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336 Whispering Oaks LnDavie County, NC , � Tax Parcel Report Tuesday, October 1 l, 2016 WAlZN1NG: 11i151S NU7' A SUKV�:Y Parcel Information Parcel Number: L30000002009 Township: Mocksville NCPIN Number: 5726098548 Municipality: Account Number: 8300360 Census Tract: 37059-801 Listed Owner 1: CARRABBA LLC Voting Precinct: SOUTH CALAHALN Mailing Address 1: 336 WHISPERING OAKS LANE Planning Jurisdiction: Davie County City: MOCKSVILLE Zoning Class: DAVIE COUNTY R-A State: NC Zoning Overlay: Zip Code: 27028-0000 Voluntary Ag. District: No Legal Description: 93.859 AC OFF RATLEDGE RD Fire Response District: CENTER,SCOTCH - IRISH Assessed Acreage: 90.41 Elementary School Zone: COOLEEMEE Deed Date: 5/2011 Middie School Zone: SOUTH DAVIE Deed Book / Page: 008590869 Soil Types: MrC2,MrB2,EnB,IrB,MsC,ChA,MsB,BuB,WATER,MsD Plat Book: Flood Zone: Plat Page: Watershed Overlay: DAVIE COUNTY Building Value: Land Value: Total Assessed Value: 1538480.00 Outbuiiding & Extra 352090.00 Freatures Value: 313190.00 Totai Market Value: 2203760.00 1975310.00 9`'�`�' Davie County, °o�N��' NC . ��1 l�� ' County Hea.�th Depal-trnent n onmental Health Section 1,� Za�� >>.o. �,X � � ��P 210 Hospital Strcec COUIICC # : O��O-O6 � __ ___�� j Mocks�illc, NC 270`l8 I'lioac: (336� - 7fi3 - 6780 ON-SITE WASTEWATER CERTIFICATION (Check One) Replacement Remodeling Reconncction Fax: C336) - 75316AD Name: � �� -�- �.-il}l �m��n��N�� 3�-�-! -a1� (Home) MailingAdd�ess: � 'S r�": �x� �-��p-�`�irC7 {Voork) C `r � �' d Y�� - i-�ecelr-��Te� ��e �---� d-�--l�?� �) �l�'o ,,�n�-i.�N� �- S�i �S�f��. s'7C- Detailad D"uectionsTo Site: �.i�+ic�1,��'��r, a � So�1t5� i i. ��,.D� � . . . �� *� Property Please �ll In Tt�e FoRowing T6e EXISTING Facility: Name S�stem installed Under:��Sd C� -? Type Of Facility�C'YY'1 Date Systan �nstalled (Month/Dat�elYear): Number Of Bedrooms:��Number Of People: [s The Faciliry Cumcntly YacanCl Ycs � If Yes, For How Long? My Known Probtems? Yss �!f Yes, Explsin: Please Fil! in'fhe Follow*iag Iaformation Abont The NEWFacility: Ty�pc Of Facility: ~� �CS¢ � Number Of Bedrooms:� Nurnber ofPcopte Pool Size: Garage Size: "—� ()thcr: --�� Requested By : Date Requested: (S►C�� ) For Env"uonmental Heatth dffice Use Only Approved Disapproved Environmental Health Specialist Date: '�The signing of this form by the Environmental Health Staf�is in no way intended, nor sho►�ld be taken as a guarantee (extended o_rj'�mited) that the on-site wastewater system will function properly for any given period of time. Payment: Money Order # Paid By: �'' Receival By: �L..��/1/l.(.u� Account #: �J' %J�� InvoIce #: 7 �� j 6'd L8L l-l9L-�OL �!4d��J dld e lZ� L l L L 60 d8S a Y� :.c a � C� H Q �,OCICdl�2a'� ��v � GoMAPS - L�avie County iVC Public Access °�''"WARNIN(i: THiS fS NOT A SURVEY!