4283 Hwy 64EDAVIE COUNTY HEALTH DEPARTMENT
IMPROVEMENT PERMIT and OPERATION PERMIT
IMPROVEMENT PERMIT „� : + «•" ,+'
**MOTE** This improvement permit DOES NOT authorize the construction or installation of a septic tank system or any wastewate
system. AN AUTHORIZATION FOR WASTEWATER SYSTEM CONSTRUCTION must be obtained from this Department prior to the
construction/installation of, a system or the issuance of a building permit.
(In compliance with Article 11 of G.S. Chapter 130A, Wastewater Systems, Section .1900 Sewage Treatment and Disposal Systems)
'NAME PRDPFI�TY,ADDRE55 i �1 `I DATE
LOCATION l7 "1'i C y rj ' td.jK ( ,
SUBDIVISION NAME LOT NUMBER SEC./BLOCK NUMBER
RESIDENTAL SPECIFICATION: BUILDING TYPE # BEDROOMS # BATHS # OCCUPANTS GARBAGE DISPOSAL.: Yes/No
COMMERCIAL SPECIFICATION: FACILITY TYPE c # PEDRLE_ # PEOPLE/SHIFT _� # SEATS INDUSTRIAL WASTE: Ye
LOT SIZE .SD ��?i TYPE WATER SUPPLY % DESIGN WASTEWATER FLOW (GPD) ,� 5` NEW SITE REPAIR SITE
SYSTEM SPECIFICATIONS: yTANK SIIE /.r''.y'r GAL.'`PUMP -TANi GAL. TRENCH WIDTH ROCK DEPTH =( LIMEAR FT.
OTHER
REQUIRED SITE MODIFICATIONS/CONDITIONS:.
***THIS PERMIT IS SUBJECT TO REVOCATION IF SITE PLANS OR THE INTENDED USE CHANGE. YOUR WASTERWATER SYS1
SEE THIS PERMIT BEFORE INSTALLING THE SYSTEM.
d ler
pq/
I6
� c
M CONTRACTOR MUST
IMPROVEMENT 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 THE DAY OF INSTALLATION. TELEPHONE # IS (704) 634-8760.
OPERATION PERMIT SYSTEM INSTALLED BY.�,����
UL), '"„''
Ae
4T
4
B Q' la ) N c, ,
AUTHORIZATION NO. •OPERATION PERMIT BY C.r? DATE 6
**T E ,ISSUANCE OFJHIS OPERATION PERMIT SHALL'INDICATE THAT THE SYSTEM DESCRIBED ABOVE HAS BEEN INSTALLED IN COMPLIANCE WITH
ARTICLE'11 OF G.S. CHAPT6 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.
l
'---DCHD 10/95
j..
1. Application/Permit Requested By *Q I -A—
Mailing Address �5 }c 3 �+�-� Home Phone 07
Business Phoneq lo
2. Name on Permit if Different than Above tC E iV tac -k Am
3. Application for: ❑ General Evaluation P(Septic Tank Installation Permit
4. System to Serve: ❑ House ❑ Mobile Home ❑ Place of Public Assembly
Business ❑ Industry ❑ Other ❑ Unknown
5. If house, mobile home: Subdivision
No. of People
No. of Bedrooms
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 Lavatories
No. of Showers
7. Type of water supply:
8. Property Dimensions
X Public
No. of Sinks
No. of Urinals
No. of Water Coolers
Water Usage Figures
❑ Private
Sewage Disposal Contractor
Section Lot #
❑ Basement/Plumbing
❑ Basement/No Plumbing
❑ Washing Machine
❑ Dishwasher
❑ Garbage Disposal
9. Do you anticipate additions/expansion of the facility this sytem is intended to serve? ❑ Yes X No
If yes, what type?
❑ Community
'NOTE: Improvements Permits shall be valid from date issued. Improvements Permits are subject to
revocation, if site plans or the intended use change. Effective October 1, 1989.
Directions to Property:
This is to certify that the information provided is correct to the b my
incurred from thi application.
15?4Li
- - - -
TE
Tax Office PIN: # 5'797 -3K-33R /
PROPERTY ADDRESS, as follows:
Road Name: E
City:Gam'
SU13MIT A PLAT WITH THIS APPLICATION.
Revisions effective October 1, 1995.
and I understand I am responsible for all charges
SIGNATURE
CONSENT FOR SITE EVALUATION TO BE DONE ON ABOVE DESCRIBED PROPERTY
MUST CHECK ONE: ❑ 1. 1 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.
