1133 Junction Rd, 139 Grant Trl Lot 1Davie County NC
Tax PnrrPl R Pnnrt
Tuesday, January 3. 2017
Zip Code: 27014-0000 Voluntary Ag. District:
Legal Description: LOT 1 GRANT HEIGHTS Fire Response District:
Assessed Acreage:
Deed Date:
Deed Book / Page:
Plat Book:
Plat Page:
Building Value:
Land Value:
Total Assessed Value:
1.65 Elementary School Zone:
12/2013 Middle School Zone:
009450493 Soil Types:
10 Flood Zone:
371 Watershed Overlay:
Outbuilding & Extra
Freatures Value:
Total Market Value:
COOLEEMEE
COOLEEMEE
SOUTH DAVIE
GnB2
DAVIE COUNTY
No
l 9A/1 1 All data is provided as Is without warranty or guarantee of any Idnd either expressed or Implied Including but not limited to the
[- i Davie County, implied warranties of merchantability or fitness for a particular use. All users of Davie County's GIS websfte shall hold harmless the
�T�v County of Davie, North Carolina, its agents, consultants, contractors or employees from any and all claims or causes of action due to +
I �obN t� 1� C or arising out of the use or Inability to use the GIS data provided by this webshe.
WARMING: '1'H1S 1S ALIT A SURVEY
Parcel Information
Parcel Number:
M401OA0001
Township:
Mocksville
NCPIN Number:
5726828083
Municipality:
Account Number:
82516538
Census Tract:
37059-801
Listed Owner 1: SPILLMAN ROGER P
Voting Precinct:
SOUTH CALAHALN
Mailing Address 1:
PO BOX 738
Planning Jurisdiction:
Davie County
City: COOLEEMEE
Zoning Class:
DAVIE COUNTY R-A,R-20
State:
NC
Zoning Overlay:
DAVIE COUNTY CZOD
Zip Code: 27014-0000 Voluntary Ag. District:
Legal Description: LOT 1 GRANT HEIGHTS Fire Response District:
Assessed Acreage:
Deed Date:
Deed Book / Page:
Plat Book:
Plat Page:
Building Value:
Land Value:
Total Assessed Value:
1.65 Elementary School Zone:
12/2013 Middle School Zone:
009450493 Soil Types:
10 Flood Zone:
371 Watershed Overlay:
Outbuilding & Extra
Freatures Value:
Total Market Value:
COOLEEMEE
COOLEEMEE
SOUTH DAVIE
GnB2
DAVIE COUNTY
No
l 9A/1 1 All data is provided as Is without warranty or guarantee of any Idnd either expressed or Implied Including but not limited to the
[- i Davie County, implied warranties of merchantability or fitness for a particular use. All users of Davie County's GIS websfte shall hold harmless the
�T�v County of Davie, North Carolina, its agents, consultants, contractors or employees from any and all claims or causes of action due to +
I �obN t� 1� C or arising out of the use or Inability to use the GIS data provided by this webshe.
y , � XO
A�JTHORIZ7-TION NO:'1435
1 DAVIE
COUNTY HEALTH DEPARTMENT
�.
Permittee'sP.O.
Name: /�
Environmental Health Section
Box 848
Mocksville, NC 27028
PROPERTY INFORMATION
Subdivision Name:
J
Directions to property: ��l ,e i',`�'?ei«-Ke
Phone #: 704-634-8760
Section: % Lot:
AUTHORIZATION FOR
WASTEWATER
Tax Office PIN: y ��
SYSTEM CONSTRUCTION
Road Name: Zip: �o1Q
**NOTE** This Authorization for Wastewater 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 Permits.
(In compliance with Article 11 of G.S. Chapter 130A, Wastewater Systems, Section .1900 Sewage Treatment and Disposal Systems)
***NOTICE*** THIS AUTHORIZATION FOR WASTEWATER CONSTRUCTION
r�'1 J tt `' . i'Al ✓ '%-' IS VALID FOR A PERIOD OF FIVE YEARS.
ENVIRONMENTAL H ALTH SPEC ALIST DATE ISSUED
At
DAVIE COUNTY HEALTH DEPARTMENT
IMPROVEMENT AND OPERATION PERMITS
PermiUee's j ,r
Name:�f�i�
Directioiis�to property:
' IMPROVEMENT
PERMIT
PROPERTY INFORMATION
Subdivision Name:�t'""
Section: I Lot:
Tax Office PIN:# fir; %�,i a` `'3 - �f
Road Name: Zip:
**NOTE** This Improvement Permit DOES NOT authorize the construction or installation 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)
�'% ✓ ***NOTICE*** TIM PERMIT IS SUBJECT TO REVOCATION IF SITE
PLANS OR THE INTENDED USE CHANGE. YOUR WASTEWATER
:79VIRONMENTAL HEALTH SPECIALIST DATE ISSUED SYSTEM CONTRACTOR MUST SEE THIS PERMIT BEFORE
INSTALLING THE SYSTEM.
