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HomeMy WebLinkAboutEHPR-11-09-2905.TIF BA ,C THIS IS NOT A PERMIT Case # EHPR-11-09-2905 CATAWBA COUNTY HEALTH DEPARTMENT V C,,: ^C Plan Review Application for Environmental Services 1842 SM Environmental Health Plan Review - OSWP EXS_SYSTEM APPLICANT OWNER CONTRACTOR MARQUITA GURLEY MARQUITA GURLEY 4041 RIVER RD 4041 RIVER RD HICKORY NC 28602 HICKORY NC 28602 828-322-2160 828-322-2160 NAME TO APPEAR ON PERMIT MARQUITA GURLEY Pin#: 370012968880 SITE ADDRESS: 4041 RIVER RD, Hickory, NC DIRECTIONS: RIVER RD GOING EAST/ ON RIGHT JUST BEFORE HIDDEN CREEK S/D NAME of SUBDIVISION: Lot # 1 Section/Block/Phase PROPERTY SIZE: Square Feet Acres 1.019 Date Platted/Recorded TYPE OF FACILITY: House X Mobile Home Dimension of Structure Bedrooms 4 Basement: No Water Using Fixtures in BasementNo No. in Family 4 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 I 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? 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 property. Any representation by you of house or structure location should conform to applicable setbacks. Date: ©Q 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 pl No Zoning Approval UDO Zoning Form A Minimum Setbacks FEE NAME DATE AMOUNT Front Side 10 Existing Tank Check Fee 11/25/2009 $80.00 Rear 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 11/25/09 10:16 ,A V_-11- 01-z~ U THIS IS NOT A PERMIT WLS # CATAWBA COUNTY HEALTH DEPARTMENT Application for Environmental Services Improvement Permit ❑ Authorization to construct ❑ Septic Repair ❑ Septic Expansion ❑ Existing Tank Check ❑ New Well Permit ❑ Replacement Well ❑ Well Abandonment ❑ 1. Name to Appear on Permit ,Kl11'St~ ~u P~~-1 2. Permit Requeste By Business Phone 12--t -I L-2 Home Phone5,/_-S~ z9q 16 Address ~~y~ 3. Property Owner Business Phone Address Home Phone 4. Name of Subdivision Lot # Section/Block/Phase Property Address 4041 ~L Z 42 D - _ Dire tions to Prope 5. Property Size: Square Feet Acres D 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 of construction 01 '1'01' future consideration should be noted asa 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 i " ante.-This may prevent the need for system size in a se in the future. Basement: ye /no Water Using Fixtures in Basement: y Ino 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 1st 2nd 3rd OTHER: (Specify) 7. Do you anticipate any additions to Facility? / No _ If so, describe: 'Z ZM n,,n l.I W_ ( r ~lC- ( GI~L~ 8. Has any grading, removal, or addition of soil been done to this property? Yesl/ No If so, describe: 9. Are there easements/right-of-ways recorded on this property? Yes / No 10. Is a public water supply available on or adjacent to the above property. Ye / 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 1 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 TO TH PROPERTY, THERE IS AN ADDITIONAL CHARGE.