The URL can be used to link to this page

4646 Hwy 601NA DAVIE COUNTY HEALTH DEPARTMENT �� 3 IMPROVEMENTS PERMIT AND . CERTIFICATE OF COMPLETION *[VOTE: Issued in Compliance With Article 11 of G.S. Chapter 130a Sanitary Sewage Systems Permit Number Name �: �, < ', �= Date C7 ..! 0 N' 6667 Location ' � ice/ � �.�..::�. {.'L'.?S�.'S.t".. ! ..1.1+�:r�•.� h'Ct.w_a \ '\tom a��i��`+ \ Subdivision Name `' Lot No. Sec. or Block No. Lot Size '�. Ct,c,� f House Mobile Home —_,____ Business Speculation No. Bedrooms _No. Baths No. in Family Garbage Disposal YES ❑ NO [' Specifications for System: ®E3Auto Dish Washer. YES ' NO Auto Wash Ma ,hine YES EJ NO ❑ C, Type Water Supply --- `This permit Void if sewage system described below is not installed within 5 years from date of issue. This permit is subject -to revocation if site plans or the intended use change. c Improvements permit by *Contact a representative of the Davie County Health Department for final inspection of this system between 8:30- 9:30 A.M. or 1:00-1:30 P.M. on day of completion. Telephone Number 704-634-5985. Final Installation Diagram: System Installed by `� \'�\ �w� 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. APPLICATION FOR SITE EVALUATION/IMPROVEMENTS PEF INRECENED Davie County Health Department Environmental Health Section FEB ��g2 P. O. Box 665 Mocksville, NC 27028 --------------- 1. _____ 1. Application/Permit Requested By Mailing Address Home Phone 2. Name on Permit if Different than Above Business Phone 99 - !Z54?! 3. Application/Permit for: ❑ General Evaluation 4. System to Serve: R -House ❑ Mobile Home ❑ Business ❑ Industry ❑ Other 5. If house, mobile home: Subdivision No. of People 3 No. of Bedrooms 3 No. of Bathrooms Dwelling Dimensions 6. If business, industry, place of public assembly, other: Specify type, No. of People Served No. of Commodes No. of Sinks _ No. of Urinals U3' Septic Tank Installation ❑ Place of Public Assembly ❑ Unknown Section Lot # ❑ Basement/Plumbing ❑ Basement/No Plumbing Er-w-'ashing Machine G -Dishwasher ❑ Garbage Disposal No. of Lavatories No. of Water Coolers No. of Showers Water Usage Figures 7. Type of water supply: ❑ Public 2 Private Ff- 8. Property Dimensions ZZ �� 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: iit �- ir Aman 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. Z2 DATE SIGNATURE CONSENT FOR SITE EVALUATION TO BE DONE ON ABOVE DESCRIBED PROPERTY MUST CHECK ONE: � 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 (12-90) DAVIE COUNTY HEALTH DEPARTMENT Environmental Health Section Soil/Site Evaluation NAME `C��.+A DATE EVALUATED ADDRESS S A^Cu�� PROPERTY SIZE i 77 1 %C o od r + PROPOSED FACIILTY o c s LOCATION OF SITE N Water Supply: On -Site Well ✓ Community Public Evaluation ByCc1 Auger Boring I% Pit Cut FACTORS 1 2 3 4 Landscape position S S -S Slope Z 'k - o g - �° $ �. $o HORIZON I DEPTH Texture group Consistence Z F Z Structure C C C Mineralogy HORIZON II DEPTH 0 0 U L Texture groupC C e - Consistence �Z \- Structure Mineralogy �, ) :1 ): 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 SITE CLASSIFICATION: 5 EVALUATED BY: LONG-TERM�ACCEPTANCE RATE: 3— OTHER(S) PRESENT: REMARKS:s�*-�,,- LEGEND Landscaoe 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 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 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 (O1-901 ■■■■■■■■■■■■■■■■■■■■■■■■■s!