HomeMy WebLinkAboutEHPR-2-11-9381 (2).TIF �`` THIS IS NOT A PERMIT Case # EHPR - - 11 - 9381
CATAWBA COUNTY HEALTH DEPARTMENT
0 Plan Review Application for Environmental Services
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1) t en+rti IMPROVEMENT - AUTH CONST - NEW WELL
enebrS NAME TO APPEAR ON PERMIT
CMH HOMES INC
SITE ADDRESS: 2365 BAYLEIGH DR, Vale, NC Pin#: 266801396617
NAME of SUBDIVISION:ELLENS WAY Lot # 15 Section/Block/Phase
PROPERTY SIZE: Square Feet Acres 0.479
DIRECTIONS: HWY 10 W/ RT PROVIDENCE CH RD/ LT OLD SHELBY RD/ RT JACOBS FORK RIVER RD/ RT INTO
ELLENS WAY ON BAYLEIGH DR / CORNER OF BAYLEIGHT DR & DOBBIN CT
APPLICANT OWNER O.NTRACTOR
PHILLIP MOOSE CMH HOMES INC (UNLIC) CLAYTON HOMES #118/
4716 CALLOWAY DR PO BOX 4007 MORGANTON
VALDESE NC 28681- MARYVILLE TN 37802- 1276 BURKEMONT AVEMORGANTON
(828)234 -1667 (865)380 -3000 NC 28655
828 -433 -8455
PRIMARY CONTACT: Contractor____) APPLICATION_EOR: New Construction
DIM EXISTING STRUCTURE: EXISTING FACILITY TYPE: N/A
NUMBER OF EXISTING BEDROOMS: SEWER TYPE: Septic Tank
NUMBER OF EXISTING OCCUPANTS: EXISTING WATER SUPPLY IN US
CALCULATED DESIGN FLOW:
Public water is * *NOT** available for this property.
PUBLIC WATER TYPE AVAILABLE:
DESCRIBE WORK: 2011 DW MOBILE HOME /MEETS APPEARANCE CRITERIA; MUST FACE FRONT OF PROPERTY;
MUST BE MASONRY UNDERPINNED; MUST HAVE 36 SQ.FT. DECK ON FRONT; AND TONGUE
MUST BE REMOVED OR SCREENED * *this lot has no rear setback per Connie Killian
PROPERTY EASEMENTS: NONE
PROPOSED CONSTRUCTION
PRIMARY RESIDENCE
NEW RESIDENCE? New Residence
# OF NEW BEDROOMS: 3 # OF STRUCTURE OCCUPANTS 4
PROJECT DESC: DW MOBILE HOME
PROJECT DIMENSION: 28 X 76
BASEMENT? No BASEMENT FIXTURES? No
APPLICATION FOR WELL CONSTRUCTION /ABANDONMENT /REPAIR
PROPOSED WELL TYPE: Individual Well ABANDONMENT TYPE:
WELL REPAI REQUESTED?
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: Signature of Applicant or Agent
An Environmental Health Specialist will contact you within 2 working days of application date.
If you need further information or assistance please call 828 - 466 -7291
AREA2
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02/15/11 10:10
gA CATAWBA COUNTY Case ii EHPR -2 -1 1 -9381
�j� Public Health Department
Subdivision ELLENS WAY
.� Environmental Health Division - Plan Review
75 0 "c' PO Box 389, 100-A Southwest Blvd, Newton, NC 28658 Lot# 15
t8 2 su PIN# 266801396617
Applicant/Owner PHILLIP MOOSE, 4716 CALLOWAY DR, VALDESE NC 28681 -
Site Address: 2365 BAYLEIGH DR, Vale, NC
Property Size: SF 0.479 ACRES
Directions: HWY 10 W/ RT PROVIDENCE CH RD/ LT OLD SHELBY RD/ RT JACOBS FORK RIVER RD/ RT INTO ELLENS WAY
ON BAYLEIGH DR / CORNER OF BAYLEIGHT DR & DOBBIN CT
Minimum SetbacKs: Front: 30 Side: 15 Rear: 0 Side St:30 Max Height:
FEE NAME DATE AMOUNT BALANCE DUE
Authorization to Construct Fee (New /Expansion) Fee 02/11/2011 $150.00 $0.00
Improvement Permit Fee 02/11/2011 $150.00 $0.00
Well Permit & Inspection Fee 02/11/2011 $300.00 $0.00
TOTAL FEES $600.00 $0.00
CHANGE WORK ORDER REQUIRING REDESIGN AND /OR RETRIP WILL INCURE AN ADDITIONAL CHARGE
(SEE FEE SCHEDULE)
02/15/11 10:10