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3097 US Highway 601 South Lots 53-55Davie Countv. NC Tax Parcel R ennrt Thursday, November 3, 2016 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: WARNIN T: '1MS IS 1VU'1' A SURVEY Parcel Information M60000001503 Township: Jerusalem 5745967131 Municipality: 82522806 Census Tract: 37059-807 FREEMAN BRYAN C Voting Precinct: JERUSALEM 1587 GILES RD Planning Jurisdiction: Davie County LEXINGTON Zoning Class: DAVIE COUNTY R-20 NC Zoning Overlay: DAVIE COUNTY CZOD Land Value: Total Assessed Value: 27295-6914 Voluntary Ag. District: No LOTS 53-55 BOXWOOD ACRES Fire Response District: JERUSALEM 0.99 Elementary School Zone: COOLEEMEE 5/2004 Middle School Zone: SOUTH DAVIE 005530675 Soil Types: Pc62 0006 Flood Zone: 031 Watershed Overlay: DAVIE COUNTY 104570.00 Outbuilding 8r Extra 1090.00 Freatures Value: 26250.00 Total Market Value: 131910.00 131910.00 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 Implied warranties of merchantability or fitness for a particular use. Ali users of Davie County's GIS website shall hold harmless the 161 �T 1\ C County of Davie, North Carolina, Its agents, consultants, contractors 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. A DAVIE COUNTY HEALTH DEPARTMENT,5 Environmental Health Section P. O. Boa 848/210 Hospital Street Mocksville, NC 27028 (336)751-8760 IMPROVEMENT/OPERATION PERMIT Account #: 990000758 Tax PIN/EH M 5745-96-7131 Billed To: Ronnie Foster Subdivision Info: Boxwood Acres Lot # 15.03 Reference Name: Ronnie Foster Location/Address: Hwy. 601 S.-27028 Proposed Facility: Residence Property Size: 1.01 Acre **NOTE*N This lin rove8m t/Operation Permit DOES NOT authorize the construction 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). THIS PERMIT IS SUBJECT TO REVOCATION IF SITE PLANS OR THE INTENDED USE CHANGE. YOUR WASTEWATER SYSTEM CONTRACTOR MUST SEE THIS PERMIT BEFORE INSTALLING SYSTEM. Residential Specification: Building Type ko 0�s #People #Bedrooms --S #Baths 2— Dishwasher: Dishwasher: 03r' Garbage Disposal: ❑ Washing Machine: 171"' Basement w/Plumbing: ❑ Basement/No Plumbing: ❑ Commercial Specification: Facility Type #People #People/Shift #Seats Industrial Waste: ❑ Lot Size 14 A& Type Water Supply Design Wastewater Flow (GPD) �'Z Site: New d Repair ❑ System Specifications: Tank Size 1CM GAL. Pump Tank GAL. Trench Width 3to Rock Depth 12' Linear Ft. Other: 1�1 %TeAeW'Tt0"Nl�pw 1tJ�Tb t� Lt,.1GS l fa.c_ M,.9 . I Required Site Modifications/Conditions: Y -r_ -t: p S 7}o�'a3 �^ V L �f S�„¢�GC�c.e. �,.� 4—► /aT -f)kSj&oC- IMPROVEMENT/OPERATION PERMIT LAYOUT - APPROVED EFFLUENT FILTER RISER(S) IF 6 " BELOW FINISHED GRADE. ****NOTICE: Contact a representative of the Davie County Health Department for final inspection of this system between 8:30 a.m. to 9:30 a.m. or 1:00 p.m. to 1:30 p.m. on the day of installation. Telephone # is (336)75 -8760.