1727 Underpass Road Lot 9 P/O 8 Section 2t r
Davie County. NC
Tax Parcel Report
Wednesday, January 11, 2017
126
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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:
Land Value:
Total Assessed Value:
WARNING: THIS IS NOT A SURVEY
Parcel Information
E8100B000101 Township: Shady Grove
5871853288 Municipality:
8306806 Census Tract: 37059-803
AGNER JOEL AUGUSTUS Voting Precinct: EAST SHADY GROVE
1727 UNDERPASS ROAD Planning Jurisdiction: Davie County
ADVANCE Zoning Class: DAVIE COUNTY R-20
NC
27006
LOT 9+P/O 8 GREENWOOD LK SECTION TWO
1.47
8/2016
010280030
Zoning Overlay:
Voluntary Ag. District:
No
Fire Response District:
ADVANCE
Elementary School Zone:
SHADY GROVE
Middle School Zone:
WILLIAM ELLIS
Soil Types: Gn132,GnC2
Flood Zone:
Watershed Overlay:
DAVIE COUNTY
Outbuilding & Extra
Freatures Value:
Total Market Value:
Davie County,
All data is provided as is without warranty or guarantee of any ldnd either expressed or Implied Including but not limited to the
Implied warnrdies of merchantability or fitness for a particular use. All users of Davie County's GIS website shall hold harmless the
NCor
County of Davie, North Carolina, Its agents, consultants, contractors or employees from any and all claims or causes of action due to
arising out of the use or Inability to use the GIS data provided by this website.
Pertnittp;'s, . '•,
Name: b r.'' WI !F => '.�'-� (, , 6 ,�= 'r,
DAVIE COUNTY HEALTH DEPARTMENT
Environmental Health Section PROPERTY INFORMATION Q
P.O. Box 848
P
Directions to property:. al
P j t` ( i.�(.t 1 5
� - Mocksville, NC 27028 Subdivision Name: '7i
-7 Phone #: 336-751-8760
Section:Lot: ' `75"
AUTHORIZATION FOR
WASTEWATER Tax Office PIN:#
SYSTF,M CONSTRUCTION - -
002720
AUTHORIZATION NO: A Road Name: h;, r`> rr'!- J`. ! Zip::
**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)
/ f ; 7 1' ***NOTICE*** THIS AUTHORIZATION FOR WASTEWATER CONSTRUCTIOI
ENVIRONMENTAL HEALTH SPECIALIST DATE ISSUED
RESIDENTIAL SPECIFICATION: BUILDING TYPE � r w r# BEDROOMS 14
IS VALID FOR A PERIOD ON FIVE YEARS.
# BATHS 1,1# OCCUPANTS -%, GARBAGE DISPOSAL: Yes o
COMMERCIAL SPECIFICATION: FACILITY TYPE # PEOPLE # PEOPLE/SHIFT # SEATS INDUSTRIAL WASTE: Yes or No
LOT SIZE TYPE WATER SUPPLY DESIGN WASTEWATER FLOW (GPD) NEW SITE REPAIR SITE
,1N,. y
SYSTEM SPECIFICATIONS: TANK SIZE QY� GAL. PUMP TANK N/3- GAL. TRENCH WIDTH 3� ROCK DEPTH 1 LINEAR FT.
A In
REQUIRED SITE MODIFICATIONS/CONDITIONS: I''A A C1 V - C, L'�,1 f ( .p rn ' L>-
J% n t-• 1 e hr. r-1 t1, ei 0("e - 4r, ? d r t1
IMPROVEMENT PERMIT LAYOUT
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FOR FINAL INSPECTION OF THIS SYSTEM PLEASE CALL BETWEEN 8:30 - 9:30 A.M. ON THE DAY OF INSTALLATION. TELEPHONE # IS (336) 751-8760.
OPERATION PERMIT
u
SYSTEM INSTALLED BY:
oy 0 -of b" 1 (`—
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AUTHORIZATION NO. 60 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.
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AUTHORIZATION NO. 60 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.
