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728 Sheffield RdDav >.016 17@1 All data Is provided as Is without warranty or guarantee of any kind either expressed or Implied Including but not limited to the Davie County, 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 NC or arising out of the use or Inability to use the GIS data provided by this website. WARNING: THIS IS NOT A SURVEY Parcel Information Parcel Number: G20000003801 Township: Calahaln NCPIN Number: 5810227132 Municipality: Account Number: 440000 Census Tract: 37059-801 Listed Owner 1: ALEXANDER MARSHA G Voting Precinct: NORTH CALAHALN Mailing Address 1: 728 SHEFFIELD ROAD Planning Jurisdiction: Davie County City: MOCKSVILLE Zoning Class: DAVIE COUNTY R-A,R-20 State: NC Zoning Overlay: Zip Code: 27028-8408 Voluntary Ag. District: No Legal Description: 2.31 AC E OFF SHEFFIELD Fire Response District: CENTER Assessed Acreage: 2.34 Elementary School Zone: WILLIAM R DAVIE Deed Date: 9/1995 Middle School Zone: NORTH DAVIE Deed Book / Page: 001820654 Soil Types: MnC2 Plat Book: Flood Zone: Plat Page: Watershed Overlay: DAVIE COUNTY Building Value: 190810.00 Outbuilding & Extra Freatures Value: 1240.00 Land Value: 19180.00 Total Market Value: 211230.00 Total Assessed Value: 211230.00 >.016 17@1 All data Is provided as Is without warranty or guarantee of any kind either expressed or Implied Including but not limited to the Davie County, 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 NC or arising out of the use or Inability to use the GIS data provided by this website. AUTHORIZATION NO: 0507 DAVIE COUNTY HEALTH DEPARTMENT Environmental Health Section PROPERTY INFORMATION Permittee's P.O. Box 848 Name: Mocksville, NC 27028 Subdivision Name: f / Phone #: 704-634-8760 Directions to property:'i "�- S".�r /�. !d A' ti Section: Lot: AUTHORIZATION FOR j,I 1 WASTEWATER Tax Office PIN:# 5� ' r" LTr •; �I{ �� ' SYSTEM CONSTRUCTION Road Name: 1` 1 1 Q_ip: ` 0, **NOTE** 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. (In compliance with Article 11 of G.S. Chapter 130A, Wastewater Systems, Section .1900 Sewage Treatment and Disposal Systems) ***NOTICE*** THIS AUTHORIZATION FOR WASTEWATER CONSTRUCTION j0Z&eAL H T_.4 a f }'Y�� t 1 IS VALID FOR A PERIOD OF FIVE YEARS. ERONMENTE'ALTH SPECCICTST DA'1 DAVIE COUNTY HEALTH DEPARTMENT IMPROVEMENT AND OPERATION PERMITS � rmll Name: Directions to property:"r "�` „rte y �i 0 PROPERTY INFORMATION Subdivision Name: Section: Lot: IMPROVEMENT PERMIT_ E Tax Office PIN: Road Name } t..1 i Zip: i **NOTE** 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 G.S. Chapter 130A, Wastewater Systems, Section .1900 Sewage Treatment and Disposal Systems) ***NOTICE*** THIS PERMIT IS SUBJECT TO REVOCATION IF SITE =b , Ao �,t``! ,1`J ' ` ) r PLANS OR THE INTENDED USE CHANGE. YOUR WASTEWATER ENVIRONMENTAL HEALTH SPECIALIST DXtt ISSUED SYSTEM CONTRACTOR MUST SEE THIS PERMIT BEFORE INSTALLING THE SYSTEM. RESIDENTIAL SPECIFICATION: BUILDING TYPE /7" # BEDROOMS # BATHS �9 # OCCUPANTS --02_ GARBAGE DISPOSAL: Yes or No COMMERCIAL SPECIFICATION: FACILITY TYPE # PEOPLE # PEOPLE/SHIFT # SEATS INDUSTRIAL WASTE: Yes or No LOT SIZE XAVIZ TYPE WATER SUPPLY DESIGN WASTEWATER FLOW (GPD) *� d NEW SITE l✓' REPAIR SITE SYSTEM SPECIFICATIONS: TANK SIZE GAL. PUMP TANK GAL. TRENCH WIDTH X ROCK DEPTH _,!