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1542 Yadkinville RdAO DAVIE COUNTY HEALTH DEPARTMENT IMPROVEMENTS PERMIT AND CERTIFICATE OF COMPLETION •NOTE-: Issued in Compliance With Article II of G.S. Chapter 130a 154nitary Sewage Systems Permit Number 7 r c1 1 'Name. ' - 1,,�,..�i.s /Date`�� N2 7 I 0 Location �_/�_ � ut y�i��r ,✓� �_— Subdivision Name Lot No. Sec. or Block No. Lot Size��1f1� — House Mobile Home —__ Business -- Industry No. Bedrooms "� —.No. Baths —c -Z2 Z6 No. in Family — Public Assembly Other Garbage Disposal YES ❑ NO [r' Specifications for System: Auto Dish Washer YES p NO p /DO�c,-( u � ,� Auto Wash Ma -hive YES p NO [� „ Type Water Supply — *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 SYSTEM. I_ Improvements permit by *Contact a representative of the Davie County Health Department for final 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—E7.60 Final Installation Diagram: System Installed by —� I a [�Tertificate'shall L` toCertificate of Completion Date 'The signin indicate that the system described above has been installed in compliance with the standards set forth in the above regulation, but shall in NO way be taken as a guarantee that the system will function satisfactorily for any given period of time. APPLICATION FOR SITE EVALUATION/IMPROVEMENTS PERMIT Davie County Health Department� I 1IV! E 10 Environmental Health Section �'�` P. o. Box 665 FEB 2 81995 Mocksville, NC 27028 -_ ----------- 1. Application/Permit Requested By i- 1. Mailing Address /,-)Sl/ /V1 2. Name on Permit if Different than Above 3. Application for: 4. System to Serve: ❑ Business /7i& h S+. Ile, n/. 0.27 ❑ General Evaluation JX House ❑ Industry 5. If house, mobile home: Subdivision No. of People 2 No. of Bedrooms 3 eth -yr No. of Bathrooms-,/ Dwelling Dimensions 6 XJ�'S� Home Phone %W-e��JI- 7137 Business Phone q1,Q — ^112 - 1-1,5-22- 0 522 0 Septic Tank Installation Permit ❑ Mobile Home ❑ Place of Public Assembly ❑ Other ❑ Unknown 6. If business, industry, place of public assembly, other: Specify type No. of People Served No. of Commodes No. of Lavatories No. of Showers No. of Sinks No. of Urinals No. of Water Coolers Water Usage Figures 7. Type of water supply: ❑ Public X Private 8. Property Dimensions A49• 9l%adJW` Sewage Disposal Contractor Section Lot # fffi Basement/Plumbing ❑ Basement/No Plumbing IN Washing Machine IN Dishwasher ❑ Garbage Disposal 9. Do you anticipate additions/expansion of the facility this sytem is intended to serve? ❑ Yes (ffi No If yes, what type? ❑ 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: y 6M7CI14 17,14 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. z — -2 y - 9� DATE SIGNATURE CONSENT FOR SITE EVALUATION TO BE DONE ON ABOVE DESCRIBED PROPERTY MUST CHECK ONE: (9 1. 1 OWN the property. ❑ 2. 