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PelpittDAVIE COUNTY HEALTH DEPARTMENT)
Name.:`-' L `7 ` `` , 1 � (= ` t (' Environmental Health Section PROPERTY INFORMATION
P.O. Box 848
Directions to property: ` 1 1 �� Mocksville, NC 27028 Subdivision Name: (If
-�
Phone #: 336-751-8760 Lot: �"
r /: ; t �; +. ,t• r , < < �.. � r � "i ; Section: ;
AUTHORIZATION FOR
WASTEWATER TaxOfficePIN:#
SYSTEM CONSTRUCTION - -
Z
AUTHORIZATION NO: 0027,20 A Road Name: k . E Zip:
**NOTE** This Authorization for Wastewater System Construction MUST BE ISSUED by the Davie County Environmental Health Section prior
to issuance of any Building Pen -nits. This Fonn/Authorization Number should be presented to the Davie County Building Inspections
Office when applying for Building Pennits.
(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
+ ✓' / ` "�' r�r IS VALID FOR A PERIOD OF FIVE YEARS.
ENVIRONMENTAL HEALTH SPECIALIST DATE ISSUED
ri -,
RESIDENTIAL SPECIFICATION: BUILDING TYPE YF•' 4 # BEDROOMS 4i # BATHS .3% Y;)# OCCUPANTS GARBAGE DISPOSAL: Yes or
COMMERCIAL SPECIFICATION: FACILITY TYPE # PEOPLE # PEOPLE/SHIFT # SEATS INDUSTRIAL WASTE: Yes or No
LOT SIZE TYPE WATER SUPPLY DESIGN WASTEWATER FLOW (GPD) NEW SITE REPAIR SITE
SYSTEM SPECIFICATIONS: TANK SIZE GAL. PUMP TANK rJl AGAL. TRENCH WIDTH fit' ROCK DEPTH I LINEAR FT.
OTHER nq `
REQUIRED SITE MODIFICATIONS/CONDITIONS: t t 'c- t,'+ `1, c- r, M r r" -+ +ir!� Y +.�- c • s �> j c c. +! '1
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IMPROVEMENT PERMIT LAYOUT
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FOR FINAL INSPECTION OF THIS SYSTEM PLEASE CALL BETWEEN 8:30 - 9:30 A.M. ON THE DAY OF INSTALLATION. TELEPHONE # IS (336) 751-8760.
OPERATION PERMIT 6N -i 1 �{ 1M
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AUTHORIZATION NO. 6 () OPERATION PERMIT BY: / Z 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 0=2 (Revised) �� � [ . I -t1 /1 j . / q � [ IT1%Y • � .- `� !: d /
DAVIE COUNTY HEALTH DEPARTMENT
(Septic Tank) Improvements Permit and Certificate of Completion 5
(Ground Ab orption Sewage Disposal sem - G:S. Chapter 30 -Article 13C).
OWNER OR �ONTRACTOR� _ i �,_„_ �., /I/.��DATE PERMIT:.,
LOCATION
i.t. rs. i 1 +-t .°,% C rJ` r; i1r .r.4�ti A �.w ,{ i N0'
73
SUBDIVISION NAME
HOUSE Q MOBILE HOME ElBUSINESS ❑
NO. BEDROOMS 4-JNO. BATHROOMS a� !
GARBAGE DISPOSAL UNIT YES ❑ NO B ---
AUTO. DISHWASHER YES NO ❑
AUTO. WASH. MACHINE YES EP NO- ❑
SITE SUITABLE„ YES C3 NQ. ❑
SIZE OF TANK gal.;
NITRIFICATION FIELD sq. ft.
DEPTH OF STONE IN LINES:
C CJb/�
WATER SUPPLY: Individual_ ❑ PLiblic ❑
IMPROVEMENTS PERMIT BY ..t`�nc._
a ,�.
House Trailer
800
S.R.
N0.
t<Z4
LOT N0: �d', /
SECTION OR
BLOCK N0.
