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1167 Hwy 801ND � '�trfci'i�' j � �' t„� "'r✓jE'� �� a•'(��:.ui:+ `Y rri�"J'T� ��t°+��`!'� ti��,..xy.F�� 46'it''i+�"��y., � t � . -. ,.., _ �""'''`K� •`,�VIE CO HEALTH DEPARTMENT DAVIE COUNTY a = = IMPROVEMENTS PERMIT AND CERTIFICATE OF COMPLETION - -,'NOTE: Issued in Compliance With Article II of G.S. Ch pter 130a - Sanitary Sewage Systems �(l�di9sl'P Permit Number ,Name /.5-/�?' _ Date /Ioc7 �f� NO 7808 Location 111�)errol 1�2�+7 g —A 7e 0 Subdivision Name Lot No. Sec. or Block No. Lot Size IV'� �� House Mobile Home `� Business __ Industry No. Bedrooms '3 No. Baths _ No. in Family _ Public Assembly Other Garbage Disposal YES ❑ NO p' Specifications for System: Auto Dish Washer YES ❑ NO Auto Wash Ma^hine YES [r NO ❑ N Type Water Supply -- /OODe"� 'This permit Void if sewage system described below is not installed within 5 years from date of issue. This permit is subject to revoc Upf site plans or the intended use change. f �i 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., 1:00-1:30 P.M. or 4:30-5:00 P.M. on day of completion. Telephone Number: 704-634-5985: y ...�� ..Final Installation Diagram: System Installed by •` ?� ,fie mr�� Certificate of Completion Date 'The signing of this 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 oftime: I 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 \--"/ 1 2�z V 0 Mailing Address Home Phone Business Phone. 2. Name on Permit if Different than Above 3. Application/Permit for: ❑ General Evaluation 4. System to Serve: douse ❑ Mobile Home ❑ Business ❑ Industry ❑ Other 5. If house, mobile home: Subdivision No. of People 2y� No. of Bedrooms 3 No. of Bathrooms Dwelling Dimensions 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: 9L -Public ❑ Private 8. Property Dimensions &-CL Sewage Disposal Contractor 9. Do you anticipate additions/expansion of the facility this sytem is intended to serve? If vac what tvna? IZ_Septic Tank Installation ❑ Place of Public Assembly ❑ Unknown Section Lot # ❑ Basement/Plumbing ❑ BaBasementlNo Plumbing ,f�Washing Machine ❑ Dishwasher ❑ Garbage Disposal ❑ Yes XNo ❑ Community "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: LIA o /IJ ,ter" N°'��` Zoe This is to certify that the information provided is corre to the best of incurred from this app ication. DATE /tfgm'f ory Lrt/4�`L esc and I understand I am responsible for all charges SIGNATURE CONSENT FOR SITE EVALUATION TO BED NE ON ABOVE DESCRIBED PROPERTY MUST CHECK ONE: Ug -1 TOWN 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 (12.90) DATE SIGNATURE • •'DAVIE COUNTY HEALTH DEPARTMENT Environmental Health Section Soil/Site Evaluation NAME 1 /Y. te'fs ADDRESS PROPOSED FACIILTY .VA_4 Z DATE EVALUATED PROPERTY SIZE r��G LOCATION OF SITE Water Supply: On -Site Well i/ Community Public Evaluation By: Auger Boring r/ Pit Cut FACTORS 1 2 3 4 Landscape position ,L L Sloe % HORIZON I DEPTH Texture group Consistence Structure Mineralogy HORIZON II DEPTH>`-" Texture groupc C Consistence 7 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 SITE CLASSIFICATION: /�_ r/ EVALUATED BY: LONG-TERM ACCEPTANCE RATE: i % 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 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 ■EOM■ME■ MEMO■■■■ ■■M■M■M■ ■■■EM■■■ ME ■ ■ ■ ■■ ■■ ■■ Parcel #: C60000010003 Davie County, NC - Basic Estate Search Basic Search Real Estate Search Tax Bill Search Sales Search I� View Property Record for this Parcel View Map for this Parcel View Tax Bill Information Parcel #: C60000010003 Owner Information ICKERS JAMES& VICKERS KAREN R COOK 1167 NC HIGHWAY 801 NORTH ADVANCE, NC 27006 Property Information nd (Units/Type): 5.820 AC ddress: 1167 N NC HWY 801 Account #: 75224000 Tax Codes ADVLTAX - COUNTY T READVLTAX - FIRE TAX Township FARMINGTON Deed Information Local Zoning ate: 01/1987 Book: 00135 Page: 0187 Plat Book: Page: Legal Description PIN 45 AC HWY 801 5862173858 Property Values uildin : 113,67 0011 BXF• 31,88 Land: 7472 Market: 22027 ssessed: 22027 eferred• Sales Information No. Book Page Month Year Instrument Qual/UnQual Improved Price 1 00135 0187 01 1987 WD Unqualified Vacant 0 2 00132 0533 06 1986 WD Qualified Vacant 53,500 View Property Record for this Parcel View Map for this Parcel View Tax Bill Information « Return to Basic Search Page 1 of 1 �0 U K� 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=1466594 9/20/2016