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1590 Junction Rd� :)8vie County, �@� - 6k4O� - September 7g,7U}� --_- . � TX t 40 TA 7 7t - 4 � ` / WARNING: THIS IS NOTA SURVEY Porrp| Information Parcel Number: M40000002301 Township: Jerusalem NCP|NNumhec 5735287820 Municipality: Account Number: 51554880 Census Tract: 37059'807 � Listed Owner 1: KxOJ|CAmwvOR Voting Precinct: C0OLeemss � Mailing Address 1: 1729ANGELLRD Planning Jurisdiction: Davie County � � City: MOCKSV|LLE Zoning Class: DAV|ECOUNTY R+A State: NC Zoning Overlay: DAV|ECOUNTY CZOD Zip Code: 27028-4003 Voluntary Ag. District: No Legal Description: LOTS G-7RVYKURFEES Fire Response District: C00LEEW1EE Assessed Acreage: 178 Elementary School Zone: COOLEEK4EE Deed Date: 2/2015 Middle School Zone: SDUTHDAV|E Deed Book /Page: 009800105 Soil Types: PoC2.CoB2 � Plat Book: 0002 Flood Zone: Plat Page: 008 Watershed Overlay: DAV|ECOUNTY � ' Building Value: 5158O00 Outbuilding &Ent'a 122000 � � FreoturesVa|ue: � Land Value: 21540.00 Total Market Value: 74350.00 Total Assessed Value: 74350.00 All data is provided as is without warranty or guarantee of any kind either expressed or implied including but not limited to the Davie implied warranties of merchantability or fitness for a particular use. All users of Davie County's GIS website shall hold harmless the County, County " Davie, North Carolina, its agents, consultants, contractors or employees from any and all claims orcauses * action due m || |Nv. |= arising out mthe use orinability muse the GIS data provided uvthis website. | r DAVIE COUNTY HEALTH DEPARTMENT IMPROVEMENT PERMIT and OPERATION PERMIT t IMPROVEMENT PERMIT **MOTE** This improvement permit DOES NOT authorize 'the construction or installation of a septic tank system or any wastewater system. AN AUTHORIZATION FOR WASTEWATER SYSTEM CONSTRUCTION must be obtained from this Department prior to the construction/installation of a system or the issuance of a building permit. (In compliance with Article 11 of B.S. Chapter 130A, Wastewater Systems, Section .1900 Sewage Treatment and Disposal Systems) NAME1 / �P� ' / S.� /�'r,. PROPERTY ADDRESS .0/ t' 07-,L DATE LOCATIONl/i/�f SUBDIVISION NAME LOT NUMBER SEC./BLOC( NUMBER RESIDENTAL SPECIFICATION: BUILDING TYPE # BEDROOMS # BATHS # OCCUPANTS GARBAGE DISPOSAL: YeVN COMMERCIAL SPECIFICATION: FACILITY TYPE # PEOPLE # PEOPLE/SHIFT # SEATS INDUSTRIAL WASTE: Yes/No LOT SIZE �'S%�!> TYPE WATER SUPPLY f G DESIGN WASTEWATER FLOW (GPD)- -nO NEW SITE t`'� REPAIR SITE SYSTEM SPECIFICATIONS: TANK SIIE f) GAL. PUMP TANK GAL. TRENCH WIDTH ROCK DEPTH %% '� LINEAR FT. OTHER REQUIRED SITE MODIFICATIONS/CONDITIONS: ***THIS PERMIT IS SUBJECT TO REVOCATION IF SITE PLANS OR THE INTENDED USE CHANGE. YOUR WASTERWATER SYSTEM CONTRACTOR MAST SEE THIS PERMIT BEFORE INSTALLING THE SYSTEM. IMPROVEMENT 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 THE DAY OF INSTALLATION. TELEPHONE # IS (704) 634-8768. OPERATION PERMIT ALLED BY ep AUTHORIZATION NO. tl �V"' OPERATION PERMIT BY DATE **THE ISSUANCE OF THIS OPERATION