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2068 Hwy 64E �, _: .s_ �,� �`i.... . �,' r . ' . �t_.:��� .._� .. _ . .. .. . . . . .: , �. ,�'. � -�,.... . ._,� ., . -. . -: � . . ,,, - 'a. , i -,� c:, , . . :. . � : ,_>.. e , _.A� . . ,.,�-:,.........__ •• .. _ —. . _ . . . .. .. , , . b'_.r 7 �.= �� .,�;�.- : --- . V v b i � �,,, � � �_. /\ '"'' `� _,� ,—'_...--� �,� �""�'�_ . . --��^' ""r . DAVIE COUNTY HEALTH DEPARTMENT '�'"���- . -r,� -: ,__1...�.:.----�- y:w --�� = ' - r IMPROVEMENTS PERMIT AND CERTIFICATE OF COMPLETION -: ...J ' � : �z .'`w�N ; . .Sanitary Sew ge Systems .-';,;-, � ,.; ��,,Chap/er 130a � Pe�mi , OT�:Issued in Com liance With Article II of G S � t Number ` J .�,�,�,:s .�''�/� � ::�:' .,�`io. _ ,i%y�,i �Date �!��`iji N� 7 7 9 U • Name - � . • • . , �, 4..�,Ju,c�,�W�?--`— � �. . �7 � , Location �- ;�� -r�. ,,_ ;i J;._;,�, /,r ,% ,,.�-..r' _ _ . — : — --�— 4'�l�s �w�� �� Subdivision Name Lot Na Sec. or Block Na Lot Siie r.r-��— _ House _ s� Mobile Home ____ Business __ Industry �,J No. Bedrooms � �—_.No. Baths �-`�__ No. in Family' ' � _ PublicAssembly Other _ Garbage Disposal YES NO p Specii�cations tor System: Auto Dish Washer YES NO p /, .�,,, , �- ,r ,�'' �-' r t fC L%�:�`"�'� r L�_.� .a., G� Auto Wash Ma^hine YES NO ❑ - �' ��/�}���S'���'�jA Type Water Supply _� l ____ _ 'This permit Void ii sewage system described below is not installed withm 5 years from date of issue. . This permit is subject to revocation if site plans or the intended use change ;ATTENTION: ' ., YOUR SEPTIC SYSTEM CONTRACTOR MUST SEE THIS PERMIT�LAYOUT BEFORE INSTALLING THIS SYSTEM. � , �o, 1��9�p �SP`'�v' �Dp�'� c/1�,5� �� h � q��. „`� � �✓°� ��n � � � �� , � w� ��"� ;�. �;.,�--� 1' Q�' _ �.�,�' ;r��` � ''` ,/ j / '". /c ,�r �! / . f( ..�:�y ; , �,� f� � � ��' ;.; �� � -l�i,F, %�, o,, ;�� � . >: _._.__T__;:_ �' � /_ . � Improvemenls permit by ����!_.,1�%�— •Contact a representative oi the Davie Counry Health Department for final inspection of this system between 8:30-9:30 A.M., 1:00-1:30 P.M.or 4:30-5:00 P.M.on day of completion.Telephone Number: 704-634-5985. Final Installation Diagram: System Installed b �a —�A� � y�^" , .pAM' $ � DR''�� ' � ' i �p� ' - . h P� 5p 0�'" � �Z: �D� _ �-_ -rv ,�3 3 ,�� �-3= �D o� � ``�,-,-�- / F'�t 9 a ♦ � � ��Q ' .� � ,� � �_ �q � � � �Z� � ,� - �. , � 1a 1{"`S•t- �' � � � / -- + .. ' Certiiicate of Completion u� __ Date �0 '�� ` + � _ 'The signing of this certificate shall indicate that the system describe above has been installed in compliance with the standards set iorth in the above�regulation, but shall in NO way be taken as a guarantee that the system will function satisfactorily tor any given period of time. ; � � ,_ APPLICATION FOR SITE EVALUATION/IMPROVEMENTS PE I�T � �Cj � Q � � Davie County Health Department � � . � Environmental Health Section �R 2 4 �,�•J P. O. Box 665 � Mocksville, NC 27028 �'3��""�T#�. �, .