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2324 Hwy 601SLT DEPARTMENT�� 5 DAVlE COUNTY HEA H IMPROVEMENTS PERMIT AND CERTIFICATE OF COMPLETION *Note: Issued in Compliance with G.S. of North Carolina Chapter 130—Article 13c. Subdivision Name Lot No Sec. or Block No Lot Size House Mobile Home — Business -- Speculation No. Bedrooms No. Baths No. in Familyl Garbage Disposal YES ❑ NO ❑ Specifications for System: Auto Dish Washer YES ❑ NO ❑ Auto Wash Machine YES ❑ NO ❑ Type Water Supply *This permit Void if sewage system described below is not installed within 36 months from date of issue. Improvements permit by.—" -- *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 day of completion. Telephone Number: 704-634-5985. 1 � Final Installation Diagr; em Installed by Certificate of Comp letion— Date �l *The signing of this certificate shall indicate that the system described above has been installed in compliance with the standards set forth in the above regulation, but shall in NO Way be taken as a guarantee that the system will function satisfactorily for any given period of time. :DAVIE COUNTY HEALTH DEPARTMENT " ' 4 IMPROVEMENTS PERMIT AND ' CERTIFICATE OF COMPLETION *Note: Issued in Compliance with G.S. of North Carolina Chapter 130—Article 13c. Permit Number -' ..__(`'``':; , , Date �. Name – -- - .... _ Subdivision Name Lot No. Sec. or Block No. Lot Size House Mobile Home— _ Business Speculation No. Bedrooms `_'��, No. Baths No. in Family J Garbage Disposal YES ❑ NO ❑ Specifications for System: Auto Dish Washer YES ❑ NO ❑ Auto Wash Machine YES ❑ NO ❑ Type Water Supply *This permit Void if sewage system described below is not installed within 36 months from date of issue. i V .1 . � r 1 Improvements permit by *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 day of completion. Telephone Number: 704-634-5985. Final Installation Diagrai m Installed by Certificate of Completion Date *The signing of this certificate shall indicate that the system described above has been installed in compliance with the standards set forth in the above regulation, but shall in NO way be taken as a guarantee that the system will function satisfactorily for any given period of time. Parcel #: L5150A0014 Davie County, NC - Basic Estate Search PAsic Search Real Estate Search Tax Bill Search Sales Search View Property Record for this Parcel View Map for this Parcel View Tax Bill Information Parcel #:L5150A0014 Account #:16657000 Owner Information Building: Tax Codes BXF: ONNELL JAMES ROBERT & CONNELL ANNIE M Land: ADVLTAX - COUNTY T Market: 324 HIGHWAY 601 SOUTH assessed: READVLTAX - FIRE TAX Deferred: MOCKSVILLE NC 27028 Information Township EressProperty (Units/Type): 1.780 AC JERUSALEM :2324 S US HWY 601 Deed Information Local Zoning Pate: 11/2000 Book: 00351 Page: 0091 [Plat Book: Page: Legal Description PIN _ 2.63 AC HWY 601 1.78 AC 5746236560 Property Values Building: 46,54 BXF: 4,02 Land: 21,49 Market: 72 05 assessed: 72 05 Deferred: Sales Information No. Book Paye Month Year Instrument Qual/UnQual Improved Price 00351 0091 11 2000 WD Unqualified Improved 20,000 View Property Record for this Parcel View Map for this Parcel View Tax Bill Information « Return to Basic Search Page 1 of 1 Orio �� 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 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/itsnettView.aspx?prid=1481627 7/14/2016 i x _..M 47 4 w; f w:.,.: .t. a. a ( '.^,rf .z ti.nu�: ,k+•a 3.. , �:e dy» ,. d .... s, i �l 1 r'Y !'4+. � ..r�cl, .y.,�, �•s.� .-i� t,: �`� i �"YS''-F ....,- y.: +..`i .. r .. .'.: ♦., y���s 3.^ti DAVIE COUNTY HEALTH DEPARTMENT 'IMPROVEMENTS PERMIT AND CERTIFICATE OF COMPLETION *NOTE: Issuedfn Compliance With Article II of G.S. Chapter 130a mita Sew,� s r e S stegmPermit uje �t Name.. .711;14Date )Alth.? Np U Locati — Subdivision Name Lot No. Sec. or Block No. t/ Lot Size House -Mobile Home _ Business __ Speculation No. Bedrooms No. Baths— No. in Family Garbage Disposal YES Q NO ❑ Specifications or System: Auto Dish Washer YES [p, 0 ]� Ai�� Auto Wash Ma thine YES E] NO [ "may Type Water Supply t __— *This permit Void if sewage system described below is not installed within 5 years from date of issue. This permit is subject to revocation if site plans or the intended use change. Improvements permit by *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 