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5035 Hwy 601N` DAVIE COUNTY ENVIRONMENTAL HEALTH P.O. Box 848/210 Hospital Street Mocksville, NC 27028 (336)753-6780 / Fax # (336)753-1680 AUTHORIZATION FOR WASTEWATER SYSTEM CONSTRUCTION Account #: 990005609 'fax P€NlEH #: 5823-06-0311 Billed To: Aubrey James Subdivision Info Reference Name:Location/Address: US Hwy 601-27028 Proposed Facility: Residence Property-Size: 8.089 Acres .. ATC Number: 5121 Site Type: )(New ❑Repair ❑Expansion **NOTE** This Authorization to Construct (ATC) MUST BE ISSUED by the Davie County Environmental Health Section prior to issuance of any building permit(s), (in compliance with Article 11 of G.S. Chapter 130A Wastewater Systems, Section .1900 Sewage Treatment and Disposal Systems). THIS AUTHORIZATION TO. CONSTRUCT IS VALID FOR A PERIOD OF FIVE YEARS. This ATC is subject to revocation if site plans, plat or the intended use change. Residential Specifications: # Bedrooms—3--# BathroomsA.S # People l Basement❑ Basement plumbing❑ Non -Residential Specifications: Facility Type # People # Seats– Square Footage(or Dimensions of Facility) Lot Size .8 !ka Type of Water Supply: ❑County/City %Well ❑Community Well System Specifications: Design Wastewater Flow (GPD) 3(U Tank SizeJWQ GAL. Pump Tank AYA GAL. Trench Width _ Max. Trench Depth AYA Rock Depth 12 Linear Ft. Site Modifications/Conditions/Other: Contact the Davie County Environmental Health Section for final inspection of this system between 8:30 – 9:30a.m. on the day of installation. Telephone # (336)751-8760. Environmental Health Specialist. DCHD 11/06 (Revised) Date: 1', Y Davie County Environmental Health P.O. Box 848/210 Hospital Street Mocksville, NC 27028 (336)753-6780 / Fax (336)753-1680 IMPROVEMENT PERMIT Account #: 990005609 Billed To: Aubrey James Address: 5051 US HWY 601 N City: Mocsville Tax PIN/EH #: 5823-06-0311 Subdivision Info: Location/Address: US Hwy 601 N-27028 Property Size: 8.089 Acres Reference Name: Proposed Facility: Residence **NOTE* *This Improvement Permit DOES NOT authorize the construction of a wastewater system. An Authorization To Construct a wastewater system must be obtained from this office prior to the construction/installation of a wastewater system or the issuance of a building permit(in compliance with Article 11 of G.S. Chapter 130A, Wastewater Systems). This Improvement Permit is subject to revocation if site plans, plat or the intended use change. Permit Type: MNew ❑Repair ❑Expansion Permit Valid for: #6Years ❑No Expiration Residential Specifications: # Bedrooms 3 # Bathrooms, 57—# People I Basement❑ Basement plumbing❑ Non -Residential Specifications: Facility Type # People # Seats Square Footage(or Dimensions of Facility) Design Flow(GPD): 3(�0 Type of Water Supply: ❑County/City [; Well ❑Community Well Site Modifications/Permit Conditions: A plicat' i Tv, e of Au is 'taw SITE EVALUATION/IMPROVEMENT PERMIT & ATC Davie County Environmental Health P.O. Box 848/210 ospital Street Mocksvill,NC 7 028 2 (336)753-6780 Fax (336)753-1680 I 1 J%1 u nprovement Permit ❑ Authorization To Construct (ATC) . Both System ❑Repair to Existing System ❑Expansion/Modification of Existing System or Facility l *� *IMPORTANT*** THIS APPLICATION CANNOT BE PROCESSED UNLESS ALL OF THE REQUIRED INFORMATION IS PROVIDED. Refer to the INFORMATION BULLETIN for instructions. ArrLIUAIN I IINV UKIVIA I IUIN Name Wrev Up—meS Contact Person RaLke Address c5 5 ��c�� V✓ Home Phone '%0/f-' r1" 0!x13 City/State/ZIP M6cki5A1 C 02 Business