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6800 Hwy 801Sit ^ei-` `.,•',t_ -,1 -`'tgi,.c..� •, •'i5�r .k .ur:�. v =�°{. .,,.;.; fi re2 .�..'�t, .. � �j'"n � �.,n , -b���a ; � .s �z •.! . ..,_x r. s DAVIE COUNTY HEALTH DEPARTMENT IMPROVEMENT PERMIT and OPERATION PERMIT IMPROVEMENT PERMIT **NOTE** This improvement permit DOES NOT authorize the construction or installation 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 I1 of G.S. Chapter 130A, Wastewater Systems, Section .1900 Sewage Treatment and Disposal Systems) NAME 25 .�/7: �/' PROPERTY ADDRESS 10 r�S • ' of "(bo5 Q DATE c IS LOCATION ref/z SUBDIVISION NAME LOT NUMBER SEC./BLOCK NUMBER RESIDENTAL SPECIFICATION: BUILDING TYPE # BEDROOMS ,I # BATHS # OCCUPANTS , GARBAGE DISPOSAL: YeSOO COMMERCIAL SPECIFICATION: FACILITY TYPE # PEOPLE # PEOPLE/SHIFT # SEATS INDUSTRIAL WASTE: Yes/No LOT SIZE fAC TYPE WATER SUPPLY JA // DESIGN WASTEWATER FLOW (GPD) 91�9'!7 FEW SITE EPAIR SITE SYSTEM SPECIFICATIONS: TANK SIZE !! Y= GAL. PUMP TANK GAL. TRENCH WIDTHROCK DEPTH /a LINEAR FT. QjL� OTHER REQUIRED SITE MODIFICATIONS/CONDITIONS: ***THIS PERMIT IS SUBJECT TO REVOCATION IF SITE PLANS OR THE INTENDED USE CHANGE. YOUR WASTERWATER SYSTEM CONTRACTOR MUST SEE THIS PERMIT BEFORE INSTALLING THE SYSTEM. IMPROVEMENT PERMIT BY **CONTACT A REPRESENTATIVE OF THE DAVIE COUNTY HEALTH DEPARTMENT FOR FILL INSPECTION OF THIS SYSTEM BETWEEN 8:30-9:30 A.M. OR 1:00-1:30 P.M. ON THE DAY OF INSTALLATION. TELEPHONE # IS (704) 634-8760. OPERATION PERMIT SYSTEM INSTALLED BY AUTHORIZATION NO. OPERATION PERMIT BY DATE eZ010X **THE ISSUANCE OF THIS OPERATION PERMIT SHALL INDICATE THAT THE SYSTEM DESCRIBED ABOVE HAS BEEN INSTALLED IN COMPLIANCE WITH ARTICLE 11 OF G.S. CHAPTER 130A, SECTION .1900 "SEWAGE TREATMENT AND DISPOSAL SYSTEMS', BUT SHALL. IN NO WAY BE TAKEN AS A GUARANTEE THAT THE SYSTEM WILL FLNCTION SATISFACTORILY FOR ANY GIVEN PERIOD OF TIME. DCHD 10/95 Davie County. Health Department ENVIRONMENTAL HEALTH SECTION 06 P.D. Box 665 Mocksville, N.C. 27 028 AUTHORIZATION FOR WASTEWATER SYSTEM CONSTRUCTION2 (Issued in compliance with Article 11 of B.S. Chapter 130A, Wastewater Systems) - ***This Authorization For Wastewater System Construction oust be issued by the,Davae County Environmental Health Section prior to issuance of any Building Permits. This.Form/Authorization Nus : ber should be presented to the Davi e'County Building Inspections. Office when applying for Building Permits.*** AUTHORIZATION NLMR, 0 5 5, NAME DATE 3 NAME ON IMPROVEMENT PERMIT (If different than above) SITE LOCATION COMMENTS/CONDITIONS ON AUTHORIZATION TO CONSTRLICT WASTEWATER SYSTEM ***NOTICE*", -THIS AUTHORIZATION WASTEWATER SYSTEM CONSTRUCTION IS VALID FOR A PERIOD OF FIVE (5) YEARS. ENVIRONMENTAL HEATH SPECIALIST , DATE DCHD 10/95' 1. Application/Permit Mailing Address APPLICATION FOR SITE EVALUATION/IMPROVEMENTS Davie County Health Department Environmental Health Section P. O. Box 665 Mocksville, NC 27028 -n"Idl Ile, MC) 2410/2,k Business 2. Name on Permit if Different than Above 3. Application for: ❑ General Evaluation 4. System to Serve: ❑ House ❑ Business ❑ Industry 5. If house, mobile home: Subdivision G(Septic Tank Installation Permit ErMobile Home ❑ Place of Public Assembly ❑ Other No. of People � No. of Bedrooms No. of Bathrooms ll'' Dwelling Dimensions 6. If business, industry, place of public assembly, other: Specify type No. of People Served No. of Commodes No. of Lavatories No. of Showers 7. Type of water supply: �Public 21, 1 ❑ Private 8. Property Dimensions !griccjz� Sewage Disposal Contractor No. of Sinks No. of Urinals No. of Water Coolers Water Usage Figures ❑ Unknown Section Lot # ❑ Basement/Plumbing ❑ BasementlNo Plumbing 2 -Washing Machine [9 -Dishwasher ❑ Garbage Disposal 9. Do you anticipate additions/expansion of the facility this sytem is intended to serve? ❑ Yes ❑ No If yes, what type? ❑ Community 'NOTE: Improvements Permits shall be valid from date issued. Improvements Permits are subject to revocation, if site plans or the intended use change. Effective October 1, 1989. Directions to Property: 6�/s.