1293 Junction Road Lot 21i t
Davie Countv. NC
Tax PnrrPi RPnnrt
Wednesday, January 4, 2017
Zip Code: 27014-0000 Voluntary Ag. District:
Legal Description: LOT 21 GRANT HEIGHTS .73 Fire Response District:
Assessed Acreage:
Deed Date:
Deed Book / Page:
Plat Book:
Plat Page:
Building Value:
Land Value:
Total Assessed Value:
0.66 Elementary School Zone:
12/2013 Middle School Zone:
009450577 Soil Types:
10 Flood Zone:
371 Watershed Overlay:
Outbuilding & Extra
Freatures Value:
Total Market Value:
COOLEEMEE
COOLEEMEE
SOUTH DAVIE
GnB2,GnC2
DAVIE COUNTY
No
All data is prodded as Is without warranty or guarantee of any kind either expressed or Implied including but not limited to they^
Davie County, I d
Implied warranties of merchantability or fitness for a particular use. All users of Dade County s GIS website shall hold harmless the
County of Dae, 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 prodded by this website. —N --
WA"I1Nli: THIN IN INU'1' A NUKVL+' Y
Parcel Information
Parcel Number:
M401OA0021 Township:
Mocksville
NCPIN Number:
5726904122 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-20
State:
NC Zoning Overlay:
DAVIE COUNTY CZOD
Zip Code: 27014-0000 Voluntary Ag. District:
Legal Description: LOT 21 GRANT HEIGHTS .73 Fire Response District:
Assessed Acreage:
Deed Date:
Deed Book / Page:
Plat Book:
Plat Page:
Building Value:
Land Value:
Total Assessed Value:
0.66 Elementary School Zone:
12/2013 Middle School Zone:
009450577 Soil Types:
10 Flood Zone:
371 Watershed Overlay:
Outbuilding & Extra
Freatures Value:
Total Market Value:
COOLEEMEE
COOLEEMEE
SOUTH DAVIE
GnB2,GnC2
DAVIE COUNTY
No
All data is prodded as Is without warranty or guarantee of any kind either expressed or Implied including but not limited to they^
Davie County, I d
Implied warranties of merchantability or fitness for a particular use. All users of Dade County s GIS website shall hold harmless the
County of Dae, 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 prodded by this website. —N --
y �/x e
AUTHORIZATIO14 NO: d715 O.15 DAVIE COUNTY HEALTH DEPARTMENT 3'
y Environmental Health Section PROPERTY INFORMATION
Permittee' ���'P.O. Box 848
Name: Ivocksville, NC 27028 Subdivision Name: /Qf
Phone #: 704-634-8760
Directions to property: .iJ Gi•/1OK f/�� Section: Lot: P
AUTHORIZATION FOR (� /
WASTEWATER
SYSTEM CONSTRUCTION Tax Office PIN:#�- j rf - ice/:
Road NamefQ, r C_' i)jtw�c: Zip: c. '
**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 l l of G.S. Chapter 130A, Wastewater Systems, Section .1900 Sewage Treatment and Disposal Systems)
J ***NOTICE*** THIS AUTHORIZATION FOR WASTEWATER CONSTRUCTION
f �G / c i r ,< ' ✓ jf �� 1 �%%/` ' IS VALID FOR A PERIOD OF FIVE YEARS.
ENVIRONMENTAL HEATH SIECIALIST DATE ISSUED
DAVIE COUNTY HEALTH DEPARTMENT
IMPROVEMENT AND OPERATION PERMITS PROPERTY INFORMATION
Permittee's
Name f,1,6J
t
Directions to property: ,: �_ 1 f (f j ak6 Z T�•
Subdivision Name:
Section: ,/ Lot:
IMPROVEMENT
PERMIT Tax Office PIN:#
Road Name', -'-,i 74;` t ; 3l R1 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)
ENVIRONMENTAL HEALTH SPECIALIST DATE ISSUED
***NOTICE*** THIS PERMIT IS SUBJECT TO REVOCATION IF SITE
PLANS OR THE INTENDED USE CHANGE. YOUR WASTEWATER
SYSTEM CONTRACTOR MUST SEE THIS PERMIT BEFORE
INSTALLING THE SYSTEM.
RESIDENTIAL SPECIFICATION: BUILDING TYPE al # BEDROOMS -r' # BATHS # OCCUPANTS - GARBAGE DISPOSAL: Yes or No
COMMERCIAL SPECIFICATION: FACILITY TYPE # PEOPLE # PEOPLE/SHIFT k # SEATS INDUSTRIAL WASTE: Yes or No
LOT SIZE � TYPE WATER SUPPLY DESIGN WASTEWATER FLOW (GPD) NEW SITE REPAIR SITE
SYSTEM SPECIFICATIONS: TANK SIZE %d GAL. PUMP TANK GAL. TRENCH WIDTH -52, ROCK DEPTH %off LINEAR FT. :7e9 !-%
REQUIRED SITE MODIFICATIONS/CONDITIONS:
IMPROVEMENT PERMIT LAYOUT
v
**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
AUTHORIZATION NO.� 1 I OPERATION PERMIT BY:
SYSTEM INSTALLED BY: �>
F
N. H('5'
0/rte.-q-
THE
2
THE ISSUANCE OF THIS OPERATION PERMIT SHALL INDICATE THA THE SYSTEII�]
WITH ARTICLE I 1 OF G.S. CHAPTER 130A, SECTION .1900 "SEWAGE TREXIMENT AN
GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORILY FOR XWY GIVEN
DCHD 05/96 (Revised)
OF TIME.
