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282 Lakeview Road Section 2 Lot 22Davie Countv. NC U T.qy Pnrnel Rennrt Tuesday. January 17. 2017 WAXN.tAU:'1'ff1N lb AUl. A bUKV-L Y Parcel Infonnation Parcel Number: 1614OA0028 Township: Shady Grove NCPIN Number: 5758834877 Municipality: Account Number: 46883000 Census Tract: 37059-804 Listed Owner 1: MALLORY PAUL J SR Voting Precinct: WEST SHADY GROVE Mailing Address 1: 282 LAKEVIEW ROAD Planning Jurisdiction: Davie County City: MOCKSVILLE Zoning Class: DAVIE COUNTY R-20 State: NC Zoning Overlay: Zip Code: 27028-7313 Voluntary Ag. District: Legal Description: LOT 22 HICKORY HILL SECTION 2 Fire Response District: Assessed Ac ane: 0.65 Elementa School Zone: Deed Date: Deed Book I Page: Plat Book: Plat Page: Building Value: Land Value: Total Assessed Value: 4/1992 Middle School Zone: 001630218 Soil Types: 0005 Flood Zone: 027 Watershed Overlay: Outbuilding & Extra Freatures Value: Total Market Value: CORNATZER - DULIN CORNATZER WILLIAM ELLIS GnC2,GaD DAVIE COUNTY Mel F07All data Is provided as Is without warranty or guarantee of any IdInd either expressed or Implied Including but not limited to the Davie County, Implied warranties of merchantability or fitness for a particular um All users of Davie County's GIS website shall hold harmless the County of Davie, No th Carolina, its agents� consultants, contractors or employees from any and all claims or causes of action due to NC or arising out of theruse or inability to use the GIS data provided by this website. 'PAVIE COUNTY HEALTH DEPARTMENT .4y IMPROVEMENTS PERMIT AND CERTIFICATE OF COMPLETION in Compliance With Article 11 of G.S. Chapter 130a AAita7,S Permit r agM stems - il 7-7 Nam Date 0 00 ,7 -;04;76 Location 7 r ;�, Subdivision Name Lot No. Sec. or Block No. Lot Size - House Mobile Home Business Speculation No.,Bedr,00ms No. Baths-. No. in Family d I Garbage -Disposal YES NO L] Auto Dish Washer j! YES NO YES NO Auto Wash Ma-.hine� Type Water Supply, *This permit Void ifs6wage systern described below is not installed within 5 years from date of issue. This permit is subject to revocation if site plans orth6 intended use change. t Improvements permit bi *Contact a representative of the'Daivie County Health Department for final i I rispection of this system between 8:30- 9:30 A.M'. or 1:00-1:30 P.M. on ..day,,O'f completion. Telephone Number 704-634-5985. Final Installation Diagram: System Installe'd by P_V_ EP 70 1z ion Certificate ot,dompleti Dat The signing of this certificate 'shall indicate 'that the system� described above has been installed with compliance the standards set forth injhe above regulation, but shall in NO way be taken as a guarante6th t th system will function satisfactorily for any given period of tim6. F1 APPLICATION FOR SITE EVALUATION/IMPROVEMENTS PERMIT Davie County Health Department Environmental Health Section P. 0. Box 665 VZ Mockpville, NC 27028 OC 1 1993 1. Application/Permit Requested By. uo(—. Mailing Address T Home Phonq �'7;f .7 J/01 or- c �i -7o Business Phone 0 2. Name on Permit if Different than Above 14 I'l C--�' 3. Application for: 0 General Evaluation erls-�eptic Tank Installation Permit 4. System to Serve: 16"'House 0 Mobile Home 0 Place of Public Assembly 0 Business 0 Industry 0 Other 0 Unknown 5. If house, mobile home: Subdivision A1-14i�OIC41 Section 7!4' Lot # / e.-gasement/Plumbing No. of People :3 No. of Bedrooms No. of Bathrooms Dwelling Dimensions 00 6. If business, industry, place of public assembly, other: Specify type No. of People Served No. of Commodes No. of Sinks No. of Urinals No. of Lavatories No. of Water Coolers No. of Showers Water Usage Figures 7. Type of water supply: ublic E-1 Private 8. Property Dimensions 4�26 X -13 7 Sewage Disposal Contractor C1 Basement/No Plumbing b"'Washing Machine Er/Di shwasher n -'Garbage Disposal 9. Do you anticipate additionslexpansion of the facility this sytem is intended to serve? 0 Yes b -ho If yes, what type? 0 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: This is to certify that the information provided Is correct to the best k ledge, and I understand lam responsible for all charges incurred from this application. L4�� — , DATE SIGNATURE CONSENT FOR SITE EVALUATION !Q BE DONE Ql� ABOVE DESCRIBED PROPERTY MUST CHECK ONE: 0��1. I OWN the property. 0 2. 