600
HOUSE Q MOBILE HOME ElBUSINESS ❑
NO. BEDROOMS 4-JNO. BATHROOMS a� !
GARBAGE DISPOSAL UNIT YES ❑ NO B ---
AUTO. DISHWASHER YES NO ❑
AUTO. WASH. MACHINE YES EP NO- ❑
SITE SUITABLE„ YES C3 NQ. ❑
SIZE OF TANK gal.;
NITRIFICATION FIELD sq. ft.
DEPTH OF STONE IN LINES:
C CJb/�
WATER SUPPLY: Individual_ ❑ PLiblic ❑
IMPROVEMENTS PERMIT BY ..t`�nc._
a ,�.
House Trailer
800
Gal.,
400
Sq. Ft.
Two Bedroom House
800.Ga1.
600
Sq. Ft.
Three Bedroom House
900
Gal.
900
Sq. Ft.
Four Bedroom House
1000
Gal.
1200
Sq. Ft.
a. q -
01r
INSTALLED BY.
DAVIE COUNTY HF,ALTH DDIPARTiMT
SEPTIC TANK PEFd-1IT
No. of Bedrooms ,S' Date
This permit is granted to1,0-d-a for the installation of
a Septic Tank at the residence of r %� Address. 'l--4
Building Contractor Address ZX,)i
Septic Tank Specifications: Length Width Depth Capacity 0,0 Gal.
Manufacturerts Name s Tww�z Address '^' � � V -
No. of lines Width in. Total length Ft. No. of Sq.Ft.
Type of filter material Total tons used
NLi.nimum Requirements: Tank Capacity Square Ft. of Line
House Trailer 800 400
Two -Bedroom House 800 600
Three -Bedroom House 900 900 G o C, f q-00
No one shall install a septic tank in Davie County Vrithout a permit from the
Health Officer or his agent.
Date of final Approval Signed:
Sanitarian
I hereby certify that the above septic tank has been installed according
to specifications.
T Signed
Septic Tank Contractor
Note: Make sketch of disposal system on back of sheet and mail to the
Health Center in Mocksvill.e..
NAME I
ADDRESS -ML
L
,zS-Usix /,,/? /I
�a -07 M3,#(ntI, ord,(Pcel Cel! N;vqam?
DAVIE COUNTY ENVIRONMENTAL HEALTH SECTION
APPLICATION FOR IMPROVEMENT PERMIT (REPAIR)
PHONE NUMBER qa-C�2qy
NAME��zoa -C
&(61041aABCD-1VISION (;i620ttb Cakcs
/�
�i �K �l � AGI �► _ LOT # q f P41n 216 F
DATE SYSTEM INSTALLED 90 NAME SYSTEM INSTALLED U
TYPE FACILITY W, NUMBER BEDROOMS
TYPE WA'
DATE REQUESTED
UMBER PEOPLE SERVED 2'
This is to certify that the information provided is correct to the best of my knowledge, and that I understand I am responsible for all charges incurred from this application.
SIGNATURE OF OWNER OR AUTHORIZED AGENT
Rev. 1193
DAVIE COUNTY HEALTH DEPARTMENT 61
V` (Septic Tank) Improvements Permit and Certificate of Completion
i
(Ground Absorption Sewage Disposal S�s>:em - G.S. Chapter 130 -Article 13C) (L"
OWNER OR CONTRACTOR DATE PERMIT
/7z� No 1737
LOCATION
_
S. R. NO.
SUBDIVISION NAME LOT NO. Rd•- 9 SECTION OR BLOCK NO. (�
HOUSE ❑ MOBILE HOME ❑ BUSINESS ❑
NO. BEDROOMS NO. BATHROOMS
GARBAGE DISPOSAL UNIT YES ❑ NO ❑
AUTO. DISHWASHER YES ❑ NO ❑
AUTO. WASH. MACHINE YES ❑ NO ❑
SITE SUITABLE YES ❑ NO ❑
SIZE OF TANK gal.
NITRIFICATION FIELD sq. ft.
