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483 Pudding Ridge Rdf DAVIE COUNTY HEALTH DEPARTMENT Environmental Health Section P. O. Boz 848/210 Hospital Street n �n� wwar Mocksville, NC 27028 (336)751-8760 E5- 000 lwa.,kcell pjo, ,C- Account #: 990002023 Tax PIN/EH #: 5841-08-8433.CE I-t IJ Billed To: Charles Eagle Subdivision Info: Reference Name: r-acii ATC Number: 2990 Location/Address: 483 Pudding Ridge Road -27028 AUTHORIZATION FOR WASTEWATER SYSTEM CONSTRUCTION **NOTE** This Authorization for Wastewater System Construction MUST BE ISSUED 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 WASTEWAyq CONSTRUCTION IS VALID F R A PERIOD OF FIVE YEARS. Environmental Health Specialist's Signature: Date: ^/d - ,�o -oy CERTIFICATE OF COMPLETION **NOTE** The issuance of this Certificate ofCompletio has been installed in compliance with Article Disposal Systems," but shall in NO WAY be given period of time. Septic System Installed By: stem described on Improvement/Operation Permit 30A, Section .1900 "Sewage Treatment and hat the system will function satisfactorily for any r Environmental Health Specialist's Signature: Date: 'V_LT_� DCHD 05/99 (Revised) DAVIE COUNTY HEALTH DEPARTMENT Environmental Health Section P. O. Boz 848/210 Hospital Street �✓ C Mocksville, NC 27028 (336)751-8760 IMPROVEMENT/OPERATION PERMIT Account #: 990002023 Tax PIN/EH #: 5841-08-8433.CE Billed To: Charles Eagle Subdivision Info: Reference Name: Location/Address: 483 Pudding Ridge Road -27028 Proposed Facility: Residence Property Size: 22.5 acres ATC Number: 2990 **NOTE** This Improvement/Operation Permit DOES NOT authorize the construction 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 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 PERMIT BEFORE INSTALLING SYSTEM. Residential Specification: Building Type _ #People #Bedrooms #Baths Dishwasher: Z Garbage Disposal: ❑ Washing Machine: l2r Basement w/Plumbing: ❑ Basement/No Plumbing: ❑ Commercial Specification: Facility Type #People #People/Shift #Seats Industrial Waste: ❑ Lot Size C Type Water Supply Design Wastewater Flow (GPD) .,,�`. Site: NewZ' Repair ❑ System Specifications: Tank Size,,!! 6 GAL. /Pump Tank GAL. Trench Width��`' Rock Depth Linear Ft.� zz, Alt,4 Other: l Required Site Modifications/Conditions: IMPROVEMENT/OPERATION PERMIT LAYOUT - APPROVED EFFLUENT FILTER. RISER(S) IF 6 " BELOW FINISIIED GRADE. ****NOTICE: Contact a representative of the Da ie County Health Department for final inspection of this system between 8:30 a.m. to 9:30 a.m. or 1:00 p.m. to 1:30 p.m. on the daf cf initatation. Telephone # is (336)751-8760.**** Environmental Health Specialist's Signature: Date: 1�6 DCHD 05/99 (Revised) iN NY f -j 483 Pudding Ridge Printed:Jul 29, 2013 All data is provided as is without warranty or guarantee of any kind either expressed or implied including but not limited to the implied warranties of merchantability or fitness for a particular use. All users of Davie County's GIS website shall hold harmless the County of Davie, North Carolina, its agents, consultants, contractors or employees from any and all claims or causes of action due to or arising out of the use or inability to use the GIS data provided by this website. Appraisal Card Page 1 of 1 ur 7/29/2013 12.54.32 PM LAKEY DEBRA L BROWN JILL C Return/Appeal Notes: ES -000-00-004 83 PUDDING RIDGE RD UNIQ ID 6229 2525371 AD79-PS ID NO: 5841088433 COUNTY TAX (100), FIRE TAX (100) CARD NO. 1 of 1 eval Year: 2013 Tax Year: 2013 LOT 1 LAKEY + BROWN S/D 3.270 AC SRC= Inspection kppraised by 02 on 06/25/2007 03003 CEDAR CREEK TW -03 C- EX- AT- LAST ACTION 20120524 CONSTRUCTION DETAIL MARKET VALUE DEPRECIATION CORRELATION OF VALUE Foundation - 3Standard 0.1100 ontinuous Footing5.0 E UA BASE RATE RCN EYB AYB CREDENCE TO MARKET ub Floor System - 4 US MO Aree a I ood 8.00 0110 11,4551 119 83.30 122702200 200 % GOOD 1 89.0 DEPR. BUILDING VALUE - CARD 109,210 xterior Walls - 10 TYPE: Single Family Residential Single Family Residential DEPR. OB/XF VALUE - CARD 19,20 luminum/Vin I Siding29.0 MARKET LAND VALUE - CARD 53,68 STORIES: 1 - 1.0 Story TOTAL MARKET VALUE - CARD 182,09 oofing Structure - 03 able 8.0 oofing Cover - 03 s halt or Composition Shingle 3.00 TOTAL APPRAISED VALUE - CARD 182,09 OTAL APPRAISED VALUE - PARCEL 182,09 nterior Wall Construction - 5 D all/Sheetrock 26.0 TOTAL PRESENT USE VALUE - PARCEL nterior Wall Construction - 6 ustom Interior 0.0c TOTAL VALUE DEFERRED - PARCEL TOTAL TAXABLE VALUE - PARCEL 182,09 nterior Floor Cover - 12 ardwood 10.0 +------------31------------+ PRIOR nterlor Floor Cover -14 ar et 0.00 I FOP I BUILDING VALUE 109,70 I I OBXF VALUE 22,80 eating Fuel - 04 lectric 1.0 B BLAND VALUE 53,68 I 1 PRESENT USE VALUE eating Type - 10 eat Pum 4-00 +------------31------------+----13-----+ DEFERRED VALUE I B A S I I I OTAL VALUE 186,180 it Conditioning Type - 03 entral 4.00 I I I I drooms/Bathrooms/Half-Bathrooms 2/0 12.00 I I I I I I PERMIT drooms S - 3 FUS - 0 LL - 0 1 I CODE DATE NOTE NUMBER AMOUNT I I [athrooms S-2 FUS-0LL-0 Z 2 9 ROUT: WTRSHD: 1 I SALES DATA flce S - 0 FUS - 0 LL - 0 I 1 FF. INDICATE I 1 RECORD DATE DEED SALES I I BOOK PAGE M R TYPE PRICE 1 1 0345 888 9 00 WD Q V 16200 1 1 0634 344 11120051 WD U I 36000 I 1 I 1 OTAL POINT VALUE 110.00 BUILDING ADJUSTMENTS Quality 3 AVG 1.000 ha a Desi 4 FACTOR 4 1.050 Size 1 3 Size 1.030 OTAL ADJUSTMENT FACTOR 1.08 OTAL QUALITY INDEX 11 +------------------44------------------+ IFOP I 6 6 HEATED AREA 1,276 I I +------------------44------------------+ NOTES 5 SALE UNQ ORGINALLY 22 G SUBAREA UNITORIG % ANN DEP % OB/XF DEPR. TYPE GS AREA % RPL CS ODE DESCRIPTIONLTH M NIT PRICE COND BLDG /B AYB EYB RATE V COND VALUE AS 1,27 I.106291 2 ARAGE 4 3 1 20 25.0 L 001 001 S 1920 OP 1 51210351 14911 OTAL OB/XF VALUE 19,200 2 - Pre IREPLACE 1,50 Fabricated USAREA 1,78 122,70 OTALS UILDING DIMENSIONS BAS=W13 FOP=N8W31SSE31 W31S29 FOP=S6E44N6W44$ E44N29$. NO INFORMATION HIGHEST OTHER ADJUSTMENTS LAND TOTAL NO BEST USE LOCAL FROM DEPTH/ LND COND AND NOTES ROA UNIT LAND UNT TOTAL ADJUSTED LAND LAND SE CODE ZONING TAGE DEPTH SIZE MOD FACT RF AC LC TO OT TYPE PRICE UNITS TYP ADJST UNIT PRICE VALUE NOTES URAL AC0120 237 0 1.4590 4 1 1.2500 +01 +14 +10 +00 +00 PW 9,000.0 3.270 AC 1.824 16,416.00 5368c GOLF RSE OTAL MARKET LAND DATA 3.270 53,68 OTAL PRESENT USE DATA http://maps.co.davie.nc.us/ITSNet/AppraisalCard.aspx?parcel=E500000004 7/29/2013 APPLICATION FOR SITE EVALUATION/IMPROVEMENT PERMIT Davie County Health Department ' Environmenta/Health Section P.O. Box 848/210 Hospital Street Mocksville, NC 27028 - Q 20,07 (336) 751-8760 fIV�IRpNMF ***IMPORTANT*** THIS APPLICATION CANNOT BE PROCESSED UNLESS ALL ilit,1H INFORMATION IS PROVIDED. Refer/)to the INFORMATION BULLETIN for instructio 1. Name to be Billed Cid"/C'$ (?i C` 4 /L4 Contact Person�7�j/i�' �g A - Mailing Address /,/�(� �lsi uy�/er�s/`` %dNL'T Home Phone l City/State/ZIP 11 e IeYy,V4, /Y C - 9 / 7 U Business Phone 'U xPL C 2. Name on Permit/ATC if Different than Above Mailing Address City/State/Zip 3. Application For: ❑ Site Evaluation `,QiImprovement Permit/ATC ❑ Both 4. System to Service: y House ❑ Mobile Home ❑ Business ❑ Industry O Other 5. If Residence: # People # Bedrooms_ # Bathrooms Dishwasher U Garbage Disposal I Washing Machine U Basement/Plumbing 11 Basement/No Plumbing 6. If Business/Industry/Other: Specify type # People # Sinks # Commodes # Showers # Urinals # Water Coolers IF FOODSERVICE: # Seats Estimated Water Usage (gallons per day) 7. Type of water supply: IV/County/City ❑ Well Il Community 8. Do you anticipate additions or expansions of the facility this system is intended to serve? 