1 DO NOT OWN the property. N C H E K 7NE. -' E' C 0 - x #2 , th ent to tj erty e Davie , G t g pr C MUS If you chocked Box #2, the rest of this form MUS 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 to conduct all testing procedures as necessary to determine said site's suitability for a ground absorption Sewage treatment and disposal system. D T ATE SIGNATURE DCHD (1/93) NAME ADDRESS - PROPOSED FACIILTY DAVIE COUNTY HEALTH DEPARTMENT Environmental Health Section Soil/Site Evaluation DATE EVALUATED PROPERTY SIZE LOCATION OF SITE Water Supply: On -Site Well Community Public Evaluation By: AugerBoring Pit Cut FACTORS 1 2 3 4 6 Landscape position Slope Z HORIZON I DEPTH Texture group Consistence Structure Mineralogy HORIZON II DEPTH Texture group 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: LONG-TERM ACCEPTANCE RATE: REMARKS: DCHD (01-901 Landscat)c Position EVALUATED BY: - OTHER(S) PRESENT: LEGEND R -Ridge S7Shoulder 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 5C -Single grain M -Massive CR -Crumb GR -Granular ABK-Angular blocky SBK-Subangular blocky PL -Platy PR -Prismatic Mineraloizy 1:1, 2:i, 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 watef 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 COUNTY HEALTH DEPARTMENT Environmental Health Section R 0. Box 665 Mocksville, N.C. 27028 SOWSITE EVALUATION Name D L Date Address 'L P"L, - a, ? Lot Size 'z lr�x so A 1:Ar.Tr)QQ APPA 1 APFA 9 ARFAR ARPA A Topography/ Landscape Position im> S S PS PS einE::) ET�� U U U U Soil Texture (12-36 in.) Sandy, d S Le /,,I S S Loamy, Clayey, (note 2:1 Clay) /01-- 3� C2:E�-> U U U U 1) Soil Structure (12-36 in.) S S 3,- S S Clayey Soils dn::> C!J� 4:�q� U U U U Soil Depth (inches) 4:�� 4f <::�� PS PS PS PS U U U U Soil Drainage: Internal S 4:�� S S <2E5::� S cfe� U U U U External <�� Z� <!� PS PS PS PS U U U U Restrictive Horizons ,,014. X- e,6� ,/ 3 Available Space PS S <1a=:1 S <In:> PS U U U U 1) Other (Specify) S PS S PS S PS S PS U U U U Site Classification V U—UNSUITABLE S—SUITABLE PS—Provisionally Suitable Recommendations /Comments: W1--- S'014'- C.— 6— Described by Title Date SITE DIAGRAM DCHD (6-82) ( +� Zz-1 ) 0 ["4�0 4,T4 vv� -1 2- 3 D APPUCATION FOR SITE EWkLUAr ION/ IMPROVEMENTS PERMIt Davie County Health D,?pajjmejjt Environmental I-lealih Sec -tion P 0. [kox 665 MOCI(Sville, N.C. 27028' CONSTRUCTION SHALL NOTBEGIN UNTIL IKIPRoVEMEN7S PERMIT HAS KFN 166UG11 149me Nono I. POrmill Requested By& )0-6-Af _.____PusIness Phone 9 2 2. A rags eA P077A ge-44 - Ale Aa, Cd E N -C 26 *7 tf A (a Prop" Owner If Dirowent than Above Address 4. Permill To: a) Install. Repair - b) Privy— Corwentional_?�f6ther Type_ Ground Absorption c) Sub-Divislony;te"� P ;. — S:e�c,_.�I____ Lot No. dl d", 5. System used to serve what tyt Housej-_ Mobile Home— Elusine$&_ Indust -y__ Othc:r--. b) Number of people 44" _. a) If b0L86 or mobile home, state size of home and number of rooms. House Dimensions �iv y Bad Rooms -3 Bath Rooms..AZA-_ Dan w/Closet-__.. b) If Suesinoss, Industry or Othar, State: Number of persons seried What type busirms, Estimate amount -of waste daily (24 hours) --.---.-- 7. Number anq type of wator-using fixtures: cosnmAes 3 garbage disposal lav3tor,y showers washing rnwhine— dishwasber inks_-/ """s S. a) Type water supply* Public_1._::__�F'rivaje_...____ Community—.— b) Has the water supply system been approved? Yes No_ 9. a) Property Dimensions Q_ 3 0 / b) Land area designated to building sit:i _Lf! c) Sewage Disposal Contractor 10. Do you anticipate any additions or expansions of ttie facility tl­�is sewa!je systern is Intended to serve? What type? This Is to cortity that the informatio�nis corre,t to th, Ole of my knowledge. "e O�ner Date Owner SignattIfe OWNER I'll SOLELY RESPON!318LE FOR C OM;:'LIAN:,E INITH ALL STATIF AND LOCAL LAWS Allow !,.tays for processing Directions to property: yc- A� L 0 7 14 Ifi 'P I XPISS 't, 'Z_ A K / .3-3- - '( -r r 4 -t -T-, cc"D 0-32) e4 yc- A� L 0 7 14 Ifi 'P I XPISS 't, 'Z_ A K / .3-3- - '( -r r 4 -t -T-, cc"D 0-32) DAVIE COUNTY HEALTH DEPARTMENT Environmental Health Section Soil/Site Evaluation NAME— ADDRESS PROPOSED FACIILTY I DATE EVALUATED I A 0 ? � f 3 4 6 7 PROPERTY SIZE /A-r7x Z_ LOCATION OF SITE 164A11 - Water Supply: On -Site Well Community Public Evaluation By: AugerBoring Pit Cut FACTORS 1 2 3 4 6 7 Landscape position Z_ Slope % HORIZON I DEPTH Texture group Consistence Structure Mineralogy HORIZON 11 DEPTH ell Texture group Consistence Structure 5-ke, rl�i'411 Mineralogy '47 HORIZON III DEPTH Texture group Consistence Structure Mineralogy HORIZON IV DEPTH Texture group Consistence Structure Mineralogy SOIL WETNESS RESTRICTIVE HORIZON SAPROLITE CLASSIFICATION ;71) LONG-TERM ACCEPTANCE RATE 5/ SITE CLASSIFICATION: EVALUATED BY: 2y��I_Z LONG-TERM ACCEPTANCE RATE: OTHER(S) PRESENT: REMARKS: LEGEND Landscape Position R -Ridge S7Shoulder L -Linear slope FS-Footslope 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 DCHD (01-901