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578 Yadkin Valley Rd w � OPERA?ION WERMIT or �ce se nv �..u.`T� Davie Counfy Heaith Department *GOP File Number 123762-1 y r•a� ?' ; 210 Hospital Stree# ca-otiaoo-ao�-2� � P.O. Box$4$ County ID Number. ��''=��'� Mocksville NC 27028 Evaluated Far: NEW Phone: 336•753•6784 Fax: 336-753-1680 Township: App��cant. Mark C and jodi Wiley Property owner: Mark �and jodi Wiley Address: 578 Yadkin Valley Road Address: 578 Yadkin Valley Road GdY� Advance ��v� Advance State2ip: NC 27006 State2ip: NC 2700� Phone#: (336)940-2341 Phone#: (336) 940•23A1 Pro ert Location & Site tnformation Address/Road #: Subdivision: Phase: Lot: 578 Yadkin Valley Road Advance NC 27006 Dlrections structure: OTHER Hwy 15$ East, turn left on Hwy 801 then turn right on Yadkin valley Rd, Property on Right #of Bedrooms: #of People: *Water Supply: �x�sricvG wE�� *IP tssued by. 2tao-r�auons,ao�ert 'System Classificatan/Description: TYPE II A.CONV SYSTEh1{SINGLE•FAMI�Y OR 480 GPD(�R LESSj *CA issued by: 2�dp.Nations,R�ert Saprolite System? (,�Yes �No Design Flow: � � (� 'p�stribution Type: G�vITY-SERwI,. Pump Requir�d? - {�Yes (�No 5oil Application Rate: � . � "P�e-Treatment: Drain field N drification Field 3 � � Sq� ft� 'System Type; INFIlTRA7QR QUICK a S7ANOARD No. Drain Lines a InSt8116�: M�rtYCater Total Trench Length: 1 0 0 '�• Cer�ification#; 3a2� Tr�ench Spacing: _ � Inches O.C. � Feet O.C. 'EHS: 2�a0-Nauons,Robert Trench Width: 3 Inches �Feet Oate: � 4 / 0 1 / � 9 1 4 Aggregate Depth: inches Minimum T�ench Depth: 3 6 Inches Hrlinimum Soil Cover. a 4 App►`ov8f Status Inches Maximum Trench Depth: 3 6 � Approved 0 Disapproved � Inches Maximum Soil Cover: a 4 Inches COP Fite Number '�23762 ` � County ID Number: `�'°°0'�'ao�-zz „ Se tic Tank Manufacturer. Sh°af Lat. . � STB: 760 long: Gallons: �ppp Insfaller: Manin Cater Certi6cation#: 3207 Date: 1a / ea / a � sa `' ' *EH S: 214�-Nations,Robert *Filter Brand: POLYIOK PL•122 With Pipe Adapter Date: . 0 4 � 0 1 / a 0 1 4 ST Ma�fcer: ❑ Yes D No ` - � ' - � Reinfarced 7ank: ❑ YeS I� NO Approval Status ' 1 Piece Tank: ❑ Yes C7 No � Approved� Disapproved Pump Tank Manufacturer. Instaper: PT: Certification#: Gallons: 'EHS: Oate: / � Date: � � RiserSeated ❑ Yes ❑ Np RiserNeght: ❑ Yes ❑ NO {Min.6 in.) ApprovalStatus Reinforced 7ank: p Yes ❑ No p Appraved 0 Disapproved 1 Piece Tank: ❑ YeS ❑ No Suppiy Line Pipe Size: inch diameter Instaqer: P�►e Length: feet Certification#: *Schedu{e: 'EHS: Pressure Ftated ❑ Yes ❑ No Date. � � Approved fittings ❑ Ye5 ❑ NO � � Approval Statu� D Approved C] Disapproved u e ui e e Pump Type: Installer: Dosing Volume: - Gat Certification�: Drawr pown: Inches *�ys' �Cha�: � � Date: Valves Accessible ❑ Yes ❑ NO Flow Adjustment Vatve ❑ Yes ❑ NO Check-valve ❑ Yes ❑ No Approval Status �vc unions ❑ Yes ❑ No p :`Approved❑ Disapproved Vent Hole ❑ Yes ❑ No Anti-siphon Nole p Yes ❑ NO 123762 " 1 County ID Number: ��°°0�0��°°��2t 1 CDf�FileNumber . , Electric E ui ment N EFAA 4X Boz or Equivalent p Yes ❑ N 0 Insfaiter: Box 12 inches Above Grade Q Yes ❑ NO Certification#: Box Adj.To Pump Tank ❑ Yes ❑ N O Conduit Sealed ❑ Yes ❑ �p "EHS: Pump Manually0perable p Yes ❑ NO , I *Activation Method: Date: _ _ Approval Status Alarm Audibte ❑ Yes ❑ No ❑ Appraved O Disapproved Alarm Visible ❑ Yes ❑ No 'Operation Pertnit compteted by: Authorized State Agent: Date of tssue: � � Owner/Applicank Signature: This system has been installed in