HomeMy WebLinkAboutEHPR-1-10-3537.TIF
. C~ THIS IS NOT A PERMIT Case # EHPR-1-10-3537
CATAWBA COUNTY HEALTH DEPARTMENT
v~ ;,sue>_; `C Plan Review Application for Environmental Services
1842 5M Environmental Health Plan Review - OSWP
REPAIR
APPLICANT OWNER CONTRACTOR
BEVERLY WILKES BEVERLY WILKES
4210 MARVIN ST 42 10 MARVIN ST
CLAREMONT NC 28610- CLAREMONT NC 28610-
(828)241-3988 (828)241-3988
NAME TO APPEAR ON PERMIT BEVERLY WILKES Pin#: 377301251079
SITE ADDRESS: 4210 MARVIN ST, Claremont, NC
DIRECTIONS: HWY 70 TO CLAREMONT - TURN LEFT ONTO BUNKER HILL SCHOOL RD - GO TO END OF RD - TURN LEFT
ONTO OXFORD SCHOOL RD - TURN RIGHT INTO ISLAND FORD PARK - 3RD HOUSE ON LEFT
NAME of SUBDIVISION: ISLAND FORD PARK Lot # 5 & ADJ L Section/Block/Phase
PROPERTY SIZE: Square Feet Acres 1.019 Date Platted/Recorded
TYPE OF FACILITY: House X Mobile Home Dimension of Structure 47 X 72 Bedrooms 3
Basement: _Yes Water Using Fixtures in Basement:Yes No. in Family 2
Whirlpool T'ub : 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 1st 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?
Ifso, describe NO
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 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 conform to app icable setbacks.
Bnte'r I/ 4-f- Si r Agent J 1-2-
44,K7 An Environmental Health Specialist will contact you within 2 wo king day 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,01/21/2010 $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
01/21/10 11:01