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Home My WebLink AboutEHPR-11-09-2450.TIF A Cpl THIS IS NOT A PERMIT Case # EHPR-1 1-09-2450 ` CATAWBA COUNTY HEALTH DEPARTMENT Plan Review Application for Environmental Services 1842 sM Environmental Health Plan Review - OSWP APPL(CaNT OWNER C ATILAC'TOR ANDREW,GRANT ANJ DRF\V GRANT NORMAN CON I K U I1Nv 1324 COURTNEYDR 1324 COURTNEY DR CONNELLY SPRINGS NC 286-12: HICKORY NC 28602 HICKORY NC 28602 828-455-6333 normanconstructionIIc@yahoo.com NAME TO APPEAR ON PERMIT ANDREW GRANT Pin#: 279010464392 SITE ADDRESS: 1324 COURTNEY DR, Hickory, NC DIRECTIONS: HWY 127 S/ LFT INTO HOMESTEAD ON VALLEY FIELD RD/ RT ON COURTNEY DR/ ON LFT NAME of SUBDIVISION: HOMESTEAD Lot# 6 Section/Block/Phase PROPERTY SIZE: Square Feet Acres 0.379 Date Platted/Recorded TYPE OF FACILITY: House X Mobile Home Dimension of Structure Bedrooms Basement: Yes Water Using Fixtures in Basement: No. in Family 3 Whirlpool Tub : Gal. Capacity: MULTIPLE FAMILY RESIDENCE: Units 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: 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 Conimunity° W 11 Municipal X 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: %I. 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 FFE NAME __n,4TF AMOUNT Side 15 ianl heck'Fee 11102 a80;00Rear 30 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 11/02/09 09:07 THIS IS NOT A PERMIT WLS # CATAWBA COUNTY HEALTH DEPARTMENT Application for Environmental Services Improvement Permit ❑ Authorization to Construct ❑ Septic Repair ❑ Septic Expansion El Existing Tank Check P New Well Permit E] Replacement Well ❑ Well Abandonment E] 1. Name to Appear on Permit 'i N r L- L- t i' /0f, A, 2. Permit Requested By ?b~, 11,4 Business Phone V z f - ti S i~ Address qq 7o ~F ro K t-,z w R-, L~•,..a z sv ~ ~ ;"e -S41e Home Phone 3. Property Owner P4-,J,- e - Business Phone Address 13;-74 to- a- 1 t)Ff<< Home Phone 4. Name of Subdivision Lot # Section/Block/Phase Property Address Directions to Property: 5. ! Property Size: Square Feet Acres t . Date Platted/Recorded 6. TYPE OF FACILITY: House ✓ Mobile Home Dimension of Structure _ Bedrooms* *~Aliv room th,[i will be intended lor`sleehing;at thc:fiu~ ~,IconsUuction ~r I()r Irian - 0111~rdcratioii -hould be notcd as a bedroom and counted ion al l` applications. The number of bedrooms will be ~ ii rmed by rooms i I, untied on house plans a~ a bedroom at the time oihLilidin`u pennitt issuance _ his may proud the raced uli syste>>1 size rncre. , in thc_futirre Basementt 0/no Water Using Fixtures in Basement: yes/no No. in Family 3 Whirlpool Tub yes/00 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 I st 2nd 3rd OTHER: (Specify) 7. Do you anticipate any additions to Facilit ? (~a / No If so, describe: , A4dL- fi N- 8. Has any grading, removal, or additi n of soil been done to this property? Yes 1&67 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 property? -0/ No Check type that is available: [ ] Community well [ ] Semi-public well ,[i ounty/City/Township water line **If No, a Well Pen-nit 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 TY, THERE IS AN ADDITIONAL CHARGE." Date Signature of Owner or Agent Catawba County, North Carolina This map product wo.s prepmed fi'orn the Catawba Comm. A'C, Geographic Informolion System. N Carawho Comm, has oracle subsiamial efforts to ensure the uacrn oci ojlocnrion and labeling in%or'rnrrrion contained on this reap. CaraL'ha C011171P pronrote.v and recommends the independent verficalion of mm data conlained on this mop product try the user. The County of Calamba, its employees, agems cord personnel disclaim, and shall nm be held liable for onv and all damages, loss or liability, whether direct, indirect or corseguemial which arises or nxm arise from this map product or the use thereof by arm person or enlih-. Legend Selected Parcel Number: 2790-10-46-4392 1 inch = 60 feet Prepared for: 1 . fit- Z -;3i f /5U 4 1 5533 00 3540 150.1 0 7 1,4 c~ 100.0 175 1/'1 7.67 5403 in 1 50 1 t 5 > 637.8 f r „ m o «0 ► ---175 . !/3 3 14tr o ~z~ r . i _ `'1392 6 l ~ t o It 100 I- 6259` 1 e_ a 4 175 /t42 72 i p cc 0) 10 -6240 150 1 - - j c r 175 o t 0 y ry ^A a, THiS IS NOT A LEGAL DOCUMENT ~ 4151 8 ~ Nionday, November 02, 2009 03:35 AM I C) CATAWBA COUNTY NC - Parcel Report Information Regarding Selected Parcel(s) Parcel ID: 2790-10-46-4392 Name: GRANT ANDREW C Name2: GRANT MARGO M Address: 1324 COURTNEY DR Address2: City: HICKORY State: NC Zip: 28602-5519 Account:. 24849800 Calc Acreage: 0.38 Tax Map: 163H 07056 LRK: 55473 Deed Book: 1882 Deed Page: 0499 Subdivision Name: HOMESTEAD Subdivision Block: E Lots: 6 Plat Book: 17 Plat Page: 2 Building Number: 1324 Street Name: COURTNEY DR Site Zip: 28602 Township: HICKORY Fire Code: MOUNTAIN VIEW City Code: COUNTY State Road: 2557 Total Bldgs Value: $102,800 Land Value: $13,400 Total Value: $116,200 Year Built: 1980 Year Remodeled: Last Sale Date: 4/1/1994 Last Sale Amount: $83,000 Neighborhood: 77 Watershed: WS-III Protected Area Watershed Split: NO Voter Precinct: P24 E911 District: COUNTY Zoning: R-20 Zoning2: Zoning3: Zoning Split: N Zoning Overlay: WP-O 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: 011801 Census Block 2010: 2004 Small Area Plan: MOUNTAIN VIEW Agricultural District: PROXIMITY Printed: Monday, November 02, 2009 08:35 AM A CATAWBA COUNTY, NC 100 South West Blvd PLAN INVOICE Newton, NC 28658- (828)465-8399 Monday, November 2 2009 I g 4 2 sM www.catawbacountync.gov Plan Case: EHPR-11-09-2450 Invoice Number: INV-11-09-256811 Environmental Health Plan Review Invoice Date: 11/02/2009 Fee Name Fee Amount Existing Ta+ak Check Fee F ~cd $80.00 Total Fees Due: $80.00 PAYMENTS Date Pay Type Check Number Amount Paid Change 1 1/0 2/2009 Check 1027. $80.00.. $0.00 Total Paid: $80.00 Total Due: $0.00 pltininvoice,~0'9e9a-G9i1~-;II %c-S33>-i9aaK~QI;a33;.ip1 11/02/2009 09:25