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207 Blevins Rd�avie Countv. NC Tax Parcel Renort Wednesdav. October 12. 201 E WARNING: THIS IS NOT A SURVEY � : �m����A �,� .�_.,s� ,� .� _ � w._��_,.� �.�. ��..�,�,��,���.., , Parcel Information w .���,�.�z.....�..��.._�...��__.�,,� ��;�,�,_..���__.._�...,�:�.�..��__.. _ Parcel Number: 6300000052 Township: Clarksville NCPIN Number: 5823291104 Municipality: Account Number: 69900000 Census Tract: 37059-801 Listed Owner 1: SPILLMAN HERMAN EUGENE Voting Precinct: CLARKSVILLE Mailing Address 1: 589 FOUR CORNERS ROAD Planning Jurisdiction: Davie County City: MOCKSVILLE Zoning Class: DAVIE COUNTY R-A,R-20 State: NC Zoning Overlay: Zip Code: 27028-6217 Voluntary Ag. District: No Legal Description: 36.398AC BLEVINS RD Fire Response District: COURTNEY Assessed Acreage: 35.42 Elementary School Zone: WILLIAM R DAVIE Deed Date: 2/1973 Middle School Zone: NORTH DAVIE Deed Book / Page: 000900126 Soil Types: MnB2,MdC,WATER Plat Book: Flood Zone: Plat Page: Watershed Overlay: DAVIE COUNTY Building Value: 47090.00 Outbuilding & Extra 9000.00 Freatures Value: Land Value: 220760.00 Total Market Value: 276850.00 Total Assessed Value: 83090.00 °"u'F Davie County, °�UN�'� NC . .: . _ : . ., .. , ti � �� II+�ROVEMENT PERMIT DRVIE COUNTY HEflITH DEPRRTMENT IMPROVEMENT PEAMIT and �ERATION PEAMIT ✓x� **NOTE+�+� This i�prove�ent per�it DDES NOT authorize the construction or installation of a septic tank syste� or any NasteNater� syste�. AN AUTHDRIZATIDN FDR NA5TE{JflTER 5Y5TEM CON5TRUCTIDN wst be ohtained fro� this Depart�ent prior to the construction/installation of a syste� or the issuance of a building per�it, IIn co�pliance with Article I1 of 6.5. Chapter 1�A, Nastewater Syste�s, Section .1900 SeNage Treat�ent and Disposal 5yste�s) NAME /� � 11r/ PRDPERTY pDDRESS �/e �J �1 �, �Cl.. . � a'�� a� � DATE �?i� LOCATION �"/f°'iiili r �[-�Gr SUBDIVISION t�AME LDT MIMIBER SEC./BLDCK NUMBER RESIDENTAL SPECIFICATION: BUILDING TYPE ,��1 f� � BEDR�MSt� i BATHS �� N OCCl1PANTS � 6ARBf�E DISP�AL: Yes/ to COMMERCIflI. 5PECIFICATION: F�ILITY TYPE # PEDPLE �k PEOF�LE/5HIFT # SEATS INDU5TRIRL NASTE: Yes/No LOT SIZE � TYPE WATER SI�PLY ,��� DESI6N �STEWATER FLDW (6PD) ��� NEN SITE � REPAIR SITE SYSTEbI SRECIFICATIONS: TRNK SIZE/Df.1� 6AL. PUMP' TRt�i 6AL. TRENCH WIDTH �,� �� ROCK DEPTH ./� ��LItJEAR FT. , Dl�� OTHER REQUIRED SITE MODIFICATION5/CO�IDITIDNS: ���THIS �RMIT IS SUBJECT TO REVOCATION IF SITE PI.ANS OR TF� INTENDED U� CFIA�E. YDUR WASTERWATER SYSTEM CONTRACTOA p�1ST 5EE THIS PERMIT BffORE INSTALLING THE SYSTEM. ..�— � -�--�..�.. IMRROUEMENT pERMIT BY /��'��L/ +�ITRCT A REPRESENTATIVE � THE DAVIE COUNTY HEALTH DEPAATt�ENT FOA FINAL INSAECTION DF THIS SYSTEM RETNEEN 8:30-9:30 A.M. OR 1:00-1:30 P.M. ON THE DAY OF INSTAI.LATION. TELEPHONE # IS (704) E34-8760. �ERATION PERMIT 5YSTEM INST E BY � �� AUTHORIZATION N0. f �� �C 7Z p�,� � � ' /CN �,��,�,�. //� . �� � �'���,� ��� � �� � � - � �� � !i � �I �I ` � .