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Home My WebLink AboutEHPR-12-09-3068 (2).TIF A U THIS IS NOT A PERMIT Case # EHPR-12-09-3068 CATAWBA COUNTY HEALTH DEPARTMENT Plan Review Application for Environmental Services 1842 SM Environmental Health Plan Review - OSWP EP_MALFUN APPLICANT. OWNER CONTRACTOR - NOELLE STEVENS NOELLE STEVENS 5725 SANDHURST RD 5725 SANDHURST RD HICKORY NC 28602 HICKORY NC 28602 C-e11Ab~is-01)•9365 NAME TO APPEAR ON PERMIT NOELLE STEVENS Pin#: 279010269605 SITE ADDRESS: 5725 SANDHURST RD, Hickory, NC DIRECTIONS: HWY 10 W, RIGHT ON 127 RIGHT VALLEYFIELD RD, 1ST RIGHT ONTO HOMESTEAD. CORNER OF HOMESTEAD AND SANDHURST NAME of SUBDIVISION: HOMESTEAD Lot # I Section/Block/Phase PROPERTY SIZE: Square Feet Acres 0.389 Date Platted/Recorded TYPE OF FACILITY: House X Mobile Home Dimension of Structure Bedrooms 3 Basement: Water Using Fixtures in Basement:Yes No. in Family 4 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: NO Has any grading, removal, or addition of soil been done to this property? If so, describe YES, ABOVE GROUND POOL JULY 2009 Are there easements/right-of-ways recorded on this property? NO Type of Water Supply: Individual Well Community Well X 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 representation by you of house or structure location should conform to applicable setbacks. Date:' Signature of Applicant or Agent C' R2& aP .t- &44A 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 FEE NAME DATE AMOUNT Side Authorization to Construct (Repair) F, 12/09/2009 $300.00 Rear TOTAL FEES $300.00 Max Hght *If a permit has to be redesigned and / or RETRIPS made to the property, there is an additional $60 charge 12/09/09 10:30 THIS IS NOT A PERMIT WLS # CATAWBA COUNTY HEALTH DEPARTMENT Application for Environmental Services Improvement Permit ❑ Authorization to Construct El Septic Repair, 121 Septic Expansion El Existing Tank Check E] New Well Permit ❑ Replacement Well ❑ Well Abandonment El 1. Name to Appear on Permit Nrl, ? ~ -P, 2. Permit Requested By ~~P, Business Phone Address °j A S~- uc . A Home Phone 3. Property Owner C' Business Phone Address 12 Home Phone KIK a134 :1:7)5-- 4. Name of Subdivision ' Lot # Section/Block/Phase Property Address Gn u<s Directions to Property: - - - b-C , 7 C~2 'A 5. Property Size: Square Feet Acres J~ Date Platted/Recorded 6. TYPE OF FACILITY: House _ Mobile Home_ Dimension of Structure Bedrooms*_3_ *Any room that will be intended for sleeping at the time of construction odor future consideration should he noted as a bedroom and counted on all applications. The number of bedrooms will be confiri»ed by rooms identified on1hoiise plates as:a bedroom at the tine of buildino permit issuance, This _may prevent the need for System size increase in the future. Basement: ye /no Water Using Fixtures in Basement: es no No. in Family L_ Whirlpool Tub yes/ ro Gallon Capacity MULTIPLE FAMILY RESIDENCES: Units 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 1st 2nd 3rd OTHER: (Specify) 7. Do you anticipate any additions to Facility? Yes If so, describe: 8. Has any grading, removal, or addition of soil been done to this property.. Ye / No If so, describe: _6blQt6l (cc b61 G- -710q 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? I --u Check type that is available: [44e0mmunity well [ ] Semi-public well [ ] ourty/City Township water line **If No, a Well Permit must be issued with the Septic Permit.** 11. 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. 1 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 PROPERTY, THERE IS AN ADDITIONAL CHARGE." Date I J~ C1 I Q'I Signature of Owner or Agent v(-,A 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 ofany J4 data contained on this map product by the user. The County of Catmvba, 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: 2790-10-26-9605 1 inch = 40 feet Prepared for: A6 4 77.35 100 ° 109.16 65 .16.4 5 00 ~0B23-- 120 95\23 ; 1 THIS IS NOT A LEGAL DOCUMENT Wednesday, December 09, 2009 10:20 AM CATAWBA COUNTY NC - Parcel Report Information Regarding Selected Parcel(s) Parcel ID: 2790-10-26-9605 Name: STEVENS PHILIP MICHAEL Name2: STEVENS NOELLE M Address: 5725 SANDHURST RD Address2: City: HICKORY State: NC Zip: 28602-5572 Account: 66849500 Calc Acreage: 0.39 Tax Map: 163H 14001 LRK: 55641 Deed Book: 1840 Deed Page: 0062 Subdivision Name: HOMESTEAD Subdivision Block: F Lots: 1 Plat Book: 15 Plat Page: 64 Building Number: 5725 Street Name: SANDHURST RD Site Zip: 28602 Township: HICKORY Fire Code: MOUNTAIN VIEW City Code: COUNTY State Road: 2558 Total Bldgs Value: $118,000 Land Value: $13,800 Total Value: $131,800 Year Built: 1973 Year Remodeled: Last Sale Date: 4/1/1993 Last Sale Amount: $89,000 Neighborhood: 77 Watershed: WS-III Protected Area Watershed Split: NO Voter Precinct: P24 E911 District: COUNTY Zoning: R-20 Zoning2: Zoning3: Zoning Split: N Zoning Overlay: WP-O 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: 2007 Small Area Plan: MOUNTAIN VIEW Agricultural District: Printed: Wednesday, December 09, 2009 10:20 AM CATAWBA COUNTY, NC 100-A South West Blvd PLAN RECEIPT Newton, NC 28658- 0 (828)465-8399 Wednesday, December 9, 2009 184 sm www.catawbacountync.gov Plan Case: EHPR-12-09-3068 Invoice Number: INV-12-09-257870 Environmental Health Plan Review Invoice Date: 12/09/2009 Fee Name Fee Amount Authorization to Construct (Repair) Fee Adjustable $300.00 Total Fees Due: $300.00 PAYMENTS Date Pay Type Check Number Amount Paid Change 12/09/2009 Credit Card -1 $300.00 $0.00 Total Paid: $300.00 Total Due: $0.00 planrcceiht;3brI63(i%-U33~-1'el-alfU-b h~daaac~h3;.rpt 12/09/2009 10:29 V-POS - Transaction Receipt Page 1 of 1 Transaction Receipt Catawba County, NC Catawba County Permit Center 100 A SW Blvd Newton, NC 28658 828-4658404 12/09/2009 10:28AM Catawba 120909102748276Eng 25861211 EHPR-12-09-3068 NOELLE N STEVENS 2 NA NOELLE M STEVENS / null null ************8863 Authorization and Capture Amount: $300.00 Cardmember acknowledges receipt of goods and/or services in the amount of the total shown hereon and agrees to perform the obligations set forth by the cardmember's agreement with the issuer. Signature click here to continue. https://www.velocitypayment.com/admin/catawbacountync/vpos/942/transactions/receipt/?... 12/9/2009