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4141 Hwy 64E � DAVIE COUNTY HEALTH DEPARTMENT �� ' � • Environmental Health Section ,���`� . P.o.Boa 848/210 Hospital Street �� ' Mocksville,NC 27028 (336)751-8760. � IMPROVEMENT/OPERATION PERMIT Account #: 990001252 Tax PIN/EH#: 5787-34-3391 ' _ Billed To: Ken Bingham � Subdivision Info: L���� Reference Name: Ken Bingham Location/Address: U.S. wy.64 E.-27006 Proposed Facility: Residence Property Size: 372 Acres ATC Number: 2489 **NOTE** This Improvement/Operation Permit DOES NOT authorize the construction of a septic tank system or any wastewater system. An ALJTHORIZATION 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 PERNIIT BEFORE INSTALLING SYSTEM. Residential Specification: Building Type 1"l���C #People 2- #Bedrooms � #Baths � Dishwasher: ❑ Garbage Disposal: ❑ Washing Machine: � Basement w/Plumbing: � BasementlNo Plumbing: � Commercial Specification: Facility Type #People #People/Shift #Seats Industrial Waste: ❑ Lot Size 72 �T'ype Water Supply� Design Wastewater Flow(GPD) 2�� Site: New� Repair❑ r� � r� r System Specifications: Tank Size��GAL. Pump Tank GAL. Trench Width� Rock Depth $ Linear Ft.� oth�: � �ST���c��-.��� . �,�1A�-t- Lt�� �'1�o.C. �M.t�J. , Required Site Modifications/Conditions: ��AU- 0^� ��� ' � � FQ� (—A1L�.{��%1' �D�F�.O�`^��� � � IMPROVEMENT/OPERATION PERMIT LAYOUT- APPROVED EFFLUENT FILTER RISER(S)IF 6"BELOW FINISHED GRADE. ****NOTICE: Contact a representative ofthe Davie County Health Deparhnent for final inspection ofthis system between 8:30 a.m.to 9:30 a.m.or 1:00 p.m.to 130 p.m.on the day of installation. Telephone#is(336)751-8760.**** �� _ � , �� �.�$ 5p' rn�r.f. 5r �t� � ° ���; F�'F�x.� �` d l.J�u.-- 5 S►„w. ' � �L�1 rs -�o � �bQ,�N r^.''. � . � � ' ���� / Environmental Health Specialist s Signature: Date: 20 � � DCHD OS/99(Revised) , DAVIE COUNI'Y HEALTH DEPARTMENT ' Environmental Health Section P.O.Boa 848/210 Hospital Street Mocksville,NC 27028 (336)751-8760 Account #: 990001252 Tax PIN/EH#: 5787-34-3391 - Billed To: Ken Birtgham Subdivision Info: Reference Name: Ken Bingham Location/Address: U.S. Hwy. 64 E-27006 Proposed Facility: Residence Property Size: 372 Acres ATC Number: 24$9 AUTHORIZATION FOR WASTEWATER SYSTEM CONSTRUCTION **NOTE** This Authorization for Wastewater System Construction MLTST BE ISSLTED 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 CO CTIO IS VALID FOR A PERIOD OF FIVE YEARS. Environmental Health Specialist's Signatur . Date: � � � CERTIFICATE OF COMPLETION **NOTE** The issuance of is ertifi e of Completion shall indicate the system descri n per tion Permit has been install in ompli ce with Article 11 of G.S.Chapter 130A,Section.1900"Sewage Trea nt and Disposal Syst s," ut shal in NO WAY be taken as a guarantee that the system will function satis ctorily for any given period o tim . I �si� � I e �� U � ,��c,� ,�� � �r � ��Septic System Installed By: � � � Environmental Health Specialist's Signature: /y�//� Date: �O�2� �l / DCHD OS/99(Revised) �; R C�/ � 3:�s ���s� -- T _ :� R M �� � — °���'fi�, APPLICATION FOR SITE EVALUATION/IMPROVEMENT PERMR&AT D L� � � O U � ���� - Davie County Health Department �� _� _ � o�G,, O��� Envirvnmenta/Hea/t�i Se�clion ���y - p.o. Bo� 848/210 Hospita7. 3treet � 2 6 �o� „. � ; Mocksnille, NC 27028 ..- . _. ..: -- ' �i�_i� ' (336)751-8760 �,4 ',,,ENVIF�O tE � j 1� ***T1�ORTANT*** THIS APPLZCATION CANNI�T BE PROCESSED UNLLSS ALL THE REQOIRED INFORMATION IS PROVIDED. Refer to the INFORI�TION BULLETIN for instructions. i. H� co � siiiea �F A/ �:�h 17I.� Contact Paraoa .��hl Q�n j�H.. Mailinq Addreae (G�0() (r:i �S Som6 Phone �'7 ^ (p��� CitY/Stata/ZI8 �.�lflCCj_ �.