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HomeMy WebLinkAboutEHPR-2-10-3852 (2).TIF A C THIS IS NOT A PERMIT Case # EHPR-2-10-3852 CATAWBA COUNTY HEALTH DEPARTMENT Plan Review Application for Environmental Services 1g-42 sM Environmental Health Plan Review - OSWP NEW WELL ARPL[CA~IT < .0~1'NER 't (Y TILACTOR VIRGINIA~GWRIGHT `VIRGINIA,,G.WRIGHT , 2579-CONCORD RD 2579 CONCORD RD VALE NC 28168 VALE NC 28168 eetl 1Dµ - q-73' Sb~9 NAME TO APPEAR ON PERMIT VIRGINIA G WRIGHT Pin#: 371118219724 SITE ADDRESS: 1885 AZTEC CT, Newton, NC DIRECTIONS: HWY 70, ROBINSON RD, 2.5 MILES, RIGHT ON THOMPSON ST, 1/3 MILE RIGHT ON AZTEC, 2ND ON LEFT NAME of SUBDIVISION: Lot # D Section/Block/Phase PROPERTY SIZE: Square Feet Acres 0.569 Date Platted/Recorded TYPE OF FACILITY: House X Mobile Home Dimension of Structure Bedrooms 3 Basement: Yes Water Using Fixtures in Basement:No No. in Family 4 Whirlpool Tub : Gal. Capacity: MULTIPLE FAMILY RESIDENCE: Units 1.00 Total Number of Bedrooms DAYCARE: Number of Children RESTAURANT: Seats Square Feet Dining _Area Square Feet Foodstand/Meat Market Floor Space TYPE OF BUSINESS: Number of Employees Ist 2nd 3rd OTHER: (Specify) Do you aniticipate any additions to Facility? If so, describe: NO _ Has any grading, removal, or addition of soil been done to;this property. '4t If so, describe NO Are there easements/right-of-ways recorded on thi's property? , ,NO Type of Water Supply: Individual Well X Community Well Municipal Semi-Public 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 represent tion by you of house or structure location should conform to applicable setbacks. Date: ~Z2 Signature of Applicant or Agent An Environmental Health Specialist will contact you within 2 w, o~ ing days of application ate. If you need further information or assistance pleas all 828-466-7291 AREA 2 (FOR OFFICE USE ONLY) Zoning Approval: Yes No Zoning Approval UDO Zoning Form A Minimum Setbacks Front FFF NAME DATE AMOUNT vuVell Permit-& hi.p,,ction Fee -'OZ/1~2/2010 • ~ SM.uu Side Rear TOTAL FEES $300.00 Max Hght *If a permit has to be redesigned and / or RETRIPS made to the property, there is an additional $60 charge 02/12/10 10:34 THIS IS NOT A PERMIT WLS # CATAWBA COUNTY HEALTH DEPARTMENT Application for Environmental Services Improvement Permit ❑ Authorization to Construct ❑ Septic Repair ❑ Septic Expansion ❑ Existing Tank Check ❑ New Well Permit ® Replacement Well ❑ Well Abandonment ❑ 1. Name to Appear on Permit n 2. Permit Requested By I l~ Business Phone ;~4 4 Address IJ / 4~1 Home Phone )!9 - 16 _732 3. Property Owner _ Business Phone Address 'f d Home Phone 4. Name of Subdivision t9 Lot # Section/Block/Phase Property Address S Directions to Property: t> ti i _ j 1 , 5. Property Size: Square Feet Acres 5 D&~e Platted/Recorded 6. TYPE OF FACILITY: House Mobile Home Dimension of Stricture - - Bedrooms* 3 *Am, wom that will be.intended l~)I at tlic time A 011struetion or for lul(u_e should be noted ;i~ bedruum a' II coLi ited on all appliih n> I he nnilih~r ~~I h~~~li. ~ms~~~i{I be co11llrii c' h\ num> id~ntit~icd on hu(_I~,e 1)iais s a bedrooin at the time of buildino p miit i-uance. This 111.1v hi_:\ 11 the need lot sy ~Lm ~ ire z~~ in ~h~ future. Basement: es7no Water Using Fixtures in Basement: yes Co No. in Family_ Whirlpool Tit T6 Gallon Capacity MULTIPLE FAMILY RESIDENCES: Units Total Number of Bedrooms DAY CARE: Number of Children RESTAURANT: Seats Square Feet Dining Area -Square Feet Food stand/Meat Market Floor Space TYPE OF BUSINESS: Number of Employees l st 2nd 3rd OTHER: (Specify) 7. Do you anticipate any additions to Facility? esl/ No If so, describe: 8. Has any grading, removal, or addition of soil been done to this property? Yes / Io If so, describe: 9. Are there easements/right-of-ways recorded on this property? Yes AN-0) 10. Is a public water supply available on or adjacent to the above property? Yes No' Check type that is available: [ ] Community well [ ] Semi-public well [ ] County/City/Township water line **If No, a Well Permit must be issued with the Septic Permit.