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161 Antler Ln' V yo DAVIE COUNTY HEALTH DEPARTMENT !%, :. ' y j IMPROVEMENTS PERMIT AND CERTIFICATE OF COMPLETION 4 'NOTE: Issued in Compliance With Article II of G.S. Chapter 130a t` Sanitary Sewage Systems G� Permit Number Name`' ,rf� �' ,� f'%11C��> j; y/,C'r'�°`/0 r`%�1 Date .L �S'�� NO 6903 Location /--IL'2Ze- .!fir i / �� �� r , �i'1�.� :� / �✓r r ���,(% Subdivision Name Lot No. Sec. or Block No. Lot Size House f' Mobile Home _ Business Speculation No. Bedrooms No. Baths No. in Family & _ Garbage Disposal YES Q NO Specifications for System: Auto Dish Washer YES NO Auto Wash Ma .hive YES � NO p p�,aX / _ � Type Water Supply �V �® 'This permit Void if sewage system described below is not installed within 5 years from date of issue. This permit is subject to revocation if site plans or the intended use change. Improvements permit by _.—AQ(l 'Contact a representative of the Davie County Health Department for final inspection of this system between 8:30- 9:30 A.M. or 1:00-1:30 P.M. on day of completion. Telephone Number 704-634-5985. Final Installation Diagram: System Installed by Certificate of Completion \ Date 'D " 'The signing of this certificate shall indicate that the system described, above has been installed in compliance with the standards set forth in the above regulation, but shall in NO way be taken as a guarantee that the system will function satisfactorily for any given period of time. ` APPLICATION FOR SITE EVALUATION/IMPROVEMENTS P Davie County Health Department Environmental Health Section P. O. Box 665 Mocksville, NC 27028 for t 1. Application/Permit Requested By Mailing Address Home Phone 2. Name on Permit if Different than Above 3. Application/Permit for: 4. System to Serve: House ❑ Business ❑ Industry 5. If house, mobile home: Subdivision IE a W [E SfP -41992 No. of People No. of Bedrooms No. of Bathrooms z - ❑ General Evaluation ❑ Mobile Home ❑ Other Dwelling Dimensions 6. If business, industry, place of public assembly, other:, Specify type No. of People Served No. of Sinks. Septic Tank Installation ❑ Place of Public Assembly ❑ Unknown Section Lot # ❑ Basement/Plumbing ❑ Basement/No Plumbing 9� ,Washing Machine ishwasher ❑ Garbage Disposal No. of Commodes No. of Urinals No. of Lavatories No. of Water Coolers No. of Showers Water Usage Figures 7. Type of water supply: ❑ Public Private 8. Property Dimensions `. dC�,Q- Sewage Disposal Contractor 9. Do you anticipate additions/expansion of the facility this sytem is intended to serve? ❑ Yes If vas_ what tvna? ME ❑ Community 'NOTE: _Improvements Permits shall be valid for a period of 5 years from date issued. Improvements Permits are subject to revocation, if site plans or the intended use change. Effective October 1, 1989. Directions to Property: �a n r � �n� M � � � ^� 0� e0 r b motor' �� as S C � ' l >y»(�A vtGF+ ori K t5 14' 0 ..P c.�►�,c• 7� ©,• This is to certify that the information provided is correct to the best of my incurred from this application. DATE and I understand I amk responsible for all charges SIGNATURE CONSENT FOR SITE EVALUATION TO BE DONE ON ABOVE DESCRIBED PROPERTY MUST CHECK ONE: 1. 1 OWN the property. ❑ 2. 1 DO NOT OWN the property. If you checked Box #2, the rest of this fo m MUST be completed by the owner or a person authorized by the owner: I hereby give consent to the authorized representative of the Davie County Health Department to enter upon above described property located in Davie County and owned by to conduct all testing procedures as necessary to determine said site's suitability for a ground absorption sewage treatment and disposal system. DATE SIGNATURE v 9� s7' Q9 9• n '91 / =417 79-G 477 941 DCHD (.12.90) � i'.' �.:. �_v._..._�_� 1 ....,._....�.�.. _ �'� . . -- ' - DAVIE COUNTY HEALTH DEPARTMENT Environmental Health Section Soil/Site Evaluation NAME _�/ i� DATE EVALUATED ADDRESS PROPOSED FACIILTY PROPERTY SIZE '412 LOCATION OF SITE Water Supply: On -Site Well ✓ Community Public Evaluation By: Auger Boringy Pit Cut FACTORS 1 2 3 4 Landscape position Sloe % -- HORIZON I DEPTH Texture group Consistence Structure Mineralogy HORIZON II DEPTH zle t' 4- +' J/ -,;?- Texture Texture rou G Consistence Structure ,L� S / Mineralogy HORIZON III DEPTH Texture group Consistence Structure Mineralogy HORIZON IV DEPTH Texture group Consistence Structure Mineralogy SOIL WETNESS RESTRICTIVE HORIZON SAPROLITE CLASSIFICATION LONG-TERM ACCEPTANCE RATE e SITE CLASSIFICATION: !