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Home My WebLink AboutEHPR-3-10-4248 (2).TIF ~A THIS IS NOT A PERMIT Case # EHPR-3-10-4248 ' CATAWBA COUNTY HEALTH DEPARTMENT Plan Review Application for Environmental Services 1842 SM Environmental Health Plan Review - Septic Malfunction SEPTIC-MALFUNCTION APPLICANT OWNER CONTRACTOR DAVID ISENHOUR DAVID ISENHOUR 1993 MOSS FARM RD 1993 MOSS FARM RD HICKORY NC 28602 HICKORY NC 28602 NAME TO APPEAR ON PERMIT DAVID ISENHOUR Pin#: 2791 15532196 SITE ADDRESS: 1993 MOSS FARM RD, Hickory, NC DIRECTIONS: HWY 127 S IN MT VIEW, TURN RIGHT AT WILCO ON MOSS FARM RD AND ITS THE FIRST HOUSE ON LEFT. NAME of SUBDIVISION: Lot # Section/Block/Phase PROPERTY SIZE: Square Feet Acres 0.92 Date Platted/Recorded TYPE OF FACILITY: House X Mobile Home Dimension of Structure Bedrooms 4 Basement: No Water Using Fixtures in Basement:No No. in Family 3 Whirlpool Tub : Gal. Capacity: MULTIPLE FAMILY RESIDENCE: Units 0.00 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: 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? YES, Dl Type of Water Supply: Individual Well X 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 stricture on this property. Any representation by you of house or stricture location should conform to applicable setbacks. Date: - f Q Signature of Applicant or Agent _ p 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) F,03/09/2010 $425.00 Rear TOTAL FEES $425.00 Max Hght *If a permit has to be redesigned and / or RETRIPS made to the property, there is an additional $60 charge 03/09/ l 0 10:10 k THIS IS NOT A PERMIT WLS # CATAWBA COUNTY HEALTH DEPARTMENT Application for Environmental Services Improvement Permit ❑ Authorization to Construct ❑ Septic Repair Septic Expansion ❑ Existing Tank Check ❑ New Well Permit E] Replacement Well ❑ Well Abandonment ❑ 1. Name to Appear on Permit'PAU 11 2 )J s yl ~ p ~ 2. Permit Requested By I-d 2 -A Business Phone Address - ~~5 l~in+ , t 'VC0 Home Phone 3. Property Owner A m i= Business Phone Address Home Phone .65I2- z yy ~3 / 6 4. Name of Subdivision Lot 4 Section/Block/Phase^ Property Address Dirp tions to Pro erty: 5. Property Size: Square Feet Acres Date Platted/Recorded 6. TYPE OF FACILITY House Mobile Home Dimension of Structure Bedrooms* 'Any room tl ate` ill' 1 {e in ended fo sleeping at the tune~of,eori`structrtin ur,fnr111 e consideration should be noted as a befdzoorm and counted~'on~a11 applications .The number of bedzoomsiT1 h ed by rooms identified on ho se laiis as a bedroom atlie tiiuc of buildingeimiTSSUance This ma ~pre~ntjtheneecl, for s st m size>increase in the future: ~ Basement: yes>oj Water Using Fixtures in Basement: yes/fi3l) No. in Family Whirlpool Tub yes/fZ 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 If so, describe: S. 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? es / No 10. Is a public water supply available on or adjacent to the above properly. es / 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 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 N This map product was prepared f •om the Catawba County, NC, Geographic Information Svstem. 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 mcn, arise from this map product or the use thereofby any person or entity. Legend Selected Parcel Number: 2791-15-53-2196 1 inch = 40 feet Prepared for: 1246 N _ 180 .oo do 1 ~ l N r Y 196 0 VIE, ~ "ICKO THIS IS NOT A LEGAL DOCUMENT Tuesday, March 09, 2010 09:47 AM CATAWBA COUNTY NC - Parcel Report Information Regarding Selected Parcel(s) Parcel ID: 2791-15-53-2196 Name:- ISENHOUR DAVID RAY Name2: ISENHOUR BETTY W Address: 1993 MOSS FARM RD Address2: City: HICKORY State: NC Zip: 28602-8310 Account: 35262000 Calc Acreage: 0.92 Tax Map: 133H 01008 LRK: 48190 Deed Book: 0748 Deed Page: 0032 Subdivision Name: Subdivision Block: Lots: Plat Book: Plat Page: Building Number: 1993 Street Name: MOSS FARM RD Site Zip: 28602 Township: HICKORY Fire Code: MOUNTAIN VIEW City Code: COUNTY State Road: 1194 Total Bldgs Value: $65,400 Land Value: $14,000 Total Value: $79,400 Year Built: 1948 Year Remodeled: Last Sale Date: Last Sale Amount: Neighborhood: 81 Watershed: Watershed Split: Voter Precinct: P24 E911 District: COUNTY Zoning: R-20 Zoning2: Zoning3: Zoning Split: N Zoning Overlay: MUC-0 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: 011101 Census Block 2010: 2009 Small Area Plan: MOUNTAIN VIEW Agricultural District: Printed: Tuesday, March 09, 2010 09:47 AM