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473 Riverview RdDav Fulton 37059-804 FULTON Davie County DAVIE COUNTY R -A No FORK CORNATZER WILLIAM ELLIS PcB2,PcC2 DAVIE COUNTY 4500.00 208460.00 ?016 WARNING: THIS IS NOT A SURVEY 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 161 Parcel Information Parcel Number: L800000014 Township: NCPIN Number: 5776450781 Municipality: Account Number: 45844000 Census Tract: Listed Owner 1: LIVENGOOD BILLY ADAIR Voting Precinct: Mailing Address 1: 473 RIVERVIEW ROAD Planning Jurisdiction: City: ADVANCE Zoning Class: State: NC Zoning Overlay: Zip Code: 27006-7035 Voluntary Ag. District: Legal Description: 1.5 AC RIVERVIEW RD Fire Response District: Assessed Acreage: 1.38 Elementary School Zone: Deed Date: 8/1974 Middle School Zone: Deed Book/ Page: 000940295 Soil Types: Plat Book: Flood Zone: Plat Page: Watershed Overlay: Building Value: 182430.00 Outbuilding & Extra Freatures Value: Land Value: 21530.00 Total Market Value: Total Assessed Value: 208460.00 Fulton 37059-804 FULTON Davie County DAVIE COUNTY R -A No FORK CORNATZER WILLIAM ELLIS PcB2,PcC2 DAVIE COUNTY 4500.00 208460.00 ?016 Davie County, 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 161 NC 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. AUTHORIZATION NO: O 9 10 DAVIE COUNTY HEALTH DEPARTMENT Environmental Health Section PROPERTY INFORMATION Permittee's • / P.O. Box 848 Name: �✓�,�'f�� Mocksville, NC 27028 Subdivision Name: Phone #: 704-634-8760 Directions to property: %' t•�? c ; �' AUTHORIZATION FOR WASTEWATER SYSTEM CONSTRUCTION Section: Lot: r� Tax Office PIN:# S Road Name: II i frT V 1 10 GID: $14? 10t)6 **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 HEALTII SPECIALIST DATE ISSUED DAVIE COUNTY HEALTH DEPARTMENT IMPROVEMENT AND OPERATION PERMITS t y. P�rmit'tee's; PROPERTY INFORMATION •T� .Name: Subdivision Name: Directions to property: +" - i " Section: Lot: IMPROVEMENT P. / PERMIT Tax Office PIN:#, 7:�,1 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/mstallation 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 TYPE # BEDROOMS -_ # BATHS _aZ # OCCUPANTS GARBAGE DISPOSAL: Yes or No COMMERCIAL SPECIFICATION: FACILITY TYPE # PEOPLE # PEOPLE/SHIFT # SEATS INDUSTRIAL WASTE: Yes or No LOT SIZE TYPE WATER SUPPLY DESIGN WASTEWATER FLOW (GPD) �'�11;_ NEW SITE l---' REPAIR SITE i SYSTEM SPECIFICATIONS: TANK SIZE ,2C, --Y— GAL. PUMP TANK GAL. TRENCH WIDTH ROCK DEPTH , l` LINEAR OTHER REQUIRED SITE MODIFICATIONS/CONDITIONS: IMPROVEMENT PERMIT LAYOUT r7 41 w,, 0 -fled %2/Yilly2�- "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 - 1:30 P.M. ON THE DAY OF INSTALLATION. TELEPHONE # IS (704) 634-8760. OPERATION PERMIT SYSTEM INSTALLED BY d.uX,.