HomeMy WebLinkAboutEHPR-3-11-10063.TIF �� C� THIS IS NOT A PERMIT Case # EHPR-3-11-10063
�" � CATAWBA COUNTY HEALTH DEPARTMENT
c�.� y��'. ''C Plan Review Application for Environmental Services
Igq SM Environmental Health Plan Review - OSWP
�� s�d �� a-Ci , A UTH CONS T
���,�.� L �� NAME TO APPEAR ON PERMIT
������ BRANDON ISENHOUR
siTE a��Ress: 5543 37TH ST NE, Hickory, NC Pin#: 373510375448
NAME of SUBDIVISION: TONY LEE LYNN Lot # � Section/Block/Phase
PROPERTY SIZE: Square Feet Acres 1.44
DIRECTIONS: SPRINGS RD, TAKE LEFT ON SULPHUR SPRINGS RD, TO 37TH ST DR NE ON LEFT, FOLLOW AROUND
LEFT CURVE 37TH BREAKS OFF TO LEFT BECOMES 37TH ST NE. TAKE FIRST LEFT ON GRAVEL RD.
PROPERTY ON RIGHT
APPLICANT OWNER CONTRACTOR
BRANDON ISENHOUR BRANDON ISENHOUR
5252 LEE CLINE RD 5252 LEE CLINE RD
CONOVER NC 28613- CONOVER NC 28613
�g2s�2� �-� 602 s2s-21�-1602
PRIMARY CONTACT: Owner APPLICATION FOR: New Construction
DIM EXISTING STRUCTURE: � EXISTING FACILITY TYPE: N/A
NUMBER OF EXISTING BEDROOMS:� SEWER TYPE: Septic Tank
NUMBER OF EXISTING OGCUPANTS�� EX{STING 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: SINGLE FAMILY RESIDENTIAL/ 1 STORY/ NO BASEMENT OR GAR.AGE
PROPERTY EASEMENTS: NO
PROPOSED CONSTRUCTION
PRIMARY RESIDENCE
NEW RESIDENCE? New Residence
# OF NEW BEDROOMS� # OF STRUCTURE OCCUPANTS: 2
PROJECT DESC: SINGLE FAMiLY RESIDENTIAL! 1 STORY/ NO BASEMENT OR GARAGE/ **Sharing well with parent
on t
PROJECT DIMENSION 30 x 44
BASEMENT? No BASEMENT FIXTURES? No
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
evaluatio� 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 nor�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
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Minimum SetbaeKs Front: 30 Side: 15 Rear: 30 Side St: Max Height:
03/29/11 09:04