HomeMy WebLinkAboutEHPR-2-11-9261.TIF A A :11-- THIS IS NOT A PERMIT Case # EHPR - - 11 - 9261
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C.P(St 6 ) ^3 kF 3 -J Re NAME TO APPEAR ON PERMIT
e hq ,l . i-i J,; DAVID R KLASSETT
SITE ADDRESS: 5354 OTTO LN, Conover, NC Pin#: 374405186009
NAME of SUBDIVISION:DAVID R. & ANNA B. BLASSETT Lot # TRACT 2 Section/Block/Phase
PROPERTY SIZE: Square Feet Acres 2.259
DIRECTIONS: HWY 16 N - TURN LEFT ONTO SPRINGS ROAD - TURN LEFT ONTO SUPERIOR ST THEN TURNS INTO
OTTO LN - AFTER PASTURE 1ST MOBILE HOME ON LEFT IN CURVE
APPLICANT OWNER CONTRACTOR
DAVID R KLASSETT DAVID R KLASSETT
1135 SAW MILL RD 1135 SAW MILL RD
CONOVER NC 28613 CONOVER NC 28613
PRIMARY CONTACT: Applicant APPLICATION FOR: Existing Structure
DIM EXISTING STRUCTURE: 28 X 52 EXISTING FACILITY TYPE: Mobile Home
NUMBER OF EXISTING BEDROOMS: 3 SEWER TYPE: Septic Tank
NUMBER OF EXISTING OCCUPANTS: 3 EXISTING WATER SUPPLY IN USE: Private Well
CALCULATED DESIGN FLOW:
Public water is **NOT** available for this property.
PUBLIC WATER TYPE AVAILABLE: N/A
DESCRIBE WORK: DIVIDING PROPERTY INTO TWO LOTS
DESCRIPTION OF DOUBLE WIDE MOBILE HOME
EXISTING STRUCTURES
ON SITE (IF ANY)
PROPOSED FUTURE ADDITIONS NONE
OR IMPROVEMENTS:
PROPERTY EASEMENTS: NONE
PROPOSED CONSTRUCTION
1 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
AREA2
Minimum Setbacks: Front: 30 Side: 15 Rear: 30 Side St: Max Height:
FEE NAME DATE AMOUNT BALANCE DUE
Improvement Permit Fee 02/04/2011 $150.00 $0.00
TOTAL FEES $150.00 $0.00
02/07/11 16:17
CATAWBA COUNTY Case #
EHPR - 2 - 11 - 9261
Public Health Department
Subdivision
T Environmental Health Division - Plan Review
0 � PO Box 389, 100 -A Southwest Blvd, Newton, NC 28658 Lot# TRACT 2
18.2 PIN#
374405186009
Applicant/Owner DAVID R KLASSETT, 1135 SAW MILL RD, CONOVER NC 28613
Site Address: 5354 OTTO LN, Conover, NC
Property Size: SF 2.259 ACRES
Directions: HWY 16N - TURN LEFT ONTO SPRINGS ROAD - TURN LEFT ONTO SUPERIOR ST THEN TURNS INTO OTTO LN -
AFTER PASTURE 1ST MOBILE HOME ON LEFT IN CURVE
CHANGE WORK ORDER REQUIRING REDESIGN AND /OR RETRIP WILL INCURE AN ADDITIONAL CHARGE
(SEE FEE SCHEDULE)
02/07/11 16:17