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141 Sunburst Lane Lot 1Davie County, NC t Tax Parcel Report 1661A Monday, October 3, 201 c WARNING: THIS IS NOT A SURVEY y„Parcel Information, Parcel Number: M40000002401 Township: Jerusalem NCPIN Number: 5735384450 Municipality: Account Number: 82526163 Census Tract: 37059-807 Listed Owner 1: PRICE ANGELA QUEEN Voting Precinct: COOLEEMEE Mailing Address 1: 141 SUNBURST LANE Planning Jurisdiction: Davie County City: MOCKSVILLE Zoning Class: DAVIE COUNTY R -A State: NC Zoning Overlay: DAVIE COUNTY CZOD Zip Code: 27028-0000 Voluntary Ag. District: No Legal Description: PARCEL 1 SUNBURST DOWNS Fire Response District: COOLEEMEE Assessed Acreage: 5.31 Elementary School Zone: COOLEEMEE Deed Date: 4/2005 Middle School Zone: SOUTH DAVIE Deed Book / Page: 006010880 Soil Types: RnC,GnB2,PcC2,GnC2,CeB2 Plat Book: 0007 Flood Zone: Plat Page: 164 Watershed Overlay: DAVIE COUNTY Building Value: 60380.00 Outbuilding & Extra 150.00 Freatures Value: Land Value: 30080.00 Total Market Value: 90610.00 Total Assessed Value: 90610.00 t,vt Davie County, 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 �O NC County of Davie, North Carolina, Its agents, consultants, contractors or employees from any and all claims or causes of action due to the Inability to the GIS data by this fl r7'�A or arising out of use or use provided website. Davie County Health Department is36Environmental Health Section P.O. Box 848` �210 Hospital Street r} Courier # : 09-40-06 U Mocksville, NC 27028 Phone: (336) - 753 - 6780 Fax: (336) - 753-1680 ON-SITE WASTEWATER CERTIFICATION (Check One) Replacement Remodeling Reconnection Name: �1��%� �l �� C� _Phone Number 7(,W-) 7 d7,,1 VV0 (Home) Mailing Address: Yl �(Wlf fig'- (Work) 1 d 645 (1/ /%9 & C 27dN" Email Address: Detailed Directions To Property Address: �3/w/ 7� >a - Please Fill In The Following Informjjation About The EXISTING Facility: Name System Installed Under: {'l %i N010 � ,5�6� � tp nd Type Of Facility: /V� 6%S611 Date System Installed (Month/Date/Year): / q ! q Number Of Bedrooms: 3 Number Of People: Is The Facility Currently Vacant? YesNo If Yes, For How Long? Any Known Problems? Yes oNoIf Yes, Explain: Please Fill In The Following Information About The NEW Facility: /� Type Of Facility: '!A fae � G(! �(i1J Al 30)(50 Number Of Bedrooms/'C� Number of People--(9— Pool eoplePool Size: Garage Size: Other: Requested B . f Date Requested: Approved isapproved Environmental Health For Environmental Health Office Use Only ' r *The signing of this form by the Environmenta eaI ay intended, nor should be taken as a guarantee (extended or limited) that the on-site wastewater system will function properly for any given period of time. Payment: Cash Check Money Order # Amount:$ Date: Paid By: Received By: Account #: Invoice #: J• 0 an� Soo �� ,: 7.5. .:.. ,. � ...'t v"` ' � t Y tw t ••-'�' 4;�-.