** Date f7-5--o9 Signature of Owner or Agent Catawba County, North Carolina This map product was prepared from the Catawba County, NC, Geographic Information System. N Catawba County has made substantial efforts to ensure the occuracy of location and labeling information contained on this map. Catawba County promotes and recommends the independent verification of any J4 data contained on this map product by the user. The County of Caiawba, 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 at- the use thereof by any person or entity. Legend Selected Parcel Number: 3700-12-96-8880 1 inch = 60 feet Prepared for: R- 0 w~4 , Plat 7 - 79 WSJ t ~ ~S JL c~ ~~a 3 7904 zqx ZH R-20'30 1.02A 7,8880 ~n Z~r 9~' /j 7 0,7 73 I I I I IS NOT A LEGAL DOCUMENT Wednesday, November 25, 2009 09:55 ANI / 1 1-1. A V' % / _ / ' ri , > Catawba County, North Carolina This map product was prepared from the Catawba County, NC, Geographic Information System. N Catawba County has made substantial efforts to ensure the accuracy of location and labeling information contained on this map. Catau-ba County promotes and recommends the independent verification of any data contained on this map product by the user. The County 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: 3700-12-96-8880 1 inch = 100 feet Prepared for: '00 a l Tas` s v, tq r. / y ~r'L'., j' 9 k 'K J i'111E QV R-;2 71y , - a Cv i• ri ~L~Q UPS t !tt 4 ~'}`q 1 i 411 1 I ~11 t tv. t ( 79°' r tf. 7t S6 Y 14 s t (77S 4 r i 3A -,l r i it A I" # 2.29 y,• , S , i• P ~ ` .a ♦ "4 ~ Iti t ~ ~ ~ ~ ~ S ` alt ~ u ~ ~ ~ o, o A a •g C~~ 7 y s 30 W"' . Y la r 1.d2A b ; ~ w • is ' V^ # L 'k 20 c 8889 a-~^ "16' 4k 58.64' ~j ~ ~ ~ ~ 263 Flat 31 -24 + t -190 .2 1 iz gj <'Y f I49 ~3 140 `r r: 3 t y d k~ yid do t t ;i:~ 4',1 y 2 4 1e'! r the 1 fig . 75 3 tj 4,7` v 9552:.. s !a 7Q 3 "t r i. 3 °k+~ ash ' ,1 I THIS IS NOT A LEGAL DOC IN ),T ~ Wednesday, November 25, 2009 09:52 AM _ ~ c CAT, ,YBA COUNTY PERMIT ~A co ZONING AUTHORIZATION R Accessory Structure P. O. Box 389 PERMIT NO: ZONR-12-09-3276 100A Southwest Blvd U APPLIED: II/25/20b9 Newton, North Carolina 28658 ( ISSUED: 12/10/2099 1p 4 SM Phone: 828-465-8380 EXPIRES: 06/08/2010 e) ~~.Q, ~~.~-~i FAX: 828-465-8962 www.catawbacountyne.gov K I~GyANT c) WN FR._ MARQUITA.GURLLY MARQU17'A uUKLLY 4041 RIVER RD - 4041 RIVER'RD HICKORY NC 28602 HICKORY NC 28602 PROPERTY ID#: 370012968880 CENSUS TRACT: STREET ADDRESS: 4041 RIVER RD, Hickory, NC LOT# 31 PROTECT DESCRIPTION: PERMIT IS FOR ALREADY CONSTRUCTED 24 x 24 DETACHED METAL CARPORT DIRECTIONS: COMMENTS: FLOOD ZONE? ,OWNER TYPE: Residential (Private)' REQUIRED SETBACKS 100 YEAR FLOOD ZONE PLAIN? No LAND OWNER: FRONT: SIDE: 10.00 FLOOD PLAIN, STRUCTURE? No MAX HEIGHT: 35.00 REAR: 30.00 SIDE 1: . VALUE: 18714.24 CORNER: SIDE 2: 1. Before an inspection can be made by the Building Inspection Office, the applicant must pull a string to designate the side and rear property lines where the structure is being placed or constructed. 2. Accessory structures shall only be located in side or rear yards. 3. Accessory structures shall not be attached in any way to the principle structure. 4. Accessory structures shall only be used for private residential purposes. 5. Manufactured homes shall not be used as accessory structures. 6. Accessory structures may not be used for living purposes. FEE DESCRIPTION DATE FEE AMOUNT- Residential Zoning Fee 12/10/2009 $25.00 TOTAL FEES $25.00 The applicant hereby certifies that all information and attachments to this Certificate of Zoning Comoiliance 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. L APP CANT NAME (PRINTED) APPLICANT SIGNATURE ZONING APPROVED BY ZONING FEES ARE NON-REFUNDABLE COMPANY NAME t s permit Page 1 of 1