1 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�he D yie Con Health Department to enter upon above described property located in Davie County and owned by �C�GG��a to conduct all testing procedures as necessary to determine s id site's suitability for a ground absorption sewage treatment and disposal system. — 252g - 117 n DATE SIGNATURE DCHD (1/93) DAVIE COUNTY HEALTH DEPARTMENT Environmental Health Section Soil/Site Evaluation NAME 4 rl ADDRESS PROPOSED FACIILTY _� m ["' DATE EVALUATED PROPERTY SIZE LOCATION OF SITE Water Supply: On -Site Well _ Community Public Evaluation By: Auger Boring Pit Cut FACTORS 1 2 3 4 Landscape position y L Sloe % HORIZON I DEPTH Texture group Consistence Structure MineralogX 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: _ EVALUATED BY: LONG-TERM ACCEPTANCE RATE: OTHER(S) PRESENT: REMARKS: 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 <Aay 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 -Finn 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 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/ftz DCHD(01-901 ■.■■..■■■■■■.■■■M■...■EE■..■..E.■O■■..■■■■■■■■■■■■■■■■■■■■■■■■■■■O ..............................................■..... ............. ■■....■■■■■■...■■■■......■■■■■■■ ■■MOMEMEEM■■■■■■■■■■■■■■■■■■■■MEIN MUMMEMMEMMMUM ■■ MINUMMI MEN MEN NAMESMIEN MI MEN MEMNORMS ME ��■��MMUMMUM■MEM0 MEN mom NEON HE MEMMOSSIMME ■■■■..■■.■■.■■■■■.■■■.■.■■..■■.■ ■MOMME■■ ■■■OH■■■■■■MEMO■■■..■ MEN MUMMEME MEN ■■.■■■■■N■■EE■E■■.■EE■■..■■■..■■■■■■■..■.■■H■■■� ■ME■EM ■M■MM■ ■ ■■■■■■■■EEE■EE■■■■■■■■■■■■■..E.■■■■■■■■■■EE■■■■■� ■MIMMMOMMO■ .........................................�...... 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ME■MM ■■ ■.■mom■M■EE■M E■E■E■■■E■EE■E■■■ ■■■EE NEEE■EHEE■� ■MM■MEmommomrmOmnC■ENowNE■OMMEEO■E MEM■■■MMOE . ... EMROo■■H■■■ ■M■■■MMMMMMMMMMMMMM M■■■E=E.■MEN=■..MEECM■MEENEa ■ . .. ENEM=■HEMMEMM■ AMEMEMEMMOMME ........... ... ....... NONE MO..■..N....EER....■..■.....■■ .M..EEE■M..EME.EE.E.■..E.......■ ...............NE.EEE.E........■■....�■...........■...........■. .................................................................. ■■■■EEM■■E■EE■■■.EEEEEEOEEEE■EEE■■■■EEN■■■EE■■■■■■N■■■ME■■■■EE■■ ■■E■■■M■■M■■E■■EE■■EE■EEE■E=■■EEE■■■■■EE■■■■E■■■■■EEEE■EE■E■■EEE■■ N ON iiii _IMMMMM MMMMMMMMNM- m Parcel #: H400000013 Davie County, NC - Basic Estate Search Basic Search Real Estate Search Tax Bill Search Sales Search Tax Codes \Aw Property Record for this Parcel View Mao for this Parcel View Tax Bill Information 723 34 Parcel #: H400000013 Account #:82526525 Building: Owner Information Tax Codes 15,59 Land: FROST BETTY G REVOCABLE TRUST& FROST BETTY G TRUSTEE ADVLTAX - COUNTY T 723 34 ssessed: 1281 NORTH MAIN STREET FIREADVLTAX - FIRE TAX MOCKSVILLE NC 27028 Property Information Township nd (Units/Type): 19.710 AC MOCKSVILLE [Address: 1542 YADKINVILLE RD Deed Information Local tonin Pate: 06/2006 Book: 00664 Page: 0998 Plat Book: Page: Le al Description PIN _ 19.712 AC HWY 601 5739047217 Property Values Building: BXF: 15,59 Land: 707,75 Market: 723 34 ssessed: 723,34 Deferred: Sales Information Yo. Book Page Month Year Instrument Qual/UnQual Improved Price 00061 0666 11 1960 WD Unqualified Vacant 0 00664 0998 06 2006 QC Unqualified Improved 0 Page 1 of 1 vN.t� t nD U R" Davie County Web Site View Property Record for this Parcel View Map for this Parcel View Tax Bill Information « Return to Basic Search 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.daviecountyne.gov/itsnettView.aspx?prid=1477899 8/10/2016