483 Pudding Ridge Rdf DAVIE COUNTY HEALTH DEPARTMENT
Environmental Health Section
P. O. Boz 848/210 Hospital Street
n �n� wwar Mocksville, NC 27028
(336)751-8760
E5- 000
lwa.,kcell pjo, ,C-
Account #: 990002023 Tax PIN/EH #: 5841-08-8433.CE I-t IJ
Billed To: Charles Eagle Subdivision Info:
Reference Name:
r-acii
ATC Number: 2990
Location/Address: 483 Pudding Ridge Road -27028
AUTHORIZATION FOR WASTEWATER SYSTEM CONSTRUCTION
**NOTE** This Authorization for Wastewater System Construction MUST BE ISSUED by the Davie County Environmental
Health Section prior to issuance of any building permit(s). This Form/Authorization Number should be presented to
the Davie County Building Inspections Office when applying for building permit(s) (in compliance with Article 11 of
G.S. Chapter 130A, Wastewater Systems, Section .1900 Sewage Treatment and Disposal Systems). THIS
AUTHORIZATION FOR WASTEWAyq CONSTRUCTION IS VALID F R A PERIOD OF FIVE YEARS.
Environmental Health Specialist's Signature: Date: ^/d - ,�o -oy
CERTIFICATE OF COMPLETION
**NOTE** The issuance of this Certificate ofCompletio
has been installed in compliance with Article
Disposal Systems," but shall in NO WAY be
given period of time.
Septic System Installed By:
stem described on Improvement/Operation Permit
30A, Section .1900 "Sewage Treatment and
hat the system will function satisfactorily for any
r
Environmental Health Specialist's Signature: Date: 'V_LT_�
DCHD 05/99 (Revised)
DAVIE COUNTY HEALTH DEPARTMENT
Environmental Health Section
P. O. Boz 848/210 Hospital Street �✓ C
Mocksville, NC 27028
(336)751-8760
IMPROVEMENT/OPERATION PERMIT
Account #: 990002023 Tax PIN/EH #: 5841-08-8433.CE
Billed To: Charles Eagle Subdivision Info:
Reference Name: Location/Address: 483 Pudding Ridge Road -27028
Proposed Facility: Residence Property Size: 22.5 acres
ATC Number: 2990
**NOTE** This Improvement/Operation Permit DOES NOT authorize the construction 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 G.S. Chapter 130A, Wastewater Systems, Section .1900 Sewage Treatment and Disposal Systems). THIS
PERMIT IS SUBJECT TO REVOCATION IF SITE PLANS OR THE INTENDED USE CHANGE. YOUR
WASTEWATER SYSTEM CONTRACTOR MUST SEE THIS PERMIT BEFORE INSTALLING SYSTEM.
Residential Specification: Building Type _ #People #Bedrooms #Baths
Dishwasher: Z Garbage Disposal: ❑ Washing Machine: l2r Basement w/Plumbing: ❑ Basement/No Plumbing: ❑
Commercial Specification: Facility Type #People #People/Shift #Seats Industrial Waste: ❑
Lot Size C Type Water Supply Design Wastewater Flow (GPD) .,,�`. Site: NewZ' Repair ❑
System Specifications: Tank Size,,!! 6 GAL. /Pump Tank GAL. Trench Width��`' Rock Depth Linear Ft.�
zz, Alt,4 Other: l
Required Site Modifications/Conditions:
IMPROVEMENT/OPERATION PERMIT LAYOUT - APPROVED EFFLUENT FILTER. RISER(S) IF 6 " BELOW
FINISIIED GRADE. ****NOTICE: Contact a representative of the Da ie County Health Department for final inspection of this
system between 8:30 a.m. to 9:30 a.m. or 1:00 p.m. to 1:30 p.m. on the daf cf initatation. Telephone # is (336)751-8760.****
Environmental Health Specialist's Signature: Date: 1�6
DCHD 05/99 (Revised)
iN NY
f
-j 483 Pudding Ridge
Printed:Jul 29, 2013
All data is provided as is without warranty or guarantee of any kind either expressed or implied including but not limited to the implied
warranties of merchantability or fitness for a particular use. All users of Davie County's GIS website shall hold harmless the County of Davie,
North Carolina, its agents, consultants, contractors or employees from any and all claims or causes of action due to or arising out of the use or
inability to use the GIS data provided by this website.
