370 Bridle Ln 3avie County,NC r* Tax Parcel Report Friday; September 23, 201(
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WARNING: THIS IS NOT A SURVEY
Parcel
Information
Parcel Number: G70000013908 Township: Shady Grove
NCPIN Number: 5779298844 Municipality:
Account Number: 29162310 Census Tract: 37059-804
Listed Owner 1: GIFF TIMOTHY GERALD Voting Precinct: EAST SHADY GROVE
Mailing Address 1: 370 BRIDLE LANE Planning Jurisdiction: Davie County
City: ADVANCE Zoning Class: DAVIE COUNTY R-A
State: NC Zoning Overlay:
Zip Code: 27006-0000 Voluntary Ag.District: No
Legal Description: LOT 10 RABBIT FARM PHASE 1 Fire Response District: ADVANCE
Assessed Acreage: 5.73 Elementary School Zone: SHADY GROVE
Deed Date: 5/2000 Middle School Zone: WILLIAM ELLIS
Deed Book/Page: 003340169 Soil Types: MrC2,GnB2
Plat Book: 0006 Flood Zone:
Plat Page: 071 Watershed Overlay: DAVIE COUNTY
Building Value: 186610.00 Outbuilding&Extra 3610.00
Freatures Value:
Land Value: 65330.00 Total Market Value: 255550.00
Total Assessed Value: 255550.00
9�v16All data Is provided as is without warranty or guarantee of any kind either expressed or Implied Including but not limited to the
Davie County, Implied warranties of merchantability or fitness for a particular use.All users of Davie County's GIS website shall hold harmless the
County of Davie,North Carolina,Its agents,consultants,contractors or employees from any and all claims or causes of action due to
c�UN� NC or arising out of the use or Inability to use the GIS data provided by this website.
I r
Davie County Health Department
s r Environmental Health Section P �.:
4 P.O. Box 848 -
14
210 Hospital Street
C�
O:U Courier# : 09-40-06 1911 ''
Mocksville, NC 27028 -
Phone:(336)-753-6780 Fax:(336)-753-1680
NOTICE OF VIOLATION
ON-SITE WASTEWATER SYSTEM
Owner Timothy Gerald Giff Mailing Address 370 Bridle Lane;
Advance,NC 27006
Occupant Timothy Gerald Giff Location 370 Bridle Lane;
Advance,NC 27006
(X)Residence () Business () Other
Dear Mr. Giff,
You are hereby notified that you are violating the Rules adopted by the North Carolina
commission for Health Services or Article 11 of Chapter 130A of North Carolina by
owning or controlling a residence,place of business, or place of public assembly which is
not provided with an approved wastewater system. Your wastewater system is not in
compliance.
On_April 6,2015_, an inspection of the wastewater system by the Davie Environmental
Health Department indicated the following violations:
VIOLATION/S LAW OR RULE
CITE
Resposibilities 15A NCAC 18A.1938
Location of Sanitary Sewage System 15A NCAC 18A.1950
Your are here by ordered to bring you wastewater system into compliance by completing
one of the following.
(X)Install/Repair wastewater system. () Other Repairs (Specify)
()Eliminate wastewater discharge and () Perform Maintenance
(Specify)
Connect to an approved wastewater
System.
y.
If the wastewater violation is not brought into compliance by May 6,2015 ,
Appropriate legal action will be taken.
Failure to comply with the laws, rules and this notice will subject you to the following
legal remedies; Injunction Relief (G.S. 130A-18),Administrative Penalties (G.S. 130-
22(c)), Suspension or Revocation of Permits (G.S. 130-32), and Criminal Penalties (G.S.
130-25).
You may contact our office at (336) 753-6780 or fax; (336) 753-1680
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• DAVIE COUNTY HEALTH DEPARTMENT
.� )",
IMPROVEMENT PERMIT and OPERATION PERMIT 'v
IMPROVEMENT PERMIT
**MOTE** 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 13OA, Wastewater Systems, Section .1900 Sewage Treatment and Disposal Systems)
NAME PROPERTY ADDRESS "' �' '-• -. DATE I6 -!O-15
LOCATION ��`t 1"� 1�\ C4 ~ rim ray .9�i,. C�+ ?-A tt, Vol LN - �CA QhRas�
SUBDIVISION NAME . �o
R sa�o 7N � P'�'�► LOT NUMBER D SEC./BLOCK NUMBER
RESIDENTAL SPECIFICATION: BUILDING TYPE # BEDROOMS # BATHS # OCCUPANTS 3 GARBAGE DISPOSAL:&o
COMMERCIAL SPECIFICATION:FACILITY TYPE # PEOPLE # PEOPLE/SHIFT # SE4b INDUSTRIAL WASTE: YAJND
LOT SIZE )J car s as TYPE;WATER SUPPLY' W)5- DESIGN,WASTEWATER. FLOW (GPD) �L NEW SITE ,,REPAIR SITE,
SYSTEM SPECIFICATIONS: TANK SIZE\ b0 C`GAL PUMRJANK GAL. TRENCH WIDTH RDCK DEPTH' I-1 LINEAR FT. D Q
`w
OTHER1d 5 b.
