153 Cress Ln DAVIE COUNTY ENVIRONMENTAL HEALTH
P.O.Box 848/210 Hospital Street .
Mocksville,NC 27028
(336)753-6780/Fax#(336)753-1680
REPAIR OPERATION PERMIT
Account #: 990005591 Tax PINI H#: 5769-87-0309
Billed To: Scott Jamie Subdivision Info:
Reference Name: REPAIR PERMIT Location/Address: 153 Cress Lane-27006
Proposed Facility: Residential Repair Property Size: 15.17 Acres
AT *fflW*Ae ss ance of this Operation Permit 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 be taken as a guarantee that the system will function satisfactorily for any given period of
time.
}System Type:_S.T.Manufacturer r7C Tank Date Tank Size
Pump Tank Size I
System Installed By: E.H.Specialist: Wte
:
GPS Coordinate:
b1 �
3
DCHD 11/06(Revised)
DAVIE COUNTY ENVIRONMENTAL HEALTH
P.O.Box 848/210 Hospital Street
- Mocksville,NC 27028
(336)753-6780/Fax#(336)753-1680
REPAIR IMPROVEMENT PERMIT
AUTHORIZATION FOR WASTEWATER SYSTEM CONSTRUCTION
Account. #: 990005591 Tax PINIEH#: 5769-87-0309
Billed To: Scott Jamie Subdivision Info:
Reference Name: REPAIR PERMIT Location%Address: 153 Cress Lane-27006
Proposed Facility: Residential Repair Property Sizer 15.17 Acres
AT lt•;W* Thi 5IP-/9Authorization to Construct(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 IP/AUTHORIZATION TO
CONSTRUCT IS VALID FOR A PERIOD OF FIVE YEARS. This ATC is subject to revocation if site plans,plat
of the intended use change.
Residential Specifications: #Bedrooms #Bathrooms #People Basement❑ Basement plumbing❑
Non-Residential Specifications: Facility Type #People #Seats
Square Footage(or Dimensions of Facility)
Lot Size 5 Q,(- Type of Water Supply: ❑County/City lKWell ❑Community Well
System Specifications: Design Wastewater Flow(GPD) Tank Size1_(t AL.Pump Tank GAL.
it
,
Trench Width� Max.Trench Depth 3(, Rock Depth Linear Ft.O _: 60-06 _ �(v�
Site Modifications/Conditions/Other: ""`" n
Contact the Davie County Environmental Health Section for final inspection of this system between
8:30—9:30a.m.on the day of installation. Telephone#(336)753-6780.
.9,
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Environmental Health Specialist DaEnvironmental
DCHD 11/06(Revised)
DAVIE COUNTY ENVIRONMENTAL HEALTH SECTION
APPLICATION FOR IMPROVEMENT PERMIT(REPAIR)
NAME PHONE NUMBER
ADDRESS '�3 Cr'e ss L441E SUBDIVISION NAME
LOT#
DIRECTIONS TO SITE rl-)
1Y. (V 10A &t6& &W10
Q res o
DATE SYSTEM INSTALLED M3 NAME SYSTEM INSTALLED UNDER ==*'IYIP.
TYPE FACILITY NUMBER BEDROOMS `3 NUMBER PEOPLE SERVED
TYPE WATER SUPPLY SPECIFY PROBL9M OCCUR
RIN E70,
, o z: 3
DATE REQUESTED INFORMATION TAKE91BY
This is to certify that the information provided is correct to the best of my knowledge.and that I understand t am responsible for all charges incurred from this application.
SIGNATURE OF OWNER OR AUTHORIZED AGENT
Rev.1/93
J 1 if
DAVIE COUNTY HEALTH.DEPARTM ENT
-`- I=MPROVEMENTS PERMIT AND CERTIFICATE OF COMPLETION
f NOTE:Issued In Compliance With Article 11 of G.S.Chapter 130a ��3 0N '55 L.C�
Sanitary Sewage Systems J e it Number
Li- l_. ? .-f, � r, Date No
Location -
��
Subdivision Name' Lot No. Sec.or Block No.
Lot Size House Mobile Home— Business Speculation
No. Bedrooms No. Baths ,�) �9 "'No. in Family�—
Garbage Disposal YES ❑ NO 0—
Specifications for System: ._
Auto Dish Washer YES NO ❑ �v,) .; 01
Auto Wash Maohine YES NO ❑
Type Water Supply
*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.
r,
Improvements permit by
'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-,55985. y'
Final Installation Diagram: System Installed by
�V
Certificate of Completion Date
`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 betaken as a guarantee that the system will function
satisfactorily for any qiven period of time.