-. mss« « a . { .., .;moi � - - _ <.... . , ... . ,..... a i .. , AUTHORIZATION NO 1 - Q 7A DAVIE COUNTY HEALTH DEPARTMENT Environmental Health Section PROPERTY INFORMATION Permittee' i (� P.O. Box 848 Name: [ILA.-Trk-i !-1ra�c f Y Mocksville, NC 27028 Subdivision Name: SL4 a -s �pwh3 Phone # 336-751-8760 Directions to property.. =S(n:C`� �T G Section: Lot: AUTHORIZATION FOR y ?i a�Cf� ,�J'GrI" "''> 1, �- n`� WASTEWATER Tax Office PIN:#�7%? 1(2 L�2� SYSTEM CONSTRUCTION ` — (�.l CY'-c'•n- ��cCCrLK vltt�rl{{i1u_t c .) l,t, Road Name�3f�it3��� Zip: **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 1pf G.S. Chapter 130A, Wastewater Systems, Section .1900 Sewage Treatment and Disposal Systems) 77 ***NOTICE*** THIS AUTHORIZATION FOR WASTEWATER CONSTRUCTION fes~ IS VALID FOR A PERIOD OF FIVE YEARS. ENVIRONMEN-TAL HEALTH SPEC ISt DATt ISS ED ;rd 571 3' R j0 7A DAVIE COUNTY HEALTH DEPARTMENT 1. IMPROVEMENT AND OPERATION PERMITS PROPERTY INFORMATION Permlttee`s ', 1 y. 1 r ` . r.. 1' Subdivision Name: Su I u rs ►i Dpw I Directions to property: Section:!- Lot: IMPROVEMENT PERMIT Tax6ffice PIN:# 1 - 1 lt/ti.i,:( 4.. +_ (.'( �.�.. Road Name f Zip: d **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 r t ; • "'a 1 c; 9 PLANS OR THE INTENDED USE CHANGE. YOUR WASTEWATER ENVIRONMENTAL HEALTH SPECIALIST DATE ISS ED SYSTEM CONTRACTOR MUST SEE THIS PERMIT BEFORE INSTALLING THE SYSTEM. RESIDENTIAL SPECIFICATION: BUILDING TYPE M 1- # BEDROOMS # BATHS # OCCUPANTS GARBAGE DISPOSAL: Yes o(No COMMERCIAL SPECIFICATION: FACILITY TYPE # PEOPLE—# PEOPLE/SHIFT # SEATS INDUSTRIAL WASTE: Yes or No �. :,c_ LOT SIZE TYPE WATER SUPPLY L ( DESIGN WASTEWATER FLOW (GPD) `' a t NEW SITE ✓REPAIR SITE .! ?� r SYSTEM SPECIFICATIONS: TANK SIZE i�Y)GAL. PUMP TANK GAL. TRENCH WIDTH,,+ ROCK DEPTH LINEAR FT. OTHER REQUIRED SITE MODIFICATIONS/CONDITIONS: ° `�� t �u. U C- �` `�� U J� Y— �-� n `-- �` +^ s• 11�-i W;rLL., IMPROVEMENT PERMIT LAYOUT r�ppR[I4'CD EFFL mT FILYir - emrsEms) IF G' ` I1mu-.i FI1}ISii :i} Giy.' DIEk Ipso 5 -5 d N r1 "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 t7U4)fW1E26(U tea}�51–FIi6'.l OPERATION PERMIT ')a 1 �r SYSTEM INSTALLED BY: SP� L W' 1,- 1+ ek-Z,4T 1-297 AUTHORIZATION NO.15e6 A, OPERATION PERMIT BY: DATE: v "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) i APPLICATION FOR Davie County Health Department � PERMIT & ATC r Environmental Health Section P.O. Box 848/210 Hospital Street Mocksville, NC 27028 (336)7;1-876OENVIRONMENTAL HEALTH DAVIE COUNTY ***XWORTANT*** THIS APPLICATION CANNOT BE PROCESSED UNLESS ALL THE REQUIRED INFORMATION IS PROVIDED. Refer to the INFORMATION BULLETIN for instructions. 