The URL can be used to link to this page

Home My WebLink AboutEHPR-3-10-4482 (2).TIF THIS IS NOT A PERMIT Case # EHPR-3-10-4482 CATAWBA COUNTY HEALTH DEPARTMENT v f Plan Review Application for Environmental Services 1842 sM Environmental Health Plan Review - OSWP IMPROVEMENT - AUTH CONST APPLICANT OWNER CONTRACTOR Hickory Hollow LLC Hickory Hollow LLC 211 Fairway DR 211 Fairway DR Fayetteville NC 28305 Fayetteville NC 28305 (828)348-4230 (828)348-4230 NAME TO APPEAR ON PERMIT Hickory Hollow LLC Pin#: 376013240174 SITE ADDRESS: 3277 FORK CREEK LN, Claremont, NC DIRECTIONS: HWY 10 & BETHAN CHURCH RD/ LT ON SHADY VALLEY/ RT ON HANOVER/ STAY STRIGHT TO FORK CREEK LN NAME of SUBDIVISION: COUNTRY VALLEY PH 2 PL50-98 Lot # 36 Section/Block/Phase PROPERTY SIZE: Square Feet Acres 0.66 Date Platted/Recorded TYPE OF FACILITY: House Mobile Home X Dimension of Structure 28 X 52 Bedrooms 3 Basement: No Water Using Fixtures in Basement: 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: 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 Community Well X 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. resentation by you of house or structure location shout conform to applicable setbacks. 7 Date: I 0010 Signature of Applicant or Agent /L 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 1 (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 03/22/2010 $150.00 Rear 30 Improvement Permit Fee 03/22/2010 $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 03/22/10 16:31 THIS IS NOT A PERMIT WLS # CATAWBA COUNTY HEALTH DEPARTMENT pplication for Environmental Services Improvement Permit Authorization to Construct 2 Septic Repair ❑ Septic Expansion ❑ Existing Tank Check E] New Well Permit ❑ Replacement Well ❑ Well Abandonment ❑ 1. Name to Appear on Permit - p' r Lam' 2. Permit Requested By Tr-o_ y:5 Business Phone $~P, 3'f h~a34 Address 'D 11 ln, e_ Home Phone 3. Property Owner o \ Business Phone Address laqo Home Phone 4. Name of Subdivision ycy a- Lot Section/Block/Phase Property Address ✓t 'u, 4U Directions to Property: e ac= Rw lO c RrJo-d r 4- A 'S 1~ be t r\ ok.0J4- W\,c S-}rC04 Vbt- rCC o.-n¢.. 5. Property Size: Square Feet Acres Date Platted/Recorded 6. TYPE OF FACILITY. House Mobile Home ~(t) imension of Structure2 X ~Z Bedrooms* *Any -room that will be intended for sleeping at the `trine' of construction or 1oi future"consideration should be rioted;as a bedroom and counted' on-all applications:' J -he number of bedrooms. ur i l l b~ conrril ed by rooms identified on Ouse plans 4§ .4 bedroom at thq time of building permit is" mc. This nay prevent-thy: nee l for system size increase in the future. Basement: yes% o Water Using Fixtures in Basement: yes/ io No. in Family Whirlpool Tub es/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 1 st 2nd 3rd OTHER: (Specify) 7. Do you anticipate any additions to Facility? Yes If so, describe: 8. Has any grading, removal, or addition of soil been done to this property? Yes QVT~ If so, describe: 9. Are there easements/right-of-ways re orded on this property? Yes kZ~Do 10. Is a public water supply available an 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 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 PEERRTY, THERE IS AN ADDITIONAL CHARGE" Date/aO~/°~0 1 Signature of Owner or Agent z Catawba County, North Carolina FN This loop product was prepared from the Catawba County, NC, Geographic h fonnalion .System. Caum,ba Comity has made substantial efforts io ensure the accuracy of location and labeling h formotion contained on this map. Catawba Counfi promotes cmd recommends the independent verification of atm_ clata contained on this map produce by the user. The County of Catawba, ils employees, agents and personnel disclaim, and shall oat be held liable for any and all damages, loss or liabilav, whether direct, indirect or ronsequentiol which arises or may arise fom this map product or the use !hereof by nny person or e,ttirn. Legend Selected Parcel Number: 3760-13-24-0174 1 inch = 60 feet Prepared for 50 143 54 109.95 110 cr OLE b -12 99 50 110 D o - - -7T ` o MONT' -IRE 2138 ' N FIRE 0174 ° N 9163 , o X\ 35 EEK ti PI at65-186 6? 6s 37 115.02 1999 /C THIS IS NOT A LE-GAL DOCUMENT ~ Monday, March 22, 2010 04:01 PJNI f " \J AOOF CATAWBA COUNTY NC - Parcel Report Information Regarding Selected Parcel(s) Parcel ID: }3'760-13-24-0174 Name: NICKORY HOLLOW LLC Name2 Address: 211 FAIRWAY DR Address2: City: FAYETTEVILLE State: NC Zip: 28305-5571 Account: 159745322 Calc Acreage: 0.66 Tax Map: LRK: 301060 Deed Book: 2929 Deed Page: 0287 Subdivision Name: COUNTRY VALLEY PH 2 PL50-98 Subdivision Block: A Lots: 36 Plat Book: 50 Plat Page: 98 Building Number: 3277 Street Name: FORK CREEK LN Site Zip: 28610 Township: CATAWBA Fire Code: CLAREMONT RURAL City Code: COUNTY State Road: Total Bldgs Value: Land Value: $10,900 Total Value: $10,900 Year Built: Year Remodeled: Last Sale Date: Last Sale Amount: Neighborhood: 122 Watershed: WS-IV Protected Area Watershed Split: NO Voter Precinct: P5 E911 District: COUNTY Zoning: R-20 Zoning2: Zoning3: Zoning Split: N Zoning Overlay: DWMH-0,WP-0 Zoning District: COUNTY Split Zoning Dist: N Split Zoning Dist(1): 0 Split Zoning Dist(2): 0 School District: COUNTY Elementary School: CATAWBA Middle School: RIVER BEND High School: BUNKER HILL School Split: NO P&Z Case Number: Census Tract 2010: 011400 Census Block 2010: 2032 Small Area Plan: BALLS CREEK Agricultural District: Printed: Monday, March 22, 2010 04:01 PM CATAWBA COUNTY, NC BOO-A tout" west Blvd PLAN INVOICE Newton, NC 28658- Q+ 0®~ (828)465-8399 Monday, March 22, 2010 184 sM www.catawbacountync.gov Plan Case: EHPR-3-10-4482 Invoice Number: INV-3-10-260671 Environmental Health Plan Review Invoice Date: 03/22/2010 Fee Name Fee Amount Improvement Permit Fee Fixed $150.00 Authorization to Construct Fee Adjustable $150.00 (New/Expansion) Fee Total Fees Due: $300.00 PAYMENTS Date Pay Type Check Number Amount Paid Change 03/22/2010 Credit Card -1 $300.00 $0.00 Total Paid: $300.00 Total Due: $0.00 plan in4<)iccc : b4e42441-61 IT-=1359-hfb6-66tt7l~hPc4'lO8; .i l)I 03/22/2010 16:37