compliance wRh applicable NC General Statutes:Article 11, Chapter 130A, Rules for Sewage Treatment and Disposa1, 15A NCAC 18A .1900 et. Seq.,and alf conditions af the lmprovement Permit and Construckion Autharizatian.This property is served by a TYpE II A. sewage septic system. Rule .1961 requires that a Type NPE��A� septic system meet the following criteria: M�imum System Review By?he Local Heatth Oepartment: �A Manegement Entity: OwNER Mi�imum System InspectionlMaintenance Fr�quencyByCertifed Operator: wA Repo�ting Frequency By Certified Operator: �A Rule .1961 requires that a Type IV and V septic systems desgned for a home/business owner must maintain a valid contract w�h a public management entirywi�h a certifi�d operatoror a private certified operatoc forthe life ofthe septic system. Rule .1961 requires that Type VI septic systems designed for a home/business owner must maintain a valid contract with a public ma�agement entitywith a certified operator for the life of the septic system. Rule. 1961 (2)(e)requires a contract shall be executed between the system orvnec and a management entrty prior to the issuance of an Operation Permit for a system required to be maintained by a public or private management ent�y, unless the system owner and certified opsrator are the same. The contract shall require specific requirements formaintenance and operation, respansibiities of the owner and systems operator,pravisions that the contract shal! be in effect for as long as the system is in use, and other requirements for the continued proper performance of the system. tt sha11 atso be a cond�ion of the Operation Permit that subsequent owners of the systems execute such a contract. �Hand Drawing Olmport Drawing **Site PIanlDrawing attached.** OPERATION PERMIT � � �i23762- 1 - t�avie County Health Department � CDP File Number: 210 Hospital Street cs-0o0-00•001-21 p.o.Box sa$ County File Number: Mocksvi0e NC 27028 Date: / � � �� Q Inch Dra�vin� Drawing Type: Operation Permit Scale: . . . . p�A k =_ . . .ft. 0 �----; ; -- _---__ �,_._._—4--�-----; ;-----;---- ; t ; �� �i , ; , , , f j i � ! 1 ? ' � j { i � � � t [ ] C , I ; 1 , , , ' I � � ___ ' (.............._y,.e.»=....-. . 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' � � � i : . _.. , .._... . ., ..... � :..._. ..____. . ..... .__ �_...__.,._ .:,..._ ....._. _ ..... . . .._... . . . ... _..... . . . ... , ._ ,.__ , � I � i � 1 _...._ . _....r� ___ �_�_____ __ . __ _,_ _ _ _. _ ____ _._ ,_� __ �_.._.._.._ _—. ___._ _.__.._____ — , ..... .._ ,. __..._ ___ i � . . . ' ' CONSTRUCT,ION For o�tice use on�v AUTHORIZATION ' *CDP File Number 123762-1 ���'� Davie County Heaith Department County ID Number. �-000-oo-00�-21 � .,�_'�- >� 210 Hospital Street Evaluated For. NEW �.�,�;;�,• P.O. Box 848 Township: Mocksville NC 27028 PERMIT VALID UNTIL: Phone:336-753-6780 Fax:336-753-1680 1 0 / a 3 / a 0 1 8 Applicant: Mark C and jodi Wiley Property Owner. Mark C and jodi wley Address: 578 Yadkin Valley Road Address: 578 Yadkin Valley Road City: Advance City: Advance State2ip: NC 27006 State2ip: NC 27006 Phone#: �336)940-2341 Phone#: (336)940-2341 Propertv Location & Site Information Address/Road#: Subdivision: Phase: Lot: 578 Yadkin Valley Road Advance NC 27006 Di�eCtiOns Structure: OTHER Hwy 158 East, tum left on Hwy 801 then turn right on Yadkin valley Rd, Property on Right #of Bedrooms: #of People: "W2t2('SUpply: IXISTING WELL �stem Specifications Minimum Trench Depth: � 4 Site Classification: Ps Inches Minimum Soil Cover: Saprolite System? �Yes �No Inches Design Flow: 1 � 0 Maximum Trench Depth: 3 6 Inches Soil Application Rate: � . 