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Home My WebLink AboutEHPR-12-09-3009.TIF A ' Cpl THIS IS NOT A PERMIT Case # EHPR-12-09-3009 ` CATAWBA COUNTY HEALTH DEPARTMENT Plan Review Application for Environmental Services 1842 Environmental Health Plan Review - OSWP SM IMPROVEMENT APPLICANT OWNER CONTRACTOR STEVEN MATTHEWS VETERINARY CLTDARRELL MATTHEWS BUILDING SYSTEMS OF CATAWBA CO HICKORY NC 28603 828-327-6677 BSOCC@EARTHLINK.NET NAME TO APPEAR ON PERMIT STEVEN MATTHEWS VETERINARY CLINIC Pin#: 266703429478 SITE ADDRESS: 9310 W NC 10 EIWY, Vale, NC DIRECTIONS: HWY 127 S/ RT ON HWY 10 W/ GO TO INTERSECTION WITH OLD SHELBY RD/ PROPERTY ON RT NAME of SUBDIVISION: Lot # Section/Block/Phase PROPERTY SIZE: Square Feet Acres 10.829 Date Platted/Recorded TYPE OF FACILITY: House Mobile Home Dimension of Structure Bedrooms 0 Basement: No Water Using Fixtures in Basement:No No. in Family 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. Any repr entation b you of hous or structure location should conform to applicable setbacks. Date: Signature of Applicant or Agent An Environmental Health Specialist will contact you within 2 working days of application d 6e. 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 FEE NAME DATE AMOUNT Side Improvement Permit Fee 12/04/2009 $150.00 Rear TOTAL FEES $150.00 Max Hght *If a permit has to be redesigned and / or RETRIPS made to the property, there is an additional $60 charge 12/04/09 14:43 THIS IS NOT A PERMIT WLS# %~7fi- CATAWBA COUNTY HEALTH DEPARTMENT Application for Environmental Services r IP J- AC F- S.T. Rpr. J- S.T. Exp. 1- Exist. S. T. F- Well Permit r Replacement Well 1. Name to Appear on Permit: BUILDING SYSTEMS OF CATAWBA COUNTY, INC. 2. Permit Requested By: DARRELL R. BROWN kt w'-5 Business Phone: 828-327-6677 P.O. BOX 3409 HICKORY, NC 28603 ~a L NkL- Address: Home Phone: I DARRELL MATTHEWS & RITA MATTHEWS 3. Property Owner. Business Phone: 3936 HWY 18 VALE, NC 28168 Address: Home Phone: [N/A 4. Name of Subdivision: Lot F Section/Block/Phase: 9310 W NC 10 HWY, VALE Property Address: [TAKE NC 127 HWY TO NC 10 HWY TURN RIGHT ON NC 10 AND TRAVEL TO THE INTERSECTION OF Directions to Property: SHELBY ROAD SR 1104 AND NC 10. THE PROPERTY IS TO THE RIGHT OF THE INTERSECTION. 1 479,160 ~ 5. Property Size: Square Feet Acres 10.83 Date Platted/Recorded 9/5/2007 House f Mobile Home 8o'xloo' N/A 6. TYPE OF FACILITY: Dimension of Structure Bedrooms '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 the 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: Yes No Water Using Fixtures in Basement: Yes No No. in Family: N/A Whirlpool Tub: Yes No Gallon Capacity: N/A MULTIPLE FAMILY RESIDENCES: Units N/A Total Number of Bedrooms N/A DAY CARE: Number of Children [N/A RESTAURANT: Seats N/A Square Feet Dining Area N/A Square Feet Food Stand/Meat Market Floor Space [N/A TYPE OF BUSINESS: VETERINARY CLINIC No. of Employees 1 st 10 2nd F-3rd F OTHER : (Specify) 7. Do you anticipate any additions to Facility? (-Yes (*-No If so describe 8. Has any grading, removal, or addition of soil been done to this property? { Yes 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 f: No Check type that is available: F Community Well F_ Semi-public Well County/City/Township water line 11. Well Type Applying For: F_ Individual Well I- Community Well Semi-public Well F_ Irrigation Well F_ Geothermal Well 12. Monitoring Well Request:(- Yes (-*No # of Wells: F-Name of Site: I understand that this 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. 