765 Howell Rd Davie County,NC Tax Parcel Report Wednesday, February 15, 2017
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WARNING: THIS IS NOT A SURVEY
Parcel Information;
Parcel Number: C300000123 Township: Clarksville
NCPIN Number: 5823608717 Municipality:
Account Number: 82525603 Census Tract: 37059-801
Listed Owner 1: SNOW MARJORIE B Voting Precinct: CLARKSVILLE
Mailing Address 1: 765 HOWELL ROAD Planning Jurisdiction: Davie County
City: MOCKSVILLE Zoning Class: DAVIE COUNTY R-A
State: NC Zoning Overlay:
Zip Code: 27028-0000 Voluntary Ag.District: No
Legal Description: 1.751 AC HOWELL RD LIFE ESTATE Fire Response District: FARMINGTON
Assessed Acreage: 1.87 Elementary School Zone: WILLIAM R DAVIE
Deed Date: 11/2005 Middle School Zone: NORTH DAVIE
Deed Book/Page: 2004EO287 Soil Types: EnB,MsC
Plat Book: Flood Zone:
Plat Page: Watershed Overlay: DAVIE COUNTY
Building Value: 44480.00 Outbuilding&Extra 6750.00
Freatures Value:
Land Value: 23970.00 Total Market Value: 75200.00
Total Assessed Value: 75200.00
161
All data Is provided as Is without warranty or guarantee of any kind either expressed or Implied including but not limited to the
Davie County, Implied warranties of merchantability or fitness for a particular use.All users of Davie County's GIS website shall hold hrmless the
County of Davie,North Carolina,Its agents,consultants,contractors or employees from any and all claims or causes of action due to
NC or arising out of the use or Inability to use the GIS data provided by this website.
OPERATION PERMIT or Ifice 13se nv
` Davie County Health Department *CDP File Number 198790-1
rte. 210 Hospital Street
P.O.Bax 848
County ID Number.
'=• Mocksville NC 27028 Evaluated For: REPAIR
Phone:336-753-6780 Fax:336-753-1680 Township:
T
ant: Marjorie Snow Property owner: Marjorie Snow
ress: 765 Howell Road Address: 765 Howell Road
Cky: Mocksville City: Mocksville
State/ZIP: NC 27028 State/zip: NC 27028
Phone#: (336)998-3224 Phone#: (336)998-3224
Property Location S Site Information
Address/Road #: Subdivision: Phase: Lot:
765 Howell Road
Mocksville NC 27028 Directions
-Structure: SINGLE FAMILY Hwy.601 North right on Hwy 801 Howell Rd on right
#of Bedrooms: 2
#of People:
*1Nater Supply: EXISTING WELL
*IP Issued by. 2140-Natwns,Robert
*System Classification/Description:
TYPE 11 A.CONY SYSTEM(SINGLE-FAMILY OR 480 GAD OR LESS)
*CA issued by: 2140-Nations,Robert Saprolite System? OYes ONo
Design Flow: 2 4 0 *Dist GRAVITY-PARALLEL d-�) Pump Regi No?
ribution Type: (��
Soil Application Rate: 0 - 2 *Pre Treatment:
Drain field
(Nitrification
d 1 2 0 0 Sq• g• *System Type: INFILTRATOR QUICK4STANDARD 3 Installer: Sherman Dunn
Total Trench Length: 3 0 0 It. Certification#:
Trench Spacing: — 9 Inches O.C.
Feet O.C. *ENS: 2140-Nations.Robert
Trench Width: 3 Inches
— Feet Date: 0 3 / 0 7 / 2 0 1 6
Aggregate Depth: inches
Minimum Trench Depth: 3 6
Inches
Minimum Soil Cover. a 4 Approval Status'
Inches
Maximum Trench Depth: 3 6 Inches ® Approved Dlsapprorred
Maximum Soil Cover. a 4
Inches
CDP File Number 198790 - 1
Septic Tank County ID Number;
Manufacturer. Lat.
STB: long:
Gallons:
Installer.
Date: Certification#:
"'EHS:
"Filter Brand:
ST Marker El Yes ❑ No Date:
Reinforced Tank: ❑ Yes ❑ No Approval Status
t Piece Tank: ❑ Yes ❑ No �❑ Approved❑ DlsapproVed
Pump Tank
Manufacturer. Installer.
PT: Certification#:
Gallons: *EHS:
Date: Date:
RiserSealed ❑ Yes ❑ No
RiserHeight: ❑ Yes ❑ No (Min.6 in.) Approval Status41-
Reinforced Tank: ❑ Yes ❑ No ❑ Approved❑ Disapproved
1 Piece Tank: ❑ Yes ❑ No
Supply Line
C� Pipe Size. inch diameter Installer.
