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HomeMy WebLinkAboutEHPR-9-10-7296.TIF C THIS IS NOT A PERMIT Case # EHPR - - 10 - 7296 CATAWBA COUNTY HEALTH DEPARTMENT (- < Plan Review Application for Environmental Services 1842 sM Environmental Health Plan Review - OSWP IMPROVEMENT NAME TO APPEAR ON PERMIT JOSEPH M CIRILLO SR • SITE ADDRESS: 1067 SPRUCEWOOD LN, HICKORY, NC Pin#: 372014330842 NAME of SUBDIVISION:COUNTRY CLUB HEIGHTS Lot # 9 -17 Section/Block/Phase PROPERTY SIZE: Square Feet Acres 0.759 DIRECTIONS: STARTOWN RD N/ LT ON SANDY FORD RD/ RT ON SPRUCEWOOD LN/ LOT ON LT ABOUT 1/4 MI APPLICANT OWNER CONTRACTOR JOSEPH M CIRILLO SR Morris McGuire Jr 2201 ZION CHURCH RD 1009 Spruce Wood LN HICKORY NC 28602- Newton NC 28658 -9266 (828)294 -6747 828 -294 -3117 PRIMARY CONTACT: Owner APPLICATION FOR: New Construction DIM EXISTING STRUCTURE: EXISTING FACILITY TYPE: N/A NUMBER OF EXISTING BEDROOMS: SEWER TYPE: Septic Tank EXISTING WATER SUPPLY IN USE: Community Well CALCULATED DESIGN FLOW: WELL TYPE: Public water is **NOT** available for this property. PUBLIC WATER TYPE AVAILABLE: DESCRIBE WORK: NEW SINGLE FAMILY DWELLING PROPERTY EASEMENTS: NO PROPOSED CONSTRUCTION PRIMARY RESIDENCE NEW RESIDENCE? New Residence # OF NEW BEDROOMS: 3 # OF STRUCTURE OCCUPANTS: 2 PROJECT DESC: SINGLE FAMILY SITE BUILT DWELLING PROJECT DIMENSION: 50 X 60 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 non - 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: / .17. Signature of Applicant or Agent "Of L / ^G� -c�C� �• An Environmental Health Specialist will contact you w in 2 working days of application date. If you need further information or assistance please call 828 - 466 -7291 AREA2 09/13/10 14:49 .� CATAWBA COUNTY Case # EHPR -9 -10 -7296 Public Health Department 2. Subdivision Environmental Health Division - Plan Review IMO 's' PO Box 389, 100 -A Southwest Blvd, Newton, NC 28658 Lot# 9 -17 1 8.2 M PIN# 372014330842 Applicant/Owner JOSEPH M CIRILLO SR, 2201 ZION CHURCH RD, HICKORY NC 28602 - Site Address: 1067 SPRUCEWOOD LN, HICKORY, NC Property Size: SF 0.759 ACRES Directions: STARTOWN RD N/ LT ON SANDY FORD RD/ RT ON SPRUCEWOOD LN/ LOT ON LT ABOUT 1/4 MI Minimum Setbacks FEE NAME DATE AMOUNT BALANCE DUE Front 30 Side 15 Improvement Permit Fee 09/13/2010 $150.00 Rear 30 TOTAL FEES $150.00 Side St Max Hght CHANGE WORK ORDER REQUIRING REDESIGN AND /OR RETRIP WILL INCURE AN ADDITIONAL CHARGE (SEE FEE SCHEDULE) 09/13/10 14:49 a cr .. J THIS IS NOT A PERMIT .- t Ilii. CATAWBA COUNTY HEALTH DEPARTMENT y ' n la ; Application for Environmental Services Page 1 184 94 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) ❑ Application is for New Construction ❑ Existing Facility n Property Address t0,p 1.SP)C1 Subdivision �',, L •t. e rr �` 6 /5/ .(y-,-- Lot # y'- / 7 Acres 0,7 6 Section/Block/Phase Driving Directions to Property . SP‘.