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3203 Hwy 601N:.v �i A°'v w-*': R"+..t J-:.a� 'tMha• o �: ter :,.;, f �v.'4::.'ra :,ti �. y.,.Vr� %aT.-.,f u, Eyf'..s4.a.:..t a•."Y 'r i=.''F «:;, t'+..�FS _,ti,....�. t , . .. � r <5. `--�' . L.; 'y�;7r....� iii .v-^-;;.tsr's°: F a-..s"'4:z;� �:u.�.:... ..-..�.r-i,.f. s......K� •,. DAVIE COUNTY HEALTH DEPARTMENT r' IMPROVEMENT PERMIT and OPERATION PERMIT j IMPROVEMENT PERMIT r **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) y ) NAME t- PROPERTY ADDRESS bO%[Y . " �1 f �� V DATE ' •� -9 LOCATION �o b N C l� ain�. ��.o• �� ` Qc� `*�9 SUBDIVISION NAME LOT NUMBER SEC./BLOCK NUMBER RESIDENTAL SPECIFICATION: BUILDING TYPE dus Q # BEDROOMS # BATHS # OCCUPANTS GARBAGE DISPOSAL.: Yes No COMMERCIAL. SPECIFICATION: FACILITY TYPE # PEOPLE # PEOPLE/SHIFT # SEATS INDUSTRIAL WASTE: Yes/No LOT SIZE iso TYPE WATER SUPPLY. Cn . DESIGN WASTEWATER FLOW (GPD) -NEW SITE ✓ REPAIR SITE SYSTEM SPECIFICATIONS: TANK'SIZE o00:GAL. PUMP, TANK GAL. TRENCH WIDTH .3 ROCK DEPTH y/a F LINEAR FT..Od r r, OTHER Y� a; REQUIRED SITE MODIFICATIONS/CONDITIONS: y ***THIS PERMIT IS SUBJECT ?0 REVOCATION IF SITE PLANS OR THE INTENDED USE CHANGE. YOUR WASTERWATER SYSTEM CONTRACTOR MUST SEE THIS PERMIT BEFORE INSTALLING THE SYSTEM. ro N1601 CvI.0 /Ou F. • IMPRDVEMENTePERMIT BY **CONTACT A REPRESENTATIVE OF'THE-DAVIE COtNJTY',HEALTH DEPARTMENT FOR -,FINAL INSPECTION OF THIS SYSTEM BETWEEN 8:30-9:30 A.M. OR 1:00-1;30-P.M11 ON THE DAY OF INSTALLATION. TELEPHONE # IS (704) 634-8760. AUTHORIZATION NO. O'�LV� OPERATION PERMIT BY DATE 1 1 **THE ISSUANCE OF THIS OPERATION PERMIT SHALL INDICATE THAT THE SYSTEM DESCRIBED ABOVE HAS BEEN INSTALLED IN COMPLIANCE WITH ARTICLE 11 OF G.S. CHAPTER 136A, 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 10/95 h Davie County Health Department ENVIRONMENTAL HEALTH SECTION 1 P.O. Box 665 $,00 Mocksville, N.C. 27026 t AUTHORIZATION FOR WASTEYATER SYSTEM CONSTRUCTION (Issued in compliance with Article 11 of r G.S. Chapter 130A, Wastewater Systems) ***This Authorization For Wastewater System Construction must be issued by the Davie County Environmental Health Section prior to issuance of any Building Permits. This.Form/Authorization Number should be presented to the Davie County Building Inspections Office when applying for Building Permits.*** R ` S �= N ey CAS �Q AUTHORIZATION NUMBER R= MOO �� G AR NATE N2, P. 1 4 NAME ON IMPROVEMENT PERMIT (If different than above) SITE LOCATIOI COIENTS/CMITIONS ON AUTHORIZATION TO CONSTRUCT WASTEWATER SYSTEM i ff+MOTICE"* THIS AUTHORIZATION FOR WASTEWATER SYSTEM.CONSTRUCTION IS VALID FOR A PERIOD OF FIVE.(5) YEARS. . EWIROIENTAL HEALTH SPECIALIST DATE DCHD 10/95, t.. APPLICATION FOR SITE EVALUATION/IMPROVEMENT Davie County Health Department Environmental Health Section�++��nnr� P. O. Box 665 1+� EP .�G 141993 Mocksville, NC 27028 yCT7l��Tt 1. Application/Permit Requested By JP -++e, -6AXYi I_ n �iYlocKS�/�lle h1C 2�c�28 Mailing Address "' CIO AQ Home Phone (q0q) L4q- q(c1& t Business Phone I'`luy) CROACL) 2. Name on Permit if Different than Above .11 3. Application/Permit for: pd General Evaluation )(Septic Tank Installation 4. System to Serve: V/House ❑ Mobile Home ❑ Place of Public Assembly ❑ Business ❑ Industry ❑ Other ❑ Unknown 5. If house, mobile home: Subdivision /' :� US e, Section Lot # �emenUPlumbing No. of People ❑ Basement/No Plumbing ® No. of Bedrooms 'Washing Machine No. of BathroomsDishwasher Dwelling Dimensions 15���d l� �� 59' �� El Disposal 6. If business, industry, place of public assembly, other: Specify type No. of People Served No. of Sinks No. of Commodes No. of Lavatories No. of Showers No. of Urinals No. of Water Coolers Water Usage Figures 7. Type of water supply: N/Public ❑ Private ❑ Community 8. Property Dimensions ACY'CS Sewage Disposal Contractor 9. Do you anticipate additions/expansion of the facility this sytem is intended to serve? ❑ Yes N No 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: •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 incur re from this application. -2�4-L� DATE CONSENT FOR SITE EVALUATION TO BE DONE ON ABOVE DESCRIBED OPERTY MUST CHECK ONE: ❑ 1. 