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3579 Hwy 601NDAVIE COUNTY HEALTH DEPARTMENT 1� Environmental Health Section • 1 P. O. Boz 848/210 Hospital Street Mocksville, NC 27028 (336)751-8760 IMPROVEMENT/OPERATION PERMIT .- Account.-#: 990002952 Billed To: Wayne Homes Statesville ' Reference Name: Anthony &Diane Sinyard Proposed Facility: Residence Tax PIN/EH #: 5821-07-2832 Subdivision Info: Location/Address: US Highway 601 N-27028 Property Size: see map ATC Number: 3606 **NOTE** 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 T OOSG #People #Bedrooms 5' #Baths 3.5 Dishwasher: 0" Garbage Disposal: ❑ Washing Machine: Basement w/Plumbing: ❑ Basement/No Plumbing: Commercial Specification: Facility Type//�� #People #People/Shift #Seats Industrial Waste: El Lot Size �'! ��ype Water Supply COL) Design Wastewater Flow (GPD) (POO Site: New 133" Repair 13 System Specifications: Tank Size 11SOGAL. Pump Tank GAL. Trench Width 310 Rock Depth 12-" Linear Ft. (0701 Other:�1STQ 1_rl.�•J Required Site Modifications/Conditions: _kt�gSTbJL 0J C-0-J-0-9�, Kt ' 15' onl- Zak, Vaw 1o, ew QPM 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: r 1:00 in. to 1:30 p.m. on the day of installation. Telephone # is (336)751-8760.**** i Zo' bP�t.► ����� 2D Fxr ct..o� ­ro lto? W1 �v h 5� �T 110 s� Fazr.J r Environmental Health Sp ialist's Signature: Date: CHD 05/99 (Rev sed) .' DAVIE COUNTY HEALTH DEPARTMENT Environmental Health Section P. O. Boa 848/210 Hospital Street Mocksville, NC 27028 (336)751-8760 Account #: 990002952 Tax PIN/EH #: 5821-07-2832 Billed To: Wayne Homes Statesville Subdivision Info: Reference Name: Anthony &Diane Sinyard Location/Address: US Highway 601 N-27028 Proposed Facility: Residence Property Size: see map ATC Number: 3606 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 ON NIS VALID FOR A PERIOD O FIVE YEARS. Environmental Health Specialist's Signa Date: ,, CERTIFICATE OF COMPLETION **NOTE** The issuance of this Certificate of Completion shall indicate the system described on Improvement/Operation Permit lW has been installed in compliance with Article 11 of G.S. Chapter 130A, Section .1900 "Sewage Treatment and \10 Disposal Systems," but shall in NO WAY be taken as a guarantee that the system will function satisfactorily for any ,3Q t � given period of time. � SO 5� CL- �o o � nn nnnn `ri4yi..cQ.-C,Jl u.t; %s:-1-NSr k Septic System Install Environmental Health Specialist's Signature uz&—� I DCHD 05/99 (Revised) Larry f.. Ricky# D.B. MA Pg. 334 T1rane ' a �� Larry J. SValey . D.B. 134, Pg. 64, kan am .; w I LEGEND C 914 Mbar set wMess err)ote7 otherwise + UMW- kee Ao.R' • Cref»ead pop . -f• jifie PI a Power POO 6 Mary% CW, Aoha•omr Uad Su•arrcr. Ma"Y soraft Par NO pkr tea dna •b1.r My e,.pivhwr torr M arwN Aw"I Mdr wokf MY M AlWalln ard. a pna,ivn rano Cf , : IA000•. N'raree ver aw sad ercnaera r� x: K aa. Ea7l. j - /Lf M Q jbr -ray ea S ?fi OJT >•• �• A.B. 118, Pg. 30 JiPy � � s7FiD10*•fes f�.7tr r � Tri ct 1 t'o e�• ,e 1 1.501 Acrotr' - 0 r J I �r Jy Tract 27?