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2469 Hwy 64W DAVIE COUNTY HEALTH DEPARTMENT - IMPROVEMENTS PERMIT AND .CERTIFICATE OF COMPLETION *NOTE:Issued in Compliance With Article 11 of G.S.Chapter 130a Sanitary Sewage Systems Permit Number Name `f�I ^� �r ,� ''�//%^ iDate /" r/�`�`� N2 Locati v Subdivision Name Lot No. Sec: or Block No. Lot Size House Mobile Home L—!- Business Speculation No. Bedrooms _.No. Baths _c— No. in Family — Garbage Disposal YES ❑ NO L2' Specifications for System: Auto Dish Washer YES p NO ❑ "i� Auto Wash Ma shine YES 4z� NO ❑ 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 dImprovements 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 704-6344-5985. Final Installation Diagram: System Installed by t7 - An.v.1.- �!3 n 1 Certificate of CompletionC�- � Date "The signing of certificate shall indicate that the system described above has been installed in compliance with 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. w APPLICATION FOR SITE EVALUATIOWIMPROVEMENTS PERMIT Davie County Health Department Environmental Health Section r •. { P. O. Box 665r Mocksville, NC 27028 1 41.9QJ 1. Application/Permit Requested By. o S -- Mailing Address l Home Phone 61-34/- 7-279 Business Phone 2. Name on Permit if Different than Above 3. Application/Permit for: ❑ General Evaluation Septic Tank Installation 4. System to Serve: ❑ House eg Mobile Home ❑ Place of Public Assembly ❑ Business ❑ Industry ❑ Other ❑ Unknown 5. If house, mobile home: Subdivision Section Lot# ❑ Basement/Plumbing No. of People ❑ Basement/No Plumbing No. of Bedrooms Washing Machine No. of Bathrooms ❑ Dishwasher Dwelling Dimensions . 66'1'( ❑ 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: ❑ Public Private ❑ Community 8. Property Dimensions_ '5'iIc-; 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 fo'•Property: � �L/ . --- �j— cud 5- ,lr f�� -7- This This is to certify that the information provided is correct to the best of my knowled e, andkbnderstand I am responsible for all charges incurred from this application. DATE SIGN URE CONSENT FOR SITE EVALUATION TO BE DONE ON ABOVE DESCRIBED PROPERTY MUST CHECK ONE: X 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. DATE SIGNATURE DCHD(12-90) f DAVIE COUNTY HEALTH DEPARTMENT Environmental Health Section Soil/Site Evaluation NAME DATE EVALUATED ADDRESS PROPERTY SIZE PROPOSED FACIILTY i,/i LOCATION OF SITE Water Supply: On-Site Well Community Public Evaluation By: Auger Boring Pit Cut FACTORS 1 2 3 4 Landscape position L L Sloe % o� HORIZON I DEPTH Texture group Consistence Structure MineralogX HORIZON II DEPTH Texture group Consistence Structure J,;,/,Mineralogy /,- HORIZON III DEPTH Texture group Consistence Structure Mineralogy HORIZON IV DEPTH Texture group Consistence Structure Mineralogy SOIL WETNESS RESTRICTIVE HORIZON SAPROLITE CLASSIFICATION LONG-TERM ACCEPTANCE RATE SITE CLASSIFICATION: EVALUATED BY: l/ LONG-TERM ACCEPTANCE RATE: / 7 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 Mineralos► 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 DCHD(01-901 ■■.