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3227 Hwy 601Nr f 1 r... --" t ...•", vt � :-.3 �.., a.J'if .L•'*" ,, w 6`rm�' �...-r+• .wr•.: v .� ..+ ... DAVIE COUNTY HEALTH DEPARTMENT V IMPROVEMENT PERMIT and OPERATION PERMIT ^JiPR661ENT PERMIT #410TE** 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. (Incompliance with Article 11 of G.S. Chapter 130A, Wastewater Systems, Section .1900 Sewage Treatment and Disposal Systems) NAME PROPERTY ADDRESS (� j Al. DATE LOCATION li Wil% ' (7 /y X.- .�` ,y .s! ? �* e" SUBDIVISION NAME LOT NUMBER SEC./BLOCK NUMBER RESIDENTAL/SPECIFICATION: BUILDING TYPE # BEDROOMS # BATHS # OCCUPANTS GARBAGE DISPOSAL: Ye i o COMMERCIAL SPECIFICATION: FACILITY TYPE # PEOPLE # PEOPLE/SHIFT # SEATS INDUSTRIAL WASTE: Yes/No LOT SIZE TYPE WATER SUPPLY (' , DESIGN WASTEWATER FLOW (GPD) �,1 NEW SITE v' REPAIR SITE SYSTEM SPECIFICATIONS: TANK SIIE/GAL. PUMP TAW GAL. TRENCH WIDTH _ 1� ROCK DEPTH .�� LINEAR FT. 5" 6 OTHER REQUIRED SITE MODIFICATIONS/CONDITIONS: ***THIS PERMIT IS SUBJECT TO REVOCATION IF SITE PLANS OR THE INTENDED USE CHANGE. YOUR WASTERWATER SYSTEM CONTRACTOR MUST SEE THIS PERMIT BEFORE INSTALLING THE SYSTEM. IMPROVEMENT PERMIT BY i r ,i **CONTACT A REPRESENTATIVE OF THE DAVIE COUNTY HEALTH DEPARTMENT FOR FINAL INSPECTION OF THIS SYSTEM BETWEEN i 8:30-9:30 A.M. OR 1:00-1:30 P.M. ON THE DAY OF INSTALLATION. TELEPHONE # IS (704) 634-8760. r OPERATION PERMIT SYSTEM INSTALLED BY ,p l AUTHORIZATION N0. OPERATION PERMIT BY DATE � **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 130A, SECTION .1900 *SEWAGE TREATMENT AND DISPOSAL SYSTEMS, BUT SHALL IN NO WAY BE TAKEN AS A RANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORILY FOR ANY GIVEN PERIOD OF TIME. DCHD 10/95 APPLICATION FOR SITE EVALUATION/IMPROVEMENTS Davie County Health Department Environmental Health Section P. O. Box 665 Mocksville, NC 27028 1'. Application/Permit Requested By /1�/V'� J ZQitl20, Mailing Address Home Phone 9/e 9w_a7>6 t Business Phone��%O%—�O3G ' e 2. Name on Permit if Different than Above 3. Application for: El General Evaluation Septic Tank Installation Permit' L/ 4. System to Serve: Ar House ❑ Mobile Home ❑ 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 lXwashing Machine 91 No. of Bathrooms ®ol5ishwasher Dwelling Dimensions 20 Sr',�- r,. ❑ 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 k 7. Type of water supply: Z?rublic ❑ Private 8. Property Dimensions .� r9creS Sewage Disposal Contractor 9. Do you anticipate additions/expansion of the facility this sytem is intended to serve? ❑ Yes If yes, what type? ❑ Community "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: Tak, Coo j Kori, / 111n1%s -From T — / n '6 � f— , l- rol Q ONOL 6 PROPERTY INFORMATION REQUIRED: Tax Office PIN # S00//—!U-4gw Load Name��(,� Box # (if available) City %1csL/i/1e NC 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 from this application. DATE Sy6NATUFR- 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 Davi Coun Health epartment enter upon above described property located in Davie County and owned by , to conduct all testing procedures as necessary to determifie said site' suitability f a gfodnd absorption sewage treatment and disposal system. DATE tIGDATURt DCHD (1193) 3 1c: ►. r -A A. TUTTEROW 71 PG. 185 1433.2 827.39 - -- 164&60 TOTAL 1 AREA = 5.000 ACRES 1c: � N} U s 3 85.3r5r E---.