` Q78D`'7arb„ '� 1.049 Acres+— r 1 mop 41a. u• _-_ K OV41 •ss•w �'s• JO.e0 ; ' Ylcinfty Map rllo scArr-j •- �' r r 1•: Survey For. ✓ hn .Dam& Railedge �4 t y 24' aa. 0604:2 Tony Sihyard & wife r o. P.A. 129, Pg. 289 , V etAvn P=d 1' ✓oynertt ; Diane Sinyard P.B. 126, Pg. 665 Lt N 2Sp 73 C l pre onl�r) Clarksville Tyrsp., Davie Co., N. rcao,n rasa• ' °. nr Deed referancss: Tmet I - D.B. 503, Pg. rosea !V eS Pe••e, J �- Trutt 2 -. D.B. 129, Pg. . Plat rsferenes: P.$. 5, Pg. t21 Surveyed October 24th, 2003 rt_ S.f2!¢ J tax PIN. SWIM= ?�Qty C,IRc21 B Scale: 1 " = 100' o+sTtr' yt� loo 0 100 200 t-k . SE►_ . t L -33S : , CPrIPNIC St.ALE — i'YET j Tg � • f • • t ' .� S4 A"��:•'� �y / Yiq tVWY Md, p'.Datd er.'10�: 1.�1 ►end! of s rola 9+n,... f! d&WOCI end fs MWP IkV WI N 47 dJW4 fflWMf alatu Mer CUNE SL*MING & PLA N dU�rra+e Or a rRxarpe CC oaev�ae rete feasti 115 Ev.n1n99 Star Dr. Statesville. W.C. 2862: (704) 546-5475 r DU FOR SITE EVALUATION/IMPROVEMENT PERMIT & ATC Davie County Health Department Environmenta/Hea/th Section P. . Box 848/210 Hospital Street QMROtiNi Mocksville, NC 27028'. DiI�E� (336) 751-8760 *,**IMPORTANT*** THIS APPLICATION CANNOT BE PROCESSED UNLESS ALL THE REQUIRED INFORMATION•IS PROVIDED. Refer to the INFORMATION BULLETIN for instructions. 1. Name to be Billed o AgNe �wlr Contact Person 2� �y wle✓z c �_ Mailing Address L ,D 0, C OxNA I& Home Phone T0'7 7 Z� Q 7!J / Q City/State/ZIP di AcTeS li�w'I Business Phono/ 7(j� "�UZ' �03 [1 2. Name on Permit/ATC if Different than Above_- &N'�7.tQ0, Mailing Address 3S-6 7 j( Ld 601 /V City/State/Zip _A1'11S I// 11n 3. Application For: ❑ Site Evaluation ❑ Improvement Permit/ATC O( I� Both 4. System to Service: •0 House ElMobile Howie 13Business ElIndustry [I Other S. Type system requested: C Conventional ❑ conventional modified 1:1innovative 6. If Residence: # People q # Bedrooms 5 # Bathrooms 7 EZishwasher ❑Garbage Disposal Washing Machine ❑Basement/Plumbing ❑Basement/No Plumbing 7.- If Business/Industry /Other: verify type # people # Sinks f, # Commodes # Showers # Urinals # Water Coolers 2 IF FOODSERVICE: • # Seats Estimated Water Usage (gallons per day) 8. Type of water Supp y: Q-15ounty/City ❑ Well ❑ Community 9. Do you anticipate additions or expansions of the facility this system is intended to serve? ❑ Yes UNo 7 If yes, what type? ***IMPORTANT#** CLIENTS MUST COAIPLETETHE REQUIRED PROPERTY INFORMATION REQUESTED BELOW. Eitlier a PLAT or SITE PLAN MUST BESUBAIITTED by the client with THIS APPLICATION. Property Dimensions: t� K D X 19�x �O� WRITE DIRECTIONS (from Mocksville) to PROPERTY: Tax Office PIN: # 3 LAA , es b P Property Address: Road Name fT� G L7 / T- qo 6 ,✓ Le u 5 f City/Zip 04n e ,,Z5 u , 1) e0, ktyXt 028 _ Vf 5{ 17/c4fW-C,1ke % If in a Subdivision provide information, as follows: Namc: Section: Block: Lot: Date home corners flagged: d This is to certify that the information provided is correct to the best of my knowledge. I understand that any permits) 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 