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198 & 214 Delanos Ln Lot 7Davie County, NC , Tax Parcel Report Tuesday, January 3, 2017 139 1126iS �-r 1133 _r 131�n 1141 r �� 123 1151 11511 '� 167 -,l�� --;i .157 f '115 7�-��10 7�� 214 1i y 116 5 1168 �'rr' V ` ' _ =198 1175 f r ��rr Y203_ J - '•�`+� ��� f� ~195 r �, ti �x �r,+•�• 18 7 I \\1199- / 179 'P 7f -'I i 1551 � f' 163 �` J ,.149 '142 �, 1234 247 :'� 1'32\ , 255r 1244%1246-0 - "--`•\'1265 Parcel Number: NCPIN Number: Account Number: Listed Owner 1: Mailing Address 1: WARNING: THIS IS NOT A SURVEY Parcel Information M401 OA0007 Township: Mocksville 5726914480 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 -A 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 7 GRANT HEIGHTS 2.91ac Fire Response District: 'rN vie County, _M 2.91 Elementary School Zone: 12/2013 Middle School Zone: 009450493 Soil Types: 10 Flood Zone: 371 Watershed Overlay: Outbuilding & Extra Freatures Value: Total Market Value: No COOLEEMEE COOLEEMEE SOUTH DAVIE GnB2,MsC DAVIE COUNTY 1 492 AUTHORIZA-000 NC s DAVIE COUNTY HEALTH DEPARTMENT i - — Environmental Health Section Pe4nittee's P.O. Box 848 S &,00:ko PROPERTY INFORMATION Name: D Mocksville, NC 27028 Subdivision Name: Phone #: 704-634-8760 Directions to property: `� ji�'�'' ®`�' �'���' Section: Lot: AUTHORIZATION FOR WASTEWATER Tax Office PIN:#.$ -2;? - SYSTEM CONSTRUCTION Road Name:Q1"r+ . R.t A' r j �0 / ***NOTICE*** 11M AUTHORIZATION FOR WASTEWATER CONSTRUCTION j C• 1 -,, E%� `' ; rte, ,% d " IS VALID FOR A PERIOD OF FIVE YEARS. ENVIRONMENTAL HEALTH SPECIALIST DATE ISSUED DAVIE COUNTY HEALTH DEPARTMENT IMPROVEMENT AND OPERATION PERMITS PROPERTY INFORMATION P6 nittee's Name: Directions to property: f **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. i I RESIDENTIAL SPECIFICATION: BUILDING TYPE /%s) ,/� # BEDROOMS --? # BATHS # OCCUPANTS GARBAGE DISPOSAL: Yes or No COMMERCIAL SPECIFICATION: FACILITY TYPE- # PEOPLE # PEOPLE/SHIFT # SEATS INDUSTRIAL WASTE: Yes or No LOT SIZE C TYPE WATER SUPPLY C/ DESIGN WASTEWATER FLOW (GPD) (? NEW SITE REPAIR SITE � SYSTEM SPECIFICATIONS: TANK SIZE 1%�/, GAL. PUMP TANK GAL. TRENCH WIDTH S�e ROCK DEPTH LINEAR Fr.--� 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. G1 OPERATION PERMIT BY: J [%�� DATE: oL **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) Subdivision Name r ;�r}' l t�? • r'� Section:- •� Lot IMPROVEMENT PERMIT Tax Office PIN:##�v` -1M/1 Road Name -�,�,�n ;r� 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*** 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. i I RESIDENTIAL SPECIFICATION: BUILDING TYPE /%s) ,/� # BEDROOMS --? # BATHS # OCCUPANTS GARBAGE DISPOSAL: Yes or No COMMERCIAL SPECIFICATION: FACILITY TYPE- # PEOPLE # PEOPLE/SHIFT # SEATS INDUSTRIAL WASTE: Yes or No LOT SIZE C TYPE WATER SUPPLY C/ DESIGN WASTEWATER FLOW (GPD) (? NEW SITE REPAIR SITE � SYSTEM SPECIFICATIONS: TANK SIZE 1%�/, GAL. PUMP TANK GAL. TRENCH WIDTH S�e ROCK DEPTH LINEAR Fr.--� 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. G1 OPERATION PERMIT BY: J [%�� DATE: oL **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 (E M N 0 V N • Davie County Health Department Environmental Health Section P. O. Box 848 JUN - 31998 Mocksville, NC 27028 (704) 634-8760 F1VIri0N .1E1fTAL HE11111 MVIE COUPIIY ****IMPORTANT**** THIS APPLICATION CANNOT BE PROCESSED UNLESS ALL THE REQUIRED INFORMATION IS PROVIDED. 