The URL can be used to link to this page

Home My WebLink AboutEHPR-12-09-3100 (2).TIF THIS IS NOT A PERMIT Case # EHPR-12-09-3100 CATAWBA COUNTY HEALTH DEPARTMENT Plan Review Application for Environmental Services Ig-42 5M Environmental Health Plan Review - OSWP EP_MALFUN APPLICANT 0'*N `TER CONTRACTOR - CYNTHIA BUMGARNER;CYNTHIA' BUMGARNER 1477 PEACEFUL VALLEY DR 1477 PEACEFUL VALLEY DR HICKORY NC 28602 HICKORY NC 28602. 828-244-6895 '828-244-6895 NAME TO APPEAR ON PERMIT CYNTHIA BUMGARNER Pin#: 269702555089 SITE ADDRESS: 5410 HOPE RD, Vale, NC DIRECTIONS: HWY 10 W - TURN LEFT ONTO PLATEAU RD - GO 4 MILES TURN LEFT ONTO HOPE RD - TURN LEFT ONTO CAJUN RD - STAY RIGHT TO END (BLUE HOUSE) NAME of SUBDIVISION: Lot # Section/Block/Phase PROPERTY SIZE: Square Feet Acres 1.57 Date Platted/Recorded TYPE OF FACILITY: House X Mobile Home Dimension of Structure 40 a 40 Bedrooms 3 Basement: Yes Water Using Fixtures in BasementNo No. in Family Whirlpool Tub : .?Gal ~Capagity: MULTIPLE FAMILY RESIDENCE: Units 1.00. Total Numberol'Bedrooms DAYCARE: Number of Children RESTAURANT: Seats Square Feet Dining Area Square Feet Foodstand/Meat Market Floor Space TYPE OF BUSINESS: Number of Employees I st 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 NO. WILL REPLACE BASEMENT WALL IN FUTURL. Are there easements/right-of-ways recorded on this property? NO Type of Water Supply: Individual Well X Community Well NIUmcipal 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 representatio by you of house or structure location should conform to applicable setbacks. Date: Idt-11 -09 Signature of Applicant or Agent An Environmental Health Specialist will contact you within 2 rking days of appli atio date. If you need further information or assistance please call 828-466-7291 AREA2 (FOR OFFICE USE ONLY) Zoning Approval: _Yes No Zoning Approval UDO Zoning Form A Minimum Setbacks Front FEE NAME. DATF. r, AMOUNT Side Au076P atiori w,Constru,;t lhc~atr)~Fri2/11;2009. $306.60 Rear TOTAL FEES $300.00 Max Fight *If a permit has to be redesigned and / or RETRIPS made to the property, there is an additional $60 charge 12/11/09 15:54 THIS IS NOT A PERMIT (?-,3 lo v CATAWBA COUNT' HEALTH DEPARTMENT Application for Environmental Services,-,/ Improvement Permit ❑ Authorization to Construct ❑ Septic Repair L2 Septic Expansion ❑ Existing Tank Check E] New Well Permit ❑ Replacement Well ❑ Well Abandonment ❑ 1. Name to Appear on Permit _ `V 1(L. Iknna ct(hp_r 2. Permit Requested By Business Phone Address 1 C cA r. ~AiCkoou. Home Phone 3. Property Owner Business Phone Address f~ f C A%(o b 2, Home Phone qq (p2q-!5 4. Name of Subdivision Lot # Section/Block/Phase Property Address 514 0 4w-- [e- Directions to Property: AIC, 16' -k J?~2-lLieLk-deoL Ivt i L.~ 5. Property Size: Square Feet 20 Acres r ~ Date Platted/Recorde lq')2 6. TYPE OF FACILITY House Mobile Home Dimension of Structure DA'-qjBedrooms*~_ aF3%.SS ,r ..,y~~ *Any, roomthat ~~~rll bL irien~icdfor sleeping ai the~t~me otCOnstnTGt~tnn +isideran ~hoiild be noted as~~a 11 h,droom ad:coinu rn:all rhhlicat oris',:Th number of,bcdn cuT ..ill he c nlincd h 'tooni rdentifed on_liouse pans asa bedtoum at tf Lillie o building perri it i suaii~q ~I#his niay~prc ~ znt tlr~.~lreci tut 5yst~ulf~i~e mcrgge in,the suture: Basement- Pub /no Water Using Fixtures in Basement: No. in Family Whirlpooyes 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 1 st 2nd 3rd OTHER: (Specify) 7. Do you anticipate any additions to Facility? Yes / o If so, describe: 8. Has any grading removal, or addition of soil been done to this property? Yes / o If so, descril- 9. Are there easements/ri ht-of ways recorded on this property? Yes / 10. Is a public water supply available on or adjacent to the above property? Yes 10 Check type that is available: [ ] Community well [ ] Semi-public well [ ] County/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. 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 7'~ THE OPERTY, THERE IS AN ADDITIONAL CHARGE.** Date Signature of Owner or Agent `L' A Cpl CATAWBA COUNTY, NC 100-A South West Blvd PLAN RECEIPT Q+ L' . ` Newton, NC 28658- v _ vDv (828)465-8399 Friday, December 11, 2009 j84'L sM www.catawbacountync.gov Plan Case: EHPR-12-09-3100 Invoice Number: INV-12-09-257971 Environmental Health Plan Review Invoice Date: 12/11/2009 Fee Name Fee Amount hAuthorization to Construct (Repair )_Fee y Adjustable $300:00 Total Fees Due: $300.00 PAYMENTS Date Pay Type Check Number Amount Paid Change 1 $300.00 $0.00 112/11/2009 Credit Card Total Paid: $300.00 Total Due: $0.00 plan receipt;?7192hd2-h3eOA 12e-3613-bcni6fl Oc74(12}.ipt 12/11/2009 15:53 Catawba County, North Carolina This map product was prepared from the Catawba County, NC, Geographic Information Svstem. 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 from this map product or the use thereof by any person or entity. Legend Selected Parcel Number: 2697-02-55-5089 1 inch = 60 feet Prepared for: 42.73 190.5 7 ,225 - r: - r 1- :57A_ cfl 7069 5,03 O 04 O 2.77A 4931 $ '7 oA THIS IS NOT A LEGAL DOCUMENT Fri, December 11, 2009 03:25 PM CATAWBA COUNTY NC - Parcel Report Information Regarding Selected Parcel(s) Parcel ID: 2697-02-55-5089 Name: BUMGARNER CYNTHIA PAYNE Name2: Address: 1477 PEACEFUL VALLEY DR Address2: City: HICKORY State: NC Zip: 28602-9283 Account: 159753671 Calc Acreage: 1.57 Tax Map: 009AJ 02015 LRK: 9235 Deed Book: 2979 Deed Page: 1465 Subdivision Name: Subdivision Block: Lots: Plat Book: Plat Page: Building Number: 5410 Street Name: HOPE RD Site Zip: 28168 Township: JACOBS FORK Fire Code: PROPST City Code: COUNTY State Road: Total Bldgs Value: $25,500 Land Value: $10,400 Total Value: $35,900 Year Built: 1972 Year Remodeled: Last Sale Date: Last Sale Amount: Neighborhood: 89 Watershed: Watershed Split: Voter Precinct: P3 E911 District: COUNTY Zoning: R-40 Zoning2: Zoning3: Zoning Split: N Zoning Overlay: DWMH-O 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: Census Tract 2010: 011802 Census Block 2010: 4014 Small Area Plan: PLATEAU Agricultural District: PROXIMITY Printed: Fri, December 11, 2009 03:25 PM