1339 Beauchamp Rd Davie County,NC Tax Parcel Report �'l, Monday, September 26, 2016
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WARNING: THIS IS NOT A SURVEY
Parcel Information_., r __...,. .. . . .,.,.
Parcel Number: E70000012704 Township: Farmington
NCPIN Number: 5861936939 Municipality:
Account Number: 20579000 Census Tract: 37059-803
Listed Owner 1: DAVIS RICKY GEORGE Voting Precinct: SMITH GROVE
Mailing Address 1: 2239 NC HIGHWAY 801 SOUTH Planning Jurisdiction: Davie County
City: ADVANCE Zoning Class: DAVIE COUNTY R-20
State: NC Zoning Overlay: DAVIE COUNTY QD
Zip Code: 27006-0000 Voluntary Ag.District: No
Legal Description: 1.402 AC BEAUCHAMP RD Fire Response District: SMITH GROVE
Assessed Acreage: 1.41 Elementary School Zone: SHADY GROVE
Deed Date: 10/1998 Middle School Zone: WILLIAM ELLIS
Deed Book/Page: 002060673 Soil Types: GnB2
Plat Book: Flood Zone:
Plat Page: Watershed Overlay: DAVIE COUNTY
Building Value: 259740.00 Outbuilding&Extra 18220.00
Freatures Value:
Land Value: 34830.00 Total Market Value: 312790.00
Total Assessed Value: 312790.00
161
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Permittees - '`�� DAVIE COUNTY HEALTH DEPARTMENT
Name: L 14-if - o5 Environmental Health Section PROPERTY INFORMATION
P.O. Box 848
Direct ons to property: Mocksville,NC 27028 Subdivision Name:
Phone#:336-751-8760
Section: Lot:
AUTHORIZATION,FOR
CE—) WASTEWATER S
SYSTEM CONSTRUCTION Tax Office l'IN:#
r '�" . :_ t,�I
AUTHORIZATION NO: 4 r A Road Name � 1 ip. oc,(.a
**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-1 I of G.S.Chapter 130A,Wastewater Systems,Section.]900 Sewage Treatment and Disposal Systems)
r :
***NOTICE***.THIS AUTHORIZATION FOR WASTEWATER CONSTRUCTION
fL., ,.Z Ll �G� IS VALID FOR A PERIOD OF FIVE YEARS.
EwIRON(iENT; L ifiAl H SPEq(�L15, DATE ISSUED
RESIDENTIAL SPECIFICATION:BUILDING TYPE11A BEDROOMS #BATHS . #OCCUPANTS GARBAGE DISPOSAL:Yes or No
COMMERCIAL SPECIFICATION: FACILITY TYPