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774-776 Williams RdDavie Countv, NC � Tax Parr.el R ennrt Tuesdav, October 11, 2016 Parcel Number: NCPIN Number: Account Number: Listed Owner 1: Mailing Address 1: City: State: Zip Code: Legal Description: Assessed Acreage: Deed Date: Deed Book / Page: Plat Book: Plat Page: Building Value: WAK1VllVCT: '1'tll� l� iVU'1� A �UKVr:Y Parcel Information 1700000032 Township: 5768667498 Municipality: 79819190 Census Tract: VVILLIAMS TINA ELAINE Voting Precinct: 774 WILLIAMS RD Planning Jurisdiction: ADVANCE Land Value: Total Assessed Value: Zoning Class: Fulton 37059-804 FULTON Davie County DAVIE COUNTY R-A NC 2oning Overlay: 27006 Voluntary Ag. District: No 19.58 AC WILLIAMS RD Fire Response District: FORK 18.52 Elementary School Zone: CORNATZER 9"�`� Davie County, °o��,�� NC 5/1996 Middle School Zone: WILLIAM ELLIS 001870556 Soil Types: GnB2,GnC2,EnB,MsD Flood Zone: Watershed Overlay: 160660.00 Outbuilding � Extra Freatures Value: 156430.00 Total Market Value: 323410.00 DAVIE COUNTY 6320.00 323410.00 , __. . ,.. . , , , _ _ ; - ' � ,;' aU�rxoRizATiorr rro:; O 5 4 3 DAVIE COUNTY HEALTH DEPARTMENT � � �.` Environmental Health Section PROPERTY INFORMATION Permittee�,..., , P.O. Box 848 Name: .�i.�7 �f/.��;��yL�" Mocksville, NC 27028 Subdivision Name: � " ` Phone #:704-634-8760 Directions to property: ��i�i ��`"�� Section: Lot: AUTHORIZATION FOR WASTEWATER Tax Office PIN:# �'7�� _��_ 7�9� SYSTEM CONSTRUCTION � Road Name: 1 �II�� •Zip: � 7�b14� **NOTE** This Authorization for Wastewatei 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 Pemuts. " (In compliance with Article 11 of G.S. Chapter 130A, Wastewater Systems, Section .1900 Sewage Treatment and Disposal Systems) lj,s.J %/ J w �_f �� ***NOTICE*** THIS AUTHORIZATION FOR WASTEWATER CONSTRUCTION �,ti" i� _��'-, �, �i /.�'.' ��f IS VALID FOR A PERIOD OF FIVE YEARS. ENVIRONMENTAL HEAL��SPECIALIST DATE ISSUED _;. fl. � , , ., „ ,� � .� � tz . . „ . � r,. . , . . . . � , , _ . , - . . � ' . . '4�i...�i " ' ' �' � DAVIE COUNTY HEALTH DEPARTMENT w � a �,,��,��` . � __,. �r •� ':_:�-: R' '� IMPROVEMENT AND OPERATION PERMITS PROPERTY INFORMATION Perrfii t e's::-» . - Name: .�r .F �"'%., r"� � ,-�� Subdivision Name: ' , Dire`ctions to property: Y'"�i �`%f+.f1.� = -`.� Section: Lot: - .. IlVIPROVEMENT �' _ rI Id' . _ . PE�T Tax Office PIN:# �� _ � �0 _ Road Name: / � � 1 � %O6 (O "d.z�p: � � **NOT'E** This Improvement Permit DOFS NOT authorize the construction or installation of a septic tank system or any wastewater system. An AiTTHORIZATION FOR WASTEWATER SYSTEM CONSTRUCITON must be obtained from this Department prior to the construction/installation of a system or the issuance of a building pernut. (In compliance with Article 11 of G.S. Chapter 130A, Wastewater Systems, Section .1900 Sewage Treatment and Disposal Systems) ,',, ;.- , f.. ***NOTICE*** THLS PERMIT IS SUBJECT TO REVOCATION IF STTE ,t' , �.i. g ,:'�, .r'' r ��` , • .. ., ,�- �:;'; PLANS OR THE IlVTENDED USE CHANGE. YOUR WASTEWATER ENVIRONMENTAL HEALTfi SPECIALIST DATE ISSUED SYSTEM CONTRACTOR MUST SEE THIS PERMIT BEFORE INSTALLING THE SYSTEM. RESIDENTIAL SPECIFICATION: BUILDING TYPE �# BEDROOMS � # BATHS -'��'�." # OCCUPANTS _s� GARBAGE DISPOSAL: Yes or No COMMERCIAL SPECIFICATION: FACILITY TYPE # PEOPLE # PEOPLFJSHIFT # SEATS INDUSTRIAL WASTE: Yes or No LOT SIZE �� TYPE WATER SUPPLY .