147 Oakdale Circle Lot 9 r
OPERATION PERMIT FOCDPFileNumber
ice use ny
Davie County Health Department 121548- 1
210 Hospital Street LSOOD00071
P.O. Box 848 mber:
Mocksville NC 27028 Evaluated For: REPAIR
Phone: 6.753-1680 Township:
Applicant: William Ray"Pete" Ludwiic Property Owner: William Ray"Pete" Ludwiick
Address: 147 'aitt a Ircle Address: 147 Oakdale Circle
City: Mocksville City: Mocksville
State2ip: NC 27028 State2ip: NC 27028
Phone#: (336)998-89701one#: (336)998-8970
Property Location & Site Information
I
RSVI
#: Subdivision: Oakdale Phase: Lot: 9
e C;NC
5
27006 Directions
Structure: SINGLE FAMILY Hwy 601 South, left onto Hwy 801 on right
#of Bedrooms: 5
#of People:
'Water Supply: NIA
'IP Issued by. 2244-oaywalt,Andrew 'System Classification/Description:
'CA issued by: 2244-Daywatt,Andrew
SaproliteSystem? QYes ONo
Design Flow: 2 4 p "Distribution Type: NIA Pump Required?
QYes QNo
Soil Application Rate: 0 2 'Pre-Treatment:
Drain field
rNtrification Field Sq.ft. *System Type: INFILTRATOR QUICK 4 STANDARD
rain Lines Installer: randy miller
Total Trench Length: 2 0 0 ft Certification#:
Trench Spacing: _ Inches O.C.
O
Feet O.C. EH S: 2244-Daywalt,Andrew
Trench Width: _ Inches
Feet Date: 0 6 / 1 3 / 2 0 1 3
Aggregate Depth: inches
Minimum Trench Depth:
Inches
Minimum Soil Cover. Inches Approval Status
Maximum Trench Depth: Inches [EApproved O Disapproved .
Maximum Soil Cover: Inches
SDP File Number 121548 - 1 County ID Number: L5"000071
Septic Tank
Manufacturer. esisting Lat.
STB: Long:
Gallons: Installer:
Date: / / Certification#:
'ENS:
'Filter Brand:
ST Marker: ❑ Yes ❑ NO
Date:
Reinforced Tank: ❑ Yes ❑ NO Approval Status
Piece Tank: ❑ Yes ❑ No ❑Approved❑ Disapproved
Pump Tank
Manufacturer. Installer:
PT: Certification#:
Gallons: 'ENS:
Date: / / Date:
Riser Sealed ❑ Yes ❑ No
Riser Height: ❑ Yes ❑ NO (Min.6 in.) Approval Status
Reinforced Tank: ❑ Yes ❑ No ❑ Approved❑ Disapproved
1 Piece Tank: [I Yes ❑ NO
Supply Line
Pipe Size: inch diameter Installer:
Pipe Length: feet Certification#:
*Schedule: *EHS:
Pressure Rated ❑ Yes ❑ No Date:
Approved fittings ❑ Yes ❑ NO Approval Status
Approved❑ Disapproved
Pump F it
r
PumpType: Installer:
ing Volume: — Gal Certification#:
Draw Down: Inches 'EHS:
*Chain:
Date:
Valves Accessible ❑ Yes ❑ NO
Flow Adjustment Valve ❑ Yes ❑ N O
Check-valve ❑ Yes ❑ NO Approval Status
PVC unions ❑ Yes ❑ No ❑ Approved❑ Disapproved
Vent Hole ❑ Yes ❑ No
Anti-siphon Hole ❑ Yes 0 NO
CDP File Number 121548 - 1 County ID Number: L500000071
Electric Equipment
NEMA 4X Box or Equivalent ❑ Yes 0 No Installer:
Box 12 inches Above Grade ❑ Yes 0 No Certification#:
Box Adj.To Pump Tank 0 Yes 0 No
Conduit Sealed ❑ Yes 0 No 'EHS:
Pum p M an ually 0 perable ❑ Yes 0 No
'Activation Method: Date:
Approval Status
Alarm audible ❑ Yes 0 No 0 Approved 0 Disapproved
Alarm Visible ❑ Yes 0 No
2244-Daywalt,Andrew
*Operation Permit completed by:
Authorized State Agent: Date of Issue: 0 6 / 1 3 / 2 0 1 3
This system has been installed in compliance with applicable NC General Statutes:Article 11,Chapter 130A, Rules for
Sewage Treatment and Disposal, 15A NCAC 18A.1900 et. Seq.,and all conditions of the Improvement Permit and
Construction Authorization.This property is served by a sewage septic system.
