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969 Deadmon Rd OPERATION PERMIT r' or ice se ny Davie County Health Department 'CDP Fite Humber 120173-2 210 Hospital Street t<caOoaa00502 Stir P.O.Box 848 County ID Number Mocksville NC 27028 Evaluated For WELL Phone:336-753-6780 Fax: 336-753-1680 Tm nshlp, Applicant Ed Bartlett ;"Property Owner Ed Bartlett Address. 939 Deadmon Rd Address. 939 Deadmon Rd City Mocksville CAV Mocksville StatecZlp: NC 27028 State Zip NC 27028 Phone (336) 998-8766 '� Phone= (336) 998-8766 ; Property Location & Site Information Address Road = Subdyis=on. Phase. Lot Deadmon Road Mocksville NC 27028 Directions Structure SINGLE FAMILY Hwy 601 S. Left on Deadmon Road. Property on of Eiedroorns right. beside 953 Deadmon Road. r of People -vlater Supply NA 'IP Issued by 22-t4-Day:al'..�rulrc.. 'System Classification Description \ . TYPE II A.CONY SYSTEM(SINGLE-FAMILY OR 480 GPD OR LESS) 'CA Issued by 22.14-Dayv:a►;.Andre,-. Sapiolite Systems f )Yes c,_)Pdo Design Flo:;, GRAVITY-SERIA: P tmn Requ:rem? 4 $ 0 'Dairhuian Type ;►ye_ +..lc Soil Application Rate 0 3 'Pre-Treatment NA i J. Drain field f' Nitrification Field Sq ft. 'Systein Type INFILTRATOR QUICK 4 STANDARD 1 No Drain LinesInstaler ben crests Total Trench Length 4 0 0 tt Certificafion ........................................ Trench Spacing 9 (,)Inches 0 C p g — (_)Feet U.C. 'ENS 22-t•t-Oayr:au.Andrew Trench L'Jidth _ 3 6 'x,lnches t�)Feet Dale 0 7 / 1 6 / 2 0 1 3 Aggregate Depth Inches f:linimum Trench Depth Inches Ia,ntmum Soil Cover Inches Approval Status 1.11.2ximuni 'l rench Depth. Inches .p Approved❑ Disapproved, 1 ff Ltaxinuin: Sot; Cover Inches _.-' --CDP F,Ie f:urnber ' 120173 - 2 Septic Tank County ID Number K60000000502 Manufacturer sr,oar tat.Long- r STB: Gallons 1000 Installer / Certification Date =. 'EHS 224:4-Day•sa"r.Mdrev. 'Filter Brand ST Marker- Yes [1 No Date. � l Reinforced Tank ❑ Yes ❑ No Approval Status ; Piece Tank El Yes ❑ No ❑ Approved El Disapproved Pump Tank Manufacturer Installer. � PT Certification Gallons 'EHS Date J / Date- R user Sealed ❑ Yes ❑ No RnerIleght ❑ Yes ❑ No U.,ill 6 ill Approval Status �eonfosced Tank ❑ Yes ❑ No ❑ Approved❑ Disapproved Piece Tank LJ Yes ❑ No Supply Line f�.. Prpe Size inch diaineter Installer ''1 Pape Length feet Certification = 'Schedule 'EHS Pressure Rated ❑ Yes ❑ No Date Approved frUngs ❑ Yes ❑ N o f Approval Status ❑ Approved ❑ Disapproved ! ,I— - J, , Pump Requirement Pump Type Installer. Dosing Volume — Val Certification= Drew Doan- Inches *EHS- 'Chain. f Date Valves Accessrrle ❑ Yes ❑ No Ftct:v Adjustment Valve ❑ Yes ❑ No Check valve ❑ Yes ❑ No Approval Status PVC unions ❑ Yes ❑ No ❑ Approved ❑ Disapproved Vent Hole ❑ Yes ❑ No '. Anti-siphon Hole ❑ Yes ❑ No ` .. . CDP File t:timber ' 120173 - 2 KGo-3O0000s02 County ID Number: Electric Equipment. ' 11FGIA4X Box or Equivalent ❑ Yes ❑ No Installer Box 12 inches Above Grade ❑ Yes ❑ No Certification =' Box Adj. To Pump Tank ❑ Yes ❑ No Co.ndu:t Sealed ❑ Yes ❑ No }Eris Pump f.tanuauyOperable ❑ Yes ❑ No / 'Activation Method Date. Approval Status Alarm Audible El Yes El No ❑ Approved❑ Disapproved Nairn Visible i_] Yes U No 22.14-Daywai:.Andrew 'Operation Permit completed by Aufhonzed State Agent Date of Issue 0 7 / 1 6 / 2 0 1 3 This system has been installed in compliance with applicable PJC General Statutes Article 11. Chapter 130A Rules for Sewage Treatment arid Disposal. 