Loading...
4080 Hwy 158 J^ a.d7=s'!r'�'�:r�..tN{w -''� ,r :::r"-'rrr;rr:,("v�r3--pti-i„” ,v,.,.5v +"3 i�." ''. .F,.� , _•n;;.��: +r's est,.,J t,.-ter �1'"..�'t n,_ ,r=-.;i' L _t . t `'p•:'V� �( f, pRZATION NO: 05997DAVIE COUNTY HEALTH DEPARTMENT oa , > ' Environmental Health Section PROPERTY INFORMATION Pehmttee's P.O.Box848 Name: �'4 t.e,�ir�• i, ce�i� Saac_1A6�Mocksville,NC27028 Subdivision Name: Phone#:704-634-8760 Directions to property: Section: Lot: AUTHORIZATION FOR �. wzr• a�\tJ ;� t��vr� mt�t WASTEWATER ` SYSTEM CONSTRUCTION Tax Office PIN:41% 05 -MO. Road ame: �S1 �,. . ��Zip;' **NOTE**This Authorization for Wastewater System Construction MUST BE ISSUED by the Davie County Environmental Health Section prior to issuance of any Building Pe"rmits.This Form/Authorization Number should be presented to the Davie County Building Inspections Office when applying for wilding Pemuts. ,. : (In compliance with Article 11.of G.S:Chapter,130A,Wastewater Systems,Section:1900 Sewage Treatment and Disposal Systems)" ***NOTICE***THIS AUTHORIZATION FOR WASTEWATER CONSTRUCTION IS VALID FOR PERIOD OF FIVE YEARS. arty ENVIRONMENTAL HEALTH SPECIALIST DATE ISSUEDlw- , _. _ .t ✓x9":t7G,rr �`�I+f-c�'R..�:+'Y •r�.rt�s.'{'-i:} ,rf.. -"t^'`r a.s.�ie.}j�-'.r+:a�hi'-.ti��'1 -...,y sX •:!"-at ' 'F v,rs'r• '" c.°��e:-. ter.-1 �` �---„..;�, ,l,w.�t'a. DAVIE COUNTY HEALTH DEPARTMENT '�...>a.:.., .:�. IMPROVEMENT AND OPERATION PERMITS PROPERTY INFORMATION it ` iame: Subdivision Name: - ;Directions to property: :r `r ` Section: Lot: ,– IMPROVEMENT t PERMIT Tax Office PIN:#j :>� _ 1:� Road Name r.:� y” ► Zip: ,La;�`t **NOTE**This Improvement Permit DOES NOT authorize the construction or installation of a septic tank system or any,wastewater system.An AUTHORIZATION FOR WASTEWATER SYSTEM CONSTRUCTION must be obtained from this Department prior to the construction/installation of a system or the issuance of a building permit. ;. -(In compliance with Article 11 of G.S.Chapter 130A,Wastewater Systems,Section.1900 Sewage Treatment and Disposal Systems) t' l ***NOTICE***THIS PERMIT IS SUBJECT TO REVOCATION IF SITE PLANS OR THE INTENDED USE CHANGE.YOUR WASTEWATER ENVIRONMENTAL HEALTH SPECIALIST DATE ISSUED SYSTEM CONTRACTOR MIDST SEE THIS PERMIT BEFORE --- INSTALLING THE SYSTEM. RESIDENTIAL SPECIFICATION:BUILDING TYPE. #BEDROOMS #BATHS' #OCCUPANTS GARBAGE DISPOSAL:Yes or No COMMERCIAL SPECIFICATION: FACILITY TYPE PEOPLE �' #PEOPLEtsH FT #SEATS INDUSTRIAL WASTE:Yes o(N) LOT SIZED-0 TYPE WATER SUPPLY DESIGN WASTEWATER FLOW(GPD). D NEW SITE,--P--" ITE ~ REPAIR SITE SYSTEM SPECIFICATIONS: TANK SIZE bb b GAL. PUMP TANK GAL. TRENCH WIDTH ROCK DEPTH LINEAR FT. 00 .OTHER REQUIRED SITE MODIFICATIONS/CONDITIONS: IMPROVEMENT PERMIT LAYOUT . Y � o, "CONTACT A REPRESENTATIVE OF THE DAVIE COUNTY HEALTH DEPARTMENT FOR FIN L INSPECTION OF THIS SYSTEM BETWEEN 8:30-9:30 A.M.OR 1:00-1:30 P.M.ON THE DAY OF INSTALLATION.TELEPHONE#IS(704)6348760. OPERATION PERMIT Sb \o3` , SYSTEM INSTALLED BY: �eJ�i►. w rn c 46 O Z C, AUTHORIZATION