190 Tall Timbers DrDavie Countv. NC
0
Tax ParrPl R Pnnrt
Tuesdav. October 11. 2016
WAK1VllV(i: "1'Hl� 1, 1VU'1' A JUKVr:Y
Parcel Information
Parcel Number: F200000030 Township:
NCPIN Number: 5811117340 Municipality:
Account Number: 82531979 Census Tract:
Listed Owner 1: BAILEY JASON DAVID Voting Precinct:
Mailing Address 1: 190 TALL TIMBERS DRIVE Planning Jurisdiction:
City: MOCKSVILLE 2oning Ciass:
State: NC Zoning Overlay:
2ip Code: 2702&0000 Voluntary Ag. District:
Legal Description: 2.54 AC TALL TIMBERS DR Fire Response District:
Assessed Acreage: 2.53 Elementary School Zone:
Deed Date: 5/2010 Middle School Zone:
Deed Book / Page: 008270428 Soil Types:
Plat Book: Flood Zone:
Plat Page: Watershed Overlay:
Building Value:
Land Value:
Totai Assessed Value:
9"�'�' Davie County,
`'°vN�c� NC
57620.00 Outbuilding & Extra
Freatures Value:
28390.00 Total Market Value:
100400.00
Clarksville
3705�801
CLARKSVILLE
Davie County
DAVIE COUNTY R-A
SHEFFIELD - CALAHALN
WILLIAM R DAVIE
NORTH DAVIE
Mn62
DAVIE COUNTY
14390.00
100400.00
No
,. ,,�.r
- �
- , ..;- - �iX�
,,
"fi �`�"��� - ' DAVIE COUNTY HEALTH DEPARTMENT ��'�� ��
� � .�-� .....: .r ;. •
"' IMPROVEMENTS PERMIT AND CERTIFICATE OF COMPLETION
! �
•NOTE: Issued in Compliance With Article II of G.S. Chapter 130a /�0 �Q�� rifylbC$��
Sanitary Sewage Systems � Permit Nurr�ber
Name ��� ��.� - �` � -. �1� � ���_' _ � Date � � _ 1 � N� U � � �
, ._ . . . .. . ,
�
-_, �.._. �— � _
r
Location .. � t �._, ,.� c = .: ,.,�, � ; � �,... ; � `y �`. �, ,�,_ `�.> '' 7 ta �
- - _ .%
i �, � _ � ._. i —. � � �, ` --� i � `,� �' - .
� 1 �'_, Y"� r.C� ♦ _�!._��.� � � t��. � � � � . 1', - ��.,.�
. ._ , . � i�
—
�� ~ `-- � . {� -�-•-._ � _ , , . _ � t . � .
, ti:.. � '. ^, �'^ �C. ..�}. �,�;'.i � S .. �.:�-.: .1.' �' �^ .,d , � �,. � ty..'V..�,. : :A' _,�_T .: , . :�
. � i�y". ,.-i�r 'c:..
; " .' \
Subdivision Name Lot No.� Sec. or Block No.
Lot Size ``% �* '_.'�-'�1�_ House _ Mobile Home _�_ 8usiness __ Industry
No. Bedrooms `�" 3�No. Baths _�� _ No. in Family J.T Public Assembly Other
Garbage Disposal YES p NO �}/
Auto Dish Washer. YES p NO [�]`� Specificat�ons for System � 1
J= - `
r�;t� �; , ;�::3* � -�-i�i'
Auto Wash Ma^hine`� � YES p�' NO Q - � ' Y »�
iype Water Supply ---- `�_1 `4�.�., _._.�----- ����% .,� �a �` �� \f\ 1 4
'This permit Void if sewage system described below is not installed within 5 years from date of issue.
This permit is subject to revocation if site plans or the intended use change
�
�-ATTENTION: YOUR SEPTIC SYSTEM CONTRACTOR MUST SEE THIS PERMIT/LAYOUT BEFORE INSTALLING THIS � b��N�.
SYSTEM, -
�' � U.�^� < �-�� i� I �,- ,
�
�
9
�'"��� �' „
/��`�,� o�� 3�,�2
yo �
_ . � �, —,—____--
. . ; . . .. l,,s�
� `'` Improvements permit by ~_-___'_ - ''ti`�-
'Contact a representative of the Davie Counry Heaith Department for (inal inspection of this system between 8:30-9:30 A.M.,
1:00-1:30 P.M. or 4:30•5:00 P.M. on day of completion. Telephone Number: 704-634-5985.
Final Installation Diagram: System Installed by _�-�'���'����'� �-, �-��-��`-
,�, �
flt�
7
��r
'The signing of this certificate
the standards set forth in the a
satisfactorily for any given peri
��
.
�}
�
� �
a 2 G:
'7 " U' 2
L' � � � � ((��
i � �. \� �—�
� �� , C�__*-_�.� '� _ � •
1..� � Certifica�t� of Co pletion _ .__ Date � � r� _
311 ind cate that�the sys em described above has been installed in compliance with
ie reg lation, b�t shall i! NO way be taken as a guarantee that the system will function
of tim .