DCHD (1193)
DATE
SIGNATURE
}
E ► - - DAVIE COUNTY HEALTH DEPARTMENT
Environmental Health Section
Soil/Site Evaluation
NAME `
ADDRESS
PROPOSED FACIILTY =�'4 —
Water Supply: On -Site Well
DATE EVALUATED CL2-&
PROPERTY SIZE
LOCATION OF SITE
Community
Public L�-'
Evaluation By: I Auger Boring 1/ Pit Cut
FACTORS
1
2
3 4
Landscape position
,C,
-4-
L
Slope %
HORIZON I DEPTH
Texture group
Consistence
Structure
Mineralogy
HORIZON II 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
S
LONG-TERM ACCEPTANCE RATE
, 1
SITE CLASSIFICATION: EVALUATED BY: An
LONG-TERM ACCEPTANCE RATE: �% OTHER(S) PRESENT:
REMARKS:
DCHD(01-901
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 :lay loam• SIL -Silty loam CL -Clay loam SCL-Sandy clay loam
SC -Sandy clay SIC -Silty clay C -Clay
CONSISTENCE
Moist
VFR- Vu -y 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
,3C --Single grain M -Massive CR -Crumb GR -Granular ABK-Angular blocky
SBK-Subangular blocky PL -Platy PR -Prismatic
Mineraloey
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
1
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� �6 , s''�s- � F��` PRELIMINARY SITE PLAN
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^ ' �' ' � • 'THE FOUNDA�ION OF QUAUIY'
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ti // GONSTRUCTION INC.
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� A DRAWING FOR: ADVANCE� NC
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. �.,._. .._ � �s�.>�. � � . � � 6 & R AUTOMOTIVE MACHINE � � �
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� . � � SCALE : �� = 3O�
DRAWN BY : �G
,r•^•. . MR DATE :
o�-2s-ss 14114
CONTRACTOR: MYRICK CONSTRUCTION, INC.
BISCOE & GREENSBORO NORTH CAROLINA
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DRAWING KEY :
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Davie County Health Department
ENVIRONMENTAL HEALTH SECTION'
P.O. Box 665
Mocksville, N.C. 27028
AUTHORIZATION FOR WASTEWATER SYSTEM CONSTRUCTION
(Issued in compliance with Article 11 of
G.S. Chapter 130A, Wastewater Systems)
***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.*** ,6j w e j
// AUTHORIIATION NUMBER.4_.
NAME i' -� S� DATE //3 heel U 1 5 J
W
NATE ON, IMPROVEMENT PERMIT (If different than above)
SITE LOCATION
COMENTS/CONDITIONS ON AUTHORIZATION TO CONSTRUCT WASTEWATER SYSTEM
**WICE*** THIS AUTHORIZATION FOR WASTEWATER SYSTEM CONSTRUCTION IS VALID FOR R PERJQD OF FIVE (5) YEARS.
Parcel #: K900000001
Davie County, NC - Basic Estate Search
Basic Search Real Estate Search Tax Bill Search Sales Search Ig
View Property Record for this Parcel View Map for this Parcel View Tax Bill Information
Parcel #: K900000001
Owner Information
INGHAM KEN CARTER& BINGHAM ELIZABETH CROWELL
00 NC HIGHWAY 801 SOUTH
DVANCE NC 27006
Property Information
nd (Units/Type): 132.850 AC
ddress: 4283 E US HWY 64
Account #:6660500
Tax Codes
ADVLTAX - COUNTY TA
FIREADVLTAX - FIRE TAX
Townshi
FULTON
Deed Information Local Zonin
Pate: 04/2008 Book: 00752 Page: 0838
Plat Book: Page:
Le al Description PIN
132.850 AC HWY 64 06660500
Property Values
uildin :
664,70
000111
BXF•
18,02
nd:
870,14
Market:
1,552,86
ssessed:
735,59
Deferred:
817,27
Sales Information
No. Book Page Month Year Instrument Qual/UnQual Improved Price
1 00166 0593 12 1992 WD Unqualified Vacant 121,000
2 00181 0581 07 1995 WD Unqualified Vacant 150,000
�3 00752 0838 04 2008 WD Unqualified Improved 0
View Property Record for this Parcel View Map for this Parcel View Tax Bill Information
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0oD 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=1469415 6/16/2016
Appraisal Card
GHAN KEN CARTER BINGHAM ELVASETH CROWELL Netwn/Apyeel Nu3a:
Pe eeN KPM0�60 01
283 E US 1DVY 61
660500
MT: / UNIQ ID 21299
SR AVfON071VE/1)399-F28 ID NO: 06660500
COUNTYTAX (100), FIRE TAX (100) CARD NO. 3 of S
6v,1Ywr:2013 TeX Yeer: 2016 132.850 AC HWYM 132.850 AC
N16 '100 11 01001 FULTON TW -0
S0.C_Inw tlon
_.4 EX• AT- ACTON 20130319
CONSTRUCTION DETAIL
MARKET VALUE
CORRELATION OF VALUE
Fleur SYlWn•3
ER.BASEO
M00 AnM
MTE
0.c. .DENCE
TO MARKET
2] 06 11]20 159
63.60
36192 996 994R.