PERMIT SHALL INDICATE THAT THE SYSTEM DESCRIBED A VE HAS BEEN INSTALLED IN COMPLIANCE WITH ARTICLE 11 OF G.S. CHAPTER 130A, SECTION .1908 'SEWAGE TREATMENT AND DISPOSAL SYSTEMS', BUT SHALL IN NO WAY BE TAKEN AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORILY FOR ANY GIVEN PERIOD OF TIME. DCHD 10/95 H .. .s FR7JUN APPLICATION FOR SITE EVALUATION/IMPROVEMENTS PERMIDavie County Health Department Environmental Health Section 1 2 1996 P. O. Box 665 Mocksville, NC 27028 1. Application/Permit Requested By fZo 6A-13 As U44 Mailing Address es y Home Phone l/l - Z' ��s�J z K— Business Phone 2_ Name on Permit if Different than Above 3. Application for: 4. System to Serve: ❑ Business ❑ General Evaluation ❑ House ❑ Industry 5. If house, mobile home: Subdivision U,Septic Tank Installation Permit p'vl!tobile Home ❑ Place of Public Assembly ❑\ Other ❑ Unknown a No. of People 2 No. of Bedrooms - ) No. of Bathrooms Dwelling Dimensions 6. If business, industry, place of public assembly, other: Specify type No. of People Served No. of Commodes No. of Lavatories _ No. of Showers No. of Sinks No. of Urinals No. of Water Coolers Water Usage Figures 7. Type of water supply: Ca-15ublic ❑ Private 8. Property Dimensions a or) 3, 4ou Sewage Disposal Contractor Section Lot # ❑ Basement/Plumbing ❑ Basement/No Plumbing 2, Washing Machine E; -Dishwasher ❑ Garbage Disposal 9. Do you anticipate additions/expansion of the facility this sytem is intended to serve? ❑ Yes 1 fkwo 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: f)1-44-3.3-01 Mal, -Aa) S+. C6pkkoral CLckws Qbm vPQ� �Ei� This is to certify that the information provided is correct to the best incurred from this application. ja J 96 DATE Tax Office PIN: # PTT) - PROPERTY ADDRESS, Road Name: City: N oe-kc u i lle SUBMIT A PLAT WITH THIS APPLICATION. Revisions effective October 1, 1995. SIGNATURE I am responsible for all charges CONSENT FOR SITE EVALUATION TO BE DONE ON ABOVE DESCRIBED PROPERTY MUST CHECK ONE: O4. I 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' to ' ity for a ground absorption sewage treatment and dispos�yste DATE SIG ATURE DCHD (1193) L N Q 9E o 0 . .. •wnw .......... ...Yr....w .» »w wn Yw.•Y................................................... ..M..nw •YY..wY .w• xYr•www.ww .......... Y•.xx YYnw ..•x.rY w»•x w• n n MrY ..wnYFw•Yn......... xw.YYw •YM M.xwn v........... n».................... n.• ...7 n•..Yr..n.............. •. •. Y•..•.•Y••.... •.•x.... ••Y•wwww». ••..SV9 �MVNINOW03►d --77w. wx Yxnw nn. Mr6 7 � � ...................Y..•w....x.ww........x..x.»»»».»».....Y..»...x.... »»..»...x i I O N W co O N W n j O N W io ` - DAVIE COUNTY HEALTH DEPARTMENT Environmental Health Section . Soil/Site Evaluation NAME ADDRESS PROPOSED FACIILTY DATE EVALUATED PROPERTY SIZE j c LOCATION OF SITE Water Supply: On -Site Well _ Community Public.'___� Evaluation By: Auger Boring �_ Pit Cut FACTORS 1 2 3 4 Landscape position L L Sloe Z HORIZON I DEPTH Texture group Consistence Structure Mineralogy HORIZON II DEPTH Texture group G Consistence Structure S Mineralogy,' / / ' / /.