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198 Sandy Lane Lot 9Dav 0 A16 9All dab Is provided as Is without wamardy or guarantee of any kind either expressed or Implied Including but not limited to the Davie County, Implied em ontles of merchantability or111ness far a particular use. All users of Davie County's 015 webalte shall hold harmless the y County or Davie, North Carolina, Its agents, eonsuhanb, contractors or employees hom any and allelalms or causes of aetlon due to �UUN't NC or adsing am 0 the use or Inability to use the GIS data provided by thle M inh& WARNING: THIS IS NOT A SURVEY ParcelInformatton..._._ Parcel Number: 170000004308 Township: Fulton NCPIN Number: 5778154831 Municipality: Account Number: 8303864 Census Tract: 37059-804 Listed Owner 1: HUTCHENS MATTHEW TODD Voting Precinct: FULTON Mailing Address 1: 198 SANDY LANE Planning Jurisdiction: Davie County City: ADVANCE Zoning Class: DAVIE COUNTY R -A' State: NC Zoning Overlay: Zip Code: 27006 Voluntary Ag. District: No Legal Description: LOT 9 GRAY & RUBY CARTER Fire Response District: FORK Assessed Acreage: 5.96 Elementary School Zone: CORNATZER Deed Date: 72014 Middle School Zone: WILLIAM ELLIS Deed Book / Page: 009630284 Soil Types: WeC,PcB2 Plat Book: 0007 Flood Zone: Plat Page: 084 Watershed Overlay: DAVIE COUNTY Building Value: 115300.00 Outbuilding & Extra Freatures Value: O.OD Land Value: 44390.00 Total Market Value: 159690.00 Total Assessed Value: 159690.00 9All dab Is provided as Is without wamardy or guarantee of any kind either expressed or Implied Including but not limited to the Davie County, Implied em ontles of merchantability or111ness far a particular use. All users of Davie County's 015 webalte shall hold harmless the y County or Davie, North Carolina, Its agents, eonsuhanb, contractors or employees hom any and allelalms or causes of aetlon due to �UUN't NC or adsing am 0 the use or Inability to use the GIS data provided by thle M inh& DAVIE COUNTY HEALTH DEPARTMENT Environmental Health Section P. O. Boa 848/210 Hospital Street Mocksville, NC 27028 (336)751-8760 IMPROVEMENT/OPERATION PERMIT Account t#: 990002250 Billed To. Timothy Roberson Reference Name: Proposed Facility: Residence /,�/3/°� Tax PIN/EH #: 5778-151831 Subdivision Info: Carters Court Lot # 9 Location/Address: Sandy Lane -27006 Property Size: see map ATC Number. 3133 **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 Zt #People �.- F— #Bedrooms #Baths 2 Dishwasher Garbage Disposal: ❑ Washing Machine Basement w/Plumbing: ❑ Basement/No Plumbing: ❑ Commercial Specification: Facility Type �r #People #People(Shift #Seats Industrial Waste: 13Lot Size 4ACA Type Water Supply t D Design Wastewater Flow (GPD) c7,/,d Site: Newe Repair ❑ System Specifications: Tank Size 16V GAL. Pump Tank Other: Required Site Modifications/Conditions: GAL. Trench Width 36/ Rock Depth _�� Linear Ftd*d 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 am. or 1:00 p.m. to 1:30 p.m. on the day of installation. Telephone # is (336)751-8760.