Loading...
1749 Hwy 64EAUTHORIZATION NO: 002756 A AUTHORIZATION FOR WASTEWATER Tax Office PIN:# SYSTEM CONSTRUCTION - - Road Name: ('7u::i } � �� Z1p lr = %tJZf= 7 **NOTE** 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. (In compliance withArticle-1) of G:S. ChapterOA, Wastewater Systems, Section .1900 Sewage Treatment and Disposal Systems) --- f' ; / ) f, ***NOTICE*** THIS AUTHORIZATION FOR WASTEWATER CONSTRUCTION )�% IS VALID FOR A PERIOD OF FIVE YEARS. ST DATE SS ED RESIDENTIAL SPECIFICATION: BUILDING TYPE NO -Z6 # BEDROOMS —� # BATHS # OCCUPANTS + GARBAGE DISPOSAL: Yes or No COMMERCIAL SPPEC�IFICATION: FACILITY TYPE # PEOPLE # PEOPLE/SHIFT # SEATS INDUSTRIAL WASTE: Yes or No LOT SIZE I' I` TYPE WATER SUPPLY �� DESIGN WASTEWATER FLOW (GPD) ` � NEW SITE REPAIR SITE t SYSTEM SPECIFICATIONS: TANK SIZE GAL. PUMP TANK GAL. TRENCH WIDTH ice' ROCK DEPTH 12LINEAR FT. 3 OTHER�G� '�T"IL�ViIC�K/ i REQUIRED SITE MODIFICATIONS/CONDITIONS: ItZ -—T6 t_ AC�,�rovo, , 141,E 1 i� O=F FQ','-' u IMPROVEMENT PERMIT LAYOUT :1� rd6 1�t -3,G5 1� 6 tom.. Gtr LjG 6-L>Z 1'110.1 a Tn,Ok 4 e LJ7Le7 7 FOR FINAL INSPECTION OF THIS SYSTEM PLEASE CALL BETWEEN 8:30 - 9:30 A.M. ON THE DA �OF INSTALLATION. TELEPHONE # IS (336) 751-8760. OPERATION PERMIT G-44(4"- I SYSTEM INSTALLED BY: ��-- s lqw3-ZS 0,0@, 1 1 r --v--) al 7 AUTHORIZATION N0%M0 J OPERATION PERMIT BY: DATE: i **THE ISSUANCE OF THIS OPERATION PERMIT SHALL INDICATE THAT THE SYSTEM D IBED 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 GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORILY FOR ANY GIVEN PERIOD OF TIME. DCeD oaroz (Revised) t f ZG 1 J( :-# 1`�9 �Z 'Perimt%'Ir's DAVIE COUNTY C) �"Y- I HEALTH DEPARTMENT PROPERTY INFORMATION+Od ' Name: Environmental Health Section D -01 Directions to property: (,�'���---'~ P.O. Box 848 4,-3 Mocksville, NC 27028 Subdivision Name: '1�1t7�j Phone #: 336-751-8760 Section: Lot: AUTHORIZATION NO: 002756 A AUTHORIZATION FOR WASTEWATER Tax Office PIN:# SYSTEM CONSTRUCTION - - Road Name: ('7u::i } � �� Z1p lr = %tJZf= 7 **NOTE** 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. (In compliance withArticle-1) of G:S. ChapterOA, Wastewater Systems, Section .1900 Sewage Treatment and Disposal Systems) --- f' ; / ) f, ***NOTICE*** THIS AUTHORIZATION FOR WASTEWATER CONSTRUCTION )�% IS VALID FOR A PERIOD OF FIVE YEARS. ST DATE SS ED RESIDENTIAL SPECIFICATION: BUILDING TYPE NO -Z6 # BEDROOMS —� # BATHS # OCCUPANTS + GARBAGE DISPOSAL: Yes or No COMMERCIAL SPPEC�IFICATION: FACILITY TYPE # PEOPLE # PEOPLE/SHIFT # SEATS INDUSTRIAL WASTE: Yes or No LOT SIZE I' I` TYPE WATER SUPPLY �� DESIGN WASTEWATER FLOW (GPD) ` � NEW SITE REPAIR SITE t SYSTEM SPECIFICATIONS: TANK SIZE GAL. PUMP TANK GAL. TRENCH WIDTH ice' ROCK DEPTH 12LINEAR FT. 3 OTHER�G� '�T"IL�ViIC�K/ i REQUIRED SITE MODIFICATIONS/CONDITIONS: ItZ -—T6 t_ AC�,�rovo, , 141,E 1 i� O=F FQ','-' u IMPROVEMENT PERMIT LAYOUT :1� rd6 1�t -3,G5 1� 6 tom.. Gtr LjG 6-L>Z 1'110.1 a Tn,Ok 4 e LJ7Le7 7 FOR FINAL INSPECTION OF THIS SYSTEM PLEASE CALL BETWEEN 8:30 - 9:30 A.M. ON