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Home My WebLink AboutEHPR-10-09-2099.TIF THIS IS NOT A PERMIT WLS # M 1),15 CATAWBA COUNTY HEALTH DEPARTMENT Application for Environmental Services Improvement Permit ❑ Authorization to construct ❑ Septic Repair ❑ Septic Expansion ❑ Existing Tank Check ® New Well Permit ❑ Replacement Well ❑ Well Abandonment ❑ I . Name to Appear on Permit Phu lIa Sty r 2. Permit Requested By Sz J Business Phone - Address )51Z C!pyerJ _-A 114'irkoco Home Phone 628-?q4- 2-/3& 3. Property Owner Business Phone _ 2,q 36, Address I 0 er - o ~S to cv Home Phone 820 - Z 94/ 4. Name of Subdivision ClectYVI eU) GYe Lot # Section/Block/Phase Property Address 5512 Oo V V G Co _ on Mo Directions to Property: 12 -1 S W - 5 SfaLpn r -I y- i h 2''0 5 1- ice e- L (Li e V- _ I e J 1. 5. Property Size: Square Feet Acres , 15 Date Platted/Recorded 6. TYPE OF FACILITY: House Mobile Home Dimension of Structure ZD~X 5D' Bedrooms*_,3 *Any rooin that will be-Intended for sleeping at the time of construction or for fixture consideration should be doted as a bedroom and counted on all applications. The number of bedrooms will be confirmed by rooms identified on house plans as a bedroom at the time of building permit issuance. This ntav prevent the rneed for system size in i ase in the fixture: Basement: D/no Water Using Fixtures in Basement: 0/no No. in Family (o Whirlpool Tub yes/C° 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? 'e, / If so, describe: 8J 1 ✓1G Vooms in u.Vl _i ei'y) 8. Has any grading, removal, or addition of soil been done to this property? No If so, describe: NEB, Y~ ld'c~.z ~r ba~ e ~h ~rC~ yl Ge. o L~y~vw~m {c ~ balhram: re,(_ Ym 9. Are there easements/right-of-ways ► corded on this property? Yes C>iV cep 10. Is a public water supply available on or adjacent to the above property? Yes /a 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 T THE PROP TY E IS AN ADDITIONAL CHARGE.** Date i ° 4 Signature of Owner or Agent p~ THIS IS NOT A PERMIT WLS # k CATAWBA COUNTY HEALTH DEPARTMENT Application for Environmental Services Improvement Permit ❑ Authorization to Construct ❑ Septic Repair ❑ Septic Expansion ❑ Existing Tank Check New Well Permit ❑ Replacement Well ❑ Well Abandonment ❑ I. Name to Appear on Permit flul.S B. sdZe_r 2. Permit Requested By AULL1b Business Phone Address 5 51 ' " S Home Phone !d2_8 -2`t' -2434, 3. Property Owner . SCA Business Phone - Address 55i 2 ' Qdd-r- J Home Phone 026-2q4-24-36 4. Name of Subdivision CLIYVinA) Ac-rep Lot # Section/Block/Phase Property Address r-3 5F 12- Noy ef St NC, 2-9- to 02, Directions to Property: 12' 4, - e tAc2bon - v- hf Ole 5S r~ -FLL( rc n d ) he- r I lA G v ~ e- f of 5. Property Size: Square Feet Acres 14' j Date Platted/Recorded 6. TYPE OF FACILITY: House Mobile Home Dimension of Structure 3o X 5D' Bedrooms* y' *AnV~ 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.l'he number of bedrooms will be confirmed by rooms identihedon 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: ( De/no Water Using Fixtures in Basement: (0e /no No. in Family (D Whirlpool Tub yese) 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? / J / 13 00I % /1 A-tf" If so, describe: u' Ai F-1 iv t k- I rJt I t 9F1 L) ri 8. Has any grading, relmoval, yor addition of so' been done t this properO 9 _ es /No 24 0 Ifso, describe: New l e-i.eJLli. V GTlU'LLY)L e, YC 9. Are there easements/right-of-ways reco ded on this property? Yes /9) 10. Is a public water supply availab on or adjacent to the above property? Yes /ED 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 0 THE PRO ERTY, THERE IS AN ADDITIONAL CHARGE.** Date 1.3 09 Signature of Owner or Agent Catawba County, North Carolina This map product was prepared from the Catawba County, NC, Geographic Information System. 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 ofany 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: 2791-10-45-9144 1 inch = 60 feet Prepared for: U fv `k H j ~ y r Et 1.42 114/ 1. 55A f ~R-2o _ 9144 % 1 1 ~ ~ ~i ~ j~ ~~Ir xx i HII,) I,, No I I'l (I \l. UU( I Nil~N I Tuesday, October 13, 200901:29 PM CATAWBA COUNTY NC - Parcel Report Information Regarding Selected Parcel(s) Parcel ID: ` `279140-45-9144 Name: SETZER DARYLL EUGENE Name2: SETZER PHYLLIS B Address: 5512 CLOVER ST Address2: City: HICKORY State: NC Zip: 28602-9416 Account: 59412500 Calc Acreage: 1.15 Tax Map: 133H 09006 LRK: 48362 Deed Book: 1262 Deed Page: 0385 Subdivision Name: CLEARVIEW ACRES PL 14-28 Subdivision Block: H Lots: 6 Plat Book: 14 Plat Page: 28 Building Number: 5512 Street Name: CLOVER ST Site Zip: 28602 Township: HICKORY Fire Code: MOUNTAIN VIEW City Code: COUNTY State Road: Total Bldgs Value: $132,200 Land Value: $18,500 J Total Value: $150,700 Year Built: 1971 Year Remodeled: 2009 Last Sale Date: 5/1/1981 Last Sale Amount: $58,500 Neighborhood: 77 Watershed: Watershed Split: Voter Precinct: P24 E911 District: _COUNTY Matrix: Zoning: R-20 Zoning2: Zoning3: Zoning Split: N Zoning Overlay: 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: 011101 Census Block 2010: 2037 Recorded Date: Lot Type: Small Area Plan: MOUNTAIN VIEW Printed: Tuesday, October 13, 2009 01:29 PM