149 Hidden Creek Drive Lot 29, +
Davie Countv. NC
Tax PnrrrPl R Prsr%rt
Thursday, January 26, 2017
WARNING: THIS 1S NOTA SURVEY
Parcel Information
Parcel Number.
E915OA0029
Township:
Farmington
NCPIN Number:
5871574706
Municipality:
Account Number.
78865500
Census Tract:
37059-803
Listed Owner 1:
WHITMAN BETTY B
Voting Precinct:
HILLSDALE
Mailing Address 1:
C/O DEBBIE W. HERMAN
Planning Jurisdiction:
Davie County
City:
CAMDEN
Zoning Class: DAVIE
COUNTY R-A,R-20
State:
SC
Zoning Overlay: DAVIE COUNTY QD
Zip Code:
29020
Voluntary Ag. District:
No
Legal Description:
LOT 29 HIDDEN CREEK LIFE ESTATE
Fire Response District:
ADVANCE
Assessed Acreage:
0.82
Elementary School Zone:
SHADY GROVE
Deed Date:
4/2009
Middle School Zone:
WILLIAM ELLIS
Deed Book / Page:
007890708
Soil Types:
GnB2
Plat Book:
0005
Flood Zone:
Plat Page:
179
Watershed Overlay:
DAVIE COUNTY
Building Value:
Outbuilding & Extra
Freatures Value:
Land Value:
Total Market Value:
Total Assessed Value:
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
�OUl1'�4 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
-'A o
**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 B.S. Chapter 130A, Wastewater Systems, Section .1900 Sewage Treatment and Disposal Systems)
NAME S�f'TJ�Ili�/�, %/�/�7✓ / PROPERTY ADDRESS 74/O�� L CSI �eE� /�� • '� ° DATE -61
LOCATION �' //l'r"i✓ /«/r`
/r�SUBDIVISION NAME � �� ./ � �" �� LOT NUMBER SEC./BLOCK NUMBER
RESIDENTAL SPECIFICATION: BUILDING TYPE / UC e # BEDROOMS ',? # BATHS e4 # OCCUPANTS GARBAGE DISPOSAL: Yes/No
COMMERCIAL SPECIFICATION: FACILITY TYPE # PEOPLE # PEOPLE/SHIFT # SEATS INDUSTRIAL WASTE: Yes/No
LOT SIZE TYPE WATER SUPPLY e-1 DESIGN WASTEWATER FLOW (GPD) 3 KZ) NEW SITE I—' REPAIR SITE
SYSTEM SRECIFICATIDNS: TANK 5IZE�6U GAL. PUMP TANK GAL. TRENCH WIDTH ROCK DEPTH �� , LINEAR FT. sFG d
OTHER
REQUIRED SITE MODIFICATIONS/CONDITIONS:
***THIS PERMIT IS SUBJECT TO REVOCATION IF SITE PIANS 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
SYSTEM INSTALLED BY lam 4�2
,l)etnr.*r 41",/�."
AUTHORIZATION NO. O b RATION PERMIT BY DATE
**THE ISSUANCE OF TH SHALL INDICATE THAT THE SYSTEM DESCRIBED ABOVE HAS BEEN INSTALLED IN COMPLIANCE WITH
ARTICLE 11 OF G.S. 1 �,SECTIOMN .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. i
DCHD 10/95
jDavie County Health Department
ENVIRONMENTAL HEALTH SECTION
` P.O. Box 665
W Mocksville, N.C. 27028
AUTHORIZATION FOR WASTEWATER SYSTEM CONSTRUCTION
(Issued in compliance with Article 11 of
G.S. Chapter 13OA, Wastewater Systems)
***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.*** /
�RUTHORIZATION NUP9ER
NAME DATE
NAME ON IMPROVEMENT PERMIT (If different than above)
SITE LOCATION If .y .•CG
COMMENTS/CONDITIONS ON AUTHORIZATION TO CONSTRUCT WASTEWATER SYSTEM
#*WICE*" THIS AUTHORIZATION FOR WASTEWATER SYSTEM CONSTRUCTION IS VALID FOR A PERIOD OF FIVE (5) YEARS.
ENVIRNiENTAL HEALTH WCIALIST DATE
D&IY1. 0/95
,1
APPLICATION FOR SITE EVALUATIONAMPROVEMENT PE
Davie County Health Department ow 12rE
Environmental Health Section
P.O. Box 8486 1995
Mocksville, NC 27028
(704) 634-8760
****IMPORTANT**** THIS APPLICATION CANNOT BE PROCESSED UNLESS ALL
THE REQUIREnD INFORMATION IS PROVIDED.
1. Name to be Billed L-►-tP'pLi%s p��s-w-aN.� � �. l.O . Contact Person a>-1
Mailing Address ?n' iJOX I SZ I Home Phone Qi 1 O 9 9 (fl - 7 Zac(
City/State/Zip W .0 • "Z7Z Business Phone O - '79 C0 --7 Za q
2. Name on Permit/ATC if Different than Above [SsrT ci (-k14 m rr A, -J, 1
Mailing Address ) a95 kDe'—k rF A -L JK � . City/State/Zip W s�,u - ��u •. - Y�i .0 . Z /c7 3
3. Application For: [ ] Site Evaluation ['Improvement Permit & ATC [ ] Both
4. System to Serve: [cyHouse [ ] Mobile Home [ ] Business [ ] Industry [ ] Other
5. If Residence: # People ! # Bedrooms 3 # Bathrooms [✓]"Dishwasher [ ] Garbage Disposal
[✓Washing Machine [ ] Basement/Plumbing [ ] Basement/No Plumbing
6. If Business/Other: Specify type # People #Sinks # Commodes
# Showers # Urinals # Water Coolers
If Foodservice: # Seats Estimated Water Usage (gallons per day)
7. Type of water supply: lu-Kcounty/City [ ] Well [ ] Community
8. Do you anticipate additions or expansions of the facility this system is intended to serve? [ ] Yes [ L] -No
If yes, what type?
