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3125 Hwy 158 1 ,u ' DAME COUNTY HEALTH DEPARTMENT Environmental Health Section P.O.Boa 848/210 Hospital Street Mocksville,NC 27028 (336)751-8760 Account #: 990003310 Tax PIN/EH#: 5850-17-3006 Billed To: Steve Hungerford Subdivision Info: Reference Name: Location/Address: 3125 Highway 158-27028 ATC Number: 4315 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 WASTEWATER CONSTRUCTION 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 P it has been installed in compliance with Article 11 of G.S.Chapter 130A,Section.1900"Sewage Treatment and Disposal Systems,"but shall ' Y be taken as a guarantee that the system will function satisfactorily for y given period of time J � r8y e IVY Septic System Installed By: Environmental Health Specialist's Signature: Date: DCHD 05/99(Revised) DAVIE COUNTY HEALTH DEPARTMENT f _ Environmental Health Section P.O.Boa 848/210 Hospital Street r Mocksville,NC 27028 (336)751-8760 IMPROVEMENT/OPERATION PERMIT Account #: 990003310 Tax PIN/EH#: 5850-17-3006 Billed To: Steve Hungerford Subdivision Info: Reference Name: Location/Address: 3125 Highway 158-27028 Proposed Facility: Residence Property Size: 51.91 acres **NOTES*This improvement/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 #People L #Bedrooms #Baths Dishwasher:f�- Garbage Disposal:0, Washing Machine:lam' Basement w/Plumbing: ❑ Basement/No Plumbing: ❑ Commercial Specification: Facility Type #People #People/Shift #Seats Industrial Waste: ❑ Lot Size l J9G Type Water Supply—&Z-)/Design Wastewater Flow(GPD) Site: New 700'Repair❑ x System Specifications: Tank Size GAL. Pump Tank GAL. Trench Width t A� Rock Depth� Linear Ft.A;�W / c-� ,BOO D Other: K !/r oL -2: �C—Ij in 15A NCAC .18A.1969(Required Site Modifications/Conditions: stemsalso hp Its may IMPROVEMENT/OPERATION PE T- APP D EFFLUENT FILTER. RISERS)IF 6"BELOW FINISHED GRADE. ****NO o a repres ive of the Davie County Health Department for final inspection of this system betwekn 8:30 a.m.to 9:30 r 1:00 p.m 1:30 p.m.on installation. Telephone#is(336)751-8760.**** Environmental Health Specialist's Signature: `all Date: DCHD 05/99(Revised) ,9��� q�006 3310 �NUOiCE o A,FPLI N FOR SITE EVALUATION/IMPROVEMENT PERMIT&ATC O ' J Davie County Health Department Environmental Health Section Q .0. Box 848/210 Hospital Street �iV1RONMENiALHf Mocksville, NC 27028 JU� '2 pp�IECAUNtV (336)751-8760 9 ***IMPORTANT*** THIS APPLICATION;CANNOT BE PROCESSED UNLESS ALL T U j INFORMATION IS PROVIDED. Refer to the .INFORMATION BULLETIN for instructs UCH 1. Name to be Billed ti�.t"P4,1Z AyycrA OAS Contact Person k (e Mailing Address �7 rj� Yh �4 Rd Home Phone 3�j6'/7s�• y City/State/ZIP J"�pC�Sjf�IIC rrV L 'Z"74 2,11 Business Phone 2. Name on Permit/ATC if Different than Above Mailing Address City/State/Zip 3. Application For: ite Evaluation ❑ Improvement Permit/ATC 1:1 Both 4. System to Service: (Mouse ElMobile Home ❑ Business ❑ Industry 13Other - 55. Type system requested: Conventional ❑ conventional modified ❑ i nor . 