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409 Cedar Creek Rd
Davie Countv, NC 0 Tax Parcel Renort Wednesdav. October 12. 2016 WAK1V11V1T: llilJ 1J 1VU1 A JUKVLY _ _ _ _______ __ _ Parcel Information _ Parcel Number: D500000039 A Township: Farmington NCPIN Number: 5832829920 Municipality: Account Number: 82521990 Census Tract: 37059-802 Listed Owner 1: POTTS DIANE H Voting Precinct: FARMINGTON Mailing Address 1: POTTS ROY L FAMILY TRUST SHARE Planning Jurisdiction: Davie County City: ADVANCE Zoning Class: DAVIE COUNTY R-A State: NC Zoning Overiay: DAVIE COUNTY QD Zip Code: 27006-0000 Voluntary Ag. District: Yes Legal Description: 8.144 AC CEDAR CREEK RD Fire Response District: FARMINGTON Assessed Acreage: 8.23 Elementary School Zone: PINEBROOK Deed Date: 2/2000 Middle School Zone: NORTH DAVIE Deed Book I Page: 2000E0057 Soil Types: Gn62,GnC2,GaD,MsC,ChA,MsD Plat Book: Flood Zone: Plat Page: Watershed Overlay: DAVIE COUNTY Building Value: 0.00 Outbuilding & Extra 4500.00 Freatures Value: Land Value: 76220.00 Total Market Value: 80720.00 Total Assessed Value: 80720.00 9"^'° F Davie County, �ot,��j NC . . " • , IMPROVEP�NT �RpIIT DAVIE COUNTY HEALTH DEPARTMENT IMAROVEMENT PERMIT and OPERATION PERMIT ✓ Xa +�+�NOTE�+� This i�prove�ent per�it DOE5 NOT authorize the construction or installation of a septic tank syste� or any wasteNater syste�. RN AUTHORIIATIDN FOR WA5TEWATER 5Y5TEP1 CDNSTRUCTION �ust be obtained fro� this Depart�ent prior to the construction/instailation of a syste� or the issuance of a building per�it. tIn co�plianre with Article il of 6.5. Chapter 13@A, {JasteNater Syste�s, 5ection .1900 Sewage treat�ent and Disposal 5yste�s) NAME �' t/ � PR�'ERTY RDDRESS C.�X'u-� ��! CI_. -��i7� A E ���. I,�,/ L�RT I ON SUBDIVI5IDN NAME LDT tdUl4AER �T,�. �� SEC./BLOCf{ NUMBER RESIDENTAL SPECIFICpTION: BUILDING TYPE �,� � BEDR�MS �� BATFIS � t OCCIIRANTS �Rflf�E DISPOSAL: Ye� COMI�RCIi� 5PECIFICATI�I: F�ILITY TYPE # PEDPLE �1 PEDF�LE/5HIFT # 5EflT5 IMDUSTRIAL NASTE: Yes/No LOT SITE : t '1� TYPE WATER SUPPLY _� DE5I6Pl V�STENATER FLOW iGPD) �,�� NEW SITE �EPAIR SITE 5YSTEM S�CIFICATI�IS: T(�IK SI2E / Y 6AL. WJMP TANK 6AL. TRENCH WIDTH ��l R�K DEPTH �� LINEAR FT. 5�9.� � OTHER REQUIRED SITE MDDIFICATIONS/CONDITIONS: ***THIS PERMIT IS SIIBJECT TO REVOCATION IF SITE PIANS OR THE INTENDED L1SE CHAN�E. YDUR WASTERWATER SYSTEM CONTRRCTOR p0.1ST SEE THIS PERMIT BEFORE INSTALLING THE SYSTEM. IMFRDUEMENT PERMIT BY �� l�j � �*CONTACT A REPRESENTRTIVE � THE DAVIE C�N1TY HEALTH DEPAATMENT FOR FINAL IN5'PECTIDN OF THIS SYSTEM AETWEEN 8:30-9:30 A.M. OR 1:00-1:30 P.M. ON TNE DAY OF INSTAI.LATION. TELEPHONE # IS i704) 634-8760. �ERATION PERMIT f � - - . 1. . ,.� aJ AUTHORIZATION N0. O��� OF'ERflTI�I PEf�IIT 9Y �• DATE �I� ' � f�THE ISSURNCE DF THIS OPERATION RERMIT SHALL INDICA7E THAT THE 5Y5TEM DESCAIBED ABOUE HAS BEEN INSTt�LED IN COh�LIt�10E 41ITH AATICLE 11 � G.5. CNAPTER 130A, SECTIOhI .1900 "SE1,� TREATMIENT AND DISPQSAL SYSTEMS°, BUT SHALL IN NO WAY �E TAI(EM AS A 6UARAMTEE T}WT TF� SYSTEM WILL Fl�TIOM SRTISFRCTORILY FOR AMY 6IVEN PERIOD � TIt�. D�HD 10/95 i . _ t�"� � � :��"^�;� t' . .. �:: _ � "���'. �''- . �.. . , �_ r_,. . � ---, �� " =°� Davie County Health Departient ENUIRONR9ENTAL HEALTH'SECTIDN " � P.O. Box 665 � Mocksville, N.C. 27028 AUTHORIZATION FOR WASTEWRTER SYSTEM (XlMSTRUCTIQI )�:3d . lIssued in co�pliance with Article li of K� : G.S. Ghapter 13aA, Wastewater Syste�s) +�+��This Ruthorization Fnr WasteNater 5yste� Construction �ust be issued by the Davie County Environ�ental Health Sectian prinr io issuance of any Building Per�its. This Fr,r�lRuthoritatian Nu�ber should be presented to the Daaie County B��ilding Inspections Dffice when applyi for Building Per�its.