HomeMy WebLinkAboutEHPR-11-09-2552.TIF
~A C THIS IS NOT A PERMIT Case # EHPR-11-09-2552
CATAWBA COUNTY HEALTH DEPARTMENT
Plan Review Application for Environmental Services
1842 SM Environmental Health Plan Review - OSWP
APPLICANT OWNER CONTRACTOR
CHARLES WHITE CHARLES WHITE ALEX S. HARRILL CONSTRUCTION CON
3973 BRICKFIELD ST 3973 BRICKFIELD ST 617
HICKORY NC 28602 HICKORY NC 28602 CENTER
828-234-5277 828-234-5277 HICKORY NC 28601
(828)228-1000
NAME TO APPEAR ON PERMIT CHARLES WHITE alex@inviRind,kroup160963874605
SITE ADDRESS: 3973 BRICKFIELD ST, Hickory, NC
DIRECTIONS: ZION CH RD/ LT INTO BRICKFIELD S/D / 1 ST LT / HOUSE ON LEFT CORNER
NAME of SUBDIVISION: BRICKFIELD Lot # 40 Section/Block/Phase
PROPERTY SIZE: Square Feet Acres 1.11 Date Platted/Recorded
TYPE OF FACILITY: House Mobile Home Dimension of Structure Bedrooms 3
Basement: No Water Using Fixtures in Basement:No 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 1st 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? 0
Type of Water Supply: Individual Well Community Well 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 nor 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 applicable setbacks.
Date: 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
(FOR OFFICE USE ONLY)
Zoning Approval _Yes No Zoning Approval UDO Zoning Form A
Minimum Setbacks
Front FEE NAME DATE AMOUNT
Side Existin.Q Tank Check Fee 11/05/2009 $80.00`
Rear TOTAL FEES $80.00
Max Hght
*If a permit has to be redesigned and / or RETRIPS made to the property, there is an additional $60 charge
11/06/09 10:10
11/05/2009 15:55 9283225814 CAT/atOSA CO PAGE 81/82
THIS IS NOT A. PERMIT WLS # E P PR- I~- 0 9- 255a
CA.TA.WBA COUNTY HEALTH DEPARTMENT
Application for Environmental Services
Improvement Pcrmit ❑ % ut`horization to Construct ❑ Septic Repair ❑ Septic Expansion ❑
Existing Tank Check ❑ Nei' Well Permit ❑ Replacement Well ❑ Well Abandonment ❑
1. Name to Appear on Permit L ~G is ~t h~
2. Permit Requested By IAj X Business Phone 4~L$ Z24i'-loon
Address (oi ? rl C c n Ite S >z. Home Phone
3. Property Owner C.I~~ rILS e.~~+ Ic Business Phone
Address 397Ir--~c,~s 1 S4 Home Phone Z3~1-5?Z7
4. Name of Subdivision ~^Sr c+tFrL~ Lot # Section/B1ockfPhase
Property Address X92,It
Directions to Properi i h 12 1 c.Tnr, nnr+k - L
I-{oLA jr (4-
5. Property Size: Square Feet _ZZ S o~0 Acres Z Date Platted/Recorded
6. TYPE OF FACILITY Holt-Se ~ _ Mobilc Nome Dimension of Stt'ucture Bedrooms*-
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Whirlpool Tub ye m Gallon Capacity
Mi ULTIPLE FAMILY RESIDENCES: Units Total Number of Bedrooms
DAY CARE: Number of Children
RESTAURANT: Seats Square Feet Dining Area -Square Fcct Food stand/Meat Market Floor Space
TYPE OF BUSINESS: Number ofEmployees lst 2nd 3rd
OTHER: (Specify)
7. Do you anticipate any additions to Facility are If so, describe: -,5.l I aJ~Ii lion
S. Has any grading, removal, or addition of soil been done to this property? Yes o
If so, describe: -
9. Are there easements/right-of-ways recorded on this property? Yes /
1.0. Is a public water supply available on or adjacent to the above properly?.
Check type that is available: [ ] Community well [ ] Scmi-public well [ County/City/To«mship 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
T understand that this is a formal application for a well permit, 11r6provcmcnt Pen-nit or Authorization to Constnict a ground absorption scNvagc
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. T certify the above information to be correct and understand that an Improvement Permit issued as a
result of this infoiTnation is valid for 5 years or may be non-expiring under certain specified conditions. Improvement Permits and Well
Petlrtits 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 fi•om the date issued and is not transferable.
