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Home My WebLink AboutEHPR-3-10-4264.TIF ys~A C0~ THIS IS NOT A PERMIT Case # EHPR-3-10-4264 CATAWBA COUNTY HEALTH DEPARTMENT V Plan Review Application for Environmental Services 1842 SM Environmental Health Plan Review - OSWP IMPROVEMENT APPLICANT OWNER CONTRACTOR ERIC RICE CHARLES BANDY 650 NW 2ND AV PO BOX 923 HICKORY NC 28601- CONOVER NC 28613 (828)446-1144 NAME TO APPEAR ON PERMIT ERIC RICE Pin#: 373511774048 SITE ADDRESS: 4163 NE 54TH AV, Hickory, NC DIRECTIONS: SPRINGS RD TO LEFT ON SULPHUR SPRINGS RD, LEFT ON 37TH ST DR, RIGHT ON 54TH AVE NE, ON LEFT OF DIXIE BOAT CLUB NAME of SUBDIVISION: CHAS&VIVIAN BANDY\BRENT&MELISSA HAYE Lot # I Section/Block/Phase PROPERTY SIZE: Square Feet Acres 0.949 Date Platted/Recorded TYPE OF FACILITY: House X Mobile Home Dimension of Structure 75X65 Bedrooms 4 Basement: Yes Water Using Fixtures in Basement:Yes No. in Family 2 Whirlpool Tub : Gal. Capacity: MULTIPLE FAMILY RESIDENCE: Units 0.00 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 1st 2nd 3rd OTHER: (Specify) Do you aniticipate any additions to Facility? If so, describe: NONE Has any grading, removal, or addition of soil been done to this property? If so, describe NONE Are there easements/right-of-ways recorded on this property? NO Type of Water Supply: Individual Well Community Well Municipal 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 norrexpiring 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: 9 - 61 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 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 Improvement Permit Fee 03/09/2010 $150.00 Rear 30 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 03/09/10 14:56 THIS IS NOT A. PERMIT GRP?) - 3-\o- 4au4 CATAWBA COUNTY HEALTH DEPARTMENT Application for Environmental Services 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 Lku c k TD n, n s on 2. Permit Requested By E r Business Phone Address Goo 7- Ave A/h/ 14, tr , NG 2-96771 Horne Phone8?8-3-2-Lf ~7-1 1 3. Property Owner ChA rJ e_ t V : tr "O n srx rr d ~a Business Phone Address P O 13 0 x 9 2-3 C or,,-, er A/C- Z-86 13 Home Phone 4. Name of Subdivision Lot #Section/Block/Phase Property Address 44J_J7 Lt 1 S ✓,e E Directions to Property: ; n 6,kl -Sie laLfe- 04 3 r2 7 V,1 5. Property Size: Square Feet Acres 97-3 Date Platted/Recorded 6. TYPE OF FACILITY: House Mobile Home Dimension of Structure .7- S -K 4 Bedrooms* *Any room that will be intended 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: es no Water Using Fixtures in Basement: (71_.~Ino No. in Family Whirlpool Tub Ceyno 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 any additions to Facility'? Yes If so, describe: 8. Has any grading, removal, or addition of soil been done to this property? Yes No If so, describe: 9. Are there easements/right-of-ways recorded on this property? Yes / N 10. Is a public water supply available on or adjacent to the above property? (Z~)/ 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 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 3 - ZD l D Signature of Owner or Agent zfi(~~ Catawba County, North Carolina N This map product was prepared from the Catawba County, NC, Geographic Information Svstem. Catawba Countv 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: 3735-11-77-4048 1 inch = 60 feet Prepared for: LO C.0 N r°; ° 31.57 49.16 C.0 o ° (6 C-5 r.: 33.18 0 33.1 35.51 20 N 17 r- M N N ( l) m 0') O N N N ( N 123 47 ~ •Z 6 ~ Plat 68-141 1.21A TR 1 6182_. 00 W 1.03A51 404 N 01 co 3047 co - ~----___-_-,-T-- 00 00 0o. L C c CY) i i i Plat 68-141 r 9582 106.58 0 THIS IS NOT A LEGAL DOCUMENT Tuesday, March 09, 2010 02:37 PM CATAWBA COUNTY NC - Parcel Report Information Regarding Selected Parcel(s) Parcel ID: 3735-11-77-4048 Name: BANDY CHARLES H Name2: BANDY VIVIAN H Address: PO BOX 923 Address2: City: CONOVER State: NC Zip: 28613-0913 Account: 159752626 Calc Acreage: 0.95 Tax Map: LRK: 404262 Deed Book: 2964 Deed Page: 0921 Subdivision Name: CHAS&VIVIAN BANDY\BRENT&MELISSA HAYE Subdivision Block: Lots: 1 Plat Book: 68 Plat Page: 141 Building Number: 4163 Street Name: 54TH AV NE Site Zip: 28601 Township: CLINES Fire Code: ST. STEPHENS City Code: COUNTY State Road: Total Bldgs Value: $700 Land Value: $128,300 Total Value: $129,000 Year Built: Year Remodeled: Last Sale Date: Last Sale Amount: Neighborhood: 58 Watershed: Watershed Split: Voter Precinct: P33 E911 District: COUNTY Zoning: R-40 Zoning2: Zoning3: Zoning Split: N Zoning Overlay: CRC-O,FPM-0 Zoning District: COUNTY Split Zoning Dist: N Split Zoning Dist(1): 0 Split Zoning Dist(2): 0 School District: COUNTY Elementary School: CLYDE CAMPBELL Middle School: ARNDT High School: ST STEPHENS School Split: NO P&Z Case Number: Census Tract 2010: 010301 Census Block 2010: 1000 Small Area Plan: ST STEPHENS/OXFORD Agricultural District: Printed: Tuesday, March 09, 2010 02:37 PM ~g'A CMG CATAWBA COUNTY, NC I00-A South West Blvd PLAN RECEIPT Newton, NC 28658- 0 (828)465-8399 Tuesday, March 9, 2010 j$ 42 sM www.catawbacountync.gov Plan Case: EHPR-3-10-4264 Invoice Number: INV-3-10-260256 Environmental Health Plan Review Invoice Date: 03/09/2010 Site Address: 4163 NE 54TH AV, Hickory, NC APPLICANT OWNER ERIC RICE CHARLES BANDY 650 NW 2ND AV PO BOX 923 HICKORY NC 28601- CONOVER NC 28613 (828)446-1144 Fee Name Fee Amount Improvement Permit Fee Fixed $150.00 Total Fees Due: $150.00 PAYMENTS Date Pay Type Check Number Amount Paid Change 03/09/2010 Check 2183 $150.00 $0.00 Total Paid: $150.00 Payer: ERIC RICE Total Due: $0.00 plan reccipE ; ef639948 92b.,-'4d 15-8e9?-28c90eb 1 clv3 ; .rpt 03/09/2010 14:55