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Home My WebLink AboutEHPR-2-10-3894.TIF ~3A~ C THIS IS NOT A PERMIT Case # EHPR-2-10-3894 CATAWBA COUNTY HEALTH DEPARTMENT y Plan Review Application for Environmental Services 1842 sM Environmental Health Plan Review - OSWP EXS_SYSTEM APPLICANT OWNER CONTRACTOR BETTY FISHER BETTY FISHER BRAD BENFIELD 106 WHITETAIL (828)294-4511 (828)294-4511 HICKORY NC 28601 828-446-1913 NAME TO APPEAR ON PERMIT BETTY FISHER Pin#: 279115531587 SITE ADDRESS: 2051 MOSS FARM RD, Hickory, NC DIRECTIONS: HWY 127 S/ RT ON MOSS FARM RD/ ON LFT NAME of SUBDIVISION: Lot # Section/Block/Phase PROPERTY SIZE: Square Feet Acres 0.93 Date Platted/Recorded TYPE OF FACILITY: House X Mobile Home Dimension of Structure 72 X 58 Bedrooms 3 Basement: No Water Using Fixtures in Basement:No No, in Family 2 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 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 NO Are there easements/right-of-ways recorded on this property? NO 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. bate: (P 0 Signature of Applicant or Agenf --Ce _ An Environmental Health Specialist will contact you within 2 working days o applicati 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 30 FEE NAME DATE AMOUNT Side / 0 Existing Tank Check Fee 02/16/2010 $80.00 Rear 30 TOTAL FEES $80.00 Max Hght yS *If a permit has to be redesigned and / or RETRIPS made to the property, there is an additional $60 charge 02/16/10 12:37 THIS IS NOT A PERMIT WLS ~-0 CATAWBA COUNTY HEALTH DEPARTMENT Application for Environmental Services Improvement Permit ❑ V Authorization to Construct El Septic Repair El Septic Expansion El Existing Tank Check New Well Permit E] Replacement Well ❑ Well Abandonment E] 1. Naive to Appear on Permit .6 rq.9t e,0 Ae__Lk 2. Permit Requested By - _ Business Phone y6 1913 Address a, C9 / ~'1 m -fir Home Phone ~~M 3. Property Owner e T Business Phone Address 2.0.51 oiyss ~a r 40. Home Phone !K'-9 ~ jY- Y-Ul 4. Name of Subdivision Lot # Section/Block/Phase Property Address ~a 0-- o v-e Directions to Property: vT rnv 40 w CQ r n a A"' 0 5. Property Size: Square Feet O d 6 0 Acres S~ Date Platted/Recorded 6. TYPE OF FACILITY: House ✓ Mobile Home Dimension of Structure ? 2 x S 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 is'??s~~uance. This may prevent the need for system size increase in the future. Basement: yes/0 Water Using Fixtures in Basement: yes/fo) No. in Family Whirlpool Tub yes/00 Galll n Capacity MULTIPLE FAMILY RESIDENCES: Units Total Number of Bedrooms DAY CARE: Number of Children V RESTAURANT: Seats 11411. 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? Yes / If so, describe: _ 8. Has any grading, removal, or addition of soil been done to this property? Yes / dSlo~ If so, describe: 1-1 9. Are there easements/right-of-ways recorded on this property? Yes / 19-10) 10. Is a public water supply available on or adjacent to the above property? &_e'S)/ No Check type that is available: [ ] Community well [ ] Semi-public well [•-rCounty/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 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 PROPERTY, THERE IS AN ADDITIONAL CHARGE.