RESIDENTIAL SPECIFICATION: BUILDING TYPE #BEDROOMS yl #BATHS_ # OCCUPANTS GARBAGE DISPOSAL: Yes or No
COMMERCIAL SPECIFICATION: FACILITY TYPE # PEOPLE # PEOPLE/SHIFT / �� # SEATS INDUSTRIAL WASTE: Yes or No
LOT SIZ���+e' TYPE WATER SUPPLY �� DESIGN WASTEWATER FLOW (GPD) 7 C/ NEW SITE ✓/ REPAIR SITE
SYSTEM SPECIFICATIONS: TANK SIZEAG GAL. PUMP TANK GAL. TRENCH WIDTH DEPTH LINEAR Fr.S?
OTHER
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
SYSTEM INSTALLED BY:
ell
LAE
r,
Pa
gb �
d � � e �ye C
AUTHORIZATION NO. H OPERATION PERMIT BY: 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 05/96 (Revised)
APPLICATION FOR SITE EVALUATIONAMPROVEMENT PE 1"
Davie County Health Department
Environmental Health Section
P. O. Box 848
Mocksville, NC 27028
(704) 634-8760
11 ENVIKUrJN1tH iHL nu.0-9
****IMPORTANT**** THIS APPLICATION.CANNOT BE PROCESS D UNLFc��_
of ALL THE REQUIRED INFORMATION IS PROVIDED.
' ' 0 `� �
1. Name to be Billed &�P) • L ( M" Contact Person
Mailing Address Pt/ –0 '� Home Phone 4#-2-74-7—
Obolfempe City/State/Zip �w a, ` 1 � Business Phone
2. Name on Permit/ATC if Different than Above
Mailing Address
3. Application For:
4. System to Serve:
5. If Residence:
Y Dishwasher
❑ Site Evaluation
Ll/
House CY Mobile Home
City/State/Zip
W Improvement Permit & ATC
❑ Business ❑ Industry ❑ Other
# People # Bedrooms 3
❑ Garbage Disposal Er/Washing Machine ❑ Basement/Plumbing
6. If Business/Other:
# Commodes
If Foodservice:
7. Type of water supply:
Specify type
# Showers
# Seats
County/City
# Urinals
3 Both
# Bathrooms
❑ Basement/No Plumbing
# People # Sinks
Estimated Water Usage (gallons per day)
❑ Well
# Water Coolers
8. Do you anticipate additions or expansions of the facility this system is intended to serve?
If yes, what type?
❑ Commu ty
❑ Yes @--"'N o
PROPERTY INFORMATION REQUIRED: *** IMPORTANT *** A PLAT OF THE PROPERTY MUST BE
SUBMITTED WITH THIS APPLICATION.
Property Dimensions:
e ((h �(
Tax Office PIN: # v 1
Property Address: Road Name
City/Zip'�l/11
1
If in Subdivision provide information, as follows: 1
Name:
RQ,f'1� �6ft) 1
SrTf'z
Lot #: 1
1
Section: 1
1
WRITE DIRECTIONS (from
Mocksville) TO PROPERTY:
This is to certify that the information provided is correct to the best of my knowledge. I understand that any permit(s) issued hereafter
are subject to suspension or revocation, if the site plans or intended use change, or if the information submitted ir.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 '5 a t f � 5 - — r j 1 ) L rn ouh to conduct all testing procedures
as necessary to determine the site suitability.
DATE 6. ;t 98 SIGNATURE G> .