Appraisal Card - ffl-3 Page 1 of 1
leval
IE COUNTY NC 7/7/20119:50:30 AM
IE SCOTT F & JAMIE ANGELA C H7-000-00-058-06
CRESS LN UNIQ ID 13758
D439-P20 ID NO:5769870309 xQ
COUNTY TAX,FIRE TAX CARD NO.1 of 1
Year:2009 Tax Year:2011 15.17 AC BRIER CREEK RD 15.110 AC SRC=Inspectionaised b 19 on 09/04/2008 07001 SHADY GROVE TW-07 C-EX- AT- LAST ACTION 20100922
CONSTRUCTION DETAIL MARKETVALUE DEPRECIATION CORRELATION OF VALUEndatlon-3 EH. BASEStandard 0.1600 tinuous Footin 5.0 SEMOD Area UA RATE RCN REDENCE TO MARKET
Floor System-4ood 8.0 01 01 2 703 133 91.772507 419931993 N GOOD 84.0 DEPR.BUILDING VALUE-CARD 210 63 Crior Walls-21 TYPE:Single Family Residential Single Family Residential EPR.OB/XF VALUE-CARD 11,99
ace Brick 34.0 MARKET LAND VALUE-CARD 163,53
tooling Structure-03 STORIES:1.0 Story �- OTAL MARKET VALUE-CARD 386,15
able 8.0
tooling Cover-03
s halt or Composition Shingle 3.0 TOTAL APPRAISED VALUE-CARD 386,15
nterior Wall Construction-5 TOTAL APPRAISED VALUE-PARCEL 386,15
)rywall/Sheetrock 20.0
nterior Floor Cover-08
heet Vinyl 6.00 TOTAL PRESENT USE VALUE-PARCEL
nterior Floor Cover-14
TOTAL VALUE DEFERRED-PARCEL
:arpet 0.0c TOTAL TAXABLE VALUE-PARCEL 386,15
eating Fuel-03
PRIOR
as 1.0
UILDING VALUE 195,47
eating Type-04 BXF VALUE
orced Air-Ducted 4.0 ND VALUE 109,53
Ir Conditioning Type-03 RESENT USE VALUE
entral 4.0 EFERRED VALUE
drooms/Bathrooms/Half-Bathrooms rOTAL VALUE 305 OO 9
/2/1 13.000 I F G D I a
drooms 1 I ^
AS-3FUS-0 LL-0 0 1
22_---+ 2
athrooms I P T O I 4 `+
AS-2 FUS-0 LL-0 1 1 I PERMIT
alf-Bathrooms 4 4 I CODE DATE NOTE I NUMBER AMOUNT O
a
AS-I FUS-OLL-O I I 1
OTAL POINT VALUE 106.00 s-''
+-12--+0AS I OUT:WTRSHD: n
BUILDING ADJUSTMENTS IWDD I I SALES DATA
ize 3 Size 0.950 I I I
uali 4 ABAVG 1.200 1 1 I FF. INDICATE N
8 6 I ECORD ATE DEEDjj SALES
ha a/Desi n 5 FACTOR 5 1.100 1 1 3 OOK AGE M R TYPE / PRICE
OTAL ADJUSTMENT FACTOR 1.25 +-12--1 2 0158 871 14 11991 WO V
OTAL QUALITY INDEX 13 1 I
I I
1 I
8 I
I +-----28------+ +--14--+ HEATED AREA 2,3S2
I4FOP 4 4
+-14--+-----28------+-14--+ NOTES
OG
OPE BROS
SUBAREA UNIT I ORIG% AN DEP % OB/XF DEPR
GS OD DESCRIPTIONLTH H NIT PRICE CORD LDGYf AYB EYB RATE V GOND VALUE
TYPE AREA % RPL CS 25 1BARN 1 41 3 1 58 15.0 10 L 1199211994 S 1 4 1164
AS 2,3 2 1001215843 10 ICON PAVING 1 241 241 5761 4.0 L 11992119921 SN 1 14 34
GD 5763451 23768 TOTAL OB XF VALUE 11,98E
OP 112 3351357
PTO 30 8)0 137
DD 19232 348
N'RELArECE &.ATA
2 7050,75G DIAS=W4FGD-W24N24E24S24 W24PT0=W22N14E22SI4$W42S2WDD-WI2S16E12N16$534E14FOP-N4E28S4W28$N4E28S4E14N4E14N32 .
