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175 Buck Miller RdDavie_County, NC Tax Parcel Report Tuesday, October 11, 2016 WAK1V11V(i: '1'lil� l� 1VU1' A,UKVLY _ _ Parcel Information Parcel Number: F500000024 Township: NCPIN Number: 5840558095 Municipality: _ __ Farmington Account Number: 72156000 Census Tract: 37059-802 Listed Owner 1: SWAIN DAVID H JR Voting Precinct: NORTH MOCKSVILLE COUNTY Mailing Address 1: 135 NORMA LANE Planning Jurisdiction: Davie County City: ADVANCE Zoning Class: DAVIE COUNTY R-20 State• NC Zoning Overlay: DAVIE COUNTY QD Zip Code: 27006-0000 Voluntary Ag. District: Legal Description: 1.80 AC BUCK MILLER RD Fire Response District: Assessed Acreage: 1.82 Elementary School Zone: Deed Date: 3/2008 Middle School Zone: Deed Book / Page: 007490488 Soil Types: Plat Book: 0002 Flood Zone: Plat Page: 029 Watershed Overlay: Building Value: 177360.00 Outbuilding & Extra Freatures Value: Land Value: 31620.00 Total Market Value: Total Assessed Value: 208980.00 °" °'F Davie County, �a�;N�� NC No SMITH GROVE PINEBROOK NORTH DAVIE EnB DAVIE COUNTY 0.00 208980.00 _ _ �. ' t� L�. M�.�►`.. , , s 1�X0 auTxoRiz.�rioiv rro: O 8 6 4 DAVIE COUNTY HEALTH DEPARTMENT , . .w.. .. + ���• •� Environmental Health Section PROPERTY INFORMATION Permittee''s/����5, ���N�- P.O. Box 848 Name: �� Mocksville, NC 27028 Subdivision Name: y�."'�/,��;� ' %� Phone #:704-634-8760 Directions to property: �'`� '"' `r���f '"'�!!�" � Section: Lot: �' j AUTHORIZATION FOR �`1Q � � i � ;:� r�t �' � WASTEWATER �T SYSTEM CONSTRUCTION Tax Office PIN•� � �^ a�� ��� r� Road Name: � � � � Zip: � ! � � � **NOTE** This Authorization for Wastewater System Construction MUST BE ISSLJED by the Davie County Environmental Health SecUon 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 Pernuts. ' (In compliance with Article 11 of G.S. Chapter 130A, Wastewater Systems, Section .1900 Sewage Treatment and Disposal Systems) �� ` �f� �> �,� ***NOTICE�'�* THIS AUTHORIZATION FOR WASTEWATER CONSTRUCTION _� "' �i�,�"�`" " k�`'`�I f��� `�"�'� 7�G�, IS VALID FOR A PERIOD OF FIVE YEARS. ENVIRONMENTAL HEALTH SP `CIALIST DATE ISSUED / i . � l' _. , , . .... , ., , ' ; _ � 'O �„`/��' �.t;- -_ � � `� ������ - - � �-.- = � : �-- � � DAVIE COUNTY HEALTH DEPARTMENT �� �-=�, �Y'- ' IMPROVEMENT AND OPERATION PERMITS PROPERTY INFORMATION Perrgitt� �; °'' , e� � ,.� Name: ���'"�� ,�` � 'td',�r' �s"'�.� Subdivision Name: ��^ �.�. .r . Direc6onsto property: �'N� % i�.�. Section: Lot: IlVIPROVEMENT �,.�+ �.r � �..d..� � . ,-�, � � t_ PERNIIT Tax Office PIN:# -�3 �'"��� ..<' .� _��'% r' ; �, !.r '�jlc^�''tirt !�r'� r.i Rj � Road Name: t'� / t� Z p:� j,1 :ri � **NOTE** This Improvement Pernut DOFS NOT authorize the construction or installation of a septic tank system or any wastewater system. An AUTHORIZATION FOR WASTEWATER SY5TEM CONSTRUGTION 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 11 of G.S. Chapter 130A, Wastewater Systems, Section .1900 Sewage Treahnent and Disposal Systems) ***NOTICE*** THIS PERMIT LS SUBJECT TO REVOCATION IF SITE . i ; �` .y :� � f , � ' �, ; •;, j ,� f + .