REQUIRED SITE MODIFICATIONS/CONDITIONS: "
***THIS PERMIT IS SUBJECT TO REVOCATION IF SITE PLANS'dR THE INTENDED USE CHANGE. : YOUR'ATERWATER SYSTEM CONTRACTOR MUST r:
SEE THIS PERMIT BEFORE INSTALLING THE tYSTEM.
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u S X;11
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IMPROVEMENT PERMIT BY
**M,ffACT'A REPRESENTATIVE,�'OFIiTHMVIE COUNTY HEALTH DEPARTMENT FOR FINAL INSPECTION OF THIS SYSTEM BETWEEN
.8:30-9:30 A.M. OR1:OO-l:3O;P,M. ON THE DAY OF INSTALLATION. TELEPHONE # IS (704) 634-8760.
OPERATION PERMIT SYSTEM JNSTALLED' f
HO
AUTHORIZATION NO. 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 13OA, 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 10/95
1.1.,Y - a .Y ni's� �,B.aLt'.} a nPSi.�d "'.lY,-Y-T-+r • (/XjL/Q
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-'"`:�,.� �'' ' ' LM• Davie County Health Department � ' ���► „.
• �`!C •'—r - '�4 is �ti, +, ENVIRONMENTAL HEALTH SECTION
P.O.'Box 665
Mocksville, N.C. 27028 , '
"F AUMIZATION FOR WASTEWATER SYSTEM CONSTRUCTION
(Issued in compliance with Article 11 of
B.S. Chapter 13OA, Wastewater Systems)
*"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.+**
• AUTHO IZATION NUMBER
q �_
NAME n.,o DATE - n 1 — 9 N2,
NAME ON IMPROVEMENT PERMIT iIf different than above)
SITE LOCATION �� VrTcs�. c,"ti
/ i
COMMENTS/CONDITIONS ON AUTHORIZATION TO CONSTRUCT WASTEWATER SYSTEM
**WICE*ff THIS AUTHORIZATION FOR WASTEWATER SYSTEM CONSTRUCTION IS VALID FOR A PERIOD OF FIVE (5) YEARS.
"MIRONMENTAL HEALTH SPECIALIST . ?i DATE
DCHD 10/95
APPLICATION FOR SITE EVALUATIONAMPROVEMENTS PERMIT a ��•.�
Davie County Health Department e-
Environmental Health Section R(�, t, _ _ E ID
P.O..Box 665
Mocksville, NC 27028 140V 0 1 1�
--mss._"`-------
1.,Application/Permit Requested By 7",L)MV11-11
Mailing Address -e('1 /1 w/ry A/�'
Home Phone Business Phone
2. Name on Permit if Different than Above
3. Applicatlon/Permit for: La-general Evaluation ❑ Septic Tank Installation
4. System to Serve: ErRouse ❑ Mobile Home ❑ Place of Public Assembly
❑ Business ❑ Industry ❑ Other ❑ Unknown
S. If house,mobile home:Subdivision- ' I-YYA Section Lot #—10
❑ Basement/Plumbing
No.of People 3 ❑ Basement/No Plumbing
No.of Bedrooms 1 [--Washing Machine
No.of Bathrooms 2-Dishwasher
Dwelling Dimensions B-Garbage Disposal
6. If business, Industry, place of public assembly,other: Specify type
No. of People Served No. of Sinks
No.of Commodes No. of Urinals
No.of Lavatories No.of Water Coolers
No.of Showers Water Usage Figures
7. Type of water supply: ❑ Public ® PrivateF, ❑ Community
8. Property Dimensions S 14e, reo`> Sewage Disposal Contractor
9. Do you anticipate additions/expansion of the facility this sytem is intended to serve? ❑ Yes ® No
If yes,what type?