••'� This mup is prcparui for the inventory af renl praperty found wilhin ihis jw•isdictiim, mnd is cornpiled From i�ec:o�til�d deeds, plats, and oci►er public records und data. Uscrs of tl.�is map are hereby notiTieci tli�t t1� aforomentioned public primary information u�urccs should be cansulted for vcrification of the inforniation rx�ntrit�fed �n thi9 mnp. The Coun ,ry and mappins compnny assume nn IegaJ re�potuibility for tl�c informatiun contuined on this map. . WAT�R_E)ObICS r""r COUNTY_BQUNDARY 4..._� S1R�EY8 �c•'` RAlLROAd, C�NYtRIINE .;;�� pARC�Le GIiY_LINpTS � o�wr.uaawa � COOLEF./�CE' �pAWFC0UNIY kOCK9YILLE tICCOtI(itl�6 DAVlE i� � � eaii elhervslurr� Wednauiay, Seplembcr 7 201 I _ . . - - _ ; � . _ , �. . ; .�,�Scv ALJT�iORI�L�TION NO: �,,�J E� DAVIE COUNTY HEALTH DEPARTMENT e. p.-�- y� � Environmental Health Section PROPERTY INFORMATION .:P �" i��ee'S P.O. Box 848 Name: �, 7�✓� _ �pr�d i�l Mocksville, NC 27028 Subdivision Name: ; �1 .' , Phone #: 704-634-8760 Directions to property: �, :;� : �rr �i%" � ✓- �. Section: Lot: ��, �/ AUTHORIZATION FOR f �4 �� ' / � .... WASTEWATER Tax Office PIN:#��- [..� f� - �� j•f � � � �'�j'�� ' '"� ' �'' '' � r `� � SYSTEM CONSTRUCTION ' c��G l�hlsD�r`�ua (��Co�f l�iame: �L��'iTf"�d�C��P: , �FG��t O **NOTE** This Authorization for Wastewater System Construction MUST BE IS�JED by the Davie Counry Environmental Health Secdon prior to issuance of any Building Pemvts. T'his Forn�/Authorization Number should be presented to the Davie County Building Inspections Office when applying for Building Pernvts. (In compliance with Ar[icle 11 of G.S. Chapter 130A, Wastewater Systems, Section .1900 Sewage Treatment and Disposal Systems) ;r.�' T� �i� �j ***NOTICE*** THIS AUTHORIZATION FOR WASTEWATER CONSTRUCTION �'"�/� �.i.,: s'�?-a . 1�Z�� t`' %�I �-,',' ��=•r,,�?� IS VALm FOR A PERIOD OF FIVE YEARS. ENVIRONMENTAL HEALTH SPECIALIST DATE ISSUED . , � �t : . � �- , . . � � b . , ,�� `- _ °� j; ,� � �� '�,�a��: O - � ,�,, , ,:t�. j �, .� DAVIE COUNTY HEALTH DEPARTMENT � �' ;;� � . - - `"` �� TMPROVEMENT AND OPERATION PERMITS PROPERTY INFORMATION - - ,. ' �. PermitZee's ' • �� ,� Name: .�� ; � °? r �'"� �"� r�� ,'"� ; �;� �'''l Directions to property: 'f�'� - f''�'' "� cf'� �j,�t �.,... �. _. ,.�� .. ,a ,� .,a. ; r' . � .r � � � � �• - - IMPROVEMENT PERMIT 1J1�Is��?r�� Subdivision Name: ` Section: Lot:'' Tax Office PIN:# �� tf'�- �' �� - C�:" ,��}� '�",; f ' , 'C�`, �� #'�"`` *`i � I�o�� Name: ;�r .> a� �==, Ir:a�-' �`'°Zip: r;,`�'� �,� **NOTE** This Improvement Pernut DOFS NOT authorize the constcuction or installation of a septic tank system or any wastewater system. An AUTHORIZATTON FOR WASTEWATER SYSTEM CONSTRUCTION must be obtained fi-om this Department prior to the construction/installadon of a system or the issuance of a building pemut. (In compliance with Article 11 of G.S. Chapter 130A, Wastewater Systems, Section .1900 Sewage Treatment and Disposal Systems) r, • � -�-* �� 3 r ,. '° r ��',-�li r �.. .