** Date I G /0 Signature of Owner or Agent r'~_. e-1-1_ 44ec Catawba County, North Carolina This map product iros prepared f om the Camrba C:aunryv, NC, Geographic Information System. N Coiawba Coinav has made substamial efforts to ensure the accuracy of location and labeling information contained on This map. Catau-ba County pi omoles and recommends the independent verif cation of any dales contained on This map product by the user. The Couniy ofCalcnrba, its employees, agents and personnel disclaim, cmd.shall nol be held liable fir ony and all damages, loss or liability, irheNier direct, unfired or consequential which arises or may arise from this map product or the use (hereof big atnv person or entity' Legend Selected Parcel Number: 2791-15-53-1537 1 inch = 60 feet Prepared for c -3 - ~0) t✓t ~~G c~ (420) s 3765 GEORGE so (44 HENRYD}~ (178) Zc ~ tr V c)I u-j j l 1 /'f 1 1 0530 _ L ~ ti?°,25 N CP O f 68.00 290 nn , 11011 ' , THIS IS NOT A LEGAL DOCUMENT ~ 0 Tuesday, February 16, 2010 11:56 Al~~l CATAbVBA COUNTY NC - Parcel Report Information Regarding Selected Parcel(s) Parcel ID: 2791-15-53-1587 Name: FISHER BETTY D HILDEBRAN Name2: Address: 2051 MOSS FARM RD Address2: City: HICKORY State: NC Zip: 28602-8311 Account: 159750330 Calc Acreage: 0.93 Tax Map: 133H 01008B LRK: 48192 Deed Book: 2954 Deed Page: 1569 Subdivision Name: Subdivision Block: Lots: Plat Book: Plat Page: Building Number: 2051 Street Name: MOSS FARM RD Site Zip: 28602 Township: HICKORY` uY Fire Code: MOUNTAIN VIEW ~City Code: COUNTY State Road: 1194 R Total Bldgs Value: $109,500r~ tt Land Value: $14,100 ~v Total Value: $123,600 Year Built: 1964 Year Remodeled: 1972 Last Sale Date: Last Sale Amount: Neighborhood: 81 Watershed: Watershed Split: Voter Precinct: P24 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: MOUNTAIN VIEW Middle School: JACOBS FORK High School: FRED T FOARD School Split: NO P&Z Case Number: Census Tract 2010: 011101 Census Block 2010: 2009 Small Area Plan: MOUNTAIN VIEW Agricultural District: Printed: Tuesday, February 16, 2010 11:56 AM n V r iJ ra v v Av 1 t tl t) ri L 1 r1 L La t' H K -1_ 1"1 L'J JN -1- (704) 46V-8330 Lot Eval. Improve. Permit Repair Permit A/Cert. of Comp. Permit 0 p r. Permit O~,mer/Agent Phone 3 7 4~_Y ~ Address Subdivision Section/Block Lot# Lot Size Directions: 7 Facility: House 14o "le Home Business Other: ning Approvq,~yes/no # Multi-family- Other 100° Re air Area ye no Bedrooms Se s Employees GPD F w A lication Rate Hot Tub or Spa !no Spec al Fixtures REP R NOTICE: PAIRS RUST BE IN Basement yes/ asement Pluming'yes/no 3 AYS OR DAYS FROM DA OF Water Supply: Private Public PERMIT. Type of System: Trench Z""Bed Pump P~ump~/Panel Panel LPP Other Tank Size: Septic Tank G_-e-_ Pump Tank Nitrification Field: Total Square Feet ~V Depth of Stone Bed Size Trench Width Total Le gth of All Trenches ~Q O Number of Trenches- Individual Trench Length,/ 4Z Feet on Center Maximum Trench Depth Distance of Nearest Well S~y Lot Evaluation: Approved yes/no (Void After 24 months) Topo a Slope I Sketch of lot Evaluation Site - System Design - Final Texture I 4~~` -GtN~I Structur Clay } n. Soil let ss Soi D th Re tr'c. Hoz. t Avai able sp a yes/noi Overall Clas S PS U I Comments: << I O 1 n i ~ I '~V I I I I **NO GUARANTEE OR WARRANTY IS IMPLIED OR GIVEN THROUGH THE ISSUANCE OF THIS PEPIfIT** Permit Date - (Improvement Permit void after 60 months) Oamer/Agent am-4 Za_~4 Sanitarian 1 Installed By J Date -11- Sanitarian ( me any changPs/1nf.ormatign,in rPd or by sketch nn harkl Wf,ite-Office Blue-Bldg. Insp. Comp. Yellow-Owner/Agent Green-Bldg. Insp.I.P.