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4110 Hwy 158 (2) DAVIE COUNTY HEALTH DEPARTMENT Environmental Health Section P.O.Boa 848/210 Hospital Street Mocksville,NC 27028 (336)751-8760 Account #: 989900635 Tax PIN/EH#: 5851-73-7257.03 Billed To: Wayne Frye Subdivision Info: Reference Name: Location/Address: Highway 158 E-27006 Proposed Facility Residence Property Size: 120'x 260 ATC Number: 4117 AUTHORIZATION FOR WASTEWATER SYSTEM CONSTRUCTION **NOTE** This Authorization for Wastewater System Construction MUST BE ISSUED by the Davie County Environmental Health Section prior to issuance of any building permit(s). This Form/Authorization Number should be presented to the Davie County Building Inspections Office when applying for building permit(s)(in compliance with Article 11 of G.S.Chapter 130A,Wastewater Systems,Section.1900 Sewage Treatment and Disposal Systems). THIS AUTHORIZATION FOR WASTEWATER CONS CTION IS VALID FOR A PERIOD OF FIVE YE S. Environmental Health Specialist's Signature: Date: CERTIFICATE OF COMPLETION **NOTE** The issuance of this Certificate of Completion shall indicate the system described on Improvement/Operation Permit 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. V c Septic System Installed By: Environmental Health Specialist's Signature: Date: DCHD 05/99(Revised) DAVIE COUNTY HEALTH DEPARTMENT Environmental Health Section ` P.O.Boa 848/210 Hospital Street Mocksville,NC 27028 (336)751-8760 IMPROVEMENT/OPERATION PERMIT Account #: 989900635 Tax PIN/EH#: 5851-73-7257.03 Billed To: Wayne Frye Subdivision Info: Reference Name: Location/Address: Highway 158 E-27006 Proposed Facility Residence Property Size: 120'x 260 ATC Number: 4117 **NOTE**This Improvement/Operation Permit DOES NOT authorize the construction 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). THIS PERMIT IS SUBJECT TO REVOCATION IF SITE PLANS OR THE INTENDED USE CHANGE. YOUR WASTEWATER SYSTEM CONTRACTOR MUST SEE THIS PERMIT BEFORE INSTALLING SYSTEM. Residential Specification: Building Type #People #Bedrooms 111 #Baths Dishwasher:/ Garbage Disposal: ❑ Washing Machine Basement w/Plumbing: ❑ Basement/No Plumbing: ❑ Commercial Specification: Facility Type #People #People/Shift #Seats Industrial Waste: ❑ Lot Size Type Water Supply C 9 Design Wastewater Flow(GPD) Site: New. Repair❑ System Specifications: Tank Size GAL. Pump Tank GAL. Trench Width s Rock Depth_/J_ Linear Ft.,W Other: s- Stated in Required Site Modifications/Conditions: accepted Systems may also be use IMPROVEMENT/OPERATION PERMIT LAYO GENT FILTER RISER(S)IF 6"BELOW FINISHED GRADE. ****NOTICE: Contact epresen �theof ounty Health Department for final inspection of this system between 8:30 a.m.to 9:30 a.m.or 1:0 p.m p.m. in Illation. Telephone#is(336)751-8760.**** C� �o Environmental Health Specialist's Signature: Awl Date: DCHD 05/99(Revised) r CATION FOR SITE EVALUATION/IMPROVEMENT PERMIT&ATC t 8 2005 Davie County Health Department 01 AA Environmental Health Section P.O. Box 848/210 Hospital Street I1�1ROtdt•".EM��N� Mocksville, NC 27028 PSY/ vnf;Ccf)J (336)751-8760 ***IMPORTANT*** THIS APPLICATION CANNOT BE PROCESSED UNLESS ALL THE REQUIRED INFORMATION IS PRfOVIDED. Refer to the INFORMATION BULLETIN for instructions. 1. Name to be Billed lyRU��. x Contact Person dd' Mailing Address A-OHome Phone �W o�d City/State/ZIP Business Phone 2. Name on Permit/ATC if Different than Above Mailing Address City State/Zip r— 3. Application For: �CYSite Evaluation 13 improvement Permit/ATC E3 Both 4. System to Service: L'7 Hooe ❑ Mobile Home ❑ Business ❑ Industry ❑ Other S. Type system requested: 13 Conventional ❑ conventional modified ❑ innovative 6. If Residence: # People �T41 # Bedrooms # Bathrooms D31 ishwasher 1]Oarbage Disposal Zahi.g Machine ❑Basement/Plumbing ❑Basement/No Plumbing 7. If Business/Industry /Other: verify type # People # Sinks # Commodes # Showers # Urinals # Water Coolers IF FOODSERVICE: # Seats Estimated Water Usage (gallons per day) S. Type of water supply: County/City ❑ Well ❑ Community 9. Do you anticipate additions or expansions of the facility this system is intended to serve? ❑Yes ❑No If yes,what type? ***IAIPORTANT***CLIENTS MUST COMPLETE THE REQUIRED PROPERTY INFORMATION REQUESTED BELOW. Either a PLAT or SITE PLAN MUST BESUBAflTTED by the client with THIS APPLICATION. r Property Dimensions: WRITE DIRECTIONS(from Mocksville)to PROPERTY: Tax Office PIN: # J��v��73 Za S'— Property Address: Road Name Awls-vg �iy� ?'/�T Aee:s City/Zip �iC� If in a Subdivision provide information,as follows: Name: �o O Section Block: Lot: Date home corners flagged: ZZ2b This is to certify that the information provided is correct to the best of my knowledge. I understand that any permit(s) issued hereafter are subject to suspension or revocation,if the site plans or intended use change,or if the information submitted in this application is falsified or changed. 1,also,understand that 1 air responsible for all charges hicurred front this application. 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 to conduct all testing procedures as necessary to determine the site suitability. DATE SIGNATURE THIS AREA MAY BE USED FOR DRAWING YOUR SITE PLAN(Include all of the following: Existing and proposed property lines and dimensions, structures, setbacks, and septic locations). Site Revisit Charge Datc(s): Client Notification Date: EHS• Sign given IV Account No. eu —9C / &O Revised DCI1D(05/03 �- 9 2 Invoice No. `-�Ir\J I-4> .S DAVIE COUNTY.HEALTH DEPARTMENT ' Environmental Health Section Soil/Site Evaluation APPLICANT INFORMATION PROPERTY INFORMATION Account #: 989900635 Tax PIN/EH#: 5851-73-7257 Billed To: Wayne Frye Subdivision Info: Frye Acres Lot# 1 Reference Name: Location/Address: US Highway 15$E-27028 Proposed Facility: Residence Property Size: see map Date Evaluated: Water Supply: On-Site Well Community_ Public Evaluation By: Auger Boring Pit Cut FACTORS 1 2 3 4 5 6 7 Landscape position L Slope% HORIZON I DEPTH Texture groupcSGL Consistence Structure Mineralogy HORIZON II DEPTH Texture group Consistence r Structure �C Mineralogy - HORIZON III DEPTH t Texture group Consistence Structure Mineralogy HORIZON IV DEPTH Texture group Consistence Structure Mineralogy SOIL WETNESS RESTRICTIVE HORIZON SAPROLITE CLASSIFICATION LONG-TERM ACCEPTANCE RATE $' SITE CLASSIFICATION: EVALUATION BY: LONG-TERM ACCEPTANCE RATE:_ S 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 oiA 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 05/99(Revised) ■■■■■■ ■■■■■■■/■■e■■■■■■■e■■■■■■■■■NOON■■■■■e■■■■■■■■■■■■■■■■■■■■■ NOON■ ■■■ ■■■■/■■■■■■s■M■■■■/■■■■■■■■■■■■■Ni■■■■■■■■■■■■■■■■■■■■■■ CCCCC CC■CCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCC NOON ME ■■■C■■N■■N■■■■■■■■■c■■■■■■■■■■■■■■■■e■■■■■■■c■■■■■■■Nc■■e■■■■■e■■■ ■■■■■INNER ■■N■■■■N/■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■e■■N■N■■cee■ceeeee■ NOON■■ ■■■■■/ee■■■■■■■■�■■■■■■ ��►i��rl.�■■■■■■■■■■■e■■■■■■■■■■e■ ■■■ C■■c■■■■e■■e■■■ec■■.i`�c�►�i�■■■■■■e■■■e■ee■■■eeee■cee■■cee■eeee■ ■O■■ ■■a■■■eN■■■■■e■■■►.O■c�■■/■■■■c■■e■eee■eeee■e■■■NeeNee■eee■O■N■ NOON■ ■■N■N■■c■■■■■c■��-■eee■seM■■■c/e■ee■ces■eeee■■■ee■■ee■■■■e■ NOON■ C■■N■N■■■■■■■■■■■N■■■■/N■■■■■■■■■■■N■■ee■■■■■■c■■e■c■N■Nece■ ■■■■■i■ ■■MN■■NN■■■■■■■■■■■■t■■■ ■■■/■■■■■■■■■■■■■/■ecce■■■■■■■■■ ■■■■■■■CN■■■■■/N■■■■M■■M■■■■■■■■ ■■■N■■■■■■Ne■■■■■■■e■■■■■■■■■■■■ ■■■■■■■N■■■■ee■■cN■■N■■eee■■■■■e■■■■■■■■■Nt■■s■■■■eN■e■■e■cM■cc■■■ ■■■■■■■■■■■■■■■■e■■■■■■t■■■■■■■■■■■■■■■■■■■■■■■■■■O■■■■■■■■■■ NOON ■■■■■■E■c■■■■■■■e■■eee■■e■■■■■■■■■■■■eeeee■■e■■■■e■■es■ee■■ ■C■se■ ■■■■■■NN■■■■■■/■■■■■■■■■■■■■■■■■■■■■■■■M■■■■M■■■M■■■■■■■■O■C■■/O■■ ■■iN■■■■■N■■■c/■ce■ecce■■■■■■■■■ee■■■■■■eeee■■�_�■e■■■■■ee■e■eeee■ /N■■ ■i■■■■■■■■■■■■■■■■■■■■■■NN■ ■■■■.�■■■■��:��■■■■e■■■eN■■■■■ CNNW mom CCCCCCi�iii�CCC:��•�'!O■�'-%Iil■■►'�t!�L.�a■■ce■■■■cee■e■■■ NOON■ ■■■N■ ■��Ciii%■■/■■■:.i/I.�frl�era■■C:�■■119■/.Oi�I.Ri/.i■■■■■■■Nee■■■■■■Nee■■ ■■■■■CtC■■Oe■■■N■O■■■LO■I■■■ %■■■■RV■/■■■■!�!'■■■■■■■■eeeete■■■e■■■ ■■NN■ ■��:::- .!�■�..w.%■■■■ , i%I■N■�■��■■■■■ ■■e■■■�NOON■■ �CeCCCCti■'iiiiiiiiiiiiiiiiiiiiC�iiiiiaiii�CCCCC■�;iCCCCCCiiiiiiis� ■■■C■■ ■■N■■■■■N■■■N■■■/■■■■N■N��N■■■■■■■■�■M■r�■eeN■■■■NNN■NN■■■■■ CCCC■CCCCCCCCCCCCCCCCCCCCCe"iCOCCCCCCCCCCCiiiiiietiCCCCCCCCCCiCCeiC CCCC�CCCCCCCCCCCCCCCCCCCCCEN/!�'.CCeC�iiiiiiiiiiiiCCCCCCCCCCCCCCCCCCCCCC CCCCCCCCCCCCCCCCCCCCCCCCCC��CCCCCCCCCCCCCC%ICCCCCCCCCCCCCCCCCCCCCC RISEN MINN CCCCCCC:CCCCCCCC:CCCC:: CCCCCCCCCCCCI�CCCCCCIICCCCCCCCCCCCCCCC ■EM■ ■ ■■OO■■■t■■■■O■O■N■■��..... ...■e■■■►........�.■.............. 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' ' N 81• 0.820 ACRE °' y 4o "Ott / H �eoo aec,o e t F�Q cp� 0 131, 4 icl; AREA = 0.879 ACRE *� se o- e�%s d fQ y l� "C U1 rY }g I�TgI` T1 NT � s Environmental Health Section P. 0. Box 848/210 Hospital Street Courier 09-40-06 Mocksville, NC 27028 r ter.« ✓ , _ �✓ yv. ti.S P p.. February 16, 2005 Wayne Frye 4110 Highway 158 E Advance,NC 27006 Re: Site Evaluation/ Highway 158 Site A&B Tax Office PIN: #5851-73-7257 Dear Client(s): As requested, a representative from this office visited the aforementioned site on, January27,2005. Based upon the information provided on the Application for Site Evaluation and after an evaluation was completed on the site,the site was found to be provisionally suitable for the installation of an on-site sewage system. Before an Improvement Permit/Authorization to Construct can be issued the appropriate application must be filled out and the house/mobile home location staked off. If you have any questions,please feel free to contact this office. Sincerely, & �• Robert B.Hall,Jr.,R.S. Environmental Health Specialist RBH/dlf Enclosure(s) e „ UkI Cf [J " iAT�I ' ` 1IT ` s . , Environmental Health Section P. 0, Box 848/210 Hospital Street Courier 09-40-06 ' Mocksville, NC 27028 February 17,2005 Wayne Frye 4110 Highway 158 E Advance,NC 27006 Re: Site Evaluations/Lot 3 and 4 Phase II Frye Acres Tax Office PIN: #5851-73-7257 Dear Client(s): As requested, a representative from this office visited the aforementioned site on, January27,2005. Based upon the information provided on the Application for Site Evaluation and after an evaluation was completed on the site,the site was found to be provisionally suitable for the installation of an on-site sewage system. Before an Improvement Permit/Authorization to Construct can be issued the appropriate application must be filled out and the house/mobile home location staked off. If you have any questions,please feel free to contact this office. Sincerely, Robert B.Hall,Jr.,R.S. Environmental Health Specialist RBH/dlf Enclosure(s) CC: John Gallimore Parcel#: E60000008401 Page 1 of 1 Davie County, NC - Basic Estate Search 1,0 v�r��, Davie County Web Site Basic Search Real Estate Search Tax Bill Search Sales Search Q View Property Record for this Parcel View Map for this Parcel View Tax Bill Information Parcel#: E60000008401 Account#:28020000 Owner Information Tax Codes RYE LUTHER WAYNE&FRYE DAPHNE A ADVLTAX-COUNTY TA 110 US HIGHWAY 158 [FIREADVLTAX-FIRE TAX DVANCE NC 27006 Property Information Township nd(Units/Type): 3.810 AC FARMINGTON ddress:4110 US HWY 158 Deed Information Local Zoning Pate: 09/1979 Book: 00109 Page:0165 Plat Book: Pa e: Le al Description PIN 09 AC HWY 158 28020000 Property Values uildin : 143,21 BXF• 46,76 nd: 62 13 01 arket: 25210 ssessed: 252 10 eferred: Sales Information No Sales Data found. View Property Record for this Parcel View Map 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.daviecountync.gov/itsnet/View.aspx?prid=1475196 6/15/2016