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Home My WebLink AboutEHPR-11-09-2920.TIF THIS IS NOT A PERMIT Case # EHPR-11-09-2920 CATAWBA COUNTY HEALTH DEPARTMENT U ^C Plan Review Application for Environmental Services 1842 SM Environmental Health Plan Review - Septic Malfunction AUTH CONST SEP MALFUN APPLICANT OWNER CONTRACTOR TERRY WILLIAMS TERRY WILLIAMS COOL PARK PUMPING, INC 1221 HIDDEN CREEK CIR 1221 HIDDEN CREEK CIR CONOVER NC 28613 HICKORY NC 28602 HICKORY NC 28602 (828)394-4942 (828)394-4942 isenhourd@aol.com NAME TO APPEAR ON PERMIT TERRY WILLIAMS Pin#: 370012953442 SITE ADDRESS: 1221 HIDDEN CREEK CIR, Hickory, NC DIRECTIONS: 321 BUSINESS TO RIVER ROAD EXIT, RIGHT ON RIVER ROAD. RIGHT INTO HIDDEN CREEK, 14TH ON RIGHT #1221 NAME of SUBDIVISION: HIDDEN CREEK ESTATES Lot # 30 & PT B Section/Block/Phase PROPERTY SIZE: Square Feet Acres 0.419 Date Platted/Recorded TYPE OF FACILITY: House X Mobile Home Dimension of Structure Bedrooms 3 Basement: Yes Water Using Fixtures in Basement:No No. in Family 4 Whirlpool Tub : Gat. 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? If so, describe NO Are there easements/right-of-ways recorded on this property? NO Type of Water Supply: Individual Well Community Well X 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 representatio y yo of house or structure location should conform to applicable setbacks. Date: ) 31 - D / Signature of Applicant or Agent An Environmental Health Specialist will contact you within 2 workin ays 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 FEE NAME DATE AMOUNT Side Authorization to Construct (Repair) F(I 1/30/2009 $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 1 1 /30/09 10:31 THIS IS NOT A PERMIT WLS # CATAWBA COUNTY HEALTH DEPARTMENT Application for Environmental Services IP AC S. T. Rpr.S. T. Exp. Exist. S. T. Well Prmt. Replacement Well I . Name to Appear on Permit If r l 1 1161 MG 2. Permit Requested By Ke ~l SSPnI~c~U.>r JT:L Business Phone ,,~c;tP agate Address 153 V 0-o-- j 0.r, 1-fi l k S r a r c.1 P C o n n k/nr Home Phone sarn e,, 3. Property Owner ( Business Phone Address Id3L 1 FAi k-n C net°k i'rtJP_ Home Phone J614-g01q-)- 4. Name of Subdivision ~fI dden XP e Lot # Sect] on/B lock/Phase Property Address G12 rmL Directions to Property: Ki'%tr IZZ -~o 14,4A,.N Cr-L lc J r~` Q,-) 1.-4. -or-122l 5. Property Size: Square Feet Acres Date Platted/Recorded 6. TYPE OF FACILITY: House NZ Mobile Home Dimension of Structure Bedrooms* 3_ *Any room that will be intended for sleeping at the time of construction 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: Oe no I/.)- Water Using Fixtures in Basement: yese No. in Family _ Whirlpool Tub yes/v 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? Yes / LO) If so, describe: 8. Has any grading, removal, or addition of soil been done to this property? Yes / If so, describe: 9. Are there easements/right-of-ways recorded on this property? Yes 11 10. Is a public water supply available on or adjacent to the above property? Yes I No Check type that is available: [Community well [ J 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 [ J Irrigation well [ ] Geothermal well 12. Monitoring Well Request? Yes / No # of wells Name of Site 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. **IF A PERMIT HAS TO BE REDESIGNED AND/OR RETRIPS MADE TO THE PROPERTY, THERE IS AN ADDITIONAL CHARGE " Date { - 30 Vq Signature of Owner or Agent rpm ~ ) Catawba County, North Carolina This map product was prepared from the Catawba County, NC, Geographic Information System. N Catmrba County has made substantial efforts to ensure the accuracy of location and labeling information contained on this map. Catawba County promotes and recommends the independent verification of any data contained on this map product by the user. The Coavy of Catawba, its employees, agents and personnel disclaim, and shall not be held liable for any and all damages, loss or liobiliiy, whether direct, indirect or consequential which arises or may arise ft om this map product or the use thereof by any person or entity. Legend Selected Parcel Number: 3700-12-95-3442 1 inch = 60 feet Prepared for: S 45,35 4r 26.4:3 16E~.40 24 y ° O 0 NZ 26.43 Q5 3580 yS0 4 moo o mo 3g~ " S 544 . 3442 700~26 WE-.,LL LOT B 5312 00 ICY 1.23A l o 2277-. ~t THIS IS NOT A LEGAL DOCUMENT i Monday, November 30, 2009 10:18 AM CATAWBA COUNTY NC - Parcel Report Information Regarding Selected Parcel(s) Parcel ID: 3700-12-95-3442 Name: WILLIAMS TERRY JAMES Name2: WILLIAMS PAMELA H Address: 1221 HIDDEN CREEK CIR Address2: City: HICKORY State: NC Zip: 28602-9704 Account: 75104350 Calc Acreage: 0.42 Tax Map: 187H 09009 LRK: 61045 Deed Book: 1801 Deed Page: 1413 Subdivision Name: HIDDEN CREEK ESTATES Subdivision Block: Lots: 30 & PT B Plat Book: 24 Plat Page: 87 Building Number: 1221 Street Name: HIDDEN CREEK CIR Site Zip: 28602 Township: HICKORY Fire Code: MOUNTAIN VIEW City Code: COUNTY State Road: Total Bldgs Value: $126,200 Land Value: $16,500 Total Value: $142,700 Year Built: 1992 Year Remodeled: Last Sale Date: 10/1/1992 Last Sale Amount: $92,750 Neighborhood: 88 Watershed: Watershed Split: Voter Precinct: P23 E911 District: COUNTY Zoning: R-20 Zoning2: Zoning3: Zoning Split: N Zoning Overlay: ED-O Zoning District: COUNTY Split Zoning Dist: N Split Zoning Dist(1): 0 Split Zoning Dist(2): 0 School District: COUNTY Elementary School: BLACKBURN Middle School: JACOBS FORK High School: FRED T FOARD School Split: NO P&Z Case Number: Census Tract 2010: 011102 Census Block 2010: 2066 Small Area Plan: MOUNTAIN VIEW Agricultural District: Printed: Monday, November 30, 2009 10:18 AM