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HomeMy WebLinkAboutEHPR-2-10-3944 (2).TIF A THIS IS NOT A PERMIT Case # EHPR-2-10-3944 CATAWBA COUNTY HEALTH DEPARTMENT Plan Review Application for Environmental Services 1842 sM Environmental Health Plan Review - OSWP IMPROVEMENT - AUTH CONST APPLICANT OWNER CONTRACTOR MILDRED MOORE MILDRED MOORE TIM E HARWELL CONSTRUCTION PO BOX 672 PO BOX 672 1455 HILDEBRAN NC 28637 HILDEBRAN NC 28637 MUSKET 828-443-7401 828-443-7401 CATAWBA NC 28609 828-241-3223 NAME TO APPEAR ON PERMIT MILDRED MOORE NA Pin#: 376107770724 SITE ADDRESS: 2485 GENELIA DR, Claremont, NC DIRECTIONS: FROM CLAREMONT/ RT ON DEPOT ST/ GO ACROSS TRACKS/ LFT ON OLD CATAWBA RD/ GO 7/1 OTHS MILES/ CHARLOTTES CROSSING ON RT ON GENELIA/ ON RT NAME of SUBDIVISION: CHARLOTTES CROSSING Lot # 5 Section/Block/Phase PROPERTY SIZE: Square Feet Acres 2 Date Platted/Recorded TYPE OF FACILITY: House X Mobile Home Dimension of Structure 58 X 70 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 1st 2nd 3rd OTHER: (Specify) Do you aniticipate any additions to Facility? If so, describe: DETACHED GARAGE 24 X 24 Has any grading, removal, or addition of soil been done to this property? If so, describe Are there easements/right-of-ways recorded on this property? NONE Type of Water Supply: Individual Well Community Well 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 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 o house or structure location should conform to applicable setbacks. C Date: Sf to Signature of Applicant or Ag t An Environmental Health Specialist will contact you within 2 working days of application date. If you need further information or assistance please call 828-466-7291 AREA 2 (FOR OFFICE USE ONLY) Zoning Approval: Yes No Zoning Approval UDO Zoning Form A Minimum Setbacks Front 15 FEE NAME DATE AMOUNT Side 8 Authorization to Construct Fee (New/Expansion) Fee 02/18/2010 5150.00 Rear 25 Improvement Pen-nit Fee 02/18/2010 $150.00 Max Hght TOTAL FEES $300.00 *If a permit has to be redesigned and / or RETRIPS made to the property, there is an additional $60 charge 02/18/10 14:15 THIS IS NOT A PERMIT WLS # CATAWBA COUNTY HEALTH DEPARTMENT Application for Environmental Services Improvement Permit ❑ Authorization to Construct 2~. Septic Repair El Septic Expansion ❑ Existing Tank Check ❑ New Well Pe In it ❑ Replacement Well ❑ Well Abandonment ❑ r^e__ ► Yt o o a-D-- 1. Name to Appear on Permit- 2. Permit Requested B r Business Phone &2F ,:A34--/3 d l Address ZCISS v c Wiz;" hle Home Phone J~f /-.3 2- z 3 3. Property Owner Liy/~ % ca l/I/lodiz Business Phone Address p ©a X 7~ `✓a~, H iyy~C~~ 7 Home Phone~~ 4. Name of Subdivision (f h~el"oKe C Lot # Section/Block/Phase Property Address_f~5' ~f(; /D Directions to Property: !Z7,- 1;-t 5. Property Size: Square Feet Acres U Date Platted/Recor 6. TYPE OF FACILITY: House Mobile Home Dimension of StructureA S~ Bedrooms*_ 3 *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 system size increase in the future. Basement: ye no Water Using Fixtures in Basement: yes/O No. in Family Whirlpool Tub ye no 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 I st 2nd 3rd OTHER: (Specify) 7. Do you anticipate any additions to Facility? Yes /6D If so, describe: 8. Has any grading, removal, or addition of soil been done to this property? Yes /D If so, describe: 9. Are there easements/right-of-ways recorded on this property? Yes 140 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 ~unty/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 [ ] Semi-Public well I understand that this is a formal application for a well pen-nit, 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 / l0 Signature of Owner or Agent Catawba County, North Carolina This map product was prepared fi-om the Catawba County, NC, Geographic Information System. N Catawba Counry has made substantial efforts to ensure the accuracy of location and labeling information contained on this map. Catawba Countypromotes and recommenos the independent verification of any data contained on this snap 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: 3761-07-77-0724 1 inch = 80 feet Prepared for: 57 r' 13 \ \ C14 ' L'`~cf ANT 985 C`' 7~O k2 6 1 1 CL.` 2.OOA ,1 0)724 FA 1 t , C rn % ~•i -9 c~J a t ~ 2`~3 gib ~ ° i 60 r ' 1.03A o 6 ~;3 2\ N THIS IS NOT A LEGAL DOCUMENT 'i Wednesday, February 10, 2010 11:15 AM Gip FEMpNT y Permit Number o 0 ,D ~ a2 1893 CITY OF CLAREMONT P.O. Box 446 3288 EAST MAIN STREET CLAREMONT, N.C. 28610 828/459-7009 - FAX 828/459-0596 ZONING COMPLIANCE CERTIFICATE Applicant: / iiyi ~!~/z P C pr✓5 "onH Phone: Address: a ss 1~l'1i~ t ~ ins i rL -1H C e60~ Owner: Phone: ,~~p 3 7 zD / Location: IN: Proposed Activity: d r ; ,g? Property Size: 2 C) (,\c • A site plan showing property size, all existing structures, proposed structures and distances from property and right(s)-of-way lines is required and considered a part of this permit. • This permit will expire six (6) months from the date it is issued if work has not begun on the approved activity. • This permit will expire if work is suspended or abandoned for a period of one year. • This permit may be revoke if the applicant gives any false information. Applicant's Signature v Date OFFICE USE ONLY Zoning District: r - I Inside City Limits: _ Census Tract: 14 ~ I Required Setbacks: Front: I Side: Flood Zone: tt Rear: 2S Street Side: BFE: J COMMENTS: -DJ O, Gk-ed, ' GLrc` __I~rY1G',/;~ ~S1 t'v1,11ul- 1'YlG`lt'1_,1 G. LDC~ Z I5 1U Zoning Administrator's Signature Date Copies of this permit for Catawba County Building Inspections and the applicant/owner's personal records are available upon request.