�% DESIGN WASTEWATER FLOW (GPD) �� NEW SITE l� REPAIR STI'E �� .. SYSTEM SPECIFICATIONS: TANK SIZE�GAL. PUMP TANK GAL. TRENCH WIDTH �-• ROCK DEPTH � LINEAR FT. ��n� OTHER r'>-� 4'�J -�Ji/Xf`'+� �1/i /� ,�%��( : / l-Lj,`. REQUIRED SITE MODIFICATIONS/CONDITIONS: IMPROVEMENT PERMIT LAYOUT ��,,,�..�..-.� /",�,.,.,_.,,r. / .�'''� ..-�-.^.... � ' **CONTACT A REPRESENTATIVE OF THE DAVIE COUNTY HEALTH DEPARTMENT FOR FINAL INSPECTION OF THIS SYSTEM BETWEEN 8:30 - 930 A.M. OR 1:00 - 1:30 P.M. ON THE DAY OF INSTALLATION. TELEPHONE # IS (704) 634-8760. OPERATION PERMIT SYSTEM INSTALLED BY: __ � �'5�� W� � � AUTHORIZATION NO.O � �3 OPERATION PERMIT BY: � • � DATE: _ � \ `� r �� **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 OSN6 (Revised) • , , � , � APPLICATION FOR SITE EVALUATION/IMPROVEMENTS PERM : �� R O M R Davie County Health Department � f5 U t5 Environmentai Health Section P. o. BoX sss OCT — 4 19� Mocksville, NC 27028 1. Application/Permit Requested By �i na F y�; i �; a S � +s��,�;_'' �#� MailingAddress 706 Williams Road HomePhone 998-2751 Advance, NC 27006 BusinessPhone 998-4280 2. Name on Permit if Different than Above 3. Application for: �] General Evaluation � Septic Tank Installation Permit 4. System to Serve: ❑ House ❑ Business ❑ Industry 5. If house, mobile home: Subdivision No. of People 1 No. of Bedrooms � No. of Bathrooms �_ �] Mobile Home ❑ Place of Public Assembly ❑ Other ❑ Unknown Dwelling Dimensions 1 2�-1 4! x h ��—�3 �� 6. If business, industry, piace of public assembly, other: Specify type No. of People Served No. of Sinks No. of Commodes No. of Urinals Section Lot # ❑ BasemenUPlumbing ❑ BasemenUNo Plumbing � Washing Machine � Dishwasher ❑ Garbage Disposal No. of Lavatories No. of Water Coolers No. of Showers Water Usage Figures 7. Type of water supply: ❑ Public � Private 8. Property Dimensions 19 Acres Sewage Disposal Contractor 9. Do you anticipate additions/expansion of the facility this sytem is intended to serve? ❑ Yes If yes, what type? L� No ❑ Community 'NOTE: Improvements Permits shall be vali irom date issued. Improvements Permits are subject to revocation, if site plans or the intended use change. Effective October 1, 1989. Directions to Property: �'7y E, � L T. Oh� %1�oC! c E� k�. � �`��• G7n1 �) � ��► ar��s �c�� i-A�ci G��rox. /DO�/ds. �ron, ��- ��v.st v�.� �''� C� t' i �e1�ct Y � /' 9 Tax Of f i ce 1'ZN: #�%�, g'- �. �� ' �y� g PROPEItTy AbbIZESS, as follows: Road Name: (.,J 111 � (;y�/�5 �a , �Lt;,: Aa��ti c e, SU$MZT A PLtLT WZTH THZS ttPPLZC�tTZON. Revisions effect�ive October 1� 1995. � .. �.r ;.-. This is to certify that the information provided is correct to the best of my knowledge, and I understand I am responsible for all charges incurred from this application. Q�.. 3 I� I 9 9(� v� c�. G�v�-� DATE SIGNATURE CONSENT FOR SITE EVALUATION TO BE DONE ON ABOVE DESCRIBED PROPERTY MUST CHECK ONE: [$ 1. I OWN the property. ❑ 2. I Dp 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 suitability for a ground absorption sewage treatment and disposal system. DATE DCHD (1/93) SIGNATURE � � 1 _ . . . . • � . . ' ! / �'�' � IN�7�ams Road - S.'R.1610 — , - 5 B ,¢a�^'i co' xiw SO'SJ"� y-,.. �y` �3 w . � N 12• 03' 41' E � srti wr, t.