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450 Cedar Grove Church Rd (2). . • DAVIE COUNTY ENVIRONMENT�IL HEALTI-I �� P.O. Box 848/210 Hospital Street Mocksville, NC 27028 (336)751-8760 Fax # (336)751-8786 Account #: 989900194 OPERATION PER1�tax PIN/EH #: 5767-94-1969 Billed To: Brian & Deanna Mcllwain Subdivision Info: Reference Name: Location/Address: Cedar Grove Church Road-27028 Proposed Facility: Residence � Property Size: 23.25 Acres ATC Number: 4853 **NOTE** The issuance of this Operation Pernut shall indicate the system described on the ATC has been installed in compliance with Article 11 of G.S. Chapter 130A, Section .1900 "Sewage Treatment and Disposal Systems," but shall in NO WAY b taken as a guaFantee that the system will function satisfactorily for any given period of time. fQ � � � �i2 ��.a� .. G � a. � �-10 System Type: � S.T. Manufacturer Tank Date �� Tank Size Pump Tank Size S stem Installed B � � 'Q-�- � � ��� ��T�.t� �' � �g .=` �� Y y:�, � E.H. Specialist: Date: ��� ,,, �13�� S��• ��7 �,�/o�o ° a7,��� ,�.� �� � . � �--. ,� . r ��_ , Q a� . .� � � �c / � _. � DAVIE COLTNTY ENVIRONMENTAL HEALTH P.O. Box 848/210 Hospit�l Street Mocksville, NC 27028 (336)751-8760 Fax # (336)751= 8786 AUTHORIZATION FOR WASTEbVATER SYSTENI CONSTRUCTION Account #: 989900194 Billed:To: Brian 8� Deanna Mcllwain Reference Name: Proposed Facility: Residence ATC Number: 4853 Tax PIN/EH #: 5767-94-1969 Subdivision Info: Location/Address: Cedar Grove Church� Road 27028 Property Size: 23.25 Acres Site Type: ew ❑Repair OExpansion **NOTE** This Authorization to Constnict (ATC) MUST BE ISSUED by the Davie County Environmental Health Section prior to issuance of any building permit(s), (in compliance with Article 11 of G.S. Chapter 130A Wastewater Systems, Section .1900 Sewage Treatment and Disposal Systems). THIS AUTHORIZATION TO CONSTRUCT IS VALID FOR A PERIOD OF FIVE YEARS. This ATC is subject to revocation if site plans, pl�t or the intended use chan�e. Residential Specifications: # Bedrooms� # Bathrooms �# People y BasementCa'F3asement plumbing� Non-Residential Specifications: Facility Type # People # Seats Square Footage(or Dimensions of Facility) Lot Size 3. �.� ��� -� 5 Type of Water Supply: ❑County/City CX�ell ❑Community Well System Specitications: Design Wastewater Flow (GPD) �'i �aTank Size� GAL. Pump Tank � GAL. � � Trench Width �� � Max. Trench Depth 3�' �r Rock Depth� Linear Ft.�� Site Modifications/Conditionsl0ther: �',� stated in 15A NCAC 1�F`,.1S�i9�:i} . G.$c.,^'.,�'�.?�i7yTTT7� c.7'.��i.Fc�T=,�c, � Contact the Davie County Environmental Health Section for final inspection of this system between 8:30 — 930a.m. on the day of�stall�'Lt1Qn. Telephone #(336)751-8760. � i .,� �j�) °`Y �- S �vo�. � �Q'��p� Pvy��s Envuonmental Health Specialist DCHD 11/06 (Revised) � (�) I ( G ` k� 3 � � � ►.-�� � , � � �Y� / r�G / � IC �i � �-t 5 � % %�fi� �1 ` f�l�N �c ��� l► rv� U s� 6� �Sd !n. �� �, Gv� r �d'a �`n c�J p �/ � � �<< � � ���`� � -- - – � �. Rr�"!_— �. , � ���� /` w� � % 't v C`� L, ��`'`� y�, / G1r. � -�. r� G �,J.�� ��J .