Phone 70#--95$-30Z2 Name on Permit/ATC if Different than Above Mailing Address 5061 M5 HU41 &J1 L PROPERTY INFORMATION *Date House/Facility Corners Flagged �f— �Z— NOTE: A survey plat or site plan must accompany this application. Included: Site Plan ❑Plat(to scale) (Permit is valid for 60 months with site plan, no expiration with complete plat.) Owner's Name AGr��y Ala,7 ine_s Phone Number 6359-D0v/3 Owner's Address 50�/ &,S; f/ l0 City/State/Zip �pGr�.5(!Z-, GZr%OZ8 Property Address 6!, S. Al City AcO sk-Mle Lot Size 9,-0y_PSCfnS7 Tax PIN# 5Y230603/� Subdivision Name(if applicable) Section/Lot# Directions To Site: JAKE #JvY 60/ _ &L %f/ G✓ y . 0 L' /`/Ousro v ELEF7" .1S"/ Gls HH/Y 6o/ N. TfyEPQOPEPTY ,ZS 77145 Lb Tb 77IE LE� W i If the answer to any of the following questions is "Yes",supporting docu entation must be attached: /ii3O, Are there any existing wastewater systems on the site? _Yes o Does the site contain jurisdictional wetlands? _Yes ,No Are there any easements or right-of-ways on the site? _Yes VINO Is the site subject to approval by another public agency? _Yes ✓No Will wastewater other than domestic sewage be Generated? Yes 7No IF RESIDENCE FILL OUT THE BOX BELOW # People -1 # Bedrooms 3 # Bathrooms 2.5 Garden Tub/Whirlpool ❑Yes Lt&o Basement: ❑Yes Ao Basement Plumbing: []Yes Vo IF NON -RESIDENCE FILL OUT THE BOX BELOW Type of Facility/Business Total Square Footage of Building # People # Sinks' # Commodes # Showers # Urinals Estimated Water Usage (gallons per day) (Attach documentation of similar facility water consumption) FOODSERVICE ONLY: # Seats Type system requested: aConventional ❑Accepted ❑Innovative ❑Alternative ❑Other. Water Supply Type: ❑ County/City Water ❑ New Well &(Existing Well ❑ Community Well Do you anticipate additions or expansions of the facility this system is intended to serve? ❑ Yes ao If yes, what type? This is to certify that the information provided on this application is true and correct to the best of my knowledge. I understand that any permit(s) or ATC(s) issued hereafter are subject to suspension or revocation if the site is altered, the intended use changes, or if the information submitted in this application is falsified or changed. I hereby grant right of entry to the Authorized Represent ive of the Davie County Health Department to conduct necessary inspections to determine compliance with applicable laws an leJg* rstand t �the m responsible for the proper identification and labeling of property lines and corners and locat' r i house/facility location, proposed well location and the location of any other amenities. 'Preertfibwl or 00, w s legal representative signature Site Revisit Charge Date(s): ////y/Z0/ 0 Client Notification Date: Date EHS: Sign given ❑Yes ❑No / Account # 666 Revised 11/06 Invoice # r/al 1 Al, A16 Per►u4 763 D r Reports Davie County, NC Tax Parcel Report Page 1 of 1 *WARNING: THIS IS NOT A SURVEY!' Monday, 5/3/2010 This map Is prepared for the Inventory of real property found within this pPoV/F jurisdiction, and is compiled from recorded deeds, plats, and other public records and data. Users of this map are OURS hereby notified that the aforementioned public primary information sources should be consulted for verification of the Information contained on this map. The County and mapping company assume no legal responsibility for the Information contained on this map. Notes: Parcel Number: FIB30000002907 PIN Number: 5823060311 Account Number: 1000082520900 Listed Owner #1: AMES AUBREY ALAN Listed Owner #2: Mailing Address 1: 5051 US HWY 601 N M ilio A r I MOCKSVILLE tate: NC Zi Code: Le al Descri tion: 27028 8.089 AC HWY 601 Acrea e: 7.49200000 Deed Date: 020041019 Book and Pa e: 05770339 FDeed Plat Book: Plat Page: Building Value: jo utbuilding and Extra Features alue: 0 Land Value: 53390 otal Market Value: 53390 otal Assessed Value: 53390 http://maps.co.davie.nc.usIGoMapslreportslreport.cfm?CFID=84798&CFTOKEN=23969486 5/3/2010 %�. S`:y►-ren 111�AO-1\ posodoid Inc ICA LI/ 4(/7gU Z �aiio S r n�Jo�� DAVIE COUNTY HEALTH DEPARTMENT Environmental Health Section Soil/ Site Evaluation APPLICANT INFORMATION PROPERTY INFORMATION Account #: 990005609 Tax PIN/EH #` 5823-06-0311 , Billed To: Aubrey James Subdivision Info: Reference Name: Location/Address: US Hwy 601 N-27028 Proposed Facility: Residence Property Size: 8.089 Acres Date Evaluated: 26/� Water Supply: O=Well Community Evaluation By: Auger Boring --, Pit Public Cut FACTORS 1 2 3 4 5 6 7 Landscape position G. Slope %• 0 ZIA HORIZON I DEPTH k Texture group 'C - Consistence Structure Q Mineralogy HORIZON H DEPTH Texture group Consistence Structure Mineralogy HORIZON III DEPTH Texture group Consistence Structure Mineralogy HORIZON IV DEPTH Texture group Consistence Structure Mineralogy SOIL WETNESS RESTRICTIVE HORIZON SAPROLITE CLASSIFICATION PIT— IQ15 LONG-TERM ACCEPTANCE RATE .22 .2 . SITE CLASSIFICATION: JpS EVALUATION BY: 6&19Z 4040dia LONG-TERM ACCEPTANCE RATE: 2 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 NS - Non sticky SS.- Slightly sticky S - Sticky VS - Very Sticky NP - Non plastic SP - Slightly plastic P - Plastic VP - Very plastic 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 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) i TAR - I nnw-term arrentanry rate - oal/`lair/ft7 ■■■/■■■■■■■■■/■■■■■■■■//■■■11■■■11■■■■►�■■■■/■■■■■■■■■■11/11■■■■■■■■■■■ ■//■■■/■■■■■/■■■■■■■■■■■■■■11■■■I■■■■■\■■/■/■■■■■■■■■■11/11■■■■■■■■■■■ ■/■■■■■■■■■/■■■■/■■■■■■■■■■11■■ail■■■■■►�■■■■n■�i�Y■■■■■11■11■■■■■■■■■■■ ■■■■■■■■■/■■■■■■/■■■■■■■■■■tl■■■ �■/■■■/\■■■Y■11!111■■■■■11■11■■■■■■■■/■■ ■■■■■■■■■■■■■■■■■■■■■■■■■■■11■■■�■■■/r':7■■■■■■■/■G�!■■■■111111■■■■■■m■■■■ ■■■■■■■■■■■■■ U■■■■■■■■■■■■■■■M■■m11■/I■■ ' ■■Em/ EM■■■■■■■K HE ME■NON ■■■■■■■■■■■■■■■■■■■■■■■■■■■IiCi�G�iGGGGiiiGiwiii�iiiiii�l■�'J■■■■■■■■■■■ ■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■ ■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■ Parcel #: B30000002907 Davie County, NC - Basic Estate Search Basic Search Real Estate Search Tax Bill Search Sales Search View Property Record for this Parcel View Map for this Parcel View Tax Bill Information Parcel #: B30000002907 Account #:82520900 Owner Information Building: I ax Codes BXF• AMES AUBREY ALAN Land: I IC ADVLTAX - COUNTY TA 035 US HIGHWAY 601 N IFIREADVLTAX - FIRE TAX Deferred OCKSVILLE NC 27028 Property Information Township Land (Units/Type): 7.490 AC CLARKSVILLE Address: 5035 N US HWY 601 Deed Information Local Zoning 1 Date: 06/2010 Book: 00828 Page: 0155 Plat Book: Page: Le al Description PIN 18.089 AC HWY 601 5823060311 Propertv Values Building: 172,41CI BXF• 01 Land: 53J39Market: 225ssessed: 225 Deferred Sales Information No. Book Page Month Year Instrument Qual/UnQual Improved Price . 00577 0339 10 2004 WD Unqualified Vacant 0 ! 00828 0155 06 2010 WD Unqualified Vacant 0 View Property Record for this Parcel View Man for this Parcel View Tax Bill Information « Return to Basic Search I/ Page 1 of 1 1-4 o t� o U I, 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=1462683 6/15/2016