HomeMy WebLinkAboutEHPR-4-11-10426 (2).TIF �� C O� THIS IS NOT A PERMIT Case # EHPR-4-1 1-1 0426
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� � CATAWBA COUNTY HEALTH DEPARTMENT
c�.� �;� �°� ''C Plan Review Application for Environmental Services
1�42 5M Environmental Health Plan Review - OSWP
�a s�� I�I c 6I�, IMPROVEMENT
:��;-` i- -� - NAME TO APPEAR ON PERMIT
RALPH EDWARD SHRUM
siYE a��RESS: 2420 TIMBERLAND HILLS DR, Newton, NC Pir►#: 371110370113
NAME of SUBDIVISION: Lot # Section/I31ock/Phase
PROPERTY SIZE: Square Feet Acres 1.259
DIRECTIONS: 10 W/ RT ON ROBINSON RD / LF WAKEFIELD / 1 ST HOUSE ON LEFT
PPLICANT OWNER CONTRACTOR
CHRIS RIES CHRIS RIES RALPH EDWARD SHRUM CHRIS RIES
3794 CLYDANNIE DR 2405 TIMBERLAND HILLS DR 3794 CLYDANNIE DRNEWTON NC
NEWTON NC 28658 NEWTON NC 28658 28658
(828)449-0294 (828)322-6907 (828)449-0294
_ cries@earthl�et cries@earthlink. net
PRIMARY CONTACT: Contractor APPLICATION FOR:
DIM EXISTING STRUCTURE: 26 x 32 EXISTING FACILITY TYPE: House
NUMBER OF EXISTING BEDROOMS: 2 SEWER TYPE: Septic Tank
NUMBER OF EXISTING OCCUPANTS: 2 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: 10 x I S uncovered deck to side of house
DESCRIPTION OF House
EXISTING STRUCTURES
ON SITE (IF ANY)
PROPERTY EASEMENTS: none
PROPOSED CONSTRUCTION
PRIMARY RESIDENCE
NEW RESIDENCE? Add/Alt to Residence
# OF NEW BEDROOMS: 0 # OF STRUCTURE OCCUPANTS:
PROJECT DESC: Uncovered Deck
PROJECT DIMENSION: 10 x 15
BASEMENT? No BASEMENT FIXTURES? No
I understand that this is a formal appiication 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 resuit of this information is
transferable and may be eligible for a norrexpiring 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 properly. Any representation by you of house or
structure location should conform to applicable setbacks.
Date: Signature ofApplicant 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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Minimum Setbacks Front: 40 Side: 10 Rear: 40 Side St: Max Height:
04l18(ll 10:51