281 Ralph Ratledge RdDavie County, NC Tax Parcel ReportK� Thursday, October 6, 2016
(2 -
Davie County,
�yS� NC
WARNING: THIS IS NOT A SURVEY
Parcel Information
Parcel Number:
F300000013
Township:
Clarksville
NCPIN Number:
5811507196
Municipality:
Account Number:
82522911
Census Tract:
37059-801
Listed Owner 1:
FROGGE ARTHUR E
Voting Precinct:
CLARKSVILLE
Mailing Address 1:
281 RALPH RATLEDGE ROAD
Planning Jurisdiction:
Davie County
City: MOCKSVILLE
Zoning Class: DAVIE COUNTY R -A
State:
NC
Zoning Overlay:
Zip Code:
27028-8327
Voluntary Ag. District:
No
Legal Description:
1.376 AC RALPH RATLEDGE
Fire Response District:
WILLIAM R. DAVIE
Assessed Acreage:
1.47
Elementary School Zone:
WILLIAM R DAVIE
Deed Date:
6/2004
Middle School Zone:
NORTH DAVIE
Deed Book / Page:
005560441
Soil Types:
MnC2,MnB2
Plat Book:
0004
Flood Zone:
Plat Page:
007
Watershed Overlay:
DAVIE COUNTY
Building Value:
0.00
Outbuilding & Extra
4500.00
Freatures Value:
Land Value:
19850.00
Total Market Value:
24350.00
Total Assessed Value:
24350.00
(2 -
Davie County,
�yS� NC
..
��ALTMORIZATION NO: 0891 DAVIE COUNTY HEALTH DEPARTMENT
✓XO
Environmental Health Section PROPERTY INFORMATION
Permiltec's P O Box 848 --
Name:��� tr 52.1 \�1 �RrDA— Mocksville, NC 27028 Subdivision Name:
V Phone #: 704-634-8760
Directions to property: ('' ! « — f'=~' Section: �- Lot:
AUTHORIZATION FOR
Tax Office PIN:# _
WASTEWATER �'
:}'•,� `y. ` . ,��� 4 — �,(�, ���ar S `t1 _ s 1 ! 6
SYSTEM CONSTRUCTION
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**NOTE** This Authorization for Wastewater System Construction MUST BE ISSUED by the Davie County Environmental Health Section prior
to issuance of any Building Permits. This Form/Authorization Number should be presented to the Davie County Building Inspections
Office when applying for Building Permits.
(In compliance with Article 11 of G.S. Chapter 130A, Wastewater Systems, Section .1900 Sewage Treatment and Disposal Systems)
***NOTICE*** THIS AUTHORIZATION FOR WASTEWATER CONSTRUCTION
IS VALID FOR A PERIOD OF FIVE YEARS.
ENVIRONMENTAL HEALTH SPECIALIST DATE ISSUED
y DAVIE COUNTY HEALTH DEPARTMENT ` o `
IMPROVEMENT AND OPERATION,P.E ITS PROPERTY INFORMATION
ame:S x;�r\1�� -StJ+ '1�1�t'. Subdivision Name:
_0
Directions to property:
Section: Lot:
IMPROVEMENT
PERMIT Tax Office PIN:#r
Road Name`�'•�'�`-�
**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 11 of G.S. Chapter 130A, Wastewater Systems, Section .1900 Sewage Treatment and Disposal Systems)
***NOTICE*** THIS PERMIT IS SUBJECT TO REVOCATION IF SITE
PLANS OR THE INTENDED USE CHANGE. YOUR WASTEWATER
ENVIRONMENTAL HEALTH SPECIALIST DATE ISSUED SYSTEM CONTRACTOR MUST SEE THIS PERMIT BEFORE
INSTALLING THE SYSTEM.
RESIDENTIAL SPECIFICATION: BUILDING TYPIN Wotr R # BEDROOMS ^ S # BATHS # OCCUPANTS �— GARBAGE DISPOSAL: Yes oiN�
COMMERCIAL SPECIFICATION: FACILITY TYPE # PEOPLE # PEOPLE/SHIFT # SEATS INDUSTRIAL WASTE: Yes or No
LOT SIZE�a� Y I--� TYPE WATER SUPPLY •a S DESIGN WASTEWATER FLOW (GPD) NEW SITE t'� REPAIR SITE
SYSTEM SPECIFICATIONS: TANK SIZE
-T'J D GAL. PUMP TANK GAL. TRENCH WIDTH - } ROCK DEPTH LINEAR FT. U
REQUIRED SITE MODIFICATIONS/CONDITIONS:
U I A
I IMPROVEMENT PERMIT LAYOUT
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"CONTACT A REPRESENTATIVE OF THE DAVIE COUNTY HEALTH DEPARTMENT FOR FINAL INSPECTION OF THIS SYSTEM
BETWEEN 8:30 - 9:30 A.M. OR 1:00 - 130 P.M. ON THE DAY OF INSTALLATION. TELEPHONE # IS (704) 634-8760.
I OPERATION PERMIT
SYSTEM INSTALLED BY:
�R 1
F
AUTHORIZATION NO. ON OPERATION PERMIT BY: DATE: oZ � 13 —11 -
"THE
91 -
"THE ISSUANCE OF THIS OPERATION PERMIT SHALL INDICATE THAT T SYS M DESRI D ABOVE HAS BEEN INSTALLED IN COMPLIANCE
WITH ARTICLE I 1 OF G.S. CHAPTER 130A, SECTION .1900 "SEWAGE TREA ENT D DIS OSAL SYSTEMS", BUT SHALL IN NOWAY BE TAKEN AS A
GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORILY FOR Y G VEN PER OD OF TIME.
