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Home My WebLink AboutEHPR-10-09-2424.TIF V " W THIS IS NOT A PERMIT Case # EHPR-10-09-2424 CATAWBA COUNTY HEALTH DEPARTMENT Plan Review Application for Environmental Services 1842 SM Environmental Health Plan Review - OSWP APPLICANT OWNER CONTRACTOR AGHI PETERS AGHI PETERS 1620 POWER LINE AV 1620 POWER LINE AV NEWTON NC 28658 NEWTON NC 28658 312-1553 312-1553 NAME TO APPEAR ON PERMIT AGHI PETERS Pin#: 374416825749 SITE ADDRESS: 1852 E PARIS DR, Conover. NC DIRECTIONS: SPRINGS RD - TURN RIGHT ONTO HOUSTON MILL RD - TURN LEFT ONTO PARIS DR - MIDDLE MOBILE HOME ON LEFT IN CUL-DE-SAC NAME of SUBDIVISION: MILL RIDGE Lot # B Section/Block/Phase PROPERTY SIZE: Square Feet Acres 0.589 Date Platted/Recorded TYPE OF FACILITY: House Mobile Home X Dimension of Structure Bedrooms 3 Basement: No Water Using Fixtures in Basement:No No. in Family 0 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 Ist 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 Are there easements/right-of-ways recorded on this property? NO Type of Water Supply: Individual Well Community Well Municipal Semi-Public X 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 7confTO to applicable setbacks. ~l ) Date: C( I Signature of Applicant or Agent r An Environmental Health Specialist will contact you within 2 wor days of application 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 DATE AMOUNT Side Authorization to Construct (Repair) F,10/29/2009 $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 10/29/09 16:38 THIS IS NOT A PERMIT WLS # CATAWBA COUNTY HEALTH DEPARTMENT Application for Environmental Services 71?a*0XI-~k Improvement Permit ❑ Authorization to Construct ❑ Septic Repair Septic Expansion ❑ Existing Tank Check E] New Well Permit E] Replacement Well ❑ Well Abandonment E] 1. Name to Appear on Permit 4'~ 2. Permit Requested By - C \k Business Phone - Address C~ L)6' YAk) ' Home Phone ~2- ' 31 - I S` 3. Property Owner Business Phone Address 1 S~ ~ L IhC 7S v Home Phone 4. Name of Subdivision Lot # Section/Block/Phase Property Address 5 (:;t /e 1 Directions to roperty: \ r\cw~ ~2A AID B1 L,~k)n rn' C~ . C7 v+ c~r-e 5. Property Size: Square Feet Acres W-Plc 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 or for future consideration should be noted 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 iswance. This may prevent the need for system size increase in the future. Basement: ye no Water Using Fixtures in Basement: yes/no No. in Family Whirlpool Tub ye no 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(/,No If so, describe: 8. Has any grading, removal, or addition of soil been done to this property? Yes No If so, describe: 9. Are there easements/right-of-ways recorded on this property? Yes No 10. Is a public water supply available n or adjacent to the a ve property. Yes / Check type that is available: [ommunity well [ Semi-public well [ County/City/Township water line **If No, a Well Pen-nit must be issued with the Septic Pernit.** 11. Well Type Applying For: [ ] Individual well [gyp orrmunity 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 Q THE PROPERTY, Z\HERE IS AN ADDITIONAL CHARGE." Date V) Signature of Owner or Agent ~A)C \1 -Q l Catawba County, North Carolina This map product was prepared from the Catawba Countv, NC, Geographic Information System. 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 anv data contained on this map product by the user. The Comity 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: 3744-16-82-5749 1 inch = 60 feet Prepared for: 2.25A ~1 4051 709 709 9 8S ~p 22 cb' CO' PLAT 47-72 C CV) /B CO / N 684-3, 31 A 57 C~ `O C `v "L x-4723 0 7741 o 68.55 c9 1. 30 3`O 40 2~0 75 Q LP 1 THIS IS NOT A LEGAL DOCUMENT 3\ Thu, October 29, 2009 04:14 PM 1T\ 1 4nr_ f~J \ `S CATAWBA-000NTY NC - Parcel Report Information Regarding Selected Parcel(s) Parcel ID: 3744-16-82-5749 Name: PETERS AGHI H Name2: Address: 3832 1ST ST CT NW Address2: City: HICKORY State: NC Zip: 28601-8069 Account: 157237000 Calc Acreage: 0.59 Tax Map: 1618 01026 LRK: 54933 Deed Book: 2859 Deed Page: 0257 Subdivision Name: MILL RIDGE Subdivision Block: Lots: B Plat Book: 47 Plat Page: 72 Building Number: 1852 Street Name: PARIS DR Site Zip: 28613 Township: CLINES Fire Code: OXFORD City Code: COUNTY State Road: Total Bldgs Value: Land Value: $7,000 Total Value: $7,000 Year Built: Year Remodeled: Last Sale Date: Last Sale Amount: Neighborhood: 67 Watershed: Watershed Split: Voter Precinct: P33 E911 District: COUNTY Zoning: R-20 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: LYLE CREEK Middle School: RIVER BEND High School: BUNKER HILL School Split: NO P&Z Case Number: Census Tract 2010: 010201 Census Block 2010: 2010 Small Area Plan: ST STEPHENS/OXFORD Agricultural District: Printed: Thu, October 29, 2009 04:14 PM CATA"A COUNTY, NC I00-A South West Blvd PLAN RECEIPT Newton, NC 28658- v (828)465-8399 Thursday, October 29, 2009 184 Sm www.catawbacountync.gov Plan Case: EHPR-10-09-2424 Invoice Number: INV-10-09-256772 Environmental Health Plan Review Invoice Date: 10/29/2009 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 10/29/2009 Check 1132 $300.00 $0.00 Total Paid: $300.00 Total Due: $0.00 Ian recciTt ; haI ~MJ1i5-1~-12-1:b1=Y8ef) 1 1« 16?cc l 3); _r~7~ 10/29/2009 16:37