Loading...
HomeMy WebLinkAboutEHPR-2-10-3958 (2).TIF A C THIS IS NOT A PERMIT Case # EHPR-2-10-3958 CATAWBA COUNTY HEALTH DEPARTMENT Plan Review Application for Environmental Services 1842 sM Environmental Health Plan Review - Septic Malfunction SEPTIC-MALFUNCTION APPLICANT OWNER CONTRACTOR RICK CROWDER 14URSHELL KEENER 4243 HWY 127 S HICKORY NC 208602 NC 828-294-2081 828-294-2081 NAME TO APPEAR ON PERMIT RICK CROWDER Pin#: 279014238271 SITE ADDRESS: 4191 S NC 127 HWY, Hickory, NC DIRECTIONS: HWY 127 DIRECTLY ACROSS FROM THE TURN OFF TO HUFFMAN FARM ROAD NAME of SUBDIVISION: Lot # Section/Block/Phase PROPERTY SIZE: Square Feet Acres 1.47 Date Platted/Recorded TYPE OF FACILITY: House X Mobile Home Dimension of Structure 22X28 Bedrooms 2 Basement: No Water Using Fixtures in Basement:No No. in Family 6 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: NO 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? NO 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 of house or structure location should conform to applicable setbacks. Date: ~r~ C? Signature of Applicant or Agent 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 FEE NAME DATE AMOUNT Side Authorization to Construct (Repair) F102/19/2010 $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 02/19/10 09:59 ' THIS IS NOT A PERMIT WLS # CATAWBA COUNTY HEALTH DEPARTMENT Application for Environmental Services Improvement Permit El Authorization to Construct ❑ Septic Repair ❑ Septic Expansion ❑ Existing Tank Check ❑ New Well Permit ❑ Replacement Well ❑ Well Abandonment ❑ 1. Name to Appear on Permit I<Sr(' 2. Permit Requested By 2, 'C-11- C I _a - Business Phone $ZSf L5 y 20 1 Address 9 ( 2 7 51 w q~ A- IU L ZBGo -L Home Phone 3. Property Owner u 1,cr ( Kc ~~ter Business Phone 8 18 32F1 `fof3 Address P6 Oic -?3y l ( i C N C L UO 3 Home Phone 4. Name of Subdivision Lot # Section/Block/Phase Property Address w z-7 a AU C z g KO Z Directions to Property: J4-v y / Z 7 - A, r e c,f ~ GC ra SS - fr u r ti -~u.r,ti U ~ ~ /~o ~tC w"``~ 5. Property Size: Square Feet Acres 0-7 -7 Date Platted/Recorded 6. TYPE OF FACILITY: House ✓ Mobile Home _ Dimension- of Structure _1 r} X of , Bedrooms* J1- *ny room that wrll+`L ' iiitcn l d.for sleeps ai the trme`ofcon. iruct±ari en l<r i iture colisid ,,tiop shou)d be noted as,a bedroom and;countetl pp,all applications .rhe number of bedrooms will bo.coti -"n d by rooms identified on house plans as a bedroom at `the tte of buildmg,peamrt I8suatt This tnay prevent the necd for system size increase in he future. Basement: Ge/no Water Using Fixtures in Basement: es o No. in Family 4 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 I st 2nd 3rd OTHER: (Specify) 7. Do you anticipate any additions to Facility? Yes o 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 / 10. Is a public water supply available on or adjacent to the above property? /No Check type that is available: [ ] Community well [ ] Semi-public well [U]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 [ ] 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 T I //0 Signature of Owner or Agent y CATAWBA COUNTY NC - Parcel Report Information Regarding Selected Parcel(s) Parcel ID: 2790-14-23-8271 Name: HAWKSRIDGE FARMS INC Name2: Address: PO BOX 3349 Address2: City: HICKORY State: NC Zip: 28603-3349 Account: 159750325 Calc Acreage: 1.47 Tax Map: 175H 01027 LRK: 59243 Deed Book: 2958 Deed Page: 1338 Subdivision Name: Subdivision Block: Lots: Plat Book: Plat Page: Building Number: 4191 Street Name: S NC 127 HWY Site Zip: 28602 Township: HICKORY Fire Code: MOUNTAIN VIEW City Code: COUNTY State Road: Total Bldgs Value: $112,500 Land Value: $21,000 Total Value: $133,500 k Year Built: 1967\ ` Year Remodeled: Last Sale Date: 3/10/2009 \ Last Sale Amount: $150,000 (,A Neighborhood: 81 Watershed: WS-III Protected Area Watershed Split: NO Voter Precinct: P24 E911 District: COUNTY Zoning: R-20 Zoning2: Zoning3: Zoning Split: N Zoning Overlay: WP-O Zoning District: COUNTY Split Zoning Dist: N Split Zoning Dist(1): 0 Split Zoning Dist(2): 0 School District: COUNTY Elementary School: MOUNTAIN VIEW Middle School: JACOBS FORK High School: FRED T FOARD School Split: NO P&Z Case Number: Census Tract 2010: 011801 Census Block 2010: 1004 Small Area Plan: MOUNTAIN VIEW Agricultural District: PROXIMITY Printed: Friday, February 19, 2010 09:36 AM Catawba County, North Carolina This map product was prepared f om the Catawba County, A'C, Geographic Information System. N Catawba County has made substantial efforts to ensure the accuracy of location and labeling information contained on this map. Catawba Count, promotes and recommends the independent verification of am data contained on this map product by the user. The County ofCatmvba, 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 a- may arise from this ntap product or the use thereof by any person or entity. Legend Selected Parcel Number: 2790-14-23-8271 1 inch = 60 feet Prepared for: Z ►-et e v t +ne. Wp 1 i Gault taCv- -fie may Y)C- C1r<-w - - - - - - - - - 140.05 ©Yl . J o 74- N l co ° 1,47A LO N 8271 10 (112) I (177 ~ j THIS IS NOT A LEGAL DOCUMENT Friday, February 19, 2010 10:42 AM f A Cpl CATAWBA COUNTY, NC '°°-A South West Blvd PLAN RECEIPT ~~►a Newton, NC 28658- v (828)465-8399 Friday, February 19, 2010 I842 sM www.catawbacountync.gov Plan Case: EHPR-2-10-3958 Invoice Number: INV-2-10-259732 Environmental Health Plan Review Invoice Date: 02/19/2010 Site Address: 4191 S NC 127 HWY, Hickory, NC APPLICANT OWNER RICK CROWDER 14URSHELL KEENER 4243 HWY 127 S HICKORY NC 208602 NC 828-294-2081 828-294-2081 Fee Name Fee Amount Authorization to Construct (Repair) Fee Adjustable $300.00 Total Fees Due: $300.00 PAYMENTS Date Pay Type Check Number Amount Paid Change 02/19/2010 Check 3215 $300.00 $0.00 Total Paid: $300.00 Payer: HAWKSRIDGE FARMS HAWKSRIDGE FARMS Total Due: $0.00 pltinrccciPi;oac.Ada(ili-b53~-4~:^.i-c>t„~-hb?!>fai3t)dRPi}.irt 02/19/2010 09:58