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HomeMy WebLinkAboutEHPR-4-11-10360.TIF .� C � THIS lS NOT A PERMIT Case # EHPR-4-11-10360 H� '; ' � � CATAWBA COUNTY HEALTH DEPARTMENT v , 4: ''C Plan Review Application for Environmental Services 1g�2 sM Environmental Health Plan Review - OSWP ----���l ` �I��J� ---- EX - ----- --- 1��e(tf ��� NAME TO APPEAR ON PERMIT rith Equipment Corporatio James Frith SITE ADDRESS: 4040 lOTH AV DR SW Hickory, NC Pir,�: 278215639399 NAME of SUBDIVISION: Lot # 3 Section/Block/Phase PROPERTY SIZE: Square Feet Acres 16.799 DIRECTIONS: BEFORE CETNERAL BAPTIST CHURCH BLD ON LF � PLICANT OWNER CONTRACTOR Frith Equipment Corporation J s Frith, BRADINGTON YOLTNG Frith Equipment Corporation Jr. 4040 l OTH AV DR SW 26 Textile RDRidgeway VA 24148- 26 Textile RD HICKORY NC 28602- (276)632-7241 Ridgeway VA 24148- (276)632-1763 j� NA � (276)632-7241 _____._._-��� — ACCOUrrT:�Stt _ _ _ __ �M ACT: . A licant APPLICATION FOR: New Construction DIM EXISTING STRUCTUR : EXISTING FACILITY TYPE: Business 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: County/City/Township Water DESCRIBE WORK: 20 X 60' GRINDER SHED ADDITION ON BACK OF EXISTING BLDG DESCRIPTION OF FURNITURE MANUFACTURING EXISTING STRUCTURES ON SITE (IF ANY) PR EASEMENTS: NA PROPOSED CONSTRUCTION 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 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 AREA2 ****************�***************�*�*�*�**�********�****�*�****�**********************�*�*�****�****************�****** Minimum Setbacks Front: Side: Rear: Side St: M� Height: FEE NAME DATE AMOUNT BALANCE DUE Existing Tank Check Fee 04/12/2011 $80.00 $0.00 TOTAL FEES $80.00 $0.00 CHANGE WORK ORDER REQUIRING REDESIGN AND/OR RETRIP WILL INCURE AN ADDITIONAL CHARGE (SEE FEE SCHEDULE) 04/20/ 11 14:54