Note: You must obtain Zoning Approval prior to locating n home or structure on this property. Any representation by you of house or
structure location should conform to applicable setbacks.
*If IF A PERMIT HAS TO BE REDESIGNED AND/OR RETRIPS MADE TO THE PROPERTY, THERE IS AN ADDITIONAL CHARGE.*"
Date I loq Signature of Owner or Agent 0 kjSL_Z T-'
11/05/2009 15:55 9283225814 CATAWBA CO PAGE 02/02
Catawba County, North Carolina
7-his nrop product 11'ar prrpctrrd f}nm'1rc Catowhe C614111r, .VC, Geographic Information Spsrrm.
N Carrrn'bo Cnnnty has made substonnal efforts ro cruiwc thr oru,ro,;v of loeatlon and labeling Infar'marlan
contah?ed on ihl,t snap. Carowba Co?tnry prmm~rme and 1'acnnin?ends the independent vertflcauon of onp
data eonrairted nn rliie map product by Ilre user Tire Couniv of Caralt-ha, Nc emplopare, ir.ecn a and
pat:;nrmrl disclaim, and shali r»r bR hrld liablr fnr ni y and nil donvTo.r, irs,c or liability, whether direct, indirect
jr cnnsequent?al which at'hses or may arum fermi dtls trap praducr or the use thereof by arty person or rnfay. Legend
Selected Pnreel Number: 3609-02-97-4605
1 inch 60 feet Prepared for:
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r THIS 15 NOT A LEGAL DOCUMENT N"I' Tbursd.ny November 05, 2009 04:41 ~ P~
r J 'A°'1t F It{M.,,'1t' .~1?e~i{t~+' Frl~1. .UM.~""!q}.".^."Ti'.^~#t^T'H:`.: , . ....I . ,
CATAWBA,COUNTY PERMIT
~A co ZONING AUTHORIZATION (R)
Addition
u P. O. Box 389
~i si►e ~ PERMIT NO: ZONR-11-09-2803
100A Southwest Blvd APPLIED: 11/05/20199
Newton, North Carolina 28658.
ISSUED: 11/19/2 1 0
Q19
84 Z SM Phone: 828-465-8380 EXPIRES: 05/18/2010
FAX: 828-465-8962. "
www.catawbacountync, gov
'CHARLEWHITE CHARLES WHITE, ALEX S: HARRILLO)I RI iCl la(_~~ CUNIP
3973 BRICKFIELD ST 3973 BRICKFIELD S'I'_ 617 N CENTER ST~' _
HICKORY NG28602 < HICKORY NC 28602 HICKORY NC 28601
PROPERTY ID#: 360902974605 CENSUS TRACT:
STREET ADDRESS: 3,973 BRICKFIELD ST, Hickory, NC LOT# 40
PROJECT DESCRIPTION: ADD 185 sq ft TO EXISTING DECK & BUILD 15 x 15-..SCREENED IN PORCH OVER EXISTING DECK AREA
DIRECTIONS:
COMMENTS:
FLOOD ZONE? OWNER "1 YPE:. Residential ;Private) " REQUIRED SETBACKS
100 YEAR FLOOD ZONE PLAIN? No =LAND OWNER: FRONT: 30.00 SIDE: 15.00
FLOOD PLAIN, STRUCTURE?., No ` -MAX HEIGHT:; 35 0~~ REAR: 30.00 SIDE 1:
,VALUE:v 0 CORNER: SIDE 2:
EKE DESC'RIP;-J, ION D,%TI rrr ;~~1(IUNT
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_Rcsidcntidl zoning ,Fe I l/ I9 2009 - $25.00
TOTAL-FEES
The applicant hereby certifies that all information and attachment to this Certificate of Zoning Compilinnce are true and correct and
acknowledges that this permit was issued on the basis of the information required herein. The applicant further acknowledges that any construction,
alteration or addition which differs from this application shall be subject to removal or alteration so as to bring said structure into conformance with the
specifications and standards of the Catawba County Zoning Ordinance. Such corrective action shall be at the expense of the applicant.
It is the responsibility of Applicant to comply with all existing deed restrictions pertaining to the property. Issuance of this permit is not certification of
such compliance and does not relieve Applicant of the duty to comply.
"This Zoning Authorization Permit shall expire six months from the date of issuance unless a building permit is secured and remains active.
A Xc S 147- ( I
APPLICANT NAME (PRINTED) APPLIC GNATURE ZONING APPROVED BY
p' l S ti C''' < < +-T-U`C_ ZONING FEES ARE NON-REFUNDABLE
COMPANY NAME
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