HomeMy WebLinkAboutEHPR-4-11-10388 (2).TIF .� � THIS IS NOT A PERMIT Case # EHPR-4-11-10388
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,� CATAWBA COUNTY HEALTH DEPARTMENT
V ,.�',�'' ''C Plan Review Application for Environmental Services
1 q 2 SM Environmental Health Plan Review - OSWP
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�� �'��l���.�- �� NAME TO APPEAR ON PERMIT
Janet Sparks
SITE ADDRESS: 2685 CINDI LN Claremont, NC Pirr�: 377106499845
NAME of SUBDIVISION:FOX HOLLOW Lot # 3 Section/Block/Phase
PROPERTY SIZE: Square Feet Acres 0.959
DIRECTIONS: HWY l0E/ TURN LF ON �TH ST SW/ LF ON OLD CATAWBA RD/ GO ABOUT 2 MILES & TURN LF INTO
FOX HOLLOW SUBDN/ THIS WILL BE CINDI LN/ FOLLOW ACROSS EVE DR
APPLICANT OWNER �CONTRACTOR
Janet Sparks Janet Sparks
PO Box 546 PO Box 546
Claremont NC 2861Q0546 Claremont NC 28610-0546
704325-0872 704325-0872
PRIMARY CONTACT: Owner APPLICATION FOR: New Construction
DIM EXISTING STRUCTURE: 12 x 60 EXISTING FACILITY TYPE: Mobile Home
NUMBER OF EXISTING BEDROOMS: 2 SEWER TYPE: Septic Tank
NUMBER OF EXISTING OCCUPANTS: 0 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 16 Storage Building
DESCRIPTION OF 12 x 60
EXISTING STRUCTURES
ON SITE (IF ANY)
PROPERTY EASEMENTS: none
PROPOSED CONSTRUCTION
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ACCESSORY STRUCTURES
DESCRIPTION: Storage Building
# OF NEW BEDROOMS: STRUCTURE DIMENSIONS: 12 x 16 ACC DWELLING?
PLUMBING? No # OF STRUCTURE OCCUPANTS:
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 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 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
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Minimum SetbacKs Front: 30 Side: 10 Rear: 5 Side St: Max Height:
04/20/ 1 I 14:50