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348 Williams RdDavie Countv. NC u Tax Parcel R ennrt Tuesdav. October 11. 2016 WAK1VllVCT: '1'tll, 1J 1VU�1� A �UKV�Y Parcel Information Parcel Number: 160000002606 Township: NCPIN Number: 5768173288 Municipatity: Account Number: 78197000 Census Tract: Listed Owner 1: WHITAKER STEVE C Voting Precinct: Mailing Address 1: 348 WILLIAMS ROAD Planning Jurisdiction: City: MOCKSVILLE Zoning Class: State: NC Zoning Overlay: Zip Code: 2702&0000 Voluntary Ag. District: Legal Description: 3.079 AC WILLIAMS RD Fire Response District: Assessed Acreage: 2.71 Elementary School Zone: Deed Date: 2/2016 Middle Schooi Zone: Deed Book / Page: 010110570 Soil Types: Plat Book: Flood Zone: Plat Page: Watershed Overlay: Building Value: Land Value: Total Assessed Value: �9"�'A Davie County, °o- �,`� NC 171270.00 Outbuilding & Extra Freatures Value: 45830.00 Total Market Value: 245470.00 Shady Grove 37059-804 WEST SHADY GROVE Davie County DAVIE COUNTY R-20 CORNATZER - DULIN CORNATZER WILLIAM ELLIS MsC,MsB DAVIE COUNTY 28370.00 245470.00 No _. sr��_� 1, . � ..� �. . . . .. .. , . � , • , , - , . . .' . . . , . ���. . „. AU'�HORIZA.TION NO: ���� DAVIE COUNTY HEALTH DEPARTMENT �t � :� '' '� "' , , ` Environmental Health Section PROPERTY INFORMATION �,` Perntittee's�...��,�` J !�•�,/ � P.O. Box 848 �, Name: '.. �,t✓`r_ r�., '�.r`,�� ste��?�^'" Mocksville, NC 27028 Subdivision Name: Directions to ro ert :�%`''. � i „r;,,� t,,�' ;�y' Phone #: 704-634-8760 P P y' � r AUTHORIZATION FOR Section: Lot: WASTEWATER Tax Office PIN:# '� ,�`� � �`�: �' - n' ` SYSTEM CONSTRUCTION Road Name ��"�%.�*�'�r:� '`�.�Lip: `� � �3 **NOT'E** This Authorization for Wastewater System Construction MUST BE ISSLTED by the Davie County Environmental Health Secdon prior to issuance of any Building Pernuts. 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) �� "(�� '� �,/� � j'' ***NOTICE*** THIS AUTHORIZATION FOR WASTEWATER CONSTRUCTION ,�"� i i��,}°�1 %� E'.c�'�',J, ,:�� i, ,��.�� IS VALm FOR A PERIOD OF FIVE YEARS. ENVIRONMENTAL HEALTH SPECIALIST DATE ISSUED � v � . 9 , ' � : , . . . ` ^ . � � • . � �,,."" u 'k " � 1 , � �� �,.,.�`� ,,.�^ s"=�`'G� A.a. � „�� - � � ; , � ��-�� � � �� "�' �` DAVIE COUNTY HEALTH DEPARTMENT � � ��"' tr " ��'' IMPROVEMENT AND OPERATION PERMITS PROPERTY INFORMATION � . - � � x� w .�r ,�� °` " P.ermitt�e'�S�''� � , ,�* . J . .. � ��'n a'a'Fi s�":..�� d,�""..�y �' a'r` 1 � ,�.a' , . � � � . . . � . .. � . ... .: . . . � Name: . _a ,�''- �-c- .� f � �?� <�'�;""° Subdivision Name: . r . , : _. _. , ., Directions to property: , •'' . � � , <" .�� ,�•�` Section: Lot: IMPROVEMENT , � � �� a PERMIT Tax Office PIN:#. ;' '�� � o r F*;';h '�,'' . . . . . . . . . .. . . . � . � . . . . ✓'`l. �F� 3 � ..��F ��; � - . . . �} C s e•"; i� , RoadName. _" ;���_.•,�,,•r�,7�' ,%•�"lip: f-�, �s :::��ci **NOTE** This Improvement Pernut DOES NOT authorize the construction or installation of a septic tank system or any wastewater system. An ALTTHORIZATION FOR WASTEWATER SYSTEM CONSTRUCTION must be obtained from this Department prior to the constcuction/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) ,�� `, � : j� :,,-'�`"' , ***NOTICE*** THIS PERNIIT IS SUBJECT TO REVOCATION IF SITE ,��` �,�:.e �`' t�' � f�''� �1' 3,-t .