Appraisal Card
Page 1 of 1
ur 7/29/2013 12.54.32 PM
LAKEY DEBRA L BROWN JILL C Return/Appeal Notes: ES -000-00-004
83 PUDDING RIDGE RD UNIQ ID 6229
2525371 AD79-PS ID NO: 5841088433
COUNTY TAX (100), FIRE TAX (100) CARD NO. 1 of 1
eval Year: 2013 Tax Year: 2013 LOT 1 LAKEY + BROWN S/D 3.270 AC SRC= Inspection
kppraised by 02 on 06/25/2007 03003 CEDAR CREEK TW -03 C- EX- AT- LAST ACTION 20120524
CONSTRUCTION DETAIL
MARKET VALUE
DEPRECIATION CORRELATION OF VALUE
Foundation - 3Standard
0.1100
ontinuous Footing5.0
E
UA
BASE
RATE
RCN
EYB
AYB CREDENCE TO MARKET
ub Floor System - 4
US
MO
Aree a
I ood 8.00
0110
11,4551
119
83.30
122702200
200 % GOOD 1 89.0 DEPR. BUILDING VALUE - CARD 109,210
xterior Walls - 10
TYPE: Single Family Residential Single Family Residential DEPR. OB/XF VALUE - CARD 19,20
luminum/Vin I Siding29.0
MARKET LAND VALUE - CARD 53,68
STORIES: 1 - 1.0 Story TOTAL MARKET VALUE - CARD 182,09
oofing Structure - 03
able 8.0
oofing Cover - 03
s halt or Composition Shingle 3.00
TOTAL APPRAISED VALUE - CARD 182,09
OTAL APPRAISED VALUE - PARCEL 182,09
nterior Wall Construction - 5
D all/Sheetrock 26.0
TOTAL PRESENT USE VALUE - PARCEL
nterior Wall Construction - 6
ustom Interior 0.0c
TOTAL VALUE DEFERRED - PARCEL
TOTAL TAXABLE VALUE - PARCEL 182,09
nterior Floor Cover - 12
ardwood 10.0
+------------31------------+ PRIOR
nterlor Floor Cover -14
ar et 0.00
I FOP I BUILDING VALUE 109,70
I I OBXF VALUE 22,80
eating Fuel - 04
lectric 1.0
B BLAND VALUE 53,68
I 1 PRESENT USE VALUE
eating Type - 10
eat Pum 4-00
+------------31------------+----13-----+ DEFERRED VALUE
I B A S I
I I OTAL VALUE 186,180
it Conditioning Type - 03
entral 4.00
I I
I I
drooms/Bathrooms/Half-Bathrooms
2/0 12.00
I I
I I
I I PERMIT
drooms
S - 3 FUS - 0 LL - 0
1 I CODE DATE NOTE NUMBER AMOUNT
I I
[athrooms
S-2 FUS-0LL-0
Z 2
9 ROUT: WTRSHD:
1 I SALES DATA
flce
S - 0 FUS - 0 LL - 0
I 1 FF. INDICATE
I 1 RECORD DATE DEED SALES
I I BOOK PAGE M R TYPE PRICE
1 1 0345 888 9 00 WD Q V 16200
1 1 0634 344 11120051 WD U I 36000
I 1
I 1
OTAL POINT VALUE 110.00
BUILDING ADJUSTMENTS
Quality 3 AVG 1.000
ha a Desi 4 FACTOR 4 1.050
Size 1 3 Size 1.030
OTAL ADJUSTMENT FACTOR 1.08
OTAL QUALITY INDEX 11
+------------------44------------------+
IFOP I
6 6 HEATED AREA 1,276
I I
+------------------44------------------+ NOTES
5 SALE UNQ ORGINALLY 22
G
SUBAREA UNITORIG % ANN DEP % OB/XF DEPR.