�'. �.'�C��n Busin�eaa Phonn �l !�"(D �J / 2. Namw on Permit/ATC if Difforent thaa Above Mailiaq ]�cldress City/State/Zip 3. Application For: ❑ Site Evaluation ❑ Improvement Permit/ATC 'f]�Both a. syratem to sa=,►i�e: �ouse ❑ Mobile Home O Business ❑ Industry ❑ Other s. �f Residence: � People 2 �i Sedrooms � # Bathrooms �_ ❑ Dishwasher ❑ Garbaqa Dispoaal ❑ Waehing Ldachin� O Baeamei►t/Plumbinq ❑ Baaemnnt/No Plumb3nq 6. I! Huaineaa/Induatry/Other: Specify type # People A Sinka � Commodea � Shonara # Vrinala � Fiater Coolera IF FOODSERVICE: # Seats EStimAted WSte= Usaqe (galione per day) �. Type of water supply: 0 County/City �Well ❑ Community e. Do you anticipate additions or eapansions of the facility this system is intended to serve? ❑Yes �'No If yes,what type? ***IMPORTANT***CLIENTS MUST COMPLETETHE REQUIRED PROPERTY INFORMATION REQUESTED BELOW. Either a PLAT or SITE PLAN MUST BESUBMITTED by the client witL THIS APPLICATION. Property Dimensions: �7 2 �L WRITE DIRECfIONS(from Mocksville)to PROPERTY: Taa O�ce PIN: # �78 7 �Y 33"l/ '�✓y �o� df}S� f}aOTJrv X Property Address: Road Name Ir�u � �� �h1 i _.... -.._ _... . � _.__ .._, _ -- City/Zip �7 Dd (o �An � --, . _ �f a f �� ��� If in a Subdivision provide information,as follows: �"��'G - 6 5 5 7 Name: Section: Block: Lot: Date Property Flagged: �a This is to certify that the information provided is correct to the best of my knowledge. I understand that any permit(s) issaed hereafter are subject to suspension or revocation,if the site plans or intended ase c6ange,or if the information submitted in this application is falsified or changed. I,also,undetstand that I ant respo»sible jor all charges IncurredJrom this appllcatlon. I,hereby,give conseut to the Authorized Representative of the Davie County Health Department to enter npon above described property located in Davie County and awned by to conduct all testing procednres as necessary to determine the site suitability. DATE �/?� �c-� SIGNATURE THIS AREA MAY BE USED FOR DRAWING'YOUR SITE PI.AN(Include atl of the following: Ezisting and proposed property lines and dimensions, stractures, setbucks, and septic locations). —� ����f�g � � y Site Revisit Charge ` �, Date(s): �� 70 �D � Client Notification Date: Zo f x�� S� EH& 2b � Acconnt Na �f "2`�� ,`.tevised DCHD(07/99) Invoice No. � 3 ! � ,,. � � �/� , � �: �. n �.��5� coJn,y �g��� ztt����5�� � — � �� � � 'oo .��1�' � � eeo-- �6� 45�� ��,�•�/ �R9H��38 ' � o _ ,'------------------------- • 2�,s�' � ; --'' r 4 z5 �',--- " z�,.�� . , / , - � ��;,1 , _ s �,•00�2—_.s'1 ,�,o-� , . �`E 32 Tndil � �Z�A1'�,� 5 Cal CL itlwr/ �;��� � �� 1 jl . .5 �p��` ����" ,-��' � \ � t� ; � � � • � —�'� ,� -��.�, \ s,T� �.. -_ 1 , - .l ry Z71.� -- �•, ,; ��------------------6�0_ EA"� ` \ ,�� . � � oV� // 660'' \ / \/ / / ' \`\ / � i / � ����� �� / � �� � � _`�o�oG°/ � / �___� � . \ � • 8 xk 34.P/0 P�t 8258�` i QP+ .,\ i m�� i b�O ,_, �,,,__----Tax Map 378�. �6g ment Co. 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Total � � . � � � `� � � � �� \'� � � � �. � \ �� � / i • , _ � � � +2 �� �Y � � \ �\ �\ �\�\ �, � �� ���s \\ �\� ��\ �` �\\ .\\� ��` \ �\ `\\_I_� / � � �� �' �iA' n�+��2�-�.\ \ �\ \ �\ �� �\�\ ', � �\ �`�\ `°o ` ' s ell'�o �`� �`� � �� \`� � : I � � � � , �� \ � \ \ O �74 \ �� 1 � \\� ��� �� � .\ � � _.� :�r � � 1 i i i / / � / �� _��1�� ' � \ \ \ �� \ \ \ .♦ ��� �i �� \ �� �\ ��\` % • �� i i / � � i j i �_��O. � \a',p1 \ \ ♦ \� \ \ �� �� \ \\�. � \ � \ �� ��` _—I i l i � � �. �� � �� � q � � � � � . I � � � � v .