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1175 Junction Rd, 211 Delanos Ln Lot 8Davie County, NC ' Tax Parcel Report Tuesday, January 3. 2017 WARNING: THIS IS NOT A SURVEY Parcel Information Parcel Number: M401OA0008 Township: Mocksville NCPIN Number: 5726819433 Municipality: Account Number: 82516538 Census Tract: 37059-801 Listed Owner 1: SPILLMAN ROGER P Voting Precinct: SOUTH CALAHALN Mailing Address 1: PO BOX 738 Planning Jurisdiction: Davie County City: COOLEEMEE Zoning Class: DAVIE COUNTY R-A,R-20 State: NC Zoning Overlay: DAVIE COUNTY CZOD Zip Code: 27014-0000 Voluntary Ag. District: No Legal Description: LOT 8 GRANT HEIGHTS 2.88 Fire Response District: COOLEEMEE Assessed Acreage: 2.88 Elementary School Zone: COOLEEMEE Deed Date: 1/2012 Middle School Zone: SOUTH DAVIE Deed Book / Page: 008790523 Soil Types: GnB2 Plat Book: 10 Flood Zone: Plat Page: 371 Watershed Overlay: DAVIE COUNTY Building Value: Outbuilding & Extra Freatures Value: Land Value: Total Market Value: Total Assessed Value: I r'pU N.S'L Davie County, I NC 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 County of Davie, North Carolina, Its agents, consultants, contactors or employees from any and all claims or causes of action due to or arising out of the use or Inability to use the GIS data provided by this website. AUTHORIZATION NO: 1493 49J DAVIE COUNTY HEALTH DEPARTMENT Environmental Health Section PROPERTY INFORMATION Permittee's ;' P.O. Box 848 �f Name: L`�G?r'f ".a - i�' ,,, Subdivision Name:'�^'/�7C/ Mocksville, NC 27028 Phone #: 704-634-8760 17 Directions to property: `� 'A.<<' 1"` '� Section: Lot: AUTHORIZATION FOR<?' .� WASTEWATER <'"' SYSTEM CONSTRUCTION Tax Office PIN:# . Road Name: -. �ia j`��'.s ='1�: (4 dip: , 70 a **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 11 of G.S. Chapter 130A, Wastewater Systems, Section .1900 Sewage Treatment and Disposal Systems) /� r✓ ' ***NOTICE*** THIS AUTHORIZATION FOR WASTEWATER CONSTRUCTION IS VALID FOR A PERIOD OF FIVE YEARS. ENVIRONMENTAL HEALTH SPECIALIST DATE ISSUED xf ;� DAVIE COUNTY HEALTH DEPARTMENT IMPROVEMENT AND OPERATION PERMITS PROPERTY INFORMATION Permittttee's / l Name: Subdivision Name: Directions to property: Section: Lot:'.. IMPROVEMENT PERMIT Tax Office PIN:# --•-- " Road Name r, rp�,.Y1'.1/4 t�(J'Zip; **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*** TEAS PERMIT IS SUBJECT TO REVOCATION IF SITE PLANS OR THE INTENDED USE CHANGE. YOUR WASTEWATER ENVIRONMENTAL HEALTH PECIALIST DATE ISSUED SYSTEM CONTRACTOR MUST SEE THIS PERMIT BEFORE INSTALLING TEIE SYSTEM. RESIDENTIAL SPECIFICATION: BUILDING TYPE/% # BEDROOMS # BATHS ^ # OCCUPANTS GARBAGE DISPOSAL: Yes or No COMMERCIAL SPECIFICATION: FACILITY TYPES # PEOPLE # PEOPLE/SHIFT # SEATS INDUSTRIAL WASTE: Yes or No LOT SIZE �TYPE WATER SUPPLY r DESIGN WASTEWATER FLOW (GPD) NEW SITE