1. Name to be Billed l.Q,Q�n �riN Contact Person �0 &qR—/ Mailing Address PO Home Phone City/State/Zip (�qo l.0 hyg, 65 5 d 7y I � Business Phone 2. Name on Permit/ATC if Different than Above Mailing Address 3. Application For: 4. System to Serve: 5. If Residence: Dishwasher 6. If Business/Other: # Commodes _ If Foodservice: 7. Type of water supply ❑ Site Evaluation LlHouse @/s Mobile Home # People ❑ Garbage Disposal Specify type _ # Showers City/State/Zip 2/Improvement Permit & ATC ❑ Business ❑ Industry # Bedrooms 3 ❑ Both ❑ Other # Bathrooms C3' Washing Machine ❑ Basement/Plumbing ❑ Basement/No Plumbing # Seats / d County/City # People # Sinks # 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 1 --"No PROPERTY INFORMATION REQUIRED: *** IMPORTANT *** A PLAT OF THE PROPERTY MUST BE "1 Al"'A�� SUBMITTED WITH THIS APPLICATION. Property Dimensions: r1 1 , f. d n 1 WRITE DIRECTIONS (from Mocksville) TO PROPERTY: Tax Office PIN: # Property Address: Road Name 1 1 City/Zip M d C&Vi 1 te, -2-)0a9 1 If in Subdivision provide information, as follows: 1 Name: � �� t' Lot #761 -)LSection:� 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 Cr to conduct all testing procedures as necessary to determine the q9 suitability. DATE �" SIGNATURE Revised DCHD (06-96) � fp 'INJI #//o DAVIE COUNTY HEALTH DEPARTMENT Environmental Health Section Soil/Site Evaluation APPLICANT'S NAME i PROPOSED FACILITY SUBDIVISION Water Supply: On -Site Well Community Evaluation By: Auger Boring Pit SECTION_. LOT I/c DATE EVALUATED PROPERTY SIZE ,/�C ROAD NAME _��T awo Public Cut FACTORS 1 2 3 4 5 6 7 Landscape position Slope % HORIZON I DEPTH Texture group Consistence Structure Mineralogy HORIZON II DEPTH Texture group(� Ci Consistence i Structure Mineralogy HORIZON III DEPTH Texture group Consistence Structure Mineralogy HORIZON IV DEPTH Texture group Consistence Structure Mineralogy SOIL WETNESS RESTRICTIVE HORIZON SAPROLITE CLASSIFICATION ej LONG-TERM ACCEPTANCE RATE 1. 1 SITE CLASSIFICATION: LONG-TERM ACCEPTANCE RATE: REMARKS: LEGEND DCHD (OI -90) Landscape Position EVALUATION BY: AI! 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 ■N■■N■■ ■■E■EM■ ■■■E■M■ ■E■■■M■ ■E■E■E■ ■NSE■■■ ■■MM■M■ ■O■■E■■ ■E■■E■■ ■MMEM■■ ■M■■■M■ ■E■■■M■ ■MO■■E■ ■■■E■E■ ■■E■■M■ ■■■■E■■ SOMEONE MEN MEN ■■■EM■■■M■■EM■ ■E■■ ■EM■■■■■ ■E■E�M■■M■MM■ ■EMM■■MEMEMEM■ ■EM■EME■MEMM■■ ■E■■E■EM■■E■E■ ■E■■■E■E■E■■■■ ■■E■EMM■■■EEE■ ■E■■■■■E■■EEE■ ■■E■ ■■E■■EM■ ■EM■ ■E■E■■E■ ■■ESE■■■E■EM■■ ■■M■■■EM■■MMO■ ■E■E■EM■■EMM■■ ■EMM■■E■■E■■■■ ■■■■■NESE■ ■E■■E■■■M■ ■■■■■SEE■■ ■E■■EM■■E■ ■■■■E■E■E■ ■EEE■■E■■■ ■E■■EN■■M■ ■E■EM■■E■■ ■■MEMS■■M■ ■■E■■E■EM■ ■E■■EEE■E■ ■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■ ■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■ ■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■ ■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■ ■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■ i■■■M■M■M■MME�■MEM■■ M■■■E■■ E■■EN■ENN■N■■M■■■ ■EEE■■E■■■■■■■■■!