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Home My WebLink AboutEHPR-2-10-4032 (2).TIF T IS IS NOT A PERMIT Case # EHPR-2-10-4032 CATAWBA COUNTY HEALTH DEPARTMENT Plan Review Application for Environmental Services 1842 sm Environmental Health Plan Review - OSWP EXPANS/O - ABANDONMENT APPLICANT OWNER CONTRACTOR RONALD BRAIM LUTHER JACOB STAFFORD HEIRS CLAYTON HOMES # 81 /CMH INC (UNLI, 4249 LEE CLINE RD 1230 CONOVER NC 28613 CONOVER CONOVER NC 28613 828-465-3450 NAME TO APPEAR ON PERMIT RONALD BRAIM Pi 4-3-ff- SITE ADDRESS: 4249 LEE CLINE RD, Conover, NC DIRECTIONS: CORNER OF RIFLE RANGE & LEE CLINE RD NAME of SUBDIVISION: Lot # SectionBlock/Phase PROPERTY SIZE: Square Feet Acres 1.21 Date Platted/Recorded TYPE OF FACILITY: House X Mobile Home Dimension of Structure 60 X 40 Bedrooms 3 Basement: No Water Using Fixtures in Basement:No No. in Family 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: Has any grading, removal, or addition of soil been done to this property? If so, describe YES, SITE PREPARATION Are there easements/right-of-ways recorded on this 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 representation by you of house or structure location should conform to applicable setbacks. Date: it, / 0 Signature of Applicant or AgentZ~4 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 30 FEE NAME DATE AMOUNT Side 15 Authorization to Construct Fee (New/Expansion) Fee 02/24/2010 $150.00 Rear Improvement Permit Fee 02/24/2010 $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 02/26/10 15:21 A THIS IS NOT A PERMIT Case # EHPR-2-10-4032 a CATAWBA COUNTY HEALTH DEPARTMENT Plan Review Application for Environmental Services 1842 M Environmental Health Plan Review - OSWP EXPANSION APPLICANT OWNER CONTRACTOR RONALD BRAIM LUTHER JACOB STAFFORD HEIRS CLAYTON HOMES # 81 /CMH INC (UNLI, 4249 LEE CLINE RD 1230 CONOVER NC 28613 CONOVER CONOVER NC 28613 828-465-3450 NAME TO APPEAR ON PERMIT RONALD BRAIM Pn#:1 SITE ADDRESS: 4249 LEE CLINE RD, Conover, NC DIRECTIONS: CORNER OF RIFLE RANGE & LEE CLINE RD NAME of SUBDIVISION: Lot Section/Block/Phase PROPERTY SIZE: Square Feet Acres 1.21 Date Platted/Recorded TYPE OF FACILITY: House X Mobile Home Dimension of Structure 60 X 40 Bedrooms 3 Basement: No Water Using:Fixtures in Basement:No No. in Family Whirlpool Tub : al 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: Has any grading, removal, or addition of soil been done to`this pi operty? If so, describe YES, SITE PREPARATION Are there easements/right-of-ways recorded on this 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 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. A presentation by you of house or structure location should conform to applicable setbacks: Date: Signature of Applicant or Agent An Environmental Health Specialist will contact you within m~ 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 30 FEE NAME DATE AMOUNT Side 15 Authorization to Construct Fee (New/Expansion) Fee 02/24/2010 $150.00 Rear Improvement Permit Fee 02/24/2010 $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 02/24/10 16:03 THIS IS NOT A PERMIT WLS # CATAWBA COUNTY HEALTH DEPARTMENT Application for Environmental Services Improvement Permit ❑ Authorization to Construct ❑ Septic Repair ❑ Septic Expansion Od Existing Tank Check ❑ New Well Permit ❑ Replacement Well ❑ Well Abandonment ❑ 1. Naive to Appear on Peryit 4 , Ls 2. Permit Requested By k o, N-e. Business Phone Address IT D 41Q1 -e-~ eleed G--) C, NUy ie, - Al C Horne Phone 3. Property Owner s6wa/~ yea, At e Business Phone Address /9"77 /a/leyfi,~,~y rA. Tuts .fXoer a. Home Phone 4. Name of Subdivision Lot # Section/Block/Phase Property Address 4fs2 `f 9 ~ GL l ;.r r GQ ell'_#&41- ~ G Directions to Property: 5. Property Size: Square Feet Acres Date Platted/Recorded 6. TYPE OF