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Home My WebLink AboutEHPR-4-11-10582.TIF ��' C O� THIS IS NOT A P�RMIT Case # EHPR-4-11-]0582 � �, � � U � � � CATAWBA COUNTY HEALTH DEPARTMENT ;; '�' Plan Review Application for Environmental Services I842 sM 1 Environmental Health Plan Review - OSWP �,� �C��; S,p.d c�� IMPROVEMENT � NAME TO APPEAR ON PERMIT DONALD POUST S�TE,4��RESS: 4724 ELMHURST DR NE, Hickory, NC Pin�: 373519600864 NAME of SUBDIVISION:CATAWBA SPRINGS Lot # 7p Section/Block/Phase PROPERTY SIZE: Square Feet Acres 0.439 DIRECTIONS: SPR[NGS RD TO SUC,PHUR SPRINGS TO WANDERING LANE/ TO ELMHURST DR/ STH HOUSE ON RT APPLICANT OWNER � CONTRACTOR DONALD POUST DONALD POUST SAME AS OWNER 828-256-5900 828-256-5900 PRIMARY CONTACT: pwner APPLICATION FOR: Existing Structure DIM EXISTING STRUCTURE• 60 X 4C� EXISTING FACILITY TYPE• House NUMBER OF EXISTING BEDROOMS: 4 SEWER TYPE ic 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: NEW CONSTRUCTION 20' X 26' DETACHED GARAGE DESCRIPTION OF HOME 60 X 40 EXISTING STRUCTURES ON SITE (IF ANY) PROPERTY EASEMENT NONE PROPOSED CONSTRUCTION ACCESSORY STRUCTURES DESCRIPTION: 20' X 26' DETACHED GARAGE # OF NEW BEDROOMS: STRUCTURE DIMENSIONS: 20' X 26' ACC DWEL�ING? No PLUMBING? No # OF STRUCTURE OCCUPANTS: 0 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 Hea�th 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 Co applicable setbacks. Date: Signature of Applicant or Agent An Environ�r�ental 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 Setbaeks Front: 30 Side: 5 Rear: 5 Side St:15 Max Height: 04/25/ 1 1 1220 �� C THIS IS NOT A PERMIT Case # EHPR-4-11-10582 rC � � � CATAWBA COUNTY HEALTH DEPARTMENT c� ;� :;: ''C ' ' Plan Review Application for Environmental Services 1842 5M Environmental Health Plan Review - OSWP IMPROVEMENT NAME TO APPEAR ON PERMIT DAVID POUST s�TE A��ESS: 4724 ELMHURST DR NE, Hickory, NC Pir,#: 373519600864 NAME of SUBDIVISION:CATAWBA SPRINGS Lot # �p Section/Block/Phase PROPERTY SIZE: Square Feet Acres 0.439 DIRECTIONS: SPRINGS RD TO SULPHUR SPRINGS TO WANDERING LANE/ TO ELMHURST DW STH HOUSE ON RT APPLICANT noN�D OWNER ��iN�YL� CONTRACTOR _D�-V-ID POUST .�A�/-�D POUST SAME AS OWNER 4724 ELMHURST DR NE 4724 ELMHURST DR NE HICKORY NC 28601 HICKORY NC 28601 828-256-5900 828-256-5900 PRIMARY CONTACT: Owner APPLICATION FOR: Existing Structure DIM EXISTING STRUCTURE: EXISTING FACILITY TYPE: Accessory Structure NUMBER OF EXISTING BEDROOMS: 4 SEWER TYPE: 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: NEW CONSTRUCTION 20' X 26' DETACHED GARAGE DESCRIPTION OF HOME 60 X 40 EXISTING STRUCTURES ON SITE (IF ANY) PROPERTY EASEMENTS: NONE PROPOSED CONSTRUCTION ACCESSORY STRUCTURES i DESCRIPTION: 20' X 26' DETACHED GARAGE # OF NEW BEDROOMS: STRUCTURE DIMENSIONS: 20' X 26' ACC DWELLING? Yes PLUMBING? No # OF STRUCTURE OCCUPANTS: 0 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 AREA2 *************************************�*�*******************************�**�******************************************* Minimum Setbacks Front: 30 Side: 5 Rear: 5 Side St:15 Max Height: 04/21 /1 I 08:56 yaa � CATAWBA COUNTY Case # EHPR-4-11-10582 G Public Health Department � t Subdivision CATAWBA SPRINGS � Environmental Health Division - Plan Review I � � PO Box 389, ]00-A Southwest