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3652 Hwy 158 yr . .. a `",'`".w:., �.«�.i: !',` `,:.d"•..,;+yf.-,}.�r:fy l;. a _., f,^ r,7�.a_....`— •, �t't..a .i.�. „ . _ . .. r..4�r:'�.ti;,r-.,. DAVIE COUNTY HEALTH DEPARTMENT — IMPROVEMENTS PERMIT AND CERTIFICATE`-0F COMPLETION *NOTE:Issued in Compliance With Article I I of G.S.Chapter 130a Sanitary Sewage Sy tems \\ Permit Number Name A Date J _3 U _ N- 7501 Subdivision Name Lot No. Sec: or Block No. �{ D' x G$o� Lot Size -'� House Mobile Home Business -- Industry No. Bedrooms No. Baths No. in Family _ Public Assembly Other Garbage Disposal YES ❑ NO pecifications for System: Auto Dish Washer YES E{ NO ❑ Auto Wash Ma^hine YES NO ❑ `' V;"v C.et 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. O r ` a 2 " 133 ! 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., 1:00-1:30 P.M.or 4:30-5:00 P.M.on day of completion.Telephone Number:704-634-5985. ST�R"k H ' SFinal Installation Diagram: r'o nstalled by utv o a -U`- U P _o o, a r ' D O N . r ° 1 14D! ! �. 13 }" Certificate of Completion ` Date 9 *The signing of thisicer.tificatel 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. a r- 9 y APPLICATION FOR SITE EVALUATION/IMPROVEMENTS PERMIT f t Davie County Health Department '�� -� 9 LA Environmental Health Section I ,1 �Vo - P. O. Box 665 l Mocksville, NC 27028 1. Application/Permit R questeed�By // G " Mailing Address 1'(iG�SU t (� �G�C 24—A Home Phone b Business Phone 2. Name on Permit if Different than Above—1 3. Application for. ❑General Evaluation 1'Septic Tank Installation Permit 4. System to Serve: ZKAouse ❑ Mobile Home ❑ Place of Public Assembly ❑ Business ❑ Industry ❑ Other ❑ Unknown 5. If house, mobile home:Subdivision-,J7�� CQLY� QSI1, /CC-A Section Lot # f[�'Basement/Plumbing No.of People2 ❑ Basement/No Plumbing No. of Bedrooms r•? Dashing Machine No. of Bathrooms - E?6ishwasher Dwelling Dimensions `�� (� ❑ Garbage Disposal 6. If business, industry, place of public assembly, other: Specify type 'No. of People Served No. of Sinks No. of Commodes No. of Urinals No. of Lavatories No. of Water Coolers No. of Showers Water Usage Figures 7. Type of water supply: Q'Pu [� blic /Q � ❑ Private f ❑ Community 8. Property Dimensions �ix M6 Sewage Disposal Contractor `) / 9. Do you anticipate additions/expansion of the facility this sytem is intended to serve? ❑ Yes Cr1lo 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. Directions to Property: �4.twc This is to certify that the information provided is correct tot e b st of my knowledge, and nde a d I am responsible for all charges incurred from this application. " DATE / SI ATURE N CONSENT FOR SITE EVALUATION TO BE DONE ON ABOVE DESCRIBED PROPERTY MUST CHECK ONE: 1. I OWN the property. ❑ 2. 1 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 Davi Coun Health Department to enter upon above described property located in Davie County and owned l: 4 to conduct all testing procedures as necessary to dete a aid site's suit ility for a gr nd absorption sewage treatment and disposal system. -- DATE SI NATURE DCHD(1193) 1. DAVIE COUNTY HEALTH DEPARTMENT Environmental Health Section Soil/Site Evaluation NAME DATE EVALUATED - o 94 ADDRESS S 'P �'` ''` PROPERTY SIZE PROPOSED FACIILTY bus'� LOCATION OF SITE Water Supply: On-Site Well Community Public L/ Evaluation By: t;� Auger Boring 4EW Pit Cut FACTORS 1 2 3 4 Landscape position s .S _S' -S Sloe % -6 I.S° - - 8 ' u' HORIZON I DEPTH Texture groupL �- Consistence 775= Structure G ie_ lzllc �t. MineralogX HORIZON II DEPTH " L`� G 6 6 Texture groupC Consistence 'L Structure Mineralogy '► 1 Ylo ' HORIZON III DEPTH Texture group Consistence Structure Mineralogy HORIZON IV DEPTH Texture group Consistence Structure Mineralogy SOIL WETNESS V S SS .sem RESTRICTIVE HORIZON be — — SAPROLITE S CLASSIFICATION LONG-TERM ACCEPTANCE RATE , SITE CLASSIFICATION: Q 'S• EVALUATED BY: LONG-TERM ACCEPTANCE RATE: 1 :� OTHER(S) PRESENT: REMARKS: sS L GEND 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 Mineralmy 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 ■■Meet■■■E■■■e■NE■■■■■NE■■e■■eE■■e■eeEEee■M■E■■N■■■ ■M■E■■Ms■■■�IE■ ■■e■e■MEE■■■e■■E■Nte■e■■ettteee■ ■■teeteee■■.Nee■:■■ea■eetteee■■i ■■e■■e■■■■■■■■■e■■■e■■■eeeeeeeee�teee■■ee■M■Me■■■■■■A■■./eeNM■N■N ■■■■eM■NE■EM■■iE■t■tet/■■■teE■■eeeee■■■tM■MEMM■■M.M■N■M■eM/..