� ---�d — Davie County Environmental Health P.O. Box 848/210 Hospital Street ' Mocksville, NC 27028 (336)751-8760/ Fax (336)751-8786 IMPROVEMENT PERMIT Account #: 989900194 Tax PIN/EH #: 5767-94-1969 Billed To: Brian & Deanna Mcllwain Subdivision Info: Address: 480 Rabbit Farm Trail ' Location/Address: Cedar Grove Church Road-27028 City: Advance � Property Size: 23.25 Acres Reference Name: Proposed Faci�ity: Residence **NOTE**This Improvement Permit DOES NOT authorize the construction of a wastewater system. An Autliorization To Construct a wastewater system must be obtained from this office prior to the construction/installation of a wastewater system or the issuance of a building permit(in compliance with Article 11 of G.S. Chapter 130A, Wastewater Systems). This Improvement Permit is subject to revocation if site plans, plat or the intended use change. Pemut Type: C33�ew ❑Repair ❑Expansion Permit Valid for: C�S�i ears ❑No Expiration Residential Specifications: # Bedrooms / # Bathrooms� # People '� Basement�t7 t3asement plumbingQ� Non-Residential Specifications: Facility Type # People # Seats_ Square Footage(or Dimensions of Facility) Design Flow(GPD):� Type of Water Supply: ❑County/City �11 ❑Community Well SiteModifications/Permit Conditions: �.�., ,.s...,,d in 1��, �i��� 18.�.2.� ��(a) rT�� �cc�pted Systems m�y also be u5�p Initial Site Plan Environmental Health Specialist i.p.l I-06 ��_'1 tk'�7�a.�J ��vu S P LTAR � '�a � y s' � � .r ���n L D �� APR��� FooB Type of Applicatio � � FOTZ SITE EVALUATION/IMPROVEMENT PERMTT & ATC / 4 Davie County Environmental Health `�, ` P.O. Boa 848R10 Hospitsl Street �" Mceksville, NC 27028 � (33�751-8760/ Faz (33�751-8786 _ �: �� (, , � » uah prwemeat Permit Authorizatio ya �r to Existing Syatea► anaion/Mod�'mation of Exiating Syatem or Facility �. '��TFI�$�I,ICATION CANNOT BEPROCESSED UNLESS ALL OF TIIE REQUIRED ��ROVIDED. Refer to the INFORMATION BLJI.LETIN fa instructions. INFORMATTON Name to be Billed 81" 1 Q vJ �'i � 1 � W A.i h Contact Person �� O� �'1 1�► G�.. M� I�W !� Billing Address �$t7 Ra.lo hi t. �Qy'�'�^ Home Phone City/State/ZIP ����,N,j,.� �[ 2.'Y bb Business Phone GD9, —3'7 "1 '7 Name on PermiUATC ifDi,�j'erent than Above Mailine Address YROYEKTY 1NN�UKMAIIUN 'llate House/raci�ty C:ome NOTE: A survey plat or aite plan must accompany this applicatioa. Included: Site Plan (Pamit is vali for 60 months with aite plaa, no expiration with eomplete plat) Owner'sName ���pr�J� C� Phon Owner's Address City/State/Zip_ Properry Address e City� Lot Size 'i •��i [� G. Tax PIN# �'T �,'''j 1�D Subdivision Name(if applicable)_�� o.. Sectioa/I.o Directions To Si�e: (�h 1 v In tL __ � r d .✓ wo u G j++a. �J P1at(to scale) Number� ��� ff the answer to any of the fo ow' questioiu '` yea ; suppoRin docnm�tation muat be atiached Are there any existing wastewater syetems on the aite7 � No — P D S 5� � �� D o e a t h e a i t e c o ntain juiiadictional wetlands? es No Ace there any easements or right-of-waya on the site? Yes o Is the aite aubject to approval by another Public agency7 Yes Will wastewatv other than domestic sewage be genaated'1 Yes No IF RESIDENCE FILL OUT THE BOX BII,OW # People # Bedrooms �_ # Bafluooms _� Garden Tub/Whirlpool Yes Basement es No Basement Plumbing: es No IF NON-RESIDENCE FILL OUT.Tf� BOX BII.OW Type of Facility/Business Total Square Footage of Building # Peopie # Sinks # Crnwnodes # Showers # Urinals Estimated Watet Usage (gallons per day) (Attach documentation of similaz facility water consump6on) FOODSERVICE ONLY: # Seats Type syatem requested: Conventional Aooepted Lmwative Akcmative Other 7 Water Supply Typa County/City Water New Well Exiating Well � Community Well Do you anticipate additiona or axpansions of the facility tLis eyatem is intended to aerve7 Yes No �yfS� W}1b�ij�1C� Thia u to certify Uwt �e infmmation provided on thia application is irue and co:rect to the best oF my knowledge. I understand th�t any permrt(s) or ATC(s) isaued haeafta are aubject to auspension or ievocation if the eite is akerecl, the intcnded use changes, or if ffia infocmation aubmiued in thie app&ca6on ia fsb�ed or changed I hereby graet right of entry W tho Authorized Representative of the Davie County Health Deparhnent to canduct necessary inspections to ddecmine compliance with applicable lavre and mles. I underataad tbat 1 am reepons�le for the proper identification and labeling of pmperty linea and cornere and loca ' and flagging or sWang the /ho�/ls dfacility location, propoaed well location and the locatioa of any othet amenitiea. I ,Y�/L�n.. � �/e�"�^"V Site Revisit Chacge Property owna'e or owna's (cgat repreaentative signature Date(a): 7 I�v�! �f Client Notification Date: � EIIS: Siga given Yes No Revised 1 U06 A�„r# ��g q o 019y Invoice # 7��� C � 0 J � L �.�- b4� - � �� -�u�ot� �� �u�s�xa.� ��"�.�-'o -a�'' s �� --� -�-1 ', ^c� -ac� c'-r a�vuo c� c�n a�! ; � �� at� aoac �a P�-3i .• � DAUIE COUHTY 19-11-9i srap�oTH �49. 00 �apUNA � Real Estate � Exc(se Tax R.t�l�w'M1t _ ..n 05�35�1 IRID FOR REG�511qi�DM October 11, 1996 10:10 A.M. an r� rwo �coaocc w �ooRl4l2.�t35 � � �t �e�sra a oon. e�, /�.°","�.°� .' �!. �/.:..,. Assist�t RecarAln� T7me, Book and Page TxxLot No . ...............�-�........................................................................ Parcel IdentiEer No. .......................................................................... Veri6edby ........................................................................ County on the ................ day of ........................................................, 19............ br...........................................................................................................................................:.................................................................................. Mail after reeordln� ? c..l./A4.Y..�'�-.....kL/.�......5.. o.�:� .........................:.. .. ........................ ............................................. .... ... . ......... ..�./.!�F.... '�d.4�...�r.'r:o.�L....l 1►.�...R..d.• .............M. . o �...k.s .d.<'//�...,..,rl�..4':.�.........�..7 0.-�.............................................:. This inatrument waa prepared by ......Clive I. Goodson . .. ................................................................................................................................................... Brief deacrlption tor the Index Tax Lot 46� Tax Map K-11 NORTH CAROLTNA GENERAL WARRANTY DEED TSI3 DEED made thia ....lOth• aAY of �• •-••� ••••• OCtOber�•••••• •�� �••� •• :� 1� 96 �� �, by and between GRANTOR RENAN LINDSAY CARTER. Single DEED TTi�::'�:FEA C�'!ED DA "�• i�,_, • ��DY � ' ' TAX 5UPEHV��� GRANTEE