[ � N 05�6�868�� - � . . � . . / —�- _ � �� J, iW� il i K . . . q . . , t [rw�s�w..w �— v iJ'3'�¢'j�-� _- i. ..wow«r - o� � `e Vicir�ty Map �.�'� 6 . � '-�a....� 8 'ta/�� s9 �S�•�6'W^E , o �ti� �o. ` •� , �� ` e- - � b / / � ' . �` g~ Riehord W. Willlame • �\ of D. B. 9I, Pg. I94 w� �� B B o ^0 \ �y 4. , n'. N N �p^ � • N� \ �� _/ � . . •— � BMIICA ��T� a J�J��i � � �� a � , • \ �q °o �.,�.,, �" .� — 19.587 Acres °�°�,�,� ' ; - / �,....�� , . m � . �, I� 4� ��_ � � __"____.�...d �....._..._._�....�.r. �....-�. . �. -,..- ...�.- -_ � c � o� �./^� � � � � . - \\\ m'ao� y ry I i' \ 3N . � � F�by. tm i°'^^ O � �qp , _ � � �` /�R R ; IeIi1 �1 Wi�lr�nM R� ' O N 27'30•p�_ EJ.�� "�. o . �� Y n �� 23).)6' . � „� • .. � N BI' 11' 10` N. � �'. \ I M� . Leila 8 �y � 99l)7• D. B. 69, P9. 54 �— " e+' zr se• w 4 I Sodie C Bur}on s�,,,, y� --- Survey For: D. B: 64, Py. 342 �. �.�. �.,.., I . � � � Dorothy M Wiliiams Jamee H. Bames ' D. 8.135, Ag, 794 , Fulton Tw�p, Davfe Co., N. C. ' - Tltle souru - D. B. 48, Py. 373 Survayed November IBIh, 1992 Tax Map Raf�rence - I-7, Porcel 32 . . s�a. - i~ = ioo• i, MARTY 5. CLINE, Re nlered Lond Surve or, hereb ceitif tAat r°��a�:1�'Mt •' 9 >Y Y Y �,: . .-. ;..��J'.; this plal wes Mown by me irom cn adual s�urvey mada Ey m� wiih � r�P`� '4�•!; ••t :` ' o pmciafon rclio ot 110.000.. I },f :,; # v 8�2-s , WHneae my hond and seal this INh doy ot � ecember,1992. '' �'.�:. "�.��f � ' • 1 /, �y,,.,.;;��„�_ � , t Cline & Associates ,,��,,�� , - ' � • ' ' ' DAVIE COUNTY HEALTH DEPARTMENT _ � Environmental Health Section SECTION LOT SoiUSite Evaluation APPLICANT'S NAME Tina E. Wi 11 iams DATE EVALUATED �L -'/{ �j.j PROPOSED FACILITY Mobi le Home PROPERTY SIZE 19.587 flcres SUBDIVISION ROAD NAME Wi 11 iams Rd. /5768-66-7498 vance Water Supply: On-Site Well t�� Community Evaluation By: Auger Boring ��/ Pit Public Cut _ HORIZON I DEPTH Texture group Consistence Structure 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 LONG-TERM ACCEPTAr SITE CLASSIFICATION: LONG-TERM ACCEPTANCE RATE: •� OTHER(S) PRESENT: ' ' ' �r/%"L�iz_�lr'////:�1� DCHD (01-90) Landscane 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 Wet NS - Non sticky NP - Non plastic FR - Friable FI - Firm VFI - Very firm EFI - Extremely frm SS - Slightly sticky S- Sticky VS - Very Sticky 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 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 - gallday/ft2 ■■■ ■■■��■ ■■■■■�■ ■■■�■■■ ■■■■■�■ ■■■�■�■ ■■■■■�■ ■■■■■�■ ■■■■■�■ ■■�■��■ ■■■■■■■ ■■��■ ■��■ ■■■■■■■ ■■�■��■ ■■■■�■■ ■��■��■ ■��■ ■■�■��■ ■��■ ■■�■��■ ■■��■ ■■�■■■■ ■■�■��■ ■��■ ■■�■��■ ■■�■��■ ■��■��■■ ■��■�■■■ ■��■■■■■ *■��■■ i��■■ ■��■■■■■ ■��■■ ■��■■■■ ■■�■■■■■ ■�■�■■■ ■��■ ■��■ ■��■ ■��■■ ■��■ ■��■ ■��■ ■��■ ■■��■ ■��■ ■��■ ■��■ ■■■�■ ■�■�■ ■��■ ■�■ ■�■��■ ■�■��■ ■�■�■■ ■��■■ ■■■■■■ ■��■ ■■�■■■ ■��■ ■■�■■■ i��■�■ ■��■�■ ■■■■■■ ■��■�■ ■��■�■ ■��■�■ ■��■�■ ■��■ ■��■■ ■�■�■�■ ■■■■■■■ ■��■ ■■■■■■■ ■��■ ■■■■■■■ ■■■■�■■ ■■■■■■■ ■�■■�■■ ■■■■■■■ ■��■■ ■��■�■ ■��■�■■ ■��■ ■■■■■■■ ■�■�■■■ ■■■■■■■ ■■��■■■ ■��■■■