HomeMy WebLinkAboutEHPR-4-11-10419.TIF �� C O G THIS IS NOT A PERMIT Case # EHPR-4-11-10419
� �� a CATAWBA COUNTY HEALTH DEPARTMENT
U';�p `�' Plan Review Application for Environmental Services
I842 5M Environmental Health Plan Review - OSWP
d �Cr� �
�P� a� IMPROVEMENT
NAME TO APP ON PERMIT
EDWARD RAY
SITE ADDRESS: LEE CLINE RD CONOVER, NC Pin#: 374414447624
NAME of SUBDIVISION:VICTORIAN HILLS SUBDN Lot# � Section/Block/Phase
PROPERTY SIZE: Square Feet Acres 093
DIRECTIONS: HIGHWAY 16 N- TURN LEFT ONTO SWINGING BRIDGE RD - TURN LEFT ONTO HOUSTON MILL RD -
TURN RIGHT ONTO LEE CLINE RD - PROPERTY ON LEFT
APPLICANT OWNER CONTRACTOR
EDWARD RAY FULBRIGHT MICHAEL
220A 14TH AV SE 3175 COMMUNITY RD
HICKORY NC 28602- CLAREMONT NC 28610-9671
(828)446-01 ] 9 828-312-8717
PRIMARY CONTACT: Applicant APPLICATION FOR: New Construction
DIM EXISTING STRUCTURE: EXISTING FACILITY TYPE: N/A
NUMBER OF EXISTING BEDROOMS: SEWER TYPE: Se�
NUMBER OF EXISTING OCCUPANTS: EXISTING WATER SUPPLY 1N U : N/A
CALCULATED DESIGN FLOW:
Public water is '"'NOT''* available for this property.
PUBLIC WATER TYPE AYAILABLE: N!A
DESCRIBE WORK: LOOKING TO BUY PROPERTY AND NEEDING A SOIL TEST
DESCRIPTION OF NONE
EXISTING STRUCTURES
ON SITE (IF ANY)
PROPOSED FUTURE ADDITIONS RESIDENTIAL HOME
OR IMPROVEMENTS:
PROPERTY EASEMENTS: NO I
PROPOSED CONSTRUCTION
PRIMARY RESIDENCE
NEW RESIDENCE? New Residence
# OF NEW BEDROOMS: 3 # OF STRUCTURE OCCUPANTS: 2
PROJECT DESC: 1-STORY HOME
PROJECT DIMENSION: 40 X 20
BASEMENT? Yes BASEMENT FIXTURES? Yes
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.
Daie: 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
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