15A NCAC 18A 1900 of Seq and ill condrions of the Improvement Penn€t and Construction Authorzat:on This property is served by a TYPE u A sewage septic system. Rule 1961 requires that a Type TYPE it A _____ septic system meet the foilovying criteria Minimum System Revievi By The Local Health Department N'A—_—__-__—___ Management Entity U NER Pauiiniun, System Inspection t,'aintenance Frequency By Certified Operator N'A ......... ......._......................................................................................................................................................... ................ .............................................. Reporting Frequency By Certif ed Operator N _________ Rule 1961 requires that a Type IV and V septic systems designed for a home business ov.ner must maintain a valid contract wt h a public management entity.. ti a certified operator or a private certified operator for the life of the septic. sr;stenl. Rule 1961 requires that Type VI septic systems designed fora home'business owner must maintain a valid contract with a public management entity:v,th a certified operator for the life of the septic system Rule 1961 (2)(e)requires a contract shall be executed het::een the system owner and a management entity prior to the issuance of an Operation Permit for a system required to be maintained by a public or private management entry. unless the sy3tein owner and certified operator are the same. T tie contract shall require specific requirements for maintenance and operation. responsibilities of the o,.v ner and systems operator provisions that the contract shall be in effect for as long as the sjstem is in use. and other requirements for the con.nnued proper performance of the system It shall also he a condition of the Operation Permit that subsequent owners of the systems execute such a contract ,-)Hand Drawing C)Import Drawing **Site Plan/Drawing attached.** Tctai -ime+.-4 Activry Code 5.1S)20B-OP AsuedNE'l:'Ty,^.e 11 Loc%413 0 1 H ;._ 0 0 ' OPERATION PERMIT Davie County Health Department CDP File Number: 120173 -2 . 210 Hospital Street KG0000000502 P.O.Box 848 County File Number: Mocksville NC 27028 Date: Olnch Drawing Drawing Type: Operation Permit Scale: , OBlock ONfn (I LtzLti 12s ,� e . CONS'TR6 -TION For office Use Only AUTHORIZATION. *CDP File Number 120173-1 ° Davie County Health Department K600000005502 ty P County ID Number. 210 Hospital Street Evaluated For. NEW P.O.Box 848 Township: Mocksville NC 27028 PERMIT VALID UNTIL/ -'8ApPhone:336-753-6780 Fax:336-753-1680 04 / A 6 �L 0 1,8- Applicant plicant Edward Bartlett Property Owner. Edward Bartlett Address: 939 Deadmon Road Address: 939 Deadmon Road City: Mocksville City: Mocksville State/Zip: NC 27028 State/Zip: NC 27028 Phone#: (336)998-8766 Phone#: (336)998-8766 Property Location & Site Information r ad#: Subdivision: Phase: Lot: Road e NC 27028 Directions Structure: SINGLE FAMILY Hwy 601 S. Left on Deadmon Road, Property on right. beside 953 Deadmon Road. #of Bedrooms: 4 #of People: 5 *Water Supply: NEW WELL System