L--''' REPAIR SITE SYSTEM SPECIFICATIONS: TANK SIZE,,:: D GAL. PUMP TANK GAL. TRENCH WIDTH f l • ROCK DEPTH i LINEAR FT. REQUIRED SITE MODIFICATIONS/CONDITIONS: IMPROVEMENT PERMIT LAYOUT "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 (704) 634-8760. OPERATION PERMIT SYSTEM INSTALLED BY: AUTHORIZATION NO. OPERATION PERMIT BY: DATE: "THE ISSUANCE OF THIS OPERATION PERMIT SHALL INDICATE THAT 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 05/96 (Revised) DAVIE COUNTY HEALTH DEPARTMENT IMPROVEMENT AND OPERATION PERMITS PROPERTY INFORMATION Permittee's xr�� Name: Subdivision Name: > 4"* / f J 7 } Directions to property: Section: r Lot: IMPROVEMENT PERMIT Tax Office PIN:# Road Name:u'_1L,, 14 Ac, Zip **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 1 I of G.S. Chapter 130A, Wastewater Systems, Section .1900 Sewage Treatment and Disposal Systems) PLANS R THE INTENDED USE CHANGE. YOUR WASTEWATER ENVIRONMENTAL HEALTH SPECIALIST DATE ISSUED SYSTEM CONTRACTOR MUST SEE THIS PERMIT BEFORE INSTALLING THE SYSTEM. RESIDENTIAL SPECIFICATION: BUILDING TYPE .4'I i" # BEDROOMS # BATHS f2- # OCCUPANTS GARBAGE DISPOSAL: Yes or No COMMERCIAL SPECIFICATION: FACILITY TYPE # PEOPLE # PEOPLE/SHIFT` # SEATS INDUSTRIAL WASTE: Yes or No LOT SIZE TYPE WATER SUPPLY �' DESIGN WASTEWATER FLOW (GPD) f. NEW SITE 1- REPAIR SITE SYSTEM SPECIFICATIONS: TANK SIZE . r' = tl GAL. PUMP TANK GAL. TRENCH WIDTH �f�^ ROCK DEPTH LINEAR FT.Y�=� OTHER REQUIRED SITE MODIFICATIONS/CONDITIONS: **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 (704) 634-8760. OPERATION PERMIT SYSTEM INSTALLED BY: AUTHORIZATION NO. OPERATION PERMIT BY: DATE: **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) APPLICATION FOR SITE EVALUATIONAMPROVEMENT PERMIT � f Davie County Health Department Environmental Health Section JUN — 3 IM d P. O. Box 848 Mocksville, NC 27028 ENVIRONMEMAL HEALTH (704) 634-8760 DAVIE COUNTY ****IMPORTANT**** THIS APPLICATION CANNOT BE PROCESSED UNLESS Q� ALL THE REQUIRED INFORMATION IS PROVIDED. 1. Name to be Billed 0 v' v` Ma h Contact Person Mailing Address �U 0% Home Phone 0,41-4. City/State/Zip (/0 0 to t 1' ►'tom r v c C; -z 1 Business Phone C;�2 U"f - �cJJ I 2. Name on Permit/ATC if Different than Above Mailing Address City/State/Zip 3. Application For: Ll Site Evaluation 'M' Improvement Permit & ATC ❑ Both 4. System to Serve: ❑ House Mobile Home ❑ Business ❑ Industry ❑ Other 5. If Residence: # People # Bedrooms # Bathrooms OYDishwasher ❑ Garbage Disposal & Washing Machine ❑ Basement/Plumbing ❑ Basement/No Plumbing 6. If Business/Other: Specify type # People # Sinks # Commodes If Foodservice: 7. Type of water supply: # Showers # Seats County/City # Urinals Estimated Water Usage (gallons per day) ❑ Well # Water Coolers 8. Do you anticipate additions or expansions of the facility this system is intended to serve? If yes, what type? ❑ Community ❑ Yes YIN PROPERTY INFORMATION REQUIRED: *** JMPORTANT ***A PLAT OF THE PROPERTY MUST BE SUBMITTED WITH THIS APPLICATION. n Property Dimensions: "! 