HomeMy WebLinkAboutEHPR-4-11-10288 (2).TIF �$� C� THIS IS NOT A PERMIT Case # EHPR-4-11-10288
�` � CATAWBA COUNTY HEALTH DEPARTMENT
v , y� ''C Plan Review Application for Environmental Services
1g�}2 sM Environmental Health Plan Review - OSWP
. ►r .
i' l� C'e�rr��� EXS SYSTEM
�� � NAME TO APPEAR ON PERMIT
Rita Moore
SITE ADDRESS: 5414 BJ DR Conover, NC Pintt: 374412775195
NAME of SUBDIVISION: Lot # 2A Section/Block/Phase
PROPERTY SIZE: Square Feet Acres 0.509
DIRECTIONS: off Lee Cline on to Eckard Rd - Right on BJ Dr - 2nd house on left
APPLICANT OWNER CONTRACTOR
Rita Moore Rita Moore
5414 BJ DR 5414 BJ DR
Conover NC 2861�79ll Conover NC 28613-7911
828-446-63 87 828-446-63 87
PRIMARY CONTACT: Owner APPLICATION FOR: Existing Structure
DIM EXISTING STRUCTURE: 12 x 56 EXISTING FACILITY TYP obile Home
NUMBER OF EXISTING BEDROOMS: 2 SEWER TYP : eptic an c
NUMBER OF EXISTING OCCUPANTS: 1 EXISTING WATER SUPPLY IN USE: Private Well
CALCULATED DESIGN FLOW:
Public water is *''NOT"* available for this property.
PUBLIC WATER TYPE AVAILABLE: N/A
DESCRIBE WORK: 12 x 18 Sunroom Addition to rear of house
DESCRIPTION OF Mobile Home
EXISTING STRUCTURES
ON SITE (IF ANY)
PROPERTY EASE none
PROPOSED CONSTRUCTION
PRIMARY RESIDENCE
NEW RESIDENCE? Add/Alt to Residence
# OF NEW BEDROOMS: 0 # OF STRUCTURE OCCUPANTS:
PROJECT DESC: Sunroom Addition
PROJECT DIMENSION: 12 x 18
BASEMENT? No BASEMENTFIXTURES? No
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. 1 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 nor�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 properiy. 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: 15 Rear: 30 Side St: Max Height:
44! 11 J 11 09:40