940 Eatons Church RdDavie County, NC
Tax Parral Rannrt
Wednesdav, October 12, 2016
WAK1V11�(�: l'Hl� 1� 1VU1 A aUKVLY
Parcel Information
Parcel Number: D300000054 Township: Clarksville
NCPIN Number: 5822606525 Municipality:
Account Number: 8300448 Census Tract: 37059-801
Listed Owner 1: EATON JAMES A Voting Precinct: CLARKSVILLE
Mailing Address 1: 940 EATONS CHRUCH ROAD Planning Jurisdiction: Davie County
City: MOCKSVILLE Zoning Class: DAVIE COUNTY R-20
State: NC Zoning Overlay:
Zip Code: 27028-0000 Voluntary Ag. District: No
Legal Description: 195.971AC EATONS CHURCH Fire Response District: WILLIAM R. DAVIE
Assessed Acreage: 205.20 Elementary School Zone: WILLIAM R DAVIE
Deed Date: 7/2011 Middle School Zone: NORTH DAVIE
Deed Book / Page: 008620943 Soil Types: MrC2,MrB2,MnC2,Mn62,Gn62,RnD,MsC,ChA,MsB,WATER,MsD
Plat Book: Flood Zone:
Plat Page: Watershed Overlay: DAVIE COUNTY
Building Value:
0.00 Outbuilding & Extra 23250.00
Freatures Value:
Land Value: 797410.00 Total Market Value: 820660.00
Total Assessed Value: 110560.00
°�^°'F Davie County,
�o�;N�i NC
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A��THnttlZ�7'�otv NO: °� ��' � DAVIE COUNTY HEALTH DEPARTMENT �
•� j Environmental Health Section PROPERTY INFORMATION
Permiftee's ;�-^ � P.O. Box 848
Name: ..��,fl r��'%`?.�"��-�"-� Mocksville, NC 27028 Subdivision Name:
„ Phone # 336-751-8760
Directions to property: �::� ��. l l�i i: c! Section: Lot:
AUTHORIZATION FOR
WASTEWATER ��-� �. �.�' s',�'��, �,,.,..�
SYSTEM CONSTRUC7'ION Tax Office PIN:# � i- G....� ti-�,;
+�" �`��f�`� �'.�l`L�ip �"? `�i��'c� �'
Road Name: % �,
**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.
(ln compliance with Artide 11 of G.S. Chapter 130A, Wastewater Systems, Section .1900 Sewage Treatment and Disposal Systems)
-� �,% ***NOTICE*** THIS AUTHORIZATION FOR WASTEWATER CONSTRUCTION
ir ,��;5,'/%.;i.�� /� �' �:1 IS VALID FOR A PERIOD OF FIVE YEARS.
ENVIRONMENTAL HEALTH SPECIALIST DATE ISSUED
�
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+[ -�..- y I. - , .. :.- ..",,,�af+:. "' � -. .� ` i s- - c=�.y, ,�. .. . . _.. . � . . ... -. ... .. .. . ...
/ -.�J t -� .. . � "'� .. . .. �.. .... . .
. . 1 . �. . . � . . � � I . � / � J- ✓ / r /�� , .a.. ' 1 : � 1 r .: i
: �� r � � -�� �^ � "� ;� `,� � DAVIE � OUNTY HEALTH DEPARTMENT , �
���` -- �- -� TMPRC�VEMENT AND OPERATION PERMITS PROPERTY INFORMATION
Peri�'ittee's ,
Name: ��.� . `: � ~ �� .� Subdivision Name:
r rv Directio�s to propertys �. :�` r•"�..; ,� .� Section: Lot:
- - Il1�PROVEMENT _ , .
PERMIT 4-`f`.; "1 `. 1' ., � -,
Tax Offce PIN;#.., � r:�� - t'�e'`'�� -�`��>, �-'= ...1
,
Road Name: � � ��,?' �..J:. .! i�ip: -� 'It�r- G
**NOTE** This Improvement Pernut DOES NOT authorize the construction or installation of a septic tank system or any wastewater system. An
AUTHORIZAT'ION FOR WASTEWATER SYSTEM CONSTRUCTION must be obtained frc�m this Department prior to the
construcdon/installadon of a system or the issuance of a building pemut.