Revised DCHD (06-96)
/A/V'a
DAVIE COUNTY HEALTH DEPARTMENT
Environmental Health Section
Soil/Site Evaluation
NAME ��'�f�I'.i% DATE EVALUATED :7/l `le
ADDRESS PROPERTY SIZE IVV41PVO
PROPOSED FACIILTY LOCATION OF SITE z'fel"O ,�
Water Supply: On -Site Well _ Community Public
Evaluation By: Auger Boring Pit J1Z Cut
FACTORS
1 2 3 4
Landscape position
,L
Sloe R
HORIZON I DEPTH
Texture group
Consistence
Structure
Mineralogy
HORIZON II DEPTH
�'� r�•
Texture group
Consistence
rl
Structure
1r S' '
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 ACCEPTANCE RATKI
Ile
SITE CLASSIFICATION: JAS EVALUATED BY: l�
LONG-TERM ACCEPTANCE RATE:C/ OTHER(S) PRESENT:
REMARKS: r
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 :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 -Firm 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
3C -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(01-901
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Davie County, NC I Tax Parcel Report Tuesday, January 3, 2017
Zip Code: 27014-0000 Voluntary Ag. District:
Legal Description: LOT 1 GRANT HEIGHTS Fire Response District:
Assessed Acreage:
Deed Date:
Deed Book / Page:
Plat Book:
Plat Page:
Building Value:
Land Value:
Total Assessed Value:
1.65 Elementary School Zone:
12/2013 Middle School Zone:
009450493 Soil Types:
10 Flood Zone:
371 Watershed Overlay:
Outbuilding & Extra
Freatures Value:
Total Market Value:
COOLEEMEE
COOLEEMEE
SOUTH DAVIE
GnB2
DAVIE COUNTY
No
9 tI�p All data is provided as Is without warranty or guarantee of any Idnd either expressed or Implied Including but not limited to the
Davie County, Implied warranties of merchantability or fitness for a particular use. All users of Davie County's GIS website 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
.____
NC
or arising out of the use or Inability to use the GIS data provided by this website. ��
WARNING: THIS IS NUT A SURVEY
Parcel Information
Parcel Number:
M4010A0001
Township:
Mocksville
NCPIN Number:
5726828083
Municipality:
Account Number:
82516538
Census Tract:
37059-801
Listed Owner 1: SPILLMAN ROGER P
Voting Precinct:
SOUTH CALAHALN
Mailing Address 1:
PO BOX 738
Planning Jurisdiction:
Davie County
City: COOLEEMEE
Zoning Class:
DAVIE COUNTY R-A,R-20
State:
NC
Zoning Overlay:
DAME COUNTY CZOD
Zip Code: 27014-0000 Voluntary Ag. District:
Legal Description: LOT 1 GRANT HEIGHTS Fire Response District:
Assessed Acreage:
Deed Date:
Deed Book / Page:
Plat Book:
Plat Page:
Building Value:
Land Value:
Total Assessed Value:
1.65 Elementary School Zone:
12/2013 Middle School Zone:
009450493 Soil Types:
10 Flood Zone:
371 Watershed Overlay:
Outbuilding & Extra
Freatures Value:
Total Market Value:
COOLEEMEE
COOLEEMEE
SOUTH DAVIE
GnB2
DAVIE COUNTY
No
9 tI�p All data is provided as Is without warranty or guarantee of any Idnd either expressed or Implied Including but not limited to the
Davie County, Implied warranties of merchantability or fitness for a particular use. All users of Davie County's GIS website 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
.____
NC
or arising out of the use or Inability to use the GIS data provided by this website. ��
DAVIE COUNTY HEALTH DEPARTMENT
IMPROVEMENT PERMIT and OPERATION PERMIT
IMPROVEMENT PERMIT
**NOTE** This improvement permit DOES NOT authorize the construction or installation 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 IM, Wastewater Systems, Section .1900 Sewage Treatment and Disposal Systems)
4
PROPERTY ADDRESS A'A(±7 O%'L \�
•• _ o% `` d� DATE
LOCATION
.q
SUBDIVISION NAME (�//i r� �i ��/T �� LOT NUMBER Z SEC. /BLOCK NUMBER
RESIDENTAL SPECIFICATION: BUILDING TYPE / # BEDROOMS �,-? # BATHS g # OCCUPANTS GARBAGE DISPOSAL: Yes/No
COMMERCIAL SPECIFICATION: FACILITY TYPE # PEOPLE # PEOPLE/SHIFT # SEATS INDUSTRIAL WASTE: Yes/No
LOT SIZE &,&A"XZ TYPE WATER SUPPLY -�-GL— DESIGN WASTEWATER FLOW (GPD) NEW SITE L, --REPAIR SITE
SYSTEM SPECIFICATIONS: TANK SIZE l0,9,0 GAL. PUMP TANK GAL. TRENCH WIDTH ROCK DEPTH LINEAR FT. -FOOD
OTHER
REQUIRED SITE MODIFICATIONS/CONDITIONS:
***THIS PERMIT IS SUBJECT TO REVOCATION IF SITE PLANS OR THE INTENDED USE CHANGE. YOUR WASTERWATER SYSTEM CONTRACTOR MUST
SEE THIS PERMIT BEFORE INSTALLING THE SYSTEM.