� ti,' f> �;!; �� �,�>°"� PLANS OR TI-IE INTENDED USE CHANGE. YOUR WASTEWATER , ENVIRONMENTAL HEALTH SPECIALIST DATE ISSUED SYSTEM CONTRACTOR MUST SEE THIS PERMIT BEFORE INSTALLING Tf� SYSTEM. � I RESIDENTIAL SPECIFTCATION:.BUILDING TYPE �# BEDROOMS _� # BATHS r=�� # OCCUPANTS .�C GARBAGE DISPOSAL: Yes or No COMMERCIAL SPECIFICATION: FACILITY TYPE # PEOPLE # PEOPLFJSHIFT # SEATS INDUSTRIAL WASTE: Yes or No �j � � LOT SIZE �r� TYPE WATER SUPPLY l.fd DESIGN WASTEWATER FLOW (GPD) �-.�� �'� NEW SITE �� REPAIR SITE _ /ri ,� SYSTEM SPECIFICATIONS: TANK SIZE GAL. PUMP TANK GAL. TRENCH WIDTH �-% l' ROCK DEPTH � LINEAR FT. �-�-�� r OTHER Y,J � .ut..1 V� REQUIRED SITE MODIFICATIONS/CONDITIONS: **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 ' , �— /1 � SYSTEM INSTALLED BY: �!�-1" '"!'� � �� �� 8�; � ��� � ��r s ���,,,, s�y �-� �- � � �x � .-� . � � AUTHORIZATION NO. ��s / OPERATION PERMIT BY. i� DATE: �/���� **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 OS/96 (Revised) APPLICA f�1 FO SITE EVALUATION/IMPROVEMENT � Davie County Health Department ! Environmental Health Seclion �%� �� � P.O. Box 848 'j � Mocksville, NC 27028 � (704)634-8760 ��� �-�AR 2 I 1997 *'�**IMPORTANT**�`* TffiS APPLICATION CANNOT BE PROCESSED UNLESS ALL THE REQUIRED INFORMATION IS PROVIDED. 1. Name to be Billed ��eVe u1�,1���C�� Mailing Address f�� ���, �,` �'�'('(�'� K-c,� City/State/Zip �`�j � 1C...� \j�l� ��.�� Z--�� d2�1, 2. Name on PermiUATC if Different than Above Mailing Address � ContactPerson ��.�� �".'�J4'. C�°i �"`�1�'o'1C I r�� �:�����.;'�i i�"�!'�' Home Phone �����e ' `���� � Business Phone City/State/Zip 3. Application For: '�ite Evaluation [] Improvement Permit & ATC [� Both 4. System to Serve: [�j'House [] Mobile Home [] Business [] Industry [] Other 5. If Residence: # People�_ # Bedrooms� # Bathrooms� [V]�Dishwasher [] Garbage Disposal [yj"��Vashing Machine [�asement/Plumbing [ ] BasemenUNo 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: �j 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? E Z THER tt PLttT OIZ S I TE PL�LN PROPERTY INFORMATION REQUIRED: *** IMPORTANT *** ��cOF THE PROPERTY MUST BE y SUBMITTED WITH T I�S APPLICATION. l Property Dimensions: � C•1CYP� � WRITE DIRECTIONS (from ocksville) TO PROPERTY: Tax Office PIN: # � �1 - ,��� '� ; 1�� �� W `1 �:-.� � `� '�7i Property Address: Roa�Name 1 1` 1 IY�� � OU � �� Ci'� � r� ��. C� r �;{._ C°�` , n C1 City/Zip ,�� C....�%1 � V �,� 1`, � � � �L �i �`��� C��^1�"' i7 i\ � � l \ \, 1 � 1'Yl � 4�f 4 , If in Subdivision provide information, as follows: � � � e �C� � \ � � k � ) � (' �� Name: � �"1�1� C1,11 C_ � �,�?�` 1�', \`�f 11:1. � � � � � Section: Lot #: ; �,�1 t`�`� �"`� ��`'r„��� � �J �9 � � \C�- �=u :C. � \� ��1 �� This is to certify that the information provided is correct to the best of my kn wledge. I understand that any permit(s) issu d 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 ��O\ �� ,�(`c���� to conduct all testing procedures as necessary to determine the site suitability. DATE �'� b"�� SIGNATURE S�' �. C.� I�,t1'C`ti�� �:�C Revised DCHD (06-96) � _ � a \ � �� � l, �� THIS ftIZEA A�tt� $E usEb �orz vr�witvc jou�ITE 1'LAN, ��'` `�``""� � � �� � � _. , _ _ ^ '� � _ � - - _ _ _ . -� _ r_ � �,. .._ f - - . � � k , , . ... ,.,,,. j�•b � „ ;.