3 Maximum Soil Cover: Inches *System Classification/Description: *Distribution Type: �►�vin-sERi,a� TYPE II A.CONV SYSTEM(SINGLE-FAMILY OR 480 GPD OR LESS) Septic Tank: 1 0 0 0 Gallons *Proposed System: 2s°io REDUCTION 1-Piece: 0 Yes �No Pump Required: Q Yes �No Q May Be Required Nitrification Field Sq.ft. Pump Tank: Gallons No. Drain Lines 1-Piece: �Yes �No Total Trench Length: 8 4 � GPM—vs— ft. TDH Trench Spacing: _ Q Inches O.C. Dosin Volume: Gallons �Feet O.C. 9 Trench Vlydth: _ Olnches �Feet Grease Trap: Gallons Aggregate Depth: inches Pre-Treatment: O NSF OTS-I O TS-II Septic Tank Installer Grade Level Required: �I �I I �I II �IV Page 1 of 3 , CDP File Number 123762 - 1 � , County ID Number: c8-000-oo-ooi-21 ❑ Open Pump System Sheet Repair System Required:�Y2S O No O No, but has Available Space Repair System Trench Spacing: �Inches O. . "Site Classification: Ps — Feet O.C. Trench Width: O Inches Design Flow: 1 0 0 — O Feet Aggregate Depth: Soil Application Rate: 0 . 3 inches u Minimum Trench Depth: a 4 Inches '`System Classification/Description: TYPE II A.CONV SYSTEM(SINGLE-FAMILY OR 480 GPD OR Minimum Soil Cover. LESS) Inches Maximum Trench Depth: 3 6 Inches "'Proposed System: 25%REDUCTION Maximum Soil Cover: Nitrification Field Inches Sq.ft. No. Drain Lines *Distribution Type: ��viTtr-sERiA� Total Trench Length: 8 4 ft Pump Required: �Yes �No Q May Be Required Pre-Treatment: O NSF OTS-I OTS-II *Site Modifications No grading or construction activity is allowed in areas designated for system and repair without approval of Health Department. "Permit Conditions The issuance of this permit by the Health Department in no way guarantees the issuance of other permits. The permit holder is responsible for checking with appropriate governing bodies in meeting their requirements. This Authorization for Wastewater System Construction shall be valid for a person equal to the period of validity of the Improvement Permit,not to exceed five years,and may be issued at the same time the Improvement Permit issued(NCGS 130A-336(b)).If the installation has not been completed during the period of validity of the Construction Permit,the information submitted in the application for a permit or Construction Authorization is found to have been incorrect,falsified or changed,or the site is altered,the permit or Construction Authorization shall become invalid,and may be suspended or revoked(.1937(g)).The person owning or controlling the system shall be responsible for assuring compliance with the laws,rules,and permit conditions regarding system location,installation,operation,maintenance,monitoring,reporting and repair (1938(b)). ApplicanULegal Reps. Signature Required? O Yes �No Applicant/Legal Reps. Signature: Date: � � *Issued By: �`�-Daywa�t,Mdrew Date of Issue: 1 0 � a 3 � a 0 1 3 Authorized State Agent: ��� Q��� Malfunction Log OYes �Hand Drawing O Import Drawing Total Time:(HH:MM) **Site Plan/Drawing attached.