� R AUTHORIZATION NO. W OPERATION PERMIT BY: DATE: 1 b - 1 "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 FUNCTION SATISFACTORILY FOR ANY GIVEN PERIOD OF TIME. DCHD 05/96 (Revised) .: APPLICATION FOR SITE EVALUATIONAMPROVEMENT PERMIT & ' Davie County Health Department Environmental Health Section P.O. Box 848 Mocksville, NC 27028 k (704)634-8760 ****IMPORTANT**** THIS APPLICATION CANNOT BE PROCESSED 1 THE REQUIRED INFORMATION IS PROVIDED. Name to be Billed Wd Mailing Address City/State/Zip 2. Name on Permit/ATC if Different than Above Mailing Address 3. Application For: [ ] Site Evaluation Contact Person W� 9 ' -g1991 ;S ALL Home Phone �JQ !ay O l//l� Business Phone ' zL ' l� � City/State/Zip [ ] Improvement Permit & ATC [� Both 4. System to Serve: [ ] House L ] Mobile Home [ ] Business [ ] Industry [ ] Other 5. If Residence: # People_ # Bedrooms_ # Bathrooms [ ] Dishwasher [ ] Garbage Disposal [ ] Washing Machine [ ] Basement/Plumbing [ ] Basement/No Plumbing 6. If Business/Other: Specify type # People #Sinks # Commodes - # Showers # Urinals # Water Coolers If Foodservice: # Seats Estimated Water Usage (gallons per day) 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 yes, what type? EITHER A PLAT OR SITE PLAN PROPERTY INFORMATION REQUIRED: *** IMPORTANT *** X-A-YAWOF THE PROPERTY MUST BE I r SUBMITTED WITH APPLICATION. Property Dimensions: �1 ri� it try WRITE DIRECTIONS (from ocksville) TO PROPERTY: Tax Office PIN: # .S17"76 � ll � J Jd1,5 n Property Address: Road Namewr [/P r 11 r%e k) /1C� 4/ 73 City/Zip �� UG��e �W If in Subdivision provide information, as follows: Name: Section: 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 County1[Iealtl rn . . A „,1 ., /Y - Revised DCHD (06-96) to enter upon above described property located in Davie County and owned to conduct all testing - /110111 /. THIS AREA MAY BE USED FOR DRAWINC7 YOUR SITE PLAN: as nece/ / y to determine the site suitability. 776 --4-.--07b'/ LO LO N (1 38A) 0781 �1 (2.09A) 31 ` 2576 ao � ZpN (3.40 4 Scale: 1" = r r r r r r r r r r June 09,1997 11:19 AM 776 --4-.--07b'/ DAVIE COUNTY HEALTH DEPARTMENT Environmental Health Section Soil/Site Evaluation APPLICANT'S NAME PROPOSED FACILITY SUBDIVISION Water Supply: On -Site Well Community Evaluation By: Auger Boring t/ Pit SECTION LOT, DATE EVALUATED PROPERTY SIZE ROAD NAME Public Cut FACTORS 1 2 3 4 5 6 7 Landscape position L Sloe % HORIZON I DEPTH Texture group Consistence Structure Mineralogy HORIZON II DEPTH Texture group Consistence Structure7% Ic Mineralogy -/ HORIZON III DEPTH Texture group Consistence r. Structure Mineralogy HORIZON IV DEPTH Texture group Consistence Structure Mineralogy SOIL WETNESS RESTRICTIVE HORIZON SAPROLITE CLASSIFICATION LONG-TERM ACCEPTANCE RATE SITE CLASSIFICATION: 02 LONG-TERM ACCEPTANCE RATE: REMARKS: DCHD (O1-90) LEGEND Landscape Position EVALUATION BY: OTHER(S) PRESENT: 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 ■■ ■■■M■■■■■■MME■E■MEMM■ ■■MEMMEMEMEMEME■■■■■■ ■■M■■■■■■■■■■MENNEMM■ ■M■■■■ ■ENNEN ■ENNEN ■ENNEN ■ENNEN ■ENNEN ■E■■EM■ ■■MMEM■ ■■■MME■ ■ IMEMEM ■■■■■■■ ■MEMEM■ ■■■■■■■ ■M■MEM■ ■EMM■■■ ■■■MEM■ ■EME■E■ ■E■M■■■ ■EM■■M■ ■E■EME■ ■■■M■E■ ■EMM■■■ ■■■■■M■ ■■MM■M■ ■MEMME■ ■■■■ME■ ■EM■E■■ ■EM■ME■ ■■■MEN■ ■EM■■■■ ■EE■■M■ ■■■MEM■ ■OMM■■■ ■EME■E■ ■EM■■E■ ■■■E■E■ ■ENO■■■ ■M■E■E■ ■■■M■M■