� . . , . ....,. ',,�. -y �,..r sy � .. «. , . ,� .�,� � '3'° fi , 7 r; n # F � . _.._ } / �' � h � � ` � � � �� ��� �t i��. 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F 44A C'.�00 �v c�v � �1., ,�,� 1354.98 � _ � . . � . � . , � � . � � ��� ��, �� 3332 , . � �'•. ". �{ ' � _ _ - _ __ _ __ _ __ _ -- r. � _ . a _� ' �. � � :� , +�,,,.�:� �. ,� . . i .. . . , . . . , . _ __ __ __ . . �i. , � .., . _ - � ' . DAVIE COUNTY HEALTH DEPARTMENT . r . . �•� Environmental Health Section SECTION LOT Soil/Site Evaluation APPLICANT'S NAME U�/�1'/f"/��l DATE EVALUATED �'f"/%— `%� PROPOSED FACILITY /� PROPERTY SIZE ��L' SUBDIVISION ROAD NAME 6�l/•• ���s�l S� Water Supply: On-Site Well Community Public � Evaluation By: Auger Boring �/ Pit Cut SITE CLASSIFICATION: !�� OV�t ,S'� 7P �✓ %%�ig(! EVALUATION BY: �`+`Q �� LONG-TERM ACCEPTANCE RATE: ,� OTHER(S) PRESENT: REMARKS: �� fl �r/ 1'vk y�'2� `e �� � T S• C' � 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 frm EFI - Extremely frm 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 Mineraloev 1:1, 2:1, Mixed Notes Horizon depth - In inches Depth of fll - 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 Classifcation - S(suitable), PS(provisionally suitable), U(unsuitable) LTAR - Long-term acceptance rate - gaUday/ft2 DCHD (O1-90) ■■�■■■■■■■■■■■■■■�■■■■■■■ ■■�■��■■■■■■■��■��■��■��■ ■■����■����■■�■■�■■■�■��■ ■■■■■■■■■■�■■��■��■■■■��■ ■■���■���■�■�■■■��■■■■��■ ■����■���■�■���■�■■e■■��■ ■�■���■��■�■■■■■��■■■■■■■ ■����■���■�■���■��������■ ■���■■■�■■�■■■■■�■■■■■■■■ ■����■��■■�■��■��■��■��■■ ■■■�■■■�■�■■��■��■�■���■■ ■�■�■■��■��■����■■����■■■ ■������������■��■■�■��■■■ ■■■�■■■■■■■■�■�t■�■■■■■■■ ■���■�����■��■��■�����■�■ ■■■■■■■■�■■■■■�■■■■�t■��■ ■��■���■��■�■�����■��■��■ ■■■■�■���■�����■ ■����������■�■�■ ■■■■■■■■■��■�■�■ ■■■■■�■■■�[rL7�J■■■ ■■■■■��■��■����■ ■��������������■ ■■����������■��■ ■■�■ ■■■■ ■��■ ■■�■ ■��■ ■■�■ ■��■ ■��■ ■��■ ■■■�■ ■■��■ ■■■■�■■�■ ■■■■ ■■■■ ■■■■���■■■ ■�����■■�■ ■�■��■■��■ ■■■■�■■■ ■������■ ■�■��■■■ ■�■����■ ■�■����■ ■■■■■�■■ ■�■�■�■■ ■■�■■■■■ ■���■��■ ■������■ ■■■■�■■■ ■������■ ■■■�■■ ■■■���� ■������■ ■■■■■■■■ ■������■ ■■■■�■ ■�■■■■ ■■■■■■ ■���■■ ■■��■■ ■■��■■ ■���■■ ■■■■�■ ■����■ ■■■�■■�■ ■■�����■ ■�■■■■■■ ■■■■���■ ■��■���■ ■������■ ■■�■��■■ ■■■■■■■■ ■■■■��■■ ■�■��■�■ ■■■�■■�■ ■■ ■■ ■■ ■■ ■■ ■■ ■■ ■■ � ' ,�y ,., . ;�. � ; I ;� �avie County .�feaCt�i �epartment � and .�Come .�leaCth �'.gency �nvironmentaC.�L'eaCth Section P.O. BOX 848 / 21 O HOSPR,�,� STREEr COURIER #09-4-06 MOCKSVILLE, N.C. 27028 . • Pr+oNe: (704) 634-8760 April 21, 1997 Steve Whitaker 277 Williams Rd. Mocksville, HC 27028 N Re: Site Evaluation Williams Road/2 Acres Tax P�H: #5768-17=3288 m Dear Mr. Whitaker: As requested, a representative from this ofiice visited the aiorementioned site on April 11, 1997. Based upon the iniormation provided on the application ior a site evaluation and after the:evaluation was completed, the site was found to be provisionally suitable on the extreme left side ior the :%' installation of a modified, oversized on-site sewage disposal system. If you have any questions, please ieel free to contact thi� oifice. Sincerely, � I � � ' obert B. Hall, Jr. , R. S. Environmental Health Section RH/vd � Enclosure(s> 0 ,