2727 Hwy 601S (2)4
DAVIE COUNTY HEALTH DEPARTMENT
IMPROVEMENTS PERMIT AND CERTIFICATE OF COMPLETION 4 o U
*NOTE: Issued in Compliance With Article 11 of G.S. Chapter 130a
Sanitary Sewage Systems Permit' Number
Name Datefid N2 H0
Local0 on
.r1
Subdivision Name Lot No
Sec. or Block No. `►
Lot Size House Mobile Home ✓ Business Speculation
c�
No. Bedrooms No. Baths `� No. in Family _
Garbage Disposal YES ❑ NO d Specifications for System.
Auto Dish Washer YES E] NO E5 p v � &i
Auto Wash Machine YES ®' N ❑
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.
r»r.
Improvements permit by. -off
*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 A
f.
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j
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b Cof'
+2zn—
Lu Ceftifi n �' Date
"The signing of this certificate shall indicate .that the system: escribed above has' been installed in compliance with
the standards set forth in the above regulation, but shall in N I way be taken as a guarantee that the system will function
satisfactorily for any given period of time. ( r
'' •� APPLICATION FOR SITE EVALUATION/IMPROVEMENTS PERMIT
Davie County Health Department
Environmental Health Sections �4
P. O. Box 665 RECEIVED
Mocksville, NC 27028
1. Application/Permit Requested By
Mailing Address
Home Phone 22f�e -R3f0: Business Phone
2. Name on Permit if Different than Above
3. Property Owner if Different than Above
4. Application/Permit For: D General Evaluation R's/Tank Installation
5. System to Serve: 0 House �obile Home � Business
0 Industry u Other 0 Unknown
6. If house, mobile home: Subdivision Sec. Lot#
No. of People Dwelling Dimensions
No. of Bedrooms _ � Basement/Plumbing
No. of Bathrooms--- Basement/No Plumbing
(/Washing Machine J Dishwasher 0 Garbage Disposal
7. If business, industry, 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
8. Type of water supply: C PublicPrivate Q Community
9. Property Dimensions �_� �cr—e- — Q lr,GCy ak
10. Sewage Disposal Contractor
11. Do you anticipate additions/e,,xp nsions of the facility this system is
intended to serve? Q Yes lo
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.
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.
Vate Signature
Directions to Property:
D/ S d 0
DCHD (10-89)
DAVIE COUNTY HEALTH DEPARTMENT
Environmental Health Section
Soil/Site Evaluation c
NAME (�'� RQDATE EVALUATED
ADDRESS PROPERTY SIZE �� to
PROPOSED FACIILTY �Q"31- LOCATION OF SITE (00/-s
Water Supply: On -Site Well v
Evaluation By: Q j , Auger Boring P'
Community
Pit
Public
Cut
FACTORS
2
3
4
Landscape position
Sloe Z
W(5�Z.Cc_
HORIZON I DEPTHTexture
rou
SGL
SGL,
5 CL -
Consistence
T I
L
V F T
Structure
C
R
C e
C
Mineralogy):)
HORIZON II DEPTH
Ll D_
Lm'►
:111
Texture groupC
Consistence
y F�j
V F_X
F
Structure
k
P $ Irl
A
Mineralogy
HORIZON III DEPTH
Texture group
Consistence
Structure
Mineralogy
HORIZON IV DEPTH
Texture group
Consistence
Structure
Mineralogy
SOIL WETNESS
SS 1
5S
Ss
RESTRICTIVE HORIZON
--•
-�
-�-
SAPROLITE
--
CLASSIFICATION
5
V3
LONG-TERM ACCEPTANCE RATEL_3
3.5-14.
SITE CLASSIFICATION: _!�' S • EVALUATED BY: C.
LONG-TERM ACCEPTANCE RATE: �6 - t4.0 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 -Finn 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
Mineraloity
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
NONE
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Parcel #: M500000028 A
Davie County, NC - Basic Estate Search
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Parcel #: M500000028 A Account #: 18084000
Owner Information
Tax Codes
ADVLTAX - COUNTY TA
�FIREADVLTAX - FIRE TAX
ORRELL TERRY G& CORRELL LOUISE S
727 US HIGHWAY 601 SOUTH
MOCKSVILLE NC 27028
BXF:
Property Information
Township
nd (Units/Type): 1.740 AC
ddress: 2727 S US HWY 601
JERUSALEM
120 02
ssessed:
Deed Information
Local tonin
Date: 12/1990 Book: 00157 Page: 0223
Plat Book: age:
Le al Description
PIN
1.69 AC HWY 601
5745695853
Property Values
Building:
96,1101
BXF:
801
Land:
23 83
Market:
120 02
ssessed:
120 02
Deferred:
Sales Information
No. Book Page Month Year Instrument Qual/UnQual Improved Price
L 00096 0829 10 1975 WD Unqualified Improved 0
t 00157 0223 12 1990 WD Qualified Improved 41,500
View Property Record for this Parcel View Map for this Parcel View Tax Bill Information
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1.5.9
http://maps.daviecountync.gov/itsnet/View.aspx?prid=1468085 7/14/2016