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2728 Farmington Rd"'' ` Parceflriformation � _ "� Parcel Number: 850000009601 Township: Farmington NCPIN Number: 5843983737 Municipality: Account Number: Census Tract: 37059-802 Listed Owner 1: Voting Precinct: FARMINGTON Mailing Address 1: Planning Jurisdiction: Davie County City: Zoning Class: DAVIE COUNTY R-A,R-20 State: Zoning Overlay: DAVIE COUNTY QD Zip Code: Voluntary Ag. District: No Legal Description: 12.364 AC FARMINGTON RD LT 2 Fire Response District: FARMINGTON BASSETT Assessed Acreage: 12.36 Elementary School Zone: PINEBROOK Deed Date: 12/1997 Middle School Zone: NORTH DAVIE Deed Book / Page: 001980815 Soil Types: GnB2,PcC2,GnC2,GaD,MsC,CeB2 Plat Book: Flood Zone: X Plat Page: Watershed Overlay: WS -IV -P Building Value: 114760.00 Outbuilding & Extra 4500.00 Freatures Value: Land Value: 117420.00 Total Market Value: 236680.00 Total Assessed Value: 236680.00 170 Davie County, NC All data is provided as is without warranty or guarantee of any kind either expressed or implied including but not limited to the 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 or arising out of the use or inability to use the GIS data provided by this website. AUTHCZRIZATi13N NO: 197" DAVIE C UNTY HEALTH DEPARTMENT m Environmental Health Section PRORf Y INFORMATION Permittee',5 ,K6 ".P <�1• �y P.O. Box 848 Name: +!" '' �:' �� Mocksville, NC 2702E Subdivision Name: / Directions to property: / %fig ^/' i Phone # 336-751-8760 Section: Lot: AUTHORIZATION FOR WASTEWATER''—✓ r. -��`, /) Office PIN:# cI''iz. c:t" SYSTEM CONSTRUCTION Tax O Road Name **NOTE** 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. (In compliance with Article 11 of G.S. Chapter 130A, Wastewater Systems, Section .1900 Sewage Treatment and Disposal Systems) vl ENVIRONMENTAL HEALTH SPECIALIST A, DATE ISSUED ***NOTICE*** THIS AUTHORIZATION FOR WASTEWATER CONSTRUCTION IS VALID FOR A PERIOD OF FIVE YEARS. 197DAVIE C UNTY HEALTH DEPAR�IV�ENT1— »b n IMPROVEMENT AND OPERATION PERMITS PRO EP R� T— NFORMATION Y PeWiLe s Name: ',�;/ r^;u# " Subdivision Name: "Directions to property: �` 1 r` Section: Lot: i• IMPROVEMENT PERMIT Tax Office PIN:#"' Road Name., m ;' rr' ; /fr+fit Zip:r, 'vw **NOTE** 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 1 I of G.S. Chapter 130A, Wastewater Systems, Section .1900 Sewage Treatment and Disposal Systems) < / f ***NOTICE*** THIS PERMIT IS SUBJECT TO REVOCATION IF SITE //' '' ,%r✓` ;"' PLANS OR THE INTENDED USE CHANGE. YOUR WASTEWATER ENVIRONMENTAL HEALTH SPECIALIST DATE ISSUED SYSTEM CONTRACTOR MUST SEE THIS PERMIT BEFORE INSTALLING THE SYSTEM. RESIDENTIAL SPECIFICATION: BUILDING TYPE IV_ # BEDROOMS 3 # BATHS # OCCUPANTS �, _ GARBAGE DISPOSAL: Yes or No COMMERCIAL SPECIFICATION: FACILITY TYPE # PEOPLE # PEOPLE/SHIFT # SEATS INDUSTRIAL WASTE: Yes or No LOT SIZE lime TYPE WATER SUPPLY h/r// DESIGN WASTEWATER FLOW (GPD) NEW SITE // REPAIR SITE SYSTEM SPECIFICATIONS: TANK SIZ5/�6 GAL. PUMP TANK GAL. TRENCH WIDTH ROCK DEPTH LINEAR FT. ?r/U REQUIRED SITE MODIFICATIONS/CONDITIONS: IMPROVEMENT PERMIT LAYOUT *APPROVED EFFLIJEI1IT FILTEn* rRIEER(0) IF Gt+ IIELDu 171III511FI) G Z'ADE* "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 TH AY OF INSTALLATION. TELEPHONE # IS (336)751-8760. OPERATION PERMIT LYY:JC�J.