� / r J . A `'a�G� c�.� %I�`�1`, .�kr nui� � G�,�'�- !� � � � .� � � " �� � �'��'x� � G�� _ �� `� _ � �� �a�- .�� �� OPERATIDN PERMIT BY )Ia�� .����'�' �Di�l� l "�' � f+�THE ISS'U�10E OF THIS OPERATIOM PERMIT SHALL INOICATE TFIAT TFIE 5Y5TEM DESCAIBED ABOVE F�S BEEN INSTALI.ED IN COp�LIANCE WITH ARTICIE 11 OF G.S. CHAPTER 130A, SECTION .19� "SE41�iE TREATMENT AND �ISpOSAL SYSTEMS', BUT SFIALL IN NO ViAY BE TAKEN AS A b`UARANTEE TF�T THE SYSTEM WILL FIINCTION SATISFACTORILY FOR ANY 6IVEN PERIOD � TIhIE. DCHD 10/95 a ,� ;__ / ; '' Davie County Health Depart�ent ' ` ENUIRONMENTAL HERLTH SECTIDN P.D. Aox 665 Macksville, N.C. 27028 AtJTHDRIZATIOi! FOR WASTE4NiER SYSTEM CONSTRUCTIa! fIssued in co�pliance with Article li of G.S. Chapter 13►�A, Wastewater Systess) +�+��This Authori;.ation For Wastewater 5yste� Construction tust be issued by the Davie Caunty Environ�ental Health 5ection prior� to issuance of any Building Per�its. Thia For�/Authorization Nu�ber sho�lld be presEnted to the Davie County B��iiding Inspectior�s Office whe applying for Building Per�its.�� � � � � � / RtlTFIDRIIATION FU6`.9ER ,� iti DATE _� /.��1;�.� �''�j o i� � r� i� NRME ON IMRROUQENi PERMIT iIf different than above) SITE LOCATIUI 0 COM��NT5/COP@ITIQrS UN RtfTHORIZATION TO CONSTRLICT NA5TENATER SY5TEM �IOTICE�++ THI5 RUTHORIZATION F A5 WflTER 5Y5TEM CONSTRLICTIDN IS VRLID FOR A F�ERIOD QF FIVE t�) YEAR5. � � '. S, ���/��� ENV AL TH SP£CIRLIST ^ DATE DCHD 10/95 � � r APPLICATION FOR SITE EVALUATION/IMPROVEMENTS PE Davie County Health Department Environmental Health Section P. O. Box 665 Mocksville, NC 27028 1. Application/Permit Requested By Mailing Address 2. Name on Permit if Different than Above 3. Application for: 4. System to Serve: p Business ❑ General Evaluation O House ❑ Industry 5. If house, mobile home: Subdivision No. of People No. of Bedrooms J No. of Bathrooms � Dwelling Dimensions �'y� �v v ECEIVE 1•iAY 2 2 I�:,,� Home Phoneq� v� I q�— )%�3 Business Phone��C�-��%- �%R� �eptic Tank Installation Permit Mobile Home ❑ Other 6. If business, industry, place of public assembly, other: Specify type No. of People Served No. of Commodes No. of Lavatories No. of Sinks No. of Urinals No. of Water Coolers No. of Showers Water Usage Figures _ 7. Type of water supply: ❑ Public Private 8. Property Dimensions 1 a��- O`�10�- 'U�� Sewage Disposal Contractor 9. Do you anticipate additions/expansion of the facility this sytem is intended to serve? If yes, what type? ❑ Place of Public Assembly ❑ Unknown Section Lot # ❑ BasemenUPlumbing ❑ BasemenbNo Plumbing B�Washing Machine �YOi§hwasher ❑ Garbage Disposal ❑ Yes ❑ No , ❑ Community 'NOTE: Improvements Permits shall be valid for a period of 5 years from date issued. Improvements Permits are subject to revocation, if site plans or the intended use change. Effective October 1, 1989. PROPERTJ IN�"OR�I�TZON REQUIIZEb: Directions to Property: Tax Office PIN: #,��oj� �� %��T �Lo ��(n���` .