DEPTH OF STONE IN LINES:
WATER SUPPLY: Individual ❑ Public ❑
IMPROVEMENTS PERMIT BY
CERTIFICATE OF COMPLETION
aye 4
(8/16/73) *Construction must comply with all
LOT AREA
House Trailer
800
Gal.
400
Sq.
Ft.
Two Bedroom House
800
Gal.
600
Sq.
Ft.
Three Bedroom House
900
Gal.
900
Sq.
Ft.
Four Bedroom House
1000
Gal.
1200
Sq.
Ft.
INSTALLED BY
t Date
ther applicable State and local regulations
t �.
HOUSE 0 MOBILE HOME El BUSINESS 0
NO. BEDROOMS NO. BATHROOMS,-,
GARBAGE DISPOSAL UNIT YES 0 NO
AUTO. DISHWASHER YES El NO ❑
AUTO. WASH. MACHINE YES Eb NO 0
SITE SUITABLE YES t] NO [3
SIZE OF TANK gal.
NITRIFICATION FIELD sq. ft.
DEPTH OF STONE IN LINES:
WATER SUPPLY: Individual 0 Public ❑
IMPROVEMENTS PERMIT BY
(8/16/73)
LOT AREA
BYE A -a -
*Construction must comply
House Trailer
DAVIE COUNTY HEALTH DEPARTMENT
Gal.
400
Sq.
Ft.
Two Bedroom House
).576e
(Septic Tank) Improvements Permit and Certificate of Completion
(Ground Absorption SewageDisposalG.S.
600
Sq.
._.,
Chapter �30-Article
13C)
Gal.
OWNER OR CONTRACTOR;
F, DATE
PERMIT
Four Bedroom House
1000
7
17ZoNO1737
1200
Sq.
LOCATION
S.R.
NO.
SUBDIVISION NAME LOT NO. W4- SECTION OR
BLOCK NO.
HOUSE 0 MOBILE HOME El BUSINESS 0
NO. BEDROOMS NO. BATHROOMS,-,
GARBAGE DISPOSAL UNIT YES 0 NO
AUTO. DISHWASHER YES El NO ❑
AUTO. WASH. MACHINE YES Eb NO 0
SITE SUITABLE YES t] NO [3
SIZE OF TANK gal.
NITRIFICATION FIELD sq. ft.
DEPTH OF STONE IN LINES:
WATER SUPPLY: Individual 0 Public ❑
IMPROVEMENTS PERMIT BY
(8/16/73)
LOT AREA
BYE A -a -
*Construction must comply
House Trailer
800
Gal.
400
Sq.
Ft.
Two Bedroom House
800
Gal.
600
Sq.
Ft.
Three Bedroom House
900
Gal.
900
Sq.
Ft.
Four Bedroom House
1000
Gal.
1200
Sq.
Ft.
INSTALLED BY
ther applicable State and local regulations
L
DAVIE COUNTY HEALTH DEPARTMENT
P. 0. BOX 57
MOCKSVILLE, N. C. 27028 r.
(704) 634-5985
Statement for Septic Tank Improvement Permits
and/or Site Evaluations
ISS
NAME DATE CED
ADDRESS
Explanation of charge
PERMIT NO.
00006 J'
AMOUNT DUES___~ SANITARIAN �.
PLEASE REMIT THE ABOVE AMOUNT ON RECEIPT OF THIS STATEMENT.
DAVIE COUNTY HEALTH DEPARTMENT
`4 (Septic Tank) Improvements Permit and Certificate of Completion
(Ground Absorption Sewage Disposal System - G.S. Chapter 130 -Article 13C)
OWNER OR CONTRACTOR DATE - 3 --17 PERMIT
LOCATION 701 Ad U Ar�_.rs._ - (�,,,� a sS }�cv . N� 1568
S.R. NO.