-- - - ---- .. 627.39 - 107.73 6+0.00 _ .y ---N 0; 26 2r w +� — -- N 85.05• Ir w _� .M. o .« o AREA = 5.000 o D8.56 PG. 160 :.4 ".. Pr 1 ' t . 1 . 827.39 1c: Itn. AREA = 5.000 ACRES =� t N 107.73 6+0.00 _ .y ---N 0; 26 2r w +� — -- N 85.05• Ir w _� .M. o .« o `^ >� JAMES CALVIN 8 INA MAE HOWELL o D8.56 PG. 160 - 1 1 ' t TOTAL AREA = 28.302 ACRES ' IRONS ALONG MY. 601 ARE PLACED APPROX. r , WEST OF EDGE OF PAVEMENT R/R SPIKES ALONG SR 1312 ARE 1N 4. ROAD LEGEND ALL AREAS INCLUDE ROAD RIGHT OF WAYS PIP: p«.4 a. w 1 6 . p• • �i•R J. FRED RATLEDGE. HEIRS TE1PfO 'Y,9 . l anal L. 1917014ti aR1r1 THAT unu . OQ Z SEAL 1n ancrno» A� neaat rRf r�r w, r Arreorco �r _ . 0ruw4 91 ..:w 01wK ►fou A11 ACT11M nr�.Y BARS 8/19/!" ZGRwl� iuTTEROWpfw ..+,� µ Jt.. ! .14 v�t�'.iw�rnv�•rA•.MV .IMrMII" --.— ,—. «..... .n.. r.! +�...! K F • I.�.• urn �r.v A✓RF1Y "... a. .- ♦.. Er .... ,�-y iy.'_.' r ' % --k APPLICATION FOR SITE EVALUATION/IMPROVEMENTS PE IR 1?7E��® t Davie County Health Department ✓ Environmental Health Section JUL 1 Z . 1994 �D + P. O. Box 665 _ Mocksville, NC_ 27028 1. Application/Permit Requested By �Ly� Ce qoo� - W a (( 4- Ohl s -;a4, -S Mailing Address 3no Syy4'1, Home Phone N IA kJOc SQ; Ile. , NC- �7-7n-L.S3 Business Phone L„ C4- Zz-7-2- 2. Name on Permit if Different than Above V S /2.n/ 2-i> 3. Application for: 4. System to Serve: ❑ Business Moral Evaluation M -blouse ❑ Industry 5. If house, mobile home: Subdivision No. of People ? No. of Bedrooms Ell Septic Tank Installation Permit ❑ Mobile Home ❑ Place of Public Assembly ❑ Other No. of Bathrooms 12�- Dwelling Dimensions VOA- X 2 6. If business, industry, place of public assembly, other: Specify type No. of People Served N f �A- No. of Commodes /(/ JA No. of Lavatories I✓ A No. of Showers Al bl- 7. Type of water supply: �blic 8. Property Dimensions ❑ Unknown Section Lot # ❑ Basement/Plumbing ❑ Basement/No Plumbing ❑ Washing Machine ❑ Dishwasher ❑ Garbage Disposal No. of Sinks ,A11, 4 No. of Urinals�� No. of Water Coolers JI/,JA Water Usage Figures ❑ Private Sewage Disposal Contractor 9. Do you anticipate additions/expansion of the facility this sytem is intended to serve? ❑ Yes T b -N If yes, what type? ❑ Community '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: Tt4-Qa� pa /� ro-// � �G2ce'l TR�tc f This is to certify that the information provided is correct to incurred from is licatio a n. DAT fDz,,-ae a,� dl,'Qe d/% NJ SLV l p�Od GIS a4Otc %a4. r si. `le bbl AAA !7te, and nderst• SIG E I am responsible CONSENT FOR SITE EVALUATION TO BE DONE ON ABOVE DESCRIBED PROPERTY MUST CHECK ONE: ❑ 1. 1 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 DCHD (1/93) SIGNATURE " DAVIE COUNTY HEALTH DEPARTMENT Environmental Health Section Soil/Site Evaluation NAME O ADDRESS PROPOSED FACIILTY DATE EVALUATED PROPERTY SIZE 1�e17 LOCATION OF SITE 4:9/AZ Water Supply: On -Site Well Community Public Evaluation By: Auger Boring ,t_ Pit Cut FACTORS 1 2 3 4 Landscape position L L L Sloe % HORIZON I DEPTH Texture group Consistence Structure Mineralogy HORIZON II DEPTH Texture groupC C Consistence r Structure 77 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: !l EVALUATED BY: LONG-TERM ACCEPTANCE RATE: 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 -Nonplastic 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 wateC 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 ■■.