HomeMy WebLinkAboutEHPR-3-10-4394 (2).TIF
BA C THIS IS NOT A PERMIT Case # EHPR-3-10-4394
CATAWBA COUNTY HEALTH DEPARTMENT
v : = Plan Review Application for Environmental Services
1842 sM Environmental Health Plan Review - OSWP
SEPTIC MALFUNCTION
APPLICANT OWNER CONTRACTOR
STEVE HUNT STEVE HUNT
3121 NW 5TH ST PL 3121 NW 5TH ST PL
HICKORY NC 28601 HICKORY NC 28601
828-324-2374 828-324-2374
NAME TO APPEAR ON PERMIT STEVE HUNT Pin#: 370411563035
SITE ADDRESS: 3121 S NW 5TH ST PL, Hickory, NC
DIRECTIONS: H WY 127 N - TURN LEFT ONTO 29TH AV DR NW - TURN LEFT ONTO 5TI-I ST PL NW - 1 ST HOUSE ON RIGHT
NAME of SUBDIVISION: JAMES A KELLER Lot # 1 Section/Block/Phase
PROPERTY SIZE: Square Feet Acres 0.46 Date Platted/Recorded
TYPE OF FACILITY: House X Mobile Home Dimension of Structure 30 X 52 Bedrooms 4
Basement: Yes Water Using Fixtures in Basement:Yes No. in Family 3
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 1 st 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 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 structure on this prope Any representation by you house or structure
location should conform applicable setbacks.
Date: Signature of Applicant or Age t
An En ironmental Health Specialist will contact you thin 2 working days of application date.
If you need further information or assistance please call 828-466-7291
AREA2
(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) Fee 03/16/2010 $425.00
Rear TOTAL FEES
Max Hght $425.00
*If a permit has to be redesigned and / or RETRIPS made to the property, there is an additional $60 charge
03/16/10 15:38
THIS IS NOT A PERMIT 4J?
CATAWBA COUNTY HEALTH DEPARTMENT
Application for Environmental Services
Improvement Permit ❑ Authorization to Construct ❑ Septic Repair 6--~Septic Expansion ❑
Existing Tank Check ❑ New Well Permit ❑ Replacement Well ❑ Well Abandonment ❑
1. Name to Appear on Permit 2 e-ye- 0- H1. n
2. Permit Requested By O-D 'e ye. . f SGL 1 "-kn Business Phone&92-, ~V-7X& £ -1.570
Address -F-I a( S _ PL N W, kb'c cc) r cl N L Ct Home Phone M2- 3a~ - a~'7r
3. Property Owner A-4e1,P. + Sc ~ 14Lk rrf- Business Phoned,98-,~97- 7W EX- , 4'7
p
Address .31AI 51`- f, L N , cko r (Q Home Phone M-Qg,8_
4. Name of Subdivision a. Lot Section/Block/Phase
Property Address • ( PU Nil
Directions to Property: N i u r ion 99't-A-Vt Di - IV W
.Sf- or) r
5. Property Size: Square Feet Acres lp Date Platted/Recorded
6. TYPE OF FACILITY: House Mobile Home Dimension of Structure DKS.'L 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 issuance. This may prevent the need for system size increase in the future.
Basement: ye ono Water Using Fixtures in Basement: ~se no No. in Family
Whirlpool Tub yesco Gallon Capacity
MULTIPLE FAMILY RESIDENCES: Units N Total Number of Bedrooms
DAY CARE: Number of Children NIA
RESTAURANT: Seats I 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 / o
If so, describe:
8. Has any grading, removal, or addition of soil been done to this property? Yes No
If so, describe:
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? Ye 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 PERMI HAS T BE REDESIGNED AND/OR RETRIPS MADE TO E PROPERTY, THERE IS AN A DI NAL CHARGE."
f
Date / Signature of Owner or Agent
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. Catmvba County promotes and recommends the independent verification of any
data contained on this map product by the user. The Comity of Catmvba, its employees, agents and
personnel disclaim, and shall not be held liable for any and all damages, loss or liability, whether direct, indirect
m• consequential which arises m• mny arise fi-onr this map product or the use thereof by any person or entity. Legend
Selected Parcel Number: 3704-11-56-3035
1 inch = 60 feet Prepared for:
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Plat 56-12
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156.00
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THIS IS NOT A LEGAL DOCUMENT Tue, March 16, 2010 03:20 PM
CATAWBA COUNTY NC - Parcel Report
Information Regarding Selected Parcel(s)
Parcel ID: 3704-11-56-3035
Name: HUNT STEVE OWEN
Name2: HUNT SARAH
Address: 3121 5TH ST PL NW
Address2:
City: HICKORY
State: NC
Zip: 28601-8053
Account: 34664580
Calc Acreage: 0.46
Tax Map: 190H 01016K
LRK: 61213
Deed Book: 1779
Deed Page: 0361
Subdivision Name: JAMES A KELLER
Subdivision Block:
Lots: 1
Plat Book: 14
Plat Page: 94
Building Number: 3121
Street Name: 5TH ST PL NW
Site Zip: 28601
Township: HICKORY
Fire Code: HICKORY RURAL
City Code: COUNTY
State Road: 1360
Total Bldgs Value: $135,400
Land Value: $24,300
Total Value: $159,700
Year Built: 1973
Year Remodeled:
Last Sale Date: 5/1/1992
Last Sale Amount: $99,500
Neighborhood: 28
Watershed: WS-IV Critical Area
Watershed Split: NO
Voter Precinct: P36
E911 District: HICKORY
Zoning: R-2
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: HICKORY
Elementary School: JENKINS
Middle School: NORTHVIEW
High School: HICKORY
School Split: NO
P&Z Case Number:
Census Tract 2010: 010500
Census Block 2010: 1066
Small Area Plan:
Agricultural District:
Printed: Tue, March 16, 2010 03:20 PM
A Cpl CATAWBA COUNTY, NC
100-A South West Blvd PLAN RECEIPT
Q+ F--] Newton, NC 28658-
0 (828)465-8399 Tuesday, March 16, 2010
1$42 sM www.catawbacountync.gov
Plan Case: EHPR-3-10-4394 Invoice Number: INV-3-10-260497
Environmental Health Plan Review Invoice Date: 03/16/2010
Site Address: 3121 S NW 5TH ST PL, Hickory, NC
APPLICANT OWNER
STEVE HUNT STEVE HUNT
3121 NW 5TH ST PL 3121 NW 5TH ST PL
HICKORY NC 28601 HICKORY NC 28601
828-324-2374 828-324-2374
Fee Name Fee Amount
Authorization to Construct (Repair) Fee Adjustable $425.00
Total Fees Due: $425.00
PAYMENTS
Date Pay Type Check Number Amount Paid Change
03/16/2010 Credit Card -1 $425.00 $0.00
Total Paid: $425.00
Payer: SARAH HUNT
Total Due: $0.00
plan receipt ; b3St2160f-a53o-41 23-8487-1 h)4- :261 Scd;.ipt 03/16/2010 15:37