SUBDIVISION NAME n,40 QL" LOT NO. oO 9' SECTION OR BLOCK NO. (,
HOUSE W MOBILE HOME ❑ BUSINESS ❑
NO. BEDROOMS 4 NO. BATHROOMS
GARBAGE DISPOSAL UNIT YES 2r NO ❑
AUTO. DISHWASHER YES Q' NO ❑
AUTO. WASH. MACHINE YES Com' NO ❑
SITE SUITABLE YES 2-00 NO ❑
SIZE OF TANK gal.
NITRIFICATION FIELD sq. ft.
DEPTH OF STONE IN LINES:
WATER SUPPLY: Individual ❑ Public CI G
IMPROVEMENTS PERMIT BY
House Trailer
Two Bedroom House
Three Bedroom House
Four Bedroom House
INSTALLED BY
800
Gal.
400
Sq.
Ft.
800
Gal.
600
Sq.
Ft.
900
Gal.
900
Sq.
Ft.
1000
Gal.
1200
Sq.
Ft.
CERTIFICATE OF COMPLETION By Date
(8/16/73) *Construction must comply with all other applicable State and local regulations
LOT AREA
.
oho o".Yd X.2f "It
i>w.se--Ta-
Cry. ea. ZIA .
DAVIE COUNTY HEALTH DEPARTMENT
w (Septic Tank) Improvements Permit and Certificate of Completion
(Ground Absorption SewaLLge Disposal System - G.S. Chapter 130 -Article 13C)
OWNER OR CONTRACTOR i!_?RCS • g+i1D'rf�`�.itr DATE PERMIT
LOCATION c� O cJ ,�. tr • ��R ¢ :� {��� . lr 9 1568
S.R. NO.
SUBDIVISION NAME i*Cirf'Pti..�.,r k-634,&, LOT NO. Rf'f SECTION OR BLOCK NO. &
HOUSE go MOBILE HOME O BUSINESS E
NO. BEDROOMS 41 NO. BATHROOMS
GARBAGE DISPOSAL UNIT YES [2r' NO ❑
AUTO. DISHWASHER YES [' NO ❑
AUTO. WASH. MACHINE YES 0' NO ❑
SITE SUITABLE YES 0" NO ❑
SIZE OF TANK gal.
NITRIFICATION FIELD sq. ft.
DEPTH OF STONE IN LINES:
WATER SUPPLY: Individual ❑ Public e
IMPROVEMENTS PERMIT BY L1tt a,.A0
House Trailer
800
Gal.
400
Sq.
Ft.
Two Bedroom House
800
Gal.
600
Sq.
Ft.
Three Bedroom House
900
Gal.
900
Sq.
Ft.
Four Bedroom House
1000
Gal.
1200
Sq.
Ft.
INSTALLED BY
CERTIFICATE OF COMPLETION By Date
(8/16/73) *Construction must comply with all other applicable State and local regulations
LOT AREA
%� tam �: �: �✓�R
d o'X.?"A.? f
DAVIE COUNTY HEALTH DEPARTIMENT
P. 0. BOX 57
HOCKSVILLE, N. C. 27028
(704) 634-5985
Statement for Septic Tank Improvement Permits
and/or Site Evaluations
NAME W _ ('T., `�,��,.� DATE ISSUED ti_ � •77
ADDRESS PERDIIT N0. ,"Yr
Explanation of charge -
AMOUNT DUE /�-, db SANITARIAN
PLEASE REMIT THE ABOVE AMOUNT ON RECEIPT OF THIS STATEMENT.
P aiiie (f ouutg Health P epartmeut
aub cuome Pealth c geuq
P. O. BOX 665
gorkoville, �Kurth ( aralina 27028
OFFICE OF THE DIRECTOR
Betty Potts
Betty Potts Realty
R. 3, Box 237-A
Advance, North Carolina 27006
Mrs. Potts:
TELEPHONE
(704) 634.5985
August 1, 1985
RE: Greenwood Lakes - Lots #8 and 9
Block 2 Soil/Site Evaluations
As per your request the aforementioned lots were evaluated by
this office on July 30, 1985. Please note below the result of said
evaluations.
