Loading...
6802 Hwy 801SDAVIE COUNTY HEALTH DEPARTMENT IMPROVEMENTS PERMIT AND CERTIFICATE -OF COMPLETION - 'NOT&I.1sued in Compliance With Article II of G.S. Cli'dpter 130a tary S wage Syste 41�;,h 1",{f i r� Permit, Number Name f. 6 ( �i Date �- y 9y N° 7 4 2 8 i Location - ��� ✓ i %/!lf /� .1 6A IV(4 Subdivision Nme Lot No. Sec. or Block No. Lot Size K// House _� Mobile Home _ Business —_ Industry No. Bedrooms No. Baths i— No. in Family_ Public Assembly Other Garbage Disposal YES NO ❑ Specifications for System: Auto Dish Washer YES NO ❑ Auto Wash Ma shine YES NO ❑ -/ u 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 it site plans or the intended use change. \ 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. ._ Final Installation Diagram: System Installed by a Certificate of Comple iron 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 of time. x _ - ` DAVIE COUNTY HEALTH DEPARTMENT f� IMPROVEMENTS PERMIT AND CERTIFICATE -OF COMPLETION _ * NOTE. Iisued in Compliance With Article 11 of G.S. CFPdpter 130a 'tary S wage yste Permit Number / f � -�� AW Name; �� � /' F r �' � � �i Date Sy NO 7428 28 Locationf,%/S- ✓�~ �/✓ 11'.�� /. %� i`/' G'f / /�7 Subdivision Name Lof'No. Sec. or Block No. Lot Size Z /Z& House _i4G— Mobile Home Business . _ Industry No. Bedrooms SL �` No. Baths t-- No. in Family Public Assembly -0ther Garbage Disposal YES NO ❑ Specifications for System: Auto Dish Washer YES NO ❑ 1 Auto Wash Ma -hive YES NO ❑ /©0'` " 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 Improvements permit by�-�� *Contact a representative of th -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. Final Installation Diagram: System Installed by S pit t t H y,� 1_ h1 3 Certificate of Comple ion 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 of time. • DAVIE COUNTY HEALTH DEPARTMENT Environmental Health Section Soil/Site Evaluation NAME ! 9 DATE EVALUATED ADDRESS PROPERTY SIZE Ale PROPOSED FACULTY e LOCATION OF SITE Water Supply: On -Site Well Community Public Evaluation By: Auger Boring �/ Pit Cut FACTORS 1 3 4 Landscape position Sloe % moi' HORIZON I DEPTH Texture group Consistence Structure Mineralogy HORIZON II DEPTH ,3 fAp,14,F Texture roup G Consistence � Structure Mineralogy, - HORIZON III DEPTH Texture group Consistence Structure Mineralogy HORIZON IV DEPTH Texture group Consistence Structure Mineralogy SOIL WETNESS RESTRICTIVE HORIZON SAPk LITE CLASSIFICATION LONG-TERM ACCEPTANCE RATE SITE CLASSIFICATION: 1 EVALUATED BY: -/—/Xl /Z LONG-TERM ACCEPTANCE RATE: OTHER(S) PRESENT: REMARKS: LEGEND Landscape Position R -Ridge S -Shoulder L -Linear slope FS -Foot slope N -Nose slope CC-ConCavP clnne 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 3C -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 DCHD(01-901 ■.■■■■■■■■■■■e■■!■!■■!■■!■■■.■■.■■!■■■■e■■■!e!!■.■■■.■.r■■ MS■i■e■ ■c■■ceee■c■■■■■■ecce■■■■■e■■■■■s ■c■■■ecce■■■.■...■■■.■■■.■■c■■■■ ■■■■■■■ccccc.■■.c.cec■■■c■■!e■■■cce■■ecce.......■■■.e.■.......■..■ ■cc■■e■■cc!■c■!■■leec..le■■■■ecce.■ccc..■■c.....■■..■e...■.s■...■ ........................... ...................................... ■■■■■■■■■■■■■■.....■■■■.....Il��.■O.■■■.■'■�..■■ ■O■■■■■M ■■■■■■N■■ ■...M■c..a....ccc■■■■.■ccc■eee.■..■e■..■....■a��M��c.►�..Mc.ec■■■ ■.....■NM.■■■■.■.......r�....■■.�M..00■■ii�/��.■M■■■■■■■■■■■■ ■■■ ■■.■■cc■■■.■eM..c■.e■cc■■■c■■c■■ see■■.ce. ee..c■eee.eeeeee.■.c.■ ■....■■..........Oce.ecce.■..■■..■.eeecc■■c■■.■cc.MMc .■..M..ec■ .................................................. ............... ■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■ CCCiiiC.NCCCCiiiiiiiiiiiiiiiiiiiC■N=CCCCCCC■N�CCCCCCCCCCC=ilii■■CN■CCCCC ■.■■■■.■.■■■....■...■■■■■■.■...■ MONSOON ■O■■■■n■■■■■■M■■■■N■O■■■ CCCCCi�iiN■iis�CiiiiC�iiiii■C CCCCCC�CCCCCC OMMEEMMEMEMEN ................■....■...............■ No MEMO No ■ ■■M■MMM■■M■M■■ ................................ .... M■NM ............■:...•.....•..�......��... � IMMUNE ■■■■MM■C.■■ .■.M■ swommom■...■■■.■■■■■e■�:■...ee.■■■...■■■rr�►��� ■ ■ Nun■. i■■s��i■■ ■ ■..■.■■■.■..■■N■■M:.■►�c_.�.��-■■■cM�i■■■N..nommumn ■■m ■■■■■■■■.