--�" V �'��' ;' ,�`,;/�;.I PLANS OR TI-IE INTENDED USE CHANGE. YOUR WASTEWATER ENVIRONMENTAL HEALTH SA�CIALIST DATE ISSUED SYSTEM CONTRACTOR MUST SEE THIS PERNII'I' BEFORE INSTALLING TI� SYSTEM. RESIDENTIAL SPECIFICATION: BUILDING TYPE �# BEDROOMS �r� # BATHS =� # OCCUPANTS '�� GARBAGE DISPOSAL: Yes or No COMMERCIAL SPECIFICATION: FACILITY TYPE # PEOPLE # PEOPLEJSHIFI' # SEATS INDUSTRIAL WASTE: Yes or No LOT SIZE /, �A �-' TYPE WATER SUPPLY �_ DESIGN WASTEWATER FLOW (GPD) "�� NEW SITE !/ REPAIR SITE i� �� SYSTEM SPECIFICATIONS: TANK SIZE GO GAL. PUMP TANK GAL. TRENCH WIDTH ��l ROCK DEPTH � LINEAR FI'. � / i // � OTHER �CJ� !.� f�.t.n t L/��� � ` �� � 4".s��.A� �� REQUIRED SITE MODIFICATIONS/CONDTTIONS: IMPROVEMENT PERMIT LAYOUT ..�,..�..�,,`'�. ..� **CONfACT 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 THE DAY OFj�NS1'ALLATION. TELEPHONE # IS (704) 634-8760. OPERATION PERMIT `ad , I �% b `� AUTHORIZATION NO. v� OPERATION PERMIT BY: DA **THE ISSUANCE OF THIS OPERATION PERMIT SHALL INDICATE THAT THE SYSTEM DESCRIBED ABOVE HAS BEEN INSTALLED IN COMPLIANCE WITH ARTICLE 11 OF G.S. CHAP'TER 130A, SECTION .1900 "SEWAGE TREATMENT AND DISPOSAL SYSTEMS", BUT SHALL IN NO WAY BE TAKEN AS A GUARANTEE THAT THE SYSTEM WII.,L FUNCTION SATISFACTORILY FOR ANY GIVEN PERIOD OF TIME. DCHD OS/96 (Revised) � t APPLICATION FOR SITE EVALUATION/IMPROVEMENT PERMIT •-- , �� �` �� Davie County Health Department � r � h Environmental Health Section e � P. O. Box 848 Mocksville, NC 27028 � � �� (704) 634-8760 ����� D �OCT I 7 I�c� � �- �� . ► u u •20 � I4 � �D ****IMPORTANT**** THIS APPLICATION CANNOT BE PROCESSED JQ1 /J� ALL THE REQUIRED INFORMATION IS PROVIDED. �.�t/, 1� Name to be Billed �� �' S E�%� n S Contact Person [,�� r�� �— J j� S Mailing Address `"� v� ��� r"`�r5� v� ��� City/State/Zip MVC��Sy� ���e lU �, � %Ua $ 2. Name on PermiUATC if Different than Above S�mG Mailing Address _ 3. Application For: 4. System to Serve: 5. If Residence: E1�Dishwasher 6. If Business/Other: # Commodes _ If Foodservice: 7. Type of water supply Home Phone �� � '�O� � Business Phone `7 y g- b sy -r ( e,,s'e� Cit /State/Zip �-g� q B O�ite Evaluation � Improvement Permit & ATC ❑ Both O�ouse ❑ Mobile Home ❑ Business ❑ Industry ❑ Other J oms � # People # Bedrooms � # Bathro � ❑ Garbage Disposal 0'Washing Machine 0'Basement/Plumbing ❑ Basement/No Plumbing Specify type # Showers _ # Seats 0'County/City # People # Sinks # Urinals Estimated Water Usage (gallons per day) ❑ Well # Water Coolers 8. Do you anticipate additions or expansions of the facility this system is intended to serve? If yes, what type? ❑ Community ❑ Yes �No PROPERTY INFORMATION REQUIRED: *** IMPORTANT *** A PLAT OF THE PROPERTY MUST BE SUBMITTED WITH THIS APPLICATION. r /' / Property Dimensions: �� � �y y 0� ���%��✓�� - � WRITE DIRECTIONS (from � Mocksville) TO PROPERTY: Tax O�ce PIN: #�8y� _ .�5� _ g0 �1.� � / 1 1 / .�� � �r Sf' G,iiPrv ,Y Srn Property Address: Road Name � JG �L M�' � �P r� G 1 � 't�r,�� � /� � on City/Zip �f%L�.'Sv����L �?CIa � 1 ' 1,,,,� /c n�, Ile.— 2 � �b���k � If in Subdivision provide information, as follows: 1 n�� 1 !� .j S �r'S1ei���nf ) Name: � � -�l��r � �o+ n►-� -E he ( e�•i Section: Lot #: � 1 I This is to certify that the information provided is correct to the best of my knowledge. I understand that any permit(s) issued hereafter aze subject to suspension or revocation, if the site plans or intended use change, or if the information submitted in this application is falsified or changed. I, also, understand that I am responsible for all charges incurred from this application. 