Lot #8, Block 2: Front portion of lot (facing Whitehead Drive) is
classified unsuitable, due to shallow soil and drainage
mottles. The rear portion of the lot is classified provisionally
suitable as the soil conditions are much better. The overall
classification of this lot is provisionally suitable. The
sewage system must be installed in the rear portion of the lot.
Lot #9, Block 2: Front portion of Lot (facing Whitehead Drive) is
classified unsuitable due to shallow soils and drainage
mottles. The rear portion of the lot is classified provisionally
suitable as the soil conditions are much better. The overall
classification of this lot is provisionally suitable. The
sewage system must be installed in the rear portion of the lot.
Before this office can issue any permits on these two lots we must
know exactly where the homes will be placed in order to make sure ample
space is available for the installation of the on-site sewage system.
Sincerely,
Joe Mando, R.S.
Environmental Health Coordinator
jh
DAVIE COUNTY HEALTH DEPARTMENT
—IMPROVEMENTS PERMIT AND CERTIFICATE OF COMPLETION
P
*NOTE., Issued in'Compliance with-G.S. of Chapter 130 Article 13c
,North -Carolina
Sewage; Treatmenti and Disposal Rules (10 -NCAC° 10A .1934-x1968) -, Pei1111t
Number
< fi
a -Name � '� �'.,�• ,.�. ;,� �� � ,. ,� Date
—
Location
,
:
Subdivision Name ;Lot No: %` Sec. or Block No
Lot Size ---_ House' Mobile Home ,__=_ Business'---- Speculation
> No..l3edrooms =- No: Baths"`_ — No. in Family
.'Garbage Disposal.,YES,.F,]'S~ NO ❑
Specifications for System:' ♦ .>> . , .'7
Auto Dish Washer, ,YES pj , NO ❑
Auto Wash Machine YES 0 N0,'❑
1,
Su I
Type, Water-. Pp y
r ;; � , . f. {. , •' f .
_ —
+1
.. *This permit Void if sewage.system,described below is no-Cinstalled within 36 months from date,of issue.
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Improvements permit by
*Contact a' representative of the Davi"e Couniy<< Health Department for final inspection of this system between
9:30A.M: or 1:00 1:30- P.M. on day. of completion.. Telephone Number: 704-634-5985.
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Final InstalllationlDiagram'=;S,ystem Installed by Q't
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Certificate of Completion — Date
i
#The -+signing of'this certificate shall .indicate that the system, described above: has been installed, in -compliance with'."`
the standards set forth in the.above.regulation,. but shall in NO way,be taken as a guwantee:.that thesystem will function .
"° satisfactorily for any.given period df'time:.
`�
DAVIE COUNTY HEALTH DEPARTMENT
Environmental Health Section
P. 0. Box 665
Mocksville, N.C. 27028
SOIL/SITE EVALUATION
Name �e- �v1+5 l F-" KN'.[ � Date—
Address Lot Size
rA rrrnoc
7 — 30 —8a"
AREA 1 AREA 9 AREA 3 AREA 4
Topography/ Landscape Position
U
U
U
U
!) Soil Texture (12-36 in.) Sandy,
Loa%,- S
S
<f5i)
t\%.k S
(�)a� S
PS
Loamy, Clayey, (note 2:1 Clay)C`7
U
! t PS
, t
1) Soil Structure (12-36 in.)
Clayey Soils
S
ZTBIi
S
S
PS
S
PS
i) Soil Depth (inches)
, SS
LP"M>
S
PS
S
PS
U
U
2SD
M>
i) Soil, Drainage: Internal
SS
u-
S
PS
S
PS
U
CT -5
2�5
External
�
�
�
�
U
U
U
U
i) Restrictive Horizons
�� `—
,.`�,
CS
aA--�
zz'
3 0"
1) Available Space
S
- S
PS
S
PS
U
U
(5>
cfIlS
3) Other (Specify)
S
PS
S
PS
S
PS
S
PS
U
U
U
U
a) Site Classification
U—UNSUITABLE S—SUITABLE CPS --Provisionally Suitable
Recommendations/Comments: —
S1r.,�...�
Described by Title Date
Date
SITE DIAGRAM
0
�D
DCHD (6-82)
I
APPLICATION FOR SITE EVALUATION/ IMPROVEMENTS PERMIT
Davie County Health Department
Environmental Health Section
R O. Box 665
Mocksville, N.C. 27028
CONSTRUCTION SHALL NOT BEGIN UNTIL IMPROVEMENTS PERMIT HAS BEEN ISSUED.