� ,�� ems- �a�/✓,, This is to certify that the information provided is correct to the best of my incurred from this application. ' -n21r� r&44430,zal 4 DATE 14 Tax Off i cc PIN: # S7Y6 - 2V - 96.9x ,(,soa a 60 098 O/ PROPERTY ADDRESS, as follows: Road Name: G% City: f �— SUBMIT A PLAT WITH THIS APPLICATION. Revisions effective October 1, 1995. e, and I understand I am responsible for all charges SIGNATURE CONSENT FOR SITE EVALUATION TO BE DONE ON ABOVE DESCRIBED PROPERTY MUST CHECK ONE: ❑ 1. 1 OWN the property. 2'17 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 dipposal system. . f-\ _ ,--. Q ' I DATE - SIGNATURE DCHD (1193) I (QV • e Y g) 2998 V 6T ' 9 (Ta' Ct75) LO i ti 1 w w M.� DAVIE COUNTY HEALTH DEPARTMENT Environmental Health Section Soil/Site Evaluation NAME J/%l 'ADDRESS PROPOSED FACIILTY . 2V41t Water Supply: On -Site Well Evaluation By: Auger Boring ZZ DATE EVALUATED PROPERTY SIZE Sii9 LOCATION OF SITE Community Pit Public Cut FACTORS 1 2 3 4 Landscape position ,.._ 7— Slope % 2 - HORIZON I DEPTH Texture group Consistence Structure Mineralogy HORIZON II DEPTH Texture group Consistence r Structure Mineralogy -11 HORIZON III DEPTH Texture group Consistence Structure Mineralogy HORIZON IV DEPTH Texture group Consistence Structure Mineralogy SOIL WETNESS RESTRICTIVE HORIZON SAPROLITE CLASSIFICATION S J LONG-TERM ACCEPTANCE RATE .. SITE CLASSIFICATION: EVALUATED BY: LANG -TERM ACCEPTANCE RATE: I L/ OTHER(S) PRESENT: REMARKS: LEGEND Landscape Position R -Ridge S -Shoulder L -Linear slope FS-Footslope 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 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 3C -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 ■..■■....■■■ee.■■...■■ne...O...E■■neee■e■ee■.■■ee■e■eeeeee.■e.e■ ■..■...■...■.■■■.■■■■..■...■■■■■ ■■■.■eEe..�..e.eeEeee■■...M■E.■■ ■■■■.■e........■.■..■...■e...e...ee.ee.eeee■eeeee■ee■e■eeeeeeeeee■ ■■■.■..■.O■...■.■■......■■e..■■.■■■■e.e■Eee�.■e■ee■■�■eeeeeee.eee■ ■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■ ■■■■■■■■ ■■■■■■■■■■■■■ ■■■■■..■■e■■..■■■O.■ee■■..e..eEe.eeeee■eee.eeeee■■e= .■eeeeee.■Ee■ ■■■■■■.■..■.■..■■■■■■■■■■..�■■■./■■..■■.■e.e.e.=ee■■eee■eeeE..e■e■ ■..■..■■e■■■e....e..e...■■■ eeeeeeee.eeeeeeeeee ■E■■■■MEN.SOMEONE ■ ■...■.■■.■...■..■.■■.■.■■■....■■e■.....Ee.E.e■ ■E.e.eH�ee.■■e.ee■ ■■■■M.■eee...e.■eeeee■■ee■■Mee■■■e■■■■■■■■■,■■■_�■�Elmo■_ ■■■■■■E_■■ ■eee■■..■■■■■eee.■e..e...eeee.e.Eeee..eE MEN ■ ■Ee eEEEeEEe ON ■■e■E■...■O.e.■■.■.O..O..e..e.e...e..■.eee■■■Mee■ .■■Mee■■■■■■e■■■ ■■.■.............■....■eee..... ■...eee■...■e..eeeeeeeMENEMeeee■ ■■■■■......■■.■.■..■...■.■..... ■..■.eeuee..eE.eEeee■.■eeeeeee■ ■eee.■........■■....■■..■■.....■.■..■.e■E.e.eeM ■e.eeE...e.E..M■ ■e■■.■■..E..e.■e.e..■■EOeeeee.■ecce■ecce.ee■eeeei�i==e■M■eE■e.e.ee■■ ■■■■■■■.■.■■■..■■■■■■■■■.■■■■■■...�■ ■.■.■. 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Basic Search Real Estate Search Tax Bill Search Sales Search 0 View Property Record for this PaMel View Mao for this Parcel View Tax Bill Information Parcel #: L50000007801 Account #:68866500 Owner Information 261,1801 Tax Codes 01 M PBELL ANGELA SNIDER &CAMPBELL ERIC L LADVLTAX FMO800 32,3701 -COUNTY T 293,5501 NC HIGHWAY 801 SOUTH 293,55g READVLTAX - FIRE TAX CKSVILLE NC 27028 Property Information Township Ll nd (Units/Type): 5.190 AC JERUSALEM ddress: 6800 S NC HWY 801 Deed Information Local tonin ate: 02/2000 Book: 00326 Page: 0783 Plat Book: Page: Legal Description PIN 5.19 AC OFF HWY 801 1 68948000 5746 -74 -8652 - Property Values Building: 261,1801 BXF' 01 Land' 32,3701 Market: 293,5501 ssessed' 293,55g Deferred' Sales Information No. Book Page Month Year Instrument Qual/UnQual Improved Price 1 00326 0783 02 2000 WD Unqualified Vacant 0 View Property Record for this Parcel View Man for this Parcel View Tax Bill Information « Return to Basic Search Page 1 of 1 o Vt 1; N.'-, 'm 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/itsnet/View.aspx?prid=1475597 8/31/2016