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Home My WebLink AboutEHPR-2-10-3874.TIF A THIS IS NOT A PERMIT Case # EHPR-2-10-3874 CATAWBA COUNTY HEALTH DEPARTMENT Plan Review Application for Environmental Services Ig42 sM ; Environmental Health Plan Review - OSWP EXPANSION APPLICANT OWNER CONTRACTOR TIMOTHY JORDAN TIMOTHY JORDAN SAME AS OWNER 1605 CORRAL DR 1605 CORRAL DR HICKORY NC 28602 HICKORY NC 28602 828-851-0975 828-851-0975 NAME TO APPEAR ON PERMIT TIMOTHY JORDAN Pin#: 370008893235 SITE ADDRESS: 1605 CORRAL DR, Hickory, NC DIRECTIONS: HWY 321 S TO MTN VIEW/ LT RIVER RD/ LT CORRAL DR./ 3RD HOUSE ON LEFT (GREEN W/RED SHUTTERS) NAME of SUBDIVISION: THE PONDEROSA Lot # 20 Section/Block/Phase PROPERTY SIZE: Square Feet Acres 0.379 Date Platted/Recorded TYPE OF FACILITY: House X Mobile Home Dimension of Structure Bedrooms 4 Basement: No Water Using Fixtures in Basement:No No. in Family 4 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: 2 STORAGE BUILDINGS, ADDITION OF 2 BEDROOMS ALL WITHOUT PERMITS 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: 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 No Zoning Approval UDO Zoning Form A Minimum Setbacks Front 30 FEE NAME DATE AMOUNT Side 15 Authorization to Construct (Repair) Fee 02/15/2010 $425.00 Rear 30 TOTAL FEES $425.00 Max Hght *If a permit has to be redesigned and / or RETRIPS made to the property, there is an additional $60 charge 02/22/10 08:59 `41 A THIS IS NOT A PERMIT Case # EHPR-2-10-3874 CATAWBA COUNTY HEALTH DEPARTMENT Plan Review Application for Environmental Services 1842 sM Environmental Health Plan Review - OSWP REPAIR APPLICANT OWNER 'CONTRACTOR TIMOTHY JORDAN TIMOTHY JORDAN SAME AS OWNER 1605 CORRAL DR 1605 CORRAL DR HICKORY NC 28602 HICKORY NC 28602 828-851-0975 828-851-0975 NAME TO APPEAR ON PERMIT TIMOTHY JORDAN Pin#: 370008893235 SITE ADDRESS: 1605 CORRAL DR, Hickory, NC DIRECTIONS: HWY 321 S TO MTN VIEW/ LT RIVER RD/ LT CORRAL DR./ 3RD HOUSE ON LEFT (GREEN W/RED SHUTTERS) NAME of SUBDIVISION: THE PONDEROSA Lot # 20 Section/Block/Phase PROPERTY SIZE: Square Feet Acres 0.379 Date Platted/Recorded TYPE OF FACILITY: House X Mobile Home Dimension of Structure Bedrooms 4 Basement: No Water Using Fixtures in Basement:No No. in Family 4 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: NO Has any grading, removal, or addition of soil been done to this property? If so, describe ADDITION ALREADY CONSTRUCTED 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 repres tation by you of house or structure location should conform to applicable setbacks. Date: 5 CD Signature of Applicant or Agent An nvironmental Health Specialist will contact you within 2 worki' days of application date. If you need further information or assistance please call 828-466-7291 (FOR OFFICE USE ONLY) Zoning Approval: _Yes No Zoning Approval UDO Zoning Form A Minimum Setbacks Front 30 FEE NAME DATE AMOUNT Side 15 Authorization to Construct (Repair) F,02/15/2010 $425.00 Rear 30 TOTAL FEES $425.00 Max Hght *If a permit has to be redesigned and / or RETRIPS made to the property, there is an additional $60 charge 02/15/10 12:59 • ~4 THIS IS NOT A PERMIT W LS CATAWBA COUNTY HEALTH DEPARTMENT Application for Environmental Services Improvement Permit F1 Authorization to Construct El Septic Repair Septic Expansion ❑ Existing Tank Check ❑ New Well Permit ❑ Replacement Well ❑ Well Abandonment ❑ 1. Name to Appear on Permit 2. Permit Requested By nip av Business Phone -Address a / J c. o~ /l/ --,2 G Gd Home Phone '1-2 5~ - S / -o S S 3. Property Owner t 7:5~r a,lk Business Phone Address Home