TYPE GS AREA % RPL CS ODE DESCRIPTIONLTH M NIT PRICE COND BLDG /B AYB EYB RATE V COND VALUE
AS 1,27 I.106291 2 ARAGE 4 3 1 20 25.0 L 001 001 S 1920
OP 1 51210351 14911 OTAL OB/XF VALUE 19,200
2 - Pre
IREPLACE 1,50
Fabricated
USAREA
1,78 122,70
OTALS
UILDING DIMENSIONS BAS=W13 FOP=N8W31SSE31 W31S29 FOP=S6E44N6W44$ E44N29$.
NO INFORMATION
HIGHEST
OTHER ADJUSTMENTS
LAND TOTAL
NO BEST
USE
LOCAL
FROM
DEPTH/
LND
COND
AND NOTES ROA
UNIT LAND UNT TOTAL
ADJUSTED LAND LAND
SE
CODE
ZONING
TAGE
DEPTH SIZE
MOD
FACT
RF AC LC TO OT TYPE
PRICE UNITS TYP ADJST
UNIT PRICE VALUE NOTES
URAL AC0120
237
0 1.4590
4
1 1.2500
+01 +14 +10 +00 +00 PW
9,000.0 3.270 AC 1.824
16,416.00 5368c GOLF
RSE
OTAL MARKET LAND DATA 3.270 53,68
OTAL PRESENT USE DATA
http://maps.co.davie.nc.us/ITSNet/AppraisalCard.aspx?parcel=E500000004 7/29/2013
APPLICATION FOR SITE EVALUATION/IMPROVEMENT PERMIT
Davie County Health Department
' Environmenta/Health Section
P.O. Box 848/210 Hospital Street
Mocksville, NC 27028 - Q 20,07
(336) 751-8760
fIV�IRpNMF
***IMPORTANT*** THIS APPLICATION CANNOT BE PROCESSED UNLESS ALL ilit,1H
INFORMATION IS PROVIDED. Refer/)to the INFORMATION BULLETIN for instructio
1. Name to be Billed Cid"/C'$ (?i C` 4 /L4 Contact Person�7�j/i�' �g A -
Mailing Address /,/�(� �lsi uy�/er�s/`` %dNL'T Home Phone l
City/State/ZIP 11 e IeYy,V4, /Y C - 9 / 7 U Business Phone 'U xPL C
2. Name on Permit/ATC if Different than Above
Mailing Address City/State/Zip
3. Application For: ❑ Site Evaluation `,QiImprovement Permit/ATC ❑ Both
4. System to Service: y House ❑ Mobile Home ❑ Business ❑ Industry O Other
5. If Residence: # People # Bedrooms_ # Bathrooms
Dishwasher U Garbage Disposal I Washing Machine U Basement/Plumbing 11 Basement/No Plumbing
6. If Business/Industry/Other: Specify type # People # Sinks
# Commodes # Showers # Urinals # Water Coolers
IF FOODSERVICE: # Seats Estimated Water Usage (gallons per day)
7. Type of water supply: IV/County/City ❑ Well Il Community
8. Do you anticipate additions or expansions of the facility this system is intended to serve? 0 Yes XNo
If yes, what type?
***IAIPORTANT*** CLIENTS MUST COMPLETE THE REQUIRED PROPER'L'Y INFORMATION REQUESTED
BELOW. Either a PLAT or SITE PLAN MUST BE SUBMITTED by the client with TIi1S APPLICATION.
