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HomeMy WebLinkAboutEHPR-3-10-4497 (2).TIF ys~A C THIS IS NOT A PERMIT Case # EHPR-3-10-4497 CATAWBA COUNTY HEALTH DEPARTMENT U Plan Review Application for Environmental Services Environmental Health Plan Review - OSWP 1842 SM SEPTIC-MALFUNCTION APPLICANT OWNER CONTRACTOR STEPHEN JULIAN STEPHEN JULIAN 706 E MAIN ST 706 E MAIN ST CHERRYVILLE NC 28021-3419 CHERRYVILLE NC 28021-3419 704-419-4493 704-419-4493 NAME TO APPEAR ON PERMIT STEPHEN JULIAN Pin#: 375513147803 SITE ADDRESS: 6270 N NC 16 HWY, Conover, NC DIRECTIONS: HWY 16 N - 1/2 MILE ON RIGHT PASS OXFORD BAPTIST CHURCH (GRAY HOUSE) NAME of SUBDIVISION: Lot # PT I OA Section/Block/Phase PROPERTY SIZE: Square Feet Acres 0.889 Date Platted/Recorded TYPE OF FACILITY: House X Mobile Home Dimension of Structure 33 X 63 Bedrooms 2 Basement: No Water Using Fixtures in Basement:No No. in Family 2 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 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 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: ^c;2 Signature of Applicant or Agent 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 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 03/23/2010 5300.00 Rear 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 03/23/10 15:33 ' THIS IS NOT A PERMIT 0C." 1/412 CATAWBA COUNTY HEALTH DEPARTMENT Application for Environmental Services Improvement Permit ❑ Authorization to construct ❑ Septic Repair KT"~ Septic Expansion ❑ Existing Tank Check ❑ New Well Permit E] Replacement Well ❑ Well Abandonment ❑ 1. Name to Appear on Permit _~5-11e y y L` A- 2. Permit Requested By 5 % y-e ~,T u Z- I y ti Address G ~Z 7 /I/ ,51 w Business Phone V/ 6 e ti©v Home Phone 700 y/ L4 C-1 3 3. Property Owner -57-7rt' i-e ~r c~ L / •t, Business Phone Address w Home Phone o 1-1 Lt i -t H 1-4 cY 3 4. Name of Subdivision Lot 4 Section/Block/Phase Property Address ell Z ?C`j Directi ns to P operty: 5. Property Size: Square Feet Acres 9 Date Platted/Recorded 6. TYPE OF FACILITY House Mobile Home Dimension of Structured Bedrooms* *An. roora,th it„ ill inland d for sleeping at tli"( tiny construc n or, inzfiituze cods derat~on should be noted as `a bedroom `and counteJ n all appl~catron . Ch',? number of bedrooms wi1115C confirmed I roorrisidentified on-house glans as a bedroom at tiie tune uL,i~ulldtngermitwissuaiic c This may przVeut the need::or systEU~ size rrlc e m the futufe Basement: yes Water Using Fixtures in Basement: yes o No. in Family Whirlpool Tub yes/9 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 Ist 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 / o If so, describe: 9. Are there easements/right-of-ways recorded on this property? Yes /(,10) 10. Is a public water supply available on or adjacent to the above prope ./0 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 Pennit.** 11. Well Type Applying For: [v]'Tndividual 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 Jy Signature of Owner or Agent /yam Wiz. Catawba County, North Carolina N This map product was prepared fi am 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 County promotes and recommends the independent verification of any 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: 3755-13-14-7803 l inch = 60 feet Prepared for: y all W PLAT '1 8-7-'1187 17 (380) 0 0 1 14 ° N 7904 2 N (378) co 0 O 10A P 0 7803 (375) R~ "YPy77 z F7 z~ Lj THIS IS NOT A LEGAL DOCUMENT Tue, March 23, 2010 03:15 PM CATAWBA COUNTY NC - Parcel Report Information Regarding Selected Parcel(s) Parcel ID: 3755-13-14-7803 Name: JULIAN GEORGE STEPHEN Name2: Address: 706 E MAIN ST Address2: City: CHERRYVILLE State: NC Zip: 28021-3419 Account: 37011990 Calc Acreage: 0.89 Tax Map: 0900 00014 LRK: 42482 Deed Book: 1828 Deed Page: 0868 Subdivision Name: Subdivision Block: Lots: PT 10A Plat Book: 11 Plat Page: 66 Building Number: 6270 Street Name: N NC 16 HWY Site Zip: 28613 Township: CLINES Fire Code: OXFORD City Code: COUNTY State Road: Total Bldgs Value: $59,300 Land Value: $13,100 Total Value: $72,400 Year Built: 1926 Year Remodeled: Last Sale Date: Last Sale Amount: Neighborhood: 67 Watershed: WS-IV Protected Area Watershed Split: YES 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: 1016 Small Area Plan: ST STEPHENS/OXFORD Agricultural District: PROXIMITY Printed: Tue, March 23, 2010 03:15 PM ~'A C~ CATAWBA COUNTY, NC I00-A South West Blvd PLAN RECEIPT Q+ f ] Newton, NC 28658- v (828)465-8399 Tuesday, March 23, 2010 18 4 Z sM www.catawbacoLintync.gov Plan Case: EHPR-3-10-4497 Invoice Number: INV-3-10-260714 Environmental Health Plan Review Invoice Date: 03/23/2010 Site Address: 6270 N NC 16 HWY, Conover, NC APPLICANT OWNER STEPHEN JULIAN STEPHEN JULIAN 706 E MAIN ST 706 E MAIN ST CHERRYVILLE NC 28021-3419 CHERRYVILLE NC 28021-3419 704-419-4493 704-419-4493 Fee Name Fee Amount Authorization to Construct (Repair) Fee Adjustable $300.00 Total Fees Due: $300.00 PAYMENTS Date Pay Type Check Number Amount Paid Change 03/23/2010 Credit Card -1 $300.00 $0.00 Total Paid: $300.00 Payer: STEVE JULIAN Total Due: $0.00 plan reccipt ;ce576283-X261-420c 97fd-chsefcf5c56cI,rpt 03/23/2010 15:33