Specifications Site Classification: Minimum Trench Depth: a 4 Inches Sa rolite System? O Yes �No Minimum Soil Cover Inches Design Flow: 4 8 0 Maximum Trench Depth: 3 6 Inches Soil Application Rate: 0 3 Maximum Soil Cover. Inches *System Classification/Description: *Distribution Type: GRAVITY-SERIAL TYPE II A.CONY SYSTEM(SINGLE-FAMILY OR 480 GPD OR LESS) Septic Tank: 1 0 0 0 Gallons *Proposed System: 25%REDUCTION 1-Piece: O Yes ®No Pump Required: QYes ®No O May Be Required Nitrification Field Sq.ft. Pump Tank: Gallons No. Drain Lines 1-Piece: QYes ONo Total Trench Length: 4 0 0 {t, GPM vs— ft. TDH Trench Spacing:. Inches O.C. — 9 RFeetO.C. Dosing Volume: Gallons Trench Width: — 3 6 ®Inches O Aggregate Depth: Feet Grease Trap: Gallons inches Pre-Treatment O NSF OTS-1 OTS-11 Septic Tank Installer Grade Level Required: 01011 O III 01V Page 1 of 3 CDP� ileNumber 120173 - 1 s -» County ID Number: Ks0000000502 ❑ Open Pump System Sheet Repair System Required:(&Yes ONO ONO, but has Available Space Repair System Trench Spacing: 9 Inches O. . *Site Classification: PS = Feet O.C. Trench Width: ®Inches Design Flow: 4 8 0 _ 3 6 O Feet Soil Application Rate: 0 3 Aggregate Depth: inches .� *System Classification/Description: Minimum Trench Depth: a 4 Inches TYPE,1 A.CONY SYSTEM(SINGLE-FAMILY OR 480 GPD OR Minimum Soil CoverLESInches Maximum Trench Depth: 3 6 Inches *Proposed System: 25%REDUCTION - - Maximum Soil Cover. Nitrification Field Sq. Inches ft. No. Drain Lines *Distribution Type: GRAVITY-SERIAL Total Trench Length: 4 0 0 ft Pump Required: OYes ®No OMay Be Required Pre Treatment: O NSF OTS-I OTS-II *Site Modifications No grading or construction activity is allowed in areas designated for system and repair without approval of Health Department. *Permit Conditions The issuance of this permit by the Health Department in no way guarantees the issuance of other permits.The permit holder is responsible for checking with appropriate governing bodies in meeting their requirements. This Authorization for Wastewater System Construction shall be valid for a person equal to the period of validity of the Improvement Permit,not to exceed five years,and may be issued at the same time the Improvement Permit issued(NCGS 130A-336(b)).If the Installation has not been completed during the period of validity of the Construction Permit,the information submitted in the application for a permit or Construction Authorization is found to have been incorrect,falsified or changed,or the site is altered,the permit or Construction Authorization shall become Invalid,and may be suspended or revoked(.1937(8)).The person owning or controlling the system shall be responsible for assuring compliance with the laws,rules,and permit conditions regarding system location,installation,operation,maintenance,monitoring,reporting and repair (1938(b)). Applicant/Legal Reps. Signature Required? OYes ®No Applicant/Legal Reps. Signature: Date: *Issued By: 2244-Daywalt,Andrew Date of Issue: 0 4 / a 6 / 2 0 1 3 Authorized State Agent: a AAA Malfunction Log OYes Hand Drawing O Import Drawing Total Time:(HH:MM) **Site Plan/Drawing attached.** Page 2 of 3 1 Hours 0 Minutes S-8-C/A ISSUED-NEW CQ'NSTQUCTION AUTHORIZATION Davi County Health Department CDP File Number. 