** � 0 Ho�� 3 0 Minutes Page 2 of 3 S-8-CA'S issued-new ' CONSTRUCTION AUTHORIZATION • • '" ` Davie County Health Department CDP File Number: 210 Hospital Street P.O.Box 848 County File Number: `�-000-oo-ooi-21 Mocksville Nc z�o2a Date: 1 0 / a 3 / a 0 1 3 O Inch Drawing Drawing Type: Construction Authorization Scale: . . OO N/A k - .ft. � C3'x8`�, � 0�'� ,�� �, � � �� � � � �t�" o� � � �,�c� � ao �T� � —� _._,� � L�C� ` r� �O Y`�� ���Ra� � ��d 5� ���w� Page 3 of 3 p1 P2 J • . Construction Authorization Fo�o��euseo��Y �. "CDP File Number " 723762;-.1 : � Davie County Health Department • 210 Hospital Street County ID Number � c8-000-00-001-21 • ' : �`�1 I Evaluated Foc ``NEW . P.O. Box 848 � Mocksville, NC 27028 PERMIT VALID UNTIL: 10i23/2018 Phone: 336-753-6780 Fax: 336-753-1680 Applicant: Mark C and jodi Wiley Property Owner: Mark C and jodi Wiley Address: 578 Yadkin Valley Road Address: 578 Yadkin Valley Road City: Advance City: Advance State/Zip: NC 27006 State/Zip: NC.27006 Phone#: home:(336)940-2341 cell:(336)345-3057 Phone#: (336)940-2341(336)345-3057 Pro e Location 8� Site Information Address/Road#: 578 Yadkin Valley Road Subdivision: Phase: NEW Lot: Advance,NC 27006 Structure: OTHER Directions Hwy 158 East,turn left on Hwy 801 then turn right on Yadkin valley Rd,Property on Right #of Bedrooms: #of People: 'Water Supply: EXISTING WELL S stem S ecifications Minimum Trench Depth: 24 Inches 'Site Classification: Minimum Soil Cover: Inches Design Flow: 100 Maximum Trench Depth: 36 Inches Soil Application Rate: 0.3000 Maximum Soil Cover: Inches 'System Classification//Description: . 'Distribution Type: GRAVI7Y-SERIAL SepticTank: 1,000 Gallons 'Proposed System: 1-Piece:OYes XO No Nitrification Field gq.g. Pump Required: O Yes OX No O May Be Required No.Drain Lines Pump Tank: Gallons Total Trench Length: 84 ft. 1-Piece: O Yes O No Trench Spacing: - Q Inches O.C. GPM—vs-- ft. TDH QFeet O.C. Inches Dosing Volume: Gallons Trench Width: - g Feet Grease Trap: Gallons Aggregate Depth: inches Pre-Treafinent: ONSF O TS-I OTS-II Septic Tank Installer Grade Level Required: O I O II O III O IV Page 1 of 2 a ' CDP File Number: 123762 County ID Number: c8-000-00-001-21 Repair Svstem Inches O.C. 'Site Classification: Trench Spacing: — V Feet O.C. Design Flow: ��� Trench Width: _ Inches Feet Soil Application Rate: 0.300 Aggregate Depth: Inches 'System Classification/Description: N/A Minimum Trench Depth: 24 Inches Minimum Soil Cover: Inches 'Proposed System: Maximum Trench Depth 36 Inches Nitrification Field Sq.ft. . No.Orain Lines Maximum Soil Cover: Inches Total Trench Length: 84 ft, 'Distribution Type:GRAVITY-SERIAL Pump Required:OYes XO No OMay Be Required Pre-Treatment:O NSF O TS-I O TS-II 'Site Modifications No grading or construction activity is allowed in areas designated for system and repair without approval of Health Department. `Permit Conditions The issuance of this permit by the Health Department in no way guarantees the issuance of other permits. The permit holder is responsible for checkinp with appropriate qoverninp bodies in meetinq their requirements. This Authorization for Wastewater System Construction shatl be valid for a person equal to the period of validity of the Improvement Permit,not to exceed five years,and may be issued at the same time the Improvement Permit issued(NCGS 130A-336(b)). If the installation has not been completed during the period of validity of the Construction Permit,the information submitted in the application for a permit or Construction Authorization is found to have been incorred,falsiTied or changed,or the site is altered,the permit or Construction Authorization shall become invalid,and may be suspended or revoked(.1937(g)). The person owning or controlling the system shall be responsible for assuring compliance with the laws,rules,and permit conditions regarding system location,instatlation,operation,maintenance,monitoring,reporting and repair ApplicanULegal Resps. Signature Required? Q Yes Q No ApplicanULegal Reps.Signature: Date: *Issued By: Daywalt,Andrew Date of issue: 10/23/2013 Authorized State Agent: Malfunction Log Q Yes Q Hand Drawing Q Import Drawing Total Time:(HH:MM) **Site PIan/Drawing attached.