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Home My WebLink AboutEHPR-3-10-4252 (2).TIF A ,~i THIS IS NOT A PERMIT Case # EHPR-3-10-4252 CATAWBA COUNTY HEALTH DEPARTMENT Plan Review Application for Environmental Services 1842 sM Environmental Health Plan Review - OSWP IMPROVEMENT APPLICANT OWNER CONTRACTOR RICKY LEE LAIL RICKY LEE LAIL 6280 ROCKY RD 6280 ROCKY RD CLAREMONT NC 28610-9704 CLAREMONT NC 28610-9704 NAME TO APPEAR ON PERMIT RICKY LEE LAIL Pin#: 375501363351 SITE ADDRESS: 6280 ROCKY RD, Claremont, NC DIRECTIONS: HWY 16 N/ RT ON RIVER BEND RD/ GO 1/4 MILE/ LFT ON ROCKY RD/ AT END OF CUL-DE-SAC NAME of SUBDIVISION: ROXBURY FIELDS Lot # 6 Section/Block/Phase PROPERTY SIZE: Square Feet Acres 1.289 Date Platted/Recorded TYPE OF FACILITY: House X Mobile Home Dimension of Structure 56 X 32 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 Ist 2nd 3rd OTHER: (Specify) Do you aniticipate any additions to Facility? If so, describe: ENCLOSING EXISTING PORCH 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 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: Signature of Applicant or Agent An Environmental Health Specialist will contact you within 2 wor 'ng 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 Improvement Permit Fee 03/09/2010 $150.00 Rear 30 TOTAL FEES $150.00 Max Hght *If a permit has to be redesigned and / or RETRIPS made to the property, there is an additional $60 charge 03/09/10 11:48 THIS IS NOT A PERMIT WLS #P~~ 7 ~J v CATAWBA COUNTY HEALTH DEPARTMENT plication for Environmental Services Improvement Permit Authorization to Construct ❑ Septic Repair ❑ Septic Expansion ❑ Existing Tank Check E] New Well Permit Replacement Well E] Well Abandonment F] I . Name to Appear on Permit _ 2. Permit Requested By Business Phone 6335 EP7 Address pO Q Home Phone S 3. Property Owner Business Phone Address ~A L° Home Phone 4. Name of Subdivision Lot # Section/Block/Phase Property Address Directions to Property: !c~ c°_ t, . - D vC 0-4E 90 O 5. Property Size: Square Feet Acres Date Platted/Recorded 6. TYPE OF FACILITY: House Mobile Home Dimension of Structure S~ 5C 3 Z.- Bedrooms* *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 pen-nit issuance. This may prevent the need for system size increase in the future. Basement: yes Water Using Fixtures in Basement: yes r2o 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 Noj If so, describe: 8. Has any grading, removal, or addition of soil been done to this property? Yes No If so, describe: 1 9. Are there easernents/right-of-ways recorded on this property? Yes o 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 [ ] County/City/Township water line **If No, a Well Pen-nit 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 7 ~d ignature of Owner or Agent Catawba County, North Carolina N This neap product was prepmrd from the Catawba Coun(y, AnC, Geographic Information System. Unawba Counp has mode substantial efforts to ensure the acorraci- of location and lobelhn q it formation , contained on this nrcip. Ccrlau ba Couunry promotes mad recommends the inclepenclent regficoion of am, data cowained on this map pi oducl by the user. The Coum' v of Cmanrbo, its employees, agents and personnel disclaim, and sholl not be held lioble for any and all damoges, loss or liabilitY, whether direct, indirect or consequential which arises oe mm o ise from this prop product or the use thereofkv any person or entity. Legend Selected Parcel Number: 3755-01-36-3351 i 1 inch = 60 feet Prepared for r~. ._4 W '0 jk~ °-„x~~`+•\~ ~I 1 IP5A co// 5 `v 35m ,i 41390 r I V) , 221,24 -b ,.Q Co 4 45 00 THIS IS NOT A LEGAL DOCUMENT Tuesday, Alarch 09, 2010 10:43 AIM CATAWBA COUNTY NC - Parcel Report Information. Regazding Selected Parcel(s) Parcel ID: 3755-01-36-3351 Name: LAIL RICKY LEE Name2: LAIL DONNA S Address: 6280 ROCKY RD Address2: City: CLAREMONT State: NC Zip: 28610-9704 Account: 159742393 Calc Acreage: 1.29 Tax Map: LRK: 402807 Deed Book: 2891 Deed Page: 0406 Subdivision Name: ROXBURY FIELDS Subdivision Block: Lots: 6 Plat Book: 51 Plat Page: 31 Building Number: 6280 Street Name: ROCKY RD Site Zip: 28610 Township: CLINES Fire Code: OXFORD City Code: COUNTY State Road: Total Bldgs Value: $54,200 Land Value: $8,900 Total Value: $63,100 Year Built: 1989 Year Remodeled: Last Sale Date: Last Sale Amount: Neighborhood: 67 Watershed: WS-IV Protected Area Watershed Split: NO Voter Precinct: P27 E911 District: COUNTY Zoning: R-40 Zoning2: Zoning3: Zoning Split: N Zoning Overlay: WP-O Zoning District: COUNTY Split Zoning Dist: N Split Zoning Dist(1): 0 Split Zoning Dist(2): 0 School District: COUNTY Elementary School: OXFORD Middle School: RIVER BEND High School: BUNKER HILL School Split: NO P&Z Case Number: Census Tract 2010: 010101 Census Block 2010: 1002 Small Area Plan: ST STEPHENS/OXFORD Agricultural District: PROXIMITY Printed: Tuesday, March 09, 2010 11:44 AM ~4'A Cpl, CATAWBA COUNTY, NC 100-A South West Blvd PLAN INVOICE 1--j Newton, NC 28658- 0 (828)465-8399 Tuesday, March 9, 2010 j$ 4 Z sm www.catawbacountync.gov Plan Case: EHPR-3-10-4252 Invoice Number: INV-3-10-260230 Environmental Health Plan Review Invoice Date: 03/09/2010 Fee Name Fee Amount Improvement Permit Fee Fixed $150.00 Total Fees Due: $150.00 PAYMENTS Date Pay Type Check Number Amount Paid Change 03/09/2010 Cash -1 $150.00 $0.00 Total Paid: $150.00 Total Due: $0.00 plan mvoic,• ; 3a I dia7S-a I N-4701-b5d?-49i;`09842a17;.1 pt 03/09/2010 11:51