HomeMy WebLinkAboutEHPR-01-2023-43204.tif $ THIS IS NOTA PERMIT Case# EHPR-Ol-2023-43204
CATAWBA COUNTY HEALTH DEPARTMENT
\ �� PLAN REVIEW APPLICATION FOR ENVIRONMENTAL SERVICES
18 s� Environmental Health Plan Review-Septic Malfunction
AJéthS&
TH CONST- ABANDONMENT- SEPTIC MALFUNCTION
))31)3 Applicant BALANCE LLC,3358 WIKE RD,CATAWBA NC 28609
C:8284992828
Contact Person *COOL PARK PUMPING,INC (KELLY ISENHOUR), 1535 VICTORIAN MILLS CIR,CONOVER NC
28613
H:8286327 1 3713:8282562926 C:8282171596 HOME:8286327137F:828-256-2926 SAME AS PHONE 41SEN
HOUR@GMAIL.COM
Paid By MICHAELAUSTIN STARNES,3358 WIKE RD,CATAWBA NC 28609
C:8284992828
NAME TO APPEAR ON PERMIT
Balance LLC
SITE ADDRESS: 6323 ST PETERS CHURCI I RD,CONOVER NC 28613 PIN# 374502656449
NAME of SUBDIVISION: Lot# Sect:on/Block
PROPERTY SIZE: Square Feet 15,246.00 Acres 0.35
DIRECTIONS: Hwy 16 N,left St Peters Church Rd,on left just after Equestrian Farm
PRIMARY CONTACT: Contact Person SEWER TYPE: Septic Tank
GALL__WERDAY: 360 WATER SUPPLY: Public Water
DESCRIBE W01tK• 1/23/23 revise to abandon well sewage on ground see EH-01-2023-9854
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: 52 x 43
NUMBER OF EXISTING BEDROOMS: 3 #OF OCCUPANTS: 2
PROPOSED CONSTRUCTION
BASEMENT? No BASEMENT FIXTURES? No PLUMBING REQUIRED?
EMPLOYEES 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:
- PLICATION FOR WELL ABANDONMEN
ABANDONMENT TYPE: Bored
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