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352 Baltimore Trails Lane Lot 5Davie County, NC Tax Parcel Report Wednesday, October 19, 2016 State: e IS1 • 77 `I It 2 1a .r 114- Zoning Overlay: DAVIE COUNTY QD rgart�rt LT111))'TT1:111r)TI 27006-0000 Parcel Number: G707OA0005 Township: Farmington IICPIN Number: 586034890 Municipality: 18.70 Account Number: 82527042 Census Tract: 37059-803 Listed Owner 1: KOHL RICHARD G Voting Precinct: WEST SHADY GROVE ;ailing Address 1: 352 BALTIMORE TRAILS LN Planning Jurisdiction: Davie County C's by: ADVANCE Zoning Class: DAVIE COUNTY R .A State: NC Zoning Overlay: DAVIE COUNTY QD Zip Code: 27006-0000 Voluntary big. District: No Legal Description: LOT 5 BALTIMORE TP.AILS Fire Response District: CORNATZER - DULIN Assessed Acreage: 18.70 Elementary School Zone: SHADY GROVE Deed Date: 1012006 Middle School Zone: WILLIAM ELLIS Deed Book I Page: 006820453 Soil Types: MrC2,SeB,MrB2,EnB,RnD,EnC,MsC,ChA,MsB Plat Book: 0008 Flood Zone: Plat Page: 278 Yfatershev Overlay: DAVIE COUNTY Build'ina Value: 638060.00 Guiiding & Ex Freatures Value: 266360.00 Land Value: 116200.00 Total Market Value: 1020620.00 Total Assessed Value: 1020620.00 � All data is provided as is without warranty or guarantee of any kind either expressed or implied including but not limned to the TT L.ia—Vic Ci unity, implied v;arra+sties of merchantability or fitness for a particular use- All users of Davie County's GIG wel:site shall hold harmless the County of Davie, North Carolina, its agents, consultants, contractors or employees from any and all claims or causes of action due to ��r L., or arising out of the use or inability to use the GIS data provided by this wcbsitc. Y DAVIE COUNTY HEALTH DEPARTMENT Environmental Health Section P. O. Boz 848/210 Hospital Street Mocksville, NC 27028 (336)751-8760 Account #: 990004149 Tax PIN/EH #: 5860-33-5745.05 Billed To: Roger Lawson Subdivision Info: Baltimore Trails Lot # 05 Reference Name: Location/Address: Baltimore Trails -27006 Proposed Facility: Residence Property Size: 18.6 acres ATC Number: 4532 AUTHORIZATION FOR WASTEWATER SYSTEM CONSTRUCTION **NOTE** This Authorization for Wastewater System Construction MUST BE ISSUED by the Davie County Environmental Health Section prior to issuance of any building permit(s). 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, Sectio e e t and Disposal Systems). THIS AUTHORIZATION FOR WASTEWATER T CTI V LID A PERIOD OF FIVE YEARS. Environmental Health Specialist's Signature: Date: to 06 i 0 CERTIFICATE OF COMPLETION **NOTE** The issuance of this Certificate of Completion shall indicate the system described on Improvement/Operation Permit 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. , be/ �O�I �,C��l eu`A I Septic System Installed By: Environmental Health Specialist's Signature: DCHD 05/99 (Revised) DAVIE COUNTY HEALTH DEPARTMENT Environmental Health Section P. O. Boz 848/210 Hospital Street P Mocksville, NC 27028 (336)751-8760 IMPROVEMENT/OPERATION PERMIT Account #: 990004149 Tax PIN/EH #: 5860-33-5745.05 Billed To: Roger Lawson Subdivision Info: Baltimore Trails Lot # 05 Reference Name: Location/Address: Baltimore Trails -27006 Proposed Facility: Residence Property Size: 18.6 acres ATC Number: 4532 **NOTE** This Improvement/Operation Permit DOES NOT authorize the construction 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). THIS PERMIT IS SUBJECT TO REVOCATION IF SITE PLANS OR THE INTENDED USE CHANGE. YOUR WASTEWATER SYSTEM CONTRACTOR MUST SEE THIS PERMIT BEFORE INSTALLING SYSTEM. Residential Specification: Building Type / #Peoples #Bedrooms #Baths `Pk Dishwasher: 2< Garbage Disposal: 711" Washing Machine: Basement w/Plumbing: ❑ Basement/No Plumbing: ❑ Commercial Specification: Facility Type 13/#People #People/Shift #Seats Industrial Waste: Lot Size L'' Type Water Supply Z06 Design Wastewater Flow (GPD) !Ce o! Site: New Repair ❑ pz System Specifications: Tank Siz/dDy GAL. Pump Tank GAL. Trench Width � Rock Depth. � Linear FtC1) As stat ;d in 15A NCAC 18A.3.969(;� l Other: a-ccerited Sv,ternc rinv mcn hm Required Site Modifications/Conditions: IMPROVEMENT/OPERATION PERMIT LAYOUT - APPROVED EFFLUENT FILTER. RISER(S) IF 6 " BELOW FINISHED GRADE. ****NOTICE: Contact a representative of the Davie County Health Department for final inspection of this system between 8:30 a.m. to 9:30 a.m. or 1:00 p.m. to 1:30 p.m. on the day of installation. Telephone # is (336)751-8760.**** Environ DCHD 05/99 (Revised) Date: /45 16', A41 Oct 23 06 04:22p APPLI1cA, I, .,o r:at'1t`d4AFA$ni�ii'For: 0 Site E davie county envhealth 336 751 8786 FOR SITE EVALUATIONAMPROVEMENT PERMIT & ATC Davie County Ilealth Department Environfnental Health LI ecdon A10 �P.O. Box 848/210 Hospital Street Mocksville, NC 27028 (336)751-8760/ Fax 6)7:;1-8786 tion/lmp Dement Permit Authcrizat.on To Construct(ATC) U Both "a*IMPORTANP' -- THIS APPLICKRON CANNOT BE PROCESSED MILESS ALL OF THE REQUIRED INFORMATION IS PROVIDED. Re rr to the INFORMATION BULLET.N for instructions. APPLICANT INFORMATION p.2 Zd-,4FaYd 3Yq -903 oR Name lobe Billed 6�o '�� _ Cortact Person 0411 1!z �-1 �r Billing Address _5 ,IQ, Hume Phone 33(n1-2,11-02PU City/State/ZIP Lexi n (�r� '7-1q5 BusinessPhone�� Name on Permit/ATC if Different &an Above Mailing Address _ PROPERTY INFORMATION NOTE: A survey plat or site plan must accompany this application. (Permit is v for 60 monthsf� ate p no expiration wit corrnletlt•�P) Street Address Alfimo r. S City (% Tax PIN# Subdivision Name }+ i M;,r e- n/Lot# Lot Size 19. (, Al re C Directions To Site: ��y �(D�,l� �4 A -+6,r I� — (1-�l l niil --hr�ql 1 :!a lob s Date House/Facility Comers•r'iaggr IUla(o In/a . If the answer to any of the following qu estions is "yes' , supporting g doctunen:adon must be attached. Are there any existing wastcw.,ter systems on the site? DYrs kNo Does the site contain jurisdictional wetlands? OYes'CNo Are there any easements or ri€ ht -of -ways on the site? DYc:s.RNo Is the site subject to approval ay another public agency? DYts.&'No Will wastewater other than domestic sewage be gcizeratcd? OY,:s ANO IF RESIDENCE FILL OUT TE! i BOX BELOW # People _�'i__ t/# Bedr_wms q 4 Bathrooms= Garden Tub/Whirlpool Wes mNo Basement: CIYes 4allo Basement Plumbing: []Yes „I�No IF NON -RESIDENCE FILL OUT THE BOX BELOW Type of Facility/Business _ Total Square Footage of Building_ # People # Sinks # Commodes # Showcrs _ # Urinals Estimated Water Usage (gallons per day) (Attach documentation of similar facility water consumption) FOODSERVICE ONLY: # Seats Type system requested: Wonventional DAccepted Olnnovative OAlutmative F]Other Water Supply Type: D County/City Water g New Well DEiisting Well O Community Well Do you anticipate additions or expansions of the facility this system is inter ded to serve? 0 Yes R No If yes, what type? _ _ This is to certify that the infomnation .irovided on this application is true ar d correct to the best of my knowledge. I understand that any permit(s) or ATC(s) issued Berea Ier are subject to suspension or revocation if the site is altered, the intended use changes, or if the information submitted in this application is falsified or changed. I understand that 1 am responsible for all charges incurred from this application. I hereby grant right of entry to the Authorized Reprsentative of the Davie County Health Dcpartment to conduct necessary inspections toAderrninc compliance with applicable laws and rules on the above described property located in Davie County and owned by Gi• �n h k---) Property o 's or owner's legal [e-,resentative signature /e 0 Dati Sign given OYes ONo Revised 2106 Site Revisit Charge Date(s):_ Client Notification Date: EHS:_ Account # Invoice # Davie County Environmental Health P.O. Box 848/210 Hospital Street Mocksville, NC 27028 (336)751-8760/ Fax (336)751-8786 IMPROVEMENT PERMIT Account #: 990004149 Tax PIN/EH #: 5860-33-5745.05 Barn Billed To: Roger Lawson Subdivision Info: Baltimore Trails Lot # 5 Address: 554 Pine Ridge Road Location/Address: Baltimore Road -27006 City: Lexington Property Size: Reference Name: Proposed Facility: Barn **NOTE**This Improvement Permit DOES NOT authorize the construction of a wastewater system. An Authorization To Construct a wastewater system must be obtained from this office prior to the construction/installation of a wastewater system or the issuance of a building permit(in compliance with Article 11 of G.S. Chapter 130A, Wastewater Systems). This Improvement Permit is subject to revocation if site plans, plat or the intended use change. Permit Type: E?1ew ❑Repair ❑Expansion Permit Valid for: R5Years ❑No Expiration Residential Specifications: # Bedrooms # Bathrooms 6.7 # People Basement❑ Basement plumbing❑ Non -Residential Specifications: Facility Type # People # Seats Square Footage(or Dimensions of Facility)—i4- Design acility)i4 Design Flow(GPD): Site Modifications/Permit Conditions: Type of Water Supply: ❑County/City ❑Well ❑Community Well As stated in 15A NCAC 18A.1969(5 accepted Systems may also be use System Type LTAR Initial �. Repair ret. y d 2 Environmental Health Specialist i.p. 11-06 Date 1-a 3—L� % DAVIE COUNTY HEALTH DEPARTMENT Environmental Health Section Soil/ Site Evaluation APPLICANT INFORMATION PROPERTY INFORMATION Account #: 990004149 Tax PIN/EH #: 5860-33-5745.05 Barn Billed To: Roger Lawson Subdivision Info: Baltimore Trails Lot # 5 Reference Name: Location/Address: Baltimore Road -27006 Proposed Facility: Barn Property Size: Date Evaluated: / — '�''a — Q Water Supply: Evaluation By: On -Site Well '� Community Auger Boring d'� Pit Public Cut FACTORS 1 2 3 4 5 6 7 Landscape position G L L Slope % L lr HORIZON I DEPTH r_ , Texture grow L L Consistence Structure 4L- Mineralo I l; rvt, /: ( G; HORIZON H DEPTH 91 —jig IT VI Texture group1 c. l_ Consistence 5fS Structure 5Sk Ciw Mineralogy HORIZON III DEPTH Texture group Consistence Structure Mineralogy HORIZON IV DEPTH Texture group Consistence Structure Mineralogy SOIL WETNESS RESTRICTIVE HORIZON SAPROLITE CLASSIFICATION 2 L. LONG-TERM ACCEPTANCE TE SITE CLASSIFICATION:�d r1 r . cap+ /i s c� • 7m� l -f LONG-TERM ACCEPTANCE RATE: �- REMARKS: LEGEND EVALUATION BY: �C n!>e/(1 �ukt S OTHER(S) PRESENT: 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 u. VFR - Very friable FR - Friable FI - Firm VFI - Very firm EFI - Extremely firm 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 1`io>t� 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 DCHD 05105 (Revised) ■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■ MENNENiiiiiiMENNENiiiiiiMENNEN i ■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■ ■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■ ■■■■/■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■/■■■■■■■■■■■■■■■■■■■■■■■■■■■. ■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■ ■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■ ■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■ ■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■ ■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■ ■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■ ■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■ ■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■ ■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■ ■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■ ■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■ ■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■ DAVIE COUNTY HEALTH DEPARTMENT Environmental Health Section • P. 0. Boz 848/210 Hospital Street ` Mocksville, NC 27028 Z�J4 (336)751-8760 lf' IMPROVEMENT/OPERATION PERMIT Account #: 990004149 Tax PIN/EH #: 5860-33-5745.05 Billed To: Roger Lawson . Subdivision Info: Baltimore Trails Lot # 05 Reference Name: Location/Address: Baltimore Trails -27006 Proposed Facility: Residence- Property Size: 18.6 acres ATC Number: 4532 **NOTE** This Improvement/Operation Permit DOES NOT authorize the construction 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). THIS PERMIT IS SUBJECT TO REVOCATION IF SITE PLANS OR THE INTENDED USE CHANGE. YOUR WASTEWATER SYSTEM CONTRACTOR MUST SEE THIS PERMIT BEFORE INSTALLING SYSTEM. Residential Specification: Building Type ` #People �_ #Bedrooms #Baths Dishwasher: 2< Garbage Disposal: Washing Machine: lr1 Basement w/Plumbing: Basement/No Plumbing: El Commercial Specification: Facility Type #People #People/Shift /#Seats Industrial Waste: Lot Size Type Water Supply I�` Design Wastewater Flow (GPD).. fa Site: New Repair El System Specifications: Tank Siz/400 GAL. Pump Tank GAL. Trench Width 0 �Rock Depth./(>z Linear Ftyw� As stated ii) 15A NCAC 1BA.:inc� ) 1` Other: acceLited Svsterns n,av nit -.n nn ite- Required Site Modifications/Conditions: .=, � 2 d -9�� 4 // A, 1/�e IMPROVEMENT/OPERATION PERMIT LAYOUT - APPROVED EFFLUENT FILTER RISERS) IF 6 " BELOW FINISHED GRADE. ****NOTICE: Contact a representative of the Davie County Health Department for final inspection of this system be V.30 a.m. to 9:30 a.m. or 1:00 p.m. to 1:30 p.m. on the day of installation. Telephone # is (336)751-8760.**** Coe liw t� sr r Environmental Health Specialists Signature: Date. 1phj f DCHD 05/99 (Revised) 690.3E 550. �9 a 0 �e H 04`4§10' E y't1 yY 2-1.46 _ 1 � f DEC 2 7 200 bfdVlROII�EAl EVALUATION/IMPROVEMENT PERMIT & ATC Davie County Environmental Health P.O. Box 848/210 Hospital Street Mocksville, NC 27028 (336)751-8760/ Fax (336)751-8786 a uation/Improvement Permit ❑ Authorization To Construct(ATC) oth ❑New System ❑Repair to Existing System ❑Expansion/Modification of Existing System or Facility ***IMPORTANT*** THIS APPLICATION CANNOT BE PROCESSED UNLESS ALL OF THE REQUIRED INFORMATION IS PROVIDED. Refer to the INFORMATION BULLETIN for instructions. APPLICANT INFORMATION Name to be Billed Contact Person�1 Billing Address Are-, Adie, 0, Home Phone S --%'o Z7,0 City/State/ZIP Lhbiq i0ki272 S Business Phone M 7-114-39 75 Name on Permit/ATC if Different than Above �jty7�i Mailing Address City/State/Zip PROPERTY INFORMATION *Date House/Facility Corners Flagged /dV�29JO& NOTE: A survey plat or site plan must accompany this application. Included: Nolite Plan ❑Plat(to scale) (Permit is valid for 60 months with site plan, no expiration with complete plat.) Owner's Name Phone Number Owner's Address �. lqW, _ City/State/Zip Property Address City I/ Lot Size R, le AAo-� , Tax PIN# 0'; - ' 51 4Y.0S ,q/ - Subdivision Name(if applical Directions To Site: 1941 E Section/Lot# ' / / /W-1 V V u the answer to any of the following questions is "yes", supporting docur&ntation must be attached. Are there any existing wastewater systems on the site? ❑Yes ❑No Does the site contain jurisdictional wetlands? ❑Yes ❑No Are there any easements or right-of-ways on the site? ❑Yes ❑No Is the site subject to approval by another public agency? ❑Yes ❑No Will wastewater other than domestic sewage be generated? ❑Yes ❑No IF RESIDENCE FILL OUT THE BOX BELOW # People # Bedrooms # Bathrooms Garden Tub/Whirlpool ❑Yes ❑No Basement: ❑Yes ❑No Basement Plumbing: ❑Yes ❑No IF NON -RESIDENCE FILL OUT THE BOX BELOW Type of FacilityBusiness�i✓ Total Square Footage of Building