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402 Howell RdDav uIrli THIS IS NOT A SURVEY Parcellnfonnatioh'77-77 '711 Parcel Number D30000004507 Township: Clarksville NCp|m0umbez 5822869573 Municipality: Account Number: 73969000 Census Tract: 37059-801 Listed Owner 1: TR|VETTEMITCHELL Q Voting Precinct: CLARK8V|LLE Mailing Address 1: POBOX 1431 Planning Jurisdiction: Davie County City: N1OCKSV|LLE Zoning Class: D/YVIECOUNTY R -A State: NC Zoning Overlay: Zip Code: 27028-1431 Voluntary Ag. District: No Legal Description: 12.10ACHOWELL ROAD Fire Response District: FARK8|NGTON.WILL|AK8R.D/YJE Assessed Acreage: 11.34 Elementary School Zone: WILLIAM RDAV|E.P|NEBRDOK Deed Date: 4K1997 Middle School Zone: NORTHD/VJ|E Deed Book /Page: 001940046 Soil Types: EnB.RvA.Chx.VVATER.KAaD Plat Book: Flood Zone: Plat Page: Watershed Overlay: DAV|ECOUNTY � Building Value: 0.00 F�~~�b O'~romd|ng ~ Extra 6700.00 Land Value: 83000.00 Total Market Value: 8970000 Total Assessed Value: 8970000 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 warranties of merchantability or fitness for a particular use. All users of Davie County* 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 NC or arising out of the use or Inability to use the GIS data provided by this webske. WARNING: 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 warranties of merchantability or fitness for a particular use. All users of Davie County* 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 NC or arising out of the use or Inability to use the GIS data provided by this webske. _ .:� t' ` -.w \ T Y �-.F •"t 'I:V t... 2:._, _ '1 iY XA } -iv .5.� fi ...:y.f ea.fs ��_� t�< 3�•�f -".jS v' . M s t :'�,iT7' fta rS i. y'"' f Y. : t � Ky„ y �r '� _ f _ •'�- A _ � �a b AUTHORI7�ATION No: 0 9 5 � DAVIE COUNTY HEALTH DEPARTMENT r*: Environmental Health Section PROPERTY INFORMATION. Permrttee'scP.O. Box 848 Name: �/ / �� a Mocksville, NC 27028 Subdivision Name: Phone #: 704-634-8760 Directions to property: Z- 4tv,Section: Lot: AUTHORIZATION FOR . 7�� r,?a _ fL! WASTEWATER Tax Office PIN:# SYSTEM CONSTRUCTION- _ `/ Road Name: n G// CL • Zip: **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. 1 (In compliance with Article 11 of G.S. Chapter 130A, Wastewater Systems, Section :1900 Sewage Treatment and Disposal Systems) ***NOTICE*** THIS AUTHORIZATION FOR WASTEWATER CONSTRUCTION IS VALIDFORA PERIOD OF FIVE YEARS. ENVIRONMENTAL HEALTH SPECIALIST DATE ISSUED . :::i e,:tt`:.t., -, � >y� � •i y J"r-'ir T' r.�;i y, ti `.,r,;.. .. y.}z.:.� - - '�, r/'J� � r ". y4 ! 5 n-.,'.: -, x: 4t' .T�. ,. , rrr•':. a •, � � r,, s'�;TI ; l'� 'ri. ! �' € DAVIE COUNTY HEALTH I TNIENT IMPROVEMENT AND OPERATION PERMITS PROPERTY INFORMATION PLL Subdivision Name: Directions to pro f ; p petty: Section: Loft: tit IMPROVEMENT MIIT Tax Office PIN:# a c _ lra 6 + Road Name: x 1 3 Zip 2 **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 y constructionlinstallation of a system or the issuance of a building permit. 5 (In compliance with Article 11 of G.S. Chapter 130A, Wastewater Systems, Section .1900 Sewage Treatment and Disposal Systems) ***NOTICE*** THIS PERMIT IS SUBJECT TO REVOCATION IF SITE 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# BEDROOMS #BATHS �_ #OCCUPANTS % GARBAGE DISPOSAL: Yes or No' COMMERCIAL SPECIFICATION: FACILITY TYPE # PEOPLE # PEOPLEISHIFT # SEATS INDUSTRIAL WASTE: Yes or No LOT SIZE .QAC TYPE WATER SUPPLY DESIGN WASTEWATER FLOW (GPD). -,'7`1'd NEW SITE REPAIR SITE r V "sYSTE1GI SPECIFICATIONS: TANK SIZE GAL. PUMP TANK GAL. TRENCH WIDTH — ROCK DEPTH �°..7 LINEAR Fr«�— OTHER dhV REQUIRED SITE MODIFICATIONS/CONDITIONS: "*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: d� 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 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) APPLICATION FOR SITE EVALUATIONAWROVEMENT PE Arrr • Davie County Health Department a Environmental Health Section P.O. Box 848 JUN 2 4 1997 Mocksville, NC 27028 (704) 634-8760 ENYiROfI11 Al H ****IMPORTANT**** THIS APPLICATION CANNOT BE PROCESSED UNLESS ALL THE-R—EQQUIRED INFORMATION IS PROVIDED. p 1. Name to be Billed 1-4 k� P 5, /T I�P_7TG Contact Person ��0CZ Mailing Address Py • 1 oA I'4S l Q Home Phone q"/ �- 2117 City/State/Zip %�l D C I�S V (%1 C, Z'7d Z 8 Business Phone 2. Name on Permit/ATC if Different than Above' 642.