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370 Hwy 901WAll DAVIE COUNTY HEALTH DEPARTMENT j7o ' IMPROVEMENTS PERMIT AND CERTIFICATE OF COMPLETION J -p06). *NOTE: Issued in Compliance With Article 11 of G.S. Chapter 130a Sanitary Sewage Systems Jame IX-,T1'S.1'd� ii�l/ddl ate -J5 if Permit . Number W 68.65 u* Subdivision Name Lot No. Sec. or Block No. Lot Size Ile House Mobile Home �'f Business __ Speculation No. Bedrooms c—�-2 .No. Baths I No. in Family Garbage Disposal YES ❑ NO Q� Specifications for System: Auto Dish Washer YES ❑ NO e1 Auto Wash Ma thine YES flNO ❑ 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 *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 byyZZ Certificate of Completion Date P *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. Y 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 Mailing Address Home Phone d 5 6' 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 Business Phone ❑ General Evaluation R(Mobile Home ❑ Other No. of People 12 No. of Bedrooms No. of Bathrooms Dwelling Dimensions 12- X ell ? 6. If business, industry, place of public assembly, other: Specify type No. of People Served No. of Sinks _ No. of Commodes No. of Urinals ------------- VSeptic Tank Installation ❑ Place of Public Assembly ❑ Unknown _ Section Lot # ❑ Basement/Plumbing ❑ Basement/No Plumbing t/Washing Machine ❑ Dishwasher ❑ Garbage Disposal No. of Lavatories No. of Water Coolers. No. of Showers Water Usage Figures. 7. Type of water supply: ❑ Public Private 8. Property Dimensions / 3 9— Sewage Disposal Contractoi 9. Do you anticipate additions/expansion of the facility this sytem is intended to serve? If yes, what type? ❑ Yes 21"No ❑ 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: 7. 10 711 e �f'i�I/�l.Ja �2 o"3'n- i" !o Gf.sCJ • CGL �� ,�/�`�� � �'d � n„� 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 thiiss/ application. ate- DATE CONSENT FOR SITE EVALUATION TO BE DONE ON ABOVE DESCRIBED PROPERTY MUST CHECK ONE: 01. 1 OWN the property. I X 2. 1 DO NOT OWN the property. If you checked Box #2, the rest of this form MU T be completed by the owner or a person authorized by the owner: I hereby give consent to the authorized representative of thgg.,,Davie ounty He th partment t nter uponabove described property located in Davie County and owned by d Gaq 2 � �ia /�1 =o7�d to conduct all testing procedures as necessary to determin6 said site's suitability for -a -g ound absorption sewage treatment and disposal system. DATE SIGNATURE DCHD (12-90) DAVIE COUNTY HEALTH DEPARTMENT Environmental Health Section Soil/Site Evaluation NAME _ (D[,� DATE EVALUATED �jQ�/� ADDRESS PROPERTY SIZE f�C PROPOSED FACIILTY LOCATION OF SITE©� Water Supply: On -Site Well Y Community Public Evaluation By: Auger Boring Pit Cut FACTORS 1 2 3 4 Landscape position ,L L Slope % — — — '- HORIZON I DEPTH Texture group Consistence Structure Mineralogy HORIZON II DEPTH Texture groupC Consistence r Structure Mineralogy ' i ,- j,'( /, 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: - /? C 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 -Concave slope CV -Convex slope T -Terrace FP -Flood plain H -Head slope Tov4nro 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 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 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 wateir 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 ■■■■■■■■■■■■■■.■■■.■■■■■■...■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■ ■■■ .�■liiiiii■�=iiiiiii.�3iiiiiiii■M=■iiiiiiiiiiiieiiiiiiiiiiiiiiiiiiii■�i iiii=��iiiiiiii■ii■iiii■iii iii■ ■■.■■■■■■■■■■■■■■■■■■■■■■■/''�1■■.■■.■■■■■��.■■■.■■■..■.■.■■..■.■�■■■■ ■■■■■■■.■/.■■./■■■■.■■/■■■■r■■■■■■■..■■`a�■■■■ ■■ ■■■■■■■ ■■■■■■.■ EMMEMEM NNE ME ................................ ................................ ■..■t.■.■■..■■.■..■■■t■■e■■■eeeee■■■eeeeeet.eee■e...t■e■■■■■etttt■ ■eeeee■■■ee■e■■■ecce■■e■■eeeest■■■■■■et■t■.....■■■.■t■■■.t.■.■...■ ■■■■..■■■■■■..■■■/■.■■■■■■■■■■■■■.■■■.■/■■■.■■■■.■■■■■.■■■■■■■■■■■ Parcel #: I100000004 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 Bill Information 16 Parcel #:I100000004 Account #:71764000 Owner Information BXF• Tax Codes Land: TROUD PHILLIP WAYNE& STROUD BETTY L arket: ADVLTAX - COUNTY TA essed: 70 HIGHWAY 901 eferred: READVLTAX -FIRE TAX HARMONY NC 28634 Property Information Township Land (Units/Type): 28.450 AC CALAHALN ddress. 370 W NC HWY 901 Deed Information Local tonin Pate: 10/1972 Book: 00087 Page: 0591 Plat Book: Page: Le al Description PIN 7.19 AC HWY 901 4798687909 Property Values uildin : 12,72 00011 BXF• 22,52 Land: 128,65 arket: 163,89 essed: 61,700 eferred: 102,190 Page 1 of 1 o1'4t� O0 tItl'S A: Davie County Web Site Sales Information No. Book Page Month Year Instrument Qual/UnQual Improved Price 00087 0591 10 1972 WD Unqualified Improved 0 View Property Record for this Parcel View Mao 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/itsnet/View.aspx?prid=1466693 7/14/2016