✓'�fY�+:l �''/ � � /' r __ 17" .e-' -r " �? ,T....t - ENVIRONMENTAL HEALTH SPECIALIST DATE ISSUED RESIDENTIAL SPECIFICATION: BUILDING TYP��'I # BEDROOMS COMMERCIAL SPECIFICATION: FACILITY TYPE LOT SIZE TYPE WATER SUPPLY # PEOPLE ***NOTICE*** THIS PERMIT IS SUBJECT TO REVOCATION IF SITE PLANS OR THE INTENDED USE CHANGE. YOUR WASTEWATER SYSTEM CONTRACTOR MUST SEE THIS PERMIT BEFORE INSTALLING TI� SYSTEM. _ # BATHS � # OCCUPANTS # PEOPLE/SHIFT ____ # SEATS GARBAGE DISPOSAL: Yes or No INDUSTRIAL WASTE: Yes or No DESIGN WASTEWATER FLOW (GPD) .� . l% NEW SITE �-'" REPAIR SITE SYSTEM SPECIFICATIONS: TANK SIZBr� � GAL. PUMP TANK GAL. TRENCH WIDTH �� ROCK DEPTH f�/` LINEAR FT. ��r�r,• OTHER REQUIRED SITE MODIFICATIONS/CONDITIONS: I TMPROVEMENT PERMIT LAYOUT �j,c] �,� �L�D� '��D M n/ WPtI R � �� U�g �yNg �� rv J� **CONTACT A REPRESENTATIVE OF THE DAVIE COUNTY HEALTH DEPARTMENT FOR FINAL INSPECTION OF THIS SYSTEM BE'TWEEN 8:30 - 930 A.M. OR I:00 - 1:30 P.M. ON THE DAY OF INSTALLATION. TELEPHONE # IS (704) 634-8760. I OPERATION PERMIT SYSTEM INSTALLED BY: � ANNV �[) �1�'�-Ct C.�C2 �� _ ' � I AUTHORIZATION NO. .�� OPERATION PERMIT BY: DATE: /r '�� l0 **THE ISSUANCE OF THIS OPERATION PERMIT SHALL INDICATE AT THE SYSTEM DESCRIBED ABOVE HAS BEEN INSTALLED IN COMPLIANCE WITH ARTICLE I 1 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 OS/96 (Revised) 1. Name to be Billed APPLICATION FOR SITE EVALUATION/IMPROVEMENT PERMIT � Davie County Health Department Environmental Health Section � �� P. O. Box 848 / � � Mo��ksville, NC 27028 r + `'�� c��,� �� `� � (336)751 8760 _ ****IMPORTANT**** THIS APPLICATION CANNOT BE PROCESSED UNL ALL THE REQUIRED INFORMATION IS PROVIDED. CAROLINA BUILDING SYSTEMS Contact Person C�[�� JUN I 0 1998 '�a::��,:'.%�`�TI'�L HE6;LTfl , B"'�,= COt1„1TY '�»- - S DOYLE OVERCASH Mailing Address P• 0. BOX 1887 Home Phone Cit�/State/Zip SALISBURY, NC 28145-1887 Business Phone �04-636-7051 2. Name on PermidATC if Different than Above STEVE ROBERTSON Mailing Address P• 0. BOX 2080 City/State/Zip ADVANCE, NC 27006 3. Application For: 4. System to Serve: 5. If Residence: ❑ Dishwasher 6. If Business/Other: 0 Site Evaluation ❑ Improvement Permit & ATC ' �J Both ❑ House ❑ Mobile Home ❑ Business 0 Industry �] Other BARN , # People # Bedrooms # Bathrooms ❑ Gazbage Disposal ❑ Washing Machine ❑ Basement/Plumbing ❑ Basement/No Plumbing Specify type H(IRSC RARN # People �_ # Sinks _�, # Commodes 1 If Foodservice: # Showers # Seats # Urinals Estimated Water Usage (gallons per day) # Water Coolers 7. Type of water supply: ❑ County/City � Well ❑ Community 8. Do you anticipate additions or expansions of the facility this system is intended to serve? ❑. Yes � No If yes, what type? !✓wT 0�- / Q�2G�-`.T��,C.�� j�K.