The URL can be used to link to this page

1961 Hwy 64W/L I DAVIE COUNTY HEALTH DEPARTMENT IMPROVEMENTS PERMIT AND . CERTIFICATE OF COMPLETION *NOTE: Issued in Compliance With Article II of G.S. Chapter 130a Sanitary Sewage Sys/temsPermit Number Name a�<' 1.-rr7�/,mss 1`f ;�f� P;ZZ / Date ZZ -Ml) / N2 ` Locatio /4") Subdivision Name Lot No. Sec. or Block No. Lot Size House Mobile Home Business Speculation No. Bedrooms No. Baths No. in Family_ Garbage Disposal YES ❑ NOSpecifications for System: Auto Dish Washer YES NO ❑ Auto Wash Ma .hine YES /JNO ❑ / 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. t� r - Improvements 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 day of completion. Telephone Number 704-634-5985. Final Installation Diagram: System Installed by Certificate of Completion �(�`� Date /1=210 *The signing of this certificate shall indicate that the system described above has been installed in compliance with -�W` the standards set forth in the above regulation, but shall in NO way be taken as a guarantee that the system will function satisfactorily for any given period of time. DAVIE COUNTY HEALTH DEPARTMENT ' Environmental Health Section Soil/Site Evaluation NAME f _ e 1 /Yi � ADDRESS 4 ROPOSED FACIILTY !� Water Supply: On -Site Well 1 DATE EVALUATED 'i�9'3l PROPERTY SIZE iffCG LOCATION OF SITE Community Public W__� Evaluation By: Auger Boring Pit Cut FACTORS I 2 3 4 Landscape position Slope % �- HORIZON I DEPTH Texture group Consistence Structure Mineralogy HORIZON II DEPTH Texture group 1 0 - Consistence - Structure S _e Mineralogy HORIZON III DEPTH Texture group Consistence Structure Mineralogy HORIZON IV DEPTH Texture group Consistence Structure Mineralogy SOIL WETNESS RESTRICTIVE HORIZON SAPROLITE CLASSIFICATION 1 77 77 LONG-TERM ACCEPTANCE RATE SITE CLASSIFICATION: LONG-TERM ACCEPTANCE RATE: REMARKS: DCHD(01-901 Landscaoe Position EVALUATED BY: "I,?- OTHER(S) OTHERS) PRESENT: LEGEND 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 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 Mineralogy 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 ■M■■■M■M■■MENEE■ ■EMMEMEMEMEMEM■■ ■ONEEMEMEMENE■M■ ■MEMEMEMEME■■■■■ ■MOME■EMEM■■■N!■ ■OMMEMENEEMEMEN■ ■■MEMEMEMENEE■E■ ■■EEM■NNE■MENO■■ ■■MMOM■EMMEMEM■■ ■OM■■■EMEMEMEEM■ ■MENNOMM■MEME■E■ ■E■MMM■■E■■MEME■ ■■MMO■■■ENNEE■E■ ■EMEMO■■■M■■■■■■ ®EMEMENNE■■EMEM■ ■■MEMEMEME■EMMO■ ■■MEMENOM■EMEMO■ ■EMEMENO■M■■EM■■ ■E■E■ME■N■MEM■■■ ■N■■■N■MME■EN■M■ ■■■EM■N■EE■E■■M■ ■M■■■OM■E■■EME■■ ■ J APPLICATION FOR SITE EVALUATION/IMPROVEMENTS PERMIT Davie County Health Department - Environmental Health Section P. O. Box 665 Mocksville, NC 27028 , 1. Application/Permit Requested By ST,,gA%toy— Mailing Address / �.� �? 7 add Home Phone �9�13 Business Phonel.�y 2. Name on Permit if Different than Above 3. Application/Permit for: ❑ General Evaluation eptic Tank Installation 4. System to Serve: ❑ House Mobile Home ❑ Place of Public Assembly ❑ Business ❑ Industry ❑ Other ❑ Unknown 5. If house, mobile home: Subdivision Section Lot # ❑ Basement/Plumbing No. of People Q< ❑ Basement/No Plumbing No. of Bedrooms ETWashing Machine No. of Bathrooms V2 Ip ishwasher Dwelling Dimensions �C« ❑ Garbage Disposal 6. If business, industry, place of public assembly, 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 Water Usage Figures 7. Type of water supply: 2 Public ❑ Private ❑ Community 8. Property Dimensions Sewage Disposal Contractor 9. Do you anticipate additions/expansion of the facility this sytem is intended to serve? ❑ Yes ❑ No 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. Directions to Property: 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. 9l DATE SIGNATURE CONSENT FOR SITE EVALUATION TO BE DONE ON ABOVE DESCRIBED PROPERTY MUST CHECK ONE: ❑ 1. I OWN the property. ❑ 2. I 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. DATE SIGNATURE DCHD (12-90) 1 Parcel #: H300000043 Davie County, NC - Basic Estate Search Basic Search Real Estate Search Tax Bill Search Sales Search �$ c: VIAV Property Record for this Parcel View Mao for this Parcel View Tax Bill Information Parcel #: H300000043 Account #:55932000 Owner Information Building: Tax Codes BXF• PEEBLES JAMES ELMER JR Land: ADVLTAX - COUNTY T Market: 1961 US HIGHWAY 64 WEST Messed: FIREADVLTAX - FIRE TAX Deferred: OCKSVILLE NC 27028 Property Information Township nd (Units/Type): 1.960 AC CALAHALN ddress: 1961 W US HWY 64 Deed Information Local Zoning ate: 07/1986 Book: 00132 Page: 0495 lat Book: Pa e: Le al Description PIN 2.02 AC HWY 64 5719915922 Property Values Building: 40 85 BXF• 64 Land: 26 17 Market: 67 66 Messed: 67 66 Deferred: Sales Information No. Book Page Month Year Instrument Qual/UnQual Improved Price 1 00132 0495 07 1986 WD Qualified Vacant 7,500 View Property Record for this Parcel View Map for this Parcel View Tax Bill Information « Return to Basic Search Page 1 of 1 gA77FIN4 000rivi--s 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 htty://maps.daviecountync.gov/itsnettView.aspx?grid=1478778 7/12/2016