THE DA �OF INSTALLATION. TELEPHONE # IS (336) 751-8760. OPERATION PERMIT G-44(4"- I SYSTEM INSTALLED BY: ��-- s lqw3-ZS 0,0@, 1 1 r --v--) al 7 AUTHORIZATION N0%M0 J OPERATION PERMIT BY: DATE: i **THE ISSUANCE OF THIS OPERATION PERMIT SHALL INDICATE THAT THE SYSTEM D IBED 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 GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORILY FOR ANY GIVEN PERIOD OF TIME. DCeD oaroz (Revised) t f ZG 1 J( :-# 1`�9 �Z ,t -t a''. r' ,;. tt •,n f- r .°. t" of .3W.r, •f ."9 VL f y+1�y , r t �•�.' .,..6 _ r . "# tY•n.B`,: .a.', sv iralst 5, 'iM2 '..,.a ,rti..f..tr+. a,•v'.a A 1z'—'�'� � � .=„- .� t 3 r• .:., e�A^��'�'xr i.✓ �' j. ^1. l p,�6 ` e 's DAVIE COUNTY HEALTH DEPARTMENT Name: i"�"" I `\t-�� �*: > "t i Environmental Health Section PROPERTY INFORMATION, ' 'N .r ` " r P.O. Box 848 0-0l t r�rl7uectiQns �gproperty:'% t �-' ��' t Mocksville, NC 27028 Subdivision Name: rYCf.� Phone #: 336-751-8760 Section: Lot: AUTHORIZATION FOR WASTEWATER Tax Office PIN:# SYSTEM CONSTRUCTION - - ;� L AUTHORIZATION NO: 002756 A Road Name: t_1LA '4 U' _' 1p f' 2 **NOTE** 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. (In compliance with Article 11 of G.S. Chapter­I�OA, Wastewater Systems, Section .1900 Sewage Treatment and Disposal Systems) s �7 ***NOTICE*** THIS AUTHORIZATION FOR WASTEWATER CONSTRUCTION ` IS VALID FOR A PERIOD OF FIVE YEARS. .,*-.-.ENVIRON NfAl HEALTNSPECiXLIST DATE ISSLAED RESIDENTIAL SPECIFICATION: BUILDING TYPE f;�1 # BEDROOMS # BATHS # OCCUPANTS { GARBAGE DISPOSAL: Yes or No COMMERCIAL SPECIFICAfION: FACILITY TYPE # PEOPLE # PEOPLE/SHIFT # SEATS INDUSTRIAL WASTE: Yes or No LOT SIZE E WATER SUPPLY�� DESIGN WASTEWATER FLOW (GPD) NEW SITE REPAIR SITE �+ � 1 SYSTEM SPECIFICATIONS: TANK SIZE GAL. PUMP TANK - GAL.TRENCH WIDTH �G' ROCK DEPTH 12 1 LINEAR FT. OTHER 2' 'N --1 k1 &A I DJ 8Y)XE,�-- REQUIRED SITE MODIFICATIONS/CONDITIONS:'t'+3- T4LL CA,) Caw JTOLI j" f It e Id IL' L-P IMPROVEMENT PERMIT LAYOUT ( (Av" 41J 01 L' ' �t�,,r _ i f-�.�: �..� c.I.3 Lr='f t-►�� Vic..' , ��'G.I-I�.C.tt G:_t.,.��=lrto,a vl'. Teak �► c.v7��7 7 FOR FINAL INSPECTION OF THIS SYSTEM PLEASE CALL BETWEEN 8:30 - 9:30 A.M. ON THE DAYOI OPEiIATION.PERMIT V- / C1at SYSTEM INSTALLED BY: tv �r 0 INSTALLATION. TELEPHONE # IS (336) 751-8760. ��- ��� SPG AUTHORIZATION NO.'��� OPERATIONPERMIT ERMIT BY: I !7_4 -� DATE: �L2 / **THE ISSUANCE OF THIS OPERATION PERMIT SHALL INDICATE THAT THE SYSTEM DE , BE QVVHASQN 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 GUARANTEE THAT THE SYSTEM WILL FUNCTION. SATISFACTORILY FOR ANY GIVENPERIOD OF TIME. DCHD OM (Revised) ��� '��.:196Z. r 2 WS AUo 'w'61u-36 "my: !L� S wt�WkAqt.� 4 �� DAVIE COUNTY ENVIRONMENTAL HEALTH SECTION ,r APPLICATION FOR IMPROVEMENT PERMIT (REPAIR) PHONE NUMBER ADDRESS ��� I 1��ir SUBDIVISION NAME LOT # DIRECTIONS TO SITE DATE SYSTEM INSTALLED NAME SYSTEM INSTALLED UNDER TYPE FACILITY NUMBER BEDROOMS NUMBER PEOPLE SERVED TYPE WATER SUPPLY CIy / 1 SPECIFY PROBLEM OCCURRING_�igL%n�L7 DATE REQUESTED INFORMATION TAKEN BY. This is to certify that the information provided is correct to the best of my knowledge, and that I understand I am responsible for all charges incurred from this application. SIGNATURE OF OWNER OR AUTHORIZED AGENT Rev. 1/93 i. _ . _._ __ . . _ ._ ._ ._ _... _. ._. . . .._. . . � • � �,rc a .r� �a.Y��. �� . �, . � �„�p, �� ,.