FACILITY: House Mo2_ Mohile Home Dimension of Structure _ Bedrooms* 3 ;Am room that vyill be intended forsleepin~atihe time ofconstruc11011 01 101 lutrur id(:111ti,1ii dhoulu he lwli l d a tec d, 1'6n all applications. Tlw nlimbecnfhcdr wn"i I1 h,, irrbd'b', -m, id~Milied on Fwui«Flans as~a bech'oonr and COLM bedroorir at the tine q1 huildin' J)Mrrit_i 1,11 lhls iua\ I,r -111 1lr n "1 I i ;stem sib, Basement: yes/& Water Using Fixtures in Basement: yes/& No. in Family Z Whirlpool Tub yes/V Gallon Capacity MULTIPLE FAMILY RESIDENCES: Units Total Number of Bedrooms 3 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 / No If so, describe: 8. Has any grading, removal, or addition of soil been done to this property? es No If so, describe: $ ' t r 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? 0/ 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 [ ] Semi-Public well 1 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 T ROPERTY, THER IS AN ADDITIONAL CHARGE" Date 7 ' ~6 Signature of Owner or Agent Catawba County, North Carolina 7his map product was prepared from the Catawba Coanfi. AIC, Geographic h formation Svstem. N Catawba Counrn has made substamial efforts to ensure the accuracv of location amcllabeling information comained on this map. Catawba Counh+ promotes card recommends the independent verification of as clam contained on this map product by the user. The County ol - Catawho, ils employees, agents and personnel discloon, otd shall not be held liahle for any and all damages, loss or liability, whether direct, mclireci m' consequential which arises or mr{v arise f nm 7his mop product or the use thereof by miy person or entih'. Legend Selected Parcel Number: 3743-10-35-3430 1 inch = 60 feet Prepared for: i y.l. 1 i 7 t 5 -T-_D E 361.46 ~ 361.66 7 ' i 21 tit aQ r v f 420~ z~ l t i e 1'I-IIS IS NOT A LLGAI, DOCUiNIF NT Wednesday, February 24, 2010 03:36 PiA9 .'l .29) AE CATAWBA COUNTY NC - Parcel Report Information Regarding Selected Parcel(s) Parcel ID.- 3743-10-35-3430 Name: STAFFORD LUTHER JACOB HEIRS Name2: Address: 208 UNION SQUARE NW Address2: City: HICKORY State: NC Zip: 28601-6119 Account: 157022000 Calc Acreage: 1.21 Tax Map: 2200 00083 LRK: 64657 Deed Book: 0358 Deed Page: 0554 Subdivision Name: Subdivision Block: Lots: Plat Book: Plat Page: Building Number: 4249 Street Name: LEE CLINE RD Site Zip: 28613 Township: CLINES , r„/~ ~1wG~ f 1~-G [ L (~[LLU~ Fire Code: CONOVER RURAL ~JCVIJ City Code: COUNTY A State Road: 1486 Total Bldgs Value: $27,900 r4 Land Value: $15,200 Total Value: $43,100 C2~14~. Year Built: 1945i~,GIC Year Remodeled: i Last Sale Date: Last Sale Amount: Neighborhood: 67 Watershed: Watershed Split: Voter Precinct: P33 E911 District: COUNTY Zoning: R-20 Zoning2: Zoning3: Zoning Split: N Zoning Overlay: Zoning District: COUNTY Split Zoning Dist: N Split Zoning Dist(1): 0 Split Zoning Dist(2): 0 School District: COUNTY Elementary School: LYLE CREEK Middle School: RIVER BEND High School: BUNKER HILL School Split: NO P&Z Case Number: R-407 Census Tract 2010: 010202 Census Block 2010: 1000 Small Area Plan: ST STEPHENS/OXFORD Agricultural District: PROXIMITY Printed: Wednesday, February 24, 2010 02:59 PM ~A C CATAWBA COUNTY, NC 100 South West Blvd PLAN INVOICE f- F-; Newton, NC 28658- ~ op® (828)465-8399 Wednesday, February 24, 2010 1g sM www.catawbacountync.gov Plan Case: EHPR-2-10-4032 Invoice Number: INV-2-10-259859 Environmental Health Plan Review Invoice Date: 02/24/2010 Fee Name Fee Amount Authorization to Construct FeE Adjustable, $150.00 (New/Expansion) Fee Improvement Permit Fee Fixed $150.001 Total Fees Due: $300.00 PAYMENTS Date Pay Type Check Number Amount Paid Change 02/24/2010 Cash -1 S300.00 _ $0.00 Total Paid: $300.00 Total Due: $0.00 planinvoice;h60d80 3-d695-4 S_'.9-8c6a-fi5<?1;~9?042b~;.rpr 02/24/2010 16:05