0 Yes XNo If yes, what type? ***IAIPORTANT*** CLIENTS MUST COMPLETE THE REQUIRED PROPER'L'Y INFORMATION REQUESTED BELOW. Either a PLAT or SITE PLAN MUST BE SUBMITTED by the client with TIi1S APPLICATION. Properly Dimensions: ��dtv � /�Lf eS WRITE DIRECTIONS (from Mocksville) to PRO PERTI': Tax Office PIN: #_ Srp 4 /_0f�p X3.3 •- Property Address: RoadNamc jvzf�' 'Ie City/zip_�Gc/cl'yf`/% ,�TGoz�j If in a Subdivision provide information, as follows: Name: Section: Block: Lot: .F. - d ,Wf' - Date Property Flagged:✓ This is to certify that the information provided is correct to the best of my knowledge. I understand that any permit(s) issued hereafter are subject to suspension or revocation, if the site plans or intended use change, or if the information submitted in this application is falsified or changed. 1, also, Understand that I am responsible for all charges incurred from this application. 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 the site suitability. O DATE CJG Z 4-_ o2 �� ( SIGNATURE -211 - THIS AREA MAY BE USED FOR DRAWING YOUR SITE PLAN (Include all of the following: Existing and proposed property lines and dimensions, structures, setbacks, and septic locations). Site Revisit Charge Datc(s): Client Notification Date: EHS: Account No. �—� 2. Revised DCHD (07/99) Invoice No.� �� J I ,per Fir, ✓`µPrr -I , #PPUCATION FOR SITE EVALUATION/IMPROVEMENT PERMIT & C1 •"�� �� / I Davie County Health Department Environmental Health Section A 2 0 W8 P.O. Box 648/210 Hospital Street ksv leoc it , NC M 27028 EtJVIRONh1ENTAL HEALTH (336) 751-8760 DAVIE COUNTY ORTANT*** THIS APPLICATION CANNOT BE PROCESSED UNLESS ALL THE REQUIRED INFORiy?ATION IS PROVIDED. Refer to the INFORMATION BULLETIN for instructions. 1. Name to be Billed ^ Contact Person / �z Mailing Address 7 � ��J- � , Home Phone City/State/ZIP 2 )4L2LLl�_,v //!/1. (�• 9� Business Phone 2. Name on Permit/ATC ifDifferentthan Abotre Mailing Address City/State/zip 3. Application For: 0 -Site Evaluation ❑ Improvement Permit/ATC ❑ Both 4. System to Service: 6-11ouse ❑ Mobile Home ❑ Business ❑ Industry ❑ Other 5. If Residence: # People # Bedrooms # Bathrooms 0 Dishwasher ❑ Garbage Disposal ❑ Washing Machine ❑ Basement/Plumbing ❑ Basement/No Plumbing 6. If Business/Industry/Other: Specify type # People # Sinks # Commodes # Showers # Urinals # Water Coolers IF FOODSERVICE: # Seats Estimated Water Usage (gallons per clay) 7. Type of water supply: ❑ County/City Well ❑ Community 8. Do you anticipate additions or expansions of the facility this system is intended to serve? ❑ Yes ❑ No If des, explain. ***IMPORTANT' CLIENTS MUST COMPLETE THE REQUIRED PROPERTY INFORMATION REQUESTED BELOW. Either a PLAT or SITE PLAN 11IUST BE SUBMITTED by the client with THIS APPLICATION. Property Dimensions: c2,9, WRITE DER: CTIONS (from Mockmille) to PROPERTY - Tax Office PIN: Property Address: Road Name i e City/Zip If in a Subdivision provide information, as follows: Name: !l . Section: Block: Lot: This is to certify that the information provided is correct to the best of my knowledge. I understand that any permit(s) issued hereafter are subject to suspension or revocation, if the site plans or intended use change, or if the information submitted in this application is falsified or changed. I, also, understand that I am responsible for all charges incurred from this application. 