aur responsible for all charges incurred fi•onr this application. I, liereby, give consent to the Autliorized Representative of the Davie County I-Iealtli Department 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 D j D SIGNATURES--- 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 —17 7 Datc(s): Sign given�� Revised DC �((O5 Client Notification Date: EHS: Account No. 2— Invoice No. --InvoiceNo. yV --I -Davie County, North Carolina Spatial Data Explorer Page I of 2 Spaial Data 13WPI(D-rer North Carolina -- Click on the Map to: Map L a ZoomIn (7 ZoomOut (7 Recenter Map r Identify: Parcels 3 Zoom Factor: 12X M r Radius Search (feet) Draw selec Boundary SW 149* - Parcel Data Find Adjoining Parcels • County ID: E30000006502 • Account Number. E30000006502 -�5821072832'�7 • Legal 1:2.500 AC HWY 601 • Owner Name: SINYARD DIANE • Owner/Address I.- SINYARD DIANE • OwnerlAddress 2:3567 HIGHWAY 601 NORTH • Owner/Address 3: • Land Unit / Type: 2.4 J AC • Deed Book/Page: 00503 / 0651 • Deed Date: 2003/08/07 • Sales Price: $0.00 • Property Address: • County Zoning: R-20 • Census Code: • City Code: • Fire District.- • Flood Zone: ZONE X :NE [a SCE Census' City Bou County; Multi S� E911 Fir r Districts Flood Pi Flood Zc F Parcels School I Multi S� Soils Town Zo Townshl FM U I -ti S) I.... ...... . .......... .. . . I- Voting P Infrastruc Drivewa, Rail Linc Street F Centerlb F US/NC H Multi S� us NC, Aerial F Photogs Physical Creeks z F Rivers E911 Ad Fire Dep Schools M.AP.1-C http://66.208.132.2541scriptslesrimap.dll?Name=Davie—sdx&Cmd=Clk&Left=1519494.883... 10/21/03 -30 1% Z �O Q Ij t 4.3 s� x9,� i DAVIE COUNTY HEALTH DEPARTMENT • Environmental Health Section SoiVSite Evaluation APPLICANT INFORMATION PROPERTY INFORMATION Account #: 990002952 Tax PIN/EH #: 5821-07-2832 Billed To: Wayne Homes Statesville Subdivision Info: Reference Name: Location/Address: US Highway 601 N-270 8 Proposed Facility: Residence Property Size: see map Date Evaluated: 'Water Supply: On -Site Well Community Public Evaluation By: ' Auger Boring t-'� Pit Cut FACTORS 1 2 3 4 5 6 7 Landscape position CVL_ Slope % 5 HORIZON I DEPTH - ©-- Texture group ct_. CL_ Consistence S Structure Mineralogyr : 1 HORIZON II DEPTH - p C -p- 2�- cl - Texture group C— Consistence P, 5 Structure /a L c . Mineralogy HORIZON III DEPTH - LkyZZW10 5 Texture group'( - Consistence Structure Mineralogy HORIZON IV DEPTH Tekture group Consistence Structure Mineralogy SOIL WETNESS 3 RESTRICTIVE HORIZON SAPROLITE . CLASSIFICATION YS LONG-TERM ACCEPTANCE RATE 0. fl� SITE CLASSIFICATION: 1" 7 LONG-TERM ACCEPTANCE RATE: ®' ?7 REMARKS: EVALUATION BY: L" -z, ,P OTHER(S) PRESENT: 4,.1 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) ■ ME ■■■SE ■■NE■ SOMME MOONS MENS■ SOMME ■■■■■ ■■■■E ■■■E■■E■E ■■■MM■■M■ M ■■ ■■■■■■■■■■■■■■■■■■■■■■■■ ■■■■■■■■■■■■■■■■■■■■■■■■ ■■■■■■■■■■■■■■■■■■■■■■■■ ■■■■■■■■■■■■■■■■■■■■■■■■ ■■N■E■ M■■MMM■■MMM■■■M■ SSSS■■ ■■■■■■■■■■■■■■■■ ■■■■■■■■■■■■■■■■■■■■■■■■ ■■■■■■■■■■■■■■■■■■■■■■■■ ■■■■■■■■■■■■■■ME■■■SSSS■■■■Es■■■■■■EEE■uMEM■E■■■M■ ■■■■■■■■■■■■■s■MM■■■■■■ ■■■■■■■■■■■■ter■■■■MM■■■■■ ■■■■■OHMS■■■M■■■■■■■■■■■■■■■■■■■■■■■■■!