430 Hobson Drive Lot 25, Section ADavie County, NC Tax Parcel Report Tuesday. January 31. 2017
WARNING: THIS 15 NU"1' A SURVEY
Parcel Information
Parcel Number: M5110B0025 Township: Jerusalem
NCPIN Number: 5745561147 Municipality:
Account Number:
82527111
Census Tract:
37059-807
Listed Owner 1:
SPILLMAN CALVIN D JR
Voting Precinct:
COOLEEMEE
Mailing Address 1:
366 HOBSON DRIVE
Planning Jurisdiction:
Davie County
City: MOCKSVILLE
State:
Zoning Class: DAVIE COUNTY R-20
NC Zoning Overlav: DAVIE COUNTY CZOD
Zip Code: 27028-0000 Voluntary Ag. District:
Legal Description: LOT 25 HOLIDAY ACRES SECTION 2 Fire Response District:
Assessed Acreage: 1.27 Elementary School Zone:
Deed Date:
Deed Book / Page:
Plat Book:
Plat Page:
Building Value:
Land Value:
Total Assessed Value:
5/2006 Middle School Zone:
2006E0184 Soil Types:
0003 Flood Zone:
111 Watershed Overlay:
Outbuilding & Extra
Freatures Value:
Total Market Value:
No
COOLEEMEE,JERUSALEM
COOLEEMEE
SOUTH DAVIE
GnB2,GnC2,ChA
DAVIE COUNTY
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AUTHORIZATION NO: 1514 DAVIE COUNTY HEALTH DEPARTMENT
Environmental Health Section
PROPERTY INFORMATION
Permittee'sr P.O. Box 848
Name: �/� Mocksville, NC 27028 Subdivision Name: �—�►
Phone # 336-751-8760
Directions to property:/ f' � Section: Lot:
AUTHORIZATION FOR
/?
WASTEWATER Tax Office PIN:#--yv+ -t
SYSTEM CONSTRUCTION ,%.+
Road Name: t Zip: '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 FomVAuthorization 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)
.71 , ***NOTICE*** THIS AUTHORIZATION FOR WASTEWATER CONSTRUCTION
,�`�� / j�,� ;3 r� �A - %j ✓, j IS VALID FOR A PERIOD OF FIVE YEARS.
ENVIRONMENTAL HEALTH SPECIALIST DATE ISSUED
- 13 .
514 DAVIE COUNTY HEALTH DEPARTMENT
IMPROVEMENT AND OPERATION PERMITS PROPERTY INFORMATION
\, x
;.: / v r �,F Subdivision Name:
,.'Name .
Directions to property: 'f Section: Jq Lot:
IMPROVEMENT
PERMITTax Office PIN:e -
Road Name: O S 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 I I of G.S. Chapter 130A, Wastewater Systems, Section .1900 Sewage Treatment and Disposal Systems)
4',; ,` i1%Vl1%1r1 -"* 111W rL'lllvul L7 OVDJL'1,l 1u xLnVV1.i111ur%lr X111r,
i
%s f PLANS OR THE INTENDED USE CHANGE. YOUR WASTEWATER
ell�ENVIRONMENTAL HEALTH SPECIALIST DATE ISSUED SYSTEM CONTRACTOR MUST SEE THIS PERMIT BEFORE
INSTALLING THE SYSTEM.
RESIDENTIAL SPECIFICATION: BUILDING TYPE 11Y It # 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 �- DESIGN WASTEWATER FLOW (GPD) ��� NEW SITEy REPAIR SITE
SYSTEM SPECIFICATIONS: TANK SIZE 6�J GAL. PUMP TANK GAL. TRENCH WIDTH 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:
v_+c �
z>
im
J (j
AUTHORIZATION NO. OPERATION PERMIT BY:
�gb 4
**THE ISSUANCE OF THIS OPERATION PERMIT SHALL INDICATE THAT THE SYSTEM DESCRIBED ABOVE HAS BEEN INSTALLED W COMPLIANCE
WITH ARTICLE i I 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
(336)751-8760
****IMPORTANT**** THIS APPLICATION CANNOT BE PROCESSED UNL
ALL THE RVJ
QUIRED INFORMATION IS PROVIDED.
Name to beBilled t�ahl�-A 0 - ./>� f 4K "1-\ U f Contact Person _
Mailing Address �' 0 ��y �7 Home Phone
City/State/Zip V oL/ eehn i/,e— 41-&& 7017 Business Phone
2. Name on Permit/ATC if Different than Above
Mailing Address :5a a e QS no Q City/State/Zip
3. Application For: eSite Evaluatio ❑ Improvement Permit & ATC ❑ Both
4. System to Serve: ❑ House Mobile Home ❑ Business ❑ Industry ❑ Other
5. If Residence: # People # Bedrooms # Bathrooms 2-
0
❑ Dishwasher ❑ Garbage Disposal ❑ Washing Machine ❑ Basement/Plumbing ❑ Basement/No Plumbing
6. If Business/Other: Specify type # People # Sinks
# Commodes # Showers # Urinals
If Foodservice: # Seats Estimated Water Usage (gallons per day)
7. Type of water supply: County/City ❑ Well
# Water Coolers
8. Do you anticipate additions or expansions of the facility this system is intended to serve?
If yes, what type?
*** IMPORTANT
❑ Community
❑ Yes U' --No
WITH THIS APPLICATION.
Property Dimensions: / 4 C 1 WRITE DIRECTIONS (from
`7 �� - �� - ��1-1 oO�ville) TO PROPERTY:
Tax Office PIN:* ..7 % / [
1 L m '�t9u T b
Property Address: Road Name ci� `> '`nCityrzip
1 �� ko n 1 bts
1 1� 3l C)
If in Subdivision provide information, as follows: 1
1 S
Name: CIAAd 1
1
1
Section: Lot #• 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 ) C� I 1 t-)1 e 1 a n O -) n , l6 Gn . •-s c • to conduct all testing procedures
as necessary to eterm1 a th
�e site suitability.
DATE /1 7 SIGNATURE
Revised DCHD (06-96)
1YOU MAY USE THE $ACK OF THIS FORM FOR I)RAWINC7 YOUR SITE PLAN.
1
DAVIE COUNTY HEALTH DEPARTMENT
Environmental Health Section SECTION_ LO
Soil/Site Evaluation
APPLICANT'S NAME / DATE EVALUATED �! / L Y
PROPOSED FACILITY PROPERTY SIZE Li4C
SUBDIVISION i ROAD NAME -AZ_1
Water Supply: On -Site Well
Community
Evaluation By: Auger Boring Pit
Public
Cut
FACTORS 1 2 3 4 5 6 7
Landscape position
Sloe %
HORIZON I DEPTH
Texture group
Consistence
Structure
Mineralogy
HORIZON II DEPTH t ��
Texture group
Consistence /
Structure
Mineralogy 7, -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
SITE CLASSIFICATION:
LONG-TERM ACCEPTANCE RATE:
REMARKS:
DCHD (01-90)
EVALUATION BY:
ZZ
OTHER(S) PRESENT:
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
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