Home Phone
1. Permit Req4ested B V O_ Business Phone
2. Address ppiytl
3. Property Owner if Different than Above _
Address
4. Permit To: a) Install Iter Repair
b) Privy Conventional= Other Type
Ground Absorption
c) Sub -Division Sec. Z- Lot No. 9/
5. System used to serve what type facility: House Mobile Home Business
Industry Other
b) Number of people a
6. a) If house or mobile home, state size of home and number of rooms.
House Dimensions
Bed Rooms -3 Bath Rooms �� Den w/Closet
b) If Business, Industry or Other, State: Number of persons served
What type business, etc.
Estimate amount of waste daily (24 hours)
7. Number and type of water -using fixtures:
commodes urinals garbage disposal
lavatory showers washing machine
dishwasher sinks
8. a) Type water supply: PublicPrivate Community
b) Has the water supply system been approved? Yeses `No
9. a) Property Dimensions 1-rn %� -4-
b) Land area designated to building site
c) Sewage Disposal Contractor
10. Do you anticipate any additions or expansions of the facility this sewage system is intended to serve?
What type?
This is to certify that the information is correct to the bet of y}my 1k/1nowledge.
--
'� s s ,Q�,/'y/
Date Owner Signature
OWNER IS SOLELY RESPONSIBLE FOR COMPLIANCE WITH ALL STATE AND LOCAL LAWS
Allow 5 days for processing
Directions to property:
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� �.. Via.. ���•�.�, `�i•�� Mc,1zs`. — �-�-- �.
Lu't .4 cy x-19
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DCHD (6-82)
tL DAVIE COUNTY HEALTH DEPARTMENT �'�"
Environmental Health Section R Z
R O. Box 665 6 ,rt-
Mocksville, N.C. 27028
SOIL/SITE EVALUATION
/1 1
Name 'te". `i 1, raCAt R- Aalaa 1 Date
Address T Lot Size ► as X 2°"
CA f`TnRc
ARFA 1 AREA 9 AREA 3 AREA 4
Topography/ Landscape Position
2)
3)
4)
6)
8)
S
S
PS
S
ZM
S
4!s::�
U
ZIb
U
U
Soil Texture (12-36 in.) Sandy,
S
S
PS
S
�
S
Loamy, Clayey, (note 2:1 Clay)
PS
U
U
Soil Structure (12-36 in.)
Clayey Soils
S
PS
S
PS
S
CEM9
S
®}
Em::�
U
U
Soil Depth (inches)
S
PS
S
PS
S
Zif9
S
I- a>
2Cj
U
U
Soil Drainage: Internal
S
S
PS
S
--Z%G-p
S
qln>
t
rib
—(,-T>
U
U
External
S
PS
S
PS
S
--M.r"M
S
U
U
Restrictive Horizons
Z.�
l 2z :.
1) Available Space
S
PS
S.
PS
S
d:±5>4�D
S
<::rl>
U
U
Other (Specify)
S
PS
S
PS
S
PS
S
PS
U
U
U
U
0) Site Classification
U—UNSUITABLE S—SUITABLE e�PS—Provisionally Suitable
Recommendations/Comments: s`aL t-- k!&� .32".