6. If Residence: # People _ # Bedrooms # Bathrooms 'Qullshwasher _Po'a—rbage Disposal asking Machine ❑Basement/Plumbing ❑Basement/No Plumbing 7. If Business/Industry /Other: verify type # People # Sinks # Commodes # Showers # Urinals # Water Coolers IF FOODSERVICE: # Seats Estimated Water Usage (gallons per day) S. Type of water supply: ❑ County/City ,Pell ❑ Community 9. Do you anticipate additions or expansions of the facility this system is intended to serve? ❑Yes If yes,what type? ***IMPORTANT'CLIENTS MUST COMPLETE THE REQUIRED PROPERTY INFORMATION REQUESTED BELOW. Either a PLAT or SITE PLAN MUST BE SUBMITTED by the client with THIS APPLICATION. Property Dimensions: I. QCRrS WRITE DIRECTIONS(from Mocksville)to PROPERTY: Tax Office PIN: # 5 Ji- 3� 1zS Property Address: Road Name ��A`"'� 15-6 City/Zip UoJcJv. J1f0&JC 17a26 If in a Subdivision provide information,as follows: Name: Q Section: Block: Lot: Date home corners flagged: v 0 / c CvfNerl �`//A 6 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 Depar(ment to enter upon above described property located in Davie County and owned by to conduct all testing procedures as necessary to determine the site suitability. DATE Qc� SIGNATURE 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 loc s). Site Revisit Charge Date(s): Client Notification Date: EHS• Sign given Account No. 3 Revised DCHD(05/03 Invoice No. �'-3 -J Davie County,North Carolina Spatial Data Explorer Page 1 of 2 O SpatialData[=p0 firer ®®® p N.� tbrti Carolina Click on the Map to: Map L; �eqve5UZoomin `--,ZoomOut r`)Recenter Map :_ Identify: Parcels Draw L Zoom Factor: 2X Radius Search (feet) 0 Draw se/ea, iQ t Boundary NW Or{[< NE ❑Census n City Bou ❑CCountyi Multi Syi "a * E911 Fin ' as es Y;� ❑Districts xa; ❑Flood Pz �3 ;E ❑Flood Zc 'ki4' t RIParcels x . xti i? i ❑School I �.' t s•. D Multi Syi ❑Soils ❑Town Zo F A ` ❑Townshi •. :c. � :' . r Multi Syi C �.. Voting ❑Precinct Infrastruc ❑Drivewa! Jr ❑Rail Line Street �w ,E ❑ SW c Centerlir ❑US/NC Parcel Data Highway Find Adjoining Parcels Multi Syius NC • Land Unit/Type: F600000002 li /AC Aerial • Deed Book/Page: ❑Photogrr • County ID: F600000002 • Deed Date:00/00/00 Physical • Account Number.-81468000 • Sales Price. $0.00 Creeks a • PIN.- 5850173006 ❑Rivers • Property Address: E911 Ad • Legal 1:49.15 AC HWY 158 003125 003125 • Owner Name:YOUNG C W DR • County Zoning: R-20ElFire • Owner/Address 1: YOUNG C W DR • Census Code: Departm • Owner/Address 2: • City Code: ❑Schools • Owner/Address 3:22 FOXGLOVE COURT • Fire Draw L Distract: http://66.208.132.254/servlet/com.esri.esrimap.Esrimap?Name=Davie&Cmd=Clk&Left=1... 7/29/2004 DAVIE COUNTY HEALTH DEPARTMENT Environmental Health Section SoiVSite Evaluation APPLICANT INFORMATION PROPERTY INFORMATION Account #: 990003310 Tax PIN/EH#: 5850-17-3006 Billed To: Steve Hungerford Subdivision Info: Reference Name: Location/Address: 3125 Highway 158-27028 Proposed Facility: Residence Property Size: 51.91 acres Date Evaluated: 1�� Water Supply: On-Site Well / Community Public Evaluation By: Auger Boring Pit Cut 'FACTORS 1 . 2 3 4 5 6 7 Landscape position ,L Slope% HORIZON I DEPTH << <J 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 SITE CLASSIFICATION: 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-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 DCHD 05/99(Revised) ■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■ ■eeeee■■ee■eee■eee■ecce■■e■■t■■■■■■■e■■et■ee■■e■■ee■■eeeee■■■■Mee■ ■■■■■■■■■/■■■■■■■■■■■■■/■■■■■■■■�■■■M■t■■■■■■■MM■■M■■■■■/■■■■■■ori ■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■ ■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■ ■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■ ■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■ ■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■ ■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■ ■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■ UMMEMEM EMEMEM MEMEME Emmons MEMNONMEMEMEMEMNONEmmons ■■■■/■■t■■■■M■■■■■retie■■r�■■tie■■■■■■■■■■■■■■■■■■MMa■■■M■■■■■■■■■■■■ ■■■■■■■■■■■■■■■■■I,■■■■Ian■■MIS■■■■■■■■■■■■■■■■■■■■■■■■■■/■■■■■Moon■ ■■■■■■■■■■■■■■n■■11/■■■■M■■EMEMM■■■■■■■■■■■e■■■■■■■■■■■■n■■■■M■■■■■ ■■■■■■■n■■■■■■■■■■■■■■■■rlvrvM■■■ ■■non■■■■■■■■■■■■■■■■■■■■■■■■■■■ ■■■■■■■■■■■■■■■■■■■■■■[��■■■■■■■■ ■■n■■■■M■■■MMM■■■■■■■MM■■■■■■■■■ ■■■■■■■■■■■■tie■■■■e■n■■■■■■e■■■■M■■■■■■■M■■■■■■■■■M■■■■■M■■MMn■■■■ ■■■■■■■■■■■■■o■nl�I�■■■■■■■■■n■■■■■■n■■■■■MMM■■■u■■■n■■■■■■■■nu■■■■■ ■■■e■eeeee■■■■■■rye■■■■■■■■e■■■■■■■■■■■■ee■ee■e■■■■■■■■■■■eeeee■■■ ■■■e■■■■■■■■■n■■■■L►,■■■■■M■■/■■■■u■■■■■■■■e■■■■■nM■■e■■■e■■en/■■M■■ ■e■■■■■■■■■■■/■■■■■■■■■■■Mee■■■■■■■■■■■■■■■■■■■■■■■■■■■■eee■■■■■■■ ■■■nu■■■■■■■n■■■■■■■■■■■■■■oM■neo■■■■■■■■■■■■■■■■■■■■■■■■■■■MM■■■■ ■1t■nun■n■■■Mtn■■■■■■t■■■■■■■■neo■■■■■■■■M■■n■nu■■■n■■nn■neMnuMee■■ ■■■■■■■■■■■■■■■■■n■■■■■■nn■■■■■■■■■■MMM■■■■■■■■■■■■■■■■■■■■■/■■■■■ ■■■■■■■■e■■■■■e■tie■■■e■■■■e/■■■e■■■■■e■ee■ee■■t■■■■e■■■/■■■■■■■■■■ ■■■■■■■■■■■■E■■■■■■■■■■■■■■■■■■■ ■■■■■■■■■■■■■M■■■■■■■■■■■■■e■■■■ ■■■■■■■e■■■■■/■■o■■■■■■■■■■e■■■■�i■■■■■e■■■■■■■■■■■■■■■■■■■■■■■■■■ Environmental Health Section P. 0. Box 848/210 Hospital Street Courier 09-40-06 Mocksville, NC 27028 750 - 7 July 9,2004 Steve Hungerford 854 Valley Road Mocksville,NC 27028 Re: Site Evaluation/ Highway 158 Tax Office PIN: #5850-17-3006 Dear Client(s): As requested,a representative from this office visited the aforementioned site on, August 9, 2004.Based upon the information provided on the Application for Site Evaluation and after an evaluation was completed on the site, the site was found to be provisionally suitable for the installation of an oversized modified system. Before an Improvement Permit/Authorization to Construct can be issued the appropriate application must be filled out and the house/mobile home location staked off. If you have any questions,please feel free to contact this office. Sincerely, Robert B. Hall,Jr.,R.S. Environmental Health Specialist RBH/dlf Enclosure(s) Parcel#: F60000000201 Page 1 of 1 oZ�v Davie County, NC - Basic Estate Search (C%— Rb NV 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#: F60000000201 Account#:82523266 Owner Information Tax Codes HUNGERFORD STEVEN WILLIAM&HUNGERFORD LORENAADVLTAX-COUNTY T 125 US HWY 158 FIREADVLTAX-FIRE TAX MOCKSVILLE NC 27028 Property Information Townshi nd(Units/Type): 49.710 AC FARMINGTON ddress: 3125 US HWY 158 Deed Information Local tonin ate: 08/2004 Book: 00568 Page: 0798 lot Book: Pa e: Legal Description PIN 9.860AC HWY 158 5850171383 Property Values Building: 494,25CI BXF: 15,06CI Land: 406,48CI Market: 915,7901 ssessed• 915,79 [Deferred: Sales Information No. Book Page Month Year Instrument Qual/UnQual Improved Price 00077 0564 05 1968 WD Unqualified Vacant 0 00184 0618 12 1995 WD Unqualified Vacant 0 00568 0798 08 2004 WD Qualified Improved 337,500 View Property Record for this Parcel View Mai)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=1478642 6/15/2016