� GC--..J e ^, Gl]�.i►"-� I� PROPERTY INFORMATION REQUIRED: *** IMPORTANT *** A P�►j'�Q�THE PROPERTY MUST BE SUBMITTED WITH THIS APPLICATION. Property Dimensions: 93 AC � WRITE DIRECTIONS (from 5726 08 6718 � Mocksville) TO PROPERTY: Tax O�ce PIN: # - - � � JUNCTION RD. SOUTH T0 Property Address: Road Name OFF RATLEDGE RD . � RATLEDGE RD . T. R. GO City/Zip MOCKSVILLE, NC � APPROX. 1 Z MILES TO 1 If in Subdivision provide information, as follows: � 1. FENCE AND,GATE ON PRIVATE Name: � GRAVEL RD. ON RIGHT 1 Section: Lot #: � I 1 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 responsible for all chazges incurred from this application. 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 STEVE ROBERTSON to conduct all testing procedures as necessary to deternune the site suitability. DATE 6-10-98 SIGNATURE CAROLINA BUI Revised DCHD (06-96) SYSTEMS BY: , IJOU Mft l� J, USE THE $ACK O�' THZ S�OIZM �'OR bRAW Z NG 1JQUR S Z TE . PL,4N . � \�'?�1`��.`� �. ,�J`. .. ,. �, w. � ��t j,� s}1��,� rt�Faan >'��9 �Y4 .. ,qM r.'� �� \,na � ,� � `�,., � � �: � ,�q. � i1 �� ,� w "` �: t �r . � . �' : i � r+ �,�� . 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DAVIE COUNTY HEALTH DEPARTMENT Environmental Health Section SECTION Soil/Site Evaluation APPLICANT'S NAME 1 PROPOSED FACILITY �i'�f`�'—` SUBDIVISION Water Supply: On-Site Well � Community Evaluation By: Auger Boring ✓ Pit DATE EVALUATED _ ��1��" PROPERTY SIZE �� C ROAD NAME �/.�"� �� t� Public Cut �' LOT �.i.�►��a � r�:�u �:�.i.� � � r:�►�.�:�:�:� �:� SITE CLASSIFICATION: EVALUATION BY: �i�/ LONG-TERM ACCEPTANCE RATE: �� OTHER(S) PRESENT: REMARKS: o<(9i,✓ i /0 DCHD (01-90) 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 Wet NS - Non sticky NP - Non plastic FR - Friable FI - Firm VFI - Very frm EFI - Extremely firm SS - Slightly sticky S- Sticky VS - Very Sticky 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 Mineralo�v 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 Classifcation - S(suitable), PS(provisionally suitable), U(unsuitable) , LTAR - Long-term acceptance rate - gaUday/ft2 ' ' f�Y, . ...�64 � •-� .. . .��.". .... �.1 , �� ' . v . W` `. y ' l... 1 —rf.. bi .' J, �.. . ..' .�. � i� .AU'�,'3t?►t1�TtoN No: �� LT , VDEPARTMENT . �'`.� �� ' �" ��x� `� �j � � DAVIE COUNTY HEA H �, � Environmental Health Section ' PROPERTY INFORMATION , Perm�ttee's � �� P.O. Box 848 �:?� �j(�hl ll�f �QLS' ��- Name: �� Mocksville, NG 2Z028 Subdivision Na�`o 1 t_L �C. � k^ f r:.,E }�c..� Phone # 336-751-8760 Directions to property: Section: Lot: r' ,5 , { AUTHORIZATION FOR Q ,1 . ` �'�/�� `� / WASTEWATER Tax Office PIN:# � 7 � "' � _ �� U��ryt i�, "i�, dr; ' `� �,`11i.� cJ � �. �-' .. t��:. — - � SYSTF.M CONSTRUCTION � �,, r� f � � , i � • �"��l t..�-f��.�i. �j`;, � �-`�'�i , � � (`I: �i �l: ��::1�1 Z �aC:' �rl.C1� Road Name: ��'E �' Zip: ,,��D� **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 Fomi/Authorization Number should be presented,to the Davie County Building Inspections Office when applying for Building Permits. (In compliance with 1Article 11 of G.S. Chapter 130A, Wastewater Systems, Section .1900 Sewage Treatment and Disposal Systems) :' �L. � '"'�, �-r ***NOTICE*** THIS AUTHORIZATION FOR WASTEWATER CONSTRUCTION �_..