120173 - 1 210 Hospital Street K60000000502 P.O.Box Bas County File Number: Mocksville NC 27028 Date: 04 / a6 / ,2013 O Inch Drawing Drawin T e: Construction Authorization Scale: . O Block 9 YP O N/A 5 i Mme..• .. - ' /r v Page 3 of 3 P1 P2 3/r r VA - I� { CONSTRUCTION For office use only AUTHORIZATION *CDP File Number,; 120173-1 •= "�° Davie CountyHealth Department. K60000000502` P County ID Number " 210 Hospital Street Evaluated F0'- '..'' NEW P.O. Box 848 Township:= Mocksville NC 27028 PERMIT VALID UNTIL: Phone:336-753-6780 Fax:336-753-1680 04 / ,26 �Z. 0 -1- 8- Applicant: Edward Bartlett Property Owner Edward Bartlett Address: 939 Deadmon Road Address: 939 Deadmon Road City: Mocksville City: Mocksville State/Zip: NC 27028 State/Zip: NC 27028 . Phone#: (336)998-8766 Phone#: (336)998-8766 . Property Location &Site Information Address/Road#: Subdivision: Phase: Lot: Deadmon Road Mocksville NC 27028 Directions Structure: SINGLE FAMILY Hwy 601 S. Left on Deadmon Road, Property on right. beside 953 Deadmon Road. #of Bedrooms: 4 #of People: 5 *Water Supply: NEW WELL System Specifications Minimum Trench Depth: a 4 rSaprolite ssification: Inches Minimum Soil Cover: System? OYes (8)No inches glow: 4 8 0 Maximum Trench Depth: 3 6 Inches Soil Application Rate: 0 3 Maximum Soil Cover. Inches . *System Classification/Description: *Distribution Type: GRAVITY-.SERIAL TYPE II A.CONV SYSTEM(SINGLE-FAMILY OR 480 GPD OR LESS) $eptlC Tank: 1 0 0 0 Gallons *Proposed System: 25%REDUCTION 1-Piece: O Yes ®No Pump Required: .O Yes ®No O May Be Required Nitrification Field Sq.ft. Pump Tank: Gallons No. Drain Lines 1-Piece: OYes ONo Total Trench Length: 4 0 0 ftGPM—vs— ft. TDH Trench Spacing: — 9 Inches O.C. — Feet O.C. Dosing Volume: Gallons Trench Width: — 3 6 Inches Feet Grease Trap: Gallons . Aggregate Depth: inches Pre-Treatment: O NSF OTS-1 OTS-11 Septic Tank Installer Grade Level Required: 01011 O 111 01V Page 1 of 3 CQP- Number Number 120173 - 1 County ID NumbeK60000000502 ❑ Open Pump System Sheet Repair System Required:OYes ONO ONO, but has Available Space rDesign ir System Trench Spacing: 9 Inches O. . assification:. Ps = Feet O.C. Trench Width: ®Inches Flow: 4 8 0 _ 3 6 o Feet Soil Application Rate: 0 3 Aggregate Depth: inches .� Inches Minimum Trench Depth: '1 4, *System Classification/Description: LESS)TYPE II A.CONV SYSTEM(SINGLE-FAMILY OR 480 GPD OR Minimum Soil Cover: Inches *Proposed System: 25%REDUCTION Maximum Trench Depth: 3 6 Inches Maximum Soil Cover. Nitrification Field Sq. Inches ft. No. Drain Lines *Distribution Type: GRAVITY-SERIAL Total Trench Length: 4 0 0 ft Pump Required: Oyes (&No O May Be Required Pre-Treatment: O NSF OTS-1 OTS-11 *Site Modifications No grading or construction activity is allowed in areas designated for system and repair without approval of Health Department. *Permit Conditions The issuance of this permit by the Health Department in no way guarantees the issuance of other permits. The permit holder is responsible for checking with appropriate governing bodies in meeting their requirements. This Authorization for Wastewater System Construction shall.be valid for a person equal to the period of validity of the Improvement Permit,not to exceed five