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161 Eric Road Lot 15Dav A16 qpm rAAll data is provided as b wlgmut wnrandy or guarantee of any kind eltherexpressed or Implied Including but not limited to to Davie County, impnedwimn es0merchantabilmarmmparticularism. m ecouyaGlswebsueshallholdbarmlesathe County of Gavlq North Carolina, Its agent. consultants, contractors oremployees from any and ag Balms or causes of action duct to n�UN24 NC ormsing out ofthe use or inabggylo use the GIS data provided by this webslta WARNING: THIS IS NOT A SURVEY ParcelInformat>on,_ Parcel Number: J609DA0008 Township: Mocksville NCPIN Number: 5757284829 Municipality: Account Number: 82514409 Census Tract: 37059-807 Listed Owner 1: HOOVER ERWIN LEE JR Voting Precinct: SOUTH MOCKSVILLE Mailing Address 1: 161 ERIC ROAD Planning Jurisdiction: Davie County City: MOCKSVILLE Zoning Class: DAVIE COUNTY R -A State: NC Zoning Overlay: Zip Code: 27028-0000 Voluntary Ag. District: No Legal Description: LOT 15 DALTON ACRES Fire Response District: FORK Assessed Acreage: 0.48 Elementary School Zone: CORNATZER Deed Date: 212000 Middle School Zone: WILLIAM ELLIS Deed Book 1 Page: 003250356 Soil Types: RnD,MsD Plat Book: 0004 Flood Zone: Plat Page: 099 Watershed Overlay: DAVIE COUNTY Outbuilding & Extra Building Value: Freatures Value: Land Value: Total Market Value: Total Assessed Value: qpm rAAll data is provided as b wlgmut wnrandy or guarantee of any kind eltherexpressed or Implied Including but not limited to to Davie County, impnedwimn es0merchantabilmarmmparticularism. m ecouyaGlswebsueshallholdbarmlesathe County of Gavlq North Carolina, Its agent. consultants, contractors oremployees from any and ag Balms or causes of action duct to n�UN24 NC ormsing out ofthe use or inabggylo use the GIS data provided by this webslta DAVIE COUNTY HEALTH DEPARTMENT /ao( Environmental Health Section _ • P. O. Box 848/210 Hospital Street Mocksville, NC 27028 (336)751-8760 IMPROVEMENT/OPERATION PERMIT Account #: 990001088 Tax PIN/EH #: 5757-28-4829 Billed To: Ervin Hoover Subdivision Info: Dalton Acres Lot # 15 Reference Name: Ervin Hoover, Jr. Location/Address: Eric Road -27028 Proposed Facility: Residence Property Size: 80'x11Vx200' * *NOTEC * Thisgprovem UOperation 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 UNTENDED USE CHANGE. YOUR WASTEWATER SYSTEM CONTRACTOR MUST SEE THIS PERMIT BEFORE INSTALLING SYSTEM. Residential Specification: Building Type O #People —/— #Bedrooms _k1? #Baths a_ Dishwasher: 13 Garbage Disposal: ❑ Washing Machine: 9?' Basement w/Plumbing: 13 Basement/No Plumbing: 13 Commercial Specification: Facility Type #People #People/Shift #Seats Industrial Waste: Lot Size A� Type Water SupplybL/— Design Wastewater Flow (GPD) ,If Site: New ®�epair ❑ System Specifications: Tank Size GAL. Pump Tank _GAL. Trench Width Rock Depthr Linear F�=3� Other: Required Site Modifications/Conditions: d //o�p,� 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.**** k7; ad W - 0�wr- Health Specialist's Signature: DCHD 05/99 (Revised) SI —75' Date: DAVIE COUNTY HEALTH DEPARTMENT Environmental Health Section P. O. Boa 848/210 Hospital Street Mocksville, NC 27028 (336)751-8760 Account M 990001088 Billed To: Ervin Hoover Reference Name: Ervin Hoover, Jr. mupuseu rauuty: mesiaence ATC Number. 2406 Tax PIN/EH M 5757-28-4829 Subdivision Info: Dalton Acres Lot # 15 Location/Address: Eric Road -27028 size: tsu'xilu,xzuu 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 permit(s) (in compliance with Article 11 of G.S. Chapter 130A, Wastewater Systems, Section .1900 Sewage Treatment and Disposal Systems). THIS AUTHORIZATION FOR WASTEWATER CONSTRUCTION IS VALID FOR A PERIOD OF FIVE YEARS. Environmental Health Specialist's Signature: CERTIFICATE OF COMPLETION Date: J`r of **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 fimction satisfactorily for any given period of time. 5 . BA&I Ant 6r - , Rif � t W—=S tic System Installed By. r ✓ �� Environmental Health Specialist's Signature: DCHD 05/99 (Revised) APPLICATION FOR SITE EVALUATION/IMPROVEMENT PERMIT & A uUE LSty N U l9 Davie County Health Department �IJllul EnvironmentalHealth Secdon R 5 2�0� P.O. Box 848/210 Hospital Street ��qqNNppL �0�0p0�, Mockaville, NC 27028 ENVII%AVIEECOTIlpfii (336) 751-8760 * MRMATIONis THIS APPLICATION CANNOT BE PROCESSED UNLESS ALL TRE REQUIRED INFORMATION IS (PR^^OVIDED. Refer to the INFORMATION BULLETIN for instructions. 