� _ .` �,f,.,_, /�•---,_, ----' I?� �� IS VALID FOR A PERIOD OF FIVEYEARS. ENV[R f �, �tti HEALTH SPECIA �� +^ DATE ISSUED _ � . a. �C /, F. ` � ,..i �: .,...t_. -.ro� - . �. , °t��" •� ., � : � .. „ � . ., ✓ . . . L � r� �{/'/i U ^'., ' , t -,:. � � z„ '��'�'„'_, �f• � �"'`�� ` �" �' DAVIE OUNTY HEALTH DEPARTMENT -+ �",:-"' , � �3 � i�i � l'.z ��."�, IMPRQVEMENT AND OPERATION PERMITS P1ROPERTY INFORMATION Pertrfii ee s - �,,,. F � � '�� l�CS,� �liUG� �i� �5 �i�� :. Name: �� .�^i� 1� �'`"�;.��'ti'��.i�'' Subdivis�on Nafne: . 1 -�--� �. �� Directions to property: ,-- ' �-: ' `s � � � � � `" ` . , '� Section: Lot: ! ; IlVIPROVEMENT �`_ r� � � �� ' �`, �`l,o;. � , . ,. i< �,�;s ' � � ,. �,,. ' .� � � ,�.u.,� F � r*. ' P�`. ' ., � PERNIIT Tax Office PIN:# � - _ . � .: j� ') ;- -,, "� "" � �}�,a ��_` 4 '4�.j� �.� �- ��i � �� ' t�;'s ,�t , <;:'�„�,.��: RoadName: ��-'��"��l�Zip; ��J�•�. **NOTE** This Improvement Pernut DOES NOT authorize the construction ar installation of a septic tank system or any wastewater system. An AUTHORIZATTON FOR WASTEWATER SYSTEM CONSTRUCTION must be obtained from this Department prior to the construction/installation of a system or the issuance of a building pernut. (In compliance with Article 11 of G.S. Chapter 130A, Wastewater Systems; Section .1900 Sewage Treatment and Disposal Systems) `__.�. +""� '""" """~� , ***NOTICE*** TIIIS PERNIIT IS SUBJECT TO REVOCATION IF SITE . _ �'-'-�•, �i ; � � � `� � .� ,�' PLANS OR TI� INTENDED USE CHANGE. YOUR WASTEWATER , _. , ''"'ENVIRQN� �I�LTAL"HEALTH SPECIA�;IST DATE ISSUED SYSTEM CONTRACTOR MUST SEE THI.S PERNIIT BEFORE � _ . , INSTALLING THE SYSTEM. ... . . � : �.. .. ... �' . � . �. �. � � � � � � �lr��f lhfii"�]Ci � . � � . � , . � . . . `.:� •.�_.. RESIDENTIAL SPECIFICATION: BUILDING TYPE �'s� # BEDROOMS -S # BATHS S'�'�- # OCCUPANTS �- GARBAGE DISPOSA �Yes r No COMMERCIAL SPECIFICATION: FACILITY TYPE `# PEOPLE # PEOPLFJSHIFT # SEATS INDUSTRIAL WASTE: Yes or No LOT SIZE �� WATER SUPPLY ��-- DESIGN WASTEWATER FLOW (GPD) � NEW SITE b/ REPAIR SITE // SYSTEM SPECIFICATIONS: TANK SIZE 1;JWGAL. PUMP TANK GAL. TRENCH WIDTH !% ROCK DEPTH I 2,' LINEAR Ff. '�� ' OTHER i�Jw� �V� �A(,,Vlt/,, , D d `�`aTQ.1�I�1�� C:.� . REQUIRED SITE MODIFICATIONS/CONDITIONS: ��`� R' G��'�`� �a-=�=� ��` D�F f,> ti'. �1Ai�% .��' F�t:�t_ i' ' '"'�--''�.�'-�----"�_.�-"��..�i'--../'� ,� .� X� G�f'�' a W 4.R.!-- i � � � ��{ .. ..--� ,.,. � . , . . m .. _. � �r:�`,c �.,:H.. . �. . , { IMPROVEMENTPERMIT,LAYOUT r ��e�;, � �� , ��-��=Z,� „ �� E!C7 /CD ;��f,� kIZ � ., r f�, �� cuc� , � �F� �� c=�-'' _. Qt� ` � -��`' _ __ /lzJ' � /�, � - �5��''� C.�'*`' ��t''�`�YA�--�K- �`�k` I � � ,� c. ,;:= N�...- .�� ' ��' �c.�� .� � � � A � �'�y �.��.. c.� :� , S'n�►�1,,.. iv r-"�►1SF- . .�� - ��s�� , **CONTACT A REPRESENTATIVE OF THE DAVIE COUNTY HEALTH DEPARTMENT FORFINAL INSPECTION OF THIS SYSTEM ' BETWEEN 8:30 - 930 A.M. OR 1:00 - 1:30 P.M. ON THE DAY OF INSTALLATION. TELEPHONE # IS (336)751-8760. ) BY: �� i/ / ii .�w —... ' ��f��t�m� -- ,,r _ �A��r� i%� �— ...J� D �"°� �� _ g AUTHORIZATION NO. _�I �2�� OPERATION PERMIT BY: C / G1 �� DATE: �""`7" �l � "THE ISSUANCE OF THIS OPERATION PERMTT 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 DISPUSAL SYSTEMS", BUT SHALL IN NO WAY BE TAKEN AS A GUARANTEE THAT THE SYSTEM WII,L FUNCTION SATISFACTORILY FOR ANY GIVEN PERIOD OF TIME. ' DCHD OS/96 (Revised) _ �_ _�,�, �.� APPLICATION FOR SITE EVALUATION/IMPROVEMENT PERMIT & ATC i��+`�'�� ca ��' , �^ i D�tvie County Health Department \ J � Environmental Health Section Q�� .� P. O. Box 848 d' �!I21 •� �i Mocksville, NC 27028 � �� ' �� (��¢'�� /Q.�[?a� � ,IQ� � (336)751-8760, „� v � � � ****IMPORTANT**** THIS APPLICATION CANNOT BE PROCESSED UNLESS ALL THE REQUIRED INFORMATION IS PROVIDED. 1. Name to be Billed S r,t�`)c-r,l IQv b r- �T 5 O�� V``� ' D� 1 Contact Person � e� �� l�tJ %�5 vA 1 Mailing Address P � ��'�' ��' � Home Phone City/State/Zip ��,�r '�^�' �-, N C- Z.-I ou b Business Phone "%�„� `%�� ,�I`_'' 7y8'lpS.3.� 2. Name on PermidATC if Different than Above �1.Qrr� Mailing Address City/State/Zip 3. Application For: � Site Evaluation ❑ Improvement Permit & ATC ❑ Both 4. System to Serve: �" House 0 Mobile Home ❑ Business ❑ Industry � ❑ Other f 5. If Residence: # People � # Bedrooms �'_� �� # Bathrooms �-�Z �Z �Dishwasher 'p'Garbage Disposal C� Washing Machine Ga' BasementlPlumbing ❑ Basement/No Plumbing 6. If Business/Other: # Commodes If Foodservice: 7. Type of water supply: Specify type # Showers _ # Seats ❑ County/City # People # Urinals Estimated Water Usage (gallons per day) � Well # Sinks # Water Coolers ❑ Community 8. Do you anticipate additions or expansions of the facility this system is intended to serve? If yes, what type? ❑ Yes � No EZZHEIl tl YLfIT OR.•SZTE PLt1N_ PROPERTY INFORMATION REQUIRED: *** IMPORTANT *** A�'�Q� THE PROPERTY MUST BE � � SUBMITTED WITH TIiIS APPLICATION. t`� �9G Property Dimensions: O � WRITE DIRECTIONS (from _ � _ ��11��cksville) TO PROPERTY: Tax Office PIN: # � � - /� ,L/ I Property Address: Road Name // � � ^p`� r _/ � � V rl-C- I i B�►J �- City/Zip • � L / � d/� �i� ,U � t0 c' c If in Subdivision provide information, as follows: � � �e ; �� .; Name: t I Section• - Lot #: � 1 1 This is to certify that the information provided is correct to the best of my knowledge. I understand that any petmit(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 responsible for all charges incurred from this application. 