� i i � / ��� i i i � �\ • � \\ � � � \� � � ♦ \ °� ��� � � ' i 1 � � � �A \ \ � � \ \ \ � \ o �� �� ♦ � � � � � � � ��i '� i/1 � \ �� \ �O \ � � \ \ \ � \ \ � `)O ♦ � 1 � . , ' � . �/ � i i i 'r � �\�\�. �� \ � \� \\ \\ � \�. \��� . \� 48Tna➢� �. \�- � �. � �`�sn � � � . � �� , . ' , DAVIE COUNTY HEALTH DEPARTMENT Environmental Health Section ' ' ' • Soil/Site EvaluaHon + APPLICANT INFORMATION PROPERTY INFORMATION Account #: 990001252 Tax PIN/EH#: 5787-34-3391 � . Billed To: Ken Bingham Subdivision Info: - Reference Name: Ken Bingham Location/Address: U.S. Hwy.64 E-27 06 Proposed Facility: Residence Property Size: 372 Acres Date Evaluated: "7 I � Water Supply: On-Site Well Community Public Evaluation By: Auger Boring Pit Cut FACTORS . 1 2 3 4 5 6 7 Landsca e osition L Slo % '� HORIZON I DEPTH � 0 - Texture rou SI� Consistence NS Structure cF,�L Mineralo HORIZON II DEPTH ( - D Texture rou 5 � � Consistence F,r Swcture Mineralo ` \ �t HORIZON III DEPTH � � a-F Texture rou S � Consistence Structure ' Mineralo � HORIZON IV DEPTH Texture rou Consistence ' Structure Mineralo SOIL WETNESS RESTRICTIVE HORIZON � SAPROLITE CLASSIFICATION LONG-TERM ACCEPTANCE RATE �- SITE CLASSIFICATION: � EVALUATION BY: �-�F' ��N��►'�� � LONG-TERM ACCEPTANCE RATE: O' . OTHER(S)PRESENT: I��C,� REMARKS: LEGEND ' Landscape Position . R-Ridge S-Shoulder L-Lineaz 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 MineralogX + 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-gaUday/ft2 DC}-ID OS/99(Revised) � ; ■��■����■■■■�����■■���■■��■��■■■■■■��■�■■����■���■��■������90�■' ■■ ■��■��■■■�■■����■■e��■������■�■■■■■��■■■■�■���■0���■■���■■■■�■���■ ■■■�����■■����■■�■���■���■■�■�■■���■�■■��■��■■�■■■���v■■■�■e■���■ ■���■��■O�■��■■■��■�■�������■■■■ ■��■�■�����■�■���■�■■�������■��■ ■■���■■����■�■eew�e�s�■���■�■����■��■��■�■���■�■s■�s■■■■������■��■ ■■����■����■■�o■■oo�a■�■�■■�■■■�����■��■��■���■■�000■■o�o�■��■■�■■ ■■����■�■�■�■���■�■�a�a�e�■■so■■�■■��■■■�■■■■�■���e■■a��e■e■■��■�■ ■��■����■�■■■�■��■���■���o����■��■■��■■■e■��■�■■�■�■■��■��■■���■�■ ■���■��■■wo�■�m�■■��a■■sao■o�s■■��■��■■■■■■■■�eo��oosA■■e■�e■�o��■ ■■�■��■�■�■�■���■��■����■�■�■■■■�■���■■■■��■■���■�■■��■■�������■�■ 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■�■�����■■�■��■�■�■■�■����■��■���i��■�����■■�►-����■����■■■��■■���■■ ■�■�■��■���■����■��■_��■■��■�■���■��■�■��■■■�■�■.��■�■��■■����■����■■ ►- --------- 1 Parcel#: K80000000109 Page 1 of 1 0�'�1� Davie County, NC - Basic Estate Search �,ov���, � Davie County Web Site �Basic Search Real Estate 5earch Tax Bill Search Sales Search � View Prouertv Record for this Parcel Yfew Mao for this Parcel Vfew Tax Bill Informatio� Parcel#:K80000000109 Account#:6660500 Owner Information Tax Codes INGHAM KEN CARTER&BINGHAM ELIZABETH CROWELL ADVLTAX-COUNTY T 00 NC HIGHWAY 801 SOUTH FIREADVLTAX-FIRE TAX DVANCE NC 27006 Pro Information Townshi nd(Units/Type); 221.53QAC FULTON � �dress."4i42'E•US FFWlY-64-•'- Deed Information Local Zonin ate: 04/2008 Book: 00752 Page: 0838 Plat Book: Pa e: . Le al DescN tion PIN 21.520 AC HWY 64 5787343391 Pro e Values uildin : 83 33 BXF• nd: 941 06 Market: 1 024 39 ssessed: 195 97 Deferred• 828 42 Sales Informatlon No. Book Paqe Month Year Instrument Qual/UnQual Improved Price 00752 0838 04 2008 WD Unqualified Improved 0 00174 0457 05 1994 WD ualified Vacant 330 000 View Pro�ertv 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�eal property found within Davie County. All data is compiled from recorded deeds, plats,and other pubtic records and data. Users of this data are hereby notified that the aforementloned public informatlon 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 Umitation the implied warranties of inerchantability 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 httn://maps.daviecountvnc.�ov/itsnetlView.aspx?nrid=1460803 6/21/2016