Blvd, Newton, NC 286�8 Lot# �� a 2 s� PIN# �37351Q600864 Applicant/Owner DAVID POUST, 4724 NE ELMHURST DR, HICKORY NC 28601 Site Address: 4724 ELMHURST DR NE, Hickory, NC Property Size: SF 0.439 ACRES Directions: SPRINGS RD TO SULPHUR SPRINGS TO WANDERING LANE/ TO ELMHURST DR/ STH HOUSE ON RT FEE NAME DATE AMOUNT BALANCE DUE Improvement Permit Fee 04/21/2011 $150.00 TOTAL FEES �150.00 - CHANGE WORK ORDER REQUIRING REDESIGN AND/OR RETRIP WILL INCURE AN ADDITIONAL CHARGE (SEE FEE SCHEDULE) 04/21 / 11 08:56 �f�' `��' �� c � �,A THIS IS NOT A PERMIT �"�� 1��/ �� ' r CATAWBA COUNTY HEALTH DEPARTMENT � � c�pplication for Environmental Services Page 1 f S 7 ' )M � Improvement Permit ❑ Authorization to Construct ❑ Septic Repair ❑ Septic Malfunction ❑ ��/ Septic Expansion ❑ New Well Permit ❑ Replacement Well ❑ Well Abandonment ❑ � Well Repair ❑ Existing System Inspection (Pre-Approval Required) ❑ �/ � (� �`'�� f Application is for New Construction ❑ Existing Facility ❑ '/ i sr_�.�' � Property Address � l ZT ��ta� �u �' I�r �� Subdivision ��aw �cZ � r;`v�S� '' "� r � L ZSs «I Lot #�s i Acres Section/BIocWPhase Driving Directions to Property � � � �u J CL NAME TO APPEAR ON PERMIT? � Owner ❑ Applicant ❑ Contractor O Applicant Contact Information U Name , � � b� :, - W Address � Ze j /,,,,� � � f � 00 ' � Phone �� Cell Phone �� '' � Owner Contact Info mation � Name z Address �/'7 Z % v� �- � Phone � �,' =� -� ' Cell Phone ~ Contractor Contact Information W Name � Address � = Phone Cell Phone � z WHO WILL BE THE PRIMARY CONTACT? ,� Owner ❑ Applicant ❑ Contractor Z Description of Existing Struc ures on Site Q # of Bedrooms *�' Structure Dimensions � ° # of Occupants 1� Basement ❑ Yes o Basement Fixtures ❑ Yes o � Planned Future Additions or Improvements (Building Permit NOT requested at this time) OC Describe � Proposed Future Structure Dimensions # of Bedrooms *�' if applicable Z Are there easements or right-of-ways recorded on this property ❑ Yes � No Describe Is a public water supply available on or adjacent to the above property ** Yes ❑ No Check type available ❑ Community Well ❑ Semi-Public Well [�trtr/City/Township Water Line Existing water supply in use ❑ Individual Well ❑ Community Well ❑ Semi-Public Well ❑ County/City/Township Water Line ❑ I WOULD LIKE TO SCHEDULE A COMBINED FLAGGING AND SOIL EVALUATION (SEE COMBINED EVALUATION PROCEDUES) ��' ' THIS IS NOT A PERMIT y ti CATAWBA COUNTY HEALTH DEPARTMENT `' '"' Y Application for Environmental Services ' Fage 2 �s z�, Proposed Facility Type ❑ Primary Residence ❑ New Residence ❑ Addition to Residence # of New Bedrooms *�' Project Description Structure Dimensions # of Occupants Basement ❑ Yes ❑ No Basement Fixtures ❑ Yes ❑ No ,�] Accessory Structure(s) Describe o- r_ .� # of New Bedrooms *�' if applicable St ucture D mensions Zc? � 7� # of Occupants �� Accessory Dwelling ❑ Yes ❑ No Plumbin ❑ Yes � No Describe Plumbing Needed ❑ Multi-Family Residence # Units #Bedrooms per Unit*�' Total # Bedrooms *�' Struc Dimensions ❑ Food Service Specify Type # Seats Floor Space -Entire Food Service Facility (Sq Ft) # Employees per Shift # of Shifts Dining Area (Sq. Ft.) ❑ Business Specific Type of Business Retail Floor Space # of Em ployees per Shift # of Shifts ❑ Other Facility Type Specify lf Church # of Seats Kitch ❑ Yes ❑ No