HomeMy WebLinkAboutEHPR-3-11-9679 (2).TIF g' THIS IS NOT A PERMIT Case # EHPR 3 -11 -9679
d - CATAWBA COUNTY HEALTH DEPARTMENT
v '' .��. Plan Review Application for Environmental Services
1842 sM Environmental Health Plan Review - OSWP
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P,tfi9C� II) eta ee t IMPROVEMENT
data & 1 31 %III NAME TO APPEAR ON PERMIT
1 TROY SIGMAN
SITE ADDRESS: 5051 S NC 127 HWY, Hickory, NC Pin#: 269913243406
NAME of SUBDIVISION: Lot # 1 Section/Block/Phase
PROPERTY SIZE: Square Feet Acres 1.429
DIRECTIONS: HWY 10 W TO PROPST CROSSROADS/ RT ON 127/ GO 1/2 MILE/ LOT ON LEFT
APPLICANT OWNER CONTRACTOR
TROY SIGMAN TROY SIGMAN
5051S NC 127 HWY 5051S NC 127 HWY
HICKORY NC 28602 HICKORY NC 28602
828 - 308 -8866 828 -308 -8866
PRIMARY CONTACT: APPLICATION FOR: New Construction
DIM EXISTING STRUCTURE: 28 x 60 EXISTING FACILITY TYPE: House
NUMBER OF EXISTING BEDROOMS: SEWER TYPE: Septic Tank
NUMBER OF EXISTING OCCUPANTS. EXISTING WATER SUPPLY IN USE: Public Water
CALCULATED DESIGN FLOW: -
Public water IS available for this property.
PUBLIC WATER TYPE AVAILABLE:
DESCRIBE WORK: PVT POLE SHED 48 X 30 / metal truss only w/ wood poles
DESCRIPTION OF single family dwelling
EXISTING STRUCTURES
ON SITE (IF ANY)
PROPERTY EASEMENTS: none
PROPOSED CONSTRUCTION
ACCESSORY STRUCTURES
DESCRIPTION: PVT POLE SHED
# OF NEW BEDROOMS: 0 STRUCTURE DIMENSIONS: 48 X 30 ACC DWELLING? No
PLUMBING? No NONE # OF STRUCTURE OCCUPANTS: 0
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
Minimum Setbacks: Front: 30 Side: 10 Rear: 5 Side St: Max Height:
03/08/11 09:08
,gA CATAWBA COUNTY Case # EHPR - - - 9679
;7 m G % Public Health Department Subdivision
., Environmental Health Division - Plan Review
1 7 PO Box 389, 100-A Southwest Blvd, Newton, NC 28658 Lot# 1
841 PIN# 269913243406
Applicant/Owner TROY SIGMAN, 5051 S NC 127 HWY, HICKORY NC 28602
Site Address: 5051 S NC 127 HWY, Hickory, NC
Property Size: SF 1.429 ACRES
Directions: HWY 10 W TO PROPST CROSSROADS/ RT ON 127/ GO 1/2 MILE/ LOT ON LEFT
FEE NAME DATE AMOUNT BALANCE DUE
Improvement Permit Fee 03/04/2011 $150.00 $0.00
TOTAL FEES $150.00 $0.00
CHANGE WORK ORDER REQUIRING REDESIGN AND /OR RETRIP WILL INCURE AN ADDITIONAL CHARGE
(SEE FEE SCHEDULE)
03/08/11 09:08