- t r ' - o ',v Ai, A/ n "7 / 7 ` u r /.. J 7 v ,,,,_7, SSq ...icy' y 'rd . , c • ' 7 4 /k r r j .,_ 74 J - S' /7r -Gc Ge. 1y4.,3 �( 0 e..:- '7' 4 'Cc c 6 a "/- / 5/ . p ,, . W . v CI., NAME TO APPEAR ON PERMIT? ❑ Owner CApplicant ❑ Contractor O Applicant Contact Information W Name 1 c_i, 4 m . c , - 'c'✓ // a - r r- Address .2a0 2,'»-' L .4 c.,..g.,_ XW- I• Phone c - 2 Fr G 7 ,/? Cell Phone /-a P - ,L /- / S' �_? C ? Owner Contact Information C Name - .ccp ,, ' vr /V&Fr.'S /✓l Cy- u. ",e r_ Z Address /0 0 9 - C�J `r r evci c° d .t-et 0 Phone Cell Phone U Contractor Contact Information Lu Name T B H Address tei = Phone Cell Phone z WHO WILL BE THE PRIMARY CONTACT? ❑ Owner Z Applicant ❑ Contractor Z Description of Existing Structures on Site iV w r_ Q # of Bedrooms *j 3 Structure Dimensions # of Occupants Basement x Yes ❑ No Basement Fixtures ❑ Yes [ No Z Planned Future Additions or Improvements (Building Permit NOT requested at this time) et Describe A ., o cc, <- 014. Proposed Future Structure Dimensions # of Bedrooms *1 if applicable Z Are there easements or right -of -ways recorded on this property ❑ Yes ❑ No Describes r- Is a public water supply available on or adjacent to the above property ** ❑ Yes ❑ No Check type available © Community Well ❑ Semi - Public Well ❑ County /City /Township Water Line Existing water supply in use ❑ Individual Well 51 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 UNI CATAWBA COUNTY HEALTH DEPARTMENT • ' Application for Environmental Services Page 2 v 4 84 2 Proposed Facility Type ❑ Primary Residence New Residence ❑ Addition to Residence # of New Bedrooms *f Project Description Structure Dimensio s 5 O X t, 0 # of Occupants Z Basement es ❑ No Basement Fixtures 4es ❑ No ❑ Accessory Structure(s) Describe f' I'c / g : # of New Bedrooms *1 if applicable Structure Dimensions # of Occupants Accessory Dwelling n Yes ❑ No Plumbing ❑ Yes ❑ No Describe Plumbing Needed ❑ Multi- Family Residence # Units #Bedrooms per Unit *I' Total # Bedrooms *I Structure 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 Employees per Shift # of Shifts ❑ Other Facility Type Specify If Church # of Seats Kitchen ❑ Yes E No If Daycare Specify Occupancy Application for Well Construction /Abandonment/Repair Proposed Well Type E Individual Well Semi - Public Well mmunity Well Abandonment Type Drilled ❑ Bored ❑ Dug ❑ Unknown Well Repair Requested ❑ Yes ❑ No Describe Calculated Design Flow, Commercial f Additional information may be required to determine design flow from certain facilities. This value will be determined during consultation with on- site staff. *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. i If structure is plumbed but no bedrooms, calculated design flow is required. ** If No, 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) I understand that this is a formal application for Environmental Services and authorize Catawba County Environmental 4. Health 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 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 m plans or intended use changes for the proposed facility. An Authorization to Construct issued by this department is valid for (5) five years from the date issued and is not transferable Lel Signature of Owner or Agent Printed Name of Owner or Agen ,i �� r �,, 4 "if . C . /l. ', Date . .