** Page 2 of 2 , • CONSTRUCTION AUTHORIZATION Davie County Health Department CDP File Number: 210 Hospital Street P.O.Box 848 County File Number: �s-000-oo-ooi-2� Mocksville Nc 2�o2s Date: 1 0 / a 3 / a 0 1 3 �Inch Drawing Drawing Type: Construction Authorization Scale: . , O B�ock = ,ft. �N/A Y �� C3'x8`�� 0�'� i •�� �, s � �� �� � � �P�u ��o� ��� � �� ao -.�. -�- --�..�- -�- � (.�C��-irr� I�r�v� �° Y`'�' ``.y - v�c��le� � ��d 5�' ���w� Page 3 of 3 P1 P2 � A.P ATION FOR SITE EVALUATION/IMI'ROVEMENT PERNIIT & ATC _ :., �� .- •• .�;,ti�.(;�+i Davie County Environmental Health ���I pA� ��'i� �p (�j P.O.Bog 848/210 Hospital Street /O /d !3 �,� Mocksville,NC 27028 � � (33�753-6780/Fax(33�753-1680 � �3Z Application For:�Site Evaluation/Improvement Permit , �,Authorization To Construct(ATC) �oth Type of ApUlication: ❑New System ORepair to Eacistin�System ❑Expansion/Modification of ExistinQ System or Facility ***IMPORTANT***THIS APPLICATION CANNOT BE PROCESSED UNLESS A.LL OF TI-�REQUIRED INFORMATION IS PROVIDED. Refer to the INFORMATION BUL�..ETIN for instructions. APPT.TC;ANT TNFnRMATT(?N • Name �o.t�+ C- o r�� ���� R , (;.), `� Contact Person dY�¢c`{- �r I�CT Address S?$ .,� a k�'-, 1leel l<.. (Zn�,d � Home Phone q�n-� c.( I City/State/ZIP �-ld va� c c N c ot.7ooG Business Phone 3y.s.�3ps? Email Name on PermidATC if D�erent than Above Mailing Address City/State/Zip PROPERTY INFORMATION *Date I3ouse/Facility Corners Flagged �d U .3 NOTE: A survey plat or site plan must accompany this application. Included: ❑ Site Plan �Plat(to scale) (Permit is valid for 60 months with site plan,no expiration with complete plat.) Owner's Name'�ec'k, C e�n� -S o d= iP 1�.�t.,.� Phone Number Owner's Address 57�S ycd�c.••./� �lo(l.,� 2e�—T City/State/Zip Property Address �"je.rti,. City Lot Size �3 f a�c�5 T�P1N# S$�3 4138�7 Subtlivision Name(if applicable) �► I R Section/Lot# Directions To Site: �b� Q� .,.. �a� k, — �1 a 11 c.� o� 2�- If the answer to any of the following questions is"Yes",supportin documentation must be attached: Are there any existing wastewater systems on the site? �Yes No Does the site contain jurisdictional wetlands7 �Yes No _ Are there any easements or right-of-ways on the site? _Yes �No ���.� . Is the site:subject to approval by another public agency? _Yes,�,No Will wastewater other than domestic sewage be generated7 Yes`'�No TF RF,S�nFNC;F,FTT,T,n1 TT TNF.RnX RF,T,(�W #People #Bedrooms � #Bathrooms Garden Tub/Whirlpool �Yes ❑No Basement: ❑Yes Basement Plumbing: ❑Yes�o .IF N(�N-RF,SiAF,NC'F., FTT.L.C)IJT THF AQX k3EI.,.OW Type of FacilityBusiness }�a�c.s �a�n Total Squaze Footage of Building 3 3�-I� #People�_ # Sinks � #Commodes�_ # Showers�_ #Urinals Estimated Water Usage(gallons per day) l c7a (Attach documentation of similar facility water consumption) FOODSERVICE ONLY: # Seats Type system requested�L�onventional ❑Accepted ❑Innovative ❑Altemative �Other � � Water Supply Type: ❑ County/City Water �New Well C�� isting Well � Community We�l Do you anticipate additions or expansions