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Home My WebLink AboutEHPR-12-09-2998.TIF A Cpl THIS IS NOT A PERMIT Case # EHPR-12-09-2998 a CATAWBA COUNTY HEALTH DEPARTMENT V Plan Review Application for Environmental Services 1842 SM Environmental Health Plan Review - OSWP IMPROVEMENT APPLICANT OWNER CONTRACTOR Abernathy Park Limited Abernathy Park Limited ABERNETHY PARK LIMITED 2945 Buena Vista RD 2945 Buena Vista RD WINSTON-SALEM NC 27106-5724 Winston Salem NC 27106 Winston Salem NC 27106 336-724-2623 NAME TO APPEAR ON PERMIT Abernathy Park Limited Pin#: 279008971692 SITE ADDRESS: 5128 ORCHARD PARK DR, Hickory, NC DIRECTIONS: BETHEL CHURCH RD TO PITTSTOWN RD, LEFT ON PITTSTOWN, LEFT ON ABERNETHY PARK DR. NAME of SUBDIVISION: ABERNETHY PARK PH 7 Lot # 64 Section/Block/Phase PROPERTY SIZE: Square Feet Acres 0.439 Date Platted/Recorded TYPE OF FACILITY: House X Mobile Home Dimension of Structure 50 X 40 Bedrooms 3 Basement: No Water Using Fixtures in Basement:No No. in Family 0 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 Ist 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? YES UT 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: 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 AREA 2 (FOR OFFICE USE ONLY) Zoning Approval: Yes No Zoning Approval UDO Zoning Form A Minimum Setbacks Front 20 FEE NAME DATE AMOUNT Side 6 Rear 12 TOTAL FEES Max Hght *If a permit has to be redesigned and / or RETRIPS made to the property, there is an additional $60 charge 12/04/09 11:02 12/03/2009 12:57 3357240494 JOt,IES ABERNETH`? ASLA PAGE 01/02 SP i?,iuew S ~ ►Zsv t a K-1(~13u I~Et~ Lr r T.HJS IS NOT A PERMIT WLS # CATAWBA COUNTY HEALTH DEPARTMENT Application for Environmental. Services IP 1. Name to Appear on Permit: Abernethy Park, Limited 2. Permit Requested By Jones Abernethy, President Business Phone 336 724-2623 office 724-0484 fax Address 2945 Buena Vista Road, Winston-Salem, NC 27106 Home Phone same 3. Property Owner Business Phone same Address same Home Phone same 4. Name of Subdivision Abernethy nark Lot 64reapylication Phase 7 Property Address: Orchard Park Drive Directions to Property: 13cthel Church Road to Pinstown Road. Left on Pinstown; Left on Abernethy Park Drive; right on Orchard Park drive 5. Property Size: Square Feet Date Planed/Recorded 6. TYPE OF FACILITY: House Dimension of Structure 50 feet x 40 feet Bedrooms 3 Basement: NO Number in Family unknown Whirlpool Tub NO 7. Do you anticipate any additions to Facility? No 8. Has any grading, removal, or addition of soil been done to this property? No 9. Are there easements/right-of-Nvays recorded on this property? Yes Utility and sidewalk easeZnpent on front SEE PLAT 10. Is a public water supply available on or adjacent to the above property? Yes County/City/Township water line 11. Monitoring Well Request? No I tnderstand 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 e,-Auation purpose:;. J eerti6' the above information to be correct and understand that an Improvement Permit issued as a result of this information is transferable and has no expiration 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 ycars from the date issued and is not transferable. Note; You must obtain Zoning Approval prior to locating a home or structure on this property. **.IF A PERMIT HAS TO BE REDESIGNED AND/OR RETR(PS MADE TO THE PROPERTY, THERE IS AN ADDITIONAL $50 CHARGE.** Dat Signature of Owner or ent *#,4M*•JrR***i-v.'..4 M.y .~~{/.*##*i- k Y r.Mk#*####xNe ieM**#* RGMM #+k**hMMM***}*kM*MM***#*MM it****k Mini clef****MhMe4wi a A J (FOR OFFICE USE ONLY) Please Contact between 8 am and 9 am Phone 12/02/2009 13:25 3367240484 JONES ABERfdETHY ASLA PAGE 04/08 Page 1 of 1 parrelMap Real Estate Search Z-6 0 \ T d g o M Q`~D 0 i Nil, Printed Ma Scale linch = 40ft Parcel Summary Parcel Address: 512$ ORCHARD PARK DR, HICKORY _ Parcel ID' 279008971692 city: WINSTON SALEM Owner: ABERNATHY PARK LIMITED Address: 2945 BUENA VISTA RD r State/Zip: NCr 27106-5724 Owner2: Address2: Land value: $24,600 Total Value: $24,600 report eullding(s) Value: trill report. Ca wba county Promo te5 red Geo GZSCLASMER~ CnSU 0t/he acc~peCy oLP lOCaponnna abeKighn~ xenon onta~ed on this map orfdaa ormation recommends the independent accu verification cy of any data contained on this maplrePorr product by the user. The county of catawoa, its employees, agen , substantial efforts and personnel, disclaim, and shall not arise from b loss or IiaMilty, whether direct, Indirect or consequential which arises or may tnis map/report product or the use thereof by any person or entity. -ci-) 4o/ )[)npr' 11/111~(1(1~ Catawba County, North Carolina This map product was prepared from the Catawba Comity, NC, Geographic /t formation System. N Catawba County has made substantial efforts to ensure the accuracy of location and labeling information contained on this map. Catawba Countypromotes 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 anv 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 anv person or entity. Legend Selected Parcel Number: 2790-08-97-1692 1 inch = 40 feet Prepared for: 1 r: 64 SE ~ 64 `t Plclt 66--~ 07 1692 r- 4P o ' 63 , 1\554 203 3 ° /00 . 6 M s THIS IS NOT A LEGAL DOCUMENT Friday, December 04, 2009 08:36 AM 1 1 ti ~ ! / CATAWBA COUNTY NC - Parcel Report Information Regarding Selected Parcel(s) Parcel ID: 2790-08-97-1692 Name: ABERNATHY PARK LIMITED Name2: Address: 2945 BUENA VISTA RD Address2: City: WINSTON SALEM State: NC Zip: 27106-5724 Account: 159750316 Calc Acreage: 0.44 Tax Map: LRK: 606222 Deed Book: 2962 Deed Page: 0697 Subdivision Name: ABERNETHY PARK PH 7 Subdivision Block: Lots: 64 In Plat Book: 66 U \ /L Plat Page: 107 Building Number: 5128 f A Street Name: ORCHARD PARK DR Site Zip: 28602 A/ Township: HICKORY Fire Code: MOUNTAIN VIEW City Code: COUNTY State Road: Total Bldgs Value: Land Value: $24,600 Total Value: $24,600 Year Built: Year Remodeled: Last Sale Date: Last Sale Amount: Neighborhood: 81 Watershed: WS-III Protected Area Watershed Split: NO Voter Precinct: P23 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: 3005 Small Area Plan: MOUNTAIN VIEW Agricultural District: Printed: Friday, December 04, 2009 08:36 AM