Pipe Length: feet Certification#:
"EHS:
"Schedule:
Pressure Rated ❑ Yes ❑ No Date: 1
Approved fittings ❑ Yes El No AppovalStatus
❑ Approved❑zDlsapproved
u p Requirement
Pump Type: Installer.
Dosing Volume: — Gal Certification#:
Draw Down: Inches "EHS:
*Chain:
Date:
Valves Accessible ❑ Yes ❑ No
Flow Adjustment Valve ❑ Yes ❑ No
Check-valve ❑ Yes ❑ NO ;
Approval Status
PVC unions El Yes El No ❑ Approued C7 Disapproved
Vent Hole ❑ Yes ❑ No
Anti-siphon Hole El Yes ❑ No
CDP File Number 198790 - fi County ID Number:
Electric E ui ment
NEMA 4X Box or Equivalent ❑ Yes ❑ No Installer.
Box 12 inches Above Grade ❑ Yes ❑ No
Certification#:
Box Adj.To Pump Tank ❑ Yes ❑ No
Conduit Sealed ❑ Yes ❑ No *EHS:
Pump Manually Operable ❑ Yes ❑ No
*Activation Method: Date:
Approval Status
Alarm Audible ❑ Yes ❑ NO
❑ Approved❑ Disapproved
Alarm Visible ❑ Yes ❑ No
2140•Nations,Robert
"Operation Permit completed by:
Authorized State A16; Date of Issue: 0 3 0 7 2 0 1 6
Owner/Applicant Signature:
This system has been installed in compliance with applicable NC General Statutes:Article 11, Chapter 130A, Rules for
Sewage Treatment and Disposal 15A NCAC 18A .1900 et. Seq.,and all conditions of the Improvement Permit and
Construction Authorization.This property is served by a TYPE It a sewage septic system.
Rule.1961 requires that a Type TYPE II A septic system meet the following criteria:
Minimum System Review By The Local Health Department: WA
Management Entity: OWNER
Minimum System Inspection/Maintenance Frequency By Certified Operator:
NIA
Reporting Frequency By Certified Operator. NIA
Rule.1961 requires that a Type IV and V septic systems designed fora home/business owner must maintain a valid contract
with a public management entitywith a certified operatoror a private certified operator forthe life of the septic system.
Rule.1961 requires that Type VI septic systems designed fora home/business owner must maintain a valid contract with a
public management entity with a certified operator for the life of the septic system.
Rule. 1961 (2)(e)requires a contract shall be executed between the system owner and a management entity prior to the
issuance of an Operation Permit for a system required to be maintained by a public or private management entity, unless the
system ownerand certified operator are the same. The contract shall require specific requirements for maintenance and
operation, responsiblities of the owner and systems operator,provisions that the contract shall be in effect for as long as the
system is in use,and other requirements for the continued proper performance of the system. It shalt also be a condition of
the Operation Permit that subsequent owners of the systems execute such a contract.
@Hand Drawing 01mport Drawing
**Site plan/Drawing attached.**
OPERATION PERMIT .
198790 - 1
Davie County Health Department CDP File Number: ,
210 Hospital Street
County File Number:
P.O.Box 848
Mocksville NC 27028 Date: /
Q Inch
Drawing DrawiON/A
ng Type: Operation Permit Scale: k = ft.
Ni
��— C-* --
w
" CONSTRUCTION For'Office use Only
Y AUTHORIZATION "CDP File Number 198,790- 1
Davie County Health Department
County ID Number.