1 OWN the property. W3,12. 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 s ' e's suitability for a ground absorption sewage treatment and disposal system. DATE AGNATURE DCHD (12.90) DAVIE COUNTY HEALTH DEPARTMENT ` Environmental Health Section Soil/Site Evaluation NAME \ • \ , un L •r�� ADDRESS tv.R PROPOSED FACIILTY f\ a ° s" DATE EVALUATED 9-D 'g- '�3 PROPERTY SIZE ``,, LOCATION OF SITE b U I N Water Supply: On -Site Well Community Public Evaluation By: Auger Boring y Pit V Cut FACTORS I 2 3 4 Landscape position 1 _ L_ Sloe R-�' O-fi° �r-�3 d'8 HORIZON I DEPTH b' Texture group C L_t- Consistence FM I�- Structure Q C Mineralo .I : 1 '• 1 ' HORIZON II DEPTH D" LI D_ Texture group 4�_' t, Consistence FZ $ F� Structure 1c_ Mineralogy► :� HORIZON III DEPTH Texture group Consistence Structure Mineralogy HORIZON IV DEPTH Texture group Consistence Structure Mineralogy SOIL WETNESS s s Ss s -- RESTRICTIVE HORIZON — — -- — SAPROLITE CLASSIFICATION S s LONG-TERM ACCEPTANCE RATEI I j Lj SITE CLASSIFICATION: ��� EV�LUATED BY: cY� LONG-TERMACCEPTANCERATE: y 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 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 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 watef 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 iiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiii■iiii,�iiiii�.il�iiiiii■ii ■■■■■■■■■■■■u■■■■■■■■■es■■■■■■.■n■=NOON■■■■■■N■■■■■■■■.■■■■■■■■■■ ■...■■■H■.■■NEE■M■E■.■EE■M.E■■■ ■■■■■■.t\�.■■■.MtM■.■■■.■..■ Et■ MEN ■.■■■.■�1L�!J.■■■■■.■■.■■■■.■■ !■■11�■■.1►1■■.■..■■■►�■■■.■■■.■■i■■■■■■■■ ■■■■■■■■■■■■■i'!�i�r■■NOON►\■■■■■■■1�■■■1!■■■.l�l,■;\■■■■■►�■■■■.■.■■■■■■■■■ ■■.■.■ ■..■\��' ■...■� .■■■■11 � ■■.■E.I �ICr■■■■ ■.NOON NOON■■ , ■...Ott■■.■...�.■.■....■■.■■..■■..■■■\' �'' ■■■■E■ ■ ■t■.■■■■.■..■■ ................................�.■■�■■■ENMMMEMON No ■ ON .■NOME. momMENMENOMMOMINNEM MEMEMMEMOMM MEN ...NOON■■.■.M.■..■.E■■N■.......■.. ........ . . ....... ...... . mom INJIMM I ■■■.■■■.■.■■■■....■■..■■..t■■A11. 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Jeffery & Karla Barneycastle Rt. 6, Box 289 Mockeville, KC 27028 Re: Site Evaluation Off Highway 601 North/5 Acres Dear Mr. & Mrs. Barneycastle: As requested, a representative from this office visited the aforementioned site on September 28, 1993. Based upon the information provided on the application for a site evaluation and after an 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 Parcel #: F30000000501 Davie County, NC - Basic Estate Search Basic Search Real Estate Search Tax Bill Search Sales Search 0 View Property Record for this Parcel View Map for this Parcel View Tax Bill Information Parcel 4:F30000000501 Account #:4814000 Owner Information 151,7901 Tax Codes 118901 BARNEYCASTLE JEFFERY E& BARNEYCASTLE KARLA D 48,8801 ADVLTAX - COUNTY TA 202,5601 203 US HIGHWAY 601 NORTH 202,56CI FIREADVLTAX - FIRE TAX 01 MOCKSVILLE NC 27028 Property Information Township nd (Units/Type): 4.840 AC CLARKSVILLE [Address: 3203 N US HWY 601 Deed Information Local Zonin Date: 07/1998 Book: 00204 Page: 0186 [Plat Book: Page: Le al Description PIN 5.00 AC US HWY 601 5811926851 Property Values Buildin : 151,7901 BXF: 118901 Land: 48,8801 Market: 202,5601 ssessed: 202,56CI Deferred: 01 Sales Information No. Book Page Month Year Instrument Qual/UnQual Improved Price L 00170 0706 10 1993 WD Unqualified Vacant 0 >_ 00204 0186 07 1998 WD Unqualified Improved 35,000 View Property Record for this Parcel View Map for this Parcel View Tax Bill Information « Return to Basic Search Page 1 of 1 vNYr,z uu ti - 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.daviecountync.gov/itsnet/View.aspx?prid=1471987 8/9/2016