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140 Duard Reavis RdDav ?016 O �I� All 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 warrartles of merchantability or fitness for a particular use. All users or Davie County's GIS website shag 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 rp O p�4 NC or arising out of the use or Inability to use the GIS data provided by this website. WARNING: THIS IS NOT A SURVEY Parcel Information Parcel Number: D200000013 A Township: Clarksville NCPIN Number: 5802810584 Municipality: Account Number: 65608000 Census Tract: 37059-801 Listed Owner 1: SHOFFNER MARGARET J Voting Precinct: CLARKSVILLE Mailing Address 1: 785 BEAR CREEK CHURCH ROAD Planning Jurisdiction: Davie County City: MOCKSVILLE Zoning Class: DAVIE COUNTY R -AR -20 State: NC Zoning Overlay: Zip Code: 27028-5624 Voluntary Ag. District: No Legal Description: 9.274 DUARD REAVIS RD Fire Response District: WILLIAM R. DAVIE Assessed Acreage: 8.73 Elementary School Zone: WILLIAM R DAVIE Deed Date: 7/1999 Middle School Zone: NORTH DAVIE Deed Book / Page: 001110422 Soil Types: MnC2,MnB2,MdE Plat Book: Flood Zone: Plat Page: Watershed Overlay: DAVIE COUNTY Building Value: 0.00 Outbuilding & Extra Freatures Value: 9000.00 Land Value: 71850.00 Total Market Value: 80850.00 Total Assessed Value: 80850.00 O �I� All 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 warrartles of merchantability or fitness for a particular use. All users or Davie County's GIS website shag 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 rp O p�4 NC or arising out of the use or Inability to use the GIS data provided by this website. XO t' } Davie County Health Department / l ENVIRONMENTAL HEALTH SECTION P.O. Box 665 Mocksville, N.C. 87028 AUTHORIZATION FOR WASTEWATER SYSTEM CONSTRUCTION (Issued,in_compliance with Article 11 of "?D S.S. Chapter 130A, 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.*** kMiDRIZATION NUMBER NAMEf jam,/'/S'� ��D % 1`/7�/ DATE �n`1 i� 8' ` 9S� N2 0 1 1 9 NAME ON IMPROVEMENT PERMIT (If different than above) SITE LOCATIONl,!!��// COMMENTS/CONDITIONS ON AUTHORIZATION TO CONSTRUCT WASTEWATER SYSTEM ***MOTICE*" THIS AUTHORIZAT� OR WASTEWATER SYSTEM CONSTRUCTION IS VALID FOR A PERIOD OF FIVE (5) YEARS. EkYlRONNNIIAL HEALTH SPECIALIST DATE DCHD 10/95 Xo DAVIE COUNTY HEALTH DEPARTMENT IMPROVEMENT PERMIT and OPERATION PERMIT IMPROVEMENT PERMIT **NOTE** This improyement 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 130A, Wastewater Systems, Section .1900 Sewage Treatment and Disposal Systems) NAME !/'r�S'/4 , S�if/1/r PROPERTY ADDRESS - GifcL aN/i /414TE ,,!V,sib-�S'f LOCATION SUBDIVISION NAME LOT NUMBER SEC./BLOCK NUMBER RESIDENTAL SPECIFICATION: BUILDING TYPE &22d9,1 # BEDROOMS �,? # BATHS ,c;?- t OCCUPANTS _'�/ GARBAGE DISPOSAL-. Yes COMMERCIAL SPECIFICATION: FACILITY TYPE # PEOPLE # PEOPLE/SHIFT # SEATS INDUSTRIAL WASTE: Yes/No LOT SIZE SIC' TYPE WATER SUPPLY DESIGN WASTEWATER FLOW (GPD) —74eO_ NEW SITE !// REPAIR SITE SYSTEM SPECIFICATIONS: TANK SIIE % GAL. PUMP TANK GAL. TRENCH WIDTH ROCK DEPTH /0"' LINEAR FT. .—?M OTHER REQUIRED SITE MODIFICATIONS/CONDITIONS: ***THIS PERMIT IS SUBJECT TO REVOCATION IF SITE PLANS OR THE INTENDED USE CHANGE. YOUR WASTERWATER SYSTEM CONTRACTOR MUST SEE THIS PERMIT BEFORE INSTALLING THE SYSTEM. v F IMPROVEMENT PERMIT BY **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 (704) 634-8760. OPERATION PERMIT SYSTEM INSTALLED BY lzlve,�,�� AUTHORIZATION NO. OPERATION PERMIT BY DATE /'A/ 4 **THE ISSUANCE OF THIS ORATION PERMIT SHALL INDICATE THAT THE SYSTEM DESCRIBED ABOVE 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. DCHD 10/95 DAVIE COUNTY HEALTH DEPARTMENT IMPROVEMENT PERMIT and OPERATION PERMIT IMPROVEMENT PERMIT r♦ ' - **K.TE�* This~improvement permit DOES NOT authorize the construction or installation of a septic tank system or anyWsietNater system. AN AUTHORIZATION FOR WASTEWATER SYSTEM CONSTRUCTION must be obtained from this Department pr,ior;to the construction/installation of a system or the issuance of a building permit. f� ' 1���, (In compliance with Article 11 of B.S. Chapter 136A, Wastewater Systems, Section .1960 Sewa Trea}ie�Y and Disposal Systems) 1 NAME PROPERTY ADDRESS &A' 4A 477614TE LOCATION ..