1. Name to be Billed Tj��Q �Z�%i2y��( `��/+ W� �(�lC/1�� Contact Person Hailin j Address 1 O ' r` ' 1 -3 Z /\ ' / Home Phone Cit_: /State/ZIP �O U Q,.OU - C a%v 14 Business Phone 2. Names on Permit/ASC if Different than Above Yr.:.ling Address City/State/Zip 3. ,;application For: U Site Evaluation ❑ Improvement Permit/ATC 0 Both 4. System to Service: ❑ House Mobile ,, Home ❑ Business ❑ Industry ❑ Other S. If Residence: # People # Bedrooms -! # Bathrooms V/ Dishwasher 0 Garbage Disposal if washing !machine 0 Basement/Plumbing 0 Basement/No Plumbing 6. If Business/Industry/Other: Specify type # People # Sinks #'Commodes # Showers # Urinals # Rater Coolers IF FOODSERVI-">E # Seats 7. Type of Water supply: Estimated Water Usage (gallons per day) ❑ County/City 0 well 3. Do yo6.1 anticipate additions or expansions of the facility this system is intended to serve? If yes, what type? 0 Cou comity ❑ Yes 00 ***1MPDRTANT***CLIENTS MUST COMPLETE THE REQUIRED PROPERTY INFORMATION REQUESTED I BELOW. Either a PLAT or SITE PLAN �IIUST BESUBAIITTED by the client with THIS APPLICATION. rams n:Propety Dimensions: ?'� Tax Office PIN: # al 3S :� b QA -7 •DD lop rn12p 4-M y _ Property Address: Road Name ;7 � ErL 4U City/Zip If in a Subdivision provide information, as follows: Name: -ri act Section: Block: IZ6. WRITE DIRECTIONS (from Mocksville) to PROPERTY: Date Property Flagged: 3 �-'2 r 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 r on ' le for all charges incurred from this application. I, hereby, give consent to the Authorized Representative of the e ounty flealth rime to enter upon above described properly/ located in Davie County and owned by ,� to conduct all testing procedures as necessary to determine the site sui lity. _ DATE -S' 2Z- / % SIGNATURE THIS AREA MAY BE USED FOR DRAWING YOUR SITE PLAN (Inc`i t>i�e all of the following: Existing and proposed property lines and dimensions, structures, setbacks, and septic locations). Account No. bd 3 Revised DCHD (07/98) Invoice No. 6516 . , ' ` i �."=..Y'.'� �! �'"!,'.'.i�4Z ��1.. '� .:4. . ' I �..---__-_ 1�/-� 1/,'� ^ �'-`-- _ _ � .._. , E . - � ,..,_ _ :=1 c � :, - .��. . -� ., :�� ; �-,� � ► �� �� i�t �f ��; : . r' i�� •� 1.;;:; �,; %�i � � , , . .—�-� I '1 � f ` �; � �_ � — � / I I���r. I '� . � (� �. ' � . . � ; ; � , �� - � �` , � , :ac � . � � � -,�;F�- r. �, � � i c t � j 'r`��V'�x) f 31 ,' -;�4 � ,v' -�C/�, , . F � � � � . .?� %Z •� '` I j � .` -= �{Z � , '� ;i �� '� .� ;• �a �-; �� . ----- I" � �- � c , �; , _, /�- ' � � ' �� : � -, ;, � ----_ _ ,. ; l��p L�� ', . C � � i `" � � ;,,�i,� � s � , i ,� � . ,� . . i , ; ��,�; ���- � � � i C,r i � --- --'���U_.. ' ; u�,� - . i . ; � �. ;. . . ..'; .� �,�:'. i��ti�t�t� �nf��c:-�'_�i�r�� f i ��I�'�'���MP� .. - -- - _.,�' � , D. B . 156 PG. 9 I 9 � ! ' � , ,. j � 'b � . ; � rIU �- ` . ' :� i n, : � ._� e� r`; s��l � fd� �1 I � � r '„ _ � ��� f� �� �-i � :_._._ _ , : M ' � . ��, 6 E� ,._.� t. � J��; ; , �. o �z ` l � ;� IRON Fq % � ' � � ! ' y . . � CURVE DATA ' R = 2691.63' ��� ; T = 400.00' ; - ' '�,�;;�, ��;5 L = 794.19' . � - 6. 0= 16•54'20.. �' ' , \o � , i \`� ���CyO� � .y . i`� � /� j , �i ' � �\�?9 � ;�C , �' �` �\�• 3/ Z.I6 ACRES+ � IRON FOUND � � � _ �� ' � �. . ',� �/ � -_ . 3 .� . � ,� � �� N . „�3� �� � � d, S� Rq��Ro �36" f ; • O \ A�Ri�.`', �. 