FORMTHERAD]USTMENTSLAND TOTALT CAL FRON DEPTH/ LND COND ND NOTES OA UNIT LAND UNT TOTAL ADJUSTED LAND LAND
ING TAGE EPTH SIZE MOD FACT RF AC LC TO OT TYPE PRICE UNITS TYP ADJST UNIT PRICE VALUE NOTES
380 01.0490 4 1.1100 OS+20+00-10+00 PW9300.0 15.10 AC 1.16 10 825.2 163525
ARKEA 15.10 16353ESE
http://maps.co.davie.nc.us/ITSNet/AppraisalCard.aspx?parcel=670000005806 7/7/2011
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�= DAVIE COUNTY HEALTH.DEPARTMENT
7-IMPROVEMENTS PERMIT AND .CERTIFICATE-OF COMPLETION
*�NCTE:Issued in Compliance With Article II of G.S.Chapter 130a Ore5:5
Sanitary Sewage Systems i Zd @ it Number
jN me, - ".//.�11�r; 1 ,�� ;��. �� � �.1., Date N2 �? .
Location
Subdivision Name Lot No. Sec. or Block No.
Lot tSize House Mobile Home Business Speculation
No. Bedrooms No. Baths `No. in Family _
Garbage Disposal YES E] NO g-- " Specifications for ySystem:
Auto Dish Washer YES ❑ NO p 1 /.
Auto Wash Ma.hine YES NO ❑ f C�Li 5 `/ ��
Type Water Supply _
*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.
1
1
Improvements permit by
*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 CompletionDate
*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.
1 3, _
S ,
PPLICATION FOR SITE EVALUATION/IMPROVEMENTS PERMIT
JV
�- Davie County Health Department
Environmental Health Section
-
P. O.- Box 665 1 Q
y ( Mockaville, NC 27028, �,�•CC AP
�O�_ fid- �.�`'9-�`- •,�' � .
1 . Application/Permit Requested By
Mailing Address i
Home Phone Business Phone
2. Name on Permit if Different than Above
3. Property Owner if Different than Above
4. Application/Permit For: neral Evaluation 0 S/Tank Installation
S. System to Serve: ff--House u Mobile Home 0 Business
Industry u Other 0 Unknown
6. If house, mobile home: Subdivision /' Sec. Lottt
No. of People Dwelling Dimensions
No. of Bedrooms J Basement/Plumbing
No. of Bathrooms a � t- Basement/No Plumbing
Washing Machinee--Dishwasher 0 Garbage Disposai
7. If business, industry, other Specify type
No. of People Serve No. of SAiTks
No. of Commodes No.
No. of Lavatorie No. f ter Coolers
No. of Showers
. f
8. Type of water supply: B--ru blic 0 Private a Community
9. Property Dimensions �-�+• Z A <
10. Sewage Disposal Contractor
11 . Do you anticipate additions/expas ions of the facility this system is
intended to serve? Q Yes 2-No
If yes, what type?
*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.
This is to certify that the information provided is correct to thEe
best of my knowledge, anis- I understand I am responsible for all
charcyes incurred , from this applic on.
/�
Ap/
Dae Signature
Directions to Property : A
n�
^ h J 1 P
C �'-
DCHD (10-89)
r , Ar
.
DAVIE COUNTY HEALTH DEPARTMENT
Environmental Health Section
Soil/Site Evaluation /A
�NAME ��_ DATE EVALUATED �Y
ADDRESS PROPERTY SIZE
PROPOSED FACIILTY LOCATION OF SITE e� o����/ �[✓
Water Supply: On-Site Well Community Public
Evaluation By: Auger Boring Pit Cut
FACTORS 1 2 3 4
Landscape position
Sloe Z —
HORIZON I DEPTH
Texture group
Consistence
Structure
MineralogX
HORIZON II DEPTH
Texture group
Consistence LL /
Structure
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 � r -
SITE CLASSIFICATION: EVALUATED BY: AZ 2
LONG-TERM ACCEPTANCE RATE: OTHER(S) PRESENT:
REMARKS:
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
CONSISTENCE
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
DCHD(01-901
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Davie County Nealtl Department
and .Mame Nealt§i Ayency
210 HOSPITAL STREET/P.O. BOX 665
MOCKSVILLE,N.C. 27028
PHONE:(704)634.5985
April 29, 1991
Angelina & Scott Jamie
c/o Potts Realty
P. 0. Box it
Advance, NC 27006
Re: Site Evaluation
Off Greenbriar Road - 15. 2 Acres
Dear Mr. & Mrs. Jamie:
As requested, a representative from this office visited the aforementioned
site on April 26, 1991. The site was found provisionally suitable for the
installation of a ground absorption sewage system.
If you have any questions, please feel free to contact this office.
Sincerely,
AW
Robert B. Hall, Jr. , R. S.
Environmental Health Section
RH/wd
Enclosure