years,and may be issued at the same time the Improvement Permit issued(NCGS 130A-336(b)).If the Installation has not been completed during the period of validity of the Construction Permit,the Information submitted in the application for a permit or Construction Authorization Is found to have been Incorrect,falsified or changed,or the site is altered,the permit or Construction Authorization shall become Invalid,and may be suspended or revoked(.1937(8)).The person owning or controlling the system shall be responsible for assuring compliance with the laws,rules,and permit conditions regarding system location,installation,operation,maintenance,monitoring,reporting and repair (1938(b)). Applicant/Legal Reps. Signature Required? O Yes ®No Applicant/Legal Reps. Signature: Date: *Issued By: 2244-Daywalt,Andrew Date of Issue: 0 4 / a 6 / 2 0 1 3 Authorized State Agent: Malfunction Log Oyes ®Hand Drawing O Import Drawing Total Time:(HH:MM) **Site Plan/Drawing attached.** 1 Hours 0 0 Minutes Page 2 of 3 S-8-C/A ISSUED-NEW ' CONSTRUCTION AUTHORIZATION 120173 - 1 ti Davie County Health Department CDP File Number: 210 Hospital Street K60000000502 P.O.Box 848 County File Number: Mocksville NC 27028 Date: 0 4 / 2 6 / 2 0 1.3 O Inch Drawing ' Drawing Type: Construction Authorization Scale: , O Block O N/A I LIM . a srci!� i ,�� t 21 Page 3 of 3 P1 P2 IMPROVEMENT PERMIT For office useonly r1CDPFileNumber 120173-1 Davie County Health Department t. 210 Hospital Streetunty ID Number.K60000000502 P.O.Box 848 Evaluated For: NEW Mocksville NC 27028 Township: Phone:336-753-6780 Fax:336-753-1680 PERMIT VALID UNTIL: 2/21/2018 "NOTE TO INSPECTIONS DIVISION: Building Permits cannot be issued with this Improvement Permit. Applicant: Edward Bartlett Property Owner. Edward Bartlett Address: 939 Deadmon Road Address: 939 Deadmon Road City: Mocksville CRY- Mocksville State/Zip: NC 27028 State2ip: NC 27028 Phone#: (336)998-8766 Phone#: (336)998-8766 Property Location & Site Information Address/Road#: Subdivision: Phase: Lot: Deadmon Road Mocksville NC 27028 Directions Structure: SINGLE FAMILY Hwy 601 S. Left on Deadmon Road, Property on #of Bedrooms: 4 right. beside 953 Deadmon Road. #of People: 5 'Water Supply: NEW WELL S stem Specifications rSaprolde tial System m asst Ica an: Minimum Trench Depth: a 4 Inches System? OYes QNo Maximum Trench Depth: 3 6 Inches Design Flow: 4 8 0 Septic Tank: 1 0 0 0 Gallons Soil Application Rate: 0 - 3 1-Piece: OYes (Z)No Pump Required: OYes ON OMay Be Required 'System Classification/Description: TYPE II A.CONY SYSTEM(SINGLE-FAMILY OR 480 GPD OR Pump Tank: Gallons LESS) 'Proposed System: 25%REDUCTION 1-Piece: OYes ONo Repair System Required:0 Yes ONo ONo, but has Available Space cs0iil(), epair System Classification: PS Minimum Trench Depth: a 4 Inches pplication Rate: 0 - 3 Maximum Trench Depth: 3 6 Inches _7 O Pump Required: Yes @ No Ma be Re uire 'System Classification/Description: O Y qd TYPE IIA.CONY SYSTEM(SINGLE-FAMILY OR 480 GPD OR LESS) 'Proposed System: 25%REDUCTION Page 1 of 3 CDP File Number 120173•- 1 County ID Number. K60000000502 'Site Modifications ❑ Open Fill Sheet No grading or construction activity is allowed in areas designated for system and repair without approval of Health