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 as necessary to determine the site suitability. DATE _ '�� 7��5 SIGNATURE Revised DCHD (06-96) conduct all testing procedures y0U MAIJ. USE THE $,;CK O� THIS �ORM �OR bRttWING I�f0U1Z SITE PL�IN. �� ACc,t � �-v. ao� � -� : DAVIE COUNTY HEALTH DEPARTMENT • Environmental Health Section SECTION LOT Soil/Site Evaluation � � APPLICANT'S NAME �� PROPOSED FACILITY SUBDIVISION Water Supply Evaluation By: FACTORS Slope % HORIZON I DEPTH Texture group Consistence HORIZON II DEPTH Texture group Consistence Structure Mineralogy HORIZON III DEPTH Texture group Consistence Structure HORIZON IV DEPTH Texture group Consistence Structure On-Site Well v Community Auger Boring �/ Pit SOIL WETNESS RESTRICTIVE HORIZON SAPROLITE LONG-TERM ACCEPTANCE RATE SITE CLASSIFICATION: LONG-TERM ACCEPTANCE RA REMARKS: DCHD (O1-90) 1 �� /�b,C� ), � DATE EVALUATED S�/�/ :yl� PROPERTY SIZE �� ROAD NAME �l'y .GI��/' Public Cut 3 4 5 6 7 LEGEND EVALUATION BY: OTHER(S) PRESENT: 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 frm 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 - Subangulaz blocky PL - Platy PR - Prismatic Mineralogv 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 - gaUday/ft2 �. 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' �:w.. ..,�r1 � \ '9� V ( 7.OI . 4O . �,/e .. , ry �I4.Jr%AC� Ip '. "2 q i q• .. , p 140 Ac . • � � � . .. 24.66Aco a � . . ' M '�sv ' , . (IO.CFAc)' •. ' 2i� . • 33q �8. �� n ' • `09 . �\ 14.57Ac°' •:.� • ��8.02 , . . 2 � � *.".•.. , � (O. 9V�cE s� � , ' 9 (3Ac:) • 9 � ., „ , ,.� t � � � 2 6� : ,,,. 18 _ , � �j /� i.' � ':.! � L�I�C . U y� l' � / '^ � ( •ff•�. .. . . ••t• ,�1.' y � , " ,;a � ,. Iy / i.U.� �;%' ! • � /. /'�� -%l`.•.�i\ • � . i �� ,� �_ _ _ __ _ -- _ a • t�- 1 ., .. N� NVM'� 'gg8 , N� Pv� �,�,PRB. �0 EF��G� 336 � �avie County �-CeaCth �epartment and .�-Come .�eaCth �[.�ency �nvironmental�CeaCth Section P.O. BOX B48 / 21 O HOSPITAL STaEEr COURIER #09-40-06 MOCKSVILLE, N.C. 270Z8 PHONe: (704) 634-8760 M�y �1, 199P Stephen Robert=_or F'. 0. Rar. LQtBC� Adv�nce, NC c7��6 Re: � Site Eval�tations/Ratledge Road T�x F�IA1: #57�E—�8-6718 Dear• h1r�. Rohertson: As req��ested, a r�epresentative fr,or� this office visited the �forer�entioned sites on M�y c�, 2998. Pased tlpon the infor*�ation provided on the application{s) for site evaluation(s) and after �n evaluation wa� coc�pleted on each site, the sites were fot►nd to be provisionally �uitable for, the installation of a modified, oversized on—site sewage disposal system on e�ch site. Pefot�e any permits c�n be issued the ho�Rsel►�abile hor�e location on each tr��ct must be established and that ir�r�ediate �r�ea eval��ated. If you h�ve �ny questions, please feel free ta contact this office. Sincer�ely, 1��,�"-��-��i �/ Robert P. H�1 I, Jr. , R. S. Envir,onmental Health Section P.Hl��d Enclasure(s) cc: Zoning �7ffice ,i . �. . . .. � . . . ..,.. . _ ,.-�. . , ,.. . ::..� t,' . .:, i. _., �.... . ., -. , .... _, . • "_ . � � . .. � . � . � . . . .