8 66� i . � N �, �,09, M o� M �/ �, �. � 1- D � � . �, \' IRON F��N� ` � \, �� � S o I '2i F/Q `• IRON PLACED � � ro �� cei \ v� ��� � S OS° 4 I ' 21 �_ __� � � � � � \ � \ � � � � t APPLICANT'S NAME PROPOSED FACILITY SUBDIVISION DAVIE COUNTY HEALTH DEPARTMENT Environmental Health Section SECTION LOT Soil/Site Evaluation DATE EVALUATED PROPERTY SIZE ROAD NAME Water Supply: On -Site Well Community Public Evaluation By: Auger Boring Pit Cut_ FACTORS 1 2 3 4 5 6 7 Landscape position Slope % o -2370 HORIZON I DEPTH eq —to Texture group 6� Consistence Structure Mineralogy HORIZON II DEPTH Texture group Consistence Structure Mineralogy/ ' 1 HORIZON III DEPTH Texture group _ X Consistence Structure G G Mineralogy HORIZON IV DEPTH Texture group Consistence Structure Mineralogy SOIL WETNESS RESTRICTIVE HORIZON SAPROLITE CLASSIFICATION LONG-TERM ACCEPTANCE RATE I tv V . SITE CLASSIFICATION: LONG-TERM ACCEPTANCE RATE: REMARKS: DCHD (01-90) EVALUATION BY: 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 Mineraloev 1:1, 2:1, Mixed Notes x, 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 ■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■ ■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■ ■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■ ■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■ ■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■ ■■■■■■■■■■■■■■■■■■■■■■■■■■■■ ■■■■■■■■■■■ ■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■ ■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■ ■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■ ■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■ ■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■ ■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■ ■■■■■■■■■■■■■■■■■■■■■■■■■■■■ ■■■■■■■■■■■ ■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■ ■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■ ■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■ ■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■ ■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■ ■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■ ■■■■■■■■■■■■■■■■■■■Ir■ma■■■■ori■■■■■■■■u,rn�rl ■■■■■■■■■■■■■■■■■■■■■■■■■Nil ■■■■■■■■■■■■■■■■■■■■■■■aid■■I ■OMMME■■■■E■M■■ME■ ■■■■ME■■E■E■EM■■E■ ■■M■EM■■EMMM■■E■E■ ■E■E■EMMEMEM■■E■M■ ■■■■E■E■■M■M■■ME■■ ■■M■■M■■EM■■■E■E■■ ■EME■■■MEMMM■M■E■■ ■EM■■MEM■■E■■MEME■ ■E■■E■■■M■E■E■E■E■ ■E■EMM■■M■■M■■E■■■ ■■■E■E■■■■■EMMEM■■ ■ ■ 0 ■ Rim Kim ■■■EME■ ■■■■M■■ ■O■■■■■ ■m■■mm■ ■EM■ME■ ■■■m■■■ ■NEEM■■ Monsoon Monsoon Monsoon ■■n■■■■ ■■■EEM■ ■M■M■M■ ■■■m■■■ ■E■■M■■ ■■m■■■■ ■EEE■■■ ■■■■■■■ ■■M■■■■ ■E■E■M■ ■■■■E■■ ■■M■■E■ 7 ■E■■EM■■■M■■ME■■ ■E■■E■■■■M■■■EM■ ■MMM■■■■MEM■■MME ■■■E■EME■■MEM■E■ ■M■E■■MEM■■■M■■■ ■M■EM■MEMM■■ME■■ ■E■■E■■MM■■■■MM■ ■E■■M■■■■ME■■■E■ ■E■■E■■■■■■■■■E■ ■■■■■■■■■■■■■■■■ ■■E■■■■■■m.■■■■■ ■■■■.N■■■■■E■■■■ ■■■■■■■■■■■■E■■■ ■E■M■■MEM■■■ME■■ ■E■■M■MME■■■■ME■ ■EM■■■EMEM■■MME■ ■.■■■■■..■■■■■■. ■■■■■■■■■■■■.NE■ ■M■■M■■E■ME■■■E■ ■■E■E■■M■■M■■■■■ ■■E■■EME■■■M■■■■ ■■OMMEM■MOMME■■■ ■M■E■■MME■■EME■■ ■E■E■■■■EM■■ME■■ MEMO MEMO NONE ■M■■ ■■E■