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1241 Hwy 801N„.t�r•4"'Tr dT i�SYwq�r^�r.+'i�f.)”5`%}�*4'7xd►+tii+h�lq''s��'��"-�a[arww+ar•°As+a�.*':+df'✓,�`tir`�[rwars+e:a+w,.yei`-Jw"°"y�!►"a°"'y"'''°.'ariert"�-`"�"`"*"""S',�,x'�.++.,.."""Cy °w'i1-ski DAVIE COUNTY HEALTH DEPARTMENT IMPROVEMENTS PERMIT AND CERTIFICATE OF COMPLETION 'NOTE: Issued in Compliance With Article II of G.S. Chapter 130a nitary stems Sewage age S ,,NQS/ Permit Number Da / �3 Name �', , /��'G' � �1�'rtr�,��e /-� -�1 NO 7131 LocaUon — �oo� Subdivision Name Lot No. Sec. or Block No. Lot Size Housey Mobile Home _T Business _— Speculation No. Bedrooms No. Baths If No. in Family Garbage Disposal YES ❑ NO Ell ` Specifications for System: �� Auto Dish Washer YES NO E]� /D�d, �� a cD ��s .uG� rc Auto Wash Ma :hive YES NO ❑ , t Type Water Supply "I?p X3Xi� ' a 'This permitVoid if sewage system described below is not installed within 5 years from date of iss,6f This permit.i,s subject to revocation if site plans or the intended use cho,nge. Q' Pet) �14 1 b0 �VOQ �,Owe x v SP J f � e vnP S- rn Imp is permit by —!A f '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. e e CZZ �D J Certificate of Completion Date �.�-�l '7 '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 of time. APPLICATION FOR SITE EVALUATION/IMPROVEMENTS PERMIT Davie County Health Department 9 Environmental Health Section P. O. Box 665. --•- _.R.:.,.._. �..,...._ -. Mocksville, NC 27028 2 1993 1. Application/Permit Requested By t-4 to W-'rj Gk k-\ H A1C N Mailing Address Z52; Q 4 1 Cu -E v.'�M s Home Phone"f19'1 (1 '�- -" -T $ S $ Business Phone 9 1 `i - D $ 1 `i 57 2. Name on Permit if Different than Above 3. Application/Permit for: 4. System to Serve: �' House ❑ Business ❑ Industry 5. If house, mobile home: Subdivision ❑ General Evaluation No. of People ?— No. No. of Bedrooms Z — 3 No. of Bathrooms Z 3 Dwelling Dimensions ", 30 0 o Sg ❑ Mobile Home ❑ Other 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: ❑ Public 8. Property Dimensions No. of Sinks No. of Urinals No. of Water Coolers _ Water Usage Figures _ ❑ Private Sewage Disposal Contractor 9. Do you anticipate additions/expansion of the facility this sytem is intended to serve? If yes, what type? X Septic Tank Installation ❑ Place of Public Assembly ❑ Unknown Section Lot # ❑ Basement/Plumbing ❑ Basement/No Plumbing Washing Machine Dishwasher Garbage Disposal ❑ Yes X No 14 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: Fe� u 5 - 4 o s vmu sec c' -c �� S `t 1ASCt- Y 1sL '\/raa-D L --k t-� czs Liv-cD F6a `d.9 fac�r<s A g a 2 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. DATE SIGNATURE CONSENT FOR SITE EVALUATION TO BE DONE ON ABOVE DESCRIBED PROPERTY MUST CHECK ONE: ❑ 1. 1 OWN the property. .V-4- 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 olAhe Davie County Health Depa ment 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 suitabilit r a ground absorption sewage treatment and disposal system. - DATE SIGNATURE DCHD (12-90) J /�/e V ecf�--r e�5 t% A", DAVIE COUNTY HEALTH DEPARTMENT Environmental Health Section Soil/Site Evaluation NAME�!!•i(1[ 6�7J DATE EVALUATED ADDRESS PROPERTY SIZE�A PROPOSED FACIILTY /WB1�'� LOCATION OF SITE Water Supply: On -Site Well Community Public t/ Evaluation By: Auger Boring Pit Cut FACTORS 1 2 3 4 Landscape position 1 L G 1 Slope X oZ 1 HORIZON I DEPTH " Q"' ell do, "' Texture group 2 Consistence Structure Mineralogy HORIZON II DEPTH Texture groupC 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 S LONG-TERM ACCEPTANCE RATE , SITE CLASSIFICATION: )04,P f0 A& EVALUATED BY: LONG-TERM AC CCE�EPT N RATE: s 1 OTHER(S) PRESENT: REMARKS: 1Ll/� f t� - DVC r -Ti t ec1 LEGEND Landscave 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 -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 - 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Basic Estate Search Basic Search Real Estate Search Tax Bill Search Sales Search View Pror)ertY Record for this Parcel View Mao for this Parcel View Tax Bill Information Parcel #: C60000010007 Account #:74920120 Owner Information uildin : Tax Codes BXF: AN AUKEN RICHARD L& VAN AUKEN ELAINE F Land: ADVLTAX - COUNTY T Market: 1241 NC HIGHWAY 801 NORTH essed• FIREADVLTAX - FIRE TAX [Deferred: ADVANCE, NC 27006 Property Information Township nd (Units/Type): 8.890 AC FARMINGTON ddress: 1241 N NC HWY 801 Deed Information Local Zoning ate: 10/1996 Book: 00190 Page: 0492 lat Book: age: Legal Description PIN 89 AC HWY 801 5862085403 Property Values uildin : 224,88 01 BXF: Land: 110,62 Market: 335 50 essed• 335,50 [Deferred: Sales Information No. Book Page Month Year Instrument Qual/UnQual Improved Price L 00168 0295 04 1993 WD Unqualified Vacant 0 >_ 00190 0492 10 1996 WD Unqualified Vacant 0 View Prooerty Record for this Parcel View Man for this Parcel View Tax Bill Information « Return to Basic Search Page 1 of 1 O1•4r� W 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/itsnetIView.aspx?prid=1461779 9/20/2016