� ) LONG-TERM ACCEPTANCE RATE: i L REMARKS: DCHD(01-901 EVALUATED BY:, l -14"I OTHER(S) PRESENT: LEGEND Landscape Position R -Ridge S -Shoulder L -Linear slope FS -Foot slope N -Nose slope CC -Concave slope CV -Convex slope T -Terrace FP -Flood plain H -Head slope Texture S -Sand LS -Loamy sand SL -Sandy loam L -Loam SI -Silt SICL-Silty clay loam, SIL -Silty loam CL -Clay loam SCL-Sandy clay loam SC -Sandy clay SIC -Silty clay C -Clay Moist VFR-Very friable FR -Friable FI -Firm VFI-Very firm EFI-Extremely firm Wet NS -Non sticky SS -Slightly sticky S -Sticky VS -Very Sticky NP -Non plastic SP -Slightly plastic P -Plastic VP -Very plastic Structure SC -Single grain M -Massive CR -Crumb GR -Granular ABK-Angular blocky SBK-Subangular blocky PL -Platy PR -Prismatic Mineralogy 1:1, 2:1, Mixed Notes Horizon depth - In inches Depth of fill - In inches Restrictive horizon Thickness and inches from land surface Saprolite - S(suitable), U(unsuitable) Soil wetness - Inches from land surface to free water' or inches from land surface to soil colors with chroma 2 or less Classification - S(suitable), PS(provisionally suitable), U(unsuitable) LTAR - Long-term acceptance rate - gal/day/ft2 ■■■.MEMO■.■.■■■■.■■e■..■.■■■■..■ ■.■...■■■■■■■■■■■■■■■■■■■.■■.■■■ ■.......■■..■■■.■■■...■0.....■■■■..■.■■■■■■.t■■■.■■■■■■■■■.■■■ ONE ■■■■■■.■■■■■■■■■■■MM■■■■■■M■O■.E■■■N■■■■■■■Ott..■■■■■■■■.■■■■■■■■ i�NNCNNN lMENNEN3MEMEMEi.�MEMEMM MENNENi1MENNENEMEMEM3ONNCNNii ...............t7■■E■O■■■■■■■■■■■ ■■■■AE■■t■■■■.O ■■ ■E■■ MEMO... ■■■.■■■■■■■■■■■M■■■■■■■■■■■■■■■■■■■■■■M■■■■.■■■■E■■■■■M■■■t■.N■■■■ NNNNNNNNNNNNNNNNNNNNNNNNNNwI■1NNNNNNNNNNNNNNNNNNNMM=NNNN'■NNNNNNNNNNN NNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNN■■NNNNNNNNNNNNNNNNNNNNN■i�iNNNNNNNNN EMMEMME NNNNNNNiiiN=NNNNNNNNNNNNNNNNNNaiiiiiiiiiiiiiiiiiNN NNNNN OMEN ........................................... ................. ... .................................................................. .................................................................. .................................................................. ■.........■.00.....■ ■■■..■.■■....■..MEMO■■t■■■■■■■O■■■■■■.i.....■ ■.■■.■■.■■■■■■■■.■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■t■■ME■■ ■■.■■........■.■....■....■■■■■■■�■■■MEMO■E..■..■■■...■■■■■...E■■. Parcel #: C70000006301 Davie County, NC - Basic Estate Search Basic Search Real Estate Search I Tax Bill Search Sales Search View Property Record for this Parcel View Map for this Parcel View Tax Bill Information Parcel #: C70000006301 Account #:46655500 Owner Information Tax Codes NCH JEFFREY BOB& LYNCH CHARLYNN ELLIS [ly6EDVANCE, ADVLTAX - COUNTYT1 ANTLER LANE READVLTAX - FIRE TAXNC 27006 Market: Property Information Township Land (Unfts/Type): 3.590 AC FARMINGTON ddress: 161 ANTLER LN Deed Information Local Zoning Date: 11/2008 Book: 00775 Page: 1054 Plat Book: Page: Le al Description PIN 3.594AC S OFF HWY 801 5862563601 Property Values Building: BXF: Land: Market: M173,39 ssessed: [Deferred: Sales Information No. Book Page Month Year Instrument Qual/UnQual Improved Price 1 00166 0334 11 1992 WD Unqualified Vacant 0 2 00775 1054 11 2008 WD Unqualified Improved 0 View Property Record for this Parcel View Map for this Parcel View Tax Bill Information « Return to Basic Search Page 1 of 1 oP�r� -°u c -I, Davie County Web Site All information on this site is prepared for the inventory of real property found within Davie County. All data is compiled from recorded deeds, plats, and other public records and data. Users of this data are hereby notified that the aforementioned public Information sources should be consulted for verification of the information. All information contained herein was created for the Davie County's Internal use. Davie County, its employees and agents make no warranty as to the correctness or accuracy of the information set forth on this site whether express or implied, in fact or in law, Including without limitation the Implied warranties of merchantability and fitness for a particular use. If you have any questions about the data displayed on this website please contact the Davie County Tax Office at (336) 753-6120. 1.5.9 http://maps.daviecountync.gov/itsnetfView.aspx?prid=1467513 9/13/2016