DATE: 4-1 r 11
HAS BEEN INSTALLED IN COMPLIANCE
S", BUT SHALL IN NO WAY BE TAKEN AS A
In
APPLICATION FOR SITE EVALUATIONAMPROVEMENT PERMIT
Davie County Health Department
Environmental Health Section
P. O. Box 848
Mocksville, NC 27028
(704)634-8760
i4AR - 51997
****IMPORTANT**** THIS APPLICATION CANNOT BE PROCESSED UNLESS
ALL THE REQUIRED INFORMATION IS PROVIDED.
1. Name to be Billed T r 6. -SPIILI'Y)An/ Contact Person P7':�oi Yfitcn
Mailing Address on my 130y Home Phone (Q?4/' O t%717
City/State/Zip ELLE rnE�. n/G 6270 14 Business Phone
2. Name on Permit/ATC if Different than Above L-lS 6600E
Mailing Address
3. Application For:
4. System to Serve:
5. If Residence:
❑ Dishwasher
6. If Business/Other:
# Commodes _
If Foodservice:
❑ Site Evaluation
❑ House Mobile Home
City/State/Zip
improvement Permit & ATC ❑ Both
❑ Business ❑ Industry ❑ Other
# People _,a_ # Bedrooms # Bathrooms
❑ Garbage Disposal U Washing Machine ❑ Basement/Plumbing ❑ Basement/No Plumbing
Specify type 6i iia # People # Sinks
7. Type of water supply:
# Showers # Urinals
# Seats Estimated Water Usage (gallons per day)
01"County/City ❑ Well
# Water Coolers
8. Do you anticipate additions or expansions of the facility this system is intended to serve?
If yes, what type?
❑ Community
❑ Yes dNo
PROPERTY INFORMATION REQUIRED: *** IMPORTANT *** A PLAT OF THE PROPERTY MUST BE
SUBMITTED WITH THIS APPLICATION.
Property Dimensions: 1r)('2' x on
-S!5,
1 WRITE DIRECTIONS (from
#
9 0
1Mocksville) TO PROPERTY:
Tax Office PIN: e5r -
Z RnJ LEEK OL✓
Property Address: Road Name ,- AJO-7T- hAi
R&
1
1 `7 0NO-ITOA) )Q16. OFF
City/Zip M 95U
-' p
L� ZVC 2702
12U
If in Subdivision provide information, as follows:
Name: ( Qm-r
1 64EP7—
Section:
Lot #: Q�!
1
1
1
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 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 s;5AU-1 L A5,cTI U » A AJ to conduct all testing procedures
as necessary to determine the site suitability.
DATEeyn5 22 SIGNATURE
Revised DCHD (06-96)
• DAVIE COUNTY HEALTH DEPARTMENT
Environmental Health Section
Soil/Site Evaluation
APPLICANT'S NAME -
PROPOSED FACILITY
SUBDIVISION
Water Supply: On -Site Well
Community
Evaluation By: Auger Boring I Pit ✓
SECTION_ LOT
DATE EVALUATED <7/�. ,i'"I
PROPERTY SIZE
ROAD NAME ,
Public r/
Cut
FACTORS
1
2 3 4 5 6 7
Landscape position
Z_
Slope %
HORIZON I DEPTH
Texture group
Consistence
Structure
Mineralogy
HORIZON II DEPTH
Texture groupC
Consistence
/
Structure
I ,
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 RATE
SITE CLASSIFICATION:
LONG-TERM ACCEPTANCE RATE:
REMARKS:
DCHD (01-90)
EVALUATION BY: � kz
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 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 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
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
■
■■MESE■
■■M■■■■
■■M■■■■
■■N■■
■NEEM
MEMO■
■N■■■
■
■■■■■■■■■■■■■■■■■■■■■ ■■■■■■■■
■ENEEM■■■■MEEM■EE■■E■ ■■■■N■E■
■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■
■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■
■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■
■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■
■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■
■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■
■E■■■MEMENNE■■■■N■EE■ ■■■■momm
■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■
■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■
■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■
■■■■■■■■■■■■■■■■■■■■■ ■■■■■■■■■■■■■■■■■■■■■■■■■■■■
■■■■Ne■■■■■■MME■O■■■■ ■■■■■■■■■■■■■■■■■■■■■■■■■■■■
■■■■■atEN■■■■ONE■■■MNEo■MNMMONMEEMEMMMMMNEE■MM■■■
■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■
■■■■■■EE■■E■■NEEM■■E■EEEEEEMNEEEEOE■MM■■M■■NEE■■■
■■■■■■M■E■■■■■■■■■■■■■■■■■■Ess■■■■■■■■■■■ss■■■■■■
■■■■■
■■■■■
■■■O■
■■■N■
MEMO■
■■■■■
■■NO■
■■■■■
■■
■■■■■M■
■■NEEM■
NEEM■■■
SEEM■■■
■■■■N■■
ONES■■■■
■■■■NEEM
■■N■■■■■
■■■■■O■■
■■NOME■■
■■■O■■■■
■■ESN■■■
sono■■■■
■■■■
■■E■
■N■■
moms
i
i
■