■■..■■e■■.■■■e■■■■■■■.■■■■.■■■■■n■e■■■■eee■■■.■■■■e..■■■.■■■■■ ■■■■■e..e.eeeee..■■■eee■■ecce■■.■.■■...■■■■....■....■■■■■■■■■.■■■■ ■■■.■.■.■e.....■■.e■■..■■e...■..�e..■..■■.■■■■.■e.■■e..■.■e■.■■■■ ■■■■■■■.■.■■......■..■■e■.■.e.■nee.■■■.■r.�e■■.■.■.ecce..■■.■■■.■■■ ■.■......■....■■■.e■c.ec■■■.■.■■r■ ■ccee■■ce■e.■...eeece...e■■son ■ ■.■■.■...■■■....■■..■■;�....■■■■. ■.■■■.e■■...■.■c.■.■...■.... ■■■ ■■■■...■■■■c■a■■■.��.■■■c.....■uc■■■..■.■ce.■■.■■■■.■■■.e■.■■■eee■ ■.ss■ecce.■..e.■..■e■...■■■■..c■■ee■..e■ccce.■■■■.■.■■■...■■..■.■■ ■.■■ecce.■.■■..■■..■.■...■■■■■..�.■■■■■.■■■■■■.■■.■..■......■..■■ .....c.c...■ece■ec■■ceece■■....■...... . ................ ■■■■■■■■ ■■■■■■■■■■.■■.■■■■■■■■.. t..■■.■..■■■■.■■..■.i■....■.......■.■■.■■.■ C�CCCCCC�CCCCCCCCCCCCiMEMEME MEMNONCCMUMMECCCCCEM"EMiiiCC�i CCCCCCCCCCCCCCCCCCCCCCCC�ICCCCCCCCC�CCCC�C�C�CCCCCCNC�C��CCCCCCCC ■........■.■e..■...■..■■ale.e■.■■e..■■..■...e■■■..■■.■■■.....■..■■■ ■..■..■e■■e■....■■.....■ale■■.e■.ee.■■.■■■■■...eee...■■■■■.e.eee■e■ CCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCiCCCCCCCCCCCCCCCCCC C�CCCCC'CCC. ..................................l�J.■■■e.e.■■■■..■.....e...■■C■■■■ ■..■......■■■■cs■.c..ce■c■■■..eccee.■e■■■■...c ■■■■■■■■■■ ■■■■■■ ■ ■■■■■■■■■■.■.■.......■.v■■.■■■..■■■■■■.■■■..■■■■�■.■■■.■'�■■■■e■■■ CCCCCCC O■CCCCCCCCCCCCCCCCCCCCCCi'iiiiiiiiiiiiiiiiiiiii CC'■=iiiiiC ................................ ................................ CCCCCCCpCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCC C ■eee.■■.■........■..■■■■■e......■■■■e■■■■■■■■....■■.e■■■■e■.e■■.■■ ■■■■■■■■■..■■e.c■■■■■■.■■.■■eee■■.■■■.■■■■ce.■■■■.c■■e.ee■.■■■■■.■ Parcel#: H2O000003801 Page 1 of 1 qA�f� Davie County, NC - Basic Estate Search nOuk-fir Davie County Web Site Basic Search Real Estate Search Tax Bill Search Sales Search View Property Record for this Parcel View Man for this Parcel View Tax Bill Information Parcel#:H2O000003801 Account#: 82524085 Owner Information Tax Codes [469 NK DONNA E ADVLTAX-COUNTY T US HIGHWAY 64 WEST FIREADVLTAX-FIRE TAX OCKSVILLE NC 27028 Property Information Township nd(Units/Type): 8.448 AC CALAHALN ddress: 2469 W US HWY 64 Deed Information Local Zoning Pate: 03/2005 Book: 00596 Page: 0656 Plat Book: Page: Le al Description PIN loAC HWY 64 5719430787 Pro a Values ulldin 63,25 BXF• nd• 76,18 arket• 139,43 ssessed: 139,43 Deferred: Sales Information No. Book Page Month Year Instrument Quai/UnQual Improved Price 00162 0537 02 1992 WD Unqualified Vacant 0 00411 0512 03 2002 WD Qualified Improved 157,000 00596 0656 03 2005 WD Qualified Improved 137,000 View Property Record for this Parcel View Map for this Parcel View Tax Bill Information «Return to Basic Search 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/itsnetfView.aspx?prid=1458012 6/30/2016