Department. *Permit Conditions The issuance of this permit bythe Health Department in no way guarantees the issuance of other permits.The permit holder is responsible for checking with appropriate governing bodies in meeting their requirements. Site Plan The Improvement Permit shag be valid for is years from date of Issue with a site pan(means a drawing not necessarily drawn to scale that shows the existing and proposed property Imes with dimensions,the location of the facility and appurtenances,the site for the proposed wastewater system,and the location of water supplies and surface waters). Plat The Improvement Permit shag be valid without expiration with plat(means a property surveyed prepared by a registered land surveyor,drawn to a scale of one inch equals no m orethan 60 1194 that Includes:the specific location of the proposed facility O and appurtenances,the site for the proposed wastewater system,and the location of water supplies and surface waters. Plat also means,for subdivision lots approved by the local planning authority and recorded with the county register of deeds,a copy of the recorded subdivisions plat that Is accompanied by a site plan that Is drawn to scale). The Department and Local Health Department may Impose conditions on the Issuance and may revoke the permits for failure of the system to satisfy the conditions,the rules,or this article.This permit Is sub)ectto revocation If the site plan,plat,or intended use changes(NCOS 130A335(q).The person owning or controlling the system shall be responsible for assuring compliance with the laws,rules,and permit conditions regarding system location,Installation,operation,maintenance,monitoring, reporting,and repair(.1938(b)} Applicant/Legal Reps.Signature Required? Oyes ONO Applicant/Legal Reps.Signature: Date: 'Issued By: 2244-Daywalt,Andrew Date of Issue: a a 1 / a 0 1 3 Authorized State Agent: OValid without Expiration? O Create CA? OHand Drawing Olmport Drawing **Site Plan/Drawing attached.** TotalTime:(HH:MM) 1 .Hours. 0 Uinutes Page 2 of 3 Activitv Code: IMPROVEMENT PERMIT : Davie CountyHealth Department CDP File Number. 120173 - 1 210 Hospital Street K60000000502 P.O.Box 848 County File Number: Mocksville NC 27028 Date: / / Q Inch Drawing Drawing Type: Improvement Permit Scale: . 08lock ON/A T- 1--1- 7 F-1 _.3_q L—IL— 1 i Ilj i I I Page 3 of 3 3d j � ^� Y Z11 3�l cl- 2011P ATION FOR SITE EVA LUATIONAMPROVEMENT PERMIT& ATC n Davie County Environmental Health P.O.Box 848/210 Hospital Street ' Mocksville,NC 27028 (336)753-6780/Fax(336)753-1680 Application For: ❑Site Evaluation/Improvement Permit ❑Authorization To Construct(ATC) )<Both Type of Application: *ew System GRepair to Existing System 17Expansion/Modification of Existing System or Facility ***lMPORTANP**THIS APPLICATION CANNOTBEPROCESSED UNLESS ALLOF THE REQUIRED INFORMATION IS PROVIDED. Refer to the INFORMATION BULLETIN for instructions. APPLICANT INFORMATION rr �^ / Name to be Billed t-�t-4J- Contact Person C C( Billing Address Home Phone to City/State/ZIP Business Phone 3-:�(e -!99t Name on Petmit/ATC if D fferent than Above Mailing Address City/State/Zip PROPERTY INFORMATION *Date House/Facility Corners Flagged a �3 NOTE: A survey plat or site plan must accompany