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HomeMy WebLinkAboutEHPR-01-2022-39798.TIF 4$� •G THIS IS NOTA PERMIT Case# EHPR-01-2022-39798 Q'' E Ilin CATAWBA COUNTY HEALTH DEPARTMENT / PLAN REVIEW APPLICATION FOR ENVIRONMENTAL SERVICES 1 2 su Environmental Health Plan Review-OSWP IMPROVEMENT 61?1» kev,Std Applicant LESLIE HUGHES,5018 HONDA DR,HICKORY NC 28602 C:8284467160 Owner STEVEN HUGHES,5018 HONDA DR,HICKORY NC 28602 NAME TO APPEAR ON PERMIT STEVEN HUGHES SITE ADDRESS: 5180 WHITENER RD,HICKORY NC 28602 PIN# 360901052234 NAME of SUBDIVISION: Lot# 2 Section/Block PROPERTY SIZE: Square Feet 91,693.80 Acres 2.105 DIRECTIONS: take exit 37 west to Hwy 10 turn right,stay straight to Whitener Rd on right turn go past 5160 Whitner Rd take next right PRIMARY C C., _CT: Applicant SEWER TYPE: Septic Tank • ONS PER DAY: 480 WATER SUPPLY: Private Well _ DESCRIBE WOR • 6/2/22 REVISED 45 X 80 INCLUDING DECKS 4 BEDROOM IP only for property subdivision SITE INFORMATION Do any of the following apply to the property for which this application is applied? If the answer to any of the questions below is"YES",then supporting documentation is required: Does this site contain any jurisdictional wetlands? No Does this site contain any existing wastewater systems? No Is any of the wastewater going to be generated on the site other than domestic sewage? No Is the site subject to approval by any other public agency? No Are there any easements or right-of-ways on this property? No APPLICATION FOR: New Structure STRUCTURE TYPE: PRIMARY RESIDENCE FACILITY TYPE: House OTHER DESCRIPTION: DESCRIPTION OF EXISTING STRUCTURES ON SITE(IF ANY) DIM EXISTING STRUCTURE: NUMBER OF EXISTING BEDROOMS: #OF OCCUPANTS: 4 PROPOSED CONSTRUCTION NEW STRUCTURE DIM:: 45 X 80 INCLUDING DECKS #OF NEW BEDROOMS:: 4 No BASEMENT FIXTURES? No PLUMBING REQUIRED? EMPLOYEES PER SHIFT: NUMBER OF SHIFTS: TOTAL EMPLOYEES: SEATING CAPACITY: TOTAL FLOOR SPACE(SO FT): Desired system types(Improvement Permit or Authorization to Construct): ACCEPTED: ALTERNATIVE: CONVENTIONAL: OTHER: INNOVATIVE: ANY: Other described: chapplication 06/02/2022 12:46 Page 1 of 3 `i CATAWBA COUNTY Case# EHPR-01-2022-39798 :.' Public Health Department Subdivision �_) Environmental Health Division PIN# 360901052234 PO Box 389,100-A Southwest Blvd,Newton,NC 28658 SM NAME ON PERMIT: (STEVEN HUGHES),5018 HONDA DR,HICKORY NC 28602 (STEVEN HUGHES) Site Address: ' 5180 WHITENER RD,HICKORY NC 28602 Property Size: Square Feet 91,693.80 Acres 2.105 Directions: take exit 37 west to Hwy 10 turn right,stay straight to Whitener Rd on right turn go past 5160 Whitner Rd take next right Completed applications are valid for a period of 2 years.Improvement Permits are valid:with complete site plan=60 months(5 years);with complete plat =without expiration. An Authorization to Construct will remain valid as long as the Improvement Permit is valid.An Authorization to Construct issued for septic repair is valid for 60 months(5 years).Permits may be revoked if the information on this application/site plan changes or if the intended use for the proposed facility changes. Permits may be revoked if site conditions are altered such that they effect permit conditions or installation requirements I have read this application and certify that the information provided herein is true,complete and correct. Authorized county and state officials are granted right of entry to conduct necessary inspections to determine compliance with applicable laws and rules. I understand that I am solely responsible for the proper identification and labeling of all property lines and corners and making the site accessible so that a complete site evaluation can be performed. The undersigned is the owner of the property or legal agent of the owner. Date: (� -01`A O'� Signature of Applicant or Age If you need further information or as ' ce ease call 8 8-46 270 AREA1 - 4i#t#t......i#1##it###k#ik#iM##tk4t##k##t/tR#ktt/ttititFMi/iii#tiitiRi#t#iitiiFt#t 1F...........itttit......R FEENAME ` t� x, at ..... _.._. ' ; a,,,, DATE : _x 1_ FEEAMOUNT Improvement Permit Fee 01/14/2022 S150.00 i TOTALFEES3' 33� �` 3,: � '��lsl iiTJ � i $150.0}" FEES ARE NON-REFUNDABLE ONCE A SITE VISIT IS MADE OR • WORK ON A PLAN REVIEW HAS COMMENCED SYSTEM REDESIGN AND/OR RETRIP WILL INCUR AN ADDITIONAL CHARGE (SEE FEE SCHEDULE) ehapplication 06/02/2022 12:46 Page 2 of 3