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Home My WebLink AboutEHPR-10-09-1909.TIF �$ THIS IS NOT A PERMIT Case # EHPR-10-09-1909 � � �" � CATAWBA COUNTY HEALTH DEPARTMENT v y�: '�' Plan Review Application for Environmental Services I842 SM Environmental Health Plan Review - OSWP ; � " i � REPA/R (�, � �� e„�I NAME TO APPEAR ON PERMIT �,�,� � '� � MCLELLAND DALE SITE ADDRESS: 2531 27TH ST NE Hickory, NC Pir�t: 372418306206 NAME of SUBDIVISION: CLEARVIEW ACRES Lot # 6& 7 Section/B1ocWPhase PROPERTY SIZE: Square Feet Acres .47 DIRECTIONS: SPRINGS RD / LEFT 28TH AV/ LEFT 25TH ST/ RT 27TH ST/ 2ND HOUSE ON LEFT APPLiCANT OWNER CONTRACTOR MCLELLAND DALE MCLELLAND DALE 2531 27TH ST NE 2531 27TH ST NE NC NC 704902-5651 704902-5651 PRIMARY CONTACT: Owner APPLICATION FOR: Existing Structure DIM EXISTING STRUCTURE: 40 X 44 EXISTING FACILITY TYPE: House NUMBER OF EXISTING BEDROOMS: 3 SEWER TYPE: Septic Tank NUMBER OF EXISTING OCCUPANTS: 2 EXISTING WATER SUPPLY IN USE: Public Water CALCULATED DESIGN FLOW: Public water IS available for this property. PUBLIC WATER TYPE AVAILABLE: CountyJCity/Township Water DESCRIBE WORK: SEPTIC REPAIR TO BRING SYSTEM INTO COMPLIANCE NEW TANK AND DRAINFIELD REQUESTED � ' 24 X 24 CARPORT ADDITION TO EXISTING DWELLING NOT ALLOWED SEPTIC TANK UNDER CONCRETE. DESCRIPTION OF SINGLE FAMILY DWELLING WITH CONCRETE PATIO EXISTING STRUCTURES ON SITE (IF ANY) PROPOSED FUTURE ADDITIONS NONE OR IMPROVEMENTS: PR E ASEMENTS: NO PROPOSED CONSTRUCTION APPLICATION FOR WELL CONSTRUCTION/ABANDONMENT/REPAIR PROPOSED WELL TYPE: ABANDONMENT TYPE: WELL REPAI REQUESTED? 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 norrexpiring 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: `�� 11� Signature of Applicant or Agent -�. t{' An Environmental Health Specialist will contact you within orking day of application date. If you need further information or assistance please call 828-466-7291 EH AREA 2 ********************************�*****************************************�*************************�***********�***** 04/OS/11 1 � 24 �BP. CATAWBA COUNTY Case # EHPR-10-09-1909 G Public Health Department Subdivision < H �2 CLEARVIEW ACRES PL 9 .� Environmental Health Division - Plan Review v ag "�' PO Box 389, 100-A Southwest Blvd, Newton, NC 28658 L�� 6&'I 18 2 �� P�# 372418306206 Applicant/Owner MCLELLAND DALE, 2531 NE 27TH ST, NC Site Address: 2531 2TTH ST NE, Hickory, NC Property Size: SF .47 ACRES Directions: SPRINGS RD / LEFT 28TH AV/ LEFT 25TH ST/ RT 27TH ST/ 2ND HOUSE ON LEFT Minimum Setbacks Front: Side: Rear: Side St: Max Height: FEE NAME DATE AMOUNT BALANCE DUE Authorization to Construct (Repair) Fee 04/OS/20ll $300.00 $0.00 Existing Tank Check Fee 10/07/2009 $80.00 $0.00 TOTAL FEES $380.00 $0.00 CHANGE WORK ORDER REQUIRING REDESIGN AND/OR RETRIP WILL INCURE AN ADDITIONAL CHARGE (SEE FEE SCHEDULE) 04/OS/11 1524 E3a!F�5f ��J11 14: 5� 8283�4�191 C C0�15TRUCTION PAGE �1 %�� :. , TIIIS IS NC)T A I'�RMI � �,�P� '�.:; :, � � , CA�rAW SA COUNTX i��',A�LTT� ��AR�'�iE�Y'�' �� '� "�� -� n��licaii0n for Fnvironm�ntll Services ��`'��` � � ;, .;. , , . .. , �� ' ..;±:� %I:�z: �r Smrroo�cmenl Pcrmit C] AutlaoCizatlU�� tn Construc9 [� `crtic Rcrair L Scpt�c 1�1alf�znriion (� Septic C�.ransion [] Ne�v Wcll ['errm�t � Re��iccm�ent �i'ell ❑�'�'�11 ,�1l�:�n�l�nment C] �l'cll Repair ❑�x:Stinr ��'�t�� I��sl��s�i�� (�'rc lYci#uirt:d) L� �t�plicntion is for 'Jc�� 4:+►n�lrtoc'diar� [� r,�iskin� rac�li[,V _I'�I �'ro�►erl,y �ldcires5 Z� S''f_. 1�.C.---.,,•.--- Sobdivision _ CL�Q✓IG�, _��5.__.__ ..� - . - �d I e�r�_�___C_-�C-. Z $ (0 1 . �.cres . � ° -�---- l.�t # __,� � � ._.,----- . _. _.—.. -- -- . _.-- . Scctic�n/6ilocl .!.",.1....___.. . __.-._. I�rivii�n nircctic�r�s t� Prc��rt�� _...�� __ ��.---?P ..-.-ZBY�,..S"t__!J:�._...�IJ.C�__L�1°7� _.__ - .oa_; a ZBrr 5 �.. �. � ._ � a .__z.s��_��r�., �u 2a C.G FT.---�G°... '�o ..E q � � rz,�.� __ �� µ ( o �_.�Z7 n''r_ .s�; ,J. �....�'�i �l� �.�c� _o.�_ CL�f'_r�--- � _ _... _.. .___-_ � ._-- �u � ...---- _._.. �,_._ _. ..... .._.. _ . -- �----- ._.._.__.. -.—..... .__.. I 4 VAi�'lE "1"0 APPi'.AR ON f�CRVi1T? [� O�ti�ner �._� �1��lican: [j Contraci.or a ,hrnlicant ContACt Information U� N�u _._ 1�e /�'1 � L la r �,� _�--- --.—._,.,, ...-- I w . /�d�lrctis 25'3 �_,�7�/ S� _l� �- _.__�!CICaR.� 1�C_.: o ., o �.._�� ..�. I ��-_.,_..— I C' � i l Ph o ii c .� �.... ------- �.., ,_ � �,onE� B Z s 3r�� o, 0 3 _ _.._.. -------J-------. - ..... _I � O ti�ncr Cootact lnf�rmatirni � �,—Namc ��1�� -. -- — ----- ---- --_.�-`—�---...... .. _� � Acldre�s � _ ._„_._.- -, -----�•-•---- ---- � � I:'hr�ne l ; cll Ph�ne � _. -.----.. _. _..� --, —..,.. -- - -- ------L-'-- ___. .... � � �'ontc�astp C�ntAC I nformnt i crn _,_—__ ---..-� •-- � _„_, �,._.. _ �.. ---•�---- . r�a,q r N�me -_..,__. �.._._-- -. __— ------__- ----......- --- -•------ �� !��Idre �,,__ =-- - ..._.---.... _.�.--- --I ` � I Phon� _ _ _ -..__ l ��I I Phon� _.._. -_�. ..._ .,. -----.. ,,. __I � - -- .. � �VI�IC� tiVll,l., �31? T1iC �'12IMARY C�P1'�'AC'f`? Y n�vner �] ,�pplicant �_� Co��ir�ctr ( ~ C:�scrirtion o1'Exis�.ing Strucrures on Site �3�!�G6_ ��iu� _., '�u�pl.l.1�1�?_ • .. - � __.._._....---- --� --------... 'd <rl f3edroom� *'i 3 S!ru�tur�. c.)im�nsions --- ��0� '� c.