�G�SYSTEM I AA0ti� AUTHORIZATION NO. �r I�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 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 05/96 (Revised) ITE 'e, APPU4AIION F Davi a County AH alth Department PERMIT &A1C EnvlronmenfofHealthSmWon 1 P.O. Box 848/210 Hospital Street FEB _ 41 Mockaville, NC 27028 (336)751-8760 ��.�r�,a,�r EE+rt� ***IMPORTANT*** THIS APPLICATION CANNOT BE PROCESSED UNLESS ALL TI Q INFORMATION IS PROVIDED. Refer to the INFORMATION BULLETIN for instructions. 1. name to be Billed P 7 / � I .-�,-7,4,p r✓ / Contact person /�` Q Mailing Address ��i�� /'H ✓ rr �� 3 c�.� t1 Rome phone e? 0 — U ` City/state/Zip iv/i,�� Sy iljr /f/G et76o;,9 Business Phone Z. Name on Permit/ATC if Different than Above Mailing Address city/state/zip 3. Application For: U Site Evaluation B"Improvement Permit/ATC ❑ Both 4. system to service: VdHouse ❑ Mobile Home ❑ Business 0 Industry 0 Other s. If Residence: # People # Bedrooms 3 # Bathrooms j /a 'Dishwasher 0 Garbage Disposal washing Machine 0 Basement/Plumbing Basement/Ho Plumbing S. If Business/Industry/other: Specify type # People # sinks # Commodes # Showers # Urinals # water Coolers IF FOODSERVICE: # Seats Estimated Water Usage (gallons per day) 7. Type of water supply: ❑ County/City Well ❑ Community e. Do you anticipate additions or expansions of the facility this system is intended to serve? ❑ Yes /No If yes, what type? ***IMPORTANT*** CLIENTS MUSTCOMPLETE THE REQUIRED PROPERTY INFORMATION REQUESTED BELOW. Either a PLAT or SITE PLAN MUST BESUBMITTED by the client with THIS APPLICATION. Property Dimensions: fd A ft S WRITE DIRECTIONS (from Mo/cksville) to PROPERTY: -X—Tai Office PIN: # S b L4 3 —'2 q — 325 7 �u (t,N �a 3cy �- / (, DDO Property Address: Road Name f ti r �o,, )� u 411) rX(J ^-I City/Zip Ack.5'�'J(r ✓t/L'. hy-c oy"rI- kti If in a Subdivision provide information, as follows: -7e Name: /1/ �l (Qll I -V41 ' Section: Block: Lot: Date Property Flagged: 4 a pe This is to certify that the information provided is correct to the best of my knowledge. 1 understand any permit(s) issued hereafter are subject to suspension or revocation, if the site pians or Intended use change, or if the information submitted in this application is falsified or changed. I, also, understand that I am responsible for all charges incurred from this application. 