HomeMy WebLinkAboutEHPR-4-11-10291.TIF � 4 ' A � THIS IS NOT A PERMIT Case # EHPR-4-11-10291
� � CATAWBA COUNTY HEALTH DEPARTMENT
c� �p ''C Plan Review Application for Environmental Services
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�� �,�� NAME TO APPEAR ON PERMIT
DON L HARTSOE
S�7E,4��RESS: 1110 HARPER LEE DR, Newton, NC Pin#: 372011655112
NAME of SUBDIVISION:AVIAN WOODS Lot # 1(, Section/Block/Phase
PROPERTY SIZE: Square Feet Acres 1.12
DIRECTIONS: l OW/ RT STARTOWN RD/ MILTON ST / INTO AVIAN WOODS / RT ON HARPER LEE / HOUSE ON RIGHT
APPLICANT OWNER CONTRACTOR
DON HARTSOE RONALD PARKER DON L HARTSOE
2012 W HWY 127 1110 HARPER LEE DR 2012 W HWY 27LINCOLNTON NC 28092
LINCOLNTON NC 28 NEWTON NC 28658 704735-7198
(828)312-3227 82&302-5171
P Y CONTACT: Contractor APPLICATION FOR: Existing Structure
DIM EXISTING STRUCTURE: 86 X 55 EXISTING FACILITY TYPE: House
NUMBER OF EXISTING BEDROOMS: 3 SEWER TYPE: Septic Tank
NUMBER OF EXISTING OCCUPANTS: 4 EXISTING WATER SUPPLY IN USE: Private Well
CALCULATED DESIGN FLOW:
Public water is **NOT** available for this property.
PUBLIC WATER TYPE AVAILABLE:
DESCRIBE WORK: ADDITION TO EXISTING DWELLING / open carport with 2nd floor unheated room area w/ spiral
staircase / attached to house by arbor
DESCRIPTION OF SINGLE FAMILY DWELLING
EXISTING STRUCTURES
ON SITE (IF ANY)
PRO P E RTY EASEMENTS: NONE
PROPOSED CONSTRUCTION
PRIMARY RESIDENCE
NEW RESIDENCE? Add/Alt to Residence
# OF NEW BEDROOMS: 0 # OF STRUCTURE OCCUPANTS: 0
PROJECT DESC: adding attached carport w/ floor above
PROJECT DIMENSION: 21 x 21
BASEMENT? No BASEMENTFIXTURES? 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 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: 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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04/11/11 09:31