■Mee■ ■■■■et■■E■Nee■■eeeete■■eeeeeeeeee■■■Mee■■■■Ee■e■■Nee■■/t.E■M/eeN�■ ■■e■■■■teieteete■■e■.■■M■■■■■eeeeei■teEN/itENee■N■■M..N.■■i.N■■NE■ ■■■M■e/■■■EMM■.cite/■Me■■eM■■ea■ ■■■■■■EMM/■■■■■■■:■■/■■■■■■■■■/■ ■e■i■■E■■■■■■■E/N■EN■tete■.■■■■■�■NE■.■►■alca■■■/■w■■.■r.■■■.■■.■■■■ ME MEN MINAE NINE ME onammummommoom ■■.■■■/■■■.■■.■■w��M■■■/NN:■■■■■■MOM/■■►��►�.■►.■■AM■E■■■Ns■E■N■N.MM■ ■.■..■■.■■../■■r►��i►■/..■■/■■■..■■ ■■.■■��./�■.■■.■■■■.■■■■■■■■.■■ ■■■■■■.■/.■■■■■■w.rt.■■■■■■■.■■■.■■■■■■■■.■/■■■■� .■■_ N■.■NA■■■.■■O MEN No ■■IN m ■.■■o■mommom ■/ ■■■..■.■.■.■■■■e�.,.■■a■■/.■.■■■■■MN=■■N.■A■■E■i ■.■■N■ ■r�►�■wuna:oso IM ■■ . ■■■■■■MNEet■M■e■.�:�■Me■■■■■■■e■I-. ■■Ir:■�■nt■■: EN■.N■■r.�:.�■■■■NM ■E■ ■■./■.■■■■■■■.■■■...■■■■■■■■/Net /■I\TilMer. �l■e/■/■i�ee/.!\`\tee tee/ ■/■■.■■■■■■■■■■/■■■■■■/.■■//■/■■■.■■■■■■. ■onomANON■IM 1HIMM MOENO.O ■■■■■■■■■.■■■.■/■.■■■■■■M■■■■/■■■■■tN■■■�/■EI/MN■■� .A '�1lO■■NOM■. : ON ,:..�:: :::::::CM :: ::,MMMMMM ■■■.:M■■E■■.■..EN.M.■M�......Sli/.l...n�.!!.■■..■..■:Milmommom-mmo ... .. . . ..... 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Al iia \MMNA■ea■■■\■o�INEO/■E■:MOO NNMNMNNM[NE MANE . ■■t: o■:�■■.■■■O1�:r!eN■E■Nta■N .e.■► NOON MIN■::N■eMMNMeeM��tee■■■ ■M�iiAANE AAM■AAetAeeV',%MGA\■■■■e1■�\N■/�OMNNe■■/NNONNANA■■A■IEA■■e■E ■.ANNA■MMM ■AA■N.EE%■ L1■\M■..■NON.\■■■ ��NAAAMNNA ANANN/�.N�r■e■M■AN ■tele!•■■■■:■cele!■//ecl�►'rlew■■M■eme/■n■M ►\■■■■■■O■:.■■tow■mommo000Nw Nee■ecce■■Eettt■■■aye■�:ieee■Ieeeeeaeeea�eel��eeeeeeeeeeeeeeeeeeeeete.tt ■■ o ■NMO■/t■Ae.Mt■■1►1_��I/E�t■t■11■■■itrNNOANONN/AM..NONAN■■1.NNE/ON :t�rA ■:tet■tMtMete■tet■■etee■■■■ ■■■t/:M■NEMEMNNNEM■NM■MMUM■■ME:M MeeE/t/BEENMete■■eeeeeee■Mee■■ MteeM■eeteeeetMMMMMMMMNMI/EeettA■ ■■eN■ ■■MMM■■■■et�e■t■eEeeEteeMMMAt■ ■ ■MN/.■MENtAENMNt�M■MA/�� Parcel#: F60000005203 Page 1 of 1 oNY1 Davie County, NC - Basic Estate Search ®ri --11r, Davie County Web Site Basic Search Real Estate Search Tax Bill Search Sales Search View Property Record for this Parcel View Map for this Parcel View Tax Bill Information Parcel#: F60000005203 Account#:34752370 Owner Information Tax Codes EO652 NDRIX CRAIG D&HENDRIX ANITA H ADVLTAX-COUNTY T US HIGHWAY 158 FIREADVLTAX-FIRE TAX CKSVILLE NC 27028 Property Information Township nd(Units/Type): 9.420 AC FARMINGTON ddress: 3652 US HWY 158 Deed Information Local Zoning Date: 12/1993 Book: 00171 Page: 0763 Plat Book: 0003 Page: 021 Legal Description PIN 10.00 AC HWY 158 5851718563 Propertv Values Building: 226,85E BXF: 34,43C Land: 110,37C Market: 371,65C essed• 371,65C [Deferred: CI Sales Information No. Book Page Month Year Instrument Qual/UnQual Improved Price 1 00171 0763 12 1993 WD Qualified Vacant 42 000 View Property Record for this Parcel View Mao for this Parcel View Tax Bill Information «Return to Basic Search All information on this site is prepared for the inventory of real property found within Davie County. All data is compiled from recorded deeds, plats, and other public records and data. Users of this data are hereby notified that the aforementioned public Information sources should be consulted for verification of the information. All information contained herein was created for the Davie County's internal use. Davie County, Its employees and agents make no warranty as to the correctness or accuracy of the information set forth on this site whether express or Implied, in fact or in law, including without limitation the implied warranties of merchantability and fitness for a particular use. If you have any questions about the data displayed on this website please contact the Davie County Tax Office at(336) 753-6120. 1.5.9 ttp://maps.daviecountync.gov/itsnet/View.aspx?prid=1465062 6/14/2016