■!■■■■■ CCC:::CCCCCCCCCCCCCCCCCCCCCCCCCCC:CCC N■:�:CC MC:���:0 CCC:::. ......N........................�C.■N.�NMN■ ■.....■..NO■■........■■■■.....■. MMM.MN■OM■ MMM■M■MMM■MMMMM.■ ■■■■■N■■■■■■■■■■■■■■_■■■■sM■■■■■■■■■=■■■M■■■ i ■■■■■■■■■■n■■■■■ CCCCCCC iiCCCCCCCCC MMMMM MMMMMMMMMMMMMMCCCiiiiiiC tME mom O�ERMAN■'�■E ON .....................................n■■.��■■..■■ CMMMM=■MMMM■MM■■ ■■■■■■■.■eee.e■■■eee.le.■..■■■el.ee.He.e■ eeeecee!■ee ■■eH�.!! ■■■■..ee.M..■■.e.ee..eeee.■■e.■N■e■ee.e■ .cN.N.M.MN■■■M...■MO■ ■■■M.O...tut■O.O■■..................■■.. .M...NM..M.■M.M...■e..■ MORE MEMMMEMMEMEMMEME ....................Cc.■.ec■ee■■�.■eecMecc.■.■M......M■.cee■.Sec■ ................................ ................................ ...................................... ........................... .................................................................. ■■■.C....■■Ne..■e.■■e.■■...■... ■■cc.....ccc...M.M.c.eee.eH■.e■ . APPLICATION FOR SITE EVALUATIONAMPROVEMENTS PERMIT Davie County Health Department Environmental Health Section _'op P. O. Box 665 Mocksville, NC 27028 1'. Application/Permit Requested By 7�'+mak .j fes, _ Home P Mailing Address K /. hone IYl0(edicc.�', .y C. Business Phone 2. Name on Permit if Different than Above IQ /77 117L L 3. Application for: ❑ General Evaluation 4. System to Serve: House ❑ Business ❑ Industry 5. If house, mobile home: Subdivision )5f,Septic Tank Installation Permit ❑ Mobile Home ❑ Place of Public Assembly ❑ Other ❑ Unknown No. of People 3 No. of Bedrooms 3 No. of Bathrooms Z ,/ Dwelling Dimensions 0 K 20 6. If business, industry, place of public assembly, other: Specify type No. of People Served No. of Commodes No. of Sinks 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 6 /�— • Sewage Disposal Contractor 9. Do you anticipate additions/expansion of the facility this sytem is intended to serve? ❑ Yes KNo If vac_ what tvna? Section Lot # �KBasement/Plumbing ❑ Basement/No Plumbing 5 Washing Machine ZDishwasher N Garbage Disposal "NOTE: Improvements Permitil 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: 46'1 `. 76 ('6yJ Co k /) &U: . This is to certify that the information provided is correct to incurred from this application. 2� 7" l / DATE and I understand I am responsible for all charges SIGNATURE CONSENT FOR SITE EVALUATION TO BE DONE ON ABOVE DESCRIBED PROPERTY MUST CHECK ONE: ❑ 1. 1 OWN the property. 1,6�2. 1 DO NOT OWN the property. If you checked Box #2, the rest of this form MUST be complet6d by the owner or a person authorized by the owner: I hereby give consent to the authorized representative gf the D�County-Pealth Department to enter upon above described property located in Davie County and owned by 1/1 f �GyS to conduct all testing procedures as necessary to deter said it 's su' bility fora ro bsorption sewage treatment and disposal system. fL/ - 3- DATE i SIGNATURE DCHD (193) Parcel #: L50000005101 Davie County, NC - Basic Estate Search Elasic Search Real Estate Search Tax Bill Search Sales Search View Prooertv Record for this Parcel View Map for this Parcel View Tax Bill Information Parcel #: L50000005101 Account #:82521429 Information Building: Tax Codes BXF• E802Owner LLIARD STEPHEN E& HILLIARD SONYA FAY Land: ADVLTAX - COUNTY YT Market: NC HIGHWAY 801 SOUTH ssessed: READVLTAX - FIRE TAX [Deferred: OCKSVILLE NC 27028 Property Information Township nd (Units/Type): 6.360 AC JERUSALEM ddress: 6802 S NC HWY 801 Deed Information Local Zonin ate: 09/2003 Book: 00510 Page: 0885 lat Book: Pa e: Legal Description PIN 16.369 AC HWY 801 5746748211 Property Values Building: 177,90 BXF• 6,7301 Land: 53,3201 Market: 237,9501 ssessed: 237,95 [Deferred: Sales Information No. Book Page Month Year Instrument Qual/UnQual Improved Price L 00196 0149 07 1997 WD Qualified Improved 171,000 z 00510 0885 09 2003 WD Qualified Improved 208,000 View Prooertv Record for this Parcel View Map for this Parcel View Tax Bill Information « Return to Basic Search Page 1 of 1 oA�f� 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=1469743 8/30/2016