The URL can be used to link to this page

119 Janice Lnt .�.�, -r•, . . , �.:,-. , � ..�_. c ,:. � .•• .., � ., �.,�w�..•.i� roe*., - � . -•r- - - ,., ' DAVIE COUNTY HEALTH DEPARTMENT Q' ..50, 0 IMPROVEMENTS PERMIT AND CERTIFICATE OF COMPLETION *NOTE: Issued in Compliance With Article 11 of G.S. Chapter 130a Sanitary Sewage Systems � �� Permit Number 7 Name —I,-"� 1.a^` b yo N - O��C\�\tiS Date —J - �� r'� f 476 • Subdivisi a i AJot No. Sec. or Block No. Loi Size House Mobile Home _ V Business __ Industry No. Bedrooms 3 No. Baths _ No. in Family _ Public Assembly Other Garbage Disposal YES ❑ NO ❑ Specifications for System: Auto Dish Washer YES ❑ >. NO ❑ f p C, o c i Auto Wash Ma^hine r, YES ❑ NO Type Water Supply *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. U iU f Go' ___�-- ----Improvements permit by��s' *Contact a representative of the Davie County 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 by r Certificate of Completion A 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. r � .. r APPLICATION FOR SITE EVALUATION/IMPROVEMENTS PERMIT Davie County Health Department Environmental Health Section P. O. Box 665 Mocksville, NC 27028 1. Application/Permit Requested By i Mailing Address � 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 Mobile Home ❑ Other No. of People ` No. of Bedrooms No. of Bathrooms Q Dwelling Dimensions 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 Q ElCommunity / 8. Property Dimensions ` Sewage Disposal Contractor 9. Do you anticipate additions/expansion of the facility this sytem is intended to serve? ❑ Yes 2-114o If yes, what type? ❑ Septic Tank Installation ❑ Place of Public Assembly ❑ Unknown Section Lot # ❑ Basement/Plumbing ❑ Basement/No Plumbing ❑ Washing Machine ❑ Dishwasher ❑ Garbage Disposal "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 too Property: I �ACIL ado �o //-Y;�� This is to certify that the information provided is correct to the best of my incurred from this application. /,O) -`L/ !�/ - X DAT and I upderstand I am responsible for all charges 0 SIGNATURE CONSENT FOR SITE EVALUATION TO BE DONE ON ABOVE DESCRIBED PROPERTY MUST CHECK ONE: ❑ 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. DATE SIGNATURE DCHD (12.90) r.- ''DAVIE COUNTY HEALTH DEPARTMENT �t Environmental Health Section Soil/Site Evaluation NAME C ci�� ADDRESS S PROPOSED FACIILTY DATE EVALUATED �- PROPERTY SIZE LOCATION OF SITE Water Supply: On -Site Well Community Public V Evaluation By:C._�-L Auger Boring ✓ Pit Cut FACTORS 1 1 2 3 4 Landscape position S S S Slope Z - $- !S - HORIZON I DEPTH ', Texture group C L C L C Consistence T'L Structure Q, '1_ G Mineralogy 1', '.1 I I HORIZON II DEPTH '' '' 2,' Texture groupC e Consistence Z Z f -C F Structure P+`3'� k At31C Mineralogy ', L ', I'A HORIZON III DEPTH Texture group Consistence Structure Mineralogy HORIZON IV DEPTH Texture group Consistence Structure Mineralogy SOIL WETNESS S SS -S SS RESTRICTIVE HORIZON --- -- r- ^- SAPROLITE — -- — -- CLASSIFICATION S S S LONG-TERM ACCEPTANCE RATE,3b:, SITE CLASSIFICATION: S EVALUATED BY: �- LONG-TERM ACCEPTANCE RATE: �� `� OTHER(S) PRESENT: N 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 -Firm VFI-Very firm EFI-Extremely firm Wet NS -Non sticky SS -Slightly sticky S -Sticky VS -Very Sticky NP -Nonplastic 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 ■■■■■■■■..■■■■.■■.■■■■■■.■■■■■■■ ■■■......e■............■...._..■ CCCCCC�Cf comm momiman f\CC1s\ M\CCCf %wMM MmMMMMCCCCCCCC ■..■■.■....11\I■.ilt■...►\t;t■■■Il■■l\►19i.�....f/:lll.i./1....■■■■...■.e....■ ■■■■.■■■■....■.■■..■■■■■..■■..■........■.0\i/■.ee..e...........■.■ ■■■■.........■........■.......■■..............■.....■■■..........■ CCCCCCCCCCCCCCCCCCCCCCCCCCCCC:::iCCCCCCCCCCCCCCCC.CC.CCCC.CCC�CCC. CCCCCCCCCCCCCCCCCCCCCC::CCCCCCCCCCCCCC.�CCC:CCCCC=CCC:CCCCCCCCCCC CCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCC=CCCCCCCCCCCCCCCCC ................................ ................................ ::::::: :::CCCCCCCCCCCCCCCCCCCCCCC no ........................................... ■■■■■■■■■■■■■■■■.f.■■ ................................ ......................■.... .... .................................................................. .................................................................. c/iii/////iii/i====/////iiiiii!•i__/1•i//i/iiiiiii�!i■�.....■■..■..■ ■■■....■�e�.■■ee■.■eee■■e■■ecce■■■■■■.■■■■■■..■■■■..■■■■.■e...■..■ ■...e..■..■ewe■■►■..■■.■■..■.■■■■.■■■■■■■■■■■■.■..■.■.■■.....■.■■■ CCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCu■CCCCCCCCCCCCeiiiiiiiiiiiiiiiiiiC Parcel #: L5100B001705 Davie County, NC - Basic Estate Search Basic Search Real Estate Search Tax Bill Search Sales Search Q View Property Record for this Parcel View Mao for this Parcel View Tax Bill Information Parcel #: L5100B001705 Account #:82523388 Owner Information BXF: Tax Codes Land: BLALOCK JEFFREY L Market: DVLTAX - COUNTY TA �FR Assessed: _ PO BOX 773 ,Deferred: EADVLTAX -FIRE TAX OOLEEMEE NC 27014 Property Information Township Land (Units/Type): 1.000 LT JERUSALEM ddress: 119 JANICE LN Deed Information Local Zonin PDate: 09/2004 Book: 00574 Page: 0072 at Book: Page: Legal Description PIN 1.258 AC HWY 601 5746330809 PropertV Values Building: 7415 BXF: 9,46 Land: 27,50 Market: 111 11 Assessed: 111 li ,Deferred: Sales Information No. Book Page Month Year Instrument Qua[/UnQual Improved Price 1 00189 0673 09 1996 WD Unqualified Vacant 5,000 2 00574 0072 09 2004 WD Unqualified Improved 0 View Property Record for this Parcel View Map for this ParcelView Tax Bill Information Page 1 of 1 o��rF nOUR� 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 wlthout limitation the Implied warrantles 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=1460748 7/21/2016