210 Hospital Street Evaluated For: REPAIR
� P.O. Box 848
Township:
Mocksville NC 27028 PERMIT VALID UNTIL:
Phone: 336-753-6780 Fax:336-753-1680 0 1 / 1 9 / a 0 a 1
Applicant: Marjorie SnowProperty Owner: Marjorie Snow
Address: 765 Howell Road Address: 765 Howell Road
City: Mocksville City: Mocksville
State/Zip: NC 27028 State/Zip: NC 27028
Phone M (336)998-3224 Phone#: (336)998-3224
Property Location & Site Information
Address/Road M Subdivision: Phase: Lot:
765 Howell Road
Mocksville NC 27028 Directions
- Structure: SINGLE FAMILY Hwy 601 North right on Hwy 801 Howell Rd on right
#of Bedrooms: 2
#of People:
"Water Supply: EXISTING WELL
System Specifications
Minimum Trench Depth: a 4
Site Classification: Provisionally Suitable Inches
Minimum Soil Cover:
Saprolite System? O Yes (&No 1 a Inches
Design Flow: 2 4 0 Maximum Trench Depth: 3 6 Inches
Soil Application Rate: 0 a Maximum Soil Cover: a 4 Inches
"System Classification/Description: "Distribution Type: GRAVITY-PARALLEL(eq.d-box)
TYPE II A.CONV SYSTEM(SINGLE-FAMILY OR 480 GPD OR LESS) Septic Tank:
Gallons
'Proposed System: 25%REDUCTION 1-Piece: O Yes O No
Pump Required: O Yes O No O May Be Required
Nitrification Field 1 a 0 0
Sq.ft. Pump Tank: Gallons
No. Drain Lines 3 1-Piece: OYes ONo
Total Trench Length: 3 0 0 ft GPM--vs— ft. TDH
Trench Spacing: _ 9 O Inches O.C.
®Feet O.C. Dosing Volume: Gallons
Trench Width: _ 3 O Inches
®Feet Grease Trap: Gallons
Aggregate Depth: inches
Pre-Treatment: O NSF OTS-1 OTS-11
Septic Tank Installer Grade Level Required: 01011 O III 01V
Page 1 of 3
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CDP File Number 198790 - 1 County ID Number: ' ' 4.
❑ Open Pump System Sheet
Repair System Required:0 Yes O No ®No, but has Available Space
rDesignFlow:
System
Trench Spacing: 9 �Inches O. .
ification: Provisionally Suitable — Feet O.C.
a 4 Trench Width: _ 3 Fe tInches
Soil Application Rate: 0 a Aggregate Depth: inches
*System Classification/Description: Minimum Trench Depth: a 4 Inches
TYPE II A.CONY SYSTEM(SINGLE-FAMILY OR 480 GPD OR Minimum Soil Cover: 1 a
LESS) Inches
*Proposed System: 25%REDUCTION Maximum Trench Depth: 3 6 Inches
Maximum Soil Cover: a 4
Nitrification Field 1 a 0 0 Inches
Sq.ft.
No. Drain Lines 3 *Distribution Type: GRAVITY-PARALLEL(eq.d-box)
Total Trench Length: 3 0 0 ft Pump Required: O Yes O No O May Be Required
Pre-Treatment: O NSF OTS-I OTS-II
*Site Modifications
No grading or construction activity is allowed in areas designated for system and repair without approval of Health Department. -mw
750 750
*Permit Conditions
The issuance of this permit by the Health Department in no way guarantees the issuance of other permits.The permit holder
is responsible for checking with appropriate governing bodies in meeting their requirements. R"m ;g
Ensure that the exit of the tank is ope and functioning.Ensure that distribution system is working.If system is completely failing,replace. 1858
This Authorization for Wastewater System Construction shall be valid for a person equal to the period of validity of the Improvement Permit,not
to exceed five years,and may be issued at the same time the Improvement Permit issued(NCGS 130A-336(b)).If the Installation has not been
completed during the period of validity of the Construction Permit,the information submitted In the application for a permit or Construction
Authorization is found to have been incorrect,falsified or changed,or the site is altered,the permit or Construction Authorization shall become
Invalid,and may be suspended or revoked(.1937(g)).The person owning or controlling the system shall be responsible for assuring compliance
with the laws,rules,and permit conditions regarding system location,installation,operation,maintenance,monitoring,reporting and repair
(1938(b)).
Applicant/Legal Reps. Signature Required? Oyes O No
Applicant/Legal Reps. Signature- Date:
*Issued By: 2140-Nations,Robert Date of Issue: 0 1 1 9 / a 0 1 6
Authorized State Agent: Malfunction Log OYes
®Hand Drawing O Import Drawing
**Site Plan/Drawing attached.**
Page 2 of 3
CONSTRUCTION AUTHORIZATION 198790 - 1
Davie County Health Department CDP File Number:
210 Hospital Street
P.O.Box 848 County File Number:
Mocksville NC 27028 Date: 01 / 19 / .2016
O Inch
Drawing Drawing Type: Construction Authorization Scale: . O Block
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CONSTRUCTION AUTHORIZATION
Davie County Health Department
210 Hospital Street CDP File Number: 198790 - 1
P.O.Box 848
Mocksville NC 27028 County File Number:
Date: A:0 1.9. /.a 0.1.6.
Click below to import an image from an external location: Drawing Type: Construction Authorization
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