■■■N■■■■■EEE■EEE■■l■■■■■■EEE■■■■■■■■■■■■ ■■■■■■■■■■■■■SE■,�E■■■■■E■■ENE■EEE■l■■■■■■■■■■■■■■■■■■■■■ ■■■■■■■■■■■■■■■■■■■■■■■■■ ■■■■■■■■■■■■■■■■■■■■■■■■■ ■■■■■■■■■■■■■■■■■■■■■■■■■ ■■■■■■■■■■■■■■■■■■■■■■■■■ ■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■ ■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■ ■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■ ■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■ Davie County, NC Tax Parcel Report Wednesday, January 4, 2017 Parcel Number: NCPIN Number: Account Number: Listed Owner 1: Mailing Address 1: City: State: Zip Code: Legal Description: Assessed Acreage Deed Date: Deed Book / Page: Plat Book: Plat Page: Building Value: 1126 ' {113 ~1311 '7 dN _ _..1A-' 1I 1136 1151 115i�1, 167 1 - — �i�+ r. .157 115 7_� 10 7 I -' 1165 214 211 1168 l 4�` �� ' -198 �- '117 5 203 \\1185fl`.-'" J L f 18'7 \1199 179 - 'P 1211 171 '-,1223 —1�`—r163Ji %,%12 29, 149• 237' 142 1234''x',1 47._! 132" 1'',125 5,r� 1244\1246 ' 1,'1265 , 1 WARNING: THIS IS NOT A SURVEY Parcel Information M401 OA0007 Township: Mocksville 5726914480 Municipality: 82516538 Census Tract: 37059-801 SPILLMAN ROGER P Voting Precinct: SOUTH CALAHALN PO BOX 738 Planning Jurisdiction: Davie County COOLEEMEE Zoning Class: DAVIE COUNTY R -A NC Zoning Overlay: DAVIE COUNTY CZOD Land Value: Total Assessed Value: 27014-0000 Voluntary Ag. District: LOT 7 GRANT HEIGHTS 2.91 ac Fire Response District: 2.91 Elementary School Zone: 12/2013 Middle School Zone: 009450493 Soil Types: 10 Flood Zone: 371 Watershed Overlay: Outbuilding & Extra Freatures Value: Total Market Value: No COOLEEMEE COOLEEMEE SOUTH DAVIE Gn132,MsC DAVIE COUNTY All data Is provided as Is without warranty or guarantee of any kind either expressed or Implied Including but not limited to the s Davie County, , Implied warranties of merchantability or fitness for a particular use. An users of Davie County's GIS website shall hold harmless the I [- County of Davie, North Carolina, Its agents, consultants, contractors or employees from any and all Balms or causes of action due to i NC �_ or arising out of the use or inability to use the GIS data provided by this website. i A TION NO: 152.6 DAVIE 'OUNTY HEALTH DEPARTMENT i Environmental Healtb Section PROPERTY INFORMATION Permittee's �/ ./ P.O. Box 848 Name: Mocksville, NC 27028 Subdivision Name: —�-' -,/ Phone # 336-751-8760 Directions to property: r'-J,+�D%�i 1 • Section: Lot: 7 AUTHORIZATION FOR WASTEWATER Tax Office PIN: SYSTEM CONSTRUCTION Road Name: **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 FORA PERIOD OF FIVE YEARS. ENVIRONMENTAL HEALTH SPECIALIST DATE ISSUED (,5 )5 DAVIE COUNTY HEALTH DEPARTMENT IMPROVEMENT AND OPERATION PERMITS PROPERTY INFORMATION I'ermittee's% / Name: �' k'' !�/ J�/Y ,'ey, �I r?�i SubdivisionName:��t /�/ /�� +' Directions to property: Section: Lot: �/� D IMPROVEMENT PERMIT Tax Office PIN:#t -4 -ZZ-(� •' Road Name: -::7z;j4 **NOTE** This Improvement Permit DOES NOT authorize the construction or installation of aseptic 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) f' ***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 # BEDROOMS # BATHS 0-- # OCCUPANTS GARBAGE DISPOSAL: Yes or No COMMERCIAL SPECIFICATION: FACILITY TYPE # PEOPLE # PEOPLE/SHIFT 7/ # SEATS - INNDUSTRIAL WASTE: Yes or No LOT SIZE LCL_ TYPE WATER SUPPLY C6 DESIGN WASTEWATER FLOW (GPD) NEW SITE l/ REPAIR SITE SYSTEM SPECIFICATIONS: TANK SIZVkV —GAL. PUMP TANK GAL. TRENCH WIDTH -JA' ROCK DEPTH LINEAR FT. 