NO. Q 5' OPERATION PERMTr BY: DATE:. o� "THE ISSUANCE OF THIS OPERATION PERMIT SHALL INDICATE THAT THE SYSTEM DESCRIBED ABOVE HAS BEEN INSTALLED IN COMPLIANCE WITH ARTICLE I 1 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. DCHD 05/96(Revised) . APPLICATION FOR SITE EVALUATION/IMPROVEMENTS P-T-ki ---@ avU Davie County Health Department Environmental Health Section Ap P. O. Box 665 R 6 19Q� Mocksville, NC 27028 1. Application/Permit Requested By ` .aro i rd Or Ftkad i4 e re �J o F-C-1 aI C. Mailing Address — A G �r '�F I f zig .Jr i JE Home Phone t i N S;&QAI- !E-�A I Em, M C- 2-17/05 Business Phone 910-7 00- 9999 2. Name on Permit if Different than Above �~' 3. 9pplication for: �2�/Gen al Evaluation McSoept c Tank Installation Permit SSysstem to Serve: ❑ House ❑ Mcbi orae ❑ Place of Public Assembly ( Business ❑ Industry ❑ Other ❑ Unknown 5. If house, mobile home:Subdivision Section Lot # ❑ Basement/Plumbing No.of People ❑ Basement/No Plumbing No. of Bedrooms - ❑ Washing Machine No. of Bathrooms ❑ Dishwasher Dwelling Dimensions ❑ Garbage Disposal 6. If business, industry, place of public assembly, other: Specify type ru-r-m i 4u-M rF__Pa i r Ir—F— P;A1 i s i i Ala No.of People Served No. of Sinks No. of Commodes Z No. of Urinals 'No. of Lavatories ; 4' No. of Water Coolers No. of Showers �/ Water Usage Figures Ltd 7. Type of water supply: Public ' $�• IePrivate C�Community � 8. Property Dimensions 12 1� 2q Av Sewage Disposal Contractor 9. Do you anticipate additions/expansion of the facility this sytem is intended to serve? ❑ Yes eNo If yes, what type? 'NOTE: Improvements Permits shall be validfrom date issued. Improvements Permits are subject to revocation, if site plans or the intended use change. Effective October 1, 1989. PROPERJU INFORMATION REQUIRED: Directions to Property: Tax Off i cc PIN: # 5&.0 PROPERTY ADDRESS,, as follows: Road Name: 158 foo, g)-r d-loowid City: Ki C- 3 SUBMIT A PLAT WITH THIS APPLICATION. - "- Revisions effective October 1, 1995. z This is to certify that the information provided is correct to the best of my knowledge, and I understand I am responsible for all charges incurred fr m thi�pplicatio 9 T p. 1 DATE SIGNATURE i i CONSENT FOR SITE EVALUATION TO BE DONE ON ABOVE DESCRIBED PROPERTY MUST CHECK ONE: ❑ 1. 1 OWN the property. pQ 2. 1 DO NOT OWN the property. i P PertY• I 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 of the Davie County Health Department to enter upon above described property located in Davie County and owned by =ryi O e 1vd.. 0a(dc.t�►l. Ny 115�0 to conduct all testing procedures as necessary to determine said site's s itability for a ground absorption sewage treatment and disposal system. - 25-90 DATE SIGNATURE DCHD(1193) ��,�/(1,,-�'(�/5' C( �K� �b l (J�� s - 9 DAVIE COUNTY HEALTH DEPARTMENT Environmental Health Section Soil/Site Evaluation q NAME \e�r ��� ��� DATE EVALUATED 110 ADDRESS Ste- PROPERTY SIZE PROPOSED FACIELTY Y2 LOCATION OF SITE wz V-� Water Supply: On-Site Well _ Community Public Evaluation