139 St Matthews RdParcel #: J20000002901
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Parcel #:320000002901 Account #: 13978000
Owner Information
Building:
Tax Codes
BXF:
RTNER DENNIS C
Land:
ADVLTAX - COUNTY T
Market:
139 ST MATTHEWS ROAD
ssessed:
FIREADVLTAX -FIRE TAX
Deferred:
MOCKSVILLE NC 27028
Property Information
Township
nd (Units/Type): 9.460 AC
CALAHALN
[Address: 139 ST MATTHEWS RD
Deed Information
Local Zoning
ate: 04/1990 Book: 00153 Page: 0888
Plat Book: 0004 Page: 046
Legal Description
PIN
11.17 AC DAVIE ACADEMY RDTRACT 313
5707797009
Property Values
Building:
207,81CI
BXF:
15,30
Land:
69,03
Market:
292 14
ssessed:
243,10
Deferred:
4904
Sales Information
No. Book Page Month Year Instrument Qual/UnQual Improved Price
1 00153 0888 04 1990 WD Unqualified Improved 0
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O° u tz,
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=1479323 10/6/2016
AUTHORIZATION NO: 1945 DAVIE COUNTY HEALTH DEPARTMENT
Environmental Health Section PROPERTY INFORMATION
Permittees' �''1P.O. Box 848
Mocksville, NC 27028 Subdivision Name:
j f, y f; J Phone # 336-751-8760
Directions to property: �/'�' Section: Lot:
AUTHORIZATION FOR
WASTEWATER Tax Office PIN:# -f 1r 22'
SYSTEM CONSTRUCTION �� f
Road Name:..._)
**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 I I of G.S. Chapter 130A, Wastewater Systems, Section .1900 Sewage Treatment and Disposal Systems)
***NOTICE*** THIS AUTHORIZATION FOR WASTEWATER CONSTRUCTION
r i:, t_.-1 �• 1� '%"r'~ c f // IS VALID FOR A PERIOD OF FIVE YEARS.
ENVIRONMENTAL HEALTH SPECIALIST DATE ISSUED
.19 4 5 DAVIE V)NTY HEALTH DEPARTMENT.
IMPROEMUENT AND OPERATION PER11�I . , 'PROPERTY INFORMATION
Permittees *.. F j
Subdivision Name:
Name:'
Ditections to property:. `'-J 'f Section: Lot:
IMPROVEMENT
f f tPERMIT Tax Office PIN:#^' er&
Road Name:. cap: 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.
an compliance with Article 1 I of G.S. Chapter 130A, Wastewater Systems, Section .1900 Sewage Treatment and Disposal Systems)
***NOTICE*** THIS PERMIT IS SUBJECT TO REVOCATION IF SITE
PLANS OR THE INTENDED USE CHANGE. YOUR WASTEWATER
ENVIRONMENTAL HEALTH SPECIALIST DATE ISSUED SYSTEM CONTRACTOR MUST SEE THIS PERMIT BEFORE
INSTALLING THE SYSTEM.
RESIDENTIAL SPECIFICATION: BUILDING TYPE e:?14 # BEDROOMS_,? #BATHSC2. J_# OCCUPANTS p2 GARBAGE DISPOSAL: Yes or No
COMMERCIAL SPECIFICATION: FACILITY TYPE # PEOPLE # PEOPLE/SHIFT # SEATS I/NDUSTRIAL WASTE: Yes or No
LOT SIZE 1l- /7r TYPE WATER SUPPLY GC'r DESIGN WASTEWATER FLOW (GPD) ",�d NEW SITEy REPAIR SITE
SYSTEM SPECIFICATIONS: TANK SIZF,/�X-22' GAL. PUMP TANK GAL. TRENCH WIDTH ROCK DEPTH LINEAR FT. 100
OTHER
REQUIRED SITE MODIFICATIONS/CONDITIONS:
"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 (336)751-8760.
OPERATION PERMIT
SYSTEM INSTALLED BY: A
J?°
AUTHORIZATION NO. OPERATION PERMIT BY: /��R DATE: 7
*"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)
Arrul;Al1UN FOR SIIE EVAILUMION/IMPROVEMENT PERMIT & ATC
Davie County Health Department
EnviroamenfofHealtfi Sedan
• '`' P.O. Box 848/210 Hospital Street
Mocksville, NC 27028
(336)751-8760
u ct��oa
FEB - 31999
ENVIRONh1ENTAL HEALTH
DAVIE COUNTY
***IWCR2'ANT*** THIS APPLICATI03 CANNOT BE PROCESSED UNLESS ALL THE REQUIRED I
INFORMATION IS PROVIDED. Refer to the INFORMATION BULLETIN for instructions.
1. Name to be Billed
Av2-7/,i e►P--
,sailing Addressi1
city/State/zip �{ , M``D GL 5u i l e- NC 02 Z
Z. Name on Permit/ATC if Different than Above
Nailing Address
3. Application For:Sit Evaluation
4. system to Service: House ❑ Mobile Home
o . :f�s'�esicienae
B"Dishwasher
contact person
J N ►may A ��Ne_�e
Boma' phone
o -L
4 q oZ- I 1 ej
Business Phone
*715-1 — S3
City/State/zip
0 Improvement Permit/ATC 0 Both
0 Business 0 Indust
# People A # Bedrooms �
ry ❑_Other
# Bathrooms —77L
04arbage Disposal alv-; ping Machine 0 Basement/Plusbing 0 Basement/No Plumbing
6. if Business/industry/other: Specify type
# Commodes # Showers # Urinals
# People # Sinks
# Water Coolers
IF FOODSERVICE: (i Seats Estimated Nater Usage (gallons per day)
7. Type of water supply: 0 County/City wNell ❑ Community
s. no you anticipate additions or expansions of the facility this system Is Intended to serve! 0 Yes C9�T�o
If yes, what type!