�f UccuE�ant.s Z � --- ' "�SF -<---..... _._.... __.... � E3ase:iricnt ❑ Ye�; lYl Nci F;a�cme�it H ixtu�•cs [] 1 c5 , � No � i'I�nnecl PUIUrC Ad�litihn5 or lmpr �vemcnls (f3uil Pcrmit 1�U 1' rcqucsted a� il,i� �ii7��) 4C I)cs�ribe ,,�i�' -.----...__.. _.— _ _ .. �'�' f'raposcd Puture Slructure Dirncnsions__ x�� '�'i��drooms *�i" i( 'applicahlc ------... . � -� �1re i.li�re casements nr rigllt-of-�vays rcc�rdcti on this pr�E;crty �,_� Ycs N� I)escribc ..----- ----_... -------�---.....-------.._.....---._..-... _..----.____... � �¢ . Is <� puUlic �vaicr suppl�� availaLlc on or acljaccnt t� the �bcr-�. ��rc��cr�y 'r:�� 1'�es (�� N�� Checlt type avail�ble. ❑ Communit� Well ��=) Semi-I'u��lic W'c�ll [r� C'ounty/Ciiyi'I'm�;n�hi� ��atcr I.:in� (�xi5�lin waters�iprly in u�c U Individu��l V�!ell [� <'nmmunit)� w'�II �J S�n,i-Puhlic ��'ell 1_Id C;o�ml,�/C.iIyJ ['ownshi)i 4��ater Linc ! ��JUUI,D �,iKl �t'O SC»rc�UL� n COM�3�� n(� LAC;C;d`'G AND S011., I�;VA1�11,1`�'IO�! ..,.. tsr,F c:oM�a�Nr.� �vn�vA�•i4�a �;z�,e��o�:�� 04i 05i ��J11 14: 5� 8283��3�191 COhd�J'�•?ER COhlSTRUCTIOtJ PAGE 0'�!0'� ;: ;;�;�-:��f, ; �fI-►IS fS NOT n rf-.iiM1"!� ( F3 ; �" -; ( `% � � � ��.:�'�-� p?Tr;l�A�2.Tl�!� �i�'T' .�' 1�� CA'1'�4.V1 �A �CC3ZJi 1'�'�rr' �-�,�', a�"�, ,i;'.,.. � , . � i�rplica�ion i�or l�'.nvironii�er�t.�� ervice� 1';t��. ,- '; .;1:?.,-,.,, p'rc;ptiaed l+t�cilit�• �I'YP� �dditinn 1r} Itcsidencc 11 ot Nc:��. I�e+:lrtx�mti ':•i . � Primnry Rcsidencc ❑ Ncw Residencc [_� �- _...._..._ I'rojecl Description --•.,.._._ ------- _ _....----�----- ...__---_.. •----..._ -----..._. ...- -- �— •- Slruct�n•e Dimcnsions _. ------•- �' � --.__ ....__------. Rasement � Yes ❑ Nu 13,�semenl Z�ix�ures [_', Y�s U No L_] Acces;cory Stnici��re(s) De�cribc __. _..---...--�------ -- --._..,..---------..._ .------..............--- � of Ne�v 13cdreoms 1 '•i ii applica.hle �tr�,c�ure Uimensions _. .___._._. .---- ;� ��rc�<<��,�s —__ n�� _«ory �),v�ellin� L..� ��s C] Nc, _ .. _. -- _.--- PliunhinR [] Ye; ❑ N�� Cescribc I'lumLin,, Ncec9ccl _,_., --------- •-._...---.--.. ._.-----. __, �._� �,1ulti-F�mily rtesidto��°'1 lJnits _..------.- ',C3edr��o�ns per t!nit�"i _.._ _...._..----.... T'ot�l #� 13eclr<ioms ""( Stn�ct�irc C)imen,i��n� -�-------.._ ..... _. -- ---- ,�,�, �� E�,��d 5crvicc Spccify f Y! ? �..__. , ..------------- -__.---�-----------..._. __..._._.__.._.._._.---�---- 11 5cats I-1pi�r Spa�;c -I',a�iire Food `;ervic� Pacility lSq F�� _., ...-•-.--- ... ±r I�?mployees pei ShiFt i# oi��i�i11.5 --- -- -- Linint, ��rea (.�q. I•t.l---- _ .... ----... [� liuvinevs Spccifc �T'r�pe ofi�RuKiness .. Reta�il l�'It>r?r ti�,:tte •----. .. ------.—... _..._..._.._.