-rn CJ Mailing Address 3. Application For: Nf Site Evaluation r4. System to Serve: [ ] House [Mobile Home [ ] Business [ ] Industry [ ] Other 5. If Residence: # People—j— # Bedrooms _ # Bathrooms [ ] Dishwasher [ ] Garbage Disposal City/State/Zip [improvement Permit &ATC {Both [Washing Machine [ ] Basement/Plumbing [ ] Basement/No Plumbing 6. If Business/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 8. Do you anticipate additions or expansions of the facility this system is intended to serve? [' ] Yes [N�No If yes, what type? EITHER A PLAT OR SITE PLAN PROPERTY INFORMATION REQUIRED: *** IMPORTANT *** SOF THE PROPERTY MUST BE y SUBMITTED WITH APPLICATION. Property Dimensions: I �� WRITE DIRECTIONS (from Mocksville) TO PROI Tax Office PIN: # 5b ZZ 4-0 "Cla Property Address: Road Name it) e- City/zip W oGk5 V i lle lU C ' If in Subdivision provide information, as follows: Name: Section: Lot # ' This is to certify that the information provided is correct to the best of my knowledge. I understand that any permit(s) issued hereafter are subject to suspension or revocation, if the site plans 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. 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 Y to condu t a t st ng procedures as necess d termine the site suitability. DATE In " Z4 " 9� SIGNATURE Revised DCHD (06-96) THIS AREA MAY $E USED FOR DRAWINC7 OUR PLA b nm � 11 q aces i2 - � J �. DAVIE COUNTY HEALTH DEPARTMENT Environmental Health Section SECTION LOT Soil/Site Evaluation ��r APPLICANT'S NAME %rn yet e PROPOSED FACILITY 012Z SUBDIVISION Water Supply: Evaluation By: On -Site Well f Community Auger Boring ✓^ Pit - DATE EVALUATED �y PROPERTY SIZE R �'— ROAD NAME Gt)p // Public Cut FACTORS 1 2 3 4 5 6 7 Landscape position AL Slope % HORIZON I DEPTH Texture group Consistence Structure Mineralogy HORIZON II DEPTH Texture group Consistence Structure 1 Mineralogy HORIZON III DEPTH Texture group Consistence Structure Mineralogy HORIZON IV DEPTH Texture group Consistence Structure Mineralogy SOIL WETNESS RESTRICTIVE HORIZON SAPROLITE CLASSIFICATION S LONG-TERM ACCEPTANCE RATE SITE CLASSIFICATION: LONG-TERM ACCEPTANCE RA REMARKS: DCHD (01-90) EVALUATION BY: 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 clay loam SIL - Silty loam CL - Clay loam SCL - Sandy clay loam SC - Sandy clay SIC - Silty clay C - Clay Moist VFR - Very 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 ■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■ ■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■ ■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■ ■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■ ■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■ ■■■■■■■■■■■■■■■■■■■■■■■■ ■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■ ■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■ ■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■ ■■■■■■■■■■■■■■■■■■■■■■■■ ■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■ ■ ■ No no i ■ MONSOON ■EMEME■ ■E■■■■■ ■M■■■■■ ■E■■ ■ NONE ■ MEMO NONE ■EM■ OR ■ ■■■■RI ■■■■IIMMOM■■■■■■■■ ■■■■■■■■■aMr�■■■Ori ■ iA■E■■ Wo■■■■ ■■■■■■ ■ ■ ■ MEMO NONE MERE vIr.7l■ E■■■■■RISEM ME ■EMEMENENTUMM ■■■M■■■U■■■M■ ■■■■■■Mir■■■■■ ■■■■■■■1I■■■■■ ■■MMEMERIM■E■■ ■■■MMMMMRIMMMU ■■■■■■ ■■■■W■■■■M■■■ ■■m►o■■Eiu■■■■ RNMEMM■EREMEM ■■■■■■■MMEMEM ■EMM■E■EKEEM■ ■■■■■■■■■E■■■ ■■■■■■■■■MMMM ■■■■■■■M■AMME ■■■■■■■■■MMEM ■■■■M■■■■WEEN ■■Mme:i■■■M■■ ■RSOMEMMMMUM■ W■■■M■■■■■■MM ■■■ENNUMM■■UM ■M■■ ■■■■ NONE