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)
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,# 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 . SI -Silt
SICL-Silty :lay loam- SIL -Silty loam CL -Clay loam SCL-Sandy clay loam
SC -Sandy clay SIC -Silty clay C -Clay
CONSISTENCE
Moist
VFR- Vc.-y 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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