IMPROVEMENT PERMIT BY
**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
INSTAI_L.ED BY
po e. -
AUTHORIZATION NO. OPERATION PERMIT BY&:::(4
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 10/95
.�)
Davie County Health Department !/�(f
ENVIRONMENTAL HEALTH SECTION
P.D. Box 665
Mocksville, N.C. 27028
NIMIZATION FOR WASTEWATER SYSTEM CONSTRUCTION
i' (Issued in compliance with Article 11 of
G.S. Chapter 130A, Wastewater Systems)
***This Authorization For Wasttwwater 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 app) ing for Building Permits.***
_ AUTHORIZATION NJF'.SER
NAME�� J/'�'i DATE /� ` �� " "o 0 3,
NAME ON IMPRDVEMENT PERMIT (If different than above)
SITE LOCATION
COMMENTS/CGRITIONS ON AUTHORIZATION TO CONSTRUCT WASTEWATER SYSTEM �'
1. Application/Permit
Mailing Address _
APPLICATION FOR SITE EVALUATION/IMPROVEMENTS PER
Davie County Health Department
Environmental Health Section
P. O. Box 665
Mocksville, NC 27028
'1
sted By f
Home Phone
Business Phone n9w(1��1,�:,��
"�%i5
1L1495 I
2. Name on Permit if Different than Above
3. Application for:
4. System to Serve: ❑ House
❑ Business ❑ Indust
5. If house, mobile home: Subdivision
ElGeneral Evaluation a Septic Tank Installation Permit
M//Mobile Home
❑ Other l
❑ Place of Public Assembly
❑ Unknown I
Section Lot #
❑ Basement/Plumbing
No. of People ❑ Basement/No Plumbing
No, of Bedrooms 7 ❑ Washing Machine
No. of Bathrooms ❑ Dishwasher
?Cno (pig /�i'Xg� ❑ Garbage Dwelling Dimensions ge Disposal
---� .-"
6. If business, industry, place of public assembly, other: Specify type
No. of People Served No. of Sinks
No. of Commodes No. of Urinals
No. of Lavatories No. of Water Coolers
No. of Showers Water Usage Figures
7. Type of water supply: 21 Public ❑ Private
8. Property Dimensions U t) X1/)(o3Sewage Disposal Contractoi
9. Do you anticipate additions/expansion of the facility this sytem is intended to serve?
If vac what tvna?
❑ Yes ❑ No
❑ Community
'NOTE: Improvements Permits shall be valid from date issued. Improvements Permits are subject to
revocation, if site plans or the intended use change. Effective October 1, 1989.
Directions to Property:
(f
1'ltUYtLtL LN UKMAI LL)N LCCC ULKtU:
Tax Office PIN: #J& t -or /o MAN
PROPERTY ADDRESS, as follows:
Road Name:
SU$MIT A PLAT WITH THIS APPLICATION.
Revisions effective October 1, 1995.
This is to certify that the information provided is correct to the b t of my knowledge, and I
incurred from this application.
5- 1 q A
DATE SIGI
0
TURE
am responsible for all charges
CONSENT FOR SITE EVALUATION TO BE DONE ON ABOVE DESCRIBED PROPERTY
MUST CHECK ONE: ❑ 1. 1 OWN the property. L5"2. 1 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 o alth De a ment to enter upon above described
property located in Davie County and owned by S A L(-/ t f✓
to conduct all testing procedures as necessary to7etermine said site's s itability for aground absorption sewage treatment
and dispossystem. 'g
t I An t
Vff,,U'�
DATE SIGN RE
DCHD (1193)
DAVIE COUNTY HEALTH DEPARTMENT
Environmental Health Section
Soil/Site Evaluation
NAME
ADDRESS
PROPOSED FACIILTY
Water Supply: On -Site Well
DATE EVALUATED
PROPERTY SIZE /txc
LOCATION OF SITE -::1 llKC 1iO A Ir
Community
Public 41--l'
Evaluation By: Auger Boring Pit 6l Cut
FACTORS
1 2 3 4
Landscapeposition__
,L
Sloe %
HORIZON I DEPTH
Texture group
Consistence
Structure
Mineralogy
HORIZON II DEPTH
F
Texture group
Consistence
Structure
Ph /
Mineralogy
HORIZON III DEPTH
Texture group
Consistence
Structure
Mineralogy
HORIZON IV DEPTH
Texture group
Consistence
Structure
Mineralogy
SOIL WETNESS
RESTRICTIVE HORIZON
SAPROLITE
CLASSIFICATION
77
LONG-TERM ACCEPTANCE RATE
.,y
SITE CLASSIFICATION
LONG-TERM ACCEPT
REMARKS:
DCHD(01-901
RATE:_ —
EVALUATED BY: /`f"cr'y
OTHER(S) PRESENT:
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 ;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 -Firm 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
.3C --Single grain M -Massive CR -Crumb GR -Granular ABK-Angular blocky
SBK-Subangular blocky PL -Platy PR -Prismatic
Mineraloity
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
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