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 R(� �J�P ��' µe✓1 e� v i� to conduct all testing procedures as necessary to determine the site suitability. /,� L;� DATE �� "'� %— i� SIGNATURE l/JL/7il/z- c'�✓tiW✓1— ., Revised DCHD (06-96) . Y .9 �� `. .66 � � s\� "�� �" � '. � �. cy �, . �,..° 0��(0.30 ACJ : • " � � . � ":.Y �5 . j � ._ . ;?. '`` t��_i. t :� < � '= � R � : :�.�'{.i a•43f,-- ?j v-�.dk'�'-:'.I � ' - , . , �� �..�: N � �� � , -� 4 , o N \� - 9� a;- f t _ �„ ;�i`r �.� � Z ,��,� t '` - \ ,� . ti�� `,' . 2 c �.:nZ �. �,'1 S`�fi+'a�v N� l� , � c a .3 , �� 2_ _ . . _ . . , . . . O�� , �`� �k,3.s�� %��` ..5'�' � r�' �+ ' . , � pl�r .. '� . ,\rV . y.. ,��. �`�, 'c"s3� � ` � � L � V��AC � . 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My.�, y� ,e�.. -..r � �- . � ,a� ��.� � _ �r �� 6ik� � ; y .�. � _ _' . . :.��}ia.�`Fv.. ,�. �i ,.�...,.- .. �.; ,.a;�. < ;:c- .fk � .� �^ .�� ' �j' Y,',�Y,: `'� �n � .•v�L�'�'e��..Y S� y'�� y;� ' ^ :; ' T �— i .� ' �`-r. •` _ �-�':.-`�'" �..,- ---.:s Ls'_.,.'4[Cdi1�4t,:�., '�� �._.._ ;_:- �i._ --^��'a- -� .-._��' .. ... � ..-�..+=+siJ�._. . - �.._ ���� ;� . � `� DAVIE COUNTY HEALTH DEPARTMENT ' • ' • ' Environmental Health Section , • Soil/Site Evaluation NAME �j/,cln/S DATE EVALUATED l� ��:9� ADDRESS PROPERTY SIZE ,f f� c PROPOSED FACIILTY �� �"° LOCATION OF SITE -�`��'.�- „��,���'1 //� Water Supply: On-Site Well _ Community Public G/ Evaluation By: Auger Boring 1� Pit Cut FACTORS 1 Z Landsca e osition ,L Slo e � HORIZON I DEPTH Texture rou Consistence Structure Mineralo HORIZON II DEPTH 3 L � i' Texture rou Consistence 11- Structure , ,f � Mineralo ` HORIZON III DEPTH Texture rou Consistence Structure Mineralo HORIZON IV DEPTH Texture rou Consistence Structure Mineralo SOIL WETNESS RESTRICTIVE HORIZON SAPROLITE CLASSIFICATION LOyG-TERM ACCEPTANCE RATE n�ub z 4 SITE CLASSIFICATION: " EVALUATED BY: _� LDNG-TERM ACCEPTANCE RATE: i��Z OTHER(S) PRESENT: REMAR KS: LEGEND Landscape Position R-Ridge 5-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 �:lay loam� SIL-Silty loam CL-Clay loam SCL-Sandy clay loam SC-Sandy clay SIC-Silty clay C-Clay CONSISTENCE Moist VFR-V+�-y friable FR-Friable FI-Firm VFI-Very firm EFI-Extremely firm Wct NS-Non sticky SS-Slightly sticky S-Sticky VS-Very Sticky NP-Non plastic SP-Slightly plastic P-Plastic VP-Very plastic Structute ,iC--Single grain M-Massive CR-Crumb GR-Granular ABK-MQular blocky SBK-Subangular blocky PL-Platy PR-Prismatic Mineralact�r 1:1, 2:1, Mixed Notes H orizon 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 wate►� 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 DCHD(01-901 ■■�■��■��■���■�����■����������■��������■ ■����■� �■���■■ ��r��■ ■■�������■��_�������■�N������������■��■ ������■� �����������■�e�■ ■■����■����■ ������■■��■�������■ ■���������������■���■��■������■■ ■■■■��■■���������■�■�■■���■������i������������■������������������■ ■�■■������■�������■����■����������������■ ■ ��■�������■����■����■ ■■��■���■■��������������■�������■������������������■����������■�■■ ■��������■�������■�■������������■■�����������������■■■�����������■ ■��■■H���������■��������■������■��■������� ■■������ ■■■���■���■�■ ...............................■■.._.■■.■■C■..