■■■■■■■■■■■■■■■■■■e■■■■■■■■■■■■..■■■■.■■.■■■■■■...■■.■■ ■■.■ .■ ■■■■.■■■■■■■..■..■■■■■■■■■■■Nee■ ■■■■■■■........■....■■eee■■■.■.■ ■■■■.■...■■■.■..■■■e■e■■■eee.ecce■■eeeeee■■..■■■ee■■e■e.■■.e■■eee■ ■■■■.■■e■■■■ecce■■■■■.■■■.■■e■■...■■■■■..■..■■■.■■■■■.■■.■■.■.■.■■ ■■.■■.■■..■■..■.■■■■.■■■■■■■■■eee■■■eeee■■■..■.■■■....■..■■.■...■■ ■■.■e.■.■.■.■■.e.s■■.■■■■■.■Nee■ ■..■■.■■■.■..■■■......■■■■e.■■■■ ■■■■....■■..■■■.■■e■■e■■■■■■■■■■■■■■■Nee■■.■■.■......e...■■■■.■■.■ ■■....■....■....■■e■■eee.■.■.....■..■..e...■.....■.....■.....■...■ ■■■..■■■■■...■..■■.■.....■ee........e.... 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BOX 665 MOCKSVILLE, N.C. 27028 PHONE: (704) 634.5985 July 20, 1994 Swicegood—Wall & Assoc. 300 S. Main St. Mocksville, NC 27028 Re: Site Evaluation/Gus Lanzo Highway 601 North/5 Acre Tract Dear Agent: As requested, a representative from this office visited the aforementioned site on July 19, 1994. Based upon the information provided on the application for a 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, z�r001* � Robert B. Hall, Jr., R.S. Environmental Health Section RH/wd Enclosure .., .v 6va':'4--+r:'r,y ''•a: ..:oF-.�:, ,y.�.a''i-s.a ._::. r ,?<..ia ..- {`: r ..,.. .. , t Davie County Health Department ENVIRONMENTAL'HEALTH SECTION P.O. Box 665 Mocksville, N.C. 27028 AUTHORIZATION FOR WASTEWATER SYSTEM CONSTRUCTION (Issued in compliance with Article 11 of 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.*** AUTHORIZATION NUMBER NAMEA///I/Cri.�7 2 l DATE �l� /� i N n U 0 6 A NATE ON IMPROVEMENT PPEERMIT (If different than above) SITE LOCATION COMMENTS/CONDITIONS ON AUTHORIZATION TO CONSTRUCT WASTEWATER SYSTEM #*OWICE*H THIS AUTHORIZATION FOR, WASTEWATER SYSTEM CONSTRUCTION IS VALID FOR A PERIOD OF FIVE (5) YEARS. Parcel #: F30000000503 Dpvie County, NC - Basic Estate Search 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 #:F30000000503 Owner Information BAILEY CYNTHIA ANN 227 US HIGHWAY 601 NORTH MOCKSVILLE NC 27028 Property Information Land (Units/Type): 10.000 AC ddress: 3227 N US HWY 601 Account #:82517381 Tax Codes ADVLTAX - COUNTY TA FIREADVLTAX - FIRE TAX Township CLARKSVILLE Deed Information Local Zoning Date: 08/2001 Book: 00383 Page: 0902 Plat Book: Page: Legal Description PIN 10.0 Ac Hwy 601 5811936066 PropertV Values . Building: 165,5901 BXF: 1,6901 Land: 87,84 Market: 255 12 ssessed: 255,12 [Deferred: 08 Sales Information No. Book Page Month Year Instrument Qual/UnQual Improved Price 1 00191 0744 12 1996 EX Unqualified Vacant 0 2 00383 0902 08 2001 QC Unqualified Improved 0 3 00176 0067 08 1994 WD Qualified Vacant 23,000 4 00614 0543 06 2005 WD Qualified Vacant 39,000 View Property Record for this Parcel View Map for this Parcel View -Tax -Bill Information « Return to Basic Search Page 1 of 1 000till's 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/itsneWiew.aspx?prid=1458955 8/23/2016