Phone SO 9- 9 - ~ % 7 S 4. Name of Subdivision Rode(-c"-so v Lot # Section/Block/Phase Property Address 160 . , c. /l/C 60 Directions to Property: 3 S. 7Co Q ' r e On o ~-e! O~ Ccrr-a / r P 5. Property Size: met Acres 3 3 D via++P~ P ~d 6. TYPE OF FACILITY: House Mobile Home Dimension of Structure 4 D S O Bedrooms*-~-/_ *Any room that will be intende 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: ye no Water Using Fixtures in Basement: yes/no No. in Family Whirlpool Tub yes/ ooGallon Capacity %VLTIPL,E FAMILY RESIDENCES: Units Total Number of Bedrooms DA C E: Number of Children RES URANT: Seats Square Feet Dining Area -Square Feet Food stand/Meat Market Floor Space TY BUSINESS: Number of Employees 1st 2nd 3rd O HER: pecify) 7. o you anticipate any additions to Facility? Yes No ~S If so, describe: 8. Has any grading, removal, or addition of soil been done to this property? Yes No h If so, describe: 9. Are there easements/right-of-ways recorded on this property? Yes / o 10. Is a public water supply available on or adjacent to the above property? es No Check type that is available:,p~Community well [ ] Semi-public well [ ] County/City/Township water line **If No, a Well Permit must be issued with the Septic Permit.** Well Type Applv,ng-E r: [ ] 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 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 PROP TY, HERE IS AN ADDITIONAL CHARGE.** Date / 6 /L) Signature of Owner or Agent /TO 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. Catawba Countv promotes and recommends the independent verification of any data contained or 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 fronr this map product or the use thereof by any person or entity. Legend Selected Parcel Number: 3700-08-89-3235 1 inch = 60 feet Prepared for: - - - • - - - -------J } R-20 1 04.49 ZQ, r i 4 73 V '401 ON ~Cb ?5.3p - R 54 26-41 10 _ ~e i 20't N ~ ? ~ •8Q Qo 21 3334 IL -D 0 Flat 19 4150 1289 179.14 N N co -20 ~P1 o 2r ~ 22 3235 z , R-20 r 213.56 Nrn 19 i ;378 3126 i N 7 co ~ s C `b 18 228 OS J 3007/` ' 10) - THIS IS NOT A LEGAL DOCUMENT Monday, February 15, 2010 12:30 PM Catawba County, North Carolina This map product was prepared from the Catawba County, NC, Geographic Information Svstem. N Catawba 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 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: 3700-08-89-3235 1 inch = 60 feet Prepared for: K -41 X00 ; R-20 z fn 44 73 SO/V ~o r ~ j t t s.3R 1 Q 54 % 264 104-49.'' , ~ r y 7 i4l f > z Oil o 9 = 1~50,~a - Flat, 1 - 4, . 1289 - N 4q»_µ -20 e _ 2 (3) 00 22, 126 "QD 7,I s 00 c r r r~ , 300~' . THIS IS NOT A LEGAL DOCUMENT Monday, February 15, 2010 12:31 PM CATAWBA COUNTY HEALTH DEPARTMENT NEWTON, NORTH CAROLINA COMPLETION PERMIT FOR SEPTIC TANKS PERMIT N°- DATE : OWNER ADDRESS BUILDING CONTRACTOR SUBDIVISION ?9-ndr LOCATION T P' LOT ~k LOT SIZE BLOCK OR SECTION HOUSE ( MOBILE HOME ( ) BUSINESS ( ) OTHER ( ) FHA-VA LOAN ( ) SEPTIC TANK: (SIZE ! Lc;, GALS) WATER SUPPLY: NO. BEDROOMS X10 FIXTURES I INDIVIDUAL PUBLIC GARBAGE DISPEL UNIT:YES (-3-N0 ( ) IF WELL, TYPE: B RED DRILLED DUG AUTO WASHING MACHINE: YES ( ) NO ( ) DISTANCE FROM SEPTIC TANK OR NEAREST NITRIFICATION FIELD: O O SQ.FT. POLLUTION: FT. 1) NUMBER OF LINES SEPTIC TAN 2) LENGTH AND WIDTTFOF IN ` `5`X E o mss- a BED SYSTEM CERTIFICA C MPLET BY- b) TRENCH SYSTEM ( ) 3) DEPTH OF STONE IN LINES-/'L- REMARKS: ADEQUATE FALL (GRADE) Obi: 1) BUILDING (HOUSE) SEWER LINE: YES ( ) NO ( ) 2) NITRIFICATION LINES: DATE INSTALLED: - 7 YES ( ) NO ( ) SEPTIC TANK LAYOUT I x ld 1 44 H NO I ra 1 HEALTH DEPARTMENT COPY