1, hereby, give consent to the Authorized Representative of the Davi Co j H b De artment to enter upon above described property located in Davie County and owned by / G' to conduct all testing procedures as necessary to determine the site suitability. C U+v &4 DATESIGNATURE THIS AREA MAY BE USED FOR DRAWING YOUR SITE PLAN (Include a r1of the following: Existing and proposed property lines and dimensions, structures, setbacks, and septic locations). Revised DCHD (07/98) Account No. Invoice No. / / _pp it p ll e 1 yDI APPLICATION FOR SITE EVALUATION/IMPROVEMENTS PER �1 Davie County Health Department Off 16 G 666 Environmental Health Section P. O. Box 665 ftt'IitOF:';lEfJTRI HEF,LtH P Mocksville, NC 27028 0laVIE COUt1TY 1. Application/Permit Requested By /e Si, /,,e f4xyj Mailing Address '��� S • uot�,+J �,-+ Home Phone t9 C Alcv 1 /U :X 9 is ' Business Phone 2. Name on Permit if Different than Above 3. Application for: 4. System to Serve: ❑ Business ❑ Industry 5. If house, mobile home: Subdivision No. of People Evaluation ❑ Septic Tank Installation Permit ❑ Mobile Home ❑ Place of Public Assembly ❑ Other No. of Bedrooms / No. of Bathrooms Dwelling Dimensionsy tj Ir�Uirti' 6. If business, industry, place of public assembly, other: Specify type No. of People Served No. of Commodes No. of Lavatories No. of Showers No. of Sinks No. of Urinals No. of Water Coolers Water Usage Figures 7. Type of water supply: ❑ Public rivate ❑ Community 8. Property Dimensions SCP 469 C Sewage Disposal Contractor 9. Do you anticipate additions/expansion of the facility this sytem is intended to serve? ❑ Yes No ❑ Unknown Section Lot # ❑ Basement/Plumbing ❑ Basement/No Plumbing ❑ Washing Machine ❑ Dishwasher ❑ Garbage Disposal If yes, what type? Directions to Property: &e -e J"P PROPERTY INFOMIATION REQUIRED: Tax Office PIN # tLe-,o AS- `34. a ) Road Name F;lam r^ ",-J Box # (if available) City ✓VI r, L k t v M This is to certify that the information provided is correct to the best of my knowledge, and I unde incurred from this application. off:'• �t���Z� DATE SIGNATU am responsible for all charges CONSENT FOR SITE EVALUATION TO BE DONE ON ABOVE DESCRIBED PROPERTY MUST CHECK ONE: ❑ 1. 1 OWN the property. ❑ 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 County Health 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's suitability for a ground absorption sewage treatment and disposal system. DATE SIGNATURE DCHD (1193) r Y�; f• �L ~Ly ti IVY loll!w:. - DAVIE COUNTY HEALTH DEPARTMENT Environmental Health Section Soil/Site Evaluation NAME 0/ ADDRESS PROPOSED FACIILTY DATE EVALUATED ,ZOZ44P5 PROPERTY SIZE Ilae LOCATION OF SITE Water Supply: On -Site Well _ Community Public Evaluation By: Auger Boring ZZ Pit Cut FACTORS 1 1 2 3 4 Landscape position Sloe % 2 HORIZON I DEPTH 67'� Texture group Z Consistence Structure Mineralogy HORIZON II DEPTH Texture group 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: EVALUATED BY: Z/ 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 :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 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 3C --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 Iiorizon 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/f12 DCHD (01-901 ................................