HomeMy WebLinkAboutEHPR-5-11-10708.TIF � � THIS IS NOT A PERMIT Case # EHPR-5-11-10708
�' � � CATAWBA COUNTY HEALTH DEPARTMENT
v �''C Plan Review Application for Environmental Services
I842 sM Environmental Health Plan Review - OSWP
3 il Q�iSe IMPROVEMENT
�a �(�� � NAME TO APPEAR ON PERMIT
Joshua Brewster
SITE ADDRESS: 215g WESTOVER RD Hickory, NC Pirr�: 279115744703
NAME of SUBDIVISION: WESTOVER WOODS Lot # 1 Section/Block/Phase
PROPERTY SIZE: Square Feet Acres 1.139
DIRECTIONS: 127 S TURN ON WESTOVER RD ACROSS FROM ABC SORE HOUSE IS IN CURVE ON RIGHT
APPLICANT OWNER � CONTRACTOR
Waller, Travis Jerome Travis Jerome Walle Joshua Brewster Waller, Travis Jerome
128 Heritage View RD 2158 Westover RD 128 Heritage View RDHickory NC 28601-
Hickory NC 28601- Hicckory NC 28602-8286 (828)312-8765
(828)312-8765 82&446-5945
PRIMARY CONTACT: Contractar APPLICATION FOR: Existing Structure
DIM EXISTING STRUCTURE: 32 x 64 EXISTING FACILITY TYPE: House
NUMBER OF EXISTING BEDROOMS: 3 SEWER TYPE: Septic Tank
NUMBER OF EXISTING OCCUPANTS: 3 EXISTING WATER SUPPLY IN USE: Public Water
CALCULATED DESIGN FLOW:
Public water IS available for this property.
PUBLIC WATER TYPE AVAILABLE: County/Ciry/Township Water
DESCRIBE WORK: 12 x 24 Uncovered deck to rear of house -** moving heat pump due to new deck location
DESCRIPTION OF House
EXISTING STRUCTURES
ON SITE (IF ANY)
P ROPERTY EA none
PROPOSED CONSTRUCTION
PRIMARY RESIDENCE
NEW RESIDENCE? Add/Alt to Residence
# OF NEW BEDROOMS: 0 # OF STRUCTURE OCCUPANTS:
PROJECT DESC: 12 x 24 Uncovered deck to rear of house
PROJECT DIMENSION: 12 x 24
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 u�derstand 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 828-46(r7291
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Minimum SetbacKs Front: 30 Side: 15 Rear: 30 Side St: Max Height:
OS/03J11 10:02
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