of the facility this system is intended to serve?"Q Yes J�o If yes,what type? This is to certify that the' ' n ided on this application is true and correct to the best of my imowledge. I understand that any permit(s)or AT er are subject to suspension or revocation if the site is altered,the intended use changes,or if the information �c � faL�ified or changed I hereby grant right of entry to the Authorized Representative of the Davie nt t onduct necessary inspections to detemline compliance with applicable laws and rules. I tmders for proper identification and labeling of property lines and comers and locating and flagging or s ' i cati proposed well location and the location of any other amenities. Pro e-' or owner's legal representative signature Site Revisit Charge Date(s): �3 Client Notification Date: Date EHS: Sign given ❑Yes ❑No ?� Account# fZ��t�7/ Revised 11/06 ���� � 5Z�J Invoice# ��� � I , • � . ' Appraisal Card �� g c� �` � �Q r/ Page 1 of 1 c., � l( � D�VI[COUNiY MC ]0 10 20131:16:OOVM LCY C M�lK WILEY)OOI l 0.�tum/Appeal Nohs: �Cl-000-00-0G3-31 ADI(IN VALLEY RD UNIQ ID 968305 SiLR F0.0M[D 2616 I011l3 ID N0:SB]3�I81]l Owner:WILEY C MARK WUNTV TA%(100),FIAE TA%(100) UM1D NO.1 0!1 w�I V���:201J T�x V�ar:7011 13.]39 AC YADqN VAIAFY I1.729 AC 13.7I9 AC S0.C• ..is.a e )on 0!2�2033 03009 YAD1(IN VPLLFY TW-03 C� E%- A1� lAST�CTION 20330/10 CONSTIIUCRON DR�IL MRMNCT VAIU[ DEVREQRiION CORRCLATION O�VRtUC oTAL iOINT V�W Elf. 645E �UILDING USE MOD Ares UAL M RCN EYB rl REDENCE TO •OJVSTMENTS 9J 00 %GOOD DEVR.�UILDING VRLUF•CARD OTRL ADJUSTMENT n,PE:������ EVR.OY/%�V�LU[•GRD 6,]5 AROR �RKETLANDV�W!-GRD 565,]I OTALQUAUTYINDE% STORIES: OT4LMAR1tCTV�W!-CARD 572�9 OTAL�VV0.IIISEDVAW!•CI1RD SJ3,{9 OTAL�PP0.AISfD VRW!•PA0.CEL 5]2I9 OTAL YNESENT USF V�LU[•V�4CEL 3],�6 OTAL VALUf DEFE0.RED-V�0.CEL 515,03 OTRI TA%A!L[VRIUf•VARCEL i]�6 P0.IOR UILDING VALUE B%F VALVE 22,33 D VRLUE RESENT USE VAIVE EFERRFD VALVE OTRI VR�UE 21 33 VE0.MlT CODE DRTE NOTF NUMBFR AMOVNT our:wrnsHo: S�LES DATA iF. ECORD AT[ O[[D INDIGTE S�LES OON •GE M R 7YV[ VRICE 0895 �]B ] O3 WD V Sb85� � NEATED A0.EA NOTES vut 2olz 6UBA0.E4 YHiT ORI6% ►NN UEP % OB/X�OEPi 65 RPL ODE ESCRIYTIONLTM H MIT PRIC! COND LDGfI �YB!Y! R�T[ V COND VRLU TYVC I1RCR CS B N SITE 1 1�500.0 _ 199 199 5 1U �SU - IREiL�CE 9 EfALBLD6 3 S !6 15.3 _ _ 19] 197 5 U�AREA 9 ETALBLDG 2 1 BO ]5.3 _ _ 199119B1 5 pTp�� 1 TOMGE t5 10.0 198 19B 5 3 325 OTAL OB XF VALUE 6)5 UILD[MG DIMENSIONS I1ND NFOMM� ON TXEN O]U3TMEXTY�ND TOTAI IOXESTAND USE LOGL iRON DEPTN/ LND COND OTES Ol1 4MDUNIT UNp UNT TOT�L �DIUSTEU LAND IAND ESTUS! COD! ONING TAGC E SI2! MOD f�R Rf �C C TO O TYVE PRICC VNlTS TYi �D]ST UMITPRICE VGLUE MOTES i0.RIVE0. 0317 B65 0 O.B130 • 1.2900 Ol*35+20-OS-30 GW 11,500.0 13.]2 AC 1.13 13,93].5 565]I LOOD ne OT�L M�RI(ET L�ND DATA Il.]3 565]I G0.{I{ 5330 0 0 1.0000 5 1.0000 590.0 36.3� AC 1.00 590.0 155� G0.IItt 5310 0 0 1.0000 5 1.0000 385.� 6.9fi RC 1.00 385.0 266 GRIIV 5�30 0 0 1.0000 5 1.0000 �O.D 0.93 AC 1.00 �0.0 3 0.5T I 6130 0 0 1.0000 5 1.0000 I15.0 0.23 AC 1.00 I15.0 91 0.5TI1 6330 0 0 1.0000 S 1.0000 i]0.0 6.0� AC 1.00 2]0.0 1631 0.5TIII 6330 0 0 1.0000 S 1.0000 330.0 3.1) AC 1.00 330.0 ]3 UBMERGED 9500 0 0 1.0000 5 1.0000 �0.0 0.11 AC 1.00 90.0 /W OT111 VMlSlNT USC DATA �3.13 30)1 http://maps.co.davie.nc.us/ITSNet/AppraisalCard.aspx?parce1=C80000000121 10/10/2013 . � - I�AVIE �OUNTY HEALTH DEPARTMENT Environmental Health Section "' Soil/Site Evaluation � APPLICANT