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"CONTACT A REPRESENTATIVE OF THE DAVIE COUNTY HEALTH DEPARTMENT FOR FINAL INSPECTION OF THIS SYSTEM
BETWEEN 8:30 - 9:30 A.M. OR 1:00 - 130 P.M. ON THE DAY OF INSTALLATION. TELEPHONE # IS (704) 634-8760.
I OPERATION PERMIT
SYSTEM INSTALLED BY:
�R 1
F
AUTHORIZATION NO. ON OPERATION PERMIT BY: DATE: oZ � 13 —11 -
"THE
91 -
"THE ISSUANCE OF THIS OPERATION PERMIT SHALL INDICATE THAT T SYS M DESRI D ABOVE HAS BEEN INSTALLED IN COMPLIANCE
WITH ARTICLE I 1 OF G.S. CHAPTER 130A, SECTION .1900 "SEWAGE TREA ENT D DIS OSAL SYSTEMS", BUT SHALL IN NOWAY BE TAKEN AS A
GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORILY FOR Y G VEN PER OD OF TIME.
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APPLICATION FOR SITE EVALUATIONAMPROVEMENT PERM
r �+� Davie County Health Department r_ _ _ R 0
Environmental Health Section D
P.O. Box 848 MAY 2 71997
Mocksville, NC 27028
(704) 634-8760
****IMPORTANT**** THIS APPLICATION CANNOT BE PROCESSED UNLESS ALL
THE REQUIRED INFORMATION IS PROVIDED.
// ,44."4" v
1. Name to be Billed_ t/ A C r q d Qef / y E Contact Person o,- Jo A. Pawl A✓' 14-C 1S
Mailing Address 3 L0 Pis r•d Home Phone 9/O- 998' '9_1101
City/State/Zip da/yapn cc N.C. a7004
1
2. Name on Permit/ATC if Different than Above l .Sa M C !
Mailing Address
Business Phone
City/State/Zip
3. Application For: ((/]/Site Evaluation Vf Improvement Permit & ATC
4. System to Serve: [ ] House [{Mobile Home [ ] Business [ ] Industry
5. If Residence: # People0*41 # Bedrooms o 3 # Bathrooms/
f/fWashing Machine [ ] Basement/Plumbing [ ] Basement/No Plumbing
6. If Business/Other: Specify
# Showers # Urinals # Water Coolers
[ ] Other
Kf Both
[ ] Dishwasher [ ] Garbage Disposal
# People #Sinks # Commodes
If Foodservice: # Seats Estimated Water Usage (gallons per day)
7. Type of water supply: [ ] County/City ;.-fWell [ ] Community
8. Do you anticipate additions or expansions of the facility this system is intended to serve? [ ] Yes 00(No
If yes, what type?
EITHER A PLAT OR SITE PLAN
PROPERTY INFORMATION REQUIRED: *** IMPORTANT *** A. MATCOF THE PROPERTY MUST BE
Rd %°n fe je- 1:2 O. G 2 SUBMITTED WITH T�II�S APPLICATION.
44, SILL. 6r7.38 /eE,fJ"/e «7 , 1(v�i
Property Dimensions: ,C3ne�4- fr�.ya' WRITE DIRECTIONS
�(from ocksville),T/�O PROPERTY:
Tax Office PIN: # .SBS/ - [ Q -_7/ (a %u'fire bV` i"orfA +c>Z.AkenI)c
Property Address: Road Name Qa_w !S �r� r(re5 14, o.,A,
City/Zip --mItck-s✓i ll2- A70A9 lP4 on/ Gt/g9 nrr /l pd., f� pn
If in Subdivision provide information, as follows: on Ro Rc/. %-1. / /'oye''Z 4s
Name: ; g Sw'te 201dla &vo// /'c,'/fOl- 5!9I7 Oh
Section: Lot #: ; (iii v /� /� 3 .L a -,A 3
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 r• toy We -6 6 t conduct all testing procedures as necessary to determine the site suitability.
DATE S� � 7/ 27 SIGNATURE t�All
Revised DCHD (06-96)
THIS AREA MAY 13E USED FOR DRAIVING YOUR SITE PLAN:
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u• `� DAVIE COUNTY HEALTH DEPARTMENT
Environmental Health Section SECTION LOT
Soil/Site Evaluation
APPLICANT'S Vs
NAME a--�. VtgX9_
PROPOSED FACILITY \-'�\ \
. R` a't`e U
SUBDIVISION
Water Supply:
Evaluation By:ct_11_
On -Site Well rCommunity
Auger Boring Pit
DATE EVALUATED lO — L1— 9-7
PROPERTY SIZE h G O o I
ROAD NAME�1P�R\L�lt
Public
Cut
FACTORS
1
2 3 4 5 6 7
Landscape position
—5 -
Slope
Sloe %
16` -3 0"
HORIZON I DEPTH
Texture group
Consistence
Structure
c"
Mineralogy;
I
HORIZON II DEPTH
Texture group
Consistence
" T
Structure
kAB
K
Mineralogy.
)
HORIZON III DEPTH
Texture group
Consistence
Structure
Mineralogy
HORIZON IV DEPTH
Texture group
Consistence
Structure
Mineralogy
SOIL WETNESS
5 S
S S
RESTRICTIVE HORIZON
—
—'
SAPROLITE
—
CLASSIFICATION
LONG-TERM ACCEPTANCE RATE
, y
SITE CLASSIFICATION: ? . S .
LONG-TERM ACCEPTANCE RATE: '
REMARKS: �c� \5�, •1 J -
DCHD (O1-90)
LEGEND
Landscape Position
EVALUATION BY:
OTHER(S) PRESENT:
oz -
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
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