Rule .1961 requires that a Type septic system meet the following criteria:
Minimum System Review By The local Health Department:
Management Entity:
Minimum System Inspection/Maintenance Frequency ByCertified Operator:
Reporting Frequency By Certified Operator:
Rule .1961 requires that a Type IV and V septic systems designed fora home/business owner must maintain a valid contract
with a public management entitywith a certified operatoror a private certified operator forthe life of the septic system.
Rule ,1961 requires that Type VI septic systems designed for a home/business owner must maintain a valid contract with a
public management entity with a certified operator for the life of the septic system.
Rule. 1961 (2)(e)requires a contract shall be executed between the system owner and a management entity priorto the
issuance of an Operation Permit fora system required to be maintained by a public or private management entity,unless the
system owner and certified operator are the same. The contract shall require specific requirements for maintenance and
operation, responsibilities of the owner and systems operator,provisions that the contract shall be in effect for as long as the
system is in use,and other requirements for the continued proper performance of the system. It shall also be a condition of
the Operation Permit that subsequent owners of the systems execute such a contract.
4Hand Drawing Olmport Drawing
**Site Plan/Drawing attached.**
Total Time:(H H:M 1-1)
Activity Code: S-23C-O/P ISSUED-REPAIR 11 0 1 Hours 0 0 minutes
OPERATION PERMIT
Davie County Health Department CDP File Number: 121548- 1
210 Hospital StreetL500000o7t
P.O.Box 848 County File Number:
Mocksville NC 27028 Date: I /
J ---
0
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Olnch
Drawing oN/A Drawing Type: Operation Permit Scale: , O = ft.
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CONSTRUCTION For office use Only
AUTHORIZATION "CDP Fite Number 121548- 1
Davie County Health Department L500000071
tY p County ID Number.
r. 210 Hospital Street Evaluated For: REPAIR
.� ,. P.O.Box 848 Township:
Mocksville NC 27028 PERMIT VALID UNTIL:
Phone:336-753-6780 Fax:336-753-1680 0 1 / 0 1 / 0 0 0 6
Applicant: William Ray"Pete"Ludwiick Property Owner: William Ray"Pete"Ludwiick
Address: 147 Oakdale Circle Address: 147 Oakdale Circle
Cily: Mocksville City: Mocksville
StatefZip: NC 27028 State/Zip: NC 27028
Phone#: (336)998-8970 Phone#: (336)998-8970
Property Location 8 Site Information
Address/Road#: Subdivision: Oakdale Phase: Lot: 9
147 Oakdale Circle
Mocksville NC 27006 Directions
Structure: SINGLE FAMILY Hwy 601 South, left onto Hwy 801 on right
#of Bedrooms: 5
#of People:
`Water Supply: N/A
System SDecifications
Minimum Trench Depth:
Site Classification: PS Inches
Minimum Soil Cover.
Saprolite System? QYes QNo Inches
Design Flow: Maximum Trench Depth:
Inches
Soil Application Rate: Maximum Soil Cover: Inches
*System Classification/Description: "Distribution Type:
Septic Tank: Gallons
*Proposed System: 1-Piece: QYes QNo
Pump Required: QYes QNo QMay Be Required
Nitrification Field Sq ft Pump Tank: Gallons
No. Drain Lines 1-Piece: QYes QNo
Total Trench Length: GPM—vs— f1. TDH
Trench Spacing: — QInches O.C. —
oFeet O.C. Dosing Volume: Gallons
Trench Width: Inches
8Feet Grease Trap: Gallons
Aggregate Depth: inches Pre-Treatment: ONSF OTS-1 OTS-II
Septic Tank Installer Grade Level Required: 01 OII 0111 OIV
Pagel of 3
1CDP Fge-Number 121548 - 1 County ID Number: L50o000071
' ❑ Open Pump System Sheet
Repair System Required:OYes ONO ONO, but has Available Space
rDesign
System
Trench Spacing: Q Inches 0. .
ification: Ps 9 Feet O.C.