-`! LINEAR FT. ,1 OTHER REQUIRED SITE MODIFICATIONS/CONDITIONS: IMPROVEMENT PERMIT LAYOUT r - "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) 634-8760. OPERATION PERMIT SYSTEM INSTALLED BY: AUTHORIZATION NO. Z OPERATION PERMIT BY:� DATE: "THE ISSUANCE OF THIS OPERATION PERMIT SHALL INDICATE THAT THE SYSTEM DESCRIBED ABOVE HAS BEEN INSTALLED IN COMPLIANCE WITH ARTICLE 11 OF G.S. CHAPTER 130A, SECTION .1900 "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 05/96 (Revised) APPLICATION FOR SITE EVALUATIONAMPROVEMENT 01 ****IMPORTANT**** Davie County Health Department Environmental Health Section D P.O. Box 848 Mocksville, NC 27028 SEP (704)634-8760 THIS APPLICATION CANNOT BE PROCESSED UNLESS ALL THE REQUIRED INFORMATION IS PROVIDED. 1. Name to be Billed l eyw l/. � Contact Person i7 1 t- '`} P1a0iCC 1)NT2AC7aR, Mailing Address ] ? ,')-8 go Home Phone �/°l �- 53 S q C-74 m Es City/State/Zip ino ckS V L LIf C a 7 0 a g Business Phone 2. Name on Permit/ATC if Different than Above Mailing Address 3. Application For: [ ] Site Evaluation 4. System to Serve: [House 5. If Residence: # People City/State/Zip [ ] Improvement Permit & ATC ] Mobile Home [ ] Business [ ] Industry [ ] Other Both # Bedrooms 3 # Bathrooms [40ishwasher [ ] Garbage Disposal [^ashing Machine [ ] Basement/Plumbing ["j Basement/No Plumbing 6. If Business/Other: Specify type # People #Sinks # Commodes # Showers # Urinals # Water Coolers If Foodservice: # Seats Estimated Water Usage (gallons per day) 7. Type of water supply: [q"County/City [ ] Well [ ] Community 8. Do you anticipate additions or expansions of the facility this system is intended to serve? [ ] Yes [ice] -No If yes, what type? PROPERTY INFORMATION REQUIRED: *** IMPORTANT *** A PLAT OF THE PROPERTY MUST BE SUBMITTED WITH THIS APPLICATION. Property Dimensions: a' Qulklo WRITE DIRECTIONS (from Mocksville) TO PROPERTY: Tax Office PIN: #�V/ e - 4"�_ - V-4,2, & q W Es -r To SH ffFX E L 0 D Property Address: Road Name l a g -S � e // e I icLT(4 7-U R N PT C K T 00 5 H E FF.Z e--0 -11T City/Zip `7'nOC�IVII��' a76A CVr-LL GC 7-J4 le 5f8 11OU5E oN If in Subdivision provide information, as follows: GIfT Name: Section: 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 0 mr.5 A 4 rnaf-sKA G. Ataxntvvetz to DATE g °l SIGNATURES Revised DCHD (06-96) all testing procedures as necessary to determine the site suitability. y =i ��4- �p .�`M ? v \ �d�C •Lj (meg rM� VN V 2, •`. 9! . �) �`' Q 2, -OBS t b .LOQ)' j lri c, 2L4e LZ 8 S� V lQ 0" r K ati ` OVOI o 0OD N (. bZ}.o (� 10`I) " . ob G) ui �y C I , 99'LZt7 f368£ 0 6E ►) y S0.9V 5 "Eat' Lb(e-5 Q.�;�0t11�:9': toOD a8l'6L t, csi (S.;� 9'V �< cq 82 o/d 9 ob ao i•G'E c,- G S9 6'OL'u `�% 9S £ 9 _ oii Edµ 9E9� ;; 6'009 �s Ln ati 9 '0d 6'i I — Od6'1 I (L) ,n d (02) 842 OZ 66 Ln � �)d 1'6 _ V I.6 (o c to —,='5L' _ 9l 0�(g)`cn ( 4v 1 � c- 6 a£ vE 9 "` W COG �a,.., r ro �' 89 CZ9�- ( Q�E�6``00£ 9* T , •"'�tibi'I " . ObO)L n4,,O )Q iV, IV, r n�:. ` DAVIE COUNTY HEALTH DEPARTMENT Environmental Health Section Soil/Site Evaluation / / NAME y E"/ DATE EVALUATED el014 � ADDRESS tA [� PROPERTY SIZE A �� PROPOSED FACIILTY LOCATION OF SITE Water Supply: On -Site Well _ Community Public Evaluation By: Auger Boring Pit Cut E---' FACTORS 1 2 3 4 Landscape position .0il Slope % 2 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 SITE CLASSIFICATION:40EVALUATED BY: cicy l LONG-TERM ACCEPTANCE RATE: r y OTHER(S) PRESENT: REMARKS: LEGEND Landscape Position R -Ridge S7Shoulder 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- V ----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 Mineralotty 1:1, 2:1, Mixed Notes Ilorizon 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 ■��t��■�■��o��u��a��n . ��■�� ■ ��■■ ■��■��■��N��■�■�■��■��■��■��■n■��t ��■�� iiiiiiiiiiii�ir��■��■��■■■��■��■■■■�■��■�■��■�__��i��t��■�� ................C::::::C::.::::::::::::::::::::o:::=:::::�.. 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