (828)465-8399 Thursday, December 3, 2009 184 'Z sM www.catawbacountync.gov Plan Case: EHPR-11-09-2918 Invoice Number: INV-12-09-257732 Environmental Health Plan Review Invoice Date: 12/03/2009 Fee Name Fee Amount Existing Tank Check Fee Fixed $80.00 Total Fees Due: $80.00 PAYMENTS Date Pay Type Check Number Amount Paid Change 12/03/2009 Cash -1 $80.00 $0.00 Total Paid: $80.00 Total Due: $0.00 plan.uuucr ; d;l l a ; lu-&l l u-.~?f,i~-aclh-bnc~315h'_',I~~; ipt 12/03/2009 15:52