HomeMy WebLinkAboutEHPR-3-11-9894.TIF /A • THIS IS NOT A PERMIT Case # EHPR - - 11 - 9894
/ ivik CATAWBA COUNTY HEALTH DEPARTMENT
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® 'C Plan Review Application for Environmental Services
1842 sM Environmental Health Plan Review - OSWP
AUTH CONST -- — — - --
efiDt 3 p J NAME TO APPEAR ON PERMIT
KENNETH & PATRICIA WILMOTH
SITE ADDRESS: 2153 ZION CHURCH RD, Hickory, NC Pin#: 370015744085
NAME of SUBDIVISION: S HILDEBRAN FARM Lot # 10 - 11 18 -1' Section/Block/Phase
PROPERTY SIZE: Square Feet Acres 2.529
DIRECTIONS: 10W/ RT ZION CHURCH RD/ BESIDE BROOKSTONE SUBDIV
APPLICANT OWNER CONTRACTOR
KENNETH & PATRICIA WILMOTH KENNETH & PATRICIA WILMOTH
1030 WILLOW CREEK DR 1030 WILLOW CREEK DR
NEWTON NC 28658 NEWTON NC 28658
(704)325 -3199 (704)325 -3199
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 OCCUPANTS: EXISTING WATER SUPPLY IN USE: Public Water
CALCULATED DESIGN FLOW:
Public water IS available for this property.
PUBLIC WATER TYPE AVAILABLE:Cro /City /Tow nship W ater
DESCRIBE WORK: 1 STORY DWELLING W/ ATTACHED GARAGE
PROPERTY EASEMENTS: NONE
PROPOSED CONSTRUCTION
PRIMARY RESIDENCE
NEW RESIDENCE? New Residence
# OF NEW BEDROOMS: 3 # OF STRUCTURE OCCUPANTS: 2
PROJECT DESC: SINGLE FAMILY DWELLING
PROJECT DIMENSION: 48 X 63
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
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
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 Setbacks: Front: 30 Side: 15 Rear: 30 Side St: Max Height:
03/21/11 14:37
CATAWBA COUNTY Case # EHPR - - - 9894
,v, CATAWBA Public Health Department
Q t 'a Environmental Health Division Plan Review Subdivision G S HILDEBRAN FARM
v < PO Box 389, 100 -A Southwest Blvd, Newton NC 28658 Lot# 10 -11 18 -19
I; M PIN#
370015744085
Applicant/Owner KENNETH & PATRICIA WILMOTH, 1030 WILLOW CREEK DR, NEWTON NC 28658
Site Address: 2153 ZION CHURCH RD, Hickory, NC
Property Size: SF 2.529 ACRES
Directions: 10W/ RT ZION CHURCH RD/ BESIDE BROOKSTONE SUBDIV
FEE NAME DATE AMOUNT BALANCE DUE
Authorization to Construct Fee (New/Expansion) Fee 03/17/2011 $150.00 $0.00
TOTAL FEES $150.00 $0.00
CHANGE WORK ORDER REQUIRING REDESIGN AND /OR RETRIP WILL INCURE AN ADDITIONAL CHARGE
(SEE FEE SCHEDULE)
03/21/11 14:37