**** D Environmental Health Specialist's Signature: i Date: DCHD 05/99 (Revised) DAVIE COUNTY HEALTH DEPARTMENT Environmental Health Section P. O. Boa 848/210 Hospital Street Mocksville, NC 27028 (336)751-8760 Account #: 990002250 Tax PIN/EHO.' 5778-154831 Billed To: Timothy Roberson Subdivision info: Carters Court Lot # 9 Reference Name: Location/Address: Sandy Lane -27006 arze: see ATG Number: 3133 AUTHORIZATION FOR WASTEWATER SYSTEM CONSTRUCTION P6 **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 O STRUCTION IS VALID FOUR A PERIODOFFIV/E YEARS. Environmental Health Specialist's Signature: -�. Date: 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. IOU ff lomya� Septic System Installed By: Environmental Health Specialist's Signature: DCHD 05/99 (Revised) Sim APPLICATION FOR SITE EVALUATION/IMPROVEMENT PERM17 & Davie County Health Department Environmenta/Nea/th Section P.O. Box 848/210 Hospital Street Mocksville, NC 27028 (336)751-8760 APR 2 2 2172 ***IMPORTANT*** THIS APPLICATION CANNOT BE PROCESSED UNLESS ALL THE REQUIRED INFORMATION IS PROVIDED. Refer to the INFORMATION BULLETIN for instructions. _.� 1. Name to be Billed II n h�TSo� Contact Person Mailing Address /� n `nk .i q l Some Phone q p City/State/ZIP (�17. VA14ve Business Phone 4'�- 7 /Q -&�7y? 2.- Name on Permit/ATC if Different than Above Mailing Address 3. Application For: ❑ Site Evaluation City/State/Zip improvement Permit/ATC 4. System to service: X House ❑ Mobile Home ❑ Business ❑ Industry ❑ Both '. ❑ Other S. If Residence: # People 1�— # Bedrooms 3 # Bathrooms r-2_ Dishwasher ❑ Garbage Disposal Washing Machine 6. If Business/Industry/Other: Specify ,type # Commodes # Showers ❑ Basement/Plumbing ❑ Basement/No Plumbing # urinals # People # Sinks # Water Coolers IF FOODSERVICE: # Seats - Estimated Water Usage (gallons per day) 7. Type of water supply: County/City ❑ Well ❑ Community e. Do you anticipate additions or expansions of the facility this system is intended to serve? ❑ Yes XNo If yes, what type? ***IMPORTANT*** CLIENTS MUST COMPLETETHE REQUIRED PROPERTY INFORMATION REQUESTED BELOW. Either a PLAT or SITE PLAN MUST BE SUBMITTED by the client with THIS APPLICATION. Property Dimensions: S J 't 1 a Tax Office PIN: # S"+t� 't' 9 Property Address: Road Name SA N D tJ CityiZipAh sic c2"0 If ins Subdivisionprovideinformation, as follows: Name: Section: Block: Lot: WRITE DIRECTIONS (from Mocksville) to PROPERTY: { I}I IItQ.. ♦ �(1Mt� V .�. Date Property Flagged: '1 C2 I -OQ 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 ani responsible for all charges incurred front 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 r.rsA l a r, hP rSn I to conduct all testing procedures as necessary to determine the site suitability. I G DATE L�- ra a b Q SIGNATURE,- THIS IGNATURE,-THIS AREA MAY BE USED FOR DRAWING YOUR SITE PLAN (Includ a property lines and dimensions, structures, setbacks, and septic locatio --{-Z •/Yv�'-� Revised DCHD (07/95)-I �++ G ke -3^2 \ ,:To r weele J �` following: Existing and proposed Site Revisit Charge Date(s): Client Notification Date: EHS: Account No.50 � (/ Invoice No. 5'� 'tel • S aq'M I APPLICATION FOR SITE EVALUATION/IMPROVEMENT PERMIT & ATC Davie County Health Department Environmental Health Section i JUN ?_ 3 1399 lfe P.O. Box 848/210 Hospital street ` Mocksville, NC 27028 (336)751-8760 Eu,ii ***IMPORTANT*** THIS APPLICATION CANNOT BE PROCESSED UNLESS ALL THE REQUIRED INFORMATION IS PROVIDED. Refer to the INFORMATION BULLETIN for instructions. 1. Nems to be Billed / Lt_�/✓ .. � �)„� Contact Parson / %( y/ Mailing Address /'o G -'L )„/'r" ��/ Boma Phone City/state/ZIP l.Y �y--�y�� % 1�2 Business Phone 2. Nemo on Parmit/ATC if Different than Hailing Address City/Stata/zip 3. Application For: ❑ site Evaluation ❑ Improvement Permit/ATC t�th 4. system to Service: f -k House ❑ Mobile Home ❑ Business ❑ Industry ❑ Other s. If Residence: It People # Bedrooms .3 i Bathrooms :01 11Dishwasher I1 Garbage Disposal ❑ Washing Machine II Basement/Plumbing ❑ Basamant/No Plumbing 6. If Business/Industry/other: specify type # People # sinks # Commodes # Showers # Urinals # Mater Coolers IF FOODSERVICE: # Seats Estimated Water Usage (gallon. par day) i. Type of water supply: ❑ County/City ❑ Well ❑ Community a. Do you anticipate additions or expansions of the facility this system is intended to serve? ❑ Yes ❑ No If yes, what type? ***IMPORTANT*** CLIENTS MUST COMPLETF I HE REQUIRFD PROPERTY INFORMATION REQUESTED BELOW. Either a PLAT or SITE PLAN MUST BESUBM17TED by the client with THIS APPLICATION. S, 967l / j-&14 Property Dimensions: %G %%� �� oC WRITE DIRECTIONS (from Mocksville) to PROPERPY: Tax Office PIN: # 5 "l 7 5' - o 6 - 7/ 7 . o p��I (p N �..t �� /a.,�=,✓<-,� Property Address: Road Name 1.t/�,,,_,�.,�,, �j.��,1� U-•� I•tJ .�/��,s.�nn�'� City/Zip270L, b r If in a Subdivision provide information, as follows: n Name: CAet-e3 t.our� l Section: Block: Lot: 1 Date Property Flogged: 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 ',also, understand that : cm c!' c.aurge5 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 to conduct all testing procedures as necessary to determine the site suitability. DAT ES//`Z'I'�P' �.3 — �I SIGNATURE, THIS AREA MAY BE USED FOR DRAWING YOUR SITE PLAN (Include all of the followin f• Existing and proposed property lines and dimensions, structures, setbacks, and septic locations). Revised DCHD (07/99) Site Revisit Charge Date(s): Client Notification Date: EHS: Account No. Invoice No. I f e go r I I \ iA.tOVE l:' ,ts 'o.If aYB �Y Z 1 n� / }�QE/�`5,130fo ACI2�S RQFA =5.-76T5 19G7�ES zz3,-i�ol4zsy 25-1) z33, ZP-7-7 2 rr IL � Lo Y� . /.l lL)`I L)D I� i • ; qac^ ' V EASE N)l EWY --.. -;. ro Fertu CixlY Rom �/_/.5' 4Z/.5 i ants DAVIE COUNTY HEALTH DEPARTMENT Environmental Health Section SoiVSite Evaluation APPLICANT INFORMATION Account #: 989900562 Billed To: Gray Carter Reference Name: Gray Carter Proposed Facility: Residence Water Supply: Evaluation By: PROPERTY INFORMATION Tax PIN/EH #: 5778-06-7187.06 q Subdivision Info: Carters Court Lot #% I Location/Address: Williams Road -27006 Property Size: 5.7675 Acres Date Evaluated:/se�oa On -Site Well Community. Auger Boring pit Public Cut rncIL)x51 2 3 4 5 6 7 Landscapeposition L Slope HORIZON I DEPTH Texture group Consistence Structure Mineralogy HORIZON 11 DEPTH Texture groupG Consistence Structure Mineralo HORIZON 11I DEPTH Texture rou Consistence Structure Mineralo HORIZON IV DEPTH Texture rou Consistence Structure Mineralogy SOIL WETNESS RESTRICTIVE HORIZON SAPROLITE CLASSIFICATION LONG-TERM ACCEPTANCE RATE SITE CLASSIFICATION:_ LONG-TERM ACCEPTANCE RATE:TC� EVALUATION BY: !G' OTHER(S) PRESENT: REMARKS: Landscape Position LEGEND 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 CONSI TEN E Moist VFR - Very friable FR - Friable FI - Finn VFI - Very firm EFI - Extremely firmWet . . 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 OR - 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 - gaVday/ft2 DCHD (Revised 05/99) ' DAME COUNTY HEALTH DEPARTMENT ENVIRONMENTAL HEALTH SECTION P. 0. Box 848/210 Hospital Street Courier #0940.06 Mocksville, NC 27028 Phone #: (336)751.8760 August 10, 1999 Mr. Gray Carter 1064 Williams Road Advance, NC 27006 Re: Lot Changes in Carters Court Dear Mr. Carter: Lot number 6 of Carters Court is now shown as Lot number 9 on the revised map submitted on August 10, 1999. This Lot was evaluated on July 20, 1999 and classified provisionally suitable. Please advise should you have any questions. Our telephone number is 336-751-8760. Sincerely, Robert B. Hall, Environmental Health Specialist @s:LI cc: John Gallimore