Trench Width: Q Inches
w: a 4 0 — 3 9 o Feet
Soil Application Rate: Aggregate Depth: inches
.__..
*System Classification/Description: Minimum Trench Depth: Inches
TYPE II A.CONY SYSTEM(SINGLE-FAMILY OR 480 GPD OR LESS) Minimum Soil Cover.
Inches
'Proposed System: 25°Io REDUCTION Maximum Trench Depth: Inches
Maximum Soil Cover:
Nitrification Field Inches
Sq.ft.
No. Drain Lines `Distribution Type: GRAVITY-SERIAL
Total Trench Length: 2 0 0 ft Pump Required: oYes ONO OMay Be Required
Pre-Treatment: ONSF OTS-1 OTS-11
"Site Modifications
No grading or construction activity is allowed in areas designated for system and repair without approval of Health Department.
'Permit Conditions
The issuance of this permit by the Health Department in no way guarantees the issuance of other permits.The permit holder
is responsible for checking with appropriate governing bodies in meeting their requirements.
This Authorization for Wastewater System Constriction shall be valid for a person equal to the period of validity of the Improvement Permit;not
to exceed five years,and may be Issued at the same time the Improvement Permit Issued(NCGS 130A-336(b)) If the installation has not been
completed during the period of validity of the Construction Permit,the Information submitted In the application for a permit or Construction
Authorization Is found to have been incomsct,falsified or changed,or the site is altered,the permit or Construction Authorization shall become
invalid,and may be suspended or revoked(.1937(g)).The person owning or controlling the system shall be responsible for assuring compliance
with the laws,rules,and permit conditions regarding system location,Installation,operation,maintenance;monitoring,reporting and repair
(1938(b)).
Applicant/Legal Reps.Signature Required? OYes ONO
Applicant/Legal Reps. Signature- Date:
'Issued By: 2244-Daywalt.Andrew Date of Issue: 0 5 / 1 5 / a 0 1 3
Authorized State Agent: %"ik Malfunction Log OYes
OHand Drawing Olrnport Drawing Total Time:(HH:AM)
**Site Plan/Drawing attached.**
Page 2 of 3 1 Hours_ 0 Minutes
S-10-CA'S issued-repair
CONSTRUCTION AUTHORIZATION
- Davie County Health Department CDP File Number: 121548 - 1
• � 210 Hospital Street L500000071
P.O.Box 848 County File Number:
Mocksville NC 27028 Date: 05 / 1 5 / 2 0 1 3
Q Inch
Drawing Drawing Type: Construction Authorization Scale: . QBtoctc
QN/A
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DAVIt COUNTY ENVIRONMENTAL HEALTH SERVICE REQUEST
,- APPLICATION IP/ATC OSWW REPAIR
i
Name e t�.(�u)l 61C Telephone Number jj� `�10
Address C-irde, 44oekville- A,/C 2
Mailing Address (if different from above)
Email Address: �d
Subdivision NameLot#
Directions o
Date System Installe �D �-�9��o Name System Installed Under
Type Facility Number Bedrooms Number People Served
T e Water Supply Specific Problem Occurring ke'5
Date Req ested Info Taken By
THIS IS TO CERTIFY THAT THE INFORMATION PROVIDED IS CORRECT TO THE BEST OF MY
KNOWLEDGE,AND THAT I UNDERSTAND THAT I AM RESPONSIBLE FOR ALL CHARGES INCURRED
FROM THIS APPLICATION.