��.. �I a��. . �(� � .i� � . . - a���� . ��/. �O "� .. � � . . _ .. . , a . . .. . '� . . . . .. .�� , . � .. ... .. . . _ . . . . 'k �'"^�"w�t �. � ��ti. #t�4AIK .. �....7. _ , 5. .. _ .-. , -.. .�� � s „� i , r. � f�' s. ' *' . � ' . . . I _. •� •�. � ,� . i .:;... ..... ., �� .. . '3a. .. . � ��� >9r,� 'a�i�;� S. � � .¢M1^ . I i �- & �,. " � /^` u . I ,. �.�, . . . , . . ._ �� �"�����'" ��" b „ � ��J r � '�r.a. '� . " e ' � °;��' �' ",� r �.� "'�,) �i. � � � -\./�/ .,T.�.1 � ,� �4 u i� '�. � �r ' . K! .� �� x �,� O `.���,P�� . ��-' , ��.ii ,. � , , � I ' „ _ r" � � m ' � '1F t a'": v��n � � �y . ��� �������4) �. ��� — � _ . . �, � � ' .. � ��a.� .. � .. I � v�p � �. �e .�e� ._ . � �� 4 '� . 8 � . ' �,`� � . �.��: � � � _ �� �d �e � ��.. �� � �.; � _ e�� � � � , � ,� a ;� � ���� ,....., �� ! 'i "`"`"� ,� � k, e,dn (�� � �. ti y.r �. �: �� � �� ��w � . . � w ^ , c ; � . ,�,., ^. .: w�.i�a- ���"��" ��� /^C1 . � Y V 6 , � p ' � � .� t...,w . � �� �R� ��t f ,.d„ �> � . s I � � � � � �u � � � ' �'� ��" r��«,�� �" � �: s �� � ��� �,�,�;,,,�' I � �� � � _,_.. �� �" , �_ .� �.` � v� �b �=�+� I " �,� � .�,,:� � e� ��^ �'� � a� . . , s 3'� � ° a z. �' I mv � �.. .:��ry a�/ el ?t e,.�, � .. � � ��,. �. ',�,` � ... ��✓� S./J �� � ,� . � , , . I� ',< . „ .. r. � a I , . . � . , .; " �� ,.� � ` ry �►�' �°�:� - -r.� _ .� . :��- . � ,� ��. ,����� � N �, . ca � � � , � , � � � d ; , � �, �� � s � , ��;�� ' �" � � � �� ��� : � � �II � � . � -I�.� a U7 � . _ . �� � � � . � . �� � � �� � ����, ���� � i� ��r' �h� ,h �� .. � ��� �,.�. . �z�4 ���` .� �� ����� � �� �� � � �� � �� � a � ,� , . �� 3 . �� . r��a:� ,. . . .. . . . . .. . � �a�,� �.�wR:' �.e tM k: �. . 4 : ..' ��, ' v' � a . " ❑ ^t. t w�Q. <. :���:� . ' • i p�` �.. '-.. . ' .�.,� . . . �. � �,�� � o .� �� �� �,;, �, � r�a �� ���� : a� '`�,,;. � (� � ��=�� ---�� �'i �� a � y� � , �,-� ,� ���, C31- "' . a � � , ,�� , _ . � ,,,� � � �� -. :.. . t . : � � � e � e �.:3� �w ��, � � � � ��u � � �� ,° .� , �� ���� ' ��������������� � '� �:r, � � I � ` � �� ��� :� �� � ' ���� 'a�� � �� ."� � .� � � ,����_ �w . �. _ APPLICANT INFORMATION Water Supply: Evaluation By: DAVIE COUNTY HEALTH DEPARTMENT Environmental Health Section Soil/ Site Evaluation On -Site Well Community Auger Boring Pit PROPERTY INFORMATION � .0 A� Public Cut FACTORS 1 2 3 4 5 6 7 Landscape position Slope % HORIZON I DEPTH Texture group Consistence Structure L Mineralogy HORIZON II DEPTH -- Texture groupG' ,Consistence 'Structure Mineralogy HORIZON III DEPTH Texture group - Consistence Structure Mineralogy HORIZON IV DEPTH Texture group Consistence Structure Mineralogy SOIL WETNESS RESTRICTIVE HORIZON 1 I SAPROLITE CLASSIFICATION I LONG-TERM ACCEPTANCE RATE �.l SITE