If Daycare Specify Occupancy Application for Well Construction/Abandonment/Repair Proposed Well Type ❑ Individual Well ❑ Semi-Public Well ❑ Community Well Abandonment Type ❑ Drilled ❑ Bored ❑ Dug ❑ Unknown Well Re pair Requested ❑ Yes ❑ No Describe Calculated Design Flow, Commercial '� Additional information may be required to determine design flow from certain facilities. This value will be determined during consultation with on- s staf *Any room that will be intended for sleeping at the time of construction or for future consideration should be noted as a bedroom and counted on all applications. The number of bedrooms will be confirmed by rooms identified on house plans as a bedroom at the time of building permit issuance. This may prevent the need for septic system size increase in the future. �'If structure is plumbed but no bedrooms, calculated design flow is required. ** IfNo, a well permit must be issued with the Authorization to Construct. 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. � CHANGE WORK ORDER REQUIRING REDESIGN AND/OR RETRIP WILL INCURE AN � ADDITIONAL CHARGE (SEE FEE SCHEDULE) a I understand that this is a formal application for Environmental Services and authorize Catawba County Environmental � Health employees to go on this property for evaluation purposes. I certify the above information to be correct and understand 0 that an Improvement Permit issued as a result of this information is valid for 5 years or may be non-expiring under certain V specified conditions. Improvement Permits and Well Permits are transferrable, but may be revoked if this information, site W plans or intended use changes for the proposed facility. An Authorization to Construct issued by this department is valid for m � (5) five years from the date issued and is not s�erable ? Signature of Owner or Agent 11� D� � Printed Name of Owner or Agent ,�- � f I ,�/ J-- Date � � ' ��, � _ _ � ' RESIDENTIAL APPLICATION . ; j,' ~�,%,, � FOR ZONING / GRADING PERMITS �� A Cit of Hicko a I�cation becomes a ermit u on a roval Count Zonin Office 828 46s-838o x;�ko�y o�e�e (szs� 3z3-�a�o ( Y rY Pp p P pp y s ( ) Hickory Fax (828) 323-7474 by a City of Hickory Zoning Administrator.) County Zoning Fax (828) 465-8484 If proposed land disturbance is'1 ACRE or MORE, applicant must obtain Erosion & Sedimentation Control Plan approval from Catawba County Erosion & Sediment Control. (828-465=8161) ✓� ��^ l ` v � ; � - f -, Parcel IdentificationNo. .=� i ("�i : �� :�,�}� ,:��; . `� :/;r�., Date =( - ��- - �'u';',; t. , Pi•o ect 911 Add °(��'� (� � �� ' �" (� � `' � J' . - j ress: � 1_ ,.��.�_r.:;_t �, !. �' ��r =,�,, , � f The building or land was previously used for: i �;•,-1 Proposed use or change to this building or land: �(:��.�' �;��+,� ,�.�,,=..t << �r ��,:� c c' �/" Z� � � APPlicant: �),; �'.�! ;�'��; ;, ;� Applicant's telephoneNo.: �_tiS �_�-. �i �, �"'�;" Applicant's Address: "� ! ��'% /...' %�,,� .�� ,� r �-' �� jt,f ,'r' �!��,�: �� -�.r ,� � 1G �, S( ( �� ( r Applicant's Fax: Applicant's Email ; ,, s � r, �� .,,; ,�` ��' - l ,.� „-� �f> , , �., ,� ? f Property Owner: ��),--. �^„l` Y"�� <'� ; Owner's Telephone No.: i':� �• ,;;;,�'S Owner's Address: �( ��(� L� �i'� Y /�i �t CJ f "i":' �,1 r,J�� /�_. r/ .