+�* Q AUTFDRIZATION N.M.9ER NRI'E Y DATE � /� �� ^ �'' i� '� ; � .�' � IV.., , , �� NAME ON IMPROUEMfNT PERMIT fIf different than above) SITE LOCATI�1 ---_( �/��/1r' C jNP/i �l� .��'i�/ � ' COl�EJ�ITS/C0�@ITI�15 ON AUTHORIZATION T0 [:ONSTRUCT WRSTEWNTER SYSTEI� , f�NOTICE� THI5 AUTHDRIZATIDN FOR STEW TER 5YSTEM CONSTRIICTION I5 VRLID FDR A GERIDD OF FIVE {5� YEARS. � _.l�'' �/ —// �?� autr�r�. �n� s�c arYsr na� DCHD 10/95 ., � . . . , , .. �, _ 4,• � ' � �' � � . ._ ,, r , � � J , APPLICATION FOR SITE EVALUATION/IMPROVEMENTS PE , Davie County Health Department Environmental Health Section P. O. Box 665 Mocksville, NC 27028 1. Application/Permit Requested By �� �; m� U Mailing Address � c� c� a � c� �°�� � 4 I�:;� Home Phone Business Phone �9� �j� 2. Name on Permit if Different than Above 3. Application for: ❑ General Evaluation Septic Tank Installation Permit 4. System to Serve: ouse L�'Mobile Home O Place of Public Assembly ❑ Business ❑ Indus ❑ Other ❑ Unknown 5. If house, mobile home: Subdivision _ �,/�� ��� l7 �� Section �'S Lot #� No. of People � No. of Bedrooms � No. of Bathrooms Dwelling Dimensions �-� � O BasemenUPlumbing � � �AL (J�/ � �� � u BasemenUNo Plumbing � /�y� � "dashing Machine /— Dishwasher 6. If business, industry, place of public assembly, other: Specify type No. of People Served No. of Commodes No. of Lavatories No. of Showers No. of Sinks No. of Urinals No. of Water Coolers Water Usage Figures O Garbage Disposal 7. Type of water supply: � Public � O Private ❑ Communiry 8. Property Dimensions f U � /� s?s�, Sewage Disposal Contractor 9. Do you anticipate additions/expansion of the facility this sytem is intended to serve? o If yes, what type? 'NOTE: Improvements Permits shall be valid rom date issued. Improvements Permits are subject to revocation, if site plans or the intended use change. Effective October 1, 1989. Directions to Property: .�v � epy'u^'p.F'' ��Q � � \ r Ar r YYti %n^G �rn,n Cr, This is to certify that the information provided is correct to the incurred from this p iica 'on. � �,� DATE Tax O,ffice PROPERTIJ � .. ollows. Road Name : (. .Q,�Q�-- [jl� %� � K t�gi city: �0�1�%//�. SU$MZT A PL�iT WZTH THIS APPLZCATION. IZevisions effective Ocfober 1� 1995. my kno���and I understand I am responsible for all charges SIGNATURE CONSENT FOR SITE EVALUATIO O BE DONE ON ABOVE DESCRIBED PROPERTY MUST CHECK ONE: . I OWN the property. ❑ 2. I DO NOT OWN the property. If you checked Box #2, the rest of this form MUST be completed by the owner or a person authorized by the owner: I hereby give consent to the authorized representative the Dav' C nt Health Department to enter upon above described property located in Davie County and owned by to conduct all testing procedures as necessary to deter ne ite's suit iM u� round absorption sewage treatment and disp� I system. �� .� �' --� DATE SIGNATURE DCHD (1/93) �,€' - ., . ' F �r a,; � � .� . i �z� _ -z� � . �f - . ,. r .,�. �?'t-��r�, �'�+;: ..i: ` . a"` "§ �"; .. . . � . '^K t "r - _ '��� R.,� - h� w.. _ . ..',--.