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Home My WebLink AboutEHPR-5-11-10876 (2).TIF y� C THIS IS NOT A PERMIT Case # EHPR-5-11-10876 y " G �' � CATAWBA COUNTY HEALTH DEPARTMENT v ,;� '�' Plan Review Application for Environmental Services 1842 sM �nvironmental I�ealth Plan Review - OSWP �� ct �?;,;�� C � �,.,N EXS SYSTEIPA ' NAME TO APPEAR ON PERMIT SF9ELBY CHESSON siTe a��Ress: 974 ASHTON GLEN CIR, Hickory, NC Pir,�e: 360901464142 NAME of SUBDIVISION:ASHTON GLEN PH 1 Lot# 54 Section/Block/Phase PROPERTY SIZE: Square Feet Acres 0.46 DIRECTIONS: 321 S/ RIVER RD EXIT/ RT AT STOP SIGN/LF AT STOP SIGN ONTO ZION CHURCH / RT ONTO PITTSTOWN RD/ LF FINGERBRIDGE RD/ RT ONTO ASHTON GLEN CIR/ 1ST LF ASTON GLEN/ 2ND HOUSE ON LF # 974 APPLICANT OWNER CONTRACTOR Harrell Construction & Remodeling SHELBY CHESSON RANDY FOREHAND HARRELL 7R 974 ASHTON GLEN CIR PO BOX 9612 HICKORY NC 28602 HICKORY NC 28603- (828)320-7386 �ay�q�e�}�ail.com Applicant APPLICATION FOR: Existing Shucture DIM EXISTING STRUCTURE: 30 X 50 EXISTING FACILITY TYPE: House NUMBER OF EXISTING BEDROOMS: 3 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: County/City/Township Water DESCRIBE WORK: ADDING COVERED DECK 29 X 20 DESCRIPTION OF HOUSE 30 X 50 EXISTING STRUCTURES ON SITE (IF ANY) PROPOSED FUTURE ADDITIONS NONE OR IMPROVEMENTS: PROPERTY EASEMENTS: NONE PROPOSED CONSTRUCTION PRIMARY RESIDENCE NEW RESIDENCE? Add/Alt to Residence # OF NEW BEDROOMS: 0 # OF STRUCTURE OCCUPANTS: PROJECT DESC: ADDING COVERED DECK 29 X 20 PROJECT DIMENSION: 29 X 20 BASEMENT? BASEMENT FIXTURES? 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 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 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 E��E�2 ******�*x�**�***********�*�:x+�x+*+***********+****+*+**************+**�*******�****�*�******+******+**+*****+*********** OS/16/11 15:07 � ; o � �S � �v3 -� � Q os,�d � c��avv�� o�v� ��rx ��a��v� I WLS# G -c�oZ / IP� // Telephone _) 465-� 70 TDD (828) 465-8200 � � AC Y Rpr Prmt. Opr Prmt. ys Type Well Prmt. Replacement Well Welt Rpr Prmt. Owner/Agent Phone �- tid� Address / Subdivisio � l'�..P�r,,,i» Section/Block/Phase Lot/1 �-S" 1/ Lot Size < <j cECiye. `� ° -�- , , Properry Address '° � (� Facility• House�,� Mobile Home Business Multi-family Other• Pin Number - p Other Zoning Approval # # Bedrooms �{ Seats fi� Employees Appl�cation Rate , GPD Flow Hot Tub or Spa yes/no Spec�al Fixtures Basemen�/no 100% Repa�r Area o Basement Plumbin�no Water Suppiv• Private Well Public_ fGSemi-Public *+**********�*�*�:*s******�*�******�***�*�******«***+*******�*�*********�***+***:*s*************r***r****s***********r��***� T}'pe of System. Trench Bed Pump Pump/Panel Panel LPP Other� o� ,�� 9-_� Septic Tank Size Dpd Pump Tank Size NitriCcation Field. Total Square Feet�_ Depth of Stone�� Bed S�ze Trench Width � Total Length of All Trenches � G!7 Number of Trenches � Trench Length�//�r1 /�Ba /�a0 /_/_ Feet on Center Maximum Trench Depth Distance of Nearest Well �a � *DO NOT INSTALL SEPTIC WHEN WET'� *WELL RE ORD REQUIRED AT COMPLETION* *�***�******s**«***** **********:**�******��►***�******** Topo � % Slope � ��-�"`�' -' 1 Texture � Structure -� � Clay Min. ' � Soil Wetness � ��, �b{/Y Soil Depth ' " � �. -� /�� • Restric Hoz at � � 1 �'`� � Available space /no � �� Overall Class � U � —' —�, - _ Comments ._ .---- •� - i - - - - - .._ _.. � �o � '` -.r'� � i �� i i i i � � �. � �, � i � � Filter Required � • Riser required when � tank is more than 6 � inches deep. � **NO GUARANTEE OR WARRANTY IS IMPLIED OR GIVEN AS TO THE PERFORMANCE OR LENGTH OF TIME THIS SYSTEM WILL FUNCTION'"* r*rr*r******s*****�**��s«t***�*�*�x*�r+*t**�**r*�***r***r***s**«r+r�r»***#*�*s:*rr***:***.*+*******t*********�****r**«******�* *Improvement Permit has no expiration date and is transferable, but may be revoked if site plans or intended use changes for the proposed facility An Authorization to Construct is valid for (S� five years from date issued and is not transferable. Well Permit valid for 5 years provided site conditions do not change. Well (ocation, installation, and protection must meet state and locat regulations, and must be inspected and approved by a representative of the Catawba County I�ealth Department before any portion of the installation is put into use, The siting of the wel! by the Health Department staff is to provide protection from known possible sources of contamination. No volume of water is guaranteed at any site by the Healfh Department. Permit Date � • EHS p � ` 'Y Owner/Age Septic Tank Installed By , Date� �--3•.-p � EHS Well Installed By Well Grout Approval Date Well Head Approval Date Date Sample Collected Dace of Results Results EHS White Office Yellow - Owner/Agenc Pink.- Buildir.g Inspection Authorization to Construct Cat�wba Co�nty, l�or°th C�ro��na N This map product was prepared from the Catawba Counry, NC. Geographic Information System. Catawba Counry has made substantial efforts to ensure the accuracv of location and labeling information contained on this map. Catawba County promotes and recommends the independent verification of any data contained on this map product by the user. The County of Catawba, its employees, agents and personnel disclaim, and shall not be held liable for any and all damages, loss or liability, whether direct, indirect or consequential which arises or may arise from this map product or the use thereof by a�ry person or entiry. Legend Selected Parcel Number: 3609-01-46-4142 1 inch = 40 feet Prepared for: � `�- . ^ �� „� `�`°d- 9$,0,— d'�,_� °`!� `� �= t ' ° '�-�.. � � • � -- � �� \. `'`� --�--_.� � ,� ---._ � �._.,.�.�y � `~ `` - ` a. �,.,_._----�--- ��, -� � �, ,R� .,�... � �12 . � �.� �. m � L4 1 , '1 ,�.��.. � . �._ � v�� t ,,..____ -��.....� �''-�._ � � ! � �~�.�I � � _ �� e `1\ � � �� 1 \ � � 54 � 53 � �� ,�o � � � . 52 THIS IS NOT A LEGAL DOCUMENT Monday, May 16, 201109:43 AM /