CLASSIFICATION: EVALUATION BY: hl LONG-TERM ACCEPTANCE RATE:" OTHER(S) PRESENT: REMARKS _.... LEGEND T, n s ne 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 ]41St VFR - Very friable FR -Friable; FI - Firm VFI - Very firm EFI - Extremely firm t NS - Non sticky SS - Slightly sticky S - Sticky 'VS - Very Sticky NP - Non plastic SP - Slightly plastic P - Plastic VP - Very plastic Stnicture 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 Nates 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 05105 (Revised) ■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■ ■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■re■pie■■■■■■■■■■■■■s■■■■■■■■i■■e■s■■■ ■■■■■■■■■■■■e■■■■■■■■■■■■■■■c>f■ecce■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■ ■■■■■■■■■■■■■■■■■■■i■■IIS■■■■o��■■u■■pie■■■■■ss■■■■■■■■■■■■■■■■■■■■■■■ ■■■■■■■■■!■■MfflCa-IN ■I■rA■IAi■■■■n■■■HE1■■■■■■■■■■■■■■■■■■■■■■■■■SON OEM ■■■■■■■■■■■©■m'mo%dmRIV■■I!1■■■■■L1■KI■ 11■■■■■e!■■■■■■■■■■■■■■■■■■■■■■■■ ■■NONE ■■C1'::.���=="=lidall ■■■■■■■tl■■■U■■■■■■1!7■■■■■■■■■■■■■e■■■■■■■■■ MEMO ■■■■%A■■■I■■■i ,11IJ n■:.■■■■11■11■■■It■■■■■■L9■■■■■■■■■■■■■■■■■■■■■■■■ ■■■■■■■■o■■■o■■■r■u�:�■■�■-.�o■■rye■■u■■�■■■■■■■�■■■■■■■■■■■■■■■■■■■■, ■■■■■■■r ■■■r ■■■r/e■■;a,■■■��e■■■ung■e■eI■■■■■enr.■e■■■u■■■■■■■■■■■■■■■■■■ ■■■■■■/■■■/■■■■I■■�J' l:��i�!\■■fiat►A■■■1�'■■■■■■Ilil�■■■1�■■■■■e■■■■■■■■■■■■ ■■■■■/■■■/■■■■I/■■ /l l■■L r7■■■■■1:==:_!%rw W■■■■■■■■■■■■■■ONES ■e■■r■■■A►,■■seri■■■■■■■■■■■A►,■■s■■■■�i■■■s■■■■e�-�®■■ ■■■■■■■■■■■■■■■■■■■ iiiiiiiiiiiiE R699aiiiioiiEMEMEM�A ■■►i■■■ri■■■■ri■■■■■■■■■■■■■I■■■cry,■■■u■■■■■■■■s;r,A��i■■■■■■■■■■■■■■■■■■■■ ■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■ ■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■ ■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■ ■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■ ■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■ ■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■ ■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■ ■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■ ■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■ Parcel #: J600000093 Davie 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 #: 3600000093 Account #: 82516613 Owner Information I Tax Codes RUSZKOWSKI PIOTR & TRUSZKOWSKI IWONA ADVLTAX - COUNTY T d23,37 25 MOCKS CHURCH RD READVLTAX - FIRE TAX ADVANCE, NC 27006 Property Information Township nd (Units/Type): 1.640 AC MOCKSVILLE ddress: 1749 E US HWY 64 Deed Information Local Zoning Date: 05/2004 Book: 00550 Page: 0158 Plat Book: 0002 Page: 010 Legal Description PIN 2.02 AC HWY 64 5757397562 Property Values Building: BXF• Land: Market• d23,37 ssessed: eferred• Sales Information No. Book Page Month Year Instrument Quai/UnQual Improved Price 1 00550 0158 05 2004 WD Qualified Improved 50.000 View Prooerty Record for this Parcel View Map for this Parcel View Tax Bill Information « Return to Basic Search Page 1 of 1 X101-DIN I-1 J10--11191" O 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=1461753 6/30/2016