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3553 Hwy 801Ndr;'{�.-- 'w'7'i�'°'' i" x, w.rw.t^wx;�'.snu'.-x�"v-rr w3"�-rxe-v�•f---,.g..y,.1v+-.•w`>av;ir..y.a..°€-^^-r-c.i.r^--•-r-rs.+r^w.ssr-^-vYr,t.1a�§n fi "+', ? DAV'IE .COUNTY HEALTH DEPARTMENT IMPROVEMENTS PERMIT AND CERTIFICATE OF COMPLETION p *NOTE: Issued in Compliance With Article 11 of G.S. Chapter 130a Sanitary SewaZe yst ,.� / Permit'7Nr�u7mber U Name �� lS%Fi/� �Date/.,% NO 1 Gr. (9 6l�- --,9-�93 Location ?x�!,f�,a iii - %l� /_T; �,/ /�°/ � Subdivision Name Lot No. Sec. or Block No. Lot Size �'S'HouseMobile Home Business Speculation No. Bedrooms .No. Baths —No. in Family Garbage Disposal YES ❑ NO Specifications Tqryst m: Auto Dish Washer YES ❑ NO Auto, Wash Ma shine YES NO ❑ �O��X/� , /�� /,� 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. a : 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 .2 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 yin 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. y Y'+v' It wJ ,�:%, di,f� sYt .'l; .,^rM { f`tt'S: s. _•i 5, s + - - _- __- - ry.. t�S;j m ,., e w Y k .„:._F .r' �/; r ),% . ,. DAVIE COUNTY HEALTH DEPARTMENT 93 IMPROVEMENTS PERMIT AND CERTIFICATE OF COMPLETION -2tp 'NOTE: Issued in Compliance eetWith Article 11 of G.S. Chapte1/r 130a Seta �Se waJ✓uy/°V/ g &41 % Name !�' I� f Date 'Location' IN Subdivision Name Lot No. Permit NO 77TRer6K Sec. or Block No. Lot Size House Mobile Home — Business _— Speculation No. Bedrooms No. Baths / No. in Family Garbage Disposal YES ❑ NO Spe ifications f¢rjSystem:_� Auto..Dish Washer YES 9 NO ❑ ,C-� G%GGt'`��, Auto Wash Ma -.hive YES ❑�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. Improvements permit by r rj `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. b Installed stem _"�'� Final Installation Diagram: System Y r l� Certificate of Completion Date 'The signing of this- certificate shall indicate that the system described above has been installed in compliance with the standards 'tet 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. ti 0 R TM APPLICATION FOR SITE EVALUATION/IMPROVEMENTS Davie County Health Department V L5 Environmental Health Section P. O. Box 665 ! 1993 Mocksville, NC 27028 1. Application/Permit Requested By. Y S �a l W a C.� l Mailing Addressp�, ` , 0-80Y- Z S_ 1� o c- 1�'50;I l - IV C, Z 70 2--c� Home Phone _/ )/,g q ln g ~ ` Z l � Business Phone :2 d ! 00 -7 (n- l Z 5- 1 2. Name on Permit if Different than Above 3. Application/Permit for: ❑ General Evaluation g,,5,eptic Tank Installation 4. System to Serve: ❑ House le -Mobile Home ❑ Place of Public Assembly ❑ Business ❑ Industry ❑ Other ❑ Unknown 5. If house, mobile home: Subdivision Section Lot # No. of People 11011 No. of Bedrooms -3 No. of Bathrooms 2 , ` Dwelling Dimensions 1 `1 )( 7 0 6. If business, industry, place of public assembly, other: Specify type No. of People Served No. of Commodes No. of Lavatories No. of Sinks No. of Urinals No. of Water Coolers No. of Showers Water Usage Figures _ 7. Type of water supply: ❑ Public Private 8. Property Dimensions �1 a c -n- X Sewage Disposal Contractor ❑ Basement/Plumbing ❑ Basement/No Plumbing IES Washing Machine ❑ Dishwasher ❑ Garbage Disposal O On1G %4 IL 9. Do you anticipate additions/expansion of the facility this sytem is intended to serve? ❑ Yes U No If yes, what type? ❑ 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: -S -Fr alshL Q c.ross K0"1\41riQ. ( S /Zd , -1v g 4( S bra 5 k+ ck G ros S 4xn 0 LJ �t t't. tj \� H'' rJ t,1 ^i -- S 1 4--1- i .J C, J 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 m this application. /' / fr 6 93 // DATE 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 abi btpw sewage treatment and disposal system. DATE SIGNATURE DCHD (12-90) V NAME :&& ADDRESS PROPOSED FACIILTY DAVIE COUNTY HEALTH DEPARTMENT Environmental Health Section Soil/Site Evaluation. DATE EVALUATED � 0 PROPERTY SIZE LOCATION OF SITE �O/�i9•P Water Supply: On -Site Well Community Public Evaluation By: Auger Boring Pit Cut FACTORS 1 2 3 4 Landscape position ZSlope % 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 LONG-TERM ACCEPTANCE RATE _�q__, SITE CLASSIFICATION: ,Cr 4�'O_ For 2 EVALUATED BY: // LONG-TERM ACCEPTA RATE: OTHER(S) PRESENT: REMARKS: f/ a 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 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 Parcel #: C400000070 Davie County, NC - Basic Estate Search Basic Search Real Estate Search Tax Bill Search Sales Search View Property Record for this Parcel View Mao for this Parcel View Tax Bili Information Parcel #: C400000070 Account #: 8302231 Owner Information Tax Codes BXF• 4 OLLARD MATTHEW TODD & WOOLLARD KAREN BARNESADVLTAX E553 - COUNTY T 48,40 NC HIGHWAY 801 NORTH READVLTAX - FIRE TAX ssessed• OCKSVILLE NC 27028 eferred• Property Information Township 4 00926 0755 05 Land (Units/Type): 2.910 AC FARMINGTON Improved 155,000 Address: 3553 N NC HWY 801 Deed Information Local tonin Pate: 05/2015 Book: 00989 Page: 0977 Plat Hook: 11 Page: 361 Le al Description PIN 12.910 AC HWY 801 5833108872 Property Values Qual/UnQual uildin : 10140 BXF• Unqualified nd• 48,40 Market: 149,80 ssessed• 149,80 eferred• Unqualified Sales Information No. Book Page Month Year Instrument Qual/UnQual Improved Price 1 00471 0646 03 2003 WD Unqualified Vacant 0 2 00551 0340 05 2004 WD Unqualified Improved 125,000 3 00989 0977 05 2015 WD Unqualified Improved 0 4 00926 0755 05 2013 WD Qualified Improved 155,000 View Property Record for this Parcel View Map for this Parcel View Tax Bill Information « Return to Basic Search Page 1 of 1 ret" ��vts� 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=1452794 9/20/2016