-;. r�. � ��. . . ` . � .. y . .. .. �.. �. . :�'� I � �"- �° ��I'Cc aU �I� Tiorv rro: �� DAVIE COUNTY HEALTH DEPARTMENT '""�' ;, f Environmental Health Section PROPERTY INFORMATION Permittee's P.O. Box 848 Name: �� :,�� Mocksville, NC 27028 Subdivision Name: ..,..��,.i �C_'. � lc� :� --�i i�-� Phone # 336-75:1-8760 Directions to propeny: �' Section: Lot: „� 1�� t--'� �� -'�'�'1 L �.�.`� -c. � � �:� � c ��i � 5`'� AUTHORIZATION FOR �.I , � WASTEWATER SYSTF,M CONSTRUCTION �'L F--�i �-�L•'t��l �,��;,-� �iCLC,q� Tax Office PIN:# -� �� : � _ ��1 �t" L' Road Name: �'��'��`' �Zip: ��'� **NOTE** This Authorization for Wastewater System Construction MUST BE ISSCIED by the Davie County Envuonmental Health Section prior to issuance of any Building Permits. This Form/Authorization Number should be presented,to fhe pavie County Building Inspections Office when applying for Building Permits. (ln complianc � ithy� rticle 11 of G.S: Chapter 130A, Wastewater Systems. Section .1900Sewage Treatment and Disposal Systems) "'� / �"""`^� 4�� ***NOTICE*** TH1S AUTHORIZATION FOR WASTEWATER CONSTRUCTION �°�,�s.,:.. /.�.,. _ .. -. J� �' � IS VALID FOR A PERIOD OF F7VE YEARS. EALTH SPECIAI�7'i DATE 1SSUED �. RESIDENTIAL SPECIFICATION: BUILDING TYPE '�`� # BEDROOMS :: # BATHS '� '- # OCCUPANTS GARBAGE DISPOS . Yes r No COMMERCIAL SPECIFICATION: FACILITY TYPE # PEOPLE # PEOPLF/SHIFT # SEATS INDUSTRIAL WASTE: Yes or No LOT SIZE �� T1'PE WATER SUPPLY ��-- DESIGN WASTEWATER FLOW (GPD) t.. % NEW SITE �/ REPAIR SITE ! ,i ,� r SYSTEM SPECIFICATIONS: TANK SIZE A:�C.��JGAL. PUMP TANK GAL. TRENCH WIDTH .^�!% ROCK DEPTH �� LINEAR Ff. ��-�' ' OTHER �&��1.., t�-1�� l4�l,.�Il.; /? �.1 �YT�L1l�'^�j,T�� J'�i�-i..C"`'.�," , ..,-,..,.. . t �w.-.. '' k . . i . . REQUIRED SITE MODIFICATtONS/CONDITIONS: �:% i��'4�'�°"' Y s �"'�;�•� �(�1�� . �l:rl=.�' �:`i � l.�� iJ ��C... �Pa�� 3�.- �(:;.j_�' ., _ ....:.: ,......`;-.;.�,._.__.., ----.�.i'..�,, Isa��;.k�.. if�!C:!t /'�,t��'ti�%� `-e.-`..----". .._—,""v...'",a✓^---'"`�. �. !./!�) KJ �'' f ?�e? IMPROVEMENT PERMIT.LAYOUT ^ - � i��t i�: � ,�� (�. � /i:� �` �. � l�)� � ��' �r� --._._.._..._ ��'�J� ._...�. _____1� f�_. _ � ��:�. -_� ►-, �� —"�� r� C'G�' .?C 3l,� k.l 2 ��U�� ,�� ___.___...� �� v`' �'Ut;�— r� h ��____.._! aS `Mo*�, 1 t�� t-�`,t.aJ��-. ��:��. ^, , ,�,�,,, r �.�:.:�;.�' "� � � a �; � , ��-�!"�3�-.�... t�,�.,� **CONTACT A REPRESENTATIVE OF THE DAVIE COUNTY HEALTH DEPARTMENT FOR FINAL INSPECTION OF THIS SYSTEM _.� BETWEEN 830 - 930 A.M. OR 1:00 - 1:30 P.M. ON THE DAY OF INSTALLATION. TELEPHONE # IS (336)751-8760. TION PERMIT -r � Uv/ g AUTHORIZATION NO. _��► �� OPERATION PERMIT BY: t. / l� �� DATE: ��`7` �l Q, •'TI-IE ISSUANCE OF THIS OPERATION PERMIT SHALL INDICATE THAT THE SYSTEM DESCRIBED ABOVE HAS BEEN INSTALLED IN COMPLIANCE WTTH ARTICLE 11 OF G.S. CHAP'TER 130A, SECI'ION .1900 "SEWAGE TREATMENT AND DISPUSAL SYSTEMS", BUT SHALL IN NO WAY BE TAKEN AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORILY FOR ANY GIVEN PERIOD OF TIME. DCHD OS/'96 (Revised)