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Home My WebLink AboutEHPR-11-09-2889.TIF A C THIS IS NOT A PERMIT Case # EHPR-11-09-2889 ~ Cr CATAWBA COUNTY HEALTH DEPARTMENT Plan Review Application for Environmental Services Environmental Health Plan Review - OSWP 1842 sM IMPROVEMENT APPLICANT OWNER CONTRACTOR GREGORY PADGETT' KELLY WARD 1020 HORSE ROCK RD HICKORY NC 28602 NAME TO APPEAR ON PERMIT GREGORY PADGETT Pin#: 278004937446 SITE ADDRESS: 1020 HORSE ROCK RD, Hickory, NC DIRECTIONS: HWY 127 S/ RT ON DWAYNES STARNES/ AT CORNER WITH HORSE ROCK NAME of SUBDIVISION: BAKER MOUNTAIN ESTATES Lot # 57 Section/Block/Phase PROPERTY SIZE: Square Feet Acres 0.92 Date Platted/Recorded TYPE OF FACILITY: House X Mobile Home Dimension of Structure Bedrooms 4 Basement: Yes Water Using Fixtures in Basement:Yes No. in Family 3 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: 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 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 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 propert Any representation by you of house or structure location should conform to applicable setbacks. Date: t~ o Signature of Applicant or Agent AEnvironmental Health Specialist will contact you within 2 working 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 FEE NAME DATE AMOUNT Front 30 Side 10 Improvement Permit Fee 11/24/2009 $150.00 Rear 10 TOTAL FEES $150.00 Max Hght *If a permit has to be redesigned and / or RETRIPS made to the property, there is an additional S60 charge 1 1 /24/09 12:12 i THIS IS NOT A PERMIT WLS CATAWBA COUNTY HEALTH DEPARTMENT Application for Environmental Services Improvement Permit K Authorization to Construct ❑ Septic Repair ❑ Septic Expansion ❑ Existing Tank Check ❑ New Well Permit ❑ Replacement Well ❑ Well Abandonment ❑ 1. Name to Appear on Permit 9 P,% PoA 12 A~ 2. Permit Requested By GNc~ Pceckc?.e A-~ Business Phone Address l3lo GRo6,,,t t cin,~ }-~~clCGn~ r nC aS(o 0,4 Home Phone 4s~,~s - aacl -o 5'i 9 3. Property Owner kg_aS4 LOOLNO ~ Business Phone Address to'D o t- OVLSQ- Rock. R6 • IA; C.I(C- kl ~\C a9coOQ Home Phone 4. Name of Subdivision "Sakayzs oar Lot # Section/Block/Phase Property Address Directions to Property: 5. Property Size: Square Feet Acres Date Platted/Recorded 6. TYPE OF FACILITY: House ✓ Mobile Home Dimension of Structure Bedrooms* *Any room that will be intended for sleeping at the time ofconstruction 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 issuance. This may prevent the need for system size increase in the future. Basement: Ce no Water Using Fixtures in Basement: es 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? Yes No If so, describe: R1 8. Has any grading, removal, or addition of soil been done to this property? Yes /({lo If so, describe: 9. Are there easements/right-of-ways recorded on this property? Yes n~ 10. Is a public water supply available on or adjacent to the above property? 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 Pen-nits 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 T T,HE PROPERTY ERE IS AN ADDITIONAL CHARGE.** Date ~ ~ _ a ` _ 0Q l Signature of Owner or Agent u~ uliv, Catawba County, North Carolina This map product was prepared from the Catawba County, NC, Geographic Information System. N Caicsvbo County has made substantial efforts to ensure the accuracy of location and labeling information contained on this map. Catawba Countv promotes and recommends the independent verification of anv data contained on this map product by the user. The Count y 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: 2780-04-93-7446 1 inch = 60 feet Prepared for: 1 r0 6 7 2/06. r' r 2 2. 54 Ja' Lr+`/ , ~Fr _ / M I 1 v Z., I ao V c~ - - co 6/ V C§1 ti 's ( ► tK { 0. 0 0 P l ~9~ 00 J j \ 6293 THIS IS NOT A LEGAL DOCUMENT J Tuesday, November 24, 2009 12:21 PM CATAWBA COUtiTY NC - Parcel Report Information Regarding Selected Parcel(s) Parcel ID.- 2780-04-93-7446 Name: WARD KELLY RHONEY Name2: Address: 1020 HORSE ROCK RD Address2: City: HICKORY State: NC Zip: 28602-8963 Account: 153551 Calc Acreage: 0.92 Tax Map: LRK: 602527 Deed Book: 2542 Deed Page: 0531 Subdivision Name: BAKER MOUNTAIN ESTATES Subdivision Block: Lots: 57 Plat Book: 43 Plat Page: 196 Building Number: 1020 Street Name: HORSE ROCK RD Site Zip: 28602 Township: HICKORY Fire Code: MOUNTAIN VIEW City Code: COUNTY State Road: Total Bldgs Value: $411,200 Land Value: $38,300 Total Value: $449,500 Year Built: 2000 Year Remodeled: Last Sale Date: 1/31/2002 Last Sale Amount: $430,000 Neighborhood: 79 Watershed: WS-111 Protected Area Watershed Split: NO Voter Precinct: P24 E911 District: COUNTY Zoning: R-40 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: 1005 Small Area Plan: MOUNTAIN VIEW Agricultural District: Printed: Tuesday, November 24, 2009 12:21 PM