BUILDING VALUE -CARD
6617WalU-21
Oan Grab► 6.
7__,
TYPE: Auto S.M. and S-1. R. OB/%►VALUE-
18,02KIT
STYLE: 1-1A Rry
LAN. VALUE -CARD
AL MARKET VALUE -CARD
670,1SUOCan-
1,552,
SO
Cover • 12
AL APPRASSEDVALUE-CARD
ALAPPRAISEDVAUMI PARCEL
1,552,
1,532,
nWor W.0 C9MbuObn-S
II tleetnlIX
10.00
I C A N I
B S
I I
AL PRESENT IISl YALYE-PARCEL
AL AWEDERRRED-PRCEL
AL TAXABLE VALUE -PA[CEL
VAL VALUE
BXF XF VALUE
DVUE
NTT USE VALUE
TTAMAL VALUE
733,5
735,591
756,2
27,2
859,97
102,
16151
ntWor r ver -03
FlnU6e6 ].
nMbr Floc Cour-1/
tlni FUN . 01
Perp rya. 10
CMaRbn9p type -03
1
I Hat SAV -2
IUST._____S•______-___I
Z 3
+•--•--If-------+•20--+
I I
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Nn9 Blnwlotlon-0]
t SuspMMa6 - CNM9 Pb Wt1
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IRA $
I f IPE
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I I I
7 7 I
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I I B
MIT
NLIS DATA
FF.
ECORD A1[ DE[D INDICA-[
F.,
N-BPtllrvan!
-0NS•OLL-0
um n9 Fb0urs
1
_ _
L POS VALUE 33.00
WY 0 -St6 Wall
0.9
1 I •
752 838 1 WD
II
♦ A VG
1.1
I I
I I I
I I I
381 581 7 99 WD V
15
FaP131 Sim
1.120
I I I
+....... I
OTAL A.IUSTNENT FACIO0. 1.1
KgUALIT/INDEX
IS
IGOP I
2 I
f I
BUILDING AREA 8,000
I i
GS
lSCRI►RON MIC! COM0 DG h Rj A"ATE COM.
VALU
AAEA%
P BDG 1,8 15. 1 _
996 1
135
2,03
1 1 55 5.1 1 _
3616 PAVING 0 07 3.
996 a 1
996 5 1
1
A
0
f 6
la
FiL 11,6
36,19
IM• DIMENSIONS BIS. 60576E60N76f5]6W6052/ERONIOOSN206N256.
NATION
MER
MAITHe'm
GMEST
D BEST USE LOCAL MON DERV / I CON.
D NOTES LAND TOTAL
BF AC LC TO UNIT LAND
UNT TOTAL
ADIUSTED LAND JOVERSID LAND
X COD[ EMIR• TAC! ! SIZE MOD
FACT OT M MIC! UNITS
TYP ADIST
UNiTPRICE VALUE VALUENOTES
WR R 0313
3000 0.67 0 / 1.1800
0]+20+ •10 PW ,200. 1273
AC 0.7
,752. 73261
]0
ND USE D600
600 0 1.0000 0 1.0000
PW 2 ,000. 5
I.00c
25,oIo.m 13M
0
OTAL MARKET LAND DATA
132.R
$70.140
RI U 5210
0 0 3.0000 5 1A000 590. OA
AC 1. 590. 1
-0 1.0000 1A000 6.432
HOMSIIE 5000
0 0 SA000 5 25000 ],200. 1
AC 2 18,000. ISON
OTLL MESlMT US! DATA
13 .R 52
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Owner: BINGHAM KEN CARTER Parcel: K9-000-00-001
http://maps.daviecountync.govlitsnetlAppraisalCard.aspx?idP=1469415&Action=Auto 6/16/2016