HomeMy WebLinkAboutEHPR-10-2022-42512.TIF BA �� THIS IS NOT PERMIT Case# EI IPR-1 0-2022-425 1 2
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„ U CATAWBA COUNTY HEALTH DEPARTMENT
PLAN REVIEW APPLICATION FOR ENVIRONMENTAL SERVICES
18. 2 sM Environmental Health Plan Review-Septic Malfunction
AUTH_CONST- SEPTIC-
MALFUNCTION
nth Se d daeM-r
Applicant TIMOTHY QUEEN,2656 SANDY FORD RD,NEWTON NC 28658
C:8283814591 TIMQUEEN1231@GMAIL.COM
NAME TO APPEAR ON PERMIT
Timothy Queen
SITE ADDRESS: 2656 SANDY FORD RD,NEWTON NC 28658 PIN# 372014337178
NAME of SUBDIVISION: COUNTRY CLUB HEIGHTS Lot# 1-8 Section/Block A
PROPERTY SIZE: Square Feet 40,510.80 Acres 0.93
DIRECTIONS: Startown Rd,Sandy Ford Rd on corner of Maple Dr
PRIMARY CONTACT: Applicant SEWER TYPE: Septic Tank
GALLONS PER DAY: 360 WATER SUPPLY: Public Water
DESCRIBE WORK: Drainfield only full or clogged
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? 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: Existing Structure
STRUCTURE TYPE: PRIMARY RESIDENCE
FACILITY TYPE: House OTHER DESCRIPTION:
DESCRIPTION OF residence
EXISTING STRUCTURES
ON SITE(IF ANY)
DIM EXISTING STRUCTURE: 82x 30 10x10 deck 6x23 front porch
NUMBER OF EXISTING BEDROOMS: 3 #OF OCCUPANTS: 4
STRUCTION
BA E6 ME Yes BASEMENT FIXTURES? J Yes PLUMBING REQUIRED?
PLOYEES PER SHIFT: NUMBER OF SHIFTS: TOTAL EMPLOYEES:
SEATING CAPACITY: TOTAL FLOOR SPACE(SQ FT):
Desired system types(Improvement Permit or Authorization to Construct):
ACCEPTED: ALTERNATIVE: CONVENTIONAL:
OTHER: INNOVATIVE: ANY:
Other described:
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