• HORIZON III DEPTH Texture group Consistence Structure Mineralogy HORIZON IV DEPTH Texture group Consistence Structure Mineralogy SOIL WETNESS RESTRICTIVE HORIZON SAPROLITE CLASSIFICATIONs LONG-TERM ACCEPTANCE RATEJ::�%,� - SITE CLASSIFICATION: EVALUATED BY: l`Y 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 -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 CONSISTENCE Moist VFR- Vl,.-y 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 ::CCCC:::aCCCCCCa.aCCCC�C:C.CCCC".�.■C.■.0/■.0■..:■.■.....■■■..�. ■/.■■■■./.■■■.■■■/■..■■■/■■.../.�......CCCCC....■......./.../.■.. ■■..././....■.■....■/■.■■..■...■...■ .....;aN tea::■.Ca...:.:m Mm MMMMMM ■■..............................�........a. .. ■ . ■ ............. ...........................a...........a;...aH.C.a.a EMENME.■E■E■ MES■.....■■.■■...■.■..■....■..■..■.....■■. .■■■.■ am am H N■MME■■■N a:aaaaaaaa�CCaaaCaCCC::CCCCCCCaCCCCC :NNMIEM'IOCINUMMEEaa:.Maaa ■...■..■■■■.■■.■■■.■.■./■■/.■■..■■..■..■.■■■EE■MMa■■N■■E■NE■■EE■M■ MOEN ■.E■■■■NEE■.EM■■.■.■/■/EM.ME.■M..■EEE.N.EM.NEE ■ ■■■EM■N■N■HM■ ■.■■/.■■//■//■../.../.■..■■■./■/■..■■....■.■■■/ ..■.■.■..■.■■. ..EM...M.■■E.■.■■...■.■M.EN..EM.. ■ ■.... ■■H .■■■. ■ MENU. ....................E.■■M■.....■.......■.c.■■■En NCNUH=■M�i CCC ■ENMH.N.......M.■./■■■..■■■... ■.M■.H■1�AMM.■.■H■.■.....■.CNH ■..■.■..■■.■■■■.■.■.■..........■�■.//N■■4'fr.�a M NNEEEEMMEN■■ME■■ ■.■■■ME..E.E■MECEEE■.■.■■■■E■■EN.U.NE..■EMI■ �■ M.CNNOMMEM ..■..■..■■ C CCCCCaaC::aa::aaaaaaa ::aaaaaaaaaaaaa::aaiEaCC a'.NONE C'a■MOMM a.0 .....HMM.EE■H■NEE■■MEEENNE.■■.E■.■. . ..■.. 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"MEMO ■� M.NEMM■■■■N■N■ H■■H■N■H ■a aECMEMN. .. C.. .. .. ■.. ...... . EHEEE.. H . . now MEN EC.MMM ■EMEMEM . ■■■MEMENNNNE EMENNO EM.■ ■E.N ■ NNEEMM M■M■ENHMM■ M.M■NME ■E■■■■.■M■.■■E■■ . ■EONM ■■■...=EEME.■M.ME MEMM.MMENEM. on........ .■UH■N■.■MNEME. .................................................................. .■■.C.■... .■.■■..■...■■.■■■■■■■■ ■.■.aCMM.■■MMMMMM■MEMMMM■EH.NaM �ME..■H■N...E......M..E...■M.. ..E.M.....M.E.C......N...N.....M t ` Davie County Health Department ' ENVIRONMENTAL HEALTH SECTION P.O. Box 665 Mocksville, N.C. 27028 AUTHORIZATION FOR WASTEWATER SYSTEM CONSTRUCTION (Issued in compliance with Article 11 of G.S. Chapter 130A, Wastewater Systems) ***This Authorization For Wastewater System Construction must be issued by the Davie County Environmental Health Section prior to issuance of any Building Permits. This Form/Authorization Number should be presented to the Davie County Building Inspections Office when applying for Building Permits.*** / AUTHORIZATION NUMBER NAME DATE ��5" ��` N2 0 4 00" NAME ON IMPROVEMENT PERMIT (If different than above) SITE LOCATION COMMENTS/CONDITIONS ON AUTHORIZATION TO CONSTRUCT WASTEWATER SYSTEM 4WICE*** THIS AUTHORIZATION F WA5 WflTER 5Y5 CONSTRUCTION IS VALID F R A PERIOD OF FIVE (5) YEARS. ENVIM ENTAL WFL1qSFECNLIST DATE DCHD'10/95 .a_„ _ _'__ �o ._r._ .;5 ' ..a3` e.. '+-L +. •. y•.. S_ e,i s a_ .._ ;. .i...r�. Y: £'.' t_ '�`r. ,. �R < _ + ...