- ■ • Catawba County, North Carolina N Thus map produCl n'as prepared Rain the Calau'ho County. NC, Geographic h frn'manon ,Crslc'm Connrbu C011171• has made substantial efforts to ensure the accm'un' of location and labeling n fmmamon A Colm an 11715 map Catawba County promotes and recommends the independent verification of a171' dam contained on this map product h7' the user. the Comity of Catawba. as employees, agents and personnel disclaim, and shall not he held liable for am and all damages, loss or liability. whether direct. indirect or consequential 7e /uch a77se5 or may arise from 1 /m5 map product or the use thereof by em person or emirP. Legend ^ ^^,_�, Selected Parcel Number: 3720- 1-t -33 -03-12 1 inch = 60 feet \D(\ � We-Q.. kLJI_��W . Prepared for: M • ._.1. N -.I O C37 O 7.4, / - /., /, 0 N. 18 ti 98.80 17 1 5t Zi ! ' c�t ,,,y 19 ..... ' d 15 , - F � 13 0842 _ LL , 0 0 1g� C. J -1 — — rn 9 193.75 7 0 L- v 1.09A 5 THIS IS NOT A LEGAL UOCUN1EN "h 0610 Monday, September 13, 2010 02:15 Pill CATAWBA COUNTY NC - Parcel Report Information Regarding Selected Parcel(s) Parcel ID: 3720 -14 -33 -0842 Name: MCGUIRE MORRIS JUNIOR Name2: Address: 1009 SPRUCEWOOD LN Address2: City: NEWTON State: NC Zip: 28658 -9266 Account: 183599 Calc Acreage: 0.76 Tax Map: 049N 07002 LRK: 31313 Deed Book: 1166 Deed Page: 0864 Subdivision Name: COUNTRY CLUB HEIGHTS Subdivision Block: G Lots: 9 -17 Plat Book: 10 Plat Page: 34 i 0( Building Number: Street Name: — Site Zip: 28658 Township: NEWTON Fire Code: HICKORY RURAL City Code: COUNTY State Road: Total Bldgs Value: Land Value: $22,300 Total Value: $22,300 Year Built: Year Remodeled: Last Sale Date: 5/1/1978 Last Sale Amount: $3,000 Neighborhood: 92 Watershed: Watershed Split: Voter Precinct: P34 E911 District: COUNTY Zoning: R -20 Zoning2: Zoning3: Zoning Split: N Zoning Overlay: Zoning District: COUNTY Split Zoning Dist: N Split Zoning Dist(1): 0 Split Zoning Dist(2): 0 School District: COUNTY Elementary School: STARTOWN Middle School: MAIDEN High School: MAIDEN School Split: NO P &Z Case Number: Census Tract 2010: 011701 Census Block 2010: 1049 Small Area Plan: STARTOWN Agricultural District: Printed: Monday, September 13, 2010 02:15 PM C t ,$A COG CATAWBA COUNTY, NC F � 100 -A South West Blvd PLAN RECEIPT Newton, NC 28658 - U ''S' (828)465 - 8399 Monday, September 13, 2010 j$ 4'J, sM www.catawbacountync.gov Plan Case: EHPR -9 -10 -7296 Invoice Number: INV -9 -10- 266915 Environmental Health Plan Review Invoice Date: 09/13/2010 Site Address: 1067 SPRUCEWOOD LN, HICKORY, NC APPLICANT OWNER CONTRACTOR JOSEPH M CIRILLO SR Morris McGuire Jr 2201 ZION CHURCH RD 1009 Spruce Wood LN HICKORY NC 28602- Newton NC 28658 -9266 (828)294 -6747 828-294-3117 Fee Name Fee Amount Improvement Permit Fee Fixed $150.00 Total Fees Due: $150.00 PAYMENTS PAYER: JOSEPH CIRCILLO SE Date Pay Type Check Number Amount Paid Chang( 09/13/2010 Check 1609 $150.00 $0.00 Total Paid: $150.00 Total Due: $0.00 ,Ilan receipt 09/13/2010 14:52