day of completion. Telephone Number 704-634-5985. Final Installation Diagram: ( (System Installed by IDL) Certificate of Completion Date *The signing of this certificate shall indicate that the system described above has been installed in compliance with the standards set forth in the above regulation, but shall in NO way be taken as a guarantee that the system will function satisfactorily for any given period of time. 1 r' APPLICATION FOR SITE EVALUATION/IMPROVEMENTS PERMIT Davie County Health Department IE;I'IV ILL i� Environmental Health Section {'� `� P. O. Box 665 AUG 0 ��y3 Mocksville, NC 27028 -------------- 1. ---- ---- -- 1. Application/Permit Requested By Mailing Address d12 Home Phone 2. Name on Permit if Different than Above — 3. Application/Permit for: 4. System to Serve: ❑ House ❑ Business ❑ Industry 5. If house, mobile home: Subdivision Business Phone ❑ General Evaluation obile Home ❑ Other tic Tank Installation ❑ Place of Public Assembly ❑ Unknown Section Lot # ❑ Basement/Plumbing No. of People 2 ❑ Basement/No Plumbing No. of Bedrooms 2 GL -Washing Machine No. of Bathrooms 2— ❑ Dishwasher Dwelling Dimensions ❑ Garbage Disposal 6. If business, industry, place of public assembly, other: Specify type No. of People Served No. of Sinks No. of Commodes No. of Urinals No. of Lavatories No. of Water Coolers No. of Showers Water Usage Figures 7. Type of water supply: ❑ Public Private ❑ Community 8. Property Dimensions -Fc re Sewage Disposal Contractor c� cssc y� `Cw C 9. Do you anticipate additions/expansion of the facility this sytem is intended to serve? 15' Yes ❑ No If yes, what type?°� ss��,/� ,��%4p, lose im -14e -t o4urc 'NOTE: Improvements Permits shall be valid for a period of 5 years from date issued. Improvements Permits are subject to revocation, if site plans or the intended use change. Effective October 1, 1989. Directions to Property: e/ -5c:— -fv � ".toss t -reeks; Corn e r -s„ egs.5 cq laXS 4. � �4 SS � XleGctij Qvrc FS'%� aK r -i9 J, d- �o c/o u & CY� / IAC- g�ve Wau.5_q� NH.^LcC�` (* C...J4fNete o., ��1.-f CPox 1x76) gcrosS ro C This is to certify that the information provided is correct to the best of my knowledge, and I understand I am responsible for all charges incurred from this application. DATE SIGNATURE CONSENT FOR SITE EVALUATION TO BE DONE ON ABOVE DESCRIBED PROPERTY MUST CHECK ONE: 6Z 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. O DATE SIGNATURE DCHD (12.90) DAVIE COUNTY HEALTH DEPARTMENT Environmental Health Section Soil/Site Evaluation NAME /�/Kii l7e // ADDRESS PROPOSED FACULTY DATE EVALUATED PROPERTY SIZE 1"%G LOCATION OF SITE �O/S Water Supply: On -Site Well Community Public Evaluation By: Auger Boring Pit Cut FACTORS 1 2 3 4 Landscape position L L- Sloe % HORIZON I DEPTH Texture group Consistence Structure Mineralogy HORIZON I.I. DEPTH Texture groupC� Consistence 1 70 =121r Structure ,r1 r6 A - Mineralogy HORIZON III DEPTH Texture group Consistence Structure Mineralogy HORIZON IV DEPTH Texturegroup Consistence Structure Mineralogy SOIL WETNESS RESTRICTIVE HORIZON SAPROLITE CLASSIFICATION LONG-TERM ACCEPTANCE RATE , SITE CLASSIFICATION: EVALUATED BY: LANG -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 -Finn 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(01-901 ■■■I■■■■li■I■■■■■■■■Iii.!■■■.■■■■■/■■lie.■■■.■..■..■■..■■■ ■■...■■ ■.■■■■.■.■■.■...■.■■■■..■■■■■iI■■i/N■■.■■.....■■...Ii.■■■.■■..iii■ ■■...■■■.■.....lilil■■■I.l.■■■■l■■■■Ill.■■■ill!■■■■■■■■liil■■■..■■ ■O■■O■■i■■■Ii■■/■l■■li■ll■O.■■IIsi....■■...■■.....■.......■..■.■■■ ■..■■■ilii.■■■■.■OO■■■■■!■■liI■■I■■...■...■..■...■.■..■.■..■O.mom ■■..il■..■■■i■I■■IIII■..I■■■■■■■ ■■I..■■iI/I■iI■■■.■■...■...■l®/■ ■■Ii■■..■■■..■■iii....■..■■■■■■■�■■■.■■..........■.■■■....■....■■ ■■..■■Oi■■■■......i■■■!■■■■...iii■■■I■■..i...■■..lei►"�■.....0■.■...■ ■.■■■.■■!■■■■■.iii■■■■.■O■■■i■■ ■■■■■ilii!■■■.■.I..■....■■i■■ii■ ■■■■..!■■■■..■■.■■.■.....■....■..■.■..■.■■■.■■..■...■.......■...■■ ■■..■...■..■..■.....■■.ail.■.I..■.■.....■...■.■.■._..■■...■..■..■■ ■■■...■l.■■Iii■....■■..■il■■■■■■ ■■■■■■■■ ■II.■Ilii.■■lll■lll■i■ MENEM ■■I..■OI/l■.O■Ill.■..O.ISI..■.I■I�.......■.■..��..■..■...■.■..■■.■■ ■■■■...■■■■.■■.■..0..■■OY■■■■■■■■iii/■■O�■■■■17L�■■... ■..■.......■■ UiiiiiiiiiiEN! 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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=1481627 7/14/2016