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 the site suital ' " y. DATE A SIGNATURE nnl THIS AREA MAY BE USED FOR DRAWING YOUR SITE PLAN: /Jac!y- Q Application No. Invoice No. /1 Revised DCHD (07/98) CID iirk« gi> 25' _ R/ W' 296, ----- M/8 SZ --- 245 — >F_ 4 2014.11 �` 2259.84 1245.73 ole -I V 782-76 396 .6 � �) msp's 4 5Z f N G tlo Co rn a W Cp � E y I 1477 08 33p — _ ape 2 99.64 1 1 78,. I co I �_- N S9 • ''UU M t17 5 25.3 6 C}' U -- Q a 10 I M LO 14: i. N O u - N 4� i 417.42 odz= L6 I 923.95 1375 U 1 b �I N •j N `r' N S LO 1 rf) 58.4 � p 484 O IOC Q 31 1.02 (I N OD 0 PG Dt q co c� N / DAVIE COUNTY HEALTH DEPARTMENT "y Environmental Health Section SECTION LOT ` Soil/Site Evaluation APPLICANT'S NAME DATEEVALUATED PROPOSED FACILITY PROPERTY SIZE ,V,22`7ac SUBDIVISION ROAD NAME Water Supply: On -Site Well E,""_ Community Public Evaluation By: Auger Boring Y Pit Cut FACTORS 1 2 3 4 5 6 7 Landscape position CONSISTENCE Sloe % VFR - Very friable HORIZON I DEPTH Wet Texture group' SS - Slightly sticky S - Sticky VS - Very Sticky •L Consistence Structure Structure M - Massive CR - Crumb GR - Granular ABK - Angular blocky (� Mineralogy HORIZON II DEPTH Texture group Consistence Structure Mineralogy HORIZON III DEPTH Texture group Consistence Structure Mineralogy HORIZON IV DEPTH Texture group Consistence Structure Mineralogy SOIL WETNESS RESTRICTIVE HORIZON SAPROLITE CLASSIFICATION ,j - LONG -TERM ACCEPTANCE RATEF . a SITE CLASSIFICATION: LONG-TERM ACCEPTANCE RATE: j C2 REMARKS: DCHD (01-90) EVALUATION BY: A,& OTHER(S) PRESENT: 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 - 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 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 ■■■N■■■■■■■■■M■■■■■ ■■■N■■■■■■■■■■■■■■■ ■■■■■■■■■s■■■■■■N■■ ■■■N■■■■■M■■■■■■■■■ ■■■N■■■■■O■■■■■■■■■ ■■MEMO■■■■N■■■■■■■■ ■■■N■■■■■■■■■■■■■■■ ■■■■■■■■■■■■■N■■■■■ ■■■■■■■■■■■■■■■■■■■ No ■■ so ■■ No ■ uiiiii w, mFwMMII EMMMUM MMMEMEMENNENEMMEME� ■■■■■■■■■■■■■■■IOW■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■ ■ ■E■■ soon NONE ■o■mi ■M■■MMM■■■KN■ ■■M■■E■EMOMM■ ■ ■■ ■■N■■ ■MME■ ■■■E■ ■E■■■ ■EN■■ ■MM■■ ■■OR■ ■■M■■ SEEMS ■ J ■■ MEMO■ MEN MEN MEN ■■M■ NONE MERE MEMO■■■ ■M■R■R■ ■■■M■■■ ■■■■■■■ ■■■■■■■ EMERSON ao■■■■■ ■o■■■■■ ■■t►m■■■ ■■■HEME ■■■11■■■ ■■■MEMS ■■■Wn■■ ■EMMII■■ ■■MMUM■ ■■■■II■■ ■■■■KEN ■■■■■AM ■■E■■N■ ■■■■■M■ ■■R■■N ■■■■■■N MONOMER ■■Off MEOW NONE OWES NEON ■■■■ ■ f August 7,1998 Howard Boger 659 Pinebrook School Rd. Mocksville, NC 27028 Re: Site Evaluation Pudding Ridge Road Tax PIN: #5841-08-8433 Dear Client(s): As requested, a representative from this office visited the aforementioned site on August 5,1998. Based upon the information provided on the application for site evaluation and after an evaluation was completed, the site was found to be provisionally suitable for the installation of a modified, oversized on-site sewage disposal system on the left side of the property. Before a representative of our office will revisit the site to issue an Improvement PermiVAuthorization to Construct the appropriate application must be completed in full and submitted to this office. The location of the facility the system is to serve must be staked off. If you have any questions, please feel free to contact this office. Sincerely, Wet�- Robert B. Hall, Jr. Environmental Health Specialist RH/wd Enclosure(s)