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Home My WebLink AboutEHPR-9-10-7183.TIF �� C� THIS IS NOT A PERMIT Case # EHPR-9-10-7183 �'� � �' CATAWBA COUNTY HEALTH DEPARTMENT � v�°°�'; :;so ''C Plan Review Application for Environmental Services I842 5M Environmental Health Plan Review - OSWP EXPANS/ON NAME TO T BRYAN MCDANIEL s�TE A�oRESS: 5373 N BETHEL CHURCH RD, Hickory, NC Pir�: 279119603629 NAME of SUBDIVISION: Lot # Section/Block/Phase PROPERTY SIZE: Square Feet Acres 1.899 DIRECTIONS: �2'7 S LEFT ON BETHEL CHURCH APPROX 2 MILE RIGHT ON LEFT. DIRECTLY ACROSS FROM WOODR[DGE DR. APPLiCANT OWNER CONTRACTOR BRYAN MCDANIEL BRYAN MCDANIEL 5373 BETHEL CHURCH RD 5373 BETHEL CHURCH RD HICKORY NC 28602 H[CKORY NC 28602 828-514-7713 828-514-7713 PRIMARY CONTACT: Owner APPLICATION FOR: Existing Structure DIM EXISTING STRUCTURE: 24X56 EXISTING FACILITY TYPE: Mobile Home NUMBER OF EXISTING BEDROOMS: 3 SEWER TYPE: Septic Tank NUMBER OF EXISTING OCCUPANTS: EXISTING WATER SUPPLY IN USE: Private Well CALCULATED DESIGN FLOW: Public water is **NOT** available for this property. PUBLIC WATER TYPE AVAILABLE: N/A DESCRIBE WORK: ADDED A 3 BDRM ADDITION TO BACK OF HOME. 20X34. EARLIER HE EXPANDED A BATHROOM AND ELIM[NATED 1 BDRM. (OK PER MC) DESCRIPTION OF DOUBLEWIDE EXISTING STRUCTURES ON SITE (IF ANY) PROPOSED FUTURE ADDITIONS NONE OR IMPROVEMENTS: PROPERTY EASEMENTS: NONE PROPOSED CONSTRUCTION PRIMARY RESIDENCE NEW RESIDENCE? Add/Alt to Residence # OF NEW BEDROOMS: � # OF STRUCTURE OCCUPANTS: 6 PROJECT DESC: DOUBLEWIDE, W[TH 20X 34 3 BDRM ADDITION PROJECT DIMENSION: 20X34 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. 1 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 repre nta ' b ou house or structure location should conform to applicable setbacks. /� / Date:�/� `� Signature of Applicant or Agent ,' �' � An Environmental Health Specialist will contact you �' '�� applie ion date. If you need further information or assistance please call 828-466-72 AREA2 ********�***********�***********�*****�*�*�*�**********************��*�***�********�************�***************�***** OS/13/Il 12:12 �BA CATAWBA COUNTY Case # EHPR-9-10-7] 83 F � • � G Public Health Department � Environmental Health Division - Plan Review Subdivision ¢`"'' o� `�' PO Box 389, 100-A Southwest Blvd, Newton, NC 286�8 Lot# !s 2 �w PIN# 279119603629 Applicant/Owner BRYAN MCDAN[EL, 5373 BETHEL CHURCH RD, HICKORY NC 28602 Site Address: �373 N B�THEL CHURCH RD, Hickory, NC Property Size: SF 1.899 ACRES Directions: 127 S LEFT ON BETHEL CHURCH APPROX 2 MILE R1GHT ON LEFT. DIRECTLY ACROSS FROM WOODRIDGE DR. Minimum Setbacks Front: Side: Rear: Side St: Max Height: FEE NAME DATE AMOUNT BALANCE DUE Autho rization to Construct Fee (New/E xpansion) Fee OS/13/2 $2 75.00 $0.00 Improvement Permit F ee � 09/03/20 $1 50.00 $0.00 TOTAL FEES $425.00 $0.00 CHANGE WORK ORDER REQUIRING REDESIGN AND/OR RETRIP WILL INCURE AN ADDITIONAL CHARGE (SEE FEE SCHEDULE) OS/l3/ll ]2:12 � ��A Cp� CATAWBA COUNTY, NC �.� � 100-A South West Blvd PLAN RECEIPT Newton, NC 28658- °��e 828 465-8399 Frida Ma 13 2011 U ;, �� ''�' ( ) Y� Y � j$ 42 sM www.catawbacountync.gov P�an �ase: EHPR-9-10-7183 �nvoice Number: INV-5-11-275279 Environmental Health Plan Review Invoice Date: 05/13/2011 Site Address: 5373 N BETHEL CHURCH RD, Hickory, NC APPLICANT OWNER CONTRACTOR BRYAN MCDANIEL BRYAN MCDANIEL 5373 BETHEL CHURCH RD 5373 BETHEL CHURCH RD HICKORY NC 28602 HICKORY NC 28602 828-514-7713 828-514-7713 Fee Name Fee Amount Authorization to Construct Fee Adjustable $275.00 (New/Expansion) Fee Total Fees Due: $275.00 PAYMENTS PAYER: BRYAN MCDANIEL Date Pay Type Check Number Amount Paid ChangE 05/13/2011 Cash -1 $275.00 $0.00 Total Paid: $275.00 Total Due: $0.00 plan receipt OS/13/2011 12:1 I