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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)