4- 1 WRITE DIRECTIONS (from Tax Office PIN: # —72 - 1 Mocksville) TO PROPERTY - Property (P ,j �'/ 1 Property Address: Road Name - J�/� • />c ) 1 City/Zip If in Subdivision provide information, asfollows: Name: C -1--V"4 4lle Section: go Lot #: 1 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 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 4 J ' �'' M �fN/' to conduct all testing procedures as necessary to determine the site suitability. 11 , DATE �v SIGNATURE �X Revised DCHD (06-96) DAVIE COUNTY HEALTH DEPARTMENT Environmental Health Section SECTION_ LOT, Soil/Site Evaluation APPLICANT'S NAME % /` DATE EVALUATEDZ. ��cF PROPOSED FACILITY PROPERTY SIZE ) to C SUBDIVISION ROAD NAME zj!L' P/ Water Supply: On -Site Well Community Public Evaluation By: Auger Boring Pity Cut FACTORS 1 2 3 4 5 6 7 Landscape position Sloe % HORIZON I DEPTH Texture group Consistence Structure Mineralogy HORIZON II DEPTH Texture group Consistence Structure / Mineralogy,1 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 V SITE CLASSIFICATION: LONG-TERM ACCEPTANCE RATE: REMARKS: LEGEND Landscape Position EVALUATION BY: i�Yl�i —a OTHER(S) PRESENT: 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 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/ft2 DCHD (01-90) ■■■ ■ ■E■■■ ■E■E■ HE■■ moon ■M■■ ■ ■ ■■■■■■■■■■■■■■■■■■■■■■■■■■■ ■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■ ■■■■■■■■■■■■■■■■■■■■■■■■■■■ ■■■■■■■■■■■■■■■■■■■■■■■■■ ■■■■■■■■■■■■■■■■■■■■■■■■■ ■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■ ■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■ ■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■ ■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■ ■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■ ■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■ ■■■■■■■■■■■■■■■■■■■■■■■■■■■ ■■■■■■■■■■■■■■■■■■■■■■■■■ ■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■ MENMENNEN MENNEN MEN NEN MENNEN ENIMEME MENNEN M ■■■■■■tM■■■M■■■MM■■■■t■t�/■/■■///■/■■■mai■■■■//■■/■■/■■■ ■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■mil■■■■■■■■■■■■■/■■■■■■■■ ■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■ ■■■■■■■■■■■■■■■■■■■■■■■■■■■ ■■■■■■■■■■■■■■■■■■■■■■■■■ ■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■ ■■■■■■■■■■■■■■■■■■■■■■■■■■■ ■■■■■■■■■■■■■■■■■■■■■■■■■ ■E■M■M■ ■■■ME■■ ■ME■EM■ ■E■MMM■ ■EM■■M■ ■MM■ME■ ■NEEM■■ ■EMMEM■ ■■■MEM■ ■MNEME■ ■EMEME■ ■EM■MM■ ■EMM■M■ ■E■■EM■ ■■■MME■ ■MNEME■ ■E■■MM■ ■M■M■E■ ■ME■■E■ ■EMEME■ ■EMM■M■ ■■M■■E■ ■E■M■M■ ■E■■E■■ ■■N■■N■ ■■■MEM■ ■E■■EM■ ■E■M■M■ ■MMMEM■ ■E■■MM■ ■E■E■E■ Davie County, NC r Tax Parcel R ennrt Wednesday, January 4, 2017 WA1UN11NU: '1n1J 111VV1 A