Describedby� •�Q^+� Title CAS Date
SITE DIAGRAM
11,01 f=r'j--
I IV b a.�
DCHD (6-82)
Zan'
APPLICATION FOR SITE EVALUATION/ IMPROVEMENTS PERMIT 1�
Davie County Health Department
Environmental Health Section
P. 0. Box 665
Mocksville, N.C. 27028
CONSTRUCTION SHALL NOT BEGIN UNTIL IMPROVEMENTS PERMIT HAS BEEN ISSUED. UED.
Home Phone 6 v �a D3
1. Permit Re sted B LZ. Business Phone
2. Address 3 ,
3. Property Owner if Different than Above
Address
4. Permit To: a) Install—' AlterRepair
b) Privy ConventionalOther Type
Ground Absorption
c) Sub -Division Sec. 2 -bile HLot No.
5. System used to serve what type facility: House Moome Business
Industry Other
b) Number of people a
6. a) If house or mobile home, state size of home and number of rooms.
House Dimensions
Bed Rooms 3 Bath Rooms Den w/Closet
b) If Business, Industry or Other, State: Number of persons served
What type business, etc
Estimate amount of waste daily (24 hours)
7. Number and type of water -using fixtures:
commodes urinals garbage disposal
lavatory showers S-A washing machine L'
dishwasher sinks
8. a) Type water supply: Public y/ Private Community
b) Has the water supply system been approved? Yes�No
9. a) Property Dimensions
b) Land area designated to building site
c) Sewage Disposal Contractor
10. Do you anticipate any additions or expansions of the facility this sewage system is intended to serve?
What type?
This is to certify that the information is correct to the befit of my knowledge.
Date Owner Signature
OWNER IS SOLELY RESPONSIBLE FOR COMPLIANCE WITH ALL STATE AND LOCAL LAWS
Allow 5 days for processing
Directions to property:
Q�
Luf W cl 4—V
21,
z
DCHD (6-82)
bel
�Pco_-j
--�3 R Of-- -�,3h-A
paiiie (fouutg �Keulth Pepartmeut
Unb pome pealth '�Beuru
P'0, BOX 665
c�flIIcksi�ille, �IICth idttrIIlizttt z7Ii28
OFFICE OF THE DIRECTOR
Betty Potts
Betty Potts Realty
R. 3, Box 237-A
Advance, North Carolina 27006
Mrs. Potts:
TELEPHONE
(704) 634-5985
August 1, 1985
RE: Greenwood Lakes - Lots #8 and 9
Block 2 Soil/Site Evaluations
As per your request the aforementioned lots were evaluated by
this office on July 30, 1985. Please note below the result of said
evaluations.
Lot #8, Block 2: Front portion of lot (facing Whitehead Drive) is
classified unsuitable, due to shallow soil and drainage
mottles. The rear portion of the lot is classified provisionally
suitable as the soil conditions are much better. The overall
classification of this lot is provisionally suitable. The
sewage system must be installed in the rear portion of the lot.
Lot #9, Block 2: Front portion of Lot (facing Whitehead Drive) is
classified unsuitable due to shallow soils and drainage.
mottles. The rear portion of the lot is classified provisionally
suitable as the soil conditions are much better. The overall
classification of this lot is provisionally suitable. The
sewage system must be installed in the rear portion of the lot.
Before this office can issue any permits on these two lots we must
know exactly where the homes will be placed in order to make sure ample
space is available for the installation of the on-site sewage system.
Sincerely,
(�St Y
Joe Mando, R.S.
Environmental Health Coordinator
jh
IN
F
paiiie (gountg Pealt4 Department
Unb (Home pzalt4 Agenru
P. O. BOX 665
c9ochstlille, �urth Carolina 27028
OFFICE OF THE DIRECTOR
May 18, 1987
Potts Realty
P. 0. Box 11
Advance, NC 27006
Attn: Diane Potts
Re: Sewage System Check
Lot 9/Greenwood Lakes
Dear Realtor:
The septic tank system that serves the house on lot 9 in
Greenwood Lakes was designed and approved by this office.
The houseis served by county water.
Sincerely,
Robert B. Hall, Jr., R.S.
Environmental Health
RH/wd
TELEPHONE
17041 634.5985