0
•' APPLICATION FOR SITE EVALUATION/IMPROVEMENTS PERMIT
Davie County Health Department
Environmental Health Section
' P. O. Box 665 � �
Mocksvilie, NC 27028
��C,�: �' � � � f
J
�
1. Appiication/Permit Requested By
Mailing Address ���� �rAr1��`��� -�� + Ho e Phone�%d� �'�'I�'���
���/'� `f � � , e �'�%tj � � Business Phone � �'� �.2,� �
2. Name on Permit if Different than Above
3. Application for: ❑ General Evaluation KdSeptic Tank Installation Permit
4. System to Serve: ❑ House
p Business ❑ Industry
5. If house, mobile home: Subdivision
�" Mobile Home ❑ Place of Public Assembly
❑ Other ❑ Unknown
No. of People �
No. of Bedrooms �
No. of Bathrooms �
Dwelling Dimensions � � X �Q
6. If business, industry, place of public assembly, other: Specify type
No. of People Served
No. of Commodes
No. of Sinks
No. of Urinals
Section Lot #
❑ BasemenUPlumbing
❑ BasemenUNo Plumbing
LN" v�lashing Machine
❑ Dishwasher
❑ Garbage Disposal
No. of Lavatories No. of Water Coolers
No. of Showers Water Usage Figures
7. Type of water supply: ❑ Public Cyl Private
8. Property Dimensions � dC f�� Sewage Disposal Contractor
9. Do you anticipate additions/expansion of the facility this sytem is intended to serve? ❑ Yes
If yes, what type?
fI. •
❑ 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:
� e. Sc' �' i-� � Q� t' �' `( C-� `� �'L � �cl �
��.l��e Y� '
rta k�
�C� �<
L �--�
Y�- L-e_-�-�
�r ��c�� C��f ��'�`�,
L � �.�proJO.. ��.
,Q .�. 0 r
� ,� -�� � � � � r.b�� ��' � \
�; ���- c���-e� 1"� bu bl� �1, �Le,
This is to certify that the information provided is correct to the best of my knowledge, and I understand I am responsible for all charges
incurred from this application. y
L� - S '" �i � � c,��?, c�Lodri
DATE SIGNATURE
CONSENT FOR SITE EVALI�,ATION TO BE DONE ON ABOVE DESCRIBED PFiOPERTY
MUST CHECK ONE: i�r 1 I OWN the property. O 2. I 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's suitabiliry for a ground absorption sewage treatment
and disposal system. ,
� - s�� ��.` �Q� � �����
DATE SIGNATURE
DCHD (1 J93)
�
� � ' , � DAVIE COUNTY HEALTH DEPARTMENT
' ' Environnlental Health Section
Soil/Site Evaluation
NAME \ . �t� �.��� � ���%'"� YJ�ti��t�-a� DATE EVALUATED � _� � r—
ADDRESS s F' �p PROPERTY SIZE 7, o..cs��D
PROPOSED FACIILTY �' �� ��� LOCATION OF SITE � 4� ��
— 1
Water Supply: On-Site Well _ Community Public
Evaluation ByC� AugerBoring Pit Cut
FACTORS
Landscape position
Slope %
HORZZON I DEPTH
Texture group
Consistence
Structure
Mineralogy
HORIZON II DEPTH
Texture group
Consistence
Structure
MineraloAy
HORIZON III DEPTH
Texture group
Consistence
Structure
Mineralogy
HORIZON IV DEPTH
Texture group
Consistence
Structure
MineraloRy
SOIL WETNESS
RESTRICTIVE HORIZON
SAPROLITE
CLASS.LFICATION
LOyG-TERM ACCEPTANCE RATE
1 2 3
_�_ L
v ' � ij'b _�s
�• ��f ti ,,•
<.
� C. L S C L. C L
�t�����
���
�'� ��E�
Q��'��
5���
��
��
SITE CLASSIFICATION: �• �
LDNG-TERM ACCE(P�T�AN��C�E� RATE: �
REMARKS: �� �'"""\ �o�� r- _
DCHD(01-901
�
a
v
nJ_�U
�
SC�
�_L
e �.
l:l
�
�.
�T
�
l:l
s � � � �
EVALUATED BY: � , ��
OTHER(S) PRESENT� U 0� �a
LEGEND
Landscape Position
R-Ridge S-Shoulder L-Linear slope FS-Foot slope N-Nose slope
CC-Concave slope CV-Convex slope T-Tenace FP-Flood plain H-Head slope
Texture
S-Sand LS-Loamy sand SL-Sandy loam L-Loam SI-Silt
SICL-Si1tY �: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-Ficm 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
,iG•S7nkle grain M-Massive CR-Crumb GR-Cranular ABK-Mgular blocky
SBK-Subangular blocky PL-Platy PR-Prismatic
Mineralagy
1:1, 2:1, Mixed
Notes
I{orizon depth - In inches
Depth of fill - In inches
Restrictive horizon - Thickness and inches from land surface
Saprolite - S(suitable), U(unsuitable)
Soil w etness - Inches from land surface to free wate►' or inches from land surface to soil colors
with chroma 2 or less
Classification - S(suitable), PS(provisionally suitable), U(unsuitable)
LTAR - Long-te�m acceptance rate - gal/day/ft2
■��u�������������■�■�u��������n�n . ���m���� ■ ����■����■��■
���■��������■���■������N�■��Y���\�■����������ni�n��■�■�_���■ �� ����������M�■
������������������������N�����■���������������������������� ��� �����������������
................C.........■...........■............_.....■ . _ .�■ ..�..■.... ..
