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Home My WebLink AboutEHPR-3-10-4145.TIF THIS IS NOT A PERMIT Case # EHPR-3-10-4145 CATAWBA COUNTY HEALTH DEPARTMENT V Plan Review Application for Environmental Services 11842 5M Environmental Health Plan Review - OSWP REPLACE WELL APPLICANT OWNER CONTRACTOR BILLY HALL BILLY HALL 3211 SHORT RD 3211 SHORT RD HICKORY NC 28602 HICKORY NC 28602 828-324-7330 828-324-7330 NAME TO APPEAR ON PERMIT BILLY HALL Pin#: 371116749189 SITE ADDRESS: 3221 SHORT RD, Hickory, NC DIRECTIONS: 321/ HWY I OW / RT STARTOWN RD/ LEFT SHORT RD/ LAST BRICK HOUSE ON LEFT NAME of SUBDIVISION: Lot # Section/Block/Phase PROPERTY SIZE: Square Feet Acres 4.07 Date Platted/Recorded TYPE OF FACILITY: House X Mobile Home Dimension of Structure 30 X 80 Bedrooms 3 Basement: Yes Water Using Fixtures in Basement:Yes No. in Family 1 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 Ist 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 Are there easements/right-of-ways recorded on this property? NONE 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 e!Y~ A Environmental Health Specialist will contact you within 2 working days of application date. If you need further infonnation 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 15 Well Permit & Inspection Fee 03/03/2010 $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 03/03/10 09:26 THIS IS NOT A PERMIT WLS # CATAWBA COUNTY HEALTH DEPARTMENT Application for Environmental Services Improvement Permit ❑ Authorization to Construct ❑ Septic Repair El Septic Expansion ❑ Existing Tank Check ❑ New Well Permit E] Replacement Well 0 Well Abandonment ❑ I. Name to Appear on Permit 2. Permit Requested By Business Phone Address 3 n Home Phone 3. Property Owner 1-71 7.1 01- Business Phone Address - t'zr ~,7- K11 Home Phone 4. Name of Subdivision c Lot # Section/Block/Phase Property Address Directions to Property: 5. Property Size: Square Feet Acres Date Platted/Recorded 6. TYPE OF FACILITY House Mobile Home Dimension of Structure oms* 1 ~ ° 4} 'mss a Yii T "+r"TS19G3!~..;4 ,sr ~„t •':"°t~ .::8+~ + ;i ~s:;i,, BedrO Any roomthatll~ then ed~fot~eepxn~ir~tnnev G, nnMs~~tt~o'kf rt~u'e-bo"~Stdelatinhould.be note asa 2M bedroom and ~ouhtean ali~dppltcati~n''~The nt~'~d`t~o~boomsawil.);15~'cifi#~f'~t1~b~ roo~r~s:tdei~hfie~'dn _ho sd ry;;x [r~r~"A~ e 1 ~~t"a kt~fg°, .a {rMf4s" trf7T~o- F~~ tc s} ;rt a , l) aI1SaSd bedroom aiathetita~epbutldtngi~rin lane ~~rinay pre'gf~theteedfolstemYe;n°ctease m tl' future: w e Basement: s/no Water Usin Fixtures in Basement. s/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 Ist 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 /)4th If so, describe: 9. Are there easements/right-of-ways recorded on this property? Yes / 10. Is a public water supply available on or adjacent to the above property? Yes 1)(6-1, 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 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 _0 _ _ j~ Signature of Owner or Agent Catawba County, North Carolina N This map product was prepared from the Catawba County, NC, Geographic htformation System. 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: 3711-16-74-9189 1 inch = 100 feet Prepared for: t ~'R 20 V i.. '.-f'r ti~ ~r,/•'~J `Y .-r: ~r~ !a ,J~. ~~n~}~ l 1 1 q 1 'r ,y..r-- f Z A ~~r*`' 'r" f J.~ t //11 J// j Y ZT - 0 9189 tis t 011 rl y I A R-207- d / /r r 1,.4 1: p~ t/ t A- A( f /f by 1"f~`T# f ~i r 7 ~ ~ ~ sue., 1a~y 1r r , j 60 i 371.00/ i . r t r., o a 1M~ f f THIS IS NOT A LEGAL DOCUMEI\ I f; r1 Wednesday, March 03, 2010 09:]0 AM , i CATAWBA COUNTY NC - Parcel Report Information Regarding Selected Parcel(s) Parcel ID: 3711-16-74-9189 Name: HALL BILLY HAROLD Name2: Address: 3221 SHORT RD Address2: City: HICKORY State: NC Zip: 28602-8377 Account: 25580990 Calc Acreage: 4.07 Tax Map: 169H 01029 LRK: 57831 Deed Book: 0598 Deed Page: 0407 Subdivision Name: Subdivision Block: Lots: Plat Book: Plat Page: Building Number: 3221 Street Name: SHORT RD Site Zip: 28602 Township: HICKORY Fire Code: HICKORY RURAL City Code: COUNTY State Road: 1166 Total Bldgs Value: $107,700 Land Value: $33,600 Total Value: $141,300 Year Built: 1969 Year Remodeled: Last Sale Date: Last Sale Amount: Neighborhood: 87 Watershed: Watershed Split: Voter Precinct: P35 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: BLACKBURN Middle School: JACOBS FORK High School: FRED T FOARD School Split: NO P&Z Case Number: Census Tract 2010: 011102 Census Block 2010: 3009 Small Area Plan: MOUNTAIN VIEW Agricultural District: Printed: Wednesday, March 03, 2010 09:10 AM Cp CATA"A COUNTY, NC 100-A South West Blvd PLAN INVOICE V Newton, NC 28658- (828)465-8399 Wednesday, March 3, 2010 84 2 sM www.catawbacountync.gov Plan Case: EHPR-3-10-4145 Invoice Number: INV-3-10-260016 Environmental Health Plan Review Invoice Date: 03/03/2010 Fee Name Fee Amount Well Permit & Inspection Fee Fixed $300.00 Total Fees Due: $300.00 PAYMENTS Date Pay Type Check Number Amount Paid Change 03/03/2010 Check 3344 $300.00 $0.00 Total Paid: $300.00 Total Due: $0.00 pIaniilk oicc :c7_212h70403h-4948-92ho-21h32d211)870;.ipt 03/03/2010 09:25