__._.,. '• cif l',m�ilo��ccs per Shi ti _. _,. ;:r r, I' Shi ('ls . �� Utlicr Fac�lilV "i'y�)e S�icCtF�' II'Church # oi�Sr�ts I;iich�n ❑ Y�s �,-� Nc� ii r�., SF��cify Ur�u��.jn�y .---------- ,.�..�4 ,+�pplic:2tinn I'�r �Vcll C��nslra�ctaoR/�Abanclonm+:nt/P.£p:iir I'rnr�sed ��e.11 l'yrc ❑ Int1i•�iduftl �'�';,�I �_� `�cmi-I'vLlii �.Vell ❑ Communitl' `'�'ell ,�h,indonmentT�re ❑ Dr;lled �.� I?orcd ❑ nu;; L� I;nkn��`n '��%cll fZ�rr�ir kequ��terl ❑ 1''es �� N�� ?:;scril .—.----.. .._.....---- _.__.. . _..------.... ...---�------.........._ .. — �.......�r.� l;al�ulated D�si�n FIoN�. Coirmcrcial 1' ----. --- ._. ,_...----- `R.�.lc➢itiorn�i ivf'orm:�li�n mal' b� r�:�uircd t�a !lctcrminc dcsi�►n Il�w frone cc�•eao�� facslitics. 3�fiis d�:r,les{. »�Al R�c de�ermincd dts► consulP:ili�n ��itb on- vir,c slaff. . , w.Twe�.fnmr�wRl�+ltrob,Y.nR'n�rw's.�nawv "�.1n�� roam tha( will be intended for sleepinr at Ihc hn�' ��fc��nst.ructi��n ur fnr 1'uture cnnsidcrfiti��n :hciuld I��; ric�ted a� tt hedr��om and counted on all applicacionc. Tl�e numbr_r ��I�hcdr��nm� �a��ll b� enl�(irmed I�� r��mti ideniilicd ��n IWUSC ��I,ms a� a hedr�iom at the timc ol buililin� permil i:ci,i�nce. 'fhi� m;.i}� �?re� ��nt il,e ne��d ti�r scptic c�. �;i�� in�:r<<�::� in thc (ulurc. � II structure i� pluml�ed but no heclro�ams. calu.il<��cd �9c.,�.,:n flc�w i� rcquirc�cl. '�'�, IC h�n. i�vell permit musl he is5i;cd � thF Au�l tc C:�,ns�ruci. N„tL: 4'ou must c�blain (qninc appreval prior i.c, Irr,aliiifT a honic nr cI� ucturc <�n tl�i; pronert��. An�� «��tirc�entatinn I�� nu c�f Ii�.,ii`c ,�r srruciurc lc,catit,n 5hnuld conl�irm te:, ��•�lic.�ble. ;elhack: �'fl i'[•LAN( ➢El�VORK O'itT)F,dZ RT�JI 116211tif: !��',9aT:��:i°d r�Ni:)/OR R�;Tflll' �'fI,1.. IN(:i)€�ti' ,�iV �� . 9— An��'1'I(?N�.1. �t:L3,:�.E�� (L:F:fr: fr9?f�; �CHTI?il]y.t?,? �a.a a I iiitder5tand that lhis i� rt fprmal appli�:tti��n f��r I:;ii�,�ir��nmcntal Scr� i,:c..ind :.iulhoriz,c Ctt'i1�r+li,i C:o�ini) f�;n�-ir�inmcnt:il � Hc:illh Cittpin,.�ees io t �,n �i,�s r��r�r�y i�,�� -<�i��<�,��,�, �tir��i:;es. ! c�rrlil;; Ihc:lhti�-c int��rin:i�ic lc, I,c �:�rrcci an�l undcrtil,ind Q I th��t an Im��rm�emcnt Permi( i�sued �.� <i result4f lhit inf�irmltion i� ��lii:l lor S vear: or m�,� h; n�,n•�x��irinsr unddr eor��in �..� sF�cc;ilicd c:ondifi,�nS Im��r��vcmc�ii. I'crmils ancl 4�.;e1! f'r,rn•,i�} �u�c� rr�in��::rra.�lc�. b�n may lie rcvokcrl if this infnrmati��n, �:it� � planc nr inicndcd use ch�n�es lar lhe ��ri��sed fi�ili�!�. ;n ,�ulhi�rir..��t�c�;i ti, i;��nslnict ic��icrl I,p �hi�: dc��artni�iii. i�; �ali�i liu• � (S) five ��cars lrom lhe d�te i�sucd <�ncl is n tra .' �,Zhlc �„_ n ' a- _ (,f�l 1 / I � Si�nalurc i,f Owner iir ��cn� . �. _�'_'�"�-a.