(� � ��r1U�� �C%, PIZOPERTy AbbRESS, as follows: °,.y� O`n�. ~Yr��C> �U -t�Q�'C CAi`C1�,'tS�� � On '£-�'� Road Name : �lev��s �� Gjo �� rp`��e� �o ��vinS � �, ��, cLt�: ��5sii\1�, ` SU$MZT tl PLttZ WITH T1iIS APPLZCttTZON. on�e m'►le -}�, 1�.��e �< <,re, Revisions effective October 1� 1995. This is to certify that the information provided is correct to the best of my knowledge, and I understand I am responsible for all charges incurred from this application. ��J �St ATE SIGNATURE CONSENT FOR SITE EVALUATION TO BE DONE ON ABOVE DESCRIBED PROPERTY MUST CHECK ONE: O 1. I OWN the property. � 2. I DO NOT OWN the property. If you checked Box #2, the rest of this form MUST be completed by the owner or a person authorized by the owner: I hereby give consent to the authorized representati e f the Davie C nty H alth Department to enter upon above described property located in Davie County and owned by �,� to conduct all testing procedures as necessary to determine said site suitability for a ground absorption sewage treatment and disposal system. � � :S ) s- � C� - �-. DATE SI NATURE DCHD (1/93) �� ---T�. - - � w s {'�� • ,��� � � '� .nR j��€ � < '� /1�� a � � � � � _ �. •� � � a ., � , � � '^�� t� � �� �� � �at '• �'4 -• �! . � �'g t�, t ,�. „ ' ! 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L � "� ' � 5 2 .0 3 � � . •,� � - - � �� � �. .,v � � t ���� 52.p2 --� ,� � �'-, _ ��,�� . �� �44. . � � �. . � � :,, ��,� I A C �� �, I 2 . ' � : `' � � 51.722�.� ���. ��.� � � . , ��� 3 I . I E t . i� 2 30 '9 IR3 .''" ,;; 1 i a, t A 'A' �. I � 53.`''0 ` _,� ' _ _ __ _ 2`(59.72 �, 9 4 9 7 4 -'�' ; x� , �. 32 � x��;�: W. / .� � �� : �, °° � 8 3 4 ,.7 � `_ \ p� � � , -- - / �� q. `," o oNo M ..io�.�5 ----�� � `� '��''O � �, �. � �' .� � y �;r C g�. y i`004 :i2 t♦ _ a � �� 44.0� � / � �� � � �_ �.� _� '� - � � j .. . /� _ � Q 'j .. �, k, e' . �` �- �\ v �� t ��. G� � � .. , � =;. ' \'� ' �," '� . (p "° \� . � `�,.� o ,�, �co C x �k R 3.�J O tr) (4iac) 3 3 '4 � \ �I 1.8 AC) `� . Z� '� ac. �� 4 �� �'� �� �, q7AC�2 ' ' � y �� � �. t �0 85 ��� ��1� �0z �� �'� '1���' � �, -r 3 ". 6' / '� 3I ' . . _ , ,,, `� , , ' '^�, '� � , ' \ (:3.7 �' ac ; � gk � : ,� � - � / �.. ,, , , � 4 2 .17 Ac � w. � # �`� .