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1285 Junction Road Lot 20Davie County, NC Tax Parcel Report Wednesday. January 4, 2017 Parcel Number: NCPIN Number: Account Number: Listed Owner 1: Mailing Address 1: WARNING: THIS IS NOT A SURVEY Parcel Information M401OA0020 A Township: Mocksville 5726903260 Municipality: 82516538 Census Tract: 37059-801 SPILLMAN ROGER P Voting Precinct: SOUTH CALAHALN PO BOX 738 Planning Jurisdiction: Davie County Zoning Class: DAVIE COUNTY R-20 NC Zoning Overlay: DAVIE COUNTY CZOD City: COOLEEMEE State: Zip Code: Legal Description: Assessed Acreage: Deed Date: Deed Book / Page: Plat Book: Plat Page: Building Value: Land Value: Total Assessed Value: 27014-0000 Voluntary Ag. District: LOT 20 GRANT HEIGHTS .73 ac Fire Response District: 0.69 Elementary School Zone: 2/2014 Middle School Zone: 009500872 Soil Types: 10 Flood Zone: 371 Watershed Overlay: Outbuilding & Extra Freatures Value: Total Market Value: No COOLEEMEE COOLEEMEE SOUTH DAVIE GnB2,GnC2 DAVIE COUNTY All data is provided as is without warranty or guarantee of any Idnd either expressed or implied Including but not limited to the m Davie County, implied warranties of merchantability or fftness for a particular use. All users of Davie Courdy's GIS webstte 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 NCor arising out of the use or Inability to use the GIS data provided by this website AUTHORIZATION NO: 0716' DAVIE COUNTY HEALTH DEPARTMENT Environmental Health Section Permittee's' PROPERTY INFORMATION / P.O. Box 848 , Name: � ! Mocksville, NC 27028 Subdivision Name: Phone #: 704-634-8760 Directions to property: U Section: Lot: -`2t 5 AUTHORIZATION FOR L� // WASTEWATER Tax Office PIN: ! - 3s'j 6 SYSTEM CONSTRUCTION Road Name: J14i Dl? 1zp: **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) ***NOTICE*** THIS AUTHORIZATION FOR WASTEWATER CONSTRUCTION IS VALID FOR A PERIOD OF FIVE YEARS. ENVIRONMENTAL HEALTH SPECIALIST DATE ISSUED DAVIE COUNTY HEALTH DEPARTMENT IMPROVEMENT AND OPERATION PERMITS Permi4 Name: ame„ Directions to property: �---J15,-;}Z IMPROVEMENT PERMIT A PROPERTY INFORMATION Subdivision Name: Section: / Lot: f . Tax Office PINA--' + .) E �t Road Name ._ a,d �it:i.1f�}� .PZ1D **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*** THIS PERMIT IS SUBJECT TO REVOCATION IF SITE PLANS OR 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 /0 H # BEDROOMS 3 # BATHS _:� # OCCUPANTS GARBAGE DISPOSAL: Yes or No COMMERCIAL SPECIFICATION: FACILITY TYPE,/ # PEOPLE # PEOPLE/SHIFT # SEATS INDUSTRIAL WASTE: Yes or No LOT SIZE %% TYPE WATER SUPPLY [ c % DESIGN WASTEWATER FLOW (GPD) 66) NEW SITE REPAIR SITE SYSTEM SPECIFICATIONS: TANK SIZE 14"l GAL. PUMP TANK GAL. TRENCH WIDTH ROCK DEPTH � 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 O AUTHORIZATION NO. OPERATION PERMIT BY: L' %�" `" f 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 Davie County Health Department [1,:-5 19�i Environmental Health Section P. O. Box 848 Mocksville, NC 27028 (704)634-8760 ****IMPORTANT**** THIS APPLICATION CANNOT BE PROCESSED UNLESS ALL THE REQUIRED INFORMATION IS PROVIDED. 1. Name to be Billed ��la! C 1 PT !-Lm P r J Contact Person Qn04t- P -!5()'l MCn Mailing Address ecy. r73 9 Home Phone a `I g - Q T 7 City/State/Zip 1rr M�z . !