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1297 Junction Road Lot 22Davie County. NC Tax Panel Rt:nnrt Wednesday, January 4. 2017 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: WARNING: IMS 1S NUT A SURVEY Parcel Information M401 OA0022 Township: Mocksville 5725994946 Municipality: 82516538 Census Tract: 37059-801 SPILLMAN ROGER P Voting Precinct: SOUTH CALAHALN PO BOX 738 Planning Jurisdiction: Davie County COOLEEMEE Zoning Class: DAVIE COUNTY R-20 NC Zoning Overlay: DAVIE COUNTY CZOD Land Value: Total Assessed Value: 27014-0000 Voluntary Ag. District: LOT 22 GRANT HEIGHTS .73 ac Fire Response District: 0.93 Elementary School Zone: 2/2014 Middle School Zone: 009500872 Soil Types: 10 Flood Zone: 371 Watershed Overlay: Outbuilding & Extra Freatures Value: Total Market Value: No COOLEEMEE COOLEEMEE SOUTH DAVIE GnB2,GnC2 DAVIE COUNTY 96�F j All data Is prodded as Is without warranty or guarantee of any Idnd either expressed or Implied Including but not limited to the 11j Davie County, Implied warranties of merchantability or fitness for a particular use. All users of Dade County's GIS website shall hold harmless the Davie, County of Dae, North Carolina, Its agents, consultants, contractors or employees from any and all claims or causes of action due to �T �o p4y �1\ C_ ___ I or arising out of the use or Inability to use the GIS data prodded by this webstte Ai3 HORIZATION NO. 0714 DAVIE COUNTY HEALTH DEPARTMENT ^� Environmental Health Section PROPERTY INFORMATION Permiftee's r P.O. Box 848 ' Name: Mocksville, NC 27028, Subdivision Name: r r Pone #l: 704'64-8760 Directions to property: Section:_ Lot: AUTHORIZATION'FOR WASTEWATER r SYS! E1VI CONSTRUCTION Tax Office PIN:#- Road Name: ('r G r ft%`�-tet zip: ay **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 IS VALID FOR A PERIOD OF FIVE YEARS. ENVIRONMENTA EALTH S�ECIALIST DATE ISSUED n t� DAVIE COUNTY HEALTH DEPARTMENT"=�� 1�► IMPROVEMENT AND OPERATION PERMITS PROPERTY INFORMATION PermKiee's Name: Z2 I Directions to property: - IMPROVEMENT PERMIT Subdivision Name: - n ala ' .r Section: l Lot: Tax Office PIN:#:'`:'�� Road Name {- + air'"��Zip:k, **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*** THIS PERMIT IS SUBJECT TO REVOCATION IF SITE PLANS OR THE INTENDED USE CHANGE. YOUR WASTEWATER ENVIRONMENTAL HEALTH SPECIALIST DATE ISSUED SYSTEM CONTRACTOR MUST SEE THIS PERMIT BEFORE INSTALLING THE SYSTEM. RESIDENTIAL SPECIFICATION: BUILDING TYPE 1,27 /;/ # BEDROOMS k--? # BATHS _? # OCCUPANTS GARBAGE DISPOSAL: Yes or No COMMERCIAL SPECIFICATION: FACILITY TYPE # PEOPLE - # PEOPLE/SHIFI' # SEATS INDUSTRIAL WASTE: Yes or No LOT SIZE �f' �' TYPE WATER SUPPLY 14e, DESIGN WASTEWATER FLOW (GPD) NEW SITE [/— REPAIR SITE SYSTEM SPECIFICATIONS: TANK SIZE fid✓ GAL. PUMP TANK GAL. TRENCH WIDTH " l.- ROCK DEPTH LINEAR FT. REQUIRED SITE MODIFICATIONS/CONDITIONS: IMPROVEMENT PERMIT LAYOUT **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. r f 4 SYSTEM INSTALLED BY: 1 `w� S It F �v(��6U� pj E /Oo• OPERATION PERMIT BY: t� DATE: 1 I - b 1 1 **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 PERMOATC— V--- Davie County Health Department I i�t� _ 197 Environmental Health Section P. O. Box 848 Mocksville, NC 27028 U (704)634-8760 ****IMPORTANT**** THIS APPLICATION CANNOT BE PROCESSED UNLESS ALL THE REQUIRED INFORMATION IS PROVIDED. 