INFORMATION PROPERTY INFORMATION Account #: �23�(QZ � , . Tax PIN/EH#: cg..b�Q-Q(�-a� `�2l Billed To: ����(G� fpd� ��`� Subdivision Info: In Reference Name: / v Location/Address: �7� �au�� ��`�`W �—"" r � Proposed Facility: ►' `f��`�,������ Property Size: Date Evaluated: � � � , �3-� � � �� I � Water Supply: On-Site Well Community Public Evaluation By: Auger Boring Pit Cut FACTORS 1 2 3 4 5 6 7 Landsca e osition Slope % HORIZON I DEPTH Texture rou Consistence Structure Mineralo HORIZON II DEPTH Texture rou Consistence Structure Mineralo HORIZON III DEPTH Texture rou Consistence Structure � Mineralo HORIZON IV DEPT'H Texture rou Consistence Structure Mineralo SOIL WETNESS RESTRICTIVE HORIZON SAPROLITE CLASSIFICATION LONG-TERM ACCEPTANCE RATE SITE CLASSIFICATION: EVALUATION BY: LONG-TERM ACCEPTANCE RATE: OTHER(S)PRESENT: REMARKS: LEGEND j,�ndscane 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 7'exture � 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 S'ONSiST .NC . , 11�Q1S� VFR-Very friable FR-Friable FI-Firm VFI-Very firm EFI-Extremely firm � � NS-Non sticky SS -Slightly sticky S-Sticky VS -Very Sticky NP-Non plastic SP-Slightly plastic P-Plastic VP-Very plastic �tructulg SC-Single grain M-Massive CR-Crumb GR-Granulaz ABK-Angular blocky SBK-Subangular blocky PL-Platy PR-Prismatic ' Mineraloev 1:1,2:1,Mixed LYQ� 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-ferm accentance rate- ual/dav/ft2 n�un nSmc rno..:�o,�� I hereby certify that I am the owner of the property shown REVIEW OFFICER'S CERTIFICATE �\ and described hereon, which located in the County of Davie that I hereby adopt this plan of subdivision with my free consent. Filed for registration at o'clock M. z� b established minimum building setback lines and dedicate all streets, I, Review officer of Davie County, s alleys, walks, parks and other sites and easement to public or certify that the map or plat to which this certification 2012 and recorded in >� S'� �% private use as noted. Furthermore, I hereby dedicate all sanitary is affixed meets all statutory requirements for recording. _ _ n�tiwy > sewer and water lines to the County of Davie - e0' DAA —��- -_ Plat Book Page BERT B. BAHNSON REVIEW OFFICER DATE Filing fee : paid. M. BRENT SHOAF — DAVIE Co. Register of Deeds �� YADKIN RIVER by — ST No DRUTY ANT 100' X 50' PERPETUAL EASEMENT ALONG RIVERBANK OF SELLER'S RETAINED PROPERTY unnmorlced I�pokt VICINITY MAP UPON WHICH SELLER AGREES TO MAINTAIN IN ITS CURRENT GRASSY STATE AND NOT rr unmorked AS AN APPROACHPLAN7 ANY SHRUBBERY. TREES O THEOR �RNER ECT �1T0 ON IMPROVEMENT OF THE ORDER ROPERTY MTO AIHCH 11S USED CH AREA S 43.391 • E –� on ►fiver �P�, AS A RUNWAY TO LAND AND TAKE OFF AIRCRAFT, PROVIDED THAT THIS EASEMENT IS ONLY FOR DA APPROVAL REQUIRED 8Y THE BUYER'S AIRCRAFT FLYING NEEDS AS AN APPROACH CORRIDOR FOR AIRCRAFT LANDING AND TAKING .p��09' E S DAVIE COUNTY PLANNING DEPT. OFF FROM THE PROPERTY. S 59 9 40'19'41• E_� unmarked 69� 41086 on ravel bank t unmarked point N 6434 ° 10' W n�w %boand mouth of ok —— —_.— .