(In compliance with Article 11 of G.S. Chapter130A, Wastewater Systems, Section .1900 Sewage Treatment and Disposal Systems)
",,� ,� ; �,.�,� ***NOTICE*** THLS PERNIIT IS SUBJECT TO REVOCATION IF SITE
�"�`. ` l'; i". `. i r:.�' ,li ? ,/": y�'' �� PLANS OR THE INTENDED USE CHANGE. YOUR WASTEWATER
ENVIRONMENTAL HEALTFiSPECIALIST DATE ISSUED SYSTEM CONTRACTOR MUST SEE TIIIS PERNIIT BEFORE
INSTALLING TEIE SYSTEM.
RESIDENTIAL SPECIFICATION: BUILDING TYPE �_ # BEUROOMS �� # BATHS �,_ # OCCUPANTS ~' GARBAGE DISPOSAL: Yes or No
COMMERCIAL SPECIFICATION: FACILITY 1'YPE # PEOPLE # PEOPLEISHIFT # SEATS INDUSTRIAL WASTE: Yes or No
LOT SIZE �=C� TYPE WATER SUPPLY Gt/P/l DESIGN WASTEWATER FLOW (GPD) � NEW SITE �REPAIR SITE
SYSTEM SPECIFICATIONS: TANK SIZE �GAL: PUMP TANK GAL. TRENCH WIDTH � ROCK DEPTH � LINEAR FT. . OZ'' +
_ OTHER �Jn !� �'O✓� ll' 7 , �71�/` %!%.�,/O r/ �' d h' � .TP!" � Y � � r /Dlt� �i ! /i �i'�/'/y/E'
REQUIRED SITE MODIFICATIONS/CONDITIONS: _
IMPROVEMENT PERMIT LAYOUT
�
**CONTACT A REPRESENTATIVE OF THE DAVIE COUNTY HEALTH DEPARTMENT FOR FINAL INSPECTION OF THIS 3YSTEM
BETWEEN 8:30 - 9:30 A.M. OR 1:00 - 1:30 P.M. ON THE DAY OF INSTALLATION. TELEPHONE # IS (336)751-8760.
��6
.�
OPERATION PERMIT
26
SYSTEM INSTALLED BY:
' r ,/✓�fjj
AUTHORIZATION NO. OPERATION PERMIT BY: DATE: ��� vv
"TE� ISSUANCE OF THIS OPERATION PERMIT SHALL INDICATE THAT THE SYSTEM DESCRIBED ABOVE HAS BEEN INSTALLED IN COMPLIANCE
WITH ARTlCLE 11 OF G.S. CHAP'TER 130A, SECI'ION .1900 "SEWAGE TREATMENT AND DISPUSAL SYSTEMS", BUT SHALL IN NO WAY BE TAKEN AS A
GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFAGTORILY FOR ANY GNEN PERIOD OF TIME.
DCHD OS/96 (Revised)
;t
` J�,� �. P��!!CIl1"��IV FOR SIIE EVAWATION/IMPROVEMENT PERMI� 8r
.� �v,,, � � Q�avie County Health Department � e [� [� � �] [�
�"�" �� • � �I }M p.� EBoiroem�enta�/H�ea/tht� t�t
� `�'�"� v �
� �� Moaksville, NC 27026 2 $ �
v•
(336)751-8760
t1V1ROtJ'.tEPtTAI HEALTN
*** IMPQRTAIITI'� ** THI3 APPLICATION CANNOT 8E PROCESSED UNLE33 AL ' LLr ------"
INFORMI�TION IS PR4VIDED. Refer to the INFORi1ATION BOLLETIN for instructions.
