HomeMy WebLinkAboutEHPR-03-2016-23357.TIF Y,A G\ THIS IS NOT A PERMIT Case # EHPR-03-2016-23357
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"- '« PLAN REVIEW APPLICATION FOR ENVIRONMENTAL SERVICES it - —4R - 47
1842 sM Environmental Health Plan Review - OSWP -•g d I..o
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Applicant CORRINE GEHRLS, 1341 E MONBO RD, STATESVILLE NC 28677
C:6037702745
NAME TO APPEAR ON PERMIT
Corrine Gehrls
SITE ADDRESS: 3917 MILL RUN, TERRELL NC 28682 PIN # 461704738662
NAME of SUBDIVISION: RIVERWOOD PL 16-257 Lot# PTS 38-39
Section/Block
PROPERTY SIZE: Square Feet 35,719.20 Acres 0.82
DIRECTIONS: 150, right Kiser Island Rd, left Riverwood, left on Mill Run
PRIMARY CONTACT: Applicant SEWER TYPE: Septic Tank
GALLONS PER DAY: 480 WATER SUPPLY: Community Well
DESCRIBE WORK: Received 4/13/16 - Received New Site plan. Changed to be 4 BdRm 480 gal/day.
Garage is now attached. No apartment in garage.
IP only, main residence with 3 bedrooms with detached garage apartment 1 bedroom with full bath, kitchenette
to include sink, fridge and stove
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? Yes
Property Easements Description: septic easement for adjoining lot
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: 2
PROPOSED CONSTRUCTION
NEW STRUCTURE DIM:: 50 x 52 house, 24x30 w/attached garage
#OF NEW BEDROOMS:: 4
BASEMENT? No BASEMENT FIXTURES? No PLUMBING REQUIRED?Yes
Desired system types(Improvement Permit or Authorization to Construct):
ACCEPTED: ALTERNATIVE: CONVENTIONAL:
OTHER: INNOVATIVE: ANY:
Other described:
•
E9-elm ppl ical ion 04/13/2016 10:56 Page I or4
s`v' CATAWBACOUNTY Case# EHPR-03-2016-23357
1 Public Health Department Subdivision RIVERWOOD PL 16-257
Q ; u Environmental Health Division PIN#
r® 461704738662
PO Box 389, 100-A Southwest Blvd,Newton.NC 28658
/842 ,''
NAME ON PERMIT: (CORRINE GEHRLS), 1341 E MONBO RD, STATESVILLE NC 28677
( Corrine Gehrls)
Site Address: 3917 MILL RUN,TERRELL NC 28682
Property Size: Square Feet 35,719.20 Acres 0.82
Directions: 150, right Kiser Island Rd, left Riverwood, left on Mill Run
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 aqd labeling of all property lines and corners and making the site acces is ble(J that a complete site evaluation can be performed.
Date: L \ 3 1 Lo Signature of Applicant or Agent LL,..,` •
An Environmental Health Specialist will contact you within 5 wor ing days of application date.
If you need further information or assistance please ca 828-466-7291
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11,,"FEENAME;__, '4t ll `„a. e l i DATEs„E,F '�A,FEFAMOUNT4
Improvement Permit Fee 03/09/2016 5150.00
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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)
P9-ehappl Ieffiion 04/13/2016 10:56 Page 2 of 4
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