The URL can be used to link to this page

Home My WebLink AboutEHPR-10-09-2435.TIF ~A C THIS IS NOT A PERMIT Case # EHPR-10-09-2435 y CATAWBA COUNTY HEALTH DEPARTMENT V .0 Plan Review Application for Environmental Services 1842 sM Environmental Health Plan Review - OSWP APPLICANT OWNER CONTRACTOR CARL COOK CARL COOK CARL COOK 5131 GROSS RD 5131 GROSS RD 5131 GROSS RD HICKORY NC 28602 HICKORY NC 28602 PO BOX 10106 828-228-3923 828-228-3923 HICKORY NC 28603 704-462-1419 NAME TO APPEAR ON PERMIT CARL COOK Pin#: 269902858820 SITE ADDRESS: 5131 GROSS RD, Hickory, NC DIRECTIONS: HWY 10 W/ GO PAST BLACKBURN SCHOOL/ RT ON WHITENER RD/ TURN ON MENNONITE CH RD/ LFT ON GROSS RD/ ON LFT NAME of SUBDIVISION: Lot # Section/Block/Phase PROPERTY SIZE: Square Feet Acres 1.44 Date Platted/Recorded TYPE OF FACILITY: House X Mobile Home Dimension of Structure Bedrooms 3 Basement: No Water Using Fixtures in Basement: No. in Family 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 1 st 2nd 3rd OTHER: (Specify) Do you aniticipate any additions to Facility? If so, describe: STORAGE BUILDING (MODULAR CLASSRM) Has any grading, removal, or addition of soil been done to this property? If so, describe Are there easements/right-of-ways recorded on this property? NO Type of Water Supply: Individual Well X Community Well Municipal 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 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:' =3 6 ? _ Signature of Applicant or Agent An Environmental Health Specialist will contact you within 2 working days of application date. If you need further information or assistance please call 828-466-7291 AREA 2 (FOR OFFICE USE ONLY) Zoning Approval: _Yes No Zoning Approval UDO Zoning Form A Minimum Setbacks Front 30 FEE NAME DATE AMOUNT Side 10 ExistinR Tank Check Fee 10/30/2009 $80.00 Rear 5 TOTAL FEES $80.00 Max Hght *If a permit has to be redesigned and / or RETRIPS made to the property, there is an additional $60 charge 10/30/09 12:16 r ~ THIS IS NOT A PERMIT WLS # f ff- /C-I)q CATAWBA COUNTY HEALTH DEPARTMENT Application for Environmental Services Improvement Permit ❑ Authorization to Construct ❑ Septic Repair F] Septic Expansion El Existing Tank Check [e-" New Well Permit[:] Replacement Well ❑ Well Abandonment ❑ 1. Name to Appear on Permit as r ~L2 L l 2. Permit Requested By Business Phone Address Home Phone _ 3. Property Owner a r Business Phone e2 ' ;`j I S Address Home Phone OS!_ X28= ~02 4. Name of Subdivision Lot # Section/Block/Phase Property Address c -2 0 Directio s to Property: N rA ~ J~r nN t-- kd , 7 Gr 61 SS 5. Property Size: Square Feet Acres Date Platted/Recorded 6. TYPE OF FACILITY: House Mobile Home t-"' Dimension of Structure Bedrooms* *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 asa bedroom at the time of building permit issuance. This may prevent the need for system size increase in the future. Basement: yes/ o) Water Using Fixtures in Basement: yes/no No. in Family Whirlpool Tub yes/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 1 st 2nd 3rd OTHER: (Specify) 7. Do you anticipate any additions to Facility Yep No If so, describe: 8. Has any grading, removal, or ad tion of soil been`don to this property? Yes / o' If so, describe: 9. Are there easements/right-of-ways recorded on this property? Yes 10. Is a public water supply available on or adjacent to the above prope Yes No 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 PERM~rIT HAS TO BE REDESIGNED AND/OR RETRIPS MADE TO HE PR ERTY, THERE IS AN A ITIONAL CHARGE.- Date ZU 5 - 9Signature of Owner or Agent ` Catawba County, North Carolina Phis map product was prepared fi-onr the Catawba Comity, A'C, Geographic h fornrolion Siwlem. N Cotcmbo Count'` hos mode substantial efforts to ensure the accuracy of location clod labeling in,formolion contained on /his map. Calowba Count ' v promotes ood recomnnends the independem rerilicolion of any doto contained mr this mop product by the user. The County ofCotanrba, its employees, agents and personnel disclaim, clad shall not he held liable for am and all damages, loss or liability, whether direct, indirect or cousegneoliol 11-111ch o1ses ar mall' arise from this mop product or the use thereof My clay person or entih'- Legend }~7 Selected Parcel Number: 2699-02-85-8820 I inch = 60 feet Prepared for: i V 1 \J 890 0 \;1.44, A N N 882 0 1.36A 0732. l'80 '00P. p THIS IS NOT A LEGAL DOCUn'IENT Friday, October 30, 2009 11:35 AM t V ,y CATAWRA-CC•UNTY NC - Parcel Report Information Regarding Selected Parcel(s) Parcel ID: 2699-02-85-8820 Name: COOK CARL DEAN Name2: COOK NAOMI E Address: 5131 GROSS RD Address2: City: HICKORY State: NC Zip: 28602-7196 Account: 14071000 Calc Acreage: 1.44 Tax Map: 001 J 02016C LRK: 230 Deed Book: 1421 Deed Page: 0937 Subdivision Name: Subdivision Block: Lots: Plat Book: Plat Page: Building Number: 5131 Street Name: GROSS RD Site Zip: 28602 Township: JACOBS FORK Fire Code: PROPST City Code: COUNTY State Road: 1136 Total Bldgs Value: $74,700 Land Value: $10,000 Total Value: $84,700 Year Built: 1976 Year Remodeled: 1999 Last Sale Date: 11/111985 Last Sale Amount: $3,700 Neighborhood: 89 Watershed: WS-III Protected Area Watershed Split: NO Voter Precinct: P3 E911 District: COUNTY Zoning: R-40 Zoning2: Zoning3: Zoning Split: N Zoning Overlay: DWMH-O,WP-O Zoning District: COUNTY Split Zoning Dist: N Split Zoning Dist(1): 0 Split Zoning Dist(2): 0 School District: COUNTY Elementary School: BLACKBURN Middle School: JACOBS FORK High School: FRED T FOARD School Split: NO P&Z Case Number: Census Tract 2010: 011802 Census Block 2010: 3000 Small Area Plan: MOUNTAIN VIEW Agricultural District: Printed: Friday, October 30, 2009 11:15 AM