HomeMy WebLinkAboutEHPR-06-2022-41259.TIF Sla• '1'1I1S IS NOT A PERMIT Case# E,l'lPR-06-2022.41259
�-3 CAIAWBA COUNTY 1-IIE,AL;I'H DI PAR'I'MFNT
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PLAN REVIEW APPLICATION FOR ENVIRONMENTAl.SERVICES
t • • w Environmental Health Plan Review-Septic Malfunction
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PROVEMENT- ACJTH CONST- EXPANSION- SEPTIC_MALF
!'I J? la UNCTION
Applicant •REAI TY SOLUTIONS DE NC TLC (BENJAMIN LARRABEE). 136 13111 ST NW,I IICKORY NC 28601
B:8286393014 C:8286393014 BLARItABEh27(n)GMAII..COM
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t Contractor ECOCI.EAN SEPTIC (WILLIAM GARRISON), 1936 JAMESI'OWN RD,MORGANTON NC 28655
13:8283341537 C:8284432537
NAME TO APPEAR ON PERMIT
'Realty Solutions of NC LLC (Benjamin Larrabee)
SITE ADDRESS: 2059 ZION CHURCI I RI),HICKORY NC 28602 - PIN# 370015648967
G S HILDEBRAN FARM 36&37
NAME of SU RUI V ISION: 1.o111 Section/Block
PROPERTY SIZE: Square Feer64,468.80 Acres_._.._1.48
DIRECTIONS: Zion Church Rd on left past past Bethel Church Rd
PRIMARY CONTACT: Contractor SEWER TYPE: Septic.Tank
GALLONS PER DAY: 360 WATER SUPPLY: Private Well
„...—tESLNlue-W 13/22 REVISE TO REPAIR EXPANSION TO UPDATE TO 3 BEDROOM
REVIOUS DESCRIPTION: replace tank and drainfield Tank Collapsed hole filled
SI INFORMATION
Do any of the following apply to the properly 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? Yes
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: Exieting Structure
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STRUCTURE TYPE: PRIMARY RESIDENCE
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FACILITY TYPE: House OTHER DESCRIPTION:
DESCRIPTION OF residence
EXISTING STRUCTURES
ON SITE(IF ANY)
DIM EXISTING STRUCTURE: 74 x 41
NUMBER OF EXISTING BEDROOMS: 3 #OF OCCUPANTS:
PROPOSED CONSTRUCTION
BASEMENT? Yes BASEMENT FIXTURES? Yes 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:
1 el.:ggdu see+ 07I13/2022 09.06 Vacs 1016
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*°w CA'1'AWIIAC(lUN'1'Y Cascq EHPR-06-2022-4125t)
C//1 fi li Public Health Department Subdivision G S HILDEBRAN FARM
\( 1 larvironmental I lcalth Ui vision
l^\'fir PO Hex 3N9, I(IU-A Southwest 141vd,Newton,
NC ?KhSN PINK 370015648967
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i NAME ON PERMIT: *REALTY SOLUTIONS OF NC I.LC ( BENJAMIN LARRAIWE). 136 131.11 ST NW.I IICKORY NC 28601
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'Realty Solutions of NC LLC (B
site Address: 2059 ZION CITIJIWI I RI).I IICKORY NC 28602
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1 Property Size: Square Feet 64.468.80 Acres 1.48
I Directions: Zion Church Rd on left past past Bethel Church Rd
I 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
iseptic repair is valid for 60 months(5 years).Permits may be revoked it the information on this applicatioNsite plan changes or if the intended use for the
I proposed facility changes. Permits may be revoked it site conditions aro 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
tresponsible for the proper identification and labeling of all properly lines and corners and making the site accessible so that a complete site evaluation
can be performed.
1 The undersigned is the owner of the property or legal agent of the owner.
Date: 7- LZ Signature ul'A Jicalu or Agent ,,
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II you need further information or assistance please call 828-465-8270
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1 AREA1
1 FEENA ME DATE PEE AMOUNT
Authorization'to Construct(Repair)Fee 0o/032022 S300 01l
I TOTALFEESS300.00
FEES ARE NON-REFUNDABLE
ONCE A SITE VISIT IS MADE OR
WORK ON A PLAN REVIEW IDS COMMENCED
SYSTEM REDESIGN AND/OR RETRIP WILL INCUR AN ADDITIONAL CHARGE
(SEE FEE SCHEDULE)
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deippli,o�"'° 117/1312022 00:03 fear 2 01I.