--k.J --- -----�---� � Prin(ed Name pf n��ner �r �lrccit ._ ... ...................._....._------...._. ______._....-------._ ... ... ....... I)ace .. _� = .5-11 _._. ....—._.....----.. Catawba County, North Carolina N This map prodact was prepared from the Catawba County, NC. Geographic Injormation System. Catawba Counry has made substantial efforts to ensure the accuracy of location and labeling information contained on this map. Catawba County promotes and recommends the rndependent verification ojany data contained on this map product by the user. The Counry of Catawba, its employees, agents and personnel disclaim, and shall not be held liable for any and all damages, loss or liabilrty, whether direct, indirect or consequentral which arises or mm� arise from this map product or the use thereojby arry person or entrtv. Legend Selected Parcel Number: 3724-18-30-6206 1 inch = 40 feet Prepared for: , 20p 1 , , , , ,� a� � � QO ,� � p �-- _ 1 � t+- � � � — � r / � ~ — — ! � 6316 �, , � � , 8 0 , , � , � � 200 f � � �, o � o --_ �-- ----_ 6206 �� --- ° 0 �� 6 ; , �. 23.39 �00 � � � � 4 3 q - _ _ "' •�..` THIS IS NOT A LEGAL DOCUMENT , Tuesday, April O5, 2011 03:09 PM _ - � cv CATAWBA COUNTY NC - Parcel Report Information Regarding Selected Parcel(s) Parcel I D: 3724-18-30-6206 Name: MCLELLAND DALE Name2: MCLELLAND LAUREN Address: 2531 27TH ST NE Address2: City: HICKORY State: NC Zip: 28601-7999 Account: 159741771 Calc Acreage: 0.47 Tax Map: 155H 02002A LRK: 53662 Deed Book: 2914 Deed Page: 0995 Subdivision Name: CLEARVIEW ACRES PL 9-50 Subdivision Block: M Lots: 6 7 Plat Book: 9 Plat Page: 50 Building Number: 2531 Street Name: 27TH ST NE Site Zip: 28601 Township: HICKORY Fire Code: ST. STEPHENS City Code: COUNTY State Road: 1636 Total Bldgs Value: $67,100 Land Value: $15,500 Total Value: $82,600 Year Built: 1978 Year Remodeled: 2005 Last Sale Date: 3/10/2006 Last Sale Amount: $105,000 Neighborhood: 56 Watershed: Watershed Split: Voter Precinct: P30 E911 District: HICKORY Zoning: R-2 Zoning2: Zoning3: Zoning Split: N Zoning Overlay: Zoning District: HICKORY Split Zoning Dist: N SplitZoning Dist(1): 0 Split Zoning Dist(2): 0 School District: COUNTY Elementary School: CLYDE CAMPBELL Middle School: ARNDT High School: ST STEPHENS School Split: NO P&Z Case Number: Census Tract 2010: 010303 Census Block 2010: 1014 Small Area Plan: Agricultural District: Printed: Tuesday, April 05, 2011 03:09 PM � Cp CATAWBA COUNTY, NC �,�' ��, 'oaA S°"th West B'`'d pLAN RECEIPT C � Newton, NC 28658- U �� (828)465-8399 Tuesday, April 5, 2011 j84'Z sM www.catawbacountync.gov P�an �ase: EHPR-10-09-1909 �nvoice Number: INV-4-11-273794 Environmental Health Plan Review Invoice Date: 04/05/2011 Site Address: 2531 NE 27TH ST, Hickory, NC APPLICANT OWNER CONTRACTOR MCLELLAND DALE MCLELLAND DALE 2531 NE 27TH ST 2531 NE 27TH ST NC NC 704902-5651 704902-5651 Fee Name Fee Amount Authorization to Construct (Repair) Fee Adjustable $300.00 Total Fees Due: $300.00 PAYMENTS PAYER: JAMES MCLELLAND Date Pay Type Check Number Amount Paid Change 04/05/2011 Credit Card -1 $300.00 $0.00 Total Paid: $300.00 Total Due: $0.00 plan receipt 04/OS/2011 15:18 Catawba County, North Carolina - Disbursement Voucher Vendor No. A Date 04/05/11 Make Payment To: �� c 0� Voucher No(s). J Dale McLelland E�+� t�'z Q y 114 S Morvue Loop v� � Statesville, NC 28625 j842 ATTACHMENT Description Amount septic tank under concreted area per LS. per applicant not wanting to add 80.00 carport selling house and want to apply for new tank and drain field to make system compliant. per mc credit $80 fee and change application to septic repair $300 fee due. Sub-Total S so.00 Food Tax Sales Tax Total $ so.00 For Accounting Account Fund Organ. Project Use Only Total - The undersigned hereby certifies that the goods or services specified above have been received or performed. Payment has not been previously authorized and this expenditure is a proper charge to the appropriation indicated. The above charge is certified to you for payment. (SIGNATURE - APPROPRIATE OFFICIAL) �$A � �� CATAWBA COUNTY v '��' � P O Box 389 - Newton, North Carolina 28658 -(828) 465-8270 - Fax (828) 465-8276 - TDD (828) 465-8200 1842 sM Public Health — Environmental Health Division AUTHORIZATION OF REFUND � Date Case # ��.- 1�3-Q9 -I�C� Applicant ,�, �� (� ��- L� u Cc�1 d Refund Amount �� C� � Refund Reason : �Qr,l� Ch�� na� ��Dr��c� n�� s�Q�, ��-eQ�z`� Authorizing Signature � , . Received By Permit Center Staff it_ . � Date � � s� � .�g' Cp� CATAWBA COUNTY, NC � ,� 100-A South West Blvd PLAN RECEIPT r-� Newton, NC 28658- V �� (828)465-8399 Tuesday, April 5, 2011 �► j$!�'Z sM www.catawbacountync.gov P�an �ase: EHPR-10-09-1909 �nvoice Number: INV-10-09-255928 Environmental Health Plan Review Invoice Date: 10/07/2009 Site Address: 2531 NE 27TH ST, Hickory, NC APPLICANT OWNER CONTRACTOR MCLELLAND DALE MCLELLAND DALE 2531 NE 27TH ST 2531 NE 2TTH ST NC NC 704902-5651 704-902-5651 Fee Name Fee Amount Existing Tank Check Fee Fixed $80.00 Total Fees Due: $80.00 PAYMENTS PAYER: JAMES MCLELLAND Date Pay Type Check Number Amount Paid ChangE 10/07/2009 Credit Card -1 $80.00 $0.00 04/05/2011 Refund -1 ($80.00) $0.00 Total Paid: $0.00 Total Due: $0.00 plan receipt 04/OS/2011 1522