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Home My WebLink AboutEHPR-3-10-4323 (2).TIF A THIS IS NOT A PERMIT Case # EHPR-3-10-4323 CATAWBA COUNTY HEALTH DEPARTMENT Plan Review Application for Environmental Services 1842 sM Environmental Health Plan Review - OSWP NEW WELL APPLICANT OWNER CONTRACTOR JAVIER BRAVO JAVIER BRAVO 6401 WINCHESTER RD 6401 WINCHESTER RD DENVER NC 28037 DENVER NC 28037 704-276-9065 704-276-9065 NAME TO APPEAR ON PERMIT JAVIER BRAVO Pin#: 369603441758 SITE ADDRESS: 6401 WINDCHESTER RD, Denver, NC DIRECTIONS: HWY 16 S - TURN LEFT ONTO GRASSY CREEK RD - TURN RIGHT ONTO WINCHESTER RD - I ST TRAILER ON RIGHT (SINGLE WIDE) NAME of SUBDIVISION: Lot # 2 Section/Block/Phase PROPERTY SIZE: Square Feet Acres 1.019 Date Platted/Recorded TYPE OF FACILITY: House Mobile Home X Dimension of Structure 16 X 72 Bedrooms 2 Basement: No Water Using Fixtures in Basement:No No. in Family 4 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: NO Has any grading, removal, or addition of soil been 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 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: _ 1f Signature of Applicant or Agent V c c~~ O1 y Q 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 AREA1 (FOR OFFICE USE ONLY) Zoning Approval: _Yes No Zoning Approval UDO Zoning Form A Minimum Setbacks Front 30 FEE NAME DATE AMOUNT Side 15 Well Permit & Inspection Fee 03/11/2010 $300.00 Rear 30 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 03/11/10 15:04 THIS IS NOT A PERMIT CATAWBA COUNTY HEALTH DEPARTMENT Application for Environmental Services Improvement Permit ❑ Authorization to construct ❑ Septic Repair ❑ Septic Expansion ❑ Existing Tank Check ❑ New Well Permit d Replacement Well ❑ Well Abandonment ❑ 1. Name to Appear on Permit v 1 ej- G V 2. Permit Req csted By usiness Phone 0 - Address 1 - - Home Phone 7bt{ 3. Property Owner r - Business Phone Address W _ Home Phone 10- P,"A 4. Name of Subdivision Lot # Section/Block/Phase Property Address U ' Directions to Property: - 5. Property Size: Square Feet Acres / o- Date Platted/Recorded 6. TYPE OF FACILITY: House Mobile Homed Dimension of Structure 14 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 permit is lance. This may prevent the need for system size increase in the future. Basement: yesi Water Using Fixtures in Basement: yes/no No. in Family Whirlpool Tub yes/no Gallon Capacity MULTIPLE FAMILY RESIDENCES: fUUnits 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 / No 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 / Nd" 10. Is a public water supply available on or adjacent to the above property? Yes / 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 3 - 11 - Signature of Owner or Agent oilU 4~2 1 U~0C ~ Catawba County, North Carolina N This map product was prepared from the Catawba County, NC, Geographic Information System. 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 ofauy 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 may arise from this map product or the use thereof by any person or entity. Legend Selected Parcel Number: 3646-03-44-1758 1 inch = 60 feet Prepared for: 60 (160 ~Z" i C*j C i> Z i 2 ' po . f X69 C} 1758 ~o Plat 4 9-42 co 0 0688 6 CD J 35• o• 25 430.1 34 . THIS IS NOT A LEGAL DOCUMENT Thu, March 11, 2010 02:44 PM CATAWBA COUNTY NC - Parcel Report Information Regarding Selected Parcel(s) Parcel ID: 3696-03-44-1758 Name: SMITH MITCHELL C Name2: Address: 1432 PRESSLEY DR Address2: City: LINCOLNTON State: NC Zip: 28092-7912 Account: 159744298 alc Acreage: 1.02 T Tax Map: 01 016 6 X 03012 LRK: 16897 Deed Book: 2923 Deed Page: 1287 Subdivision Name: Subdivision Block: Lots: 2 Plat Book: 49 Plat Page: 42 Building Number: 6401 Street Name: WINDCHESTER RD Site Zip: 28037 Township: MOUNTAIN CREEK Fire Code: SHERRILLS FORD City Code: COUNTY State Road: 3111110 Total Bldgs Value: $1,000 Land Value: $9,200 Total Value: $10,200 Year Built: Year Remodeled: Last Sale Date: Last Sale Amount: Neighborhood: 129 Watershed: WS-IV Critical Area Watershed Split: NO Voter Precinct: P41 E911 District: COUNTY Zoning: R-30 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: BALLS CREEK Middle School: MILL CREEK High School: BANDYS School Split: NO P&Z Case Number: R-184 Census Tract 2010: 011502 Census Block 2010: 4059 Small Area Plan: SHERRILLS FORD Agricultural District: Printed: Thu, March 11, 2010 02:44 PM CATAWBA COUNTY, NC 100-A South West Blvd PLAN RECEIPT Newton, NC 28658- 0 (828)465-8399 Thursday, March 11, 2010 184 Z sm www.catawbacountync.gov Plan Case: EHPR-3-10-4323 Invoice Number: INV-3-10-260373 Environmental Health Plan Review Invoice Date: 03/11/2010 Site Address: 6401 WINDCHESTER RD, Denver, NC APPLICANT OWNER JAVIER BRAVO JAVIER BRAVO 6401 WINCHESTER RD 6401 WINCHESTER RD DENVER NC 28037 DENVER NC 28037 704-276-9065 704-276-9065 Fee Name Fee Amount Well Permit & Inspection Fee Fixed $300.00 Total Fees Due: $300.00 PAYMENTS Date Pay Type Check Number Amount Paid Change 03111/2010 Cash -1 $300.00 $0.00 Total Paid: $300.00 Payer: JOVIER BRAVO Total Due: $0.00 pl,in receipt ; h26ccntto-ael-leeb-aRd(i-~3Radrrhdc%i~;.rp~ 03/11/2010 15:03