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2666 Hwy 601N (2)DAVIE COUNTY HEALTH DEPARTMENT IMPROVEMENTS PERMIT AND CERTIFICATE OF COMPLETION •NOTE: Issued in Compliance With Article II of G.S. Chapter 130a Sanitary Sewage Systems Permit Number Name . Jzie --- Date <-- 15;11 Sf 2 �- 8046 LocatioL1��"'� Subdivision Name Lot No. Sec. or Block No. Lot Size _— — House — Mobile Home fir— Business -- Industry No. Bedrooms "�Z— No. Baths —— No. in Family— Public Assembly Other Garbage Disposal YES p NO p" Specifications for System: Auto Dish Washer YES NO p Auto Wash Ma^hine YES NO Type Water Supply __ lii// /� -- --- ^✓'C� k .�`l� " !J /: f 'This permit Void if sewage system described below isnot installed within 5 years from date of issue. This permit is subject to revocation if site plans or the intended use change ATTENTION: YOUR SEPTIC SYSTEM gONTRACTOR MUST SEE THIS PERMIT/LAYOUT BEFORE INSTALLING THIS SYSTEM. n! c Improvements permit by *Contact a representative of the Davie County Health Department for final inspection qTf 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- 9 5. `- - --.–"✓ Final Installation Diagram: ystem I stalled b S 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 be taken as,a guarantee;that the system will function satisfactorily for any given period of time. - 1 3 • S 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 be taken as,a guarantee;that the system will function satisfactorily for any given period of time. - . po 9� APPLICATION FOR SITE EVALUATION/IMPROVEMENTS PERMIT I ��3i19� Davie County Health Department 0 VI Environmental Health Sectionr liQ P. O. Box 665 e D) Mocksville, NC 27028 1.pplication/Permit Requested By Mailing Address Civ ! Home Phone Business Phone 2. Name on Permit if Different than Above 3. Application for: jateneral Evaluation6 10).94-6eptic Tank Installation Permit 4. System to Serve: ❑ House Mobile Home ❑ Place of Public Assembly ❑ Business ❑ Industry ❑ Other ❑ Unknown 5. If house, mobile home: Subdivision Section Lot # ❑ Basement/Plumbing ❑ Basement/No Plumbing C�Washing Machine , p Dishwasher ❑ Garbage Disposal . No. of People 2 J No. of Bedrooms ''41 a No. of Bathrooms Dwelling Dimensions 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: ❑ Public Private 8. Property Dimensions ZZ /p('� Sewage Disposal Contractor 9. Do you anticipate additions/expansion of the facility this sytem is intended to serve? ❑ Yes If yes, what type?'' ❑ Community ❑ No '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: This is to certify that the information provided is correct to the incurred from this ap lication. C DATE c of my knowledge, and I understand I am responsible for all charges I / — r'e / /I ` IGNATURE 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 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 said site's suitability for a ground absorption sewage treatment and disposal system. DATE SIGNATURE DCHD (1/93) ' • DAVIE COUNTY HEALTH DEPARTMENT Environmental Health Section Soil/Site Evaluation NAME I�mef DATE EVALUATED ADDRESS PROPOSED FACIILTY PROPERTY SIZE / fAe LOCATION OF SITE 4 6m/ Water Supply: On -Site Well Community Public Evaluation By: Auger Boring Pit Cut FACTORS 1 2 3 4 Landscape position 4 - -SloeZ Slope Z HORIZON I DEPTH Texture group Consistence Structure MineralogX HORIZON II DEPTH t" e Texture group G G Consistence � Structure .r44 1 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 < ,< SITE CLASSIFICATION: LONG-TERM ACCEPTANCE RATE: , Y REMARKS: DCHD(01-901 EVALUATED BY: _A // OTHER(S) PRESENT: LEGEND Landscape Position "r 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- Vc-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 ........................... ................... 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Z .■ HE■■E■� ■■■■■■■■.■■/■MIIH.I■■11■MlIM■SME MM ■ SOMEONE MKNEMM�NONE 1MMlMIIMm1AMMM■MH■■■UM■ONE ■■ ■ME■■■■NONNI CMoN■■eELOCailosimmml!■■IIS■ISI/.ONES M ..■■ ■■ e.■.■.H.1■. ■■■■ ■■ E■.■■ ■■■■■■■■■■./S■■■■■■■I■.t■■■11■■■■lM/J7■N MEN■p■■ ����v■����������M�I���I��11���1%lri'`iiE■WE■YM ■ ■ �MEmoM■■:■M��■ MMENNEN■■i�M... , Eiieii ■�■ S t■Elm MMMMMMMMM --- MMMM ■EMNON ■mmMMMmM MlmMllM■MMMMMMMMM ii M■■i■iii t1■�MMMM111M111 MEMO ■■M■■■■■■■■mMl1■■■■■■■■■ ■�■■�E■■■■■M�.M■■/■H.■E■H■■■ MMMMlMM*mMllMMMMMMMMM mom ■.■■■■■M.■■■■■■■■■■■i.■IMM■■■■■■■■■■■■■U■■■■■■■■■■Mu.M■■.■.MM■■E■ ■■■._■■■■■■■■■■■■■■■■■■■■■■■■■■■ ■■■■E�ii ■■■.■■■■E■■MM■■■■.■su■■1�■ Parcel #: F300000102 Davie County, NC - Basic Estate Search Basic Search Real Estate Search Tax Bill Search Sales Search Q View PrQpertv Record for this Parcel View Map-for-this_Parcel View Tax Bill Information Parcel #:F300000102 Account #:39084000 Owner Information Building: Tax Codes BXF• AMES LUCILLE Land: ADVLTAX - COUNTY T Market: 651 US HIGHWAY 601 NORTH Assessed: FIREADVLTAX - FIRE TAX [Deferred: OCKSVILLE NC 27028 Property Information Township nd (Units/Type): 9.440 AC CLARKSVILLE ddress, 2666-N US HWY 6Gr" Deed Information Local Zoning ate: 03/2006 Book: 00653 Page: 1034 Plat Book: Pa e: Legal Description PIN 11.000 AC HWY 601 LIFE ESTATE 5820361502 Propertv Values Building: 36,1901 BXF• 11,84 Land: 92,29 Market: 140 32 Assessed: 140,3 [Deferred: Sales Information No. Book Pape Month Year Instrument Qual/UnQuai Improved Price 1 00088 0545 12 1972 WD Unqualified Improved 0 2 00653 1034 03 2006 WD Unqualified Improved 120,000 View Property Record for this Parcel View Map for this Parcel View Tax Bill Information « Return to Basic Search Page 1 of 1 o� U K� Davie County Web Site 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.daviccountync.gov/itsneWiew.aspx?prid=1461283 8/23/2016