***IMPORTANT***CLIENTS AIUSTCOMPLETETHE REQUIRED PROPERTY INFORMATION REQUESTED
BELOW. Either a PLAT or SITE PLAN MUST BESUBMITTED by the client with THIS APPLICATION.
Property Dimensions: I 1 • 1 '� �L WRITE I tRCTIONS (from Mocksville) to PROPERTY:
--� o — �t q —�a o , 04d4/T1 ' I —, �' �nr�Nev 15
Ta:Office PIN: # 1 � 4 Vy e S T- 10
Property Address: Road Name5T 11\A-'C•Vk6J'3S STo ce� o 1'J Le-F�-F o C Q 0 S I +e 4ul Cl b .
City/Zip AA0yL\3 % kje1")-c . oZ'102$1 Pr�: l -e S CI �2 0 oZ I a M1,
If in a Subdivision provide information, as follows:
Name:
Section: Block: Lot:
4- rnk.w s c ����,� . ����Se ► S
bels, oe.CNofc.�A . New hbose. kor,. i
r;e ib bektvO 0 us2
Date Property Flagged: A - *- '7q
This is to certify that the information provided is correct to the best or my knowledge. I understand that any permit(s)
issued hereafter are subject to suspension or revocation, if the site plans or intended use change, or if the information
submitted In this application Is falsified or changed. I, also, understand that I am r+esponsiblefor all charges Incurred from
this application. 1, hereby, give consent to the Authorized Representative of the Davie County Health Department
to eater upon above described property located in Davie County and owned b. � Al CLQ" V -
le conduct all testing procedures as necessary to determine the site suitability. n
J
DATE CZ aC� SIGNATURE QAtw, a
,max USED WOR DRAWING YOUR SITE PLAN (Include all of the following: Existing and proposed
property lines and dimensions, structures, setbacks, and septic locations).
Revised DCHD (07/98)
Acc at No. %d
In ce a
10 7.4 2 Ac t -
Ila / 64.2 A
j (.
Ea
°�' , 10
12Ac. est _2 S.R21C
�h
N. 2
Q ? �o i 5 A;, a LO r
cc m 5� "
q� �/ s ,S 33.0'L LO
11.eA
208.5.5 X4.0 ��2 ° � =� � � -.
s 27 �"�,
` uR o P .' N N
X15 0
`"!2q Q w 9.36 Ac • '` 8.17AC 0 3. 2
3 IX -
- 01
- C 5
I.
14.41 h {
.e co 5
to - I �, 1.5A. �n c
2.77PF 4. AC N' µ' k' 3 Am. 9 314 82 z + 9.3 a 2�T5 —AC �
"v' ..V4
1 LO _ 26 �� 2 26
217 \ 277 32 50Q� `� �3AC!n. d29ak� 3 — —pAVIE AC DE !$ �17cn°� 26c, 0,;
6
AC 290.24 MY
- 3.9 �1. r1N �-25
3- �2ov `� X10 �52� � 9.8
33 -2,62.
>c
51 33. i
13 A c . �� �` �. OI � O /
— -. 6.23AoC j a
–I
ro
rna �y.tf7 c>
. � `= + 0 382.66 183.
32 40
Q
4.51 Ac v // to
17 A
tiry
^
NN N QFC
11.45 55.03
3 2 tih�
174 vvg
55.02
3A51. 45
1
74 A� .01_
of'�
i
_.
438.0} 15AC :" h 415A7
0 O1 0 ��—
A�• 2 , I
,
APPLICANT'S NAME
PROPOSED FACILITY
FACILITY
SUBDIVISION
Water Supply:
Evaluation By:
DAVIE COUNTY HEALTH DEPARTMENT
Environmental Health Section SECTION
Soil/Site Evaluation
On -Site Well ✓ Community
Auger Boringy Pity/
LOT
DATE EVALUATED
PROPERTY SIZE
ROAD NAME
Public
Cut
FACTORS 1 2 3 4 5 6 7
Landscape position
Slope %
HORIZON I DEPTH
Texture group
Consistence
Structure
Mineralogy
HORIZON II DEPTH
Texture group C
Consistence i
Structure �( b
Mineralogy
HORIZON III DEPTH
Texture group
Consistence
Structure
Mineralogy
HORIZON IV DEPTH
Texture group
Consistence
Structure
Mineralogy
SOIL WETNESS
RESTRICTIVE HORIZON
SAPROLITE
CLASSIFICATION Tt
LONG-TERM ACCEPTANCE RATE
SITE CLASSIFICATION:/
LONG-TERM ACCEPTANCE RATE:
REMARKS:
LEGEND
DCHD (01-90)
Landscape Position
EVALUATION BY:
OTHER(S) PRESENT:
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
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