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2161 Hwy 158 (2) DAVIE COUNTY HEALTH DEPARTMENT Environmental Health Section / P.O.Boa 848/210 Hospital Street �Ct 7- Mocksville,NC 27028 (336)751-8760 IMPROVEMENT/OPERATION PERMIT Account M 989900603 Tax PIN/EH M 5749-29-5480 Billed To: Bonanza Mobile Homes Subdivision Info: Reference Name: Location/Address: Highway 158-27028 Proposed Facility: Residence Property Size: see map **NOTE* i�is�iiprovein nt/Operation Permit DOES NOT authorize the construction 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). THIS PERMIT IS SUBJECT TO REVOCATION IF SITE PLANS OR THE INTENDED USE CHANGE. YOUR WASTEWATER SYSTEM CONTRACTOR MUST SEE THIS PERMIT BEFORE INSTALLING SYSTEM. Residential Specification: Building Type /0/1/ #People 3 #Bedrooms -, #Baths -�?- Dishwasher: Garbage Disposal:❑ Washing Machine Basement w/Plumbing: ❑ Basement/No Plumbing: El Commercial Specification: Facility Type #People #People/Shift #Seats Industrial Waste:El tr Lot Size C Type Water Supply_ Design Wastewater Flow(GPD) C��o Site: New Repair 0 System Specifications: Tank Size/ GAL. Pump Tank GAL. Trench Width� Rock Depth 4� Linear Ft c&V Other: Required Site Modifications/Conditions: IMPROVEMENT/OPERATION PERMIT LAYOUT- APPROVED EFFLUENT FILTER RISER(S)IF 6"BELOW FINISHED GRADE. ****NOTICE: Contact a representative of the Davie County Health Department for final inspection of this system between 8:30 a.m.to 9:30 a.m.or 1:00 p.m.to 1:30 p.m.on the day of installation. Telephone#is(336)751-8760.**** Environmental Health Specialist's Signature: Date: '! 0 2— DCHD 05/99(Revised) _ DAVIE COUNTY HEALTH DEPARTMENT Environmental Health Section P.O.Boa 848/210 Hospital Street Moclksville,NC.27028 (336)751-8760 Account #: 989900603 Tax PIN/EH#: 5749-29-5480 Billed To: Bonanza Mobile Homes Subdivision Info: Reference Name: Location/Address: Highway 158-27028 Proposed Facility: Residence Property Size: see map ATC Number: 3170 AUTHORIZATION FOR WASTEWATER SYSTEM CONSTRUCTION **NOTE** This Authorization for Wastewater System Construction MUST BE ISSUED by the Davie County Environmental Health Section prior to issuance of any building permit(s). This Form/Authorization Number should be presented to the Davie County Building Inspections Office when applying for building permit(s)(in compliance with Article 11 of G.S.Chapter 130A,Wastewater Systems,Section.1900 Sewage Treatment and Disposal Systems). THIS AUTHORIZATION FOR WASTE WATE NSTRUCTION IS VALID FOR A PERIOD OF FIVE YEARS. Environmental Health Specialist's Signature: Date: CERTIFICATE OF COMPLETION **NOTE** The issuance of this Certificate of Completion shall indicate the system described on Improvement/Operation Permit 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. Nomc s' 16FVz"T- 12 , I ' x ''x-I z' lmri I pp leo Septic System Installed By: Environmental Health Specialist's Signature: Date: DCHD 05/99(Revised) n \} 4P UCATION FOR SITE EVALUATION/IMPROVEMENT PERMIT&ATC -� - Davie County Health Department F�� 2 Environmental Health Section 0 ,Fi\V,6 P.O. Box 848/210 Hospital Street Mocksville, NC 27028 p,�'• (336)751-8760 ****1MPO�RTANT*** THIS APPLICATION CANNOT BE PROCESSED UNLESS ALL THE REQUIRED INFORMATION IS PROVIDED. Refer ; to the INFORMATION BULLETIN for riinstrr�uctions. 1. Name to be Billed � /'/7� Illd Contact Person (/2/ f Mailing Address ZX).,,/J d N n Home Phone 9 City/State/ZIP #10 P� /lT��� K/ i� w Business Phone _Zj 6--254-1--Zi 2. Name on Permit/ATC if Different than Above Mailing Address City/State/Zip 3. Application For: Site Evaluation ❑ Improvement Mit/ATC ❑ Both 4. system to Service: ❑ House G��Mobile Home ❑ Business ❑ Industry ❑ Other 5. If Residence: ! # People '� # Bedrooms J # Bathrooms 1_ f_ ishwasher ET Garbage Disposal "asking Machine O Basement/Plumbing ❑ Basement/No Plumbing 6. 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 ❑ Commu;:o 8. Do you anticipate additions or expansions of the facility this system is intended to serve? ❑Yes If yes,what type? ***IMPORTANT***CLIENTS MUSTCOMPLETETHE REQUIRED PROPERTY INFORMATION REQUESTED BELOW. Either a PLAT or SITE PLAN MUST BESUBMITTED by the client.with THIS APPLICATION. 