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Home My WebLink AboutEHPR-2-10-4015.TIF THIS IS NOT A PERMIT Case # EHPR-2-10-4015 CATAWBA COUNTY HEALTH DEPARTMENT re~Ge Plan Review Application for Environmental Services 18 SM Environmental Health Plan Review - Septic Malfunction SEPTIC MALFUNCTION FAWCICANT ;OWN=ER t O NTR VAOR THOMAS MC'NEELY I I-IOMAS MCNEELY 4093 HERIvMAN SIPE RD 4093 HERMAN SIDE RD CONOVER NC 28613 CONOV EWNC 28613 828-464-7925 828-46,4-7925 NAME TO APPEAR ON PERMIT THOMAS MCNEELY Pin#: 371212869433 SITE ADDRESS: 531 SE 21 ST ST, Hickory, NC DIRECTIONS: MCDONALD PKWY TURN LEFT ON TO 21ST PROPERTY WILL BE ON RIGHT BESIDE SWEETWATER BAPTIST CHURCH. NAME of SUBDIVISION: Lot # SectionBlock/Phase PROPERTY SIZE: Square Feet Acres 1.1 Date Platted/Recorded TYPE OF FACILITY: House - X, Mobile Home Dimension of Structure 40X50 Bedrooms 4 Basement: Yes Water U~in Fixtures in Basement: Yes No. in Family 0 Whirlpool Tub : Cial Capacity: MULTIPLE FAMILY RESIDENCE: Units 0.00 ` t Total Number cif Bedrooms DAYCARE: Number of Children i E RESTAURANT: Seats Square Feet DiningtArea 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? s 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 1 Type of Water Supply: Individual Well Community Well Nlunicipal 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 representatiori~by you of house or structure location should conform to applicable setbacks. n Date: Signature of Applicant or Agent w r 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 FEE NAME DATE AMOUNT - --1--------- _ r . f r Side Authorization to Construct (Repair)-Fi02/21I 10-0 3125 00 Rear 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 02/24/10 09:58 THIS IS NOT A PERMIT WLS # CATAWBA COUNTY HEALTH DEPARTMENT Application for Environmental Services A101P n Improvement Permit ❑ Authorization to Construct ❑ Septic Repair ❑ Septic Expansion ❑ Existing Tank Check ❑ New Well Permit ❑ Replacement Well ❑ Well Abandonment ❑ 1. Name to Appear on Permit %ho,~y az, v Al-,-21,e e.<y 2. Permit Requested By e Business Phone Address -10P0 6ei-mc¢A/ Home Phone 3. Property Owner ie14 e Business Phone Address S e. Home Phone 4. Name of Subdivision Lot # Section/Block/Phase Property Address S31 e - Directions to Property: 5. Property Size: Square Feet Acres Date Platted/Recorded 6. TYPE OF FACILITY: House Mobile Home Dimension of Structure Bedronms* IOr` tlltUlC Il>Id,fUU0 ll ';h0UI(1 he ntl~c~ ;ti a *A11 100111a11at w i I I be intended Ioi slee1)i11 g at the time 01' construction or.- bedroom al d counted--on-all applicati6ns. i he iI'umbei, ofbcdr00111s Will he 'eJnfirlll~,I I)\ n0 1111; id:nlified oil hvu~,~ Alas ~,_a bedroom at the time of building J~ermit issuance This, max pr`~~ i~t the need for Sysl~.:n: iii:. iii~r~ in the future: Basement. Ono Water Using Fixtures in Basement: es no 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 I st 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 / N 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? 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 fonnal 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 infonnation 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 Pen-nits 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 c',I,~ -90iv Signature of Owner or Agent G_ 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 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 a" 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: 3712-12-86-9433 1 inch = 60 feet Prepared for: 1.01A 7~ 8572 30 o 9386 f ~o SWEETWATER 'BAPTIST CHURCH 'Po 1.83A~, r--~ 0244 s c SWEET 6 THIS IS NOT A LEGAL DOCUMENT J Wednesday, February 24, 2010 09:18 AM ~ ~ , BAP CATAWBA COUNTY NC - Parcel Report ` Information Regarding Selected Parcel(s) Parcel ID: 3712-12-86-9433 Name: MCNEELY EDWIN DORMAN Name2: MCNEELY THOMAS PAUL Address: 4093 HERMAN SIPE RD NW Address2: City: CONOVER State: NC Zip: 28613-8908 Account: 163618 Calc Acreage: 1.1 Tax Map: 124H 02011 LRK: 47186 Deed Book: 2390 Deed Page: 0872 Subdivision Name: Subdivision Block: Lots: Plat Book: Plat Page: Building Number: 531 Street Name: 21ST ST SE Site Zip: 28602 Township: HICKORY Fire Code: HICKORY RURAL City Code: COUNTY State Road: Total Bldgs Value.- $56,100 Land Value: $10,100 Total Value: $66,200 Year Built: 1938 Year Remodeled: 1973 Last Sale Date: Last Sale Amount: Neighborhood: 53 Watershed: Watershed Split: Voter Precinct: P35 E911 District: HICKORY Zoning: R-3 Zoning2: Zoning3: Zoning Split: N Zoning Overlay: Zoning District: HICKORY Split Zoning Dist: N Split Zoning Dist(1):0 Split Zoning Dist(2): 0 School District: COUNTY Elementary School: ST STEPHENS Middle School: ARNDT High School: ST STEPHENS School Split: NO P&Z Case Number: Census Tract 2010: 011000 Census Block 2010: 3013 Small Area Plan: Agricultural District: Printed: Wednesday, February 24, 2010 09:18 AM BA C~ CATAWBA COUNTY, NC 100-A South West Blvd PLAN RECEIPT Newton, NC 28658- ~I (828)465-8399 Wednesday, February 24, 2010 1$ sM www.catawbacountync.gov Plan Case: EHPR-2-10-4015 Invoice Number: INV-2-10-259832 Environmental Health Plan Review Invoice Date: 02/24/2010 Site Address: 531 SE 21ST ST, Hickory, NC APPLICANT OWNER THOMAS MCNEELY THOMAS MCNEELY 4093 HERMAN SIPE RD 4093 HERMAN SIPE RD CONOVER NC 28613 CONOVER NC 28613 828-464-7925 828-464-7925 Fee Name Fee Amount Authorization to Construct (Repair) Fee Adjustable $425.00 Total Fees Due: $425.00 PAYMENTS Date Pay Type Check Number Amount Paid Change 02/24/2010 Check 2658 $425.00 $0.00 Total Paid: $425.00 Payer: THOMAS MCNEELY Total Due: $0.00 plan recciptI1'(180cdbe-2cac=1086-ba89-6dIbc2R139Ihl,rrt 02/24/2010 09:56