� r',� , '�� fir.- �� /rrr �'/� "'��v, `�`'1�� /r' , — /� ii/ r/ : �- ✓ SUBDIVISION NAME LOT NUMBER SEC./BLOCK NUMBER RESIDENTAL SPECIFICATION: BUILDING TYPE rvf~ # BEDROOMS IJ? #-BATHS 4- # OCCUPANTS -/ GARBAGE DISPOSAL: YesLlrp COMMERCIAL SPECIFICATION: FACILITY TYPE # PEOPLE # PEOPLE/SHIFT # SEATS INDUSTRIAL WASTE: Yes/No LOT SIZE -.:"' )K TYPE WATER SUPPLY, DESIGN WASTEWATER FLOW (GPD) .. 1 NEW SITE 1% REPAIR SITE SYSTEM SPECIFICATIONS: TANK SIIE % SAL. PUMP TANK GAL. TRENCH WIDTH JW `ROCK DEPTH /J L LINEAR FT. OTHER REQUIRED SITE MODIFICATIONS/CONDITIONS:-ri ***THIS PERMIT IS SUBJECT TO REVOCATION IF SITE PLANS OR THE INTENDED USE CHANGE. YOUR WASTERWATER SYSTEM CONTRACTOR MUST SEE THIS PERMIT BEFORE INSTALLING THE SYSTEM. 4 IMPROVEMENT PERMIT BY�f **CONTACTIA 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 (704) 634-8760. OPERATION PERMIT SYSTEM INSTALLED BY - A l f AUTHORIZATION N0.lZq OPERATION PERMIT BY � �"" DATE A//`�! **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 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 10/95 r APPLICATION FOR SITE EVALUATION/IMPROVEMENTS P Davie County Health Department Environmental Health Section P. O. Box 665 Mocksville, NC 27028 1. Application/Permit Requested By //'� s Mailing Address �J S(P ,�[ 46A V /42 -US's KV- Home Phone 020((1 my, D yr %I T'�,� -270F a—II Business Phone11910 ) -7 Z( 00t Name on Permit if Different than Above ~7 -i -re SCc rn _ Stip Me r 3. Application for: ❑ General Evaluation "ptic Tank Installation Permit 4. System to Serve: ❑ House ❑ Business ❑ Industry 5. If house, mobile home: Subdivision No. of People q No. of Bedrooms N? bile Home ❑ Place of Public Assembly ❑ Other ❑ Unknown No. of Bathrooms pp Dwelling Dimensions , 6. If business, industry, place of public assembly, other: Specify type No. of People Served No. of Commodes No. of Sinks _ No. of Urinals No. of Lavatories No. of Water Coolers. No. of Showers Water Usage Figures 7. Type of water supply: PKublic ❑ Private 8. Property Dimensions Sewage Disposal Contractoi 9. Do you anticipate additions/expansion of the facility this sytem is intended to serve? If yes, what type? Section Lot # ❑ Basement/Plumbing ❑ Basement/No Plumbing Z�-Washing Machine ❑ Dishwasher ❑ Garbage Disposal ❑ Yes CNo ❑ Community t 'NOTE: Improvements Permits shall be valid for a period of 5 years from date issued. Improvementd Permits are subject to revocation, if site plans or the intended use change. Effective October 1, 1989. 1.'::Ul trL11 1C.lrUliina-l:lu:l Xzqu.Ll 1tl): Tai: Office PIPs # S p $ 1 -6 Sg Directions to Property: n � � a OQ-LAI�-aad1 Road Dame 1J a&%ls P—C co C� L C� c� PL& Box (if available) L e 6� Dvl City IrYlL one� die -nlco y - h�- � �-a-,-� tea-'►� 2 �`� `OL"9) 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. DATE CONSENT FOR SITE EVALUATION TO BE DONE ON ABOVE DESCRIBED PROPERTY MUST CHECK ONE: El 1. 1 OWN the property. M2. 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 County Heath De rtm to ente upon above described property located in Davie County and owned by to conduct all testing procedures as necessary to determine said s'ts suitability for a ground absorption sewage treatment and disposal system. j . DATE. SIGNATURE DCHD (1193) vt M a --Itol f- .. NI ,.14� -tiro 4si, 00 Got 19 _I . . 7'C U n, 4E¢, 5 6 •t Q i t i 89 8g6 ` ti�� , 0 0 (�.I N ` -- O Y r..' O 0� Off, 99Z u' cr � co N1 O?" Lo p .��{ 41 9b£ � eta a , nl �'ft.a { ,y1•w 84.41 L( �r'�j 5` r' s 8L1? 99Z ro l - r 9z � n f � 114 .y f ti' r LO — A r � I z ,# DAVIE COUNTY HEALTH DEPARTMENT Environmental Health Section Soil/Site Evaluation 1714 NAME a'9 C oo,l ADDRESS j PROPOSED FACIILTY�t/ DATE EVALUATED PROPERTY SIZE SIZE LOCATION OF SITE Water Supply: On -Site Well/ _ Community Publican Evaluation By: Auger Boring Pit Cut FACTORS 1 2 3 4 Landscape position L Slope Z HORIZON I DEPTH Texture group Consistence Structure Mineralogy HORIZON II DEPTH -IlF1' Texture group 2— Consistence Consistence Structure Mineralogy/• -! 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: ,K LONG-TERM ACCEPTANCE RATE: y REMARKS: DCHD(01-901 EVALUATED BY: J`YAiI/I 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 . 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