�,.. ��r . ` � 1. Application/Permit Requested By ' �'� , Mailing Address Home Phone 9 7 I "T� � �, p ��^ Business Phone ��d^ �� 2. Name on Permit if Different than Above �- �''���;s�,��,�d.y-� ��1�- �� 3. Application for: ❑General Evaluation �7Septic Tank Installation Permit 4. System to Serve: �ouse � Mobile Home � Place of Public Assembly ❑ Business ❑ Industry ❑ Other ❑ Unknown 5. If house, mobile home: Subdivision Section Lot # p Basement/Plumbing No.of People � ' �asemenUNo Plumbing No. of Bedrooms ;� B'Gaashing Machine No. of Bathrooms � �shwasher Dwelling Dimensions �U n S�� G�Garbage Disposal 6. If business, industry, place of public assembly, other: Specify rype 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: l� Public ❑ Private � Community 8. Property Dimensions � a-C��A Sewage Disposal Contractor 9. Do you anticipate additions/expansion of the facility this sytem is intended to senre? ❑ Yes �� If yes, what type? '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: � � c� � w �s �- ��-�L �� ��S �ti � ��- r�x► �,��-) �} �n; I-�s o�-�- o � �� v; 1 l� PP � ��S � �I�.SS 1N�ers Gc.�i�a1✓ d � �rt'V A-�-2e�" �-c� �,�d. (��4 d r., j�..; �a- s This is to certity 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. �-r-�-�t-��. � ` DATE SIGNATURE CONSENT,F�R SITE EVALUATION TO BE D NE ON ABOVE DESCRIBED PROPERTY MUST CHECK ONE: O 1. I OWN the property. � 2. I 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 representaty'�e of the Davig Cou ty alth D�qartr�ent to enter upon above described property located in Davie County and owned by �J�I��S C�.S��Ht�- H-)i�l to conduct all testing procedures as necessary to determine sai site's suitability for a ground absorption sewage treatment and disposai system. , �!���1-9� � , DATE IGNATURE DCHD�(1/93) � . � '� , � < DAVIE COUNTY HEALTH DEPARTMENT �• , Environmental Health Section : ` Soil/Site Evaluation /f T i NAME �iSYL( DATE EVALUATED J QS" ADDRESS PROPERTY SIZE ��/'¢e PROPOSED FACIILTY J� ri�J�ll-�� LOCATION OF SITE r�'��,L-J Water Supply: On-Site Well _ Community Public 1� Evaluation By: AugerBoring � Pit Cut FACTORS 1 2 3 4 Landsca e osition .L �-- Slo e � HORIZON I DEPTH Texture rou Consistence ' Structure Mineralo HORIZON II DEPTH �' �` " Texture rou Consistence Structure ,� /� Mineralo ' � HORIZON III DEPTH Texture rou Consistence Structure Mineralo HORIZON IV DEPTH Texture rou Consistence Structure Mineralo SOIL WETNESS RESTRICTIVE HORIZON SAPROLITE CLASS.LFICATION LONG-TERM ACCEPTANCE RATE � SITE CLASSIFICATION: �� EYALUATED BY: � LDNG-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 -:lay loam• SIL-Silty loam CL-Clay loam SCL-Sandy clay loam SC-Sandy clay SIC-Silty clay C-Clay ; CONSISTENCE Moist ; VFR-Vc.-y friable FR-Friable FI-Firm I 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 .iC--Sinfile grain M-Massive CR-Crumb GR-Granular ABK-M�ular blocky SBK-Subangular blocky PL-Platy PR-Prismatic Mi neralagy 1:1, 2:1, Mixed . Notes Horizon depth - In inches Depth of fill - In inches Restrictive horizon - Thickness and inches from land surface Sapcolite - S(suitable), U(unsuitable) Soil wetness - Inches from land surface to free wate�' 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/ftz DCHD(01-901 M����■��� ����■�■��■�■���■�������������■ ■��■■ ■�■■■����■�����■����■■���■■ ■����■�■ v1������/������������■���������■������■�������������■�����■�����■■�■���������■����■ ■����■��������n���■��■�■�■�����■■■������■��������■■�■■�����■��e�■■■���■������������■ ■�����������■��������■��■�����■����■������■��������������������■��■�■��■■�■���������■ ■�H��������■���■ ����\�������■■���������������v����������■���■��■���■�������■�■���■ ���������������������■�� ■����a�����■����������■ ■■ ■�����■�e��������■��������■�■�■�■ ■�'■'��'�■ ■■'�������=■Ciiiiiiiriiiiiiiiiiii'�iii=iiiiii'iiiiiiiiiiiiiiiiiiiiiiiiii �iiiiiiii=��iiiiiiii�i=t������������■■ ■�������■�■ ■■���■■����■���■�������■■����■ ���■�������������������������n���������������������_��■���������������■������■���■ ii�iiiii�i ii�iiii,iiiiiiiiiiiiiCi�ii�=siiiiiiiiiiiiiiiiiiiiiiiiiiiiiii'e��■'�■■■���■ ..