■......... ■■M MEN■ MMMM■MMMM■MM■ ■■■■//■■■■■■■■■////■■■■■■■■■■■■■ ■■■■M■■■ ■■■■E■■■ MMMMM■M■■■■■■■ �C���CC�C�C�C��C�CC�C��CC�C�C���CC�C�■�CCCC�C�C�CNSECCmomCEMENNEEN immms 0 nMMmMMMMM Mimi Ill Imommo9mo M MENEM am ME ■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■ ■■■■■S�MEN MM■M■■ ■■■■■■./■/■■■■■■■■■■■/■■.■■■■■■.■■■■■■■■■■■■■■■ ■NE■■■■■■■■■■■ ■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■ ■N■■■ ■■■■■■ ■■■■■ ■ M■M■M■ ■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■=.0■■■■■■ ■■.N■■■■■■.C.S�■■■■■CC :C::C:�.::".CCCCC EN MO■C:C'C■I CCCCCCmm no MM MMMm_ CC�C=mom ..........■.......................■nN■■■■■■nM■C' iE■■■=■M■■■■■■■■ ...............■N■■■■nu■■■N■■S■■■■■■■N■■■■■E■■ .■. ■N■i■■E■■■� ................................�........ ..... . mm ■EC■■■■ CS■M■■NE ■■N■.■■■/■■■■■■■//■/■■■/■///n■L MEM■H■■n■■M ■■■■ ■■ ■■■■■■■ ■Cii'�CCiiuiiiiiiuiiiC'iiii'iiiiiiiiMEMO"CCiiiiiCCC""■'=iCCC"""'C ■■■■■■■■■■■■■■■■ ...'C'S_N■MmM=C■ _■ CCCCC� ' C.■ '_■■■ ■■■■■■■■■■■■■■■■ ■■■ ■■■■■■■ ■■ ■■■■■ ■■■■■■■■■■■■■■■■■ ■■■■ ■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■ ■■ ■ ■■■■■■■ ■=■■■■C■i■■■'i■■■■�■/■■■■■■C■■■■i■■■■i■■■■■�■■■■�i■■■■'i■■■NiN■■■iE■NiN■Ni■■i■■■■■■■■■'■■■■■i■■■■i■■Ci■■■■i■■■■u■■■■■■■■�■H■■■i■■■'C�■■■■u■■■■■■■■■■■■■■■'io■■��■i■ ■■■■ " ' Cll""C" ■ ■■ ■■■■■C■ ■ ■E MM■MMM■� C■ ■ ■ MMMMMMMM ■� ■n ■ ■ M■NE■ ■ NI ■ ■ MESON mi CNCCCCuONEEM=mmCCCC=C � ■ ■ ■■■■■■■■■■■■■�■N■NN■ CM�CEEC ■ �C'Clm N■■ENO ■�■ ■S■■M■■S■ N■E N■NMEN■ CCC%C�CC�CCC�CCC�■SCC somms ■■ 'moommsC ■■■■■M■■■■■■■N■■ME■MN■■N■■N■■m OMEN ■■■■■■SEM■■■■HN■■■■■■■■■■■■■.■ ■ ■ u■■NM ■MENNEMENNE■■SS■N■■mum■N■oo:mom■SCC YCC'■C�C�C�\ ■onommomn■■■■■ Commosommom M:CCCC.. H ■SCO'..' Monsoon ■ ■ ■n■■■EE■N■EM■E■M►.�E■C ■■ . . ■■■■■■■E■MC■E■nnM■■■■■■■■■■■■■■■.■■ ■ ■ i■■ ■H■■ ■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■LM■■■N ME EN ■■/////nn■■■n■■■■■■■■■■■■EN■■■■�O" ■ ■ ■ MEMO IKE■ C�CONOMMON�uCCCCONESEMOSEMENNON��■����CC����■C ' smom■■CC ■■■■■■■■■■ NOONN■ Nmossmossomm nMSEM�CMENM■■ MENS■. ES■M■MEN■M .. nCC■a■■■ MEN MENSONE SS■mom�■■NEE■C■■■■■siommommomomuM■mom ■ ■ONE 10 ME �■HMM■■MMM NONEmosommommommoomm ■.■...N......■N........■■■n■■ N■.�........0................. ..................... ................ .......................... moon .................................................................. ���■���'�CCC�����C�C����CCC����■,■CC�� "�CCC�n�CCmommommommooCC� I • . Davie County Neall Department and Nome NealK Ayency 210 HOSPITAL STREET/ P.O. BOX 665 MOCKSVILLE. N.C. 27028 PHONE: (704) 634-5985 October 26, 1995 Kyle Swicegood 300 S. Main St. Mocksville, NC 27028 Re: Site Evaluation Farmington Road/11 Acres Dear Mr. Swicegood: As requested, a representative from this office visited the aforementioned site on October 19, 1995. Based upon the information provided on the application for 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, x/ozex�X Robert B. Hall, Jr., R.S. Environmental Health Section RH/wd Enclosure(s)