Properly Dimensions: ��dtv � /�Lf eS WRITE DIRECTIONS (from Mocksville) to PRO PERTI':
Tax Office PIN: #_ Srp 4 /_0f�p X3.3 •-
Property Address: RoadNamc jvzf�' 'Ie
City/zip_�Gc/cl'yf`/% ,�TGoz�j
If in a Subdivision provide information, as follows:
Name:
Section: Block: Lot:
.F. - d
,Wf' -
Date Property Flagged:✓
This is to certify that the information provided is correct to the best of my knowledge. I understand that any permit(s)
issued hereafter are subject to suspension or revocation, if the site plans or intended use change, or if the information
submitted in this application is falsified or changed. 1, also, Understand that I am responsible for all charges incurred from
this application. 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 the site suitability. O
DATE CJG Z 4-_ o2 �� ( SIGNATURE -211 -
THIS AREA MAY BE USED FOR DRAWING YOUR SITE PLAN (Include all of the following: Existing and proposed
property lines and dimensions, structures, setbacks, and septic locations).
Site Revisit Charge
Datc(s):
Client Notification Date:
EHS:
Account No. �—� 2.
Revised DCHD (07/99) Invoice No.� �� J
I
,per
Fir,
✓`µPrr -I ,
#PPUCATION FOR SITE EVALUATION/IMPROVEMENT PERMIT &
C1
•"�� �� / I Davie County Health Department
Environmental Health Section A 2 0 W8
P.O. Box 648/210 Hospital Street
ksv leoc it , NC
M 27028
EtJVIRONh1ENTAL HEALTH
(336) 751-8760 DAVIE COUNTY
ORTANT*** THIS APPLICATION CANNOT BE PROCESSED UNLESS ALL THE REQUIRED
INFORiy?ATION IS PROVIDED. Refer to the INFORMATION BULLETIN for instructions.
1. Name to be Billed ^ Contact Person
/ �z
Mailing Address 7 � ��J- � , Home Phone
City/State/ZIP 2 )4L2LLl�_,v //!/1. (�• 9� Business Phone
2. Name on Permit/ATC ifDifferentthan Abotre
Mailing Address City/State/zip
3. Application For: 0 -Site Evaluation ❑ Improvement Permit/ATC ❑ Both
4. System to Service: 6-11ouse ❑ Mobile Home ❑ Business ❑ Industry ❑ Other
5. If Residence: # People # Bedrooms # Bathrooms
0 Dishwasher ❑ Garbage Disposal ❑ Washing Machine ❑ Basement/Plumbing ❑ Basement/No Plumbing
6. If Business/Industry/Other: Specify type # People # Sinks
# Commodes
# Showers
# Urinals
# Water Coolers
IF FOODSERVICE: # Seats Estimated Water Usage (gallons per clay)
7. Type of water supply: ❑ County/City Well ❑ Community
8. Do you anticipate additions or expansions of the facility this system is intended to serve? ❑ Yes ❑ No
If
des, explain.
***IMPORTANT' CLIENTS MUST COMPLETE THE REQUIRED PROPERTY INFORMATION REQUESTED
BELOW. Either a PLAT or SITE PLAN 11IUST BE SUBMITTED by the client with THIS APPLICATION.
Property Dimensions: c2,9,
WRITE DER: CTIONS (from Mockmille) to PROPERTY -
Tax Office PIN:
Property Address: Road Name i e
City/Zip
If in a Subdivision provide information, as follows:
Name: !l .
Section: Block: Lot:
This is to certify that the information provided is correct to the best of my knowledge. I understand that any permit(s)
issued hereafter are subject to suspension or revocation, if the site plans or intended use change, or if the information
submitted in this application is falsified or changed. I, also, understand that I am responsible for all charges incurred from
this application. 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 the site suital ' " y.
DATE A SIGNATURE nnl
THIS AREA MAY BE USED FOR DRAWING YOUR SITE PLAN:
/Jac!y- Q
Application No.