JUKVL' Y Parcel Information Parcel Number: M4010A0008 Township: Mocksville NCPIN Number: 5726819433 Municipality: Account Number: 82516538 Census Tract: 37059-801 Listed Owner 1: SPILLMAN ROGER P Voting Precinct: SOUTH CALAHALN Mailing Address 1: PO BOX 738 Planning Jurisdiction: Davie County City: COOLEEMEE Zoning Class: DAVIE COUNTY R-A,R-20 State: NC Zoning Overlay: DAVIE COUNTY CZOD Zip Code: 27014-0000 Voluntary Ag. District: Legal Description: LOT 8 GRANT HEIGHTS 2.88 Fire Response District: COOLEEMEE Assessed Acreage: Deed Date: Deed Book / Page: Plat Book: Plat Page: Building Value: Land Value: Total Assessed Value: 2.88 Elementary School Zone: COOLEEMEE 1/2012 Middle School Zone: SOUTH DAVIE 008790523 Soil Types: GnB2 10 Flood Zone: 371 Watershed Overlay: DAVIE COUNTY Outbuilding & Extra Freatures Value: Total Market Value: No C t•/� r All data Is provided as is without warranty or guarantee of any kind either expressed or Implied Including but not limited to the e Davie County, Impliedwarranties of merchantability or fitness for a particular use. All users of Davie County's GIS website shall hold harmless the County of Davie, North Carolina, its agents, consultants, contractors or employees from any and all claims or causes of action due to NC or arising out of the use or Inablltty to use the GIS data provided by this website. .._.......___.._..�_......_� �..._�._____...._.______._..__......__.__,_�_.._........_.�..._.._._._.._.......__..�__._—'--^'___...��__...._._...,.___.......__..._�_._..�..�.___._...._.._..___...�...�d..._�...�..W_______. _sill i IMPROVEMENT PERMIT DAVIE COUNTY HEALTH DEPARTMENT IMPROVEMENT PERMIT and OPERATION PERMIT **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 6.5. Chapter 130A, Wastewater Systems, Section .1900 Sewage Treatment and Disposal Systems) NAME .�� PROPERTY ADDRE55 C. - — -) DATE LOCATION SUBDIVISION NAME//9N /�`Pi �� �1 i�� LOT NUMBER SEC. /BLOCK NUMBER RESIDENTAL SPECIFICATION: BUILDING TYPE 14 A/ # BEDROOMS # BATHS t OCCUPANTS GARBAGE DISPOSAL.: Yes/No COMMERCIAL SPECIFICATION: FACILITY TYPE # PEOPLE # PEOPLE/SHIFT # SEATS INDUSTRIAL WASTE: Yes/No LOT SIZE / TYPE WATER SUPPLY el DESIGN WASTEWATER FLOW (GPD) _ /-•D NEW SITE A---- REPAIR SITE SYSTEM SPECIFICATIONS: TANK SIZE ZeZp GAL. PUMP TANK GAL. TRENCH WIDTH ,� ROCK DEPTH X ' LINEAR FT.:jDO OTHER + REOUIRED SITE MODIFICATIONS/CONDITIONS: ***THIS PERMIT IS SUBJECT TO REVOCATION IF SITE PLANS OR THE INTENDED USE CHANGE. YOUR WASTERWATER SYSTEM CONTRACTOR MUST SEE THIS PERMIT BEFORE INSTALLING THE SYSTEM. IMPRDUEMENT 'ERMIT BY **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 (704) 634-8760. OPERATION PERMIT SYSTEM INSTALLED BY r40 � .00l/o AUTHORIZATION NO. OPERATION PERMIT BY 3°0 DATE — **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 FLNCTION SATISFACTORILY FOR ANY GIVEN PERIOD OF TIME. DCHD 10/95 0 y � /b-96 WAD :Z:H 6K ' 1 Davie County Health Department ENVIRONMENTAL HEALTH SECTION P.O. Box 665 Mocksville, N.C. 27028 AUTHORIZATION FOR WASTEWATER SYSTEM CONSTRUCTION (Issued in compliance with Article 11 of G.S. Chapter 130A, Wastewater Systems) ***This Authorization For Wastewater System Construction oust 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 applying for Building Permits.*** / AUTHORIZATION NUIBLR NAME r , , / DATE i NAME ON IMPROVEMENT PERMIT (If different than above) 41 SITE LOCATION COMMENTS/CONDITIONS ON AUTHORIIATION TO CONSTRUCT WASTEWATER SYSTEM 1. Application/Permit Mailing Address _ APPLICATION FOR SITE EVALUATION/IMPROVEMENTS PER Davie County Health Department Environmental Health Section P. O. Box 665 Mocksville, NC 27028 FMG 5 i nfi.^.innnr: Phan -(OD`/) Qaq—.DS5) ' 2. Namo on Pormlt It Difloront than Abovo 3. Applicnllon for: O Gonornl Evnluation �l Soptic Tank Installation Permit 4. System to Serve: ❑ House Mobile Home ❑ Place of Public Assembly ❑ Business ❑ Industry I� ❑ Other ❑ Unknown 1 5. If house, mobile home: Subdivision aJ'Qfl�" i�IP�lf3h Section Lot # �1 No. of People No. of Bedrooms No. of Bathrooms a Dwelling Dimensions 6. If business, industry, place of publ'c assembly, other: S;>ecify type No. of People Served No. of Commodes No. of Sinks No. of Urinals ❑ Basement/Plumbing ❑ Basement/No Plumbing ❑ Washing Machine ❑ Dishwasher ❑ Garbage Disposal No. of Lavatories No. of Water Coolers No. of Showers Water Usage Figures 7. Type of water supply: Public ❑ Private O Community 8. Property Dimensions 10(A( Sewaga Disposal Contractor — 9. Do you anticipate additions/expansion of the facility this sytem is intended to s•rve? ❑ Yes No If yes, what type? I 'NOTE: Improvements Permits shall be valid for a period of 5 years from date issued. Improvementt Permits are subject to revocation, if site plans or the intended use change. Effective October 1, 1989. PROPERTY INFORNMATI 1 REQUIRED: ^,� Directions to Property: Tax Office PIPJ # p 1 / +r! Ll Road Name On `1 _ Box irk (if- available) City Ml OC 1)" II'9=e _ This is to certify that the information provided is correct to the best of incurred from this application. D TE , and I unde�t'and I am responsible for all charges CONSENT FOR SITE EVALUATION TO BE DONE ON ABOVE DESCRIBED PROPERTY MUST CHECK ONE: ❑ 1. 1 OWN the property. DI -151"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: 1 hereby give consent to the authorized representative of the Davie Co my H D partme t to enter upon above described property located in Davie County and owned by L L �.�/(/ V --- to conduct all testing procedures as necessary to Zrefdrmine said site's suitability for a ground absorption sewage treatment and disposal system. °J Ms —X .. DATE vf SIGNATURE DCHD (1193) NAME ADDRESS PROPOSED FACIILTY _ Water Supply: Evaluation By: DAVIE COUNTY HEALTH DEPARTMENT Environmental Health Section Soil/Site Evaluation �7 �/� DATE EVALUATED _?-I& PROPERTY SIZE ! }G LOCATION OF SITE On -Site Well Community Auger Boring Pit FACTORS 1 2 3 4 Landscape position Sloe % HORIZON I DEPTH Texture group Consistence Structure Mineralogy HORIZON II DEPTH Texture groupt Consistence Structure /C 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: JK EVALUATED BY: LONG—TERM ACCEPTANCE RATE: ' REMARKS: DCHD (01-901 OTHER(S) PRESENT: LEGEND Public Cut 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 :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 -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 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 watef 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 ■.■■■■■■■■■■■■.■■■■■■.■■■■.■■■■■■■■■..■■ ■ME■NN■:■■NOMMEN MENS■■■ ■.■■■■N■■■■■_■.■■■NE■■N■■.■■■■■E■■NEO■ ■ESS■MM■ �O��■MMOS■SM■E■■ ■■■■■■■■.■■■■.■■.■■■■■■■■.■■■..■ NOON■■■ ■ ■.■■■■.■■■■■.N■■MENE■ ■■■■■■■.■.■.■.■■.N■■■■■■■■■.■.■.■N■■■■NN■::M:■■■■■■■■■■■NM■MOMMEM■ ■■■■■■..■■■■■■■■■■■■..■■NN.■■■■.■Ntt■■■EEE.■SMMMMEMMMM■■■..■■ENE■■ .....H■■.■■■■■.N■■■■......................�........ ■EMMM■ON■OON■ ...............■............■... ........�........ ..■■■.■.■..■■■ MONSOONS■■■■EOMMMEMO■■.EEE.EEE■OEEM�■OM■MMMMMMEOMEO■■MEM=MMM �■■.■�■■■EMNON ■■■NNNM■t■■■■.■■■■..■■■.■.■ ■■■■■EEtMM■EM■M.■MM ■MM■ ME■■ MONSOONS ■■■■OMMMM■■■■■■OM■■■M■■.E■■.■■■M■■■■■.■OOEEOOMoEE■EE■H ■MONSOONS ■■■■■EM■■■■M■■EM.■■EMN■■MMMM.■ME■■SEES■■AMM■= S■�S=■SE�'�'i■E■..S=.E ■■■MMMM■■■■■■MMOMN■Et.NE■E■.NN.tMMt.EE■■ MEN ■ ■■■ ■■■MESH ■■ NONE No ONE M ■■MMM■MM■■MMMMMMM■■M■N■MM■■MMMM�MM■■■MM■MMM■■MMMEMMMMMMEN■■EM■■ ■EM■■■t■■MO■■■OM■■■.■DOE■■■MM■■■■OMMMMO■M■MHME■�==■■MO■MMOMEM■M■M■ MENEM ...............OEM■MOM■■■EOM■■■OMMaN■�MMMM.O=NNOM■■ OOEO■=■=N■■■=■� ...............■............■N■■■■ ■ MM■EMM MMMMMSMM■MS■ ■ MMMM■ ■■■■s■■■■.MMMME■MMM..MEME■■EM■MME■ ■■■MEEE.■.M.MMHM■SCM�■EMMM■ ■M■�E■ _ ■■■■■■■■■■■■■■■.■■■■■■■■■■■■■■■■■■■■■■MM■■ HMM ■ 0 ■ ■■■■ ■■ ■■■■■.■■■■■■..■■■.■■■.■■■.■..■■.�■■■.NNH�NO■NO00■NO■NODE■MEN:ONE ■..■.■■■■■■OO.■■■■■■ENNNNNN■■N■NNNNONNMNN■DMO EMM■�■■E■■OSEEM ■■■■■■■OOO■O■N■OMON■t00HN■■■■■■.■■■■■■NH■MMM■OM0 ■t MEMM■OE ........uN■NM.0000■■■.NN■t■■N■■■■■■MMMME■EMOMHM■■: NONE:MOM■EM: ■MM■■MMMM■■■MMM■t■MMM■■■MMMOMMM■OMMM■MMMMmom■ON MEN MONSOON .........................................�...■■ In�■■■ ■M=MEMMEM■ NOON■■MEM■OOOMMM■OMO■RMMMMOOO■■�M.MMRMMMMMEMMM SHRHN■MSOON MEMO:EMM■MME■ ■.H■■■■■■■■NNNE■..■■.NNN■■■■■OJ NEON NMNOEMM MEHOM■■ MMM■MMM■ ■M■�HOMMOONNEHMMMMOO■■■MMM��/EMMMMM■NEON■EH0 MHMH MONSOON NOON ■.■■■■■■■■O.NN■■■.NO■OONO■�IEOMME■ M.M■OMMO ■ EM ■■■■MM= ■NN■OEM.■■■■NME.N■■.■.■■EMM■OMN.I7 ■ tO■. ■ ■ MOO OM■■.O ••••••••••• ■NEE■EN■■MMNMMOM■EN ■■E MO m NEON ■ O�"i■MM■MN: ......�.:...■�......�.....:�.... 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