CHARLIS W. COPE and wifa, VIRGINU B. COPE Enler ln aPVroO►I�k bixk f�r ueh part�: o�me. addres�, and. it sPO�PNate, chu■eler ot wU/7� aq. �ryo�'stlon �r yutcershlµ TLe deaignatton Grantor nnd Grantee sa uaed herein shall include eaid partiea,their he3re, succeeeacs, �nd aeel�aa, rnd ehall include ain�ular, plural, msaculine, feminine or neuter as requlred by contexk WITNESSETH, that the Grantor, for a valuable conaideratton paid by the Grsatee, the receipt of whtch ia hereby sclrnowledged, haa and by theae presente doea grant, bazgain, aell and convey unto the Grantea in fee almple, sll that certain lot or parcel of lrnd nituated in the City of ............................................................. ................................................ Townehip, ...........Ad.Y.�,s ........................... County, North Carollna and more particularly deseribed aa follows: see attached Exhibit "A" for complete property description. Said Exhibit "A" is incorporated herein by reference as if fully•set out herein. N. C. Wr A . Form No. 3 0 1976, RrYbed O 1977 - l.�.wwww � p. Ma, w �n, r.euw.�., r. t t�o66 hwY W ��rwtiM wit� �M N. C. N/�sa. - p!1 � • • GoMAPS - Davie County NC Public Access ,• Davie County, NC - GIS/Mapping System U �s9s � +� �� �� � � i� ,�.� ,,,r� �C7 �, �'C �' �'q � � � � � �� ES Click Here To 5#art Over f#ctiv e L�a}�e r. � ffse Map 'T{rs PARCELS (Map Tips Availabie} f•r' Page 1 of 1 QUick �e�arch:�CoUnty ID c GIS r1ap Layers � Resul#� � http://maps.co.davie.nc.us/GoMaps/map/Index.cfm?mainmapservice=gomaps&CFID=412... 4/ 10/2008 �. , ,� � ' DAVIE COUNTY HEALTH DEPARTMENT Environmental Heaith Section ` , Soil/Site Evaluation APPL�A�TitII�FC���SiA'ri'i�1 Tax PIN/EH #: 57f,��P'r��Y INFORMATION Billed To: B�ian & Deanna Mcllwain Subdivision Info: Reference Name: Location/Address: Cedar Grove Church Road-27028 Proposed Facility: Residence Property Size: 23.25 Acres Date Evaluated: �% � a 3— �� Water Supply: ' On-Site Well " Community Public Evaluation By: Auger Boring Pit Cut tviineraiogy TTl1TTrJlIAT TTT TrT]T�T HORIZON IV DEPTH Texture group SOIL WETNESS TT[�TTT/�✓T�T<lT Tt/lTTrllITT SITE CLASSIFICATION: P�i EVALUATION BY: �.� ��Q !�d rl S LONG-TERM ACCEPTANCE RATE: �' a 7� OTHER(S) PRESENT: �!,l -P a Ul v� Q/ ���l ��^'oy v` REMARKS : LEGEND r,�n s ane Position . R- Ridge S- Shoulder L- Linear slope FS - Foot slope N- Nose slope CC - Concave slope CV - Convex slope T- Tenace FP - Flood plain H- Head slope � 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 �ONSISTENCE a'I4is.t . VFR - Very friable FR - Friable FI - Firm VFI - Very firm EFI - Extremely firm � NS - Non sticky SS.- Slightly sticky S- Sticky VS - Very Sticky NP - Non plastic SP - Slightly plastic P- Plastic VP - Very plastic �tri�ct� SC - Single grain M- Massive CR - Crumb GR - Granular ABK - Angular blocky SBK - Subangular blocky PL - Platy PR - Prismatic Mineralo�v " 1:1, 2:1, Mixed 1YQt� ' Horizon depth - In inches Depth of �11 - 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 r�r-Ur� n�inc in....:..,,.,. ����� o-� � �� , � '1vv� �,,- ---" � � �� , 3 � .� `�' � � , r � � � �"' C ` � ,,,.�, . �' � �� ��" � � � �� v �- �, � J � ;,,.�� �a ���` f� S � � s` ��' �� � r � '�'d (Uv ., p / ,�. �- �� 3 � �l � � �� � vJ � Sa �-�.