�■■■■■■s■■■■ ■■■■■M■■■■■■■EEM■■■■EM■MMEE■■E■■■a■Ser,■■■■■■■■■■■■ ■e■■■■■■■■M■M■■■�i■M■■■■■■■■t■■■■■■■tilt■■■■■■■■■■■■ SSSS■■ SSSS■■'======�======� �����■ SSSS■■ ■ ■■■■■■ ■■■■■■�i■■■ME■�■■■■■■' ■■EE■E�■■■E■■�■ ■■■■■�■�■�Gir■!!�1■■SSSS■H■■■■■■i■■■■■■■■■■■■■■■■■■ ■■■I�■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■ -- ■■■I�■■■e■■■■■■SSSS■M■E■■E■■■■■■■■■■■■■■■■■■■■ ■■■n■■E ■■MINE■■' ■■■n■■■. ■N■It■■■ ■■■IN■■■ ■■■Il■■■ ■■elim"M ■■Mllliul] ■MMM!■M ■MMINME■ ■E■It■■■ ■■■It■■■ E■■It■■■ ■■■le■■■ ■■MIN■■■ ■■■I!■■■ ■■■Il■■■ ■■■IN■■■ ■■■It■■■ ■■■II■■■ ■■MIN■■■ MONOMER ■■■M■■■ M■■■M■■ MONOMER ■■■MMM■ MONOMER MONOMER ■M■M■■■ MONOMER MONOMER ■■MEM■■ ■■■■M■■ ■M■■■■■ M■■O■■■ MEMS■■■ MEMO ■■■■ MEMO ■E■■ NONE NONE MEMO ■EE■ ■M■■ MEMO NONE MEMO ■E■■■■M■■■ ■■■MOMS■■■ ■■■■MEEM■■ ■ESE■■■■■■ MEMS■■■■■■ ■ r,. i � I 7 3 y 3� Fy, 3 � � d SLK yG� a 8 � � a E y a � stt *u r 3 3 3 6xuI. . . .....I ......... ..................................................... ..............I... ...... ............. k -... "mac '��, n� � m -�7�. ��1'��9�.:�y� '. �a", ate" '� �i��`Ea�z� .�- ',��' .. �' _� E � �3 a k 3� #Pfii. I. ........... ........... .......... 60 a 3 298 933 M n 33s4 �x� na � 3 f ...�� � �� �ri ..S '+�" fix, as a A7 �Yl��L yr 3 d a E�ww� � d y/ ''*�.' '�''a�-fix* '�" � �* Z �✓ ..hy c8' � : � 3 v x � £ # 029 ' £� �� M `5391 Y , � T a e i � T k m� F ,a iE r" 107 fi 5848 3502' 2 �ib3e.k.�aw.cri .• ... c��mwivae✓aa.,saw&'' ��� ��� � £ k.rzx.�.".nTT�E� n� �aemww�vuRXa'$rs._acrcx�.+vd+ n...wnay. .u3 ..... —crswm�nh 47 r i- Parcel #: E30000006502 Davie County, NC - Basic Estate Search • Basic Search Real Estate Search Tax Bill Search Sales Search IQ VieXE Property Record for this Parcel View Mao for this Parcel View Tax Bill Information Parcel #:E30000006502 Account #:82521843 owner Information Buildin Tax Codes BXF• INYARD ANTHONY R& SINYARD DIANE Land: ADVLTAX - COUNTY TA arket: 579 US HIGHWAY 601 NORTH ssessed: JFIREADVLTAX - FIRE TAX Deferred: OCKSVILLE NC 27028 Unqualified Vacant Property Information Z Township Land (Units/Type): 2.400 AC 08 CLARKSVILLE ddress: 3579 N US HWY 601 Vacant 0 Deed Information 00525 Local Zoning Date: 11/2003 Book: 00525 Page: 0223 2003 WD Unqualified Plat Book: Page: 0 Legal Description PIN 12.500 AC HWY 601 5821072832 Property Values Buildin 180,20 0011 BXF• Year Instrument Land: 2622 arket: 20642 ssessed: 206 42 Deferred: 1986 WD Sales Information No. Book Page Month Year Instrument Qual/UnQual Improved Price L 00129 0671 01 1986 WD Unqualified Vacant 1 Z 00503 0651 08 2003 WD Unqualified Vacant 0 3 00525 0223 11 2003 WD Unqualified Vacant 0 View Prooertv Record for this Parcel View Mao for this Parcel View Tax Bill Information « Return to Basic Search Page 1 of 1 qA.7tcZ L c,'1 Davie County Web Site 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 f=itness 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.daviecountyne.gov/itsnet/View.aspx?prid=1464463 8/24/2016