– _ — _ S 44'53'46' on neer bank – E 'r -04 on ver 538.84 creek - DAVIE COUNTY PLANNING DIRECTOR AIR STRIP r _ � AIR STRIP — � CO – ROk. ?per "e ^�� HE-ri O + � � --_ O concrete f _ft – ��CONTROL CORNER 06 fance post r� BAHNSON rX BERT B. ``���� �NGgR 1�C� � 74 3Y39 W D.B. 19,2, PG. 183 Q I concrete N sa- d GIS AREA � 1 fence post � EXISTING DIRT DRIVE 1`1`–�� `�� '/'– PIN# 5873413877 ` flow —ew ���' creek � �e�G –ice 4V O -mss 6O . , s� r BEEKER B. STRAND D.B. 165, PG. 295 �4s�, exit g PI N# 5873602472 � a i iron 41 = 43- �10O Aj-c-Yes Ye. esu ,��,�"� r°r' -� �M fiT i►� �1 6-0734 • SELLER AND BUYER SHALL EACH GRANT TO THE O ERP A PERPETUAL EASEMENT OVER AND UNDER FRED BAHNSON ROAI) rRNA 30' FROM riew THE CENTER OF FRED BAHNSON ROAD FOR A COM NED EASEMENT FOR Z(,,�A• iron urlLmES. INGRESS, EGRESS, REGRESS AND ACCESS TO EACH BUYER'S AND SELLER'S PROPERTY. i ti BERT B. BAHNSON THIS EASEMENT WILL INCLUDE THE PROPERTY ON YADKIN VALLEY ROAD(SJL1452) TO THE BRIDGE ON FRED BIWNSON ROAD(PRNATE). i D.B. 192, PG. 183 NEW PROPERTY LINE ALONG FRED BAHNSON ROAD(PRIVATE) ; PIN# 5873413877 unman t cu + IS C/L NEW 60' EASEMENT ; PLAT MAP: unmarked point in poin C/L Yadkin Valley I rn ' • BER B e / ey in C/L Drive and of 20' ^ J BAHNSON RfNr N 44`15'28• V = � existing pavement unpmoQnr}ced unmarked � ��L ,,��,!!�ti ��, in C/L Drive in CAL Drive �— Rh ------------------ i OWNER DEVELOPER RAW`.► — 428.19 — — —— — 3. ——_ ` _ _ ,� 111 BERT B. BAHNSON p tiw unmarked point J J 2039 HWY. 801 NORTH S; •�� 6: in C/L Drive ,rLPI' unmp \.•� f y�Q f°� io� / g�1 in �%�Drive I' �©� MOCKSVILI.E, N.C. 27028 20. ved. � BERT B. BAHNSON unmarked„pointt,eIn drive \J lye -� Pry g \ FARMINGTON TOWNSHIP D.B. 192, PG. 183 at edge of bridge .� ( end of 60' easement ) DAVIE COUNTY, NORTH CAROLINA ,Surveyor Certification for Subdivision —_Davie County. North Carolina 0t�rri18rr I, Grad L Tutterow, Registered Land Surveyor, Number L-2527 PIN 5873413877 ,��� CA '", DATE: JUNE 11, 2012 H certify to one or mon of the following as indicated by an X: .`��� ''� gg q /�% PIN# 5873413877 X a. That this is a plat of a survey that creates a subdivision of 1, Grady L Tutterow, certify that this plat was drawn S SQL SURVEYED BY: land within an area of a county or municipality that has an under my supervision from an actual survey made TUTTEROW SURVEYING COMPANY ordinance that regulates parcels of land; under my supervision (deed descn tion recorded in = L-2527 ' = 107 NORTH SALISBURY STREET b. That this plat is of a survey that is located in such a :� Book -- ; Page , etc.) (other);that the ->' Q��: portion of a county or municipality that is unregulated as to an boundaries not surveyed are clearly indicated as drawn'�'9 �;y� ���O. MOCKSVILLE, NC 27028 ordinance that regulates parcels of land; from information found in PL Book till Sui,v•,,,•� �.` c. That this plat is of a survey of an existing parcel or Page , ��,�'.�.` 1; (336) 751-5616 parcels of land; that the ratio of precision is calculated as 1; +20.000 °�. ;rrTi) ��• d. That this plat is of a survey of another category, such as the that this plat was prepared in accordance with G.S. NOTES: 1" 150• recombination of existing parcels, a court-ordered survey, or 47--30 as amended. Witness my original signature, 150 75 0 150 300 450 other exception to the definition of a subdivision; registration number and al this II day of e. That the information available to this surveyor is such 1. PROPERTY LIES WITHIN WS-IV P WATERSHED OVERLAY. �� �__� that I am unable to make a determination to the best of my J UNE D. 0 — -- profession ty abi as provisions contained in a. thrUugh d. above. 2. NO NCGS MONUMENTS WITHIN 2000' OF PROPERTY. SCALE IN FEET FILE NAME: COORD NAME: DRAWING NUMBER: Signator I i2L5 Z52Z (Seal or StRT Registration Number BAHN–BU BAHN–BU/94 7412-3 rveyo Registration Number FIRM# F-0372