Invoice No. /1
Revised DCHD (07/98)
CID
iirk«
gi>
25' _ R/ W'
296,
----- M/8 SZ --- 245 —
>F_ 4
2014.11 �`
2259.84
1245.73
ole -I
V
782-76
396 .6
� �) msp's
4 5Z
f
N
G
tlo Co
rn a W
Cp �
E
y I
1477 08
33p — _
ape 2 99.64 1 1 78,. I
co I
�_-
N S9
• ''UU
M
t17 5 25.3 6
C}' U
-- Q
a
10
I M LO 14:
i. N O
u -
N 4�
i
417.42
odz=
L6 I
923.95
1375
U
1 b �I N •j N
`r' N S LO
1 rf)
58.4 �
p 484 O IOC Q
31 1.02 (I N
OD
0
PG
Dt q
co
c� N /
DAVIE COUNTY HEALTH DEPARTMENT
"y Environmental Health Section SECTION LOT
` Soil/Site Evaluation
APPLICANT'S NAME DATEEVALUATED
PROPOSED FACILITY PROPERTY SIZE ,V,22`7ac
SUBDIVISION
ROAD NAME
Water Supply: On -Site Well E,""_
Community Public
Evaluation By: Auger Boring Y Pit Cut
FACTORS
1 2
3 4 5 6 7
Landscape position
CONSISTENCE
Sloe %
VFR - Very friable
HORIZON I DEPTH
Wet
Texture group'
SS - Slightly sticky S - Sticky VS - Very Sticky
•L
Consistence
Structure
Structure
M - Massive CR - Crumb GR - Granular ABK - Angular blocky
(�
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
,j -
LONG -TERM ACCEPTANCE RATEF
. a
SITE CLASSIFICATION:
LONG-TERM ACCEPTANCE RATE: j C2
REMARKS:
DCHD (01-90)
EVALUATION BY: A,&
OTHER(S) PRESENT:
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
■■■N■■■■■■■■■M■■■■■
■■■N■■■■■■■■■■■■■■■
■■■■■■■■■s■■■■■■N■■
■■■N■■■■■M■■■■■■■■■
■■■N■■■■■O■■■■■■■■■
■■MEMO■■■■N■■■■■■■■
■■■N■■■■■■■■■■■■■■■
■■■■■■■■■■■■■N■■■■■
■■■■■■■■■■■■■■■■■■■
No
■■
so
■■
No
■
uiiiii w, mFwMMII EMMMUM MMMEMEMENNENEMMEME�
■■■■■■■■■■■■■■■IOW■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■
■
■E■■
soon
NONE
■o■mi
■M■■MMM■■■KN■
■■M■■E■EMOMM■
■
■■
■■N■■
■MME■
■■■E■
■E■■■
■EN■■
■MM■■
■■OR■
■■M■■
SEEMS
■
J
■■
MEMO■
MEN
MEN
MEN
■■M■
NONE
MERE
MEMO■■■
■M■R■R■
■■■M■■■
■■■■■■■
■■■■■■■
EMERSON
ao■■■■■
■o■■■■■
■■t►m■■■
■■■HEME
■■■11■■■
■■■MEMS
■■■Wn■■
■EMMII■■
■■MMUM■
■■■■II■■
■■■■KEN
■■■■■AM
■■E■■N■
■■■■■M■
■■R■■N
■■■■■■N
MONOMER
■■Off
MEOW
NONE
OWES
NEON
■■■■
■
f
August 7,1998
Howard Boger
659 Pinebrook School Rd.
Mocksville, NC 27028
Re: Site Evaluation
Pudding Ridge Road
Tax PIN: #5841-08-8433
Dear Client(s):
As requested, a representative from this office visited the aforementioned site on
August 5,1998. Based upon the information provided on the application for site
evaluation and after an evaluation was completed, the site was found to be
provisionally suitable for the installation of a modified, oversized on-site sewage
disposal system on the left side of the property.
Before a representative of our office will revisit the site to issue an Improvement
PermiVAuthorization to Construct the appropriate application must be completed
in full and submitted to this office. The location of the facility the system is to serve
must be staked off.
If you have any questions, please feel free to contact this office.
Sincerely,
Wet�-
Robert B. Hall, Jr.
Environmental Health Specialist
RH/wd
Enclosure(s)