�.....�.�..0................. . .C. ,...�................................�.::::CC:CC: ............ ■ .......■ .....C■C. 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DAVIE COUNTY HEALTH DEPARTMENT � ` '� ' , _ � � - ' (Septic Tank) Lnprovements Permit and Certificate of Completion , , (Ground Absorption Sewage Disposal System - G.S. Chapter 130-Article 13C) OWNER OR CONTRACTOR 1.. r�x.,,'_, ?-,;�� DATE �' ��'�!- PERMIT l .. , _. LOCATION �t��a� . ;��k� r- , ,.� L..�_ ,..,,,..,. 1��_� � I-�r -, N� 1021 . � 1 � S.R. N0. SUBDIVISION NAME LOT N0. SECTION OR BLOCK N0. HOUSE MOBILE HOME $USINESS ❑ House Trailer 800 Gal. 400 Sq. Ft. N0. BEDROOMS �� N0. B�ATHROOMS �. Two Bedroom House 800 Gal. 600 Sq. Ft. GARBAGE DISPOSAL UNIT YES ❑ NO ❑ Three Bedroom House 900 Gal. 900 Sq. Ft. � AUTO. DISHWASHER YES �' N0 ❑ Four Bedroom House 1000 Gal. 1200 Sq. Ft. AUTO. WASH. MACHINE YES �� NO ❑ SITE SUITABLE YES 0" NO ❑ SIZE OF TANK (S'� gal. NITRIFICATION FIELD sq. ft. , DEPTH OF STONE IN LINES: �. ����t,�•�t.Q,�iv�. � WATER SUPPLY: Individual � Public ❑ IMPROVEMENTS PERMIT BY r`',°��? �"�"'��t?�,��t= INSTALLED BY p,r „ L u� CERTIFICATE OF COMPLETI03�i �By `= �` Date 4'�(r��� � (8/16/73) *Construction must co ply with all other applicable State and local regulations LOT AREA c� 1�C' '`� , ' . � , " /So X 3 r�a� !e.��.1 _ . .. . _ . , � .. � . � . . . 4 . . . . ' . � .. . . . . .. ., . .:... ,. �. ,. ...'� . .. � ;,. .. .. . � ., . .. . , . . . . . . .. . - . . . . . __.W�wr. , . . . . ' ' . ��;��.ti;�� a,` � ��� ��..,..,.���..w.,.........•..,.,..... .........�.................�....�...,��..,.r,�...--»-...._...,_.....,�...`�.—. . �........_ . +�.,.�.�...-_.,..,...._......,._.,...,...................-----, �� � r� ,� � €at'�� '"".' !�'„t� w:_,,....�...,_...._.,.,.,_,. ,, ...,,,,�.,, �.��...�,.__ Parcel#: J60000007404 Page 1 of 1 o�'�t� Davie County, NC - Basic Estate Search �oU�,�.� - Davie County Web Site Basic Search Real Estate Search Tax Bili Search Sales Search � View Pro�ertv Record for this Parcel Vfew Maa for this Parcel View Tax Bill Information Parcel#:J60000007404 Account#:31716000 Owner Information Tax Codes HALL LEWIS ALLEN&HALL SANDRA BOGER ADVLTAX-COUNTY T 068 US HIGHWAY 64 EAST FIREADVLTAX-FIRE TAX MOCKSVILLE NC 27028 Pro e Information Townshi nd(Units/Type): 3.200 AC FULTON ddress: 2068 E US HWY 64 Deed Information Local 2onin Date: 01/1900 Book: Page: Plat Book: Pa e: Le al Descri tion PIN 3.203 AC HWY 64 5757785899 Pro e Vatues uildin : 250 73 BXF• 7 90 nd• 37 62 Market: 296 25 essed• 296 25 eferred• Sales Information No Sales Data found. View Prooertv Record for this parcel y�gw Mao for this Parcel�/iew Tax Bill Infortnation « Return to BasTc 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(nformation set forth on thfs site whether express or implied, in fact or in law, including without 1lmitation the implied warranties of inerchantability and fitness for a particular use. If you have any questions about the data displayed o�thls website please contact the Davie County Tax Office at(336) 753-6120. 1.5.9 http://maps.daviecountync.gov/itsnet/View.aspx?prid=1460818 6/28/2016