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Home My WebLink AboutEHPR-2-10-3916.TIF ~ THIS IS NOT A PERMIT Case # EHPR-2-10-3916 2 CATAWBA COUNTY HEALTH DEPARTMENT a V ^C Plan Review Application for Environmental Services 1842 sM Environmental Health Plan Review - Septic Malfunction SEPTIC MALFUNCTION APPLICANT OWNER CONTRACTOR WILLIAM EARLEY WILLIAM EAR-LEY 1220 RESERVE CT 1220 RESERVE CT FLOWER MOUND NC 75028-8315 FLOWER MOUND NC 75028-8315 214-793-4915 214-793-4915 NAME TO APPEAR ON PERMIT WILLIAM EARLEY Pin#: 373519702289 SITE ADDRESS: 5736 SULPHUR SPRINGS RD, Hickory, NC DIRECTIONS: SPRINGS RD - TURN LEFT ONTO WANDERING LN - TURN RIGHT ONTO SULPHUR SPRINGS RD (1 ST RIGHT) - TURN RIGHT ONTO PEGGY ST (1 ST RIGHT) -1 ST HOUSE ON LEFT (CORNER OF PEGGY ST AND SULPHUR SPRINCDS (1A&!tf§IS FACING SULPHUR SPRINGS RD) 5-7 NAME of SUBDIVISION: Lot # Section/Block/Phase PROPERTY SIZE: Square Feet Acres 0.49 Date Platted/Recorded TYPE OF FACILITY: House X Mobile Home Dimension of' Structure 27 X 70 Bedrooms 3 Basement: No Water Using Fixtures in Basement:No No. in Family 1 Whirlpool Tub : Gal. Capacity: MULTIPLE FAMILY RESIDENCE: Units 0.00 Total Number of Bedrooms DAYCARE: Number ol'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 X Community Well 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 V 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 AREA2 (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) 17,02/17/2010 $300.00 Rear 30 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 02/ l 7/ 10 14:54 THIS IS NOT A PERMIT CATAWBA COUNTY HEALTH DEPARTMENT Application for Environmental Services Improvement Permit ❑ Authorization to Construct ❑ Septic Repair Septic Expansion ❑ Existing Tank Check ❑ New Well Permit El Replacement Well ❑ Well Abandonment ❑ I . Name to Appear on Permit I t 2. Permit Reques ed By ~r A- k) e ja P►_ Business Phone Address S a ! ; ~T ; s Home Phone $ 4'E a $ Co - 5 0d2 3. Property Owner Business Phone Address . ao Le r v C e Ml u v Home Phone j ~3 -9 6 4. Name of Subdivision Lot # Section/Block/Phase Property Address .Sul lt~; r 5 Directions to Property: IV ur r 5. Property Size: Square Feet Acres Date Platted/Recorded 6. TYPE OF FACILITY House V Mobile Home Dimension of Structure Bedrooms* *AIl}; room that 111h'e In prided fOI Sleep"f"nne OfrGOnS 5 ~W ctidtlrr ftte conideratibn'8hould b noted e as id bedroom and`cuuntcacsr~~allpphcationshe`niiaiSet of bedroamsuiII lSec'tifi1 b~ morns identified on house laps as a = r FE+' has t~'t':~n`3 'Y}t' ~2+r,} ~.t.+;.,.,Iy.,.-•: bedroor> at the time ut,t ~3tld:ing,pertiiYisuance~~hi may„present the'rieed for,Y~?stem size increase m tlic ft7ture Basement: yes no Water Using Fixtures in Basement. yes/ io No. in Family Whirlpool Tub yes ti 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 No If so, describe: 8, Has any grading, removal, or addition of soil been done to this property? Yes / If so, describe: 9. Are there easeinents/right-of-ways recorded on this property? Yes /J9 10. Is a public water supply available on or adjacent to the above property? Yes / No Check type that is available: [ ] Community well [ L]- Semi-public well [ ] County/City/Township water line **If No, a Well Permit must be ispied with the Septic Permit.** 11. Well Type Applying For: [ ndividual 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." Datc o- 1 2 - IL Signature of Owner or Agent G` Catawba County, North Carolina This map product was prepared from the Catawba County, NC, Geographic (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 ofanv 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: 3735-19-70-2289 1 inch = 60 feet Prepared for: 227.59 Plat 49-98 14.50 N - o 86.68 50 Go - - - 2 - -2398 3-~0 260.86 ' > 4 AO(A N " 00 5 4361 2289 o° 147.16 7 ry / ' PEGGY o ' / S ' (155) r / / t THIS IS NOT A LEGAL DOCUMENT ' Wed, February 17, 2010 02:26 PM CATAWBA COUNTY NC - Parcel Report Information Regarding Selected Parcel(s) Parcel ID: 3735-19-70-2289 Name: EARLEY WILLIAM JAY Name2: EARLEY WENDY Address: 2012 RESERVE CT Address2: City: FLOWER MOUND State: TX Zip: 75028-8315 Account: 156411000 Calc Acreage: 0.49 Tax Map: 0814 11002 LRK: 40634 Deed Book: 2853 Deed Page: 0052 Subdivision Name: DEAL ACRES Subdivision Block: B Lots: 5-7 Plat Book: 13 Plat Page: 69 Building Number: 5736 Street Name: SULPHUR SPRINGS RD Site Zip: 28601 Township: CLINES Fire Code: ST. STEPHENS City Code: COUNTY State Road: Total Bldgs Value: $74,500 Land Value: $10,700 Total Value: $85,200 l~ Year Built: 1970 / 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: SNOW CREEK Middle School: ARNDT High School: ST STEPHENS School Split: NO P&Z Case Number: Census Tract 2010: 010201 Census Block 2010: 1027 Small Area Plan: ST STEPHENS/OXFORD Agricultural District: PROXIMITY Printed: Wed, February 17, 2010 02:26 PM ~+4 CATAWBA COUNTY, NC I00-A South West Blvd PLAN RECEIPT r-] Newton, NC28658- U®~ (828)465-8399 Wednesday, February 17, 2010 184 Z sM www.catawbacountync.gov Plan Case: EHPR-2-10-3916 Invoice Number: INV-2-10-259678 Environmental Health Plan Review Invoice Date: 02/17/2010 Site Address: 5736 SULPHUR SPRINGS RD, Hickory, NC APPLICANT OWNER WILLIAM EARLEY WILLIAM EARLEY 1220 RESERVE CT 1220 RESERVE CT FLOWER MOUND NC 75028-8315 FLOWER MOUND NC 75028-8315 214-793-4915 214-793-4915 Fee Name Fee Amount Authorization to Construct (Repair) Fee Adjustable $300.00 Total Fees Due: $300.00 PAYMENTS Date Pay Type Check Number Amount Paid Change 02/17/2010 Credit Card -1 $300.00 $0.00 Total Paid: $300.00 Payer: VANESSA EARLEY Total Due: $0.00 nlanrccci0t;?3 "76.'s ~h<ac-•1Rd~-17hbd->a7=1t~ihbfidld;.rpt 02/17/2010 14:53