**** ` Sy _ moi= 2 17l v -L), ve-ts,lo�-' b."r 0 T T o�, � Q x IM Health Specialist's Signature: / Date: 4t1,We0 DCHD 05/99 (Revised) ..i P. -- Account #: 990000758 Billed To: Ronnie Foster Reference Name: Ronnie Foster Proposed Facility: Residence ATC Number: 2385 DAVIE COUNTY HEALTH DEPARTMENT Environmental Health Section P. O. Boa 848/210 Hospital Street Mocksville, NC 27028 (336)751-8760 Tax PIN/EH #: 5745-96-7131 Subdivision Info: Boxwood Acres Lot # 15.03 Location/Address: Hwy. 601 S.-27028 Property Size: 1.01 Acre AUTHORIZATION FOR WASTEWATER SYSTEM CONSTRUCTION **NOTE** This Authorization for Wastewater System Construction MUST BE ISSUED by the Davie County Environmental Health Section prior to issuance of any building permit(s). This Form/Authorization Number should be presented to the Davie County Building Inspections Office when applying for building permit(s) (in compliance with Article 11 of G.S. Chapter 130A, Wastewater Systems, Section .1900 Sewage Treatment and Disposal Systems). THIS AUTHORIZATION FOR WASTEWATER CONT 4CISID FOR A PERIOD OF FIVE YEARS. Environmental Health Specialist's Signatur Date:-1loell'o CERTIFICATE OF COMPLETION **NOTE** The issuance of this Certificate of Completion shall indicate the system described on Improvement/Operation Permit 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. 40 Septic System Installed By� Environmental Health Specialist's Signature: Date: DCHD 05/99 (Revised) All / ON FOR SITE EVALUATION/IMPROVEMENT PERMIT & I '- M Davie County Health Department u 1K Environmental Hea/dt Section 2000 P.O. Box 848/210 Hospital Street 0301999 I 'Z Mockaville, NC 27028 (336) 751-8760 ENVIRONMENTAL HEALTH jr)ffi**,N ICATION CANNOT BE PROCESSED UNLESS ALL THE REQUIRED --7 ON IS PROVIDED. Refer to the INFORMATION BULLETIN for instructions. 1. Name td be Billedo 1n n , "o W 1 Os�r6 R Contact person &k]J�21ej 9--r�e— MailingAddress 3&3 A d it eST Wh (i Homs Phone �s/ - ..Z, q G e!)City/State/ZIP (/ ! f l f_ Al c. _ ;i16.206 Business Phone 2. Name on Permit/ATC if Different than Above Mailing Address City/state/Zip 3. Application For: -%r";'ite Evaluation ❑ Improvement Permit/ATC W,Both 4. System to Service: e'House ❑ Mobile Home ❑ Business ❑ Industry 0 Other 5. If Residence: # People /�� # Bedrooms _ # Bathrooms 0115ishwasher ❑ Garbage Disposal Wirt.bing Machine ❑ Basement/Plumbing ❑ Basement/No Plumbing 6. 2f Business/industry/Other: Specify type # People # Sinks # Commodes # Showers # Urinals # Nater Coolers IF FOODSERVICE: # Seats Estimated Water Usage (gallons per day) 7. Type of Nater supply: Ercounty/City ❑ Well ❑ Community 9. Do you anticipate additions or expansions of the facility this system Is intended to serve? ❑ Yes "o If yes, what type? ***IMPORTANT*** CLIENTS MUST COMPLETE THE REQUIRED PROPERTY INFORMATION REQUESTED BELOW. Either a PLAT or SITE PLAN MUST BE SUBMLJ= by the client with THIS APPLICATION. Property Dimensions: 4 ���� �`�� WRITE DIREC11ONS (from Mocksville) to PROPERTY: Tax Office PIN: # ��`^''� ��cJ(-- Property Address: Road Name 7'L, C f' G ScS' %%% �� le 46 City/Zip �OGK , . If in a Subdivision provide information, as follows: Name: _ �al�GlJGacL�G/4=. 