1 Property Dimensions: S WRITE DIRECTIONS(from Mocksville)to PROPERTY: Tax Office PIN: # / ' 5OL S' Property Address: Road Name City/Zip �y1Ye 0� ' �✓ Ctr } �v�S- f o C r� CJ_ If in a Subdivision provide information,afollows: Name: Section: Block: Lot: '/4ate Property Flagged: D-� 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 amVowned by to conduct all testing procedures as necessary to determine the sitesuipbility. DATE 2-- NATUR>J THIS AREA MAY BE USED FOR DRAWING YOUR SITE PLAN(Include all of the following: Existing and proposed property lines and dimensions, structures, setbacks, and septic locations). Site Revisit Charge Date(s): Client Notification Date: EHS• Account No. Revised DCHD(07/99) Invoice No. C�� -moo N CD 185; (3.93A) 6773 0N (2(3 8) 1646 604 230 meq, (28p) 0586 (204) (2.78A) , G500000030 2414 =° co0412 (3.30A) .� 5480 w 257 158 N (362) 463 0209 116 co 148 N 406 206 289 _ co(133) SR 1641 2118 0 ^ (1.01A) (473) 31854 ti rS0 r moo, " 5058 N . DAVIE COUNTY HEALTH DEPARTMENT Environmental Health Section Soil/Site Evaluation APPLICANT INFORMATION PROPERTY INFORMATION _ Account #: 989900603 Tax PIN/EH#: 5749-29-5480 Billed To: Bonanza Mobile Homes Subdivision Info: Reference Name: Location/Address: Highway 158-27028 / Proposed Facility: Residence Property Size: see map Date Evaluated: Water Supply: On-Site Well Community Publicy Evaluation By: Auger Boring Pit Cut FACTORS 1 2 3 4 5 6 7 Landscape position L Slope% HORIZON I DEPTH Texture group 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 L SITE CLASSIFICATION: �S EVALUATION BY: 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 CONSISTENCE Moist . VFR-Very friable FR-Friable FI-Firm VFI-Very firm EFI-Extremely firm Wet NS-Non sticky SS-Slightly sticky S-Sti4 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 DCHD 05/99(Revised) ■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■ ■■■■■ ■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■ ■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■ ■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■ ■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■ ■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■ ■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■ MonsonMENNENMEMNONMENNEN EMEMiiiiNNEN Monson ■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■ ■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■ ■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■ ■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■ ■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■ ■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■ ■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■ ■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■ Parcel#: G500000030 Page 1 of 1 Davie County, NC - Basic Estate Search tA. O U t14 Davie County Web Site Basic Search Real Estate Search Tax Bill Search Sales Search View Property Record for this Parcel View Mao for this Parcel View Tax Bill Information Parcel#:G500000030 Account#:82531341 Owner Information Tax Codes ARREN CHANDRA ADVLTAX-COUNTY T 161 US HWY 158 FIREADVLTAX-FIRE TAX EOCKSVILLE NC 27028 Property Information Township nd(Units/Type): 1.620 AC MOCKSVILLE ddress: 2161 US HWY 158 Deed Information Local Zoning Pate: 02/2016 Book: 01011 Page: 0573 Plat Book: 0010 Page: 129 9 Legal Description PIN 1.734AC LOT 1 US HWY 158 5749295480 Property Values uildin 88,08 BXF• nd: 28,40 cl Market: 116 48 ssessed: 116,48 eferred: Sales Information No. Book Pape Month Year Instrument Qual/UnQual Improved Price 00685 0170 10 2006 WD Unqualified Improved 116,500 00999 0070 08 2015 TD Unqualified Improved 86,500 01011 0573 02 2016 WD Unqualified Improved 58,500 00190 0604 10 1996 WD Qualified Improved 96,000 00345 0068 08 2000 WD Qualified Improved 140,000 00685 0170 10 2006 WD Qualified Improved 116,500 00813 0837 12 2009 WD Qualified Improved 127,500 View Property Record for this Parcel View Mao for this Parcel View Tax Bill Information «Return to Basic Search All information on this site is prepared for the inventory of real property found within Davie County. All data is compiled from recorded deeds, plats, and other public records and data. Users of this data are hereby notified that the aforementioned public information sources should be consulted for verification of the information. All information contained herein was created for the Davie County's internal use. Davie County, its employees and agents make no warranty as to the correctness or accuracy of the information set forth on this site whether express or Implied, in fact or in law, including without limitation the Implied warranties of merchantability and fitness for a particular use. If you have any questions about the data displayed on this website please contact the Davie County Tax Office at(336) 753-6120. 1.5.9 http://maps.daviecountync.gov/itsnet/View.aspx?prid=1414363 6/9/2016