By:t,�Auger Boring U Pit Cut FACTORS 1 2 3 4 Landscape position Sloe Z - 5 HORIZON I DEPTH r " lo` Texture group L Consistence Structure Mineralogy HORIZON II DEPTH Texture group C Consistence _ Structure k �- Mineralogy HORIZON III DEPTH Texture group Consistence Structure Mineralogy HORIZON IV DEPTH Texture group Consistence Structure Mineralogy SOIL WETNESS S RESTRICTIVE HORIZON SAPROLITE — CLASSIFICATION LONG-TERM ACCEPTANCE RATE LA SITE CLASSIFICATION: •S EVALUATED BY: LONG-TERM ACCEPU NCE RATE: v \ 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 :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 ,3C-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 ■■■■/ecce■■■■■tt■■etet■tt■■eeeeE■■■■■Ee■ ■eee■ttttte■■■■■ ■� ■■■■ ■■■■■■■tlet■tteetee■■■Nee■ecce■■eEnet■=■■■■■■■■■■■■■■■■■■■■■■■■■ ■■■■eeeee■■ecce■■■eee■■■Eeee■eee�eeE■tltee■■tMEeeeeeee■eeeeee■ee■ ■■■Melt■■t■■■tEE■■■■eetE■eee■e■■ ■ee■■ee■lt ■E■l■■■tt■■t■eet■tlt■ ■■■■e■eee■■este■■t■■■■■■■■■■l■■asettt■tt■■■MCt/■■■■■■■■■■■■■■■■■■■ ■■eettt■■■Ott■■■tee■■■este■■■■■E■t■■■■M■t■■■■■■■■■■■■■tM■MMM/■t■■■ ■■■■■■■■■■■tete■■■e■■■■■l■■ee■eeeet■■ee■te■t■■t■■■■■■■■M■l/let/M■■ .■t■tt■M■■■t■letttttett■t■teeet■ ................. .............. ........................... ...................................... ■■■■■■■■■■■■e■■■■■tE■■Ott■■■■■■■■■■■■■■■EC■■■C MC�=mom CM■MMEMEM■M ■■//■■■■■ttE■■■t■■■■Mt■■■■■■■■■ ■■■■■■■■■■■■■■■■■■■■■■■■■MEMO■■■ ■■t■■■■■■■■■■■■■■■■ecce■Mee■■O■ ■■■■■■■Net■■Olt■■■■■E■■ME■■■E■■ EMMEMMEMMUMMEMEMM ■■■■■■M■■■■■■■■■■■■■■■■■■■■■■■■■■■■■�ON■■■=EIMOM■ ■OEM■�■■MMEMMO� Ott■tet■■tl■■■■■■■■meet■■■OtttM■■■■■O■■■■■tM■DEE■■■E ■ /F ■■O■■■■■�EM■ ■■■■■■■N■tet■Ottfeet■eO■t■O■■■E�ee■/tNN�tlue■■■■Et■■O■■ OEM ■■■■■■eeet■■ttttEEeeeel■■ettOOEO ■■ttN■■ ■■ Nt■■■■O■/MOOt■■■■ ■■■■■■■■■■■■■■■■■■■■tut■■■■Ot■■t■lN■t■■■MME■C�■/■■ ■■■■/M■OOEO Ott■■■■■■t■t■■■■■■■■EEEO■��ett■t■■■■■tttO■■■■OtIM M■■ MNEME I ■■E■�O■■■■BEM ■uM■■■.... .....■.... ■tO■■N■■■■■■MEM■■■■■■■■E■■MMM■■■■■■■■MM■■M■■■■■■ ■EMEMEMMEMEMME■ ■■■■■■M/tM■/tlttt/■tENOtot■■tt■�l■l/NM■tNNNNtIM■MMCO/OOMOt■ ■■H■■Ott■■■■■■■/■OOt■tMO■ME■■■■ O■MMMOMMM■ME� MM■■MMMMMMMMMMMM■ ■■■ N■■M■■■ONEN■■t■■■■■lM/■FEMME■EOMOMM■MM■ ■NEHN MM■MMEE■ ■M■■ ■M■■EO■■MMO■■■■■■■■tM■■■■E■■■■■■■�■M■MMM■■ SEEN■■■■mo■■■■■■� ■■■■■■■■■■■■E■■■■MME■■EO■■■■■tEH■Nle No ONE ■ ■■■ MMO■■■ ■�e�t■■OOOI■lttEEeeEOEO■MMM■■■■■��■ 1M E��■■E �E■■ �ME■EM ■■■■OMMM■■MEM■■■■■■■■■■NN■M■■■ ■� ■ ■ ■■ ■■ ■■■■� ■■■/tlt■Ott■■■■■■Ott■O■A■■tE1■■■■■O MM ■N��■ ■MM0M�■ MUNSON■ UO■/MO■ ■■■ME■ ■■■■tO �lIPMOEMM EO■M ■MM■ M■■■■■�i■■■■t■M■E■■EP-0 isiiM■■EuE■et ■ ■ ■t■t�■■■■■■ ■■■■■■tett/tl■■■■■■ttMMi/r■ E.%NE■E■■EM■ M■E■■MEMEME■ ■■■■■■MM■■■M■■M■■■■MO■rONIM■■EMEME■MM IMMME MOF■■■■■ ■EMMMME■MMEMHM■■■Ott■■■■■■E■■■■■■■E■ ■■ E■■M■M■■ ■■■ME■■■E■O■■O■■M■■■■■■■■■MO■O■■ ■ ■■O /T� ■ ■■ ONE ■■ Eee■■■t■■■ONN■■■OttetEEE■MONt�e�M!� O■ ■■■■ECM■ CCCEME mommoCCCCCCCC�C:C:CC':M �: --._. CCC:CCMEMME C ■■tttltt■OOMMt■t■t■tel■l■■■M■■OC . in ■OO■N■EWE■■■ MEMO■■■■■OOO■EMM ■IMMt/Ht M■■= MM MEE so ■ � �iNMM■ mom■■■t■ HMN■■E■ ■EME■■ME■C■O■EEE■MMNO ■■■■O■N■ ON NM ■E■■E■ONE mommmC ■tMlle■■■E■M■■N■■MM■■■■M...