Signature of owner or Authorized Agent
Initial Fee Date REHS
Revisit Charge Date Reason
Revised 2-2011
C+v;--� �4, U1o�l
•—• Appraisal Card Page 1 of 1
DAVIE COUNTY NC 5110/2013 4:18:23 PM
UDWICK WILLIAM RAY LUDWICK GLENDA P Retum/Appeal Notes: LS-000-00-071
147 OAKDALE CR UNIQ ID 21719
6516000 D323-P26 ID NO:5746837733
COUNTY TAX(100),FIRE TAX(100) CARD NO.1 of I -
eval Year:2013 Tax Year:2013 LOT 9+P/O 8+10 OAKDALE 0.940 AC SRC=Inspection
Appraised by 07 on 08/09/2007 05003 CHERRYHILL TW-05 C- EX-AT- LAST ACTION 20130425
CONSTRUCTION DETAIL MARKET VALUE DEPRECIATION - CORRELATION OF VALUE �c
oundation-3 1 Standard TO.4700 _
ontinuous Footing 5.00 Elf. BASE
ub Floor System-4 S MO Area QUA RATE RCN EYB AYB CREDENCE TO MARKET
Ilywood 8._00 01 1 01 11,3051108 75.60 8658196 196 %GOOD 1 53.0 DEPR.BUILDING VALUE-CARD 52,29
xterlor Walls-21TYPE:Single Family Residential Single Family Residential EPR.OB/XF VALUE-GRD SS
ace Brick 34.00 MARKET LAND VALUE-CARD 25,00
oo0ng Structure-03 STORIES:1-1.0 Story TOTAL MARKET VALUE-CARD 77,84
able 8.0
oo0ng Cover-03 -c
ksphalt or Composition Shingle 3.00 TOTAL APPRAISED VALUE-CARD 77,84
nterior Wall Construction-5 TOTAL APPRAISED VALUE-PARCEL 77,84
)rywall/Sheetrock 20.0
nterior Floor Cover-08
;beet Vinyl/Laminate 10.0 OTAL PRESENT USE VALUE-PARCEL
teriFloor Cover-12 OTAL VALUE DEFERRED-PARCEL
nor .
terl OTAL TAXABLE VALUE-PARCEL 77,84
oo l 0.0
eating Fuel-02 PRIOR
11 Wood or Coal 0.0c BUILDING VALUE 53,38
eating Type-04 BXF VALUE
orced Air-Ducted 4.00 AND VALUE 25,00
it Conditioning Type-02 RESENT USE VALUE
Nall Unit 2.0c EFERRED VALUE
Bedrooms/Bathrooms/Half-Bathrooms OTAL VALUE 78,38(
1 1 11.00
rooms
S-3FUS-OLL-O -
throoms
AS-IFUS-0LL-0 +--12---+--------------45--------------+ PERMIT
all-Bathrooms IFCP ISAS I CODE DATE NOTE NUMBER AMOUNT
AS-IFUS-0 LL-0 1 1 1
fce I I 1
S-0 FUS-0 LL-0 I I I OUT:WTRSHD:
I I I R
OTAL POINT VALUE 104.00 1 1 1 SALES DATA
BUILDING ADJUSTMENTS 2 2 2 FF. INDICATE 5
uali 3 AVG 1.000 7 7 7 RECORD ATE DEED SALES c
I I I OOK PAGE R TYPE / / PRICE c
ha a Desl 3 FACTOR 3 1.000 I I I 0081 548 12119691 WD I X I I
Ize 3 Size 1.040 1 1 1 0
OTAL ADJUSTMENT FACTOR 1.04 I I I o
OTAL QUALITY INDEX 108 I I I .,
I I 1
+--12---+--11---+--9--+-------25-------+ HEATED AREA 1,215
4 U O P 4 NOTES
SUBAREA UNIT ORIG% ANN DEP % OB/XF DEPR
GS RPL ODE DESCRIPTION LTH H NIT PRICE COND LDG#L B AYB EYB RATE V4 COND VALUE
TYPE AREA % CS 01 ISTORAGE 1 121 10 194 15.01 01 _ I_ 11986119861 S3 1 191 54
S
1,21 10 91854 TOTAL_OB XF VALUE 54
CP 32 2 612
OP 3 21 68
FIREPLACE 1-None
UBAFDE
1,57 98,65
DIMENSIONS BAS=W45FCP=W12S27E12N27 S27EIIUOP=S4E9N4W9 E34N27 .
ORMATIONTHERADJUSTMENTS TOTAL
USE LOCAL FRON DEPTH/ LND COND ND NOTES OA LAND UNIT LAND UNT TOTAL ADJUSTED LAND LAND
CODE ZONING TAGE DEPT SIZE MOD FAR RF AC LCTOOTTYPE PRICE UNITS TYP ADJST UNIT PRICE VALUE NOTES
0100 2001.0000 0 1.0000 RP 12 500.0 2.00 LT 1.00 12 500.0 2500RKET LAND DATA 25,00
OTAL PRESENT USE DATA
http://maps.co.davie.nc.us/ITSNet/AppraisalCard.aspx?parcel=L500000071 5/10/2013