� / �! JLl � !' ' �i � � �i f ALL BUSINESSES OPERATING IN THE CITY LIMITS MUST HAVE A PRIVILEGE LICENSE Tl:is Permit is perfor`nance-oriented. Property owner is responsible for taking any additional measures not sl�own on tlae approved plan to prevent erosion and offsite sedimentation. f � , � �/ ' / � � � Applicant's Signature �),_y;A.-�'-t't;� l�/ �)� <'' Date `�� ;�^ ��r�(( FOR OFFICIAL USE ONLY r �� ZONING CENSUS TRACT c3� Front Setback � Size of Lot ��Approved PD � Side Street Setback Lot of Record ..� Approved Minor PD S Side Setback Use Permitted �Elevation Certificate Required �� Rear Setback Flood Plain � c� Maximum Height Watershed 1_ 2 3 4 Protected Critical Other (Describe): � Zoning/Grading Permit Approved: Date: ` � Zoning A min� r tor C nditions of Appr val: Zoning/Grading Permit Disapproved: Date: Zoning Administrator • Reasons For DisapprovaL Rev031909 Received By: Date CATAWBA COUNTY NC - Parcel Report Information Regarding Selected Parcel(s) ParcellD: 3735-19-60-0864 Name: POUST �JONALD WADE Name2: LEINBACH-POUST JANET Address: 4724 ELMHURST DR NE Address2: City: HICKORY State: NC Zip: 28601-8715 Account: 187537 Calc Acreage: 0.44 Tax Map: 0814 08002 LRK: 40614 Deed Book: 2519 Deed Page: 1806 Subdivision Name: CATAWBA SPRINGS Subdivision Block: Lots: 70 Plat Book: 15 Plat Page: 14 Building Number: 4724 Street Name: ELMHURST DR NE Site Zip: 28601 Township: CLINES Fire Code: City Code: HICKORY State Road: Total Bldgs Value: $209,000 � � Land Value: $29,400 � � Total Value: $238,400 Year Built: 1976 � Year Remodeled: Last Sale Date: 1/1/1999 /► Last Sale Amount: $210,000 '�� Neighborhood: 63 � , n� Watershed: V ,/' Watershed Split: � /� Voter Precinct: P33 /^� , 1 �� E911 District: HICKORY �(, �� n Zoning: R-2 y Zoning2: W Zoning3: A � � Zoning Split: N /� / ,Z Zoning Overlay: �/ Zoning District: HICKORY Split Zoning Dist: N Split Zoning Dist(1): 0 � � Split Zoning Dist(2): 0 School District: COUNTY � Elementary School: SNOW CREEK Midd{e School: ARNDT High School: ST STEPHENS � � School Split: NO P&Z Case Number: Census Tract 2010: 010301 � �v Census Block 2010: 1051 ✓ Small Area Plan: Agricultural District: PROXIMITY � Printed: Thursday, April 21, 2011 08:29 AM � � ' Catawba County, North Carolina N This nrap prodt�ct was preparedJrom d7e Catmvba Counry, NC, Geographic Inforn:ation System. Catawba Counry has made substantia! ejjorts to ennme the accuracy ojlocation and labeling injormation contarned on thls map. Catmvba Cmmry promotes and recommends dze independent verification oJany data contarned on this map product by the user. The Counry of Cutawba, its employees, agents and personne! disdaim, and shall not be laeld liab/e jor any nnd all damages, loss or liabi/itv, whether drrect, indirect or consequential which arises or may arrse from this map product or the use thereof by any person or entity. Legend Selected Parcel Number: 3735-19-60-0864 1 inch = 60 feet Prepared for: � � �� -_ _� �` . i � , 7S � �---__ . � _. _� i - -- �- � ,,,� ��1.) �J��_ __�,_ � � : � ; � ; _ _. , � r- �__., / _ .............._i �, ��p � �'�` � �-�----_._.__� �S � � �� O 7 � �p� ;' st � —� ' � ., } � ' 89 �� 5 ��. �, ��-�5 �� , � �� / � `�, � ��.� � � � _ �..--�-'"� ,� ��' � � �� 1 �S �° � �� '� ��`� � � 0 �� h�� ,�a s . ffa '� � � �, � �.,. � � `� �.,.�� r � �. 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