1 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 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. Any representation by you of house or structure location should conform to applicable set backs. **IF A PERMIT HAS TO BE REDESIGNED AND/OR RETRIPS MADE TO THE PROPERTY, THERE IS AN ADDITIONAL CHARGE"* Date: 12/4/2009 Signature of Owner or Agent: DARRELL R. BROWN Print Form Catawba County Environmental Health Contact Information for Plan Review 100A Southwest Boulevard, Newton, NC 28658 1842 (828) 465-8270 phone (828) 465-8276 fax FLI Case # PLN Case# Property Location Property ID# * (o !o - 03 - Va - 912F~ Street Address * 93,10 W A!C ZQ I-lWq City * - zip Business Name: Mailing Address Address 2 City Zip Phone Owner Name ATTHL tn/5 Owner Mailing Address 3 93 /fwa /ff Crnt Physical Mailing Address City _V L- Zip a~ (o Phone E1J"NbZ;2 ATeh4teet- 514 Pt A L D1 N 6'MC-VVL2=12TNG Contact Address 9905- 9M 517-77 PL NL: Address 2 City Azx i crL-y NC Zip 09;F~6 0 / Phone XZT- 3~ - 2,25-9 Contractor el':~ urLDSN4 Ss-r'm 5 ^F C.4ngw44 Pc...rAlc. Contact Address 2.0. f Y X409 Address 2 City 4=C.,W jo Y Zip kKU 0 3 Phone $Zlr- 327- (o1077 Contact Information Sheet and a fee required to begin plan review process. See fee schedule Complete and return Food Establishment Application * Required field Applicant Signature Date .21Y14P147- Catawba County, North Carolina This map product was prepared from the Catawba County, NC, Geographic Information System. N Catmvba 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 airy 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. Legend Selected Parcel Number: 2667-03-42-9478 1 inch = 100 feet Prepared for: 4~ t t X17;13 j Flp (305) 1/1, Cl) o r` 4.044 Lr) 752 • l (23 (0 0~t - - f 10.83A 160 i 2A THIS IS NOT A LEGAL DOCUMENT ~ j ` ~ Friday, December 04, 2009 02:36 PM W~ \ CATAWBA COUNTY NC - Parcel Report Information Regarding Selected Parcel(s) Parcel ID: • 2667-03-42-9478 Name: MATTHEWS DARRELL LESTER Name2: MATTHEWS RITA GALE Address: 3936 HWY 18 Address2: City: VALE State: NC Zip: 28168-9549 Account: 159750249 Calc Acreage: 10.83 Tax Map: 011 B 05016 LRK: 11072 Deed Book: 2961 Deed Page: 1131 Subdivision Name: Subdivision Block: Lots: Plat Book: Plat Page: Building Number: 9310 Street Name: W NC 10 HWY Site Zip: 28168 Township: BANDY'S Fire Code: COOKSVILLE City Code: COUNTY State Road: Total Bldgs Value: $49,900 Land Value: $118,000 Total Value: $167,900 Year Built: 1900 Year Remodeled: Last Sale Date: Last Sale Amount: Neighborhood: 89 Watershed: WS-III Protected Area Watershed Split: YES Voter Precinct: P2 E911 District: COUNTY Zoning: HC-CD 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: BANOAK Middle School: JACOBS FORK High School: FRED T FOARD School Split: NO P&Z Case Number: RZ2009-02,SUP2009-004 withdrew Census Tract 2010: 011802 Census Block 2010: 1010 Small Area Plan: PLATEAU Agricultural District: Printed: Friday, December 04, 2009 02:36 PM