�. N� �� 8���� .�;��„�, L G�o,� ���t �s� .�.:� r,-, � a�--a�
►����nQ ��s �i �� �� �-('o �,,AY� �, �r d. 8� �,�e R� � - �3ay 3
City/State/ZIp ��` \S\i`1 1'� 1 JV l_- o{ / � d� Business phone 'i� 0' ! Ot h�
2. tlame � IIermit/A?C i! Di!lereat thaa Above
1laiiing llddtesa City/8tate/Zip
3. ]►pplica*...�.oa Sor: 1'f�site Evaluation �,✓Iag+rov�ement P�rmit/ATC ��..D:
�. �tyr:r:es r:o serv�.w: �/�a���� � L?��?��.3e Home L� .�us�ness 0 ;Ladust:s;�+ � *�*.ixe�r __ , _
�. If Residence: {i People � � Bedreoms ��, � IE,a::zsac;ats _�, � _
0 Dishwasher U aarbaqe Diaposal 0 tiaahing liachine 0 Haaem+�►t/Plumbinq 0 Aaaer�ent/No Pl�a�nb".:.R
6. i! 8nsinesa/Industry/Other: specilY type # Peapie � 81nke r-- —
• Co�od�ea ` � Bho�ers� * Urinals � Rater Caoxers
ITi �'9�DSERVICS: � Seats Estimated iiater LJsage tQalions per aay)
�. �►pe of water supplp: ❑ Conaty/City ' i%11 U C�itg
e. Do yo� anticipate Additiona or e:pAnaions of t6e facility t6is ryatem ia intended to aerve? �� es C do
If yes, w6at type'
"**IMPIORTANT"" CLIENTS �lUST COalPLETE THE REQUIRED PROPERTY TNFORMATION REQITLSTED
BELOW. Either a PLAT or S[TE PLAN �IIIST BESUBt1lITTED by the clteat wit6 THIS APPI.ICATIUN.
Propecty Dimensiona: __ _� C� (! %�S �''' DIREG7'IONS (trom Malcsvilie) to PROP�R'!'�:
Tai Q�ffice PIN:
Property Addrea�s:
#. ..�_��a_��� =��5�a�,��� ���..�.����.�_
j f ,
Ro�d NAme��,���r�,5 C� ,�6 �1 •��U rC,h �Gl . I �� m�les _
City/ZiP �LK�s! �. I l e.�t>C a 7� ��� �'��t��n t'a� m,� -�..�►' Vl-- �
If in a Subdiviaion pTovide iniorroation, as followa: y''�� Q�,�`FA
Name:
Section: Block: Lot: Date Property I�lagged: ��
This i� to certity t6at t6e information pravide� is correct to the beat of my kaowledga I underataad that any permit(a)
issued bereafter are aubject to auspension or revocation, if the aite pixns ar intended use c6ange, or if tbe iaformation
submitted in thia ApplicAtioa i� falsified or chxaged. I, also; rtnderstand that I am ►�esponsible jor all clyargu 3nc�rred jrom
this applicaation. I, her�eby, give coaaent to the Aat6orized Repreaentative of the Davie Ca�unty Healt6 Department
to eoter upon above described property located in Davie County and owned b�• �'� „r,-, f� ,hC�r�p �j=��r,
to conduct all testing procedures as necawry to determine t6e �ite witabilih. ,
., ...
DATE I r � � C S1Gl�lATURE ` �_._�_ _ _ ,,_ _ _ � _
TH'dS AREA MA�+t *�� II;��� "'":, : r��+t�v�%.�Y�-'��ITIt SI II'�: P (�ns�ade all of t6e tollowing: E�sting wd propost�
prnperty linea nnd dimensions, atructurea, aetb�ka, and =eptic I�ations).
Reviaed DCflD (07/98)
Account No. �� �
Invqice Na � �U
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: t -� "` x ��
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. � �
, , � � • DAVIE COUNTY HEALTH DEPARTMENT
°., • Environmental Health Section SECTION LOT
Soil/Site Evaluation
_>�,.
APPLICANT' S NAME ,�� ��f�J n DATE EVALUATED �' 7��X
PROPOSED FACILITY ,�°d� PROPERTY SIZE � r �t C
SUBDIVISION ROAD NAME / /� /D�,/ �� ��
Water Supply: On-Site Well �/ Community
Evaluation By: Auger Boring Pit
HORIZON II DEPTH
HORIZON III DEPTH
Texture group
••__..........,...
icr.� i tu�. i i v n nvtuc.viv
SITE CLASSIFICATION: �
LONG-TERM ACCEPTANCE RATE: i �-�
REMARKS:
DCHD (O]-90)
Public
Cut
EVALUATION BY:
OTHER(S) PRESENT:
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 - Subangulaz blocky PL - Platy PR - Prismatic
Mineralogv
1:1, 2:1, Mixed
Notes
Horizon depth - In inches
Depth of fill - In inches
Restrictive horizon - T'hickness 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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