\A �,n %,01 Business Phone C�) $`t �Z-- I 2. Name on Permit/ATC if Different than Above j AU -Tr 5P1 LLmA rJ Mailing Address P CYo r City/State/Zip 1 WRITE DIRECTIONS (from Tax Office PIN: # � / � % - �` �_ - �'�7P__n+ 1 Mocksville) TO PROPERTY: 3. Application For: El Site Evaluation GY Improvement Permit & ATC ❑ Both Property Address: Road Name \ 11IC -71U1 t) 12D 1 1 �-'7&/I/e,�lU/✓PD 4. System to Serve: ❑ House u/mobile Home ❑ Business ❑ Industry ❑ Other 5. If Residence: # People # Bedrooms_ # Bathrooms 1 ❑ Dishwasher ❑ Garbage Disposal a --'Washing Machine ❑ Basement/Plumbing ❑ Basement/No Plumbing 6. If Business/Other: Specify type # People # Sinks # Commodes # Showers # Urinals # Water Coolers If Foodservice: # Seats Estimated Water Usage (gallons per day) _r- 1 1 1 7. Type of water supply: a/ County/City ❑ Well ❑ Community 8. Do you anticipate additions or expansions of the facility this system is intended to serve? ❑ Yes 2 -No If yes, what type? PROPERTY INFORMATION REQUIRED: *** IMPORTANT *** A PLAT OF THE PROPERTY MUST BE SUBMITTED WITH THIS APPLICATION. Property Dimensions: (t q J4 , 3 (o1 1 WRITE DIRECTIONS (from Tax Office PIN: # � / � % - �` �_ - �'�7P__n+ 1 Mocksville) TO PROPERTY: 1 Property Address: Road Name \ 11IC -71U1 t) 12D 1 1 �-'7&/I/e,�lU/✓PD City/zip �D('S(l_7 LG F, /✓G c�'7�? . �TCl2LG�Ha L'�lC[�C'N 1 If in Subdivision provide information, as follows: 1 �j &RAn%r %7� Name: �I r(A i_ Section: Lot #: . _r- 1 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 �� JAZ SP�L�mA /V to conduct all testing procedures as necessary to determine the site suitability. DATE e?O— 7 SIGNATURE YA!Aev,4 Revised DCHD (06-96) dw DAVIE COUNTY HEALTH DEPARTMENT ' Environmental Health Section Soil/Site Evaluation NAME ADDRESS PROPOSED FACIILTY Water Supply: On -Site Well DATE EVALUATED PROPERTY SIZE LOCATION OF SITE Community Public Evaluation By: Auger Boring Pit I �- Cut FACTORS 1 2 3 4 Landscape position 4, -1— Sloe % Slope HORIZON I DEPTH Texture group Consistence Structure Mineralogy HORIZON II DEPTH > Texture groupC 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 ;lay loam, SIL -Silty loam CL -Clay loam SCL-Sandy clay loam SC -Sandy clay SIC -Silty clay C -Clay CONSISTENCE Moist VFR- Vc-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 Mineralo¢y 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(01-901 ■■■■■■■.■■■■■■■.■■■■■■■.■■■■■■■■■■■■■■■■ ■ME■E■■ ■■NOM■E■ ME■■■■■ ■■.■■.■■■■■.=EEEEEEEEEHEE■E■Ee■EEEHME■ ■■■■■■■■�■E■E■■E■Emom ■■■■ ■■■■■.■■■■■■.■■■■■..■■■■.■■.M■■■■■■■■■■■■ ■. ■■M■■■■■■■■■■■■■■■■■■ .....■.........■.......................■■.■�■.■■■■■.S■■■■■■.■■■■■■ ■... ..............■........................... .... ■■■■■■■ME■■E■ ...............■............■...■■■■■.■■■■■■■■■■■■■_ ■■■■■■■■■■■■■ ■■■■■■■■■■■MMM■■■■M■■■M■■■■■■■.■ ■■■■E■■■■■■■■■E■■�.■■■■■■■■■■.■■ ...............■...........�...............■■.■�... �.■.■.■.■■■■■■ MMmMmMMMMMMMMMMMMmM so■■.■...■..■■■■.■■■O■■■■■■■■■■■■■..■..■■e■■■■.. ■■.E■EN No Ill Ill mommom ■■.■■■■■■ ...............■........................�..._�..�.=EE.�ss■E.M■M�E■ ...............■........................ ... 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