�' - � _ " . . `�_;.. � �, - ;�� h� . : i . � ��?R -� �: .. � . '�'� zx „< -.� �F�a'< ��,.i.' ,� -ss n st`' : � "'�F'"'^" �:�: � F:} . _ . -.- � . _ ,. _ ., `. � . ��i.�"��,�-� . .,,.�. .. �.. .,, .a�''. � ,l•�•'' '�.t��� r`,�- � . . • s.s,_ _ry�.,�.� ,`� ,f� :,4g ' '.�� _!�K:�'a �.; t,c. � jP.. , � � Y'� .. . 'i�''x..;; 4 ;';.... - �-� -.i`,: s iy. � . ��.�=, , . �'� � . 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ADDRESS PROPERTY SIZE a' ' - PROPOSED FACIILTY ��'✓" LOCATION OF SITE C G% �''✓C ��`�''� Water Supply: On-Site Well _ Community Public Evaluation By: AugerBoring (� Pit � Cut FACTORS Landscape position Slope � HORIZON I DEPTH Texture group Consistence Structure Mineralogy HORIZON II DEPTH Texture Aroup Consistence Structure Mineralogy HORIZON III DEPTH Texture group Consistence Structure Mineralogy HORIZON IV DEPTH Texture group Consistence Structure Mineralogy SOIL WETNESS RESTRICTIVE HORIZON SAPROLITE CLaSSIFICATION LO�1G-TERM ACCEPTANCE 1 r � 4 SITE CLASSIFICATION: JT_ EVALUATED BY: � LDNG-TERM ACCEPTANCE RATE: ' OTHER(S) PRESENT: REMAR KS: 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-Silt,y •: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 Wet NS-Non sticky SS-Slightly sticky S-Sticky VS-Very Sticky NP-Non plastic SP-Slightly plastic P-Plastic VP-Very plastic Structure ,iC--Sin�le grain M-Massive CR-Crumb GR-Granular ABK-MYular blocky SBK-Subangular blocky PL-Platy PR-Prismatic Mineralo�cy 1:1, 2:1, Mixed Notes }iorizon 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(O1-9o� ■����■■■��■���������������■������������■ ■��t���=���■���■ ■s�■ ■ ■■��■����■��_�������■■����■�������■�e�■ ■�_����■ ���■��■��■��■ ■■ ■�������■��� ■���������■�������� ■�������� ���������■������■����■ ■■■�■�■������■�������������■��������■�■■ ■ ■■��������■��������■■ ■�■■■���■��■����■��������������■����■����__����������������������■ ■�■�■�■■�■■■����■�■���■�������������■■■���■■�������■�■����■�����■■ ■���■■��■�����������������■�����������■�����������■■�■���������■�■ ...........................................�........ ............. ...................................■...... ■...■... ...■....■.... .......................................■..■...■■■.._ ...■■■...■... ■���■�������■���■����■�����������N�����������■��■ ■���■�■������■ ■����■��■����■��■��������������� ����������������� ■■���■����■■�■ ■��������■■���■���■�■��������������■����������■S■����■�������■���■ ■�■���������■����■�������■■ ����■�������������� ■��� ■��� ���■�■�� ■��\�����������■��■������������������■■/������ ��■■��H���������� ■�■■�����■������■�����■����■���������e�����������_�■�� ■���■���■ ■■�����■������������������_■�������■���■ ��■ ■ � �■� ■��■��n �� ■�■�����������������■�■��■ ■■���■�����■���������� ���■�������■��■■ ■�����■����������■���■��������������■�����■������■������u�■���■ ■�■����■����■■�■����������A�■�� ■������N�■������■�■�■���■■���■■ ■��������■■����e�������������■���■��■■��������■���������H���■��v■ ■��■��■�������■���■�������������������������■�� �■�■�����������■ ■■■�■�����■■���■������������■■�����■ ��■��� ��■�■■ ■���■ �/��■��� ■��■�o���������■��������������■����■����■�■�������■����������■�� ::::::::::C�::�::::::::C::::::::::::::::..::.�:C:::::.::�':._ ■������n��■��■■�������h������■������Nv��■N�u��■����������� ■■■����i��■���������■��■��������. ■■��N�■ ��N■■■■������������ CC:CC::::::::C::::C::::::CC:::::�C:C:�::::::■.' 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