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 (336)751-8760. OPERATION PERMIT SYSTEM INSTALLED BY L.J AUTHORIZATION NO.17 OPERATION PERMIT BY: DATE: r **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) r' APPLICATION FOR SITE EVALUATIONAMPROVEMENT PERMIT Davie County Health Department Environmental Health Section P. O. Box 848 Mocksville, NC 27028 (704)634-8760 ****IMPORTANT**** THIS APPLICATION CANNOT BE PROCESSED UNLESS n (� ALL THE REQUIRED INFORMATION IS PROVIDED. 1. Name to be Billed ko6 Z M"P) mW,_ Contact Person Mailing Address PV 130—`' --8 ° Home Phone City/State/Zip coo tt � ""� ��� I Business Phone ao 2. Name on Permit/ATC if Different than Above Mailing Address _ 3. Application For: 4. System to Serve: 5. If Residence: 0/Dishwasher 6. If Business/Other: # Commodes _ If Foodservice: ❑ Site Evaluations ❑ House J, -'Mobile Home # People ❑ Garbage Disposal Specify type _ # Showers 7. Type of water supply: City/State/Zip Improvement Permit & ATC ❑ Business # Bedrooms 3 ❑ Industry ❑ Other C/Washing Machine ❑ Basement/Plumbing # Seats LY County/City # Urinals ❑ Both # Bathrooms a' ❑ Basement/No Plumbing # People # Sinks 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 ElJ---No Ye s PROPERTY INFORMATION REQUIRED: *** IMPORTANT *** A PLAT OF THE PROPERTY MUST BE SUBMITTED WITH THIS APPLICATION. Property Dimensions: WRITE DIRECTIONS (from Q' 1 Mocksville) TO PROPERTY: Tax Office PIN: # 45�� (o- - )NU O 1 Property Address: Road Name �` 1 City/Zip myck1 w u a�oag 1 1 1 If in Subdivision provide information, as follows: 1 ' Name: 1 1 Section: 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 Representatives of the, Davie County Health Department to enter upon above described property located in Davie County and owned by �G� SCJ' Q 1. to conduct all testing procedures as necessary to /determine the site suitability. _ p DATE U/ ID SIGNATURE Revised DCHD (06-96) DAVIE COUNTY HEALTH DEPARTMENT + Environmental Health Section Soil/Site Evaluation NAME ADDRESS PROPOSED FACIILTY 42 1& DATE EVALUATED PROPERTY SIZE LOCATION OF SITE J uAell%D n Water Supply: On -Site Well _ Community Public r/ Evaluation By: Auger Boring Pit !Z Cut FACTORS 1 2 3 4 Landscape position .L Sloe Z HORIZON I DEPTH Texture group Consistence Structure Mineralogy 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 L �. SITE CLASSIFICATION: J4& EVALUATED BY: h;� ! LANG -TERM ACCEPTANCE RATE: /y 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 'r__*-_ 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 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 ■■■■■■■■■■■■■■..■■.■■■■■■■■■■■■■■■■■■■■■ EMEN■E■ME■MEMME■ ME■■■■■ ■■■.■■■■■■■!�■■■■■■■■■N■■■■.■■■■■■N■■. ■■■.■■■■.■■■■■■.!.■■■■■■■ ■■■■■■■■■■■■ ■■■■■■■■■!■■.■■■■■■�■■■.■■./■MOON/■■■■.■.■■■■■■/NOON ■■■■■■■■■.■■■■■■■■■■■■■■■■■■■■■■ NOON■■■ ■ ■■■■■■■■■■■■■■■■■■■■■ ■■■■■■■■■■■■.■■■■■■■a.■■■■M■N■.■MM■■■■■■■��■�MEN■.SEE.■■■■■■■■■.■■ ■■MOON■■■■■■■■■E■■.EMM■■■■■■M■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■ ■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■.■■■■■/■■■■■.■■■■■■..■■■■■■■■ ■■■■■NM■.■■■■■!■MM■■..!!■■■.■■■■■.■■■.■.■■I■■■■■■■■ ..■■■■■■■■■■■ ■■■■■■.■■■■■■■a■■■■M■■■■■■■■■.■■■/■■/■■.■■ ■■■EEE■■=EEEEE■■■E■■■■ ■.■■■■■■■■■■■■■■■■■■■.■■■■■■■■■■■■■■■■■■■■■■■■EN ME ■■■■■.■■■■■■■ ■.■.■■■■■■■■■■■■■■■■■■■■■■■■.■■. 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