L5& 6il P # People # Sinks �_ # Commodes �_ # Showers # Urinals Estimated Water Usage (gallons per day) (Attach documentation of similar facility water consumption) FOODSERVICE ONLY: # Seats //Z kd& Type system requested;, 2 onventional ❑Accepted ❑Innovative ❑Alternative ❑Other Water Supply Type: ❑ County/City Water J�Wew Well ❑Existing Well ❑ Community Well Do you anticipate additions or expansions of the facility this system is intended to serve? ❑ Yes ❑ No If yes, what type? This is to certify that the information provided on this application is true and correct to the best of my knowledge. I understand that any permit(s) or ATC(s) issued hereafter are subject to suspension or revocation if the site is altered, the intended use changes, or if the information submitted in this application is falsified or changed. I hereby grant right of entry to the Authorized Representative of the Davie County Health Department to conduct necessary inspections to determine compliance with applicable laws and rules. I understand tha responsible for the proper identification and labeling of property lines and corners and locating and flagging or staking theJ}ouse/ cilialocation, proposed wgll location and the location of any other amenities. �� Site Revisit Charge y oners r ovum ' 1 epresentative signature rtw Date(s): 12, L7 6 Client Notification Date: Date EHS: Account # t� Sign given ❑Yes ❑No Revised 11/06 Invoice # Jul eu ub ue:uup davie county envhealth 336 751 8786 p.3 All No < -.:;� .. ,t v t J , f . 1 62 OSS �l 3E'D69 i.OE,6t.'�• .• DAVIE COUNTY ENVIRONMENTAL HEALTH P.O. Box 848/210 Hospital Street Mocksville, NC 27028 (336)751-8760 Fax # (336)751-8786 AUTHORIZATION FOR WASTEWATER SYSTEM CONSTRUCTION Account #: 990004149 Billed To: Roger Lawson Reference Name: Proposed Facility: Barn ATC Number: 4576 Tax PIN/EH #: 5860-33-5745.05 Barn Subdivision Info: Baltimore Trails Lot # 5 Location/Address: Baltimore Road -27006 Property Size: **NOTE** This Authorization to Construct (ATC) MUST BE ISSUED by the Davie County Environmental Health Section prior to issuance of any building permit(s), (in compliance with Article 11 of G. S. Chapter 130A Wastewater Systems, Section .1900 Sewage Treatment and Disposal Systems). THIS AUTHORIZATION TO CONSTRUCT IS VALID FOR A PERIOD FIVE YEARS. This ATC is subject to revocation if site plans, plat or the intended use change. Residential Specification: Building Type �� #People #Bedrooms ¢ #Bathsd. Basement w/Plumbing: _ Basement/No Plumbing _ Commercial Specification: Facility Type #People #People/ShiR #Seats Lot Size t C .4 4' Type Water Supply `" Design Wastewater Flow (GPD) 25-- Site: New Repair System Specifications: Tank Size I-" GAL. Pump Tank T GAL. Trench Width 3b "Trench Trench Depth 3 4 -'^—e Rock Depth Linear Ft. 1 o o 7, 4 " 04 '.It Other: As stat -:d in 25;-N NC^,C !SA.J960(5) Required Site Modifications/Conditions:— ircceptect 5y�tr »� nl v ,if- ti-, uspdd Contact the Davie County Environmental Health Section for final inspection of this system between 8:30 — 9:30a.m. on the day of installation. Telephone # (336)751-8760. DCHD 11/06 (Revised) S Account #: 990004149 Billed To: Roger Lawson Reference Name: Proposed Facility: Barn ATC Number: 4576 DAVIE COUNTY ENVIRONNIENTAL HEALTH P.O. Box 848/210 Hospital Street Mocksville, NC 27028 (336)751-8760 Fax # (336)751-8786 OPERATION PERMIT Tax PIN/EH #: 5860-33-5745.05 Barn Subdivision Info: Baltimore Trails Lot # 5 Location/Address: Baltimore Road -27006 Property Size: **NOTE** The issuance of this Operation Permit shall indicate the system described on the ATC 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. System Type: S.T. Manufacturer Tank Date Tank Size Pump Tank Size System Installed By: DCHD 11/06 (Revised) E.H. Specialist: Date: