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190 Tall Timbers DrDavie Countv. NC 0 Tax ParrPl R Pnnrt Tuesdav. October 11. 2016 WAK1VllV(i: "1'Hl� 1, 1VU'1' A JUKVr:Y Parcel Information Parcel Number: F200000030 Township: NCPIN Number: 5811117340 Municipality: Account Number: 82531979 Census Tract: Listed Owner 1: BAILEY JASON DAVID Voting Precinct: Mailing Address 1: 190 TALL TIMBERS DRIVE Planning Jurisdiction: City: MOCKSVILLE 2oning Ciass: State: NC Zoning Overlay: 2ip Code: 2702&0000 Voluntary Ag. District: Legal Description: 2.54 AC TALL TIMBERS DR Fire Response District: Assessed Acreage: 2.53 Elementary School Zone: Deed Date: 5/2010 Middle School Zone: Deed Book / Page: 008270428 Soil Types: Plat Book: Flood Zone: Plat Page: Watershed Overlay: Building Value: Land Value: Totai Assessed Value: 9"�'�' Davie County, `'°vN�c� NC 57620.00 Outbuilding & Extra Freatures Value: 28390.00 Total Market Value: 100400.00 Clarksville 3705�801 CLARKSVILLE Davie County DAVIE COUNTY R-A SHEFFIELD - CALAHALN WILLIAM R DAVIE NORTH DAVIE Mn62 DAVIE COUNTY 14390.00 100400.00 No ,. ,,�.r - � - , ..;- - �iX� ,, "fi �`�"��� - ' DAVIE COUNTY HEALTH DEPARTMENT ��'�� �� � � .�-� .....: .r ;. • "' IMPROVEMENTS PERMIT AND CERTIFICATE OF COMPLETION ! � •NOTE: Issued in Compliance With Article II of G.S. Chapter 130a /�0 �Q�� rifylbC$�� Sanitary Sewage Systems � Permit Nurr�ber Name ��� ��.� - �` � -. �1� � ���_' _ � Date � � _ 1 � N� U � � � , ._ . . . .. . , � -_, �.._. �— � _ r Location .. � t �._, ,.� c = .: ,.,�, � ; � �,... ; � `y �`. �, ,�,_ `�.> '' 7 ta � - - _ .% i �, � _ � ._. i —. � � �, ` --� i � `,� �' - . � 1 �'_, Y"� r.C� ♦ _�!._��.� � � t��. � � � � . 1', - ��.,.� . ._ , . � i� — �� ~ `-- � . {� -�-•-._ � _ , , . _ � t . � . , ti:.. � '. ^, �'^ �C. ..�}. �,�;'.i � S .. �.:�-.: .1.' �' �^ .,d , � �,. � ty..'V..�,. : :A' _,�_T .: , . :� . � i�y". ,.-i�r 'c:.. ; " .' \ Subdivision Name Lot No.� Sec. or Block No. Lot Size ``% �* '_.'�-'�1�_ House _ Mobile Home _�_ 8usiness __ Industry No. Bedrooms `�" 3�No. Baths _�� _ No. in Family J.T Public Assembly Other Garbage Disposal YES p NO �}/ Auto Dish Washer. YES p NO [�]`� Specificat�ons for System � 1 J= - ` r�;t� �; , ;�::3* � -�-i�i' Auto Wash Ma^hine`� � YES p�' NO Q - � ' Y »� iype Water Supply ---- `�_1 `4�.�., _._.�----- ����% .,� �a �` �� \f\ 1 4 '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 � �-ATTENTION: YOUR SEPTIC SYSTEM CONTRACTOR MUST SEE THIS PERMIT/LAYOUT BEFORE INSTALLING THIS � b��N�. SYSTEM, - �' � U.�^� < �-�� i� I �,- , � � 9 �'"��� �' „ /��`�,� o�� 3�,�2 yo � _ . � �, —,—____-- . . ; . . .. l,,s� � `'` Improvements permit by ~_-___'_ - ''ti`�- 'Contact a representative of the Davie Counry Heaith Department for (inal 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 _�-�'���'����'� �-, �-��-��`- ,�, � flt� 7 ��r 'The signing of this certificate the standards set forth in the a satisfactorily for any given peri �� . �} � � � a 2 G: '7 " U' 2 L' � � � � ((�� i � �. \� �—� � �� , C�__*-_�.� '� _ � • 1..� � Certifica�t� of Co pletion _ .__ Date � � r� _ 311 ind cate that�the sys em described above has been installed in compliance with ie reg lation, b�t shall i! NO way be taken as a guarantee that the system will function of tim . 0 •' APPLICATION FOR SITE EVALUATION/IMPROVEMENTS PERMIT Davie County Health Department Environmental Health Section ' P. O. Box 665 � � Mocksvilie, NC 27028 ��C,�: �' � � � f J � 1. Appiication/Permit Requested By Mailing Address ���� �rAr1��`��� -�� + Ho e Phone�%d� �'�'I�'��� ���/'� `f � � , e �'�%tj � � Business Phone � �'� �.2,� � 2. Name on Permit if Different than Above 3. Application for: ❑ General Evaluation KdSeptic Tank Installation Permit 4. System to Serve: ❑ House p Business ❑ Industry 5. If house, mobile home: Subdivision �" Mobile Home ❑ Place of Public Assembly ❑ Other ❑ Unknown No. of People � No. of Bedrooms � No. of Bathrooms � Dwelling Dimensions � � X �Q 6. If business, industry, place of public assembly, other: Specify type No. of People Served No. of Commodes No. of Sinks No. of Urinals Section Lot # ❑ BasemenUPlumbing ❑ BasemenUNo Plumbing LN" v�lashing Machine ❑ Dishwasher ❑ Garbage Disposal No. of Lavatories No. of Water Coolers No. of Showers Water Usage Figures 7. Type of water supply: ❑ Public Cyl Private 8. Property Dimensions � dC f�� Sewage Disposal Contractor 9. Do you anticipate additions/expansion of the facility this sytem is intended to serve? ❑ Yes If yes, what type? fI. • ❑ Community '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 to Property: � e. Sc' �' i-� � Q� t' �' `( C-� `� �'L � �cl � ��.l��e Y� ' rta k� �C� �< L �--� Y�- L-e_-�-� �r ��c�� C��f ��'�`�, L � �.�proJO.. ��. ,Q .�. 0 r � ,� -�� � � � � r.b�� ��' � \ �; ���- c���-e� 1"� bu bl� �1, �Le, This is to certify that the information provided is correct to the best of my knowledge, and I understand I am responsible for all charges incurred from this application. y L� - S '" �i � � c,��?, c�Lodri DATE SIGNATURE CONSENT FOR SITE EVALI�,ATION TO BE DONE ON ABOVE DESCRIBED PFiOPERTY MUST CHECK ONE: i�r 1 I OWN the property. O 2. I 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 suitabiliry for a ground absorption sewage treatment and disposal system. , � - s�� ��.` �Q� � ����� DATE SIGNATURE DCHD (1 J93) � � � ' , � DAVIE COUNTY HEALTH DEPARTMENT ' ' Environnlental Health Section Soil/Site Evaluation NAME \ . �t� �.��� � ���%'"� YJ�ti��t�-a� DATE EVALUATED � _� � r— ADDRESS s F' �p PROPERTY SIZE 7, o..cs��D PROPOSED FACIILTY �' �� ��� LOCATION OF SITE � 4� �� — 1 Water Supply: On-Site Well _ Community Public Evaluation ByC� AugerBoring Pit Cut FACTORS Landscape position Slope % HORZZON I DEPTH Texture group Consistence Structure Mineralogy HORIZON II DEPTH Texture group Consistence Structure MineraloAy HORIZON III DEPTH Texture group Consistence Structure Mineralogy HORIZON IV DEPTH Texture group Consistence Structure MineraloRy SOIL WETNESS RESTRICTIVE HORIZON SAPROLITE CLASS.LFICATION LOyG-TERM ACCEPTANCE RATE 1 2 3 _�_ L v ' � ij'b _�s �• ��f ti ,,• <. � C. L S C L. C L �t����� ��� �'� ��E� Q��'�� 5��� �� �� SITE CLASSIFICATION: �• � LDNG-TERM ACCE(P�T�AN��C�E� RATE: � REMARKS: �� �'"""\ �o�� r- _ DCHD(01-901 � a v nJ_�U � SC� �_L e �. l:l � �. �T � l:l s � � � � EVALUATED BY: � , �� OTHER(S) PRESENT� U 0� �a LEGEND Landscape Position R-Ridge S-Shoulder L-Linear slope FS-Foot slope N-Nose slope CC-Concave slope CV-Convex slope T-Tenace FP-Flood plain H-Head slope Texture S-Sand LS-Loamy sand SL-Sandy loam L-Loam SI-Silt SICL-Si1tY �:lay loam SIL-Silty loam CL-Clay loam SCL-Sandy clay loam SC-Sandy clay SIC-Silty clay C-Clay CONSISTENCE Moist VFR-V��-y friable FR-Friable FI-Ficm 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 ,iG•S7nkle grain M-Massive CR-Crumb GR-Cranular ABK-Mgular blocky SBK-Subangular blocky PL-Platy PR-Prismatic Mineralagy 1:1, 2:1, Mixed Notes I{orizon depth - In inches Depth of fill - In inches Restrictive horizon - Thickness and inches from land surface Saprolite - S(suitable), U(unsuitable) Soil w etness - Inches from land surface to free wate►' or inches from land surface to soil colors with chroma 2 or less Classification - S(suitable), PS(provisionally suitable), U(unsuitable) LTAR - Long-te�m acceptance rate - gal/day/ft2 ■��u�������������■�■�u��������n�n . ���m���� ■ ����■����■��■ ���■��������■���■������N�■��Y���\�■����������ni�n��■�■�_���■ �� ����������M�■ ������������������������N�����■���������������������������� ��� ����������������� ................C.........■...........■............_.....■ . _ .�■ ..�..■.... .. ..............................■....■........... . .. ... _. 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