this application. Included: Site Plan GPlat(to scale) (Permit is va•d for 60 o the with site plan,n xpiration wi complete plat.) Owner's Name E r Phone Number - 7 Owner's Address City/State/Zip Property Address C ity Lot Size R. Vn7-gs'+r-s Tax PIN# Subdivision Name(if applicable) Section/fot#_ Directions To Site: If the answer to any of the following questions is"yes",supporting documentation must he attached. Arc there any existing wastewater systems on the site? i IYes)dqo Does the site contain jurisdictional wetlands? I YesANo Are there any easements or right-of-ways on the site? GYes)ANo Is the site subject to approval by another public agency? 11Yes13Mo Will wastewater other than domestic sewage be generated? GYes XNo IF RESIDENCE FILL OUT THE BOX BELOW +f #People #Bedrooms #Bathrooms el Garden Tub/Whirlpool kYes DNo Basement: OYes o Basement Plumbing: ❑Yes Ako IF NON-RESIDENCE FILL OUT THE BOX BELOW Type of Facility/Business Total Square Footage of Building #People #Sinks #Commodes #Showers #Unnals Estimated Water Usage(gallons perday) (Attach documentation of similar facility water consumption) FOODSERVICE ONLY: #Seats Type system requested: ❑Conventional ClAccepted Glnnovative GAlternative 1101her Water Supply Type:G County/City Water New Well !?Existing Well 0 Community Well Do you anticipate additions or expansions of the facility this system is intended to serve?C Yes �<No If yes,what type? This is to certify that the information provided on this application is true and correct to the best of my knowledge. I understand that any permit(s)or ATC(s)issued hereafter are subject to suspension or revocation if the site is altered,the intended use changes,or if the information submitted in this application is falsified or changed I hereby grant right of entry to the Authorized Representative of the Davie County Health Department to conduct necessary inspections to determine compliance with applicable laws and rules. I understand that I am responsible for the proper identification and labeling of property lines and corners and loc�ing and�ggin or staktn 1 se/facility location,proposed well location and the location of any other amenities. �'K Site Revisit Charge Property owner's or owner's legal representative signature Date(s): eZ Client Notification Date: Date EHS:_ Sign given GYes ONo Account# Q t) Revised 11/06 Invoice# 6�?# !20173 �`�' Pio Q OS ec� N ou.S e- q /cT1 c ce-g s � yJe�l - �ro p e scd NogsC- - v p�rn6� KC� • ; �K -101 VCi UOb . EXHIBIT "A" Beginning at a mag nail In Deadmon Road (State Road 1801), thence with Deadman Road North 85 deg. 09 min. 25 sec. West 436.26 feet to a mag nail in the right of way of Deadmon Road; thence North 07 dog. 34 min. 43 sec. East 31.47 foot to a % -inch existing iron pin in the line of Roy Vestal Spry; thence with the line of Spry North 07 deg. 34 min. 43 sec: East 318.53 feet to a now.iron pin in the line of Spry; thence South 86 deg. 09 min. 25 sec. East 412.73 feet to a new iron pin in the northeastem corner of the within described tract; thence South 03 deg. 43 min. 26 sec. West 349.67 feet to the point and place of beginning; containing 3.407 acres, more or less, all as set forth in Plat of Survey for James Garwood, by Grady