=��=== == ■ ■N■■■■ ■■■O■■NEO■MED■H■M■■M■MMMMM■■■■ �M �G/ CHMMHM MEMEMANi iiii�ii■il�iiiiiiiiiiiii���i�i■ uimONE MEMEMEN NEMENNEN iLloonommo� mM ,■■■■■■■M ME■I■■■■■■■■■ii■■i/■■M■ii./■M ■■ slim H■Ct .......OOM■MO■■MMMMMMMMMMINMMMMMMMMM�M N■1�■■■ .tett • ■eE■■t■■■■E■E■MOO■OO■OtO■I■l■O■l■■■■■H Hilt■■� ME ■■EEOOee/■■EtEIE■OOOIt■ttllN■ttO�OOt �NIIEENtHE ■■■eNt■■OOlt■■■eNEt■■e■c���■�•�����-�—--�_ ■ -�i�J■ENuMee■ ■■■tet■lO■tOEe■■■OOt■Ott■■M■■��MIEM�I=M � MOM■■MMOME CC=�C�CC�ON■C�i■i����C���CCCMi■iCCCCECCCIE 1E EmCmi C�mCCC C ■ . MCC. CM ME ME ■eO■■■ C■E■EHOMM"MMMMEMC■■O■■HOO ON ■ OOMHM ■u■MOM■ ':ONECCCC:CtCCCCCCC:CCCC''CCCCCCC: � mCCCC■CS . tmmmC � ■ t/MEtI/uM■t■tEUM■OMMEMEMMMOM■■FHM■■t■tlO■OO■OO■EIEEO■ME■■M■MM■ ...........NMOL■NOOMOO■tet■NO■■■■OO�t■■O■■■OO■OOt■tet■NO■O■MM■ .................................................................. ■■■■MtM■■■■■Et■EEtt■■■Eft■■tett■■■■■■■N■■■E■■■■■■MN■■■M■MMM■■■■■ ■■■■■■■■■■■■■■tett■■■■■■■■■�t■■■■■■■elltO■tO■tl■■t■■■■EteEEOO■■■■■ M ME ■CEMEI�OCCC =' Mee■e■e■■■eEEMeteMeettele■eee■ ■E■/O■■MEMEM■■MM■MMEMEMOMMEMEME■ ■■O■■■MtttO■■■■■E■tOE■EME■■■■u■■■O■ ■ Ott//■■OOMOee/tt■Et■■■OE■ Dade County Nealtlr rDepanment and NOifle.Nealtfr Agency ` 210 HOSPITAL STREET P.O. BOX 665 MOCKSVILLE.N.C. 27028 PHONE:(704)634-5985 May 8, 1996 Carolina Furniture Specialists 111-A Griffith Plaza Dr. Winston-Salem, NC 27103 Re: Site Evaluation Hwy. 158 & Howardtown Rd. Tax PIN: #5861-05-6892 Dear Client: As requested, a representative from this office visited the aforementioned site on May 3, 1996. Based upon the information provided on the application for site evaluation and after the evaluation was completed, the site was found to be provisionally suitable for the installation of an on-site sewage disposal system. If you have any questions, please feel free to contact this office.. Sincerely, Charles E. Little, R.S. Environmental Health Section CL/wd Enclosure(s) i 1 , Parcel#: E600000085 Page 1 of 1 o Davie County, NC - Basic Estate Search ��vtt�� Davie County Web Site Basic Search Real Estate Search Tax Bill Search Sales Search View Property Record for this Parcel View Mao for this Parcel View Tax Bill Information Parcel#: E600000085 Account#:82532897 Owner Information I Tax Codes REGORY JEFFREY TODD&DAVIS RICKY G&STEPHANIEADVLTAX-COUNTY Tikvl 15 BRIAR CREEK ROAD FIREADVLTAX-FIRE TAX DVANCE NC 27006 Property Information Township nd (Units/Type): 1.450 FARMINGTON ddress:4080 US HWY 158 Deed Information Local Zonin ate: 09/2011 Book: 00868 Page: 0924 Plat Book: 11 Page: 298 Legal Description PIN K.212 AC HWY 158 1.450 AC LOT 1 5861056892 PropertyValues Building: 102,140 BXF• 95 Land: 126,320 Market: 229,410 ssessed: 229,41 Deferred: 01 Sales Information No. Book Page Month Year Instrument Qual/UnQual Improved Price 00189 0416 08 1996 WD Unqualified Vacant 47,500 00868 0924 09 2011 QC Unqualified Improved 0 View Prooerty 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 http://maps.daviecountyne.gov/itsneWiew.aspx?prid=1470591 6/9/2016