�. � � . �cp o � � Q�� " ' � � � � -� �' . � «�f" ����3'� � . . . Dc/�a " . -.. - ' • Fi2 i� � �r ,�� \ . ; � .._ � 69�i� . � �, _, � � _`�'�� � •� ' �_.. _ _��� ��_�__. -- -- — ---- ---- -- — ---- - — _, _ _ �. _ _ '' — ' ' � DAVIE COUNTY HE�LTH DEPARTMEIV'T . f � Environmental Health Section Soil/Site Evaluation NAME r/✓�//1J7/1�' DATE EVALUATED (� �Q_�� ADDRESS PROPERTY SIZE �D�4G PROPOSED FACIILTY -� �T" LOCATION OF SITE /��U7`S G�✓ Water Suppiy: On-Site Well Evaluation By: AugerBoring FACTORS Landscape position Slope 7. HORIZON I DEPTH Texture group Consistence Structure Mineralogy HORIZON II DEPTH Texture group Consistence Structure Mineralogy HORIZON III DEPTH Texture group Consistence Structure Mineraloqy HORZZON IV DEPTH Texture group Consistence Structure Mineralo�y SOIL WETNESS RESTRICTIVE HORIZON SAPROLITE CL�SS.LFICATION LOyG-TERM ACCEPTANC SITE CLASSIFICATION: TE 1 Community Pit 4 EVALUATED BY: LDNG-TERM ACCEPTANCE RATE• � OTHER(S) PRESENT: REMAR KS: DCHD (01-90� LEGEND Public Cut Landscr.pe 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-Silt,y -;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 fizm EFI-Extremely firm Wet NS-Non sticky SS-Slightly sticky S-Sticky VS-Very Sticky NP-Non plastic SP-Slighily plastic P-Plastic VP-Very plastic Structure .iC--Sin�le grpin M-Massive CR-Crumb GR-Granular ABK-Anguimr blocky SBK-Subangular blocky PL-Platy PR-Prismatic Mi neralagy 1:1, 2:1, Mixed Notes F�orizon depth - In inches Depth of fill - In inches Restrictive horizon - Thickness and inches fcom land surface Saprolite - S(suitable), U(unsuitable) Soil w etness - Inches from land surface to free wate�` 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 a�����■ ■ ���������������������������■ ■���� ■����������■�■������������■ ■����■�■ �1���/��/ �// ����������������������������������������������■�����������E��������■ ■�����/���N������������������������������������ �����������i■���■���■��■����������■ ����������������������n����������■ �������������=����o�����������������■�����������■ ��a��■���������■ �������� ������������������v�����■����■�������■����■��������■����■ ����n����� ■ ���C������ ■ ��������������������� ■■ ����■���■���������������� ������■ .......... ..........�. . ...... ............C..=.........................5....... ........ ......■�� .C......C... .■................ .......................... ........._. ....... ......■.....�. ........... ...�.......................... ���������a���n���� �� ������n�� ■ ���������� ■����_���■ ■ ����������■�����■�����■ ii��������n� �n ���=n'�i�i������ �� ■ ��� ■ ����� ■����������i�■��������■��■����������■■ iiiiii�i� � �i���n����■ ���=i���� ��� ■ ���■�������� ����s���� ������n��� ���� ■ ■ ■ ��� ����� ■���� ��i���������iiiiiiiiiiiiiiii��■ ■�������� ■ ����� ��� ��� � �� ������� ����■���■ ■��������������■�����H� �o������� �■ � ������� � ��� �� �� � � � �� �n ■ C��i �ii'ii�i=iu'i'iiuiii�iiiiiiiiiiiiiiiiiiiiiiii C::::::� :�':::'::: :_: .... . ...._= C. 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