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Home My WebLink AboutEHPR-2-10-3889 (2).TIF ~A C THIS IS NOT A PERMIT Case # EHPR-2-10-3889 CATAWBA COUNTY HEALTH DEPARTMENT v Plan Review Application for Environmental Services 1gr}2 $M Environmental Health Plan Review - Repair REPAIR APPLICANT OWNER I CONTRACTOR'- WALTER F. LEACH WALTER F. LEACH 3050 NW 5TH ST PL 3050 NW 5TH ST PL HICKORY NC 28601 HICKORY NC 28601 828-322-6328 828-322-6328 NAME TO APPEAR ON PERMIT WALTER F. LEACH Pirt#: 370411554864 SITE ADDRESS: 3040 NW 5TH ST PL, Hickory, NC DIRECTIONS: HW 127 N/ LF 29TH AV ; TO 5TH ST LF 4TH HOUSE ON LF NAME of SUBDIVISION: Lot # 17 Section/Block/Phase PROPERTY SIZE: Square Feet Acres 0.349 Date Platted/Recorded TYPE OF FACILITY: House X Mobile Home Dimension of Structure 40 X 40 Bedrooms 3 Basement: No Water Using Fixtures in Basement:No No. in Family 2 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 I st 2nd 3rd OTHER: (Specify) Do you aniticipate any additions to Facility? If so, describe: NONE Has any grading, removal, or addition of soil been done to this property? If so, describe NONE Are there easements/right-of-ways recorded on this property? NONE Type of Water Supply: Individual Well Community Well X Municipal X 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 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. ° Signature of Applicant or Agent Date: En ironmental 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 (FOR OFFICE USE ONLY) Zoning Approval: Yes No Zoning Approval G6Lo~ UDO Zoning Form A Minimum Setbacks Front FEE NAME DATE AMOUNT Side 10 Authorization to Construct (Repair) F,02/16/2010 $300.00 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 S~ ~l ~9A 02/16/10 10:41 THIS IS NOT A PERMIT WLS # Lam`, r - Z-t ° CATAWBA COUNTY HEALTH DEPARTMENT 3M Application for Environmental Services Improvement Permit ❑ Authorization to Construct ❑ Septic Repair L~'1 Septic Expansion ❑ Existing Tank Check ❑ New Well Permit ❑ Replacement Well ❑ Well Abandonment ❑ I . Name to Appear on Permit Cf /7-- -lecrL 2. Permit Re uest By P Business Phone Address 3 Q Home Phone 3. Property Owner Business Phone Address 24 Home Phone 4. Name of Subdivision Lot # Section/Block/Phase Property Address 3 n o 5M r P L ,o w Directions to Prope 0 p ftifl i~h : ~Zq cot 0A 1-2 U 0117 5. Pro ertySize: Square Feet Acres Date Platted/Recorded 6. TYPE OF FACILITY House Mobile Home Dimension of Structure e oms* K~ *Any room tha#wt1115e itt err ed,faftsleep gp twth'e tirrie'?off constr ~iox f fui e ca is~~dera ibnshou~d be noted as a ! bedroom and counted ors all apphcahons The numbet of bedroomsIl t5eod#1~1 b~ roorhs.tderihfied on house plans, I as -A bedreiom at,the time of bulldmgptrr ~tY ~5su~nce may pze ent the~rrecd for ystetu t e Ac.(gase in the fiifti Basement: yes/r(o) Water Using Fixtures in Bas ement. yes o No. in Family Whirlpool Tub yes/~ 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 1 st 2nd 3rd OTHER: (Specify) 7. Do you anticipate any additions to Facility? Yes / If so, describe: 8. Has any grading, removal, or addition of soil been done to this property? Yes / If so, describe: 9. Are there easements/right-of ways recorded on this property? Yes / o 10. Is a public water supply available on or adjacent to the above property? 6e )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: [ ] Individual well [ ] Community well [ J 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 PROPERTY, THERE IS AN ADDITIONAL CHARGE.- Date Signature of Owner or Agent • 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 ofany 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 J4 Selected Parcel Number: 3704-11-55-4864 1 inch = 60 feet Prepared for: ' / ~'~g Ob cr w CO '0) \ -r0 5092 ~ r~s N07 24 ~99 li 12 p7 - ~ . 7495 12 2, 13 D 0 .00 o~ 87 6~ O ~ cA 4864 X17 0° °o Q) ~o _=9.97 l~ r_ 74y° r` CP ct t ~L ~ 18 ~ o C_ 4 4734 0 ti 1498, cs O B C1;1 o co - ' - Q) 2.47A 4695-1 '11-P 66105 THIS IS NOT A LEGAL DOCUMENT O%~ Tuesday, February 16, 2010 10:17 AM ` CATAWBA COUNTY NC - Parcel Report Information Regarding Selected Parcel(s) Parcel ID: 3704-11-55-4864 Name: LEACH ESTHER R Name2: Address: 3040 5TH ST PL NW Address2: City: HICKORY State: NC Zip: 28601-8053 Account: 40569120 Calc Acreage: 0.35 Tax Map: 190H 01016F LRK: 61209 Deed Book: 1814 Deed Page: 0414 Subdivision Name: Subdivision Block: Lots: 17 Plat Book: UNRE Plat Page: UNRE Building Number: 3040 Street Name: 5TH ST PL NW - Site Zip: 28601 kj , Township: HICKORY Fire Code: HICKORY RURAL City Code: COUNTY State Road: 1360 Total Bldgs Value: $135,400 Land Value: $20,000 Total Value: $155,400 Year Built: 1968 Year Remodeled: 1972 Last Sale Date: 11/1/1992 Last Sale Amount: $114,900 Neighborhood: 28 Watershed: WS-IV Critical Area Watershed Split: NO O Voter Precinct: P36 E911 District: HICKORY Zoning: R-2 Zoning2: Zoning3: Zoning Split: N Zoning Overlay: Zoning District: HICKORY Split Zoning Dist: N Split Zoning Dist(1): 0 Split Zoning Dist(2): 0 School District: HICKORY Elementary School: JENKINS Middle School: NORTHVIEW High School: HICKORY ' l School Split: NO P&Z Case Number: Census Tract 2010: 010500 l l Census Block 2010: 1070 Small Area Plan: Agricultural District: Printed: Tuesday, February 16, 2010 10:17 AM