** 11. Well Type Applying For: _N Individual well [ ] Community well [ ] Semi-Public well 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 valid for 5 years or may be non-expiring under certain specified conditions. Improvement Permits and Well Permits are transferable, but may be revoked if this information, site 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. 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. **IF A PERMIT HAS TO BE REDESIGNED AND/OR RETRIPS MADE TO THE P; OPERTY, THERE IS AN ADDITIONA HAR E" Date Signature of Owner or Agent ZZ 7, J Catawba County, North Carolina This map product was prepared from the Catawba County, NC, Geographic Information System. N Catawba County has made substantial efforts to ensure the accuracy of location and labeling information contained on this map. Catawba County promotes and recommends the independent verification of anv data contained on this map product by the user. The County of Catawba, its employees, agents and personnel disclaim, and shall not be held liable for any and all damages, loss or liability, whether direct, indirect or consequential which arises or may arise from this map product or the use thereof by any person or entity. Legend Selected Parcel Number: 3711-18-21-9724 1 inch = 40 feet Prepared for: 78A 84 s w~ 9724, 3.1 0 0+ 1.67A ,T5 THIS IS NOT A LEGAL DOCUMENT Friday, February 12, 2010 10:08 AM • of n w /1 C1~ CATAWBA COUNTY NC - Parcel Report Information Regarding Selected Parcel(s) Parcel ID: 3711-18-21-9724 Name: WRIGHT HUBERT DALE Name2: WRIGHT VIRGINIA GOODMAN Address: 2579 CONCORD RD Address2: City: VALE State: NC Zip: 28168-8582 Account: 76828600 Calc Acreage: 0.57 Tax Map: 131H 01005E LRK: 47795 Deed Book: 2236 Deed Page: 0911 Subdivision Name: Subdivision Block: Lots: D Plat Book: 31 Plat Page: 175 Building Number: 1885 Street Name: AZTEC CT Site Zip: 28658 Township: HICKORY Fire Code: HICKORY RURAL City Code: COUNTY State Road: Total Bldgs Value: $39,700 Land Value: $8,200 Total Value: $47,900 Year Built: 1951 Year Remodeled: 2008 Last Sale Date: Last Sale Amount: Neighborhood: 87 Watershed: Watershed Split: Voter Precinct: P35 E911 District: COUNTY Zoning: R-20 Zoning2: Zoning3: Zoning Split: N Zoning Overlay: ED-O Zoning District: COUNTY Split Zoning Dist: N Split Zoning Dist(1): 0 Split Zoning Dist(2): 0 School District: COUNTY Elementary School: BLACKBURN Middle School: JACOBS FORK High School: FRED T FOARD School Split: NO P&Z Case Number: Census Tract 2010: 011102 Census Block 2010: 2081 Small Area Plan: MOUNTAIN VIEW Agricultural District: Printed: Friday, February 12, 2010 10:08 AM ~~A CD CATAWBA COUNTY, NC 100-A South West Blvd PLii A1 e9/1~pECEI®T Newton, NC 28658- I (828)465-8399 Friday, February 12, 2010 Ig 42 sM www.catawbacountync.gov Plan Case: EHPR-2-10-3852 Invoice Number: INV-2-10-259546 Environmental Health Plan Review Invoice Date: 02/12/2010 Site Address: 1885 AZTEC CT, Newton, NC APPLICANT OWNER VIRGINIA G WRIGHT VIRGINIA G WRIGHT 2579 CONCORD RD 2579 CONCORD RD VALE NC 28168 VALE NC 28168 Fee Name Fee Amount Well Permit & Inspection Fee Fixed $300.00 Total Fees Due: $300.00 PAYMENTS Date Pay Type Check Number Amount Paid Change 02/12/2010 Check 5725 $300.00 $0.00 Total Paid: $300.00 Payer: VIRGINIA WRIGHT Total Due: $0.00 plan i~,~cipi I'c?fat-~~+Y;--ll,$~_g9;?=IurBFtiRaS99f}.rpt 02/12/2010 10:33