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Home My WebLink AboutEHPR-12-09-2965.TIF THIS IS NOT A PERMIT Case # EHPR-12-09-2965 J f CATAWBA COUNTY HEALTH DEPARTMENT y Plan Review Application for Environmental Services 184 sM Environmental Health Plan Review - OSWP EXS_SYSTEM APPLICANT OWNER CONTRACTOR GERALD CLINE MARK ROWE NC (828)855-1050 NAME TO APPEAR ON PERMIT GERALD CLINE Pin#: 374501468578 SITE ADDRESS: 6366 HAVENWOOD LN, Conover, NC DIRECTIONS: HWY 16 N/ LFT ON ST PETERS CH RD/ RT ON VALWOOD/ LFT ON CURLEE/ LOT # 6 ON RT/ HAVENWOOD LN/ NAME of SUBDIVISION: Lot # 1 & ADJ A Section/Block/Phase PROPERTY SIZE: Square Feet Acres 5.88 Date Platted/Recorded TYPE OF FACILITY: House Mobile Home X Dimension of Structure Bedrooms 2 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? 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 representation by you of house or structure location should conform to applicable setbacks. Date: / Z / d o C/ Signature of Applicant or Agent 'Aa& 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 FEE NAME DATE AMOUNT Front 10 Side 10 Existing Tank Check Fee 12/02/2009 $80.00 Rear 10 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 12/02/09 14:19 ti THIS IS NOT A PERMIT W L S CATAWBA COUNTY HEALTH DEPARTMENT Application for Environmental Services Improvement Permit ❑ uthorization to Construct ❑ Septic Repair ❑ Septic Expansion ❑ Existing Tank Check New Well Permit ❑ Replacement Well ❑ Well Abandonment ❑ 1. Name to Appear on Permit - -e i' 2. Permit Requested B ~ C r Business Phone h c h IL Address Ci G. e ~,7 Home Phone ~2 L~ 6 , cYZ 7 C` 2 j 3. Property Owner off Address Home Phone 4. Name of Subdivision O L-0 in x &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 L/ Dimension of Structure Bedrooms* 4 *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: yes/co ) Water Using Fixtures in Basement: yes/6 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? QYess t./ No If so, describe: f i; ✓c-c 10 f %'I ( ct , x ~Z 8. Has any grading, removal, or ad rtion of soil been dok to this property? Yes / 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? 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 Pen-nits 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 THE PROPERTY, THERE IS AN ADDITIONAL CHARGE.- Date /2 ZC~~' Signature of Owner or Agent . Catawba County, North Carolina This map product was prepared ft'mn the Calawho Comity, NC, Geographic h formation System. N Catawba Comity has mac% substantial efforts to ensure the accm'crcp of location and labeling it jn motion COntalned on this map. CaRnrba County pronrnles and reconnnends the independent verification of arn' data contained an this map product hr the user. The Coualr afCalawba, its employees, ageats and persomrel disclaim, and .shall not be held liable far mm and all dcnncrges, loss or liabilim, whether direct. indirect J4 or canoequenlial which arises or may arise from this map product at- the use !hereof by any person or entity'- Legend Selected Parcel Number: 3745-01-46-8578 1 inch = 60 feet eb Prepared for - --_--_r____--~~--- 85 ,,,444... - 7,.,o t1 GL + v~. ~A tit u S • _j, I (6 jt" 88 r` 1""- ub7~ 8 R-20 0 U , \\C - 10 0 100 R-20 THIS IS NOT A LEGAL DOCUMI, NT 0 Wednesday, December 02, 2009 01:58 PiM CATAVVBA COUNTY NC - Parcel Report Information Regarding Selected Parcel(s) Parcel ID: 3745-01-46-8578 Name: ROWE MARK ALLEN Name2: Address: 2631 23RD AVE PL NE Address2: City: HICKORY State: NC Zip: 28601-7925 Account: 57444520 Calc Acreage: 5.88 Tax Map: 0300 00002C LRK: 91915 Deed Book: 2608 Deed Page: 0216 Subdivision Name: Subdivision Block: Lots: 1 & ADJ ACRE Plat Book: 31 Plat Page: 174 Building Number: 6338 Street Name: HAVENWOOD LN Site Zip: 28613 Township: CLINES Fire Code: OXFORD City Code: COUNTY State Road: 1618 Total Bldgs Value: $18,900 Land Value: $81,200 Total Value: $100,100 Year Built: Year Remodeled: Last Sale Date: Last Sale Amount: Neighborhood: 58 Watershed: Watershed Split: Voter Precinct: P33 E911 District: COUNTY Zoning: R-20 Zoning2: Zoning3: Zoning Split: N Zoning Overlay: Zoning District: COUNTY Split Zoning Dist: N Split Zoning Dist(1): 0 Split Zoning Dist(2): 0 School District: COUNTY Elementary School: OXFORD Middle School: RIVER BEND High School: BUNKER HILL School Split: NO P&Z Case Number: Census Tract 2010: 010201 Census Block 2010: 1010 Small Area Plan: ST STEPHENS/OXFORD Agricultural District: Printed: Wednesday, December 02, 2009 01:58 PM Cpl CATAWBA COUNTY, NC Ne ton, NC28658vd PLAN INVOICE -ell (828)465-8399 Wednesday, December 2, 2009 g 42 sM www.catawbacountync.gov Plan Case: EHPR-12-09-2965 Invoice Number: INV-12-09-257665 Environmental Health Plan Review Invoice Date: 12/0212009 Fee Name Fee Amount Existing Tank Check Fee Fixed $80.00 Total Fees Due: $80.00 PAYMENTS Date Pay Type Check Number Amount Paid Change 12/02/2009 Cash -1 $80.00 $0.00 Total Paid: $80.00 Total Due: $0.00 planin"oic;,: ,h15icb-6680-1cI7-8h>?-b;+ d:~63008df;.rpi 12/02/2009 14:30