PROPERTY INFORMATION REQUIRED: *** IMPORTANT *** A PIAT OF THE PROPERTY MUST BE
SUBMITTED WITH THIS APPLICATION.
Property Dimensions: 14JD' k ZN Z I X 1 S6 k Z S CaWRITE DIRECTIONS (from Mocksville) TO PROPERTY:
Tax Office PIN: # 58-71 - Sri - 4:1n -10 001 i u z+..) tZzL�N�-
Property Address: Road Name (Itc-sr, (Z&,
City/Zip AWAOCS--
If in Subdivision provide information, as follows:
Name:
,
Section: Lot #:
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
:T��7���1Ri
Revised DCHD (06-96)
1 testikg qTfedures as necessary to determine the site suitability.
f APPLICATION FOR SITE EVALUATION/IMPROVEMENTS PERMIT
Davie County Health Department "` ED
Environmental Health Section
P. O. Box 665 MAY 0 9 1934
Mocksville, NC 27028
1. Application/Permit Requested By �e-& 9• 1-�%�✓�'J
Mailing Address /9A l(%e,��.o�.. G�!. ��iiivs ,v- A -h-- Q1,(• a27/03 Home Phone 7-13`ZL/a
2. Name on Permit if Different than Above
3. Application for: CEJ General Evaluation
4. System to Serve: Er House
Business Phone
❑ Septic Tank Installation Permit
❑ Mobile Home ❑ Place of Public Assembly
❑ Business ❑ Industry ❑ Other ❑ Unknown
5. If house, mobile home: Subdivision i d��ti ����� Section Lot # n2
No. of People 1
No. of Bedrooms 3
No. of Bathrooms a
Dwelling Dimensions
6. If business, industry, place of public assembly, other: Specify type
No. of People Served
No. of Commodes
No. of Lavatories
No. of Showers
7. Type of water supply: ❑ Public
8. Property Dimensions
No. of Sinks
No. of Urinals
No. of Water Coolers _
Water Usage Figures _
❑ Private
Sewage Disposal Contractor
❑ Basement/Plumbing
❑ Basement/No Plumbing
ED/Washing Machine
Q"Dishwasher
El" Garbage Disposal
9. Do you anticipate additions/expansion of the facility this sytem is intended to serve? ❑ Yes U No
If yes, what type?
❑ Community
'NOTE: Improvements Permits shall be valid for a period of 5 years from date issued. Improvements Permits are subject to
revocation, if site plans or the intended use change. Effective October 1, 1989.
Directions to Property: d I� OYD o? 9 i �✓ /�� �d�e•J �xCG �� S'� 6 di �' s �'�10 re C4/,,
P ti Le m d` o i` - 5/ :`� o .cam �o rwt rG . 4-7 �W e. �
w44
This is to certify that the information provided is correct to the best of my knowledge, and I understand I am responsible for all charges
incurred his application.
ATE SIGNATURE
CONSENT FOR SITE EVALUATION TO BED NE ON ABOVE DESCRIBED PROPERTY
MUST CHECK ONE: O'1. I OWN the property. ❑ 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 County Health Department to enter upon above described
property located in Davie County and owned by - H '3. 1(,xr "AW." -J
to conduct all testing procedures as necessary to determine pard site's suitability for a ground absorption sewage treatment
and disposal syst m.
761,DATE. SIGNATURE
DCHD'(1193)
DAVIE COUNTY HEALTH DEPARTMENT
Environmental Health Section
• Soil/Site Evaluation
NAME " Z;?/44 fi✓
ADDRESS
PROPOSED FACIILTY 4— IF r- r
DATE EVALUATED
PROPERTY SIZE -Z/ "ve--,
LOCATION OF SITE
Water Supply: On -Site Well Community Public '—'--
Evaluation By: Auger Boring (/ Pit Cut
FACTORS
1
2
3 4
Landscape position
4—
—S10
Slope
e Z
-2
HORIZON I DEPTH
Texture group
Consistence
Structure
Mineralogy
HORIZON II DEPTH
Texture groupC
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
„3
,
SITE CLASSIFICATION: ,,?!�K
LONG-TERM ACCEPTANCE RATE: ,
REMARKS:
DCHD(01-901
EVALUATED BY:
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
SILL -Silty -:lay loam SIL -Silty loam CL -Clay loam SCL-Sandy clay loam
SC -Sandy clay SIC -Silty clay C -Clay
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
Davie Coanly Nealtir Department
and .dome Nealil A ency
210 HOSPITAL STREET/ P.O. BOX 665
MOCKSVILLE. N.C. 27028
PHONE: (704) 634.5985
May 13, 1994
Betty B. Whitman
198 Wexham Rd.
Winston—Salem, NC 27103
Re: Site Evaluation
Hidden Creek/Sec. 1—Lot 29
Dear Ms. Whitman:
As requested, a representative from this office visited the aforementioned
site on May 10, 1994. Based upon the information provided on the
application for a site evaluation and after the evaluation was completed, the
site was found to be provisionally suitable for the installation of an on—site
sewage disposal system.
If you have any questions, please feel free to contact this office.
Sincerely,
Robert B. Hall, Jr., R.S.
Environmental Health Section
RH/wd
Enclosure
cc: Betty B. Whitman (6-2$-96)