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HomeMy WebLinkAboutEHPR-3-10-4565 (2).TIF A C THIS IS NOT A PERMIT Case # EHPR-3-10-4565 CATAWBA COUNTY HEALTH DEPARTMENT V ~C Plan Review Application for Environmental Services 1842 sm Environmental Health Plan Review - Septic Malfunction SEPTIC-MALFUNCTION APPLICANT OWNER CONTRACTOR BILLY LITTLE BILLY LITTLE 6520 N NC 16 HWY 6520 N NC 16 HWY CONOVER NC 28613 CONOVER NC 28613 828-247-4575 828-247-4575 NAME TO APPEAR ON PERMIT BILLY LITTLE Pin#: 375501073929 SITE ADDRESS: 6490 ALICE LN, Conover, NC DIRECTIONS: HWY 16 N CONOVER TO ST PETER'S CHURCH RD TURN LEFT ON ALICE LN AND HOUSE ON LEFT, WHITE HOUSE NAME of SUBDIVISION: BILLY CHASE LITTLE Lot # PT 2 Section/Block/Phase PROPERTY SIZE: Square Feet Acres 2.14 Date Platted/Recorded TYPE OF FACILITY: House X Mobile Home Dimension of Structure Bedrooms 3 Basement: No Water Using Fixtures in Basement:No No. in Family 1 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 1st 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 property. Any representation by you of house or structure location should conform to applicable setbacks. Date: '3- D-9--a0&7 Signature of Applicant or Agent An Environmental Health Specialist will contact you within 2 wo g days of application date. ' NZ 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 FEE NAME DATE AMOUNT Side Authorization to Construct (Repair) Fee 03/29/2010 $300.00 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 03/29/10 11:22 THIS IS NOT A PERMIT WLS # CATAWBA COUNTY HEALTH DEPARTMENT Application for Environmental Services Improvement Permit ❑ Authorization to Construct El Septic Repair ❑ Septic Expansion El Existing Tank Check E] New Well Permit ❑ Replacement Well F ~ Well Abandonment O 1. Name to Appear on Permit- A' / / V C 2-' * tel 2. Permit Reque ted By t Business Phone ado Address n A/ A) ki Ve Y Home Phone 3. Property Owner s Business Phone -a Address C q L92 e' Home Phone oz r- /fS~S 4. Name of Subdivision )-y W Lot # Section/Block/Phase Property Address 141 `G v ✓ , IF Ni - /I Directions to Property: 9 v U C LAS ive v~ e- F C r 5. Property Size: Square Feet Acres Date Platted/Recorded 6. TYPE OF FACILITY House Mobile Home Dimension of Structure Bedrooms*. ' any roorrrtt dt vtii1P1 intended -()r lei mg at il1ebIne3 l cuflstructiuri or fc futni'e c nrs deratrot shou)d be noted'as a bedroom and'count~d on all applrc Tli(2 number o hcdrooms wdlb~ can limned by rooms id_erltified on house plans as a bedroom at the tzrn- tof~bB dementryes no Luce ThisWater Using Fixtures n gas"tem size meree in,the fin6r(,ement: ye no 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 1 st 2nd 3rd OTHER: (Specify) 7. Do you anticipate any additions to Facility? Yes N If so, describe: 8. Has any grading, removal, or addition of soil been done to this property? Yes dLo-j 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?/ No Check type that is available: [ ] Community well [ ] Semi-public well [-Kcounty/City/Township water line **If No, a Well Permit must be issued with the Septic Permit.** H. 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 ` d ao Signature of Owner or Agent L 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 accuracv 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: 3755-01-07-3929 1 inch = 80 feet Prepared for: I O ~ o PLAT 48-57 149.6 3 N a - co ° 3. 00 ° rn N cog ° ' ~ 1 - 0 1. 15A c9 0156 2 z02• 45 Pia 63 X158 'Q 5008 c5` 15 PLAT 37-10 6-, 2;14A~ 01 .0 3929 ~ $ (0 ~i-O 59 1 ` U 6`` PLAT 37-102 THIS IS NOT A LEGAL DOCUMENT PLAT 48-57, Monday, March 29, 2010 10:59 AM ~r - \ J CATAWBA COUNTY NC - Parcel Report Information Regarding Selected Parcel(s) Parcel ID: 3755-01-07-3929 Name: LITTLE BILLY CHASE Name2: - - Address: 6520 N NC HWY 16 Address2: City: CONOVER State: NC Zip: 28613-7413 Account: 41754000 Calc Acreage: 2.14 Tax Map: 0300 00018D LR K: 26468 Deed Book: 1020 Deed Page: 0016 Subdivision Name: BILLY CHASE LITTLE Subdivision Block: n1n`G~ I Lots: PT 2 Plat Book: 48 Plat Page: 57 Building Number: 6490 Street Name: ALICE LN Site Zip: 28613 Township: CLINES Fire Code: OXFORD City Code: COUNTY State Road: Total Bldgs Value: $372,800 Land Value: $27,300 Total Value: $400,100 Year Built: 1982 Year Remodeled: Last Sale Date: Last Sale Amount: Neighborhood: 58 Watershed: Watershed Split: Voter Precinct: P33 E911 District: COUNTY Zoning: R-20 Zoning2: Zoning3: Zoning Split: N Zoning Overlay: 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: R-144 Census Tract 2010: 010201 Census Block 2010: 1001 Small Area Plan: ST STEPHENS/OXFORD Agricultural District: PROXIMITY Printed: Monday, March 29, 2010 11:00 AM