1. Name to be Billed Contact Person PharL-P 61pjam/ Mailing Address �7 �C»C 3 Home Phone ori 19U — a I Ll 17 City/State/Zip of FFrn 4 E WC a,761Y Business Phone 01 " "^)55/ 2. Name on Permit/ATC if Different than Above Ar AS SOtIE Mailing Address _ 3. Application For: 4. System to Serve: 5. If Residence: ❑ Dishwasher 6. If Business/Other: # Commodes _ If Foodservice: ❑ Site Evaluation ❑ House [B Mobile Home City/State/Zip 2/ Improvement Permit & ATC ❑ Business ❑ Industry ❑ Other ❑ Both # People 3_ / # Bedrooms 3 # Bathrooms � ❑ Garbage Disposal 2" Washing Machine ❑ Basement/Plumbing ❑ Basement/No Plumbing Specify type /J Ag # People # Sinks 7. Type of water supply: # Showers # Seats WI/County/City # Urinals 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? ❑ Community ❑ Yes 4:!' No PROPERTY INFORMATION REQUIRED: *** IMPORTANT *** A PLAT OF THE PROPERTY MUST BE SUBMITTED WITH THIS APPLICATION. Property Dimensions: 1 q I 7 ()1 y ���i� •l0� t 1 WRITE DIRECTIONS (from 7a5 _ �_ _ ,qq y 1 Mocksville) TO PROPERTY: Tax Office PIN: # � 1 1 %UR / LC.. QAZ Property Address: Road Name c7rrn f'1 12.0. 1 1 JUNC-qOn! ,eD City/Zip PIG ( 160 S ; 1 `T�2.L�Nv Chu � If in Subdivision provide information, as follows:S+ Md PAaK- 1 Name: 2aArr MST �H iS 1 1 L,Crr _ Lot #: 0-3- a 1 Section: 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 -1'--rI✓ 6 17SPlun-)OA)to conduct all testing procedures as necessary to determine the site suitability. DATE a 31n�/9 SIGNATURE Revised DCHD (06-96) DAVIE COUNTY HEALTH DEPARTMENT ' Environmental Health Section Soil/Site Evaluation NAME ADDRESS % PROPOSED FACIILTY � '' W�� DATE EVALUATED Z6� /&-- PROPERTY SIZE y,�C LOCATION OF SITE Water Supply: On -Site Well _ Community Public C/ Evaluation By: Auger Boring Pit Cut FACTORS 1 2 3 4 Landscape position 'L_ L Slope % HORIZON I DEPTH Texture group Consistence Structure Mineralogy HORIZON II DEPTH Texture groupG 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 ACCEPTANCE RATE SITE CLASSIFICATION: EVALUATED BY: ��/ LONG-TERM ACCEPTANCE RATE: )C OTHER(S) PRESENT: REMARKS: LEGEND Landscape Position R -Ridge S -Shoulder L -Linear slope FS -Foot slope N -Nose slope CC-COnCnvP cinnr 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- Vl::-y friable FR -Friable FI-Firn► 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 ■■■.....■■.■■.......■■NMN■N■■■■■.■NNEM.■ ■E■EEE■■■■E■M■■■ MENS■E■ ■■.■....■■■■■.■E■■■■■■H■m■E■■■E■■sn.m.■e■■■■..■■.■■■■■■.■■■■NONE ■■.■..■■..■.■■..■.■.■...........�■■EE■E■C■■C■■■■mmE■■■E■EN■■■ENE■ ■■...■..■......■.■.■■.■■■.■.■■.■■■■■.■..■ ■■ ■NO■ENE■NE■.■M■■■■E.■ ■■...■.■■■......■..■..■.■■■.■....■■■EE■■O■m■■m■■m■■■MEN■■.■..■■■■■ ■■■■■■..■■■.■..■..■■■.■..■■..■■■■■■■..■■■■■■■■■■..■■.■.■..■.■■MEMO ...........................................�...■..■IN MMMM■.■.■.... ................................■......... ........ ■■N■■E■OMMEN■ ■■■NENOE..ENNN■■■N...EON.E■■..■■ ■■■NE■EE■Emm..mm■■■..■■■mem■m■m■ ...............■........... ...................I....1.■.■.....■■MMMmMMMMMMMMMMMMMMN .. ■■■■■■■■■■■■■mm■■■..■■.■■■■■■■■■■■■■.e■.■.■ IN 0 IN MENEM ■■■ ■.■ �■MMMMMMM .MEE■■ ■■■■■EEE■■■■■EE■■■■■■■■EE■■■■■■■■■■■■■■■�...� .�■�.■■CC•■.■.■!�■■ ■....■■■■■■■■■..■■■■■■■■■■.■■■■■■■/mm■■■ O■m IN mom NooO■■■■ ■■ ■■■■■■■■■■■Ne■■■■■■■EE.■■■■Mee■ ■■.■mo■■..■■..memm■OMEN mmom■■■■ ■■■■■■mE■EE■■■■ME.E■■■■■■■■■■■EE■■■■■■■■■EmmaE■CNC■N■■mmumEMENEO■ ■■■mEEE■■EEE■■NEE■EE■E■■■NE■■■Em■■■Nee■■■mem■m■ ■ C■E000mo■■memo■■ ■■EE■...■■EM■■NE■■■EEEEMEEEEE■■■■■.■ EHE■M ENoE■■ No.■■ IN MIN ■■.■■■■■■Nm■■m■EEm■■■eeE■■e■m■m■■m=■ OMEN■■C■■�m■■=o.■.■o=o=E■m■■CC ..............................■... 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