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HomeMy WebLinkAboutEHPR-3-10-4261.TIF A ys$ c~G THIS IS NOT A PERMIT Case # EHPR-3-10-4261 CATAWBA COUNTY HEALTH DEPARTMENT v Plan Review Application for Environmental Services 1842 SM Environmental Health Plan Review - OSWP IMPROVEMENT - AUTH CONST APPLICANT OWNER CONTRACTOR JEON REAL ESTATE INC JEON REAL ESTATE INC RON A JOYCE PO BOX 2365 PO BOX 2365 PO BOX 716 HICKORY NC 28602 HICKORY NC 28602 HICKORY NC 28603- 828-381-2520 828-381-2520 828-381-2520 NAME TO APPEAR ON PERMIT JEON REAL ESTATE INC Pin#: 370005090783 SITE ADDRESS: 1698 BERKSHIRE DR, Hickory, NC DIRECTIONS: I-IWY 127 S/ LT ON BETHEL CH RD/ LT ON BERKSHIRE DR/ STRAIGHT TO END OF SUBD NAME of SUBDIVISION: BERKSHIRE PLACE PH I Lot # 24 Section/Block/Phase PROPERTY SIZE: Square Feet Acres 0.519 Date Platted/Recorded TYPE OF FACILITY: House X Mobile Home Dimension of Structure 30 X 36 Bedrooms 3 Basement: Yes Water Using Fixtures in Basement:No No. in Family 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 1 st 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? NO Type of Water Supply: Individual Well Community Well Municipal X Semi-Public 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 operty. represen tion by you of house or structure location should conform to applicable setbacks. Date: Signature of Applicant or Agent n Environmental Health Specialist will contact you withi 2 working days app ication date. If you need further infonnation or assistance please call 828-46 f 291 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 Authorization to Construct Fee (New/Expansion) Fee 03/09/2010 $150.00 Rear 30 Improvement Permit Fee 03/09/2010 $150.00 Max Hght TOTAL FEES $300.00 *If a permit has to be redesigned and / or RETRIPS made to the property, there is an additional $60 charge 03/09/10 13:12 THIS IS NOT A PERMIT WLS # CATAWBA COUNTY HEALTH DEPARTMENT Application for Environmental Services Improvement Permit 0 Authorization to Construct © Septic Repair ❑ Septic Expansion El Existing Tank Check ❑ New Well Permit ❑ Replacement Well ❑ Well Abandonment ❑ 1. Name to Appear on Permit cia * yrf~ 2. Permit Requested By Business .phone Z ZSZD Address 7710 6-~k4Y? /V / Home Phone L( ZJ tf 3f 3. Property Owner Business Phone 5~iA3 1' Address Home Phone Cr Z~ y 3 y 5 4. Name of Subdivision lh-e- yo Lot #:]~q Section/Block/Phase Property Address i if 'tom r _ - 2-OpLk4 Dir tions to Property: / Z7 0 - 6 ~ 1/1-L 61 4-162- c ~ - S l~ V i v 5. Property Size: Square Feet Acres Z Date Platted/Recorded 6. TYPE OF FACILITY: House Mobile Home Dimension of Structure 004 :~3~ Bedrooms*3 *Any room that will be intende for sleeping at the time of construction or for future consideration should be noted as a bedroom and counted on all applications. The number of bedrooms will be confirmed by 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: s ,o Water Using Fixtures in Basement: yes No. in Family Whirlpool tub yes6l Gallon Capacity MULTIPLE FAMILY RESIDENCES: Units Total Number of Bedrooms DAY CARE: Number of Children _ RESTAURANT: Seats N A Square Feet Dining Area -Square Feet Food stand/Meat Market Floor Space TYPE OF BUSINESS: _ Number of Employees 1st 2nd 3rd OTHER: (Specify) if 7. Do you anticipate any additions to Facility? Yes o If so, describe: 8. Has any grading, removal, or addition of soil been done to this property? Yes / 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? / N Check type that is available: [ ] Community well [ ] Semi-public we [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 P OPERTY, THERE IS AN ADDITIONAL CHARGE." Date "G ~ o Signature of Owner or Agent Catawba County, North Carolina N This crap product it cis prepared fi om the Ccnawho Count v, AtC, Geographic h jormalion Svstem. Colawba County has made subsie nlial efforts to ensure the accuracy of location and labeling infornmlion contained on this mop. Calau,ba Comfit, promoter cmd recommends the independent verification of cnm data contained on this map product by the user. The Comity ofCatcnrbo, its employees, agents and personnel disclaim, and shall not he held liable for any and all damages, loss or liabilim, whether direct, indirect or consequential which arises or tole arise f om this map product or the use thereof by om, person or emit:. Legend Selected Parcel Number: 3700-05-09-0733 1 inch = 60 feet Prepared for: f \at f 2931 Pr ^4~ cS ~ 23 j f x.873 57 30 q of 2 -A- 0,783 `q ! t "r J j } Q19 N -r. 161,_ 2670 C 25 0) ,..-'r`ye _ - - - - - - - - - -2 V 291.09 168-37 THIS IS NOT A DECAL DOCUMEN ' r'`'` 2 Tuesday, March 09, 2010 12:56 PNI CATAWBA COUNTY NC - Parcel Report Information Regarding Selected Parcel(s) Parcel ID: 3700-05-09-0783 'Name: JEON REAL ESTATE INC Name2: Address: PO BOX 2365 Address2: City: HICKORY State: NC Zip: 28603-2365 Account: 159739225 Calc Acreage: 0.52 Tax Map: LRK: 606162 Deed Book: 2868 Deed Page: 1466 Subdivision Name: BERKSHIRE PLACE PH 1 Subdivision Block: Lots: 24 Plat Book: 66 Plat Page: 174 Building Number: 1698 Street Name: BERKSHIRE DR Site Zip: 28602 Township: HICKORY Fire Code: MOUNTAIN VIEW City Code: COUNTY State Road: Total Bldgs Value: Land Value: $25,200 Total Value: $25,200 Year Built: Year Remodeled: Last Sale Date: Last Sale Amount: Neighborhood: 88 Watershed: Watershed Split: Voter Precinct: P23 E911 District: COUNTY Zoning: R-20 Zoning2: Zoning3: Zoning Split: N Zoning Overlay: ED-0 Zoning District: COUNTY Split Zoning Dist: N Split Zoning Dist(1): 0 Split Zoning Dist(2): 0 School District: COUNTY Elementary School: MOUNTAIN VIEW Middle School: JACOBS FORK High School: FRED T FOARD School Split: NO P&Z Case Number: Census Tract 2010: 011102 Census Block 2010: 2031 Small Area Plan: MOUNTAIN VIEW Agricultural District: Printed: Tuesday, March 09, 2010 12:56 PM