■■■■■�■■.■.■..■■■.■ .................................... ............... ............. ■������■�■�■■����■�������������� N��■����■�■����■ ■■��■��������■ ■���■■��■�������■�����������������������������������������������\ ■�����■■�����■■�����■���������■�■�����������\�■���� �■�����■�����■ ■������������������■■■����■ �■����■�■�������■�� ���� ���� �����■�■ ■�■�����������e���■��������������■�����/�■���■ ■��■�\H ���■���■�■ iiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiii�iii=�i��=iii�iiiiiin�iii ■���■��������������■�����■���■�����■■�����■���■������■��_■���■���� ■����■■�����■■�����■�■��������■■�■���������■�■��������� �����■��■ ■�■����■��■�■■��������������■�■ �����■�N��������■����■�■�■�■��■ ■■�������■■������������������■������■■�■���N�■������■��N■���■��� ■�■���■�■���������■■����������■�■������■��■���� ■ � ���■����■�■��� ■�■����■�����������■���■��■■�����■���■�����������■ ��■�■�■�■��■■�� ■■�■■��������������■�����������■�■ ■ ■����� ■ ■u�����■■ ■ ����■ ■■e����■■�■■■N■�■��■������s�■�■��_��������■�C������������_■■_��__ ■■��■■�������������■■■������■�����■■��■��������u� ■ �■��■��� �� ■■■■�■�n■�■■■■��������n�������������N■����N�u��■���■��■���� ■�■�����������\����■����■���■■�� ��I1�N�■ ■ �■�■�����■������� ■������■��������■��■■N�������������%��������� ■ �■ ■�����■���� ...................................�............ 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' �'.:::::: �����u��������p���������� �� N���N��� ...�... C::��::::::�:::C=:.': . . .. ...�=a. ... ... ....... ... ...................�. .. . ... . ■�������������������������������� '% ■ v��■�N�� ■���■����N�■�����■■������������■[It1■N �■ �� ■�������������������������u�����■�� N������N� ��������������������������■����� ������ ■ ■ ����■��■u■■�■ ■�������■� ����������u������������N����■u�� ■ u����N�u�� ...... =a.............. ...... ... ... .�...... .::::: .:...:C:::=:'CC�E:C:CC:�:C .: ..: :. :::::.::.::::::: .... ..�:.......C........... . ..'_......:_.■................ ................................i�...._... .... ............... :::::C:::C :C::::�:C :CCCCC::'C:CCCC: .._....�::5............... C � �.■......■................. .................................................................. ...............■.................................................. ........................................■......_■...■............. ::::.::::::::::::::::::::::.::::�::::_::::::::::::::::::::�:_: =1�:::'::::�.::::::::::::::::::..::::':":::::::::::::::::::::::: �avie County �feaCth �epartment and �-Come .�Cealth .�[.�ency �nvironmental �CeaCth Section P.O. Box 848 / 210 HosPiTn� SraEtr COURIER #09-40-06 MOCKSVILLE, N.C. 27028 PrioNE: (704) 634-8760 Chris Evans 409 Farmington Rd. Mocksville, NC 27028 October 29, 1996 Re: Site Evaluation Buck Miller Road Tax PIN: 5840-55-8095 Dear Mr. Evans: As requested, a representative from this ofiice visited�the aforementioned site on October 23, 1996. Based upon the information provided on the application for a site evaluation and after the evaluation was completed, the site was found to be provisionally suitable for the installation of a modified, oversized on-site sewage disposal system. Ii you have any questions, please feel free to contact this ofiice. RH/wd Enclosure(s) Sincerely, �G� �O. �ar.�c°��j . Robert B. Hall, Jr. , R. S. ' Environmental Health Section f