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HomeMy WebLinkAboutEHPR-2-10-4014 (2).TIF ~A C THIS IS NOT A PERMIT Case # EHPR-2-10-4014 CATAWBA COUNTY HEALTH DEPARTMENT v h o;~ `C Plan Review Application for Environmental Services x`84 sM Environmental Health Plan Review - OSWP 1842 IMPROVEMENT - AUTH CONST APPLICANT OWNER - c(iNTWVCTOR THOMAS MCNEELY THOMAS NICNEELY~ 4093 HERIMIAN.SIPL RD 4093 HERMAN SIDE RD` CONOVER NC 28613 CONOVER NC 28613 - 828-464-7925 828-464-7925 r . NAME TO APPEAR ON PERMIT THOMAS MCNEELY Pin#: 371212869386 SITE ADDRESS: 603 SE 21ST ST, Hickory. NC DIRECTIONS: MCDONALD PKWY TURN LEFT ON TO 21ST PROPERTY WILL BE ON RIGHT BESIDE SWEETWATER BAPTIST CHURCH. NAME of SUBDIVISION: Lot# Section/Block/Phase PROPERTY SIZE: Square Feet Acres 0.449 Date Platted/Recorded TYPE OF FACILITY: House -X Mobile Home Dimension of Structure 45X30 Bedrooms 2 Basement:, Yes, Water Using Fixtures in Basement:Ycs No. in Family 0 Whirlpool Tub : v it Capacity: MULTIPLE FAMILY RESIDENCE: Units 4.00 1 Total Number ol'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: NO Has any grading, removal, or addition of soiIbeen done to this property? If so, describe NO 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 prop erty.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: Signature of Applicant or Agents 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 77- Side l,ce (Nrw/-02/24/201o stX0.00 ,,.,r Rear Irnprovc~u.ui Pennit.Fee •~02r~42610 - $150.00 Max Hght $300.00 TOTAL FEES *If a permit has to be redesigned and / or RETRIPS made to the property, there is an additional $60 charge 02/24/10 09:41 THIS IS NOT A PERMIT WLS # CATAWBA COUNTY HEALTH DEPARTMENT A plication for Environmental Services Improvement Permit Authorization to Construct R11", Septic Repair ❑ Septic Expansion ❑ Existing Tank Check ❑ New Well Permit ❑ Replacement Well ❑ Well Abandonment ❑ 1. Name to Appear on Permit i h v m re ,5 4 c/V'e e- y 2. Permit Requested By e_ Business Phone .'t/ S; e fed 'i' o i'ce-- C - Home Phone >;'9e Address VD y3 n9 © 3. Property Owner X4_0 Business Phone Address Home Phone 4. Name of Subdivision Lot # Section/Block/Phase Property Address f D 3, a / - en- Directions to Property: 5. Property Size: Square Feet Acres • 45 Date Platted/Recorded 6. TYPE OF FACILITY: House Mobile Home Dimension of Structure Bedrooms* *Any r,,,~i>> that will be intended I',I sleepillo at the.time of Construction 0I for lutnre c~~n;ider,~tion should be noted ~i, ;i ~i hedrooiil ,end Counted oirall appli~<<ti ,i~ I hc~nttmhcir'of hcdrooms will bc;,wnfirined bj r<<~>>s identilied On hon"~ JLidtl n~ bedroom it the time of bLiilcliilg IN611tt tisnaneC 1 llis'may I)Lc ~jtthe need tot system iiici-case ill the futiir~'. Basement: Ono Water Using Fixtures in Basement: . es o No. in Family Whirlpool Tub yes/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 1st 2nd 3rd OTHER: (Specify) 7. Do you anticipate any additions to Facility? Yes N 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 N 10. Is a public water supply available on or adjacent to the above property?Y(No Check type that is available: [ ] Community well [ ] Semi-public well [vj 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 o~~ - ~0/6 Signature of Owner or Age a'o- Catawba County, North Carolina This map product was prepared from the Catawba Comnty, 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 Countv promotes and recommends the independent verification ofany data contained an this map product by the user. The County of Catawba, its employees, agents and personnel disclaim, and shall not be held liable for anv 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: 3712-12-86-9386 1 inch = 60 feet Prepared for: 1.10A 'o °0 9433 / d 9386 c 1 / v SWEETWATER -BAPTIST / CHURCH / 1.83A Y , 0244 / 00 SWEETWATER BAPTIST CHURCH `\1,1, 22 j \ f s ~,5 THIS IS NOT A LEGAL DOCUMENT O~J Wednesday, February 24, 2010 09:17 AM , CATAWBA COUNTY NC - Parcel Report Information Regarding Selected Parcel(s) Parcel ID: 3712-12-86-9386 Name: MCNEELY EDWIN DORMAN Name2: MCNEELY THOMAS PAUL Address: 4093 HERMAN SIPE RD NW Address2: City: CONOVER State: NC Zip: 28613-8908 Account: 163618 Calc Acreage: 0.45 Tax Map: 124H 02010 LRK: 47185 Deed Book: 2390 Deed Page: 0872 Subdivision Name: Subdivision Block: Lots: Plat Book: Plat Page: Building Number: 603 Street Name: 21 ST ST SE Site Zip: 28602 Township: HICKORY Fire Code: HICKORY RURAL City Code: COUNTY State Road: Total Bldgs Value: $41,200 Land Value: $4,900 Total Value: $46,100 Year Built: 1939 Year Remodeled: Last Sale Date: Last Sale Amount: Neighborhood: 53 Watershed: Watershed Split: Voter Precinct: P35 E911 District: HICKORY Zoning: R-3 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: COUNTY Elementary School: ST STEPHENS Middle School: ARNDT High School: ST STEPHENS School Split: NO P&Z Case Number: Census Tract 2010: 011000 Census Block 2010: 3013 Small Area Plan: Agricultural District: Printed: Wednesday, February 24, 2010 09:17 AM g,A ~o CATAWBA COUNTY, NC 100-A South West Blvd F-21-AN RECEIPT ~ Newton, NC 28658- r (828)465-8399 Wednesday, February 24, 2010 84 sM www.catawbacountync.gov Plan Case: EHPR-2-10-4014 Invoice Number: INV-2-10-259829 Environmental Health Plan Review Invoice Date: 02/24/2010 Site Address: 603 SE 21 ST ST, Hickory, NC APPLICANT OWNER THOMAS MCNEELY THOMAS MCNEELY 4093 HERMAN SIPE RD 4093 HERMAN SIPE RD CONOVER NC 28613 CONOVER NC 28613 828-464-7925 828-464-7925 Fee Name Fee Amount Authorization to Construct Fee Adjustable $150.00 (New/Expansion) Fee Improvement Permit Fee Fixed $150.00 Total Fees Due: $300.00 PAYMENTS Date Pay Type Check Number Amount Paid Change 02/24/2010 Check 2658 $300.00 $0.00 Total Paid: $300.00 Payer: THOMAS MCNEELY Total Due: $0.00 plan receipt {If6c8330-d2fa-4451-8aOb-54b803acec3c}.rpt 02/24/2010 09:56