'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.
Directions to Property:
y s ,�' � �a•�vr�z�r k�l /1 /�1� vZ.
Er J �F/J� 14 F14 a-1)7 tD
fit > 04,Ll A
J U,
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.
/0 — V- 9/1—/ 17
DATE SIGNATURE
CONSENT EM 5M EVALUATION IQ BE DONE QN ABOVE DESCRIBED PROPERTY
MUST CHECK ONE: ❑ 1. 1 OWN the property. 12 2. 1 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 representative of the Davie C,oy�my ealth Department to enter upon above described
property located in Davie County and owned by- Z44 ae � � �➢` a/_
to conduct all testing procedures as necessary to determine said site's suitability for a ground absorption sewage treatment
and disposal system.
DATE SIGNA U E
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.is r+•a i......w Ot<r.•i.•••••at.i•im er 1•ee•itnte I (wal hereby certify that I (•e ■n) aw the owner(s) of the
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r..•1.a•. 1•er iaw, e.',ty w<n.•.n oral"m<.an.a property shown and deacri Dad hereon and that I (we) hereby
c' c"iee r w+<• adopt this plan of aubdivl cion with my (our) free eonaent, •DAV IE C
rq w.u•ur " r:Irr• - -y<ant•viten is t wt is 1•c•4a in••<n►ortim4 Of u a »:•4444^. 1: •.i1^., - ' sew<r es iiy that i•4.w•sv+•t+a••ae.n ora w,4<•that seta Dl iah all lots, end dedicate ell roads, walks, parka,
cn c.nr.uN 4444.. r., •.vlm.r r,�.1•t.•Nr<.1•Of i.ha1 eaaewenta rights of way, and other open spaces to public
Lwi«nu Yui e1N s.�.a•+••+ - r.<ere•c+•t t••••rn.et M.•i.uK pirn1.'"er vr<•t••t ivN, $EIwiG A Po2T1o•.i OF
0410 tet, .. •,,,,,e.rr•••• - a i•v+•a i..r.•or•.t•r u4eah•r ...n.•Nn••u• or private uses as nobd.
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• DAVIE COUNTY HEALTH DEPARTMENT
Environmental Health Section
Soil/Site Evaluation
NAME 1 i-tr 0\\'N\J \'Z DATE EVALUATED 1 1` y 4
ADDRESS A M'Q PROPERTY SIZE
PROPOSED FACIILTY ���" LOCATION OF SITE
Water Supply: On-Site Well Community Public
Evaluation By:�fk.\_ Auger Boring Pit Cut
FACTORS 1 2 3 4
Landscape position
Slope Z -/ - S (:�A -V-
HORIZON I DEPTH (n u
Texture group (11 L CL L..
Consistence F :51 F�
Structure
Mineralogy
HORIZON II DEPTH » Nc Z" 'Z,\% Lk-.4.V
Texture group
Consistence V_ PM F-T_
Structure V-1 K g
Mineralogy � '• ); ;� ;)
HORIZON III DEPTH
Texture group
Consistence
Structure
Mineralogy
HORIZON IV DEPTH
Texture group
Consistence
Structure
Mineralogy
SOIL WETNESS SS SS �5' SS
RESTRICTIVE HORIZON
SAPROLITE —
CLASSIFICATION ,5._ t
LONG-TERM ACCEPTANCE RATE C
SITE CLASSIFICATION: EVALUATED BY:
LONG-TERM ACCEPTANCE RATE: OTHER(S) PRESENT: )
REMARKS: \1
��_
\1 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-Finn 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(01-901
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�a�ne County .�ealtfr De arrment
and .dome Nealtl yency
210 HOSPITAL STREET P.O.BOX 885
MOCKSVILLE.N.C. 27028
PHONE:(704)834-5985
November 4, 1994
Timothy Giff
2620 S. Main St.
Winston—Salem, NC 27127
Re: Site Evaluation
Rabbit Farm—Lot 1Q
Dear Mr. Giff:
As requested, a representative from this office visited the aforementioned
site on November 2, 1994. Based upon the information provided on the
application fora site evaluation and after the evaluation was completed, the
site was found to be provisionally suitable for the installation of an on—site
sewage disposal system.
If you have any questions, please feel free to contact this office.
Sincerely,
Charles E. Little, R.S.
Environmental Health Section
CL/wd
Enclosure