5 Section: Block: Lot: Date Property Flagged: 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 to conduct all testing procedures as necessary to determine the site sulob DATE SIGNATURE THISA MAY BE USED FOR DRAWING YOUR SITE (Include all of ollowing: Existing and proposed prope lines and dimension struclures, setb c and septic I tions). Revised DCHD (07/99) ll T EHS: Account No. Invoice No. 60X60 CLICK CEME ( 154.40ACA 4L 1.9 -Ac 41 14.01 cli 19 At OD -187 41 - ols, %14 206 0 (12) m 14-02n 72 7-- �o5 150, 0 a die200 2 1 ck (5.3AC) 273 05 10.1 3D 0 Aic 36 Ac) .4 414.46 A maim I A.] ACG- 250M SEE M— 5 /5 JEAUSM RAPT CHURCH A SEE N-6 Yt N FACTORS 1 2 3 4 5 6 7 Landscape position DAVIE COUNTY HEALTH DEPARTMENT ' L Environmental Health Section 7- Soil/Site Evaluation D -3-7 APPLICANT INFORMATION O - O PROPERTY INFORMATION Account M 990000758 Tax PIN/EH #: 5745-96-7131 Billed To: Ronnie Foster Subdivision Info: Boxwood Acres Lot # 15.03 Reference Name: Ronnie Foster Location/Address: Hwy. 601 S.-27028 Proposed Facility: Residence Property Size: 1.01 Acre Date Evaluated: I �% HORIZON II DEPTH Water Supply: On -Site Well Community Public Evaluation By: Auger Boring Pit Cut Structure FACTORS 1 2 3 4 5 6 7 Landscape position l L L Sloe % 7- HORIZON I DEPTH D -3-7 t`9 -'i O - O Texture group Consistence 5g tj P rr SS i Structure 2 6 2 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 $ $ S CLASSIFICATION S S LONG-TERM ACCEPTANCE RATE o , 0. SITE CLASSIFICATION: es LONG-TERM ACCEPTANCE RATE: ©. L( EVALUATION BY: � a -i 1�.- f 1 \\ OTHER(S) PRESENT: REMARKS: SOIL 1 }�S t�s%W cor C/ - 6,/. DVi.'Q m QST O -f- t_o-r 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 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 05/99 (Revised) ■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■ ■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■ ■■eee■■■■■■■■■■■■�■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■ ■■■■■■■■■■■■■eee■■E■■■■ecceeececM■■■■■■E■eE■■■■■■■■ ■■■■■■e■■■■■■■■■■O■e■■■■■■■■■■■■eee■■■■■■■■ecce■■■■ ■■■■■■■■■■■■■■■■■■■■■■■■■■►;a■■■■■■■■■■■■■■■■EEE■■■■ ■■■■■■■■■■■■■■■■■■■■■e■■■■■■■■■■■■■■ecce■■■■■■E■MM■ ■■■■■■■■■■■■■■■■■■■■■■■■■O■■■■■■c■■■■■■■■■■■■Oce■■■ J■■■■■■■■■■■■■■■■�■■■■■■■■■■■■■■■■■■eee■■■■■■■■■■■ ■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■ ■■■■■■■■■■■■■■■■■■/:■■■■■■..moi■■■■■■■■■■■■■■■■■■■■■ ■■■■■eee■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■ M MENNEN MENNEN MENNENMENNEN MEMNON iMENNEN ■■■s■■■O■O■s■■cO■ ■■s■■■■■■■■■■■eee■Oc■■Oce■■■■■e■ ■■■■■■■■■■■■■■■■■■Et�1x.11■■■■■■■■■■■■■■■■■■■■■■■■■■■ ■■■■■■■■■■O■■■■■O■■■I.itis`►\■■■■■■■■e■■■■■■■■■■■■■■■■■■ ■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■ ■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■ ■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■ ■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■ ■■■■O■ MEMO■■ ■e■■E■ ■■■■■■ ■■■■■■■■■■■■■■■■■■■■■■■■■■ ■■■■■■■■■■■■■■ ■■■■■■■■■■ ■■■■■■■■■■O■■■ ■■■■■■■■O■ ■■■■■■■■■■■■■■■■■■■■■■■■■■ ■■■■■■■■■■■■■■■■■■■■■■■■■■ ■■■■■■■■■■■■■■■■■■■■■■■■■■ ■■■■■■■■■■■■■■■■■■■■■■■■■■ i