L. Tutterow, P.L.S., dated 29 December 1999, drawing number 27599-4. • f • s Appraisal Card• Page 1 of 1 DAVIE COUNTY NC 2/6/2013 1:41:47 PM ARTLETT EDWARD E BARTLETT SHARON S Return/Appeal Notes: K6-000-00-005-02 EADMON RD UNIQ ID 20941 2527667 ID NO:5757139302 O COUNTY TAX(100),FIRE TAX(100) CARD NO.1 of I eval Year:2013 Tax Year:2013 3.407 AC DEADMON RD 3.100 AC SRC- raised by 55 on 10 Ol 2008 06006 DALTON TW-06 C- EX-AT- LAST ACTION 20110712 [a ONSTRUCTION DETAIL MARKET VALUE DEPRECIATION CORRELATION OF VALUE OTAL POINT VALUE Eff. BASE BUILDING USE MOD Area UAL RATE RCN EYB AYB REDENCE TO m ADJUSTMENTS 97 00 %GOOD EPR.BUILDING VALUE-CARD ~ ti OTALADJUSTMENT TYPE:Vacant EPR.OB/XF VALUE-CARD Cc ACTOR 4ARKET LAND VALUE-CARD 27,21 OTAL QUALITY INDEX STORIES: OTAL MARKET VALUE-CARD 27,21 j OTAL APPRAISED VALUE-CARD 27,21 OTAL APPRAISED VALUE-PARCEL 27,21Cm OTAL PRESENT USE VALUE-PARCEL OTAL VALUE DEFERRED-PARCEL - OTAL TAXABLE VALUE-PARCEL 27,21( PRIOR UILDING VALUE BXF VALUE -AND VALUE 27,21 RESENT USE VALUE EFERRED VALUE OTAL VALUE 27,21C PERMIT CODE I DATE NOTE I NUMBER AMOUNT OUr:WTRSHD: SALES DATA [ECORD ATE DEED INDICATE SALES K AGE R TYPE PRICE 1 603 2 00 WD Q V 27009 990it 00 QC C V8 596 3 00 FD U 1 HEATED AREA NOTES c SUBAREA UNIT ORIG% SIZE ANN DEP % OB/XF DEPR. GS RPL OD UA DESCRIPTIO T N PRICE COND LDG FAR Y RATE V GOND VALUE TYPE AREA CS OTAL OB XF VALUE 0 REPLACE 0 UBAREA N TALS 0 UILDING DIMENSIONS r� NO INFORMATION IGHEST JOTHERAD3USTMENTS LAND TOTAL NO BEST USE LOCAL FRON DEPTH/ LND CONDNO NOTES RDA UNIT LAND LINT TOTAL I ADJUSTED LAND LAND 5E CODE ZONING TAGE EPT SIZE MOD FAR rRF AC LC TO OT TYPE PRICE UNITS TYP ADJST 1 UNIT PRICE VALUE NOTES URAL AC 0120 436 0 1 1.4840 4 0.97001+06+14+00+00-23 PW 1 6,100.0 3.100 AC 1.4391 8,777.90 27211 ASEMENT OTAL MARKET LAND DATA 3.IDO 27,211 OTAL PRESENT USE DATA http://maps.co.davie.nc.us/ITSNet/AppraisalCard.aspx?parcel=K60000000502 2/6/2013 . '`DAVIE COUNTY HEALTH DEPARTMENT Environmental Health Section Soil/Site Evaluation APPLICANT INFORMATION PROPERTY INFORMATION Account #: 990006019 Tax PIN/EH#: K60000000502 Billed To: Edward Bartlett Subdivision Info: Reference Name: Location/Address: Deadmon Road-27028 Proposed Facility: Residence Property Size: 3.100 Ac Date Evaluated: i�Ln�3 Water Supply: On-Site Well Community Public Evaluation By: Auger Boring Pit Cut FACTORS 1 2 3 4 5 6 7 Landscape position Slope% mp 447, HORIZON I DEPTH 3y Texture group to C Consistence Structure Mineralogy ; HORIZON II DEPTH Texture group cWrn Consistence Structure ! Mineralogy HORIZON III DEPTH - Texture group Consistence Structure Mineralogy HORIZON IV DEPTH Texture group Consistence f Structure Mineralogy SOIL WETNESS RESTRICTIVE HORIZON SAPROLITE CLASSIFICATION 5 LONG-TERM ACCEPTANCE RATE SITE CLASSIFICATION: EVALUATION BY: A.Vied LONG-TERM ACCEPTANCE RATE: OTHER(S)PRESENT: REMARKS: 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 CONSTSTENCE II'IQ1St VFR-Very friable FR-Friable FI-Firm VFI-Very firm EFI-Extremely firm 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 chro l,a 2 or less Classification-S(suitable),PS(provisionally suitable),U(unsuitable) LTAR-Long-term acceptance rate-gal/day/ft2 . 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