..............................■....■........... . .. ... _. C. ■ . ■_.........._..
'C::::::::::::::::5:::::::::::�::::... ::C::.=_.■'�::_.��: '.._ :�:�:::'::::::::
�������������■��■��■ ��������u�i�u��ii� uu�=uN� �� ��� ��n�i���=■�������
■■������������ ��n��i�u������������ �����i��■�o����� ■�� �� ■ �� ■�� �� ���■���
���■����������������■����.�����■���i��■�����■��� _�_� ■� �� i■�=N�■iii=iiiiiii
���������■�������.���������■��� ���■ ��u �■
���n�/��������G%�/��t�7% ■�Nt����/��1� �� � �����■���������
�������H���N�i������I.i�i/��:��t v� ,/. �� � � ■ ■ ■��■ ■���■
���������Hn��:��■�■�lC�!il��!���/1 ���� �\ � ����■�������■
■■�■■��■�■��■��u����H���uiiu����i�_ �. � ■ ■ ■ �� �����■���■
u���������N���N��MU�1��1'�:�iC��.�/�: � �������■■
�■�������■�■���n/l�u� \/'�i=�J��::�u� ���■�����
���■���n����������n����!!' ���1N:�'j/� ■�������I
���■����������n��������i��� __���■ �\�� ■ ■ . ■ ���������1
��/■���■�������H■����� �N��� ��%�!►\� ■ ����������1
�����u�����������■ ��������l���I/S\ i:�/.►��\�� H����/�������
■�//��■ ��������■����NI��[� ���I��\�;I,.,�iJ�,� ■�������■u
�������■■��������������1���:'����I����CV�/�?/�1 �. �������������
���/I�� �����nu► .�►�1 1 ����/��■� ■
■■i����������������� �I�■ :���/��������\����_ .� ■ ■ ������/�■
�����������������������1���9�������\ ���1� ■ /�������� ��
�1�■������■���/�■����L- �I���������r�■�����\1�� ■ h ■ ■_ ���� ..����������—• e�'/
. .s�.. �� �'�■ y%
� �������������������������0 �����1������ �������� �������_ ����u��������������� •
■C�������■ ■������������i����=■����u����-:�-� . ��n�� ��������■
■��������■_�■������■��������■��■�i.�i r��►���i�� ii�i�i�i i����■������ _��������■
ii�i iiiiiii�iiiiii iiiiiii i�ii�iiiii���"�i��iiiiiiiiii������i�cw►iin�e�iiiiii�i �
■����������■�����■�������ii:��I�����������N������■ ���� ��I�[��i�17�1�L��■�J��.:����■■�■�
■������������������������������/����/������/���� ���������/� �������il��►`���1������/�
■�����������■��������������■�■���������■�����N■���■��� ��n ■ ��������������������■ •
■���������i�■�������■��������������������■������ ■N����N �������■■���������■��■
■�■�����■�������■������������/��s��■���■��/■� ������������■������������������f■��/_
■�������■■��■������i����■����/�C'�������� ��uw��!■■..====��==..�:■����::��=C��::i��■
■�����������������������������ir���i�■����� i=���i�iiii�����i�u��������u������������
■������������������������� I%!11NI���I/������ ��� ■ ■������ ����■����������������■
�������������������������� ��i������� �������� �������� �������������������������������
���■�������������■��������������■�������������■ ��■ ■���■��� �������� ��/����������/
..................................■............=■.■=C.�.■.■..�........_...■.........�
..........................■.......■........■..■...■._■ ....._.....■..................�
......................................■... ...■..._. ���■■■. ■■.■.■_........�........�
.................................... ..... ..■.■. .. ..■._.....■ ..■..... ........�
......................................■... ..■... . .... . .■.■.■.......■ . .......
.................................... ............ =.5�... �................C.�.......
............................................... �... ... . ........ ...........
..............................�...............___._.�.... .�........ _�:...........
.............................. ............... . . . ..... ........... .. .. ..... ..
................................................�.�..................� ..�.�.....�..
.................................... ....... ..... .................. ... ..........
..........................................�..........................■..............
.......................... ... ........... .............. ....... .. .........
..........................C...............■......�....■..■ �'�..■...■ �........
..............................■.._..�............ ........ ._.■........ ...■......
................................. .. .............■....... . .■...■�... ..■....■.....
■���■���■����������■����������������n�■��������������������������� ■■�����■�����N�■
■������■��������\�����������■��������■■������■�■■ ■�■��■���■�u��■�������■����������■
■���������������������������������� ���������������������������������N�����/��������
■����������■�■��■������■�����■��■��������������■������������������■������ ■������<H
■������■ ■�������������■�����������■ ■���■ ■�������������������■������� ■ ■■��■�!N