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Home My WebLink AboutEHPR-3-10-4186.TIF THIS IS NOT A PERMIT Case # EHPR-3-10-4186 CATAWBA COUNTY HEALTH DEPARTMENT Plan Review Application for Environmental Services 1842 SM Environmental Health Plan Review - Accessory Structure IMPROVEMENT APPLICANT OWNER CONTRACTOR SHERRY MCCLELLAN SHERRY MCCLELLAN 8155 YOUNG RD 8155 YOUNG RD HICKORY NC 28602 HICKORY NC 28602 828-234-9115 828-234-9115 NAME TO APPEAR ON PERMIT SHERRY MCCLELLAN Pin#: 266802990633 SITE ADDRESS: 8155 YOUNG RD, Hickory, NC DIRECTIONS: HWY 127 TO GREEDY HWY/ LEFT OLD SHELBY RD/ 1.6 MILES TO YOUNG RD ON LEFT/ 1 ST HOUSE ON RIGHT NAME of SUBDIVISION: VERTIE HOFFMAN Lot # PT 2 Section/Block/Phase PROPERTY SIZE: Square Feet Acres 1.769 Date Platted/Recorded TYPE OF FACILITY: House X Mobile Home Dimension of Structure 82 X 37 Bedrooms 4 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 Ist 2nd 3rd OTHER: (Specify) Do you aniticipate any additions to Facility? If so, describe: PVT ACCESSORY BUILDING 10 X 16 W/ 14 X 16 LENTO ON SIDE 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. n Date: 3- q b&o _ Signature of Applicant or Agent 10 R-u An Environmental Health Specialist will contact you within 2 workin 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 80 FEE NAME DATE AMOUNT Side 10 Improvement Permit Fee 03/04/2010 $150.00 Rear 5 TOTAL FEES $150.00 Max Hght *If a permit has to be redesigned and / or RETRIPS made to the property, there is an additional $60 charge 03/04/10 15:55 THIS IS NOT A PERMIT WLS # CATAWBA COUNTY HEALTH DEPARTMENT Application for Environmental Services Improvement Permit ❑ Authorization to Construct ❑ Septic Repair ❑ Septic Expansion El Existing Tank Check ❑ New Well Permit ❑ Replacement Well ❑ Well Abandonment E] 1. Name to Appear on Permit Aw- A c 2. Permit Requested By e r Business Phone Address R~.S <1 t 1)Iq rt "NA 14,-c k(_)ru 1j s'PD~ Home Phone 3. Property Owner :5a mP Business Phone Address Home Phoned I/S`" 4. Name of Subdivision Lot # Section/Block/Phase Property Address /S dU 14 Directions to Property: PW 'Ec> Qlej to m d,_e~ ±o~tf vnu d nn ICS ~ , 'rs E ~(DUC~ ~r~ k;J/~ 5. Property Size: Square Feet Acres dQC/'eS Date Platted/Recorded 6. TYPE OF FACILITY: House Mobile Home Dimension of Structure edrooms* *Any room that will be intended for sleeping at the time of construction or foi- future consideration should be noted as a bedroom and counted on all applications. The number of bedrooms will be confirmed b~l rooms identified on house plans as a bedroom at the time of building permit issuance. This may prevent the need for system size increase in the future. Basement: yes no Water Using Fixtures in Basement: yes/no No. in Family Whirlpool Tub yes/ to 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 an additions to Facility? _10e / No If so, describe: ddi a 11N1~ 8. Has any grading, removal, or addition of soil ben done to this property? Yes /0 If so, describe: 9. Are there easements/right-of-ways recorded on this property? Yes No 10. Is a public water supply available on or adjacent to the above property? CDA06 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: [vf 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." t Date3 X010 Signature of Owner or Agent J)Ojtq AT&4~2 Catawba County, North Carolina N This map product was prepared from the Catawba County, NC, Geographic Information 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 ofany 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 thereofby any person or entity. Legend Selected Parcel Number: 2668-02-99-0633 1 inch = 80 feet Prepared for: 5 ~ R-40 j nj < 1 (364) "b j(313) 1.77A R-40 2,N ID a / en 0633,.. 11-0 3503 Zell ~ X80 R-40 2 3J 9 JP THIS IS NOT A LEGAL DOCUMENT Thursday, March 04, 2010 03:08 PMT /1100 CATAWBA COUNTY. HEALTH DEPA THENT ' Telephone: (704) 465-8270 TDD: (704) 465-8200 O 27 1 / Improve. Permit~uthorization to ConstructX1 ltepair Permit Oper. Permi System Type Owner/Agent IVY W\A t-e Phone a2 Address / Subdivision .4ildbiq 9d Section/Block/Phase Lot# Lot Size a A .C erections: k o eM Facility: House Mobile Home_ Business Other: Tax Map # Multi-family Other Zoning Approval # a:,9 O 74/ 7, -j # Bedrooms- 41 # Seats # Employees Application Rate a C1 GPD Flow Hot Tub or Spa yes/6 Special Fixtures 1006 Repair Area /no Basement yes/0) Basement Plumbing yes/no Water Supply: Private Well Public Type of System: Trench N_Bed Pump. Pump/Panel Panel LPP Other Tank Size: Septic Tank Size / Pump'Tank Size Nitrification Field: Total Square Feet / z0 v Depth of Stone Bed Size Trench Width ,36 Total Length of All Trenches X/00 Number of Trenches Individual Trench Length/,eV /,(0Z) 140_116V / Feet on Center- - Maximum Trench Depth Distance of Nearest Well-- 10 0 *DO NOT INSTALL WHEN WET* Topo 0--3 6 Slope Texture C / :!~w_ 1 Structure 3000fCti ( f Clay Min. Soil Wetness Soil Depth Restric. Hoz. at Available space es/nol Overall Class S~~~~ U Comments: ~i I ~ 50 1 i I I vac r~~ 2 I - **NO GUARANTEE OR WARRANTY IS IMPLIED OR GIVEN AS TO THE PERFORMANCE OR LENGTH OF TIME THIS SYSTEM WILL FUNCTION** *,r,t*,t**,r,t*,t,t*,t*,r,t*,v,r*,r*,r*,t**rt,t*,r*,t*,t****,t*,t,t,r,t*,t*,r**rr,t,r*,t*,t*,r,r*,tw,t,t**,w,r,r,t,t,t,r,r,t,r,r,r,t,t,r,t,t,t*,r**,►*,t,► *Improvement Permit has no expiration date and is transferable, but may be revoked if site plans or intended use changes for the proposed facility. An Authorization to Construct is valid for (5) five years fr date issued and is not transferable. Permit Date Owner/Agent Sanitarian Installed By Date -/i'? anitar' n 9. White - Office Blue - Building Inspection Operation Permit Yellow - Owner/Agent Green - Building Inspection Authorization to Construct ~~A . Cpl CATAWBA COUNTY, NC I00-A South West Blvd PLAN INVOICE Newton, NC 28658- (828)465-8399 Thursday, March 4, 2010 184 2 sM www.catawbacountync.gov Plan Case: EHPR-3-10-4186 Invoice Number: INV-3-10-260090 Environmental Health Plan Review Invoice Date: 03/04/2010 Fee Name Fee Amount Improvement Permit Fee Fixed $150.00 Total Fees Due: $150.00 PAYMENTS Date Pay Type Check Number Amount Paid Change 03/04/2010 Cash -1 $150.00 $0.00 Total Paid: $150.00 Total Due: $0.00 plan invoice ; (1067401'a 106-431=1-8000-3438aSboU-191'; .rpt 03/04/2010 15:54