■■■■.■.■■ems•-- ---_ ■..■■es...■■.■■■■■■■_�-e■■■■■.ww.eine!�i■■■■■s■..■M■ii■..■e■■.e■■■■■ ■■■■■■e■■■■■■e■■•.a■■■■■►�.■�w■r.■►■■�a■■■■■■t■_..tee■■■■■■■ ■■■■■■■■■ ■..■■■.■■.■■.■ee■e■..■■iteer"�:::isi■■■..i■ee■■.ee■■■■■ee■�■■■■Mee■■ ■■■■■■■■■■■■/%■■■■■■/■GGrI■■■■■■ttt■■■■ttttttttttttttt■Ott■■■■■■/■■ ■■■■■■■■e%■■■■■//■■■■■■■■■Ili!■■!■ ■■e■■■(1\�IP�■�■■■■■■■■■e%■■■■■■■■■ ■.■..■■■II■■■■.��.■■■.■/��C�ii1i��■/■■■Gil■1��1■■■■.■■■/I■■■■■■■■■■ ■■■■■■■■/1■■■■■//■■iii■■■■■■■■■■■■■■■■■■e■�■■■■■■■■■■■■■■%■■��■■\\■■ ■■■■■■■■/■■■■Etc■■■■■■■■■e■■■e■■■■/��ee_ ■■■■■■.■■■■■■/le■■\Q�eL�et�e■ ■.■■■■■■■■■■■■11■■ei�li�i!!..:is iCii!■■■■.■■■■■ti.■■■.■■■■tl■■■■�\lail■!■ ■■■■■■■■.■■■■■Ifr�■■■■■■coca■■■■■■■■■■■■■■■!■e■■al>t�■■■■■■■��!■■■■■__�.■■ ■■■■■■■■►�■■■e■��■■■■e��e'�::::■■��::�:�•�■■■■■■.tee■■■e■■�i■■■■■..■■■■ ■.0■.�■■■■■\`...\\.....��...■� ■i1�11Calei■....�I....��►:��I.....CMEN ME■!■■. .■■e■■■■■■■.■..■►►�1...■■l�iM■■■■■■■�■■■■Neil■■■■■■■■■■■.■■■■■■■■■.■■■ ■CCCCCCCC■CCCCCCC�CCCCCC��C��S \■��CCCCCCCCCCCCCCCCCCCCCCCCC C■!■■■■■■C■■■■Oee.C........... :............e................■.... C■CCCCC�CCCCCCC�CC'CC:CCCCCCCCCCCCCCCCCCCCCCiCCCCCCCCCCCCCCCCCCC .CMORMON CMM■.MMMMM.C.............................................. ■■M.C■■■■..■_.■■..��1\! 'r�iH�liM.iiiCCi......�/■■■■■■■e■■■■■■■■■ tsee:e�::�:::■t■t/■■■t■�i■ie■ii■■■■■■■■■e■Mee■■■■e■e■■■■■■■■■■■ CCCCCCCiCCCCCCCCCCCCCCCCC■■CCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCC UMMMEEM MENNEN MENNEN MENNEN MEMNONMEMEMMMENNENCCCCCC ■■■ ■■.■■■■E■■■..■■■■.■■.■■■■■■■■.■■■■■■■■■■■■■■■...■■.■..■■■■■.■■ .................................................................. .................................................................. ■■■■■■■■■■■■■■■■■■■■■■■e■■■■■■■■■■■■■■ ■■■■■■■■■■■■■■■.■■■■■■■OMEN ■■M.■■..■...■■.■.■■...■■..■■■■.■■■■■■■■■EOE■■■■■■■■■N■■■M■■■■■■■■■ Parcel #: C30000004702 Page 1 of 1 ANY Davie County, NC - Basic Estate Search � ' �, Davie County Web Site Illiasic Search Real Estate Search Tax Bill Search Sales Search View Property Record for this Parcel View Man for this Parcel View Tax Bill Information Parcel #: C30000004702 Account #:7386000 Owner Information BXF• Tax Codes Land: BLEDSOE TEDDY Market: ADVLTAX - COUNTY T ssessed: 646 US HIGHWAY 601 NORTH Deferred: FIREADVLTAX - FIRE TAX OCKSVILLE NC 27028 Property Information Township Land (Units/Type): 2.010 AC CLARKSVILLE Address: 4646 N US HWY 601 Deed Information Local tonin Date: 07/1994 Book: 00175 Page: 0394 Plat Book: Page: Le al Description PIN 08 AC HWY 601 N 5823118645 Property Values uildin BXF• 5,52 01 Land: 2679 Market: 3231 ssessed: 3231 Deferred: Sales Information INo. Book Page Month Year Instrument Qual/UnQual Improved Pricel 1 00175 0394 07 1994 WD Unqualified Vacant 0 View Property Record for this Parcel View Map for this Parcel View Tax Bill Information 1<< 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=1468961 8/9/2016