1. Wass to be Billed U.f?.VL'%- VZ J e Wailing Address 354' ,rj Contest Person4Wi.ti.bU{.C, j2� "- 1I _ S_Q �4 `? t'3 - City/state/22P �QCSy t41 "(v Bose Phone a'. 3q �„)n� 2. Wase on Permit/ATC if Different than Above Business Phone Mailing Address wl�3. Application For: ❑ Site Evaluation 4. System to Harvie,: ❑ House [W Mobile Home 5. If Residence: 11 Dishwasher City/state/Zip ❑ Improvement Permit/ATC ❑ Business ❑ Industry ❑ Other 940-0 h I People I M Bedrooms i Sathroeme % it Garbage Disposal KWaehing Machine 6. If Business/Industry/Other: specify type Commodes # Showers IF FOODSERVICE: # Seats 7. Type of Water Supply: II Basement/Plumbing 11 Basement/Wo Plumbing Y People t Sinks I'Urinale i Water Coolers Estimated Water Usage (gallons par day) ❑ County/City Well e. Do you anticipate additions or expansions of the facility this system is intended to serve? If yes, what type? ❑ Community ❑ Yes X No ***1JfPORTANT*** CLIENTS MUSTCOMPLETE THE REQUIRED PROPERTY INFORMATION REQUESTED BELOW. Either a PLAT or SITE PLAN MUST BE SUBMITTED by the sliest with THIS APPLICATION Property Dimensions:_D �d X `� / X 20 Qw� WRITE DIRECTIONS (from Mocksville) to PROPERTY: r p� ✓ Tax Office PIN: Property Address: RoadName q 17 1 C �CQ�o It�1� D . Q� City/Zip I 'w S� (��� t�1 . V o\' If is a Subdivision Provide information, as follows: Name: !✓nfieMoI7 / G/er j - Section: Block: Lot: ZJ— ✓Date Property Flagged: . d. S— OCi P This is to certify that the information provided is correct to the best of my knowledge. I understand that any permit submitted in this application is falsified or changed. 1, also, understand that (,) issued hereafter are subject to suspension or revocation, if the site plans or Intended use change, or if the information re this application. I, hereby, give consent to the Authorized Representative of I am sponsible jor al/charges Incurred from the Davie County Health Department to enter upon above described property located in Davie County and owned by _r(L3 lin, to conduct all testing procedures as necessary to determine the site suitability. DATEJP�ji-(i60 SIGNATURE q, - i my THIS AREA MAY BE USED FOR DRAWING YOUR SITE.PLAN (include all of the following: Existing and proposed property lines and dimensions, structures, setbacks, and septic locations). Site Revisit Charge Date(s): Client Notification Date: EHS• Revised DCHD (07/99) Account No., (/ fJ p Invoice No. " DAVIE COUNTY HEALTH DEPARTMENT n Environmental Health Section Soil/Site Evaluation APPLICANT INFORMATION PROPERTY INFORMATION Account #. 9900010 #: 88 Tax PIN/EH 5757-28-4829 Ervin H J Billed To: Hoover Subdivision Info: Dalton Acres Lot # 15 ; Reference Name: Ervin Hoover Jr Location/Address: Eric Road-27028 . Proposed Facility: Residence Property Size: 80'x119x20V Date Evaluated: Water Supply: t e ell Community Public Evaluation. , , .., By: uger Boring Pit Cut FACTORS 1 2i 3 4 5.. 6 7 Landscape position - Slo e % . o i HORIZON I DEPTH-49 Texture group Consistence SS S Structure .. _.. . Mineralogy HORIZON H DEPTH ID-_ — O Texture group -. Consistence Structure I- Mineralogy HORIZON IH DEPTH Texture groupSA Sg Consistence Structure Mineralogy. HORIZON IV DEPTH bb¢ . Texture group Consistence Structure 412 Mineralogy SOIL WETNESS .i RESTRICTIVE HORIZON SAPROLITE CLASSIFICATION ' LONG-TERM ACCEPTANCE RATE SITE C P LASSIFICATION:� � - EVALUATIONBY:, _ LONG-TERM ACCEPTANCE RATE: �%OTHER(S) PRESSENT: �% /� �� REMARKS. ss a'!��(` p w2y C c�ct/nfi ( ©! `G�. 11 eF11C: 71 1&4 Landscape Position R - Ridge S - Shoulder - ` L =Linear slope FS - Foot slope N - Nose slope H -Head slope .. CC = Concave slope. '. CV -Convex slope, T = Terrace FP -Flood plain " 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 _.Moist _ CONSISTENCE VFR - Very friable. FR -Friable TFI _ Firm ' VFI Veryfirm 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 Structur 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 DCHD 05/99 (Revised) OEM 05/24/2000 , 20:44 7046575859 - UPRIGHT GRADING & SE PAGE 02 STATEMENT . OWN 4LR HGOVLR DALTON ACRLS IAT IS MOCXSVILL&NC May 22,2(XM DAVIE COVNT'Y }IEALTH DEPARTMENT To whom it may epncern: - . I Ervin Hoover undcrsunA rbat the piny liswd above hu ban chankrd to a Chamber SYsfdn `-ftvinL i Z0 39tld b0b906966L " ZE:9I 008ZlZVGO