136 Briar Cliff Ln�avie Countv. N' C
Tax Parcel Renort Wednesdav. October 12. 201 E
WAK1V11V(T: "1'Hl5 1� 1VU'1' A �Ul�Vr:Y
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; Parcel Information . , a� � r x� ,
Parcel Number: C20000001103A Township: Clarksville
NCPIN Number: 5802778593 Municipality:
Account Number: 6680000 Census Tract: 37059-801
Listed Owner 1: BINKLEY JEFFREY B Voting Precinct: CLARKSVILLE
Mailing Address 1: 136 BRIARCLIFF LANE Planning Jurisdiction: Davie County
City: MOCKSVILLE Zoning Class: DAVIE COUNTY R-A
State: NC Zoning Overiay:
Zip Code: 27028-0000 Voluntary Ag. District: No
Legal Description: 2.541 AC OFF SHOFFNER RD Fire Response District: SHEFFIELD - CALAHALN
Assessed Acreage: 2.53 Elementary School Zone: WILLIAM R DAVIE
Deed Date: 9/1997 Middle School Zone: NORTH DAVIE
Deed Book / Page: 001970415 Soil Types: MnC2,MnB2,MdE
Plat Book: Flood Zone:
Plat Page: Watershed Overlay: DAVIE COUNTY
Building Value: 188770.00 Outbuilding 8� Extra 7140.00
Freatures Value:
Land Value: 15500.00 Total Market Value: 211410.00
Total Assessed Value: 211410.00
9"°'A Davie County,
`'oUN�'" NC
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AUTHOI�IZATION NO: � �
� ;� � �i� DAVIE COUNTY HEALTH DEPARTMENT
�--` Environmental Heaith Section PROPERTY INFORMATION
,� � �
Permittee's P.O. Box 848
Name: ��'`� ��-n �� /� �e_t�.`� Mocksville NC 27028 Subdivision Name:
/ ,�/ ., Phone # 336-751-8760
Directions to property: C"�-�/Y ��a �� ��� Section: Lot:
•--- AUTHORIZATION FOR
' �f /��j f����� .,,,� ,f1 `� �2 � �~J WASTEWATER Tax Office PIN:#� - ? � _ �.�
��1`'� ' �'" SYSTEM CONSTRUCTION
c� ��;,� ,�1�rt;;,,r��Lz.1 ��a�r,� �h�r=F�c', �L.'c�,f t����rc���� L.�, �-r� �' R a'd �vame� �i�C� 1�� CLiFF� Z` ip G%:2�1
**NOTE** This Authorization for Wastewater System Construction MUST BE ISSUED by the Davie County Environmental Health Section prior
to issuance of any Building Pernuts. This Form/Authorization Number should be presented to the Davie County Building Inspections
Office when applying for Building Permits.
(In compliance with Article l l�of G.S. Chapter 130A, Wastewater Systems, Section .1900 Sewage Treatment and Disposal Systems)
ENVIRiYNI�,F,IdTAL HEALTI
�'IST DAT� 1
I/� �� ***NOTICE*** THIS AUTHORIZATION FOR WASTEWATER CONSTRUCTION
IS VALID FOR A PERIOD OF FIVE YEARS.
SS ED
/ ��R. •y � . ,� /* �. . .., . . . . ,. . . .. - , - � � � - � � � A�/� f /J� � �. �C..,�
:. � t� s/
� � • - '—,x .� _ i :� a� +��� DAVIE COUNTY HEALTH DEPARTMENT �
; ��' ` � ,:-_ . -_ - _ _ TMPROVEMENT AND OPERATION PERMITS PROPERTY INFORMATION
Pertnittee's �
Name: t� j�� f,.i.. :�� � � �5s !'�?'.��:.� ..
Directions to property: <� �' 1,`�'�' `.``' t��j'�%`:i:�. + t;'
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`i f t r � i�'
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Il1�IPROVEMENT
PERMIT
,.. ,�:. , . :..i��,' '
Subdivision Name:
Section: Lot:
Tax Office PIN:#
_, ,� 1 •!`� l _��,
-- � . e , l .; ..i
Road �1ame , �: � � � i . �" t. ! � s Zip; .�
**NO.T'E** This Improvement Pernut DOES NOT authorize the construction or installation of a septic tank system or any wastewater system. An
�AUTHORIZATION FOR WASTEWATER SYSTEM CONSTRUCTTON must be obtained from this Department prior to the
construction/installation of a system or the issuance of a building permit.
(In compliance with Article l l.of G.S. Chapter 130A, Wastewater Systems, Section .1900 Sewage Treatment and Disposal Systems)
,.
� �t' """^�. ,r ***NOTICE*** TI-IIS PERMIT IS SUBJECT TO REVOCATION IF SITE
_;.� '`� '. /'� � ��: � C'- ��t`� °,'� '�` I PLANS OR TI-� IlVTENDED USE CHANGE. YOUR WASTEWATER
ENVIRONIkIENT L HEALTH SPECIALIST DA'I� ISSUED SYSTEM CONTRACTOR MUST SEE TiII.S PERMIT BEFORE
t... - : INSTALLING THE SYSTEM.
�,
RESIDENTIAL SPECIFICATION: BUILDING TYPE �I1J`�# BEDROOMS F # BATHS G•� # OCCUPANTS � GARBAGE DISPOSAL: Yes o�o
COMMERCIAL SPECIFICATION: FACILTfY TYPE # PEOPLE # PEOPLE/SHIFf # SEATS INDUSTRIAL WAS"fE: Yes or No
LOT SIZ�� TYPE WATER SUPPLY '"�=u" DESIGN WASTEWATER FLOW (GPD)�� NEW SITE �REPAIR SITE
f' �i
SYSTEM SPECIFICATIONS: TANK SIZE� �v�GAL. PUMP TANK GAL. TRENCH WIDTH '—�''�' ROCK DEPTH � LINEAR FT. ��
OTHER �w ( 1�"'���.I�I�IJ'J ��%S
REQUIREDSITEMODIFICATIONS/CONDITIONS:�(�T��.L.- ��� �N�J�� �""C':�-i� ��l �-Q�r�+- W�..Li.-, �C1-� I�,
nt� ��I1�7C`IL/i
IMPROVEMENT PERMIT LAYOUT ���,�,����p ��LOE�IT' I'�L�`�[t�
� C v` St-:-�.�=' �-I
, � �t
� L.(7 �
/-�i' �C%SC- . � �C 1
**CONTACT A
OPERATION
, ��
gIZI��R(5� .T.� f�" CE�.O�] ['IPIISi:E� G �t,DE�
L�1
ry. ,,,,, �� ��. �-
��
ATIVE OF THE DAVIE COUNTY HEALTH DEPARTMENT FOR FINAL INSPECTION OF THIS SYSTEM
- 30 A.M. OR 1:00 - 1:30 P.M. ON THE DAY OF INSTALLATION. TELEPHONE # IS (ZQ,4,k¢�4,$7l�SkI�
SYSTEM INSTALLED BY:
��-
No�s,s
L
�r
.!6
AUTHORIZATION NO. r�� OPERATION PERMIT B• DA� �vL� � Xi
**THE ISSUANCE OF THIS OPERATION PERMIT SHALL INDICATE THAT THE SYSTEM DESCRI ABOVE HAS BEEN INSTALLED IN COMPLIANCE
WTTH ARTICLE 11 OF G.S. CHAPTER 130A, SECI'ION .1900 "SEWAGE TREATMENT AND DISPOSAL SYSTEMS", BUT SHALL IN NO WAY BE TAKEN AS A
GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORILY FOR ANY GIVEN PERIOD OF TIME.
DCHD OS/96 (Revised)
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� APPUCAl10N FUIt SIlE EVAUlA71UN/IMPROVEMENT PEflMIT dc
Davie County Health Department
- E�vfronmen�aal Nea/tfi Se�cdon
, P.O. Box 8�B/210 Hoapitatl Street
Moakaville, NC 27028
(336)751-8T60
DL�IyU� U1J 1
A r���,� � 6 �:�
•** Zl�ORTANT* *� THI S APPLICATZdN CAI�lN01' SE PROCE3SED LTNLE33 ALb
INeOYiMATION IS PROVIDED. Refex to the INFORMATION SOLLETIN ior iastruations.
i. �amn ro be siai� l� N'D 2G A(�(i •� U� �J !Z.\2 u aontact ra=son t� N/7 K£�r �i N 1�. � e�/
ilailinq J1d�dreas t53 '3(t� A 2C� � �-� � N Hama phone 3 �� 7
csty/state/ztp Q�110CKSV I lle N C o� � �01� susiness phone �`�" � 3�' `�( c� r'JU
�
Z. lisme on Pessit/1►?C if DSfierent thaa Abwe ,
�lailing Address City/Btate/Zip
9. J►ppliaatioa S�.r: � Site Evaluation �) Improvement Permit/ATC �' Both
4. �►atem to serviex: � Honse 0 Mobile Home � Busineas 0 Industry ❑ Other
e. Yf Re�idence: # People o2 / H�dtooms � f Hathrooms a- ��---
��ishxasher U Oarbaqe Disposal �Nashinq Machine �Hasment/Pinst�inQ 0 Hasement/No Pinmbing
6. I! 8nsineas/Zndustry/other: Specity type � people # SiNcs
• Coicmodea
i 8howers f Uriaals � Nater Coolers
IF FOOD3ERVICE: # 3eats Estimated Water tJaaqe (qalions per day)
7. Tp�w of Mater supplp: 0 Connty/City �ilell 0 Co�nunity
e. Do you aaticipate additiona or e:pAuaious of the facility thia ayatem is iutwded to aerve! 0 Yes �lo
flf yea, wbat type'
"* *IMPORTAN?'''" CLIENTS 11lUST COIIlPLETE TH� REQUlRED PROPERTY INFORMATION REQUESTED
BELOW. Either a PI.AT or SITE PI.AN MUST BESUBMITTEL 6y the client wit6l�ilS APPL[CATION.
Property Dimeosions: �,e mo..
.�`8 - � -���1,3 .
Ta: Ofiice PIN:
Property Addre�s: RoAd Name�riO,rc�i-� `c]fl e�
c��y�z�P M oc.Ks,� i��e t� c��1 oa8
WRITE DIREC'fIONS (from Mocicsvllle) to PROPLRTY:
� o �( f'1 o r�-h �-o ���De r�-� C�n�rC i� Yd .
-�-t�Yr le��- n��r GYe�.K G�IeYGI, Rd•
-}�er� �'i�1��- or �en (�ndevsor �-hc�n
;
i� in a Subdivision provide informAtion, a� follow': r;a �.� Sho�ni Y�ti. �-e-�'�- o ��' `�Ya i�
Name: 1Ane aN D c�v �vc or, r iGh� c.�t- �4�; �-c.�e..r1c,�
Section: Block: Lot: ' Date Property Flagged: -� a�'��
This l� to certify ihat t6e informatioo provided is correct to the best of my knowledga I underat�uod ihst �uay permit(a)
issued hereafter are subject to auspeaaion or revocation, if !he aite plans or intended ase cbange, or if the intormation
submitted in t6is applicatfoa ia talsitied or c6snged I, also, understand tArat I am responsible jor all dlrmgu irrcrured fmm
tbis appifcation. I, 6ereby, give consent to the AatLoriud Repreaentative of t6e Davie County He�lt6 Department
to enter upon above described property located in Davie County and owaed b�• Tei� Q na/ ���A 3; n K.IcU
to conduct all testing procedures Aa necessAry to determine t6e dte witabilih.
DATE 3/as 19 q SIGNATURE �`
THIS AREA MAY BL USED FOR DRAWING YOUR SITL PLAN pnclude all oit6e following: E�ating �nd pr+uposed
property lines and dimenaiona, atructures, setbacks, and aeptic locatlona).
QY'L rY�0.r ��.td
j� 1 � �-�' CA'r' n e r S o� P r o�x.r �-..� � �J �� S�-C� Kt S l,J ��
�;r �� � ��.�5 .
�Co�-ners o-F �1o�s�
G.r �e., mo�. r 1� ���4. S��. K�e S o.. n ci
�j r p T� os � Ci W� � 1 S� 't� C \ S \ cl '�Q. r ���, ,� I��'t r lc. r1 C� SI ��.
i � '� f0
O� � o�s 2• Account Na
Se� �,���.td m�.� - /
Revised DCHD (07/98) Invoice No. � ��
4 •
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A
DAVIE COUNTY HEALTH DEPARTMENT
Environmental Health Section SECTION LOT
Soil/Site Evaluation
APPLICANT' S NAME CTN ����-�-�%} DATE EVALUATED � K�
PROPOSED FACILITY 'rTvuSt'S PROPERTY SIZE
SUBDIVISION ROAD NAME I.�i'Yi1�ti��i�l� LJ"
Water Supply: On-Site Well Community Public
Evaluation By: Auger Boring ✓ Pi[ Cut
FACTORS
Slove %
HORIZON I DEPTH
Texture group
Consistence
Structure
HORIZON II DEPTH
Texture eroun
Structure
HORIZON III DEPTH
Consistence
Structure
:• .Mineralogy
` HORIZON IV DEPTH
Texture group
Consistence
SOIL WETNESS
RESTRICTIVE HORIZON
SAPROLITE
CLASSIFICATION
LONG-TERM ACCEPTANCE RATE
SITE CLASSIFICATION:
LONG-TERM ACCEPTANCE RA'
REMARKS:
DCHD (01-90)
��
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���
�000�
��---�
'�'�����
��--��
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EVALUATION BY:
OTHER(S) PRESENT:
LEGEND �
Landscape Position
R- Ridge S- Shoulder L- Lineaz slope FS - Foot slope N- Nose slope
CC - Concave slope CV - Convex slope T- Tenace 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
CONSISTENCE
Moist
VFR - Very friable
Wet
NS - Non sticky
NP - Non plastic
FR - Friable FI - Firm VFI - Very firm EFI - Extremely firm
SS - Slightly sticky S- Sticky VS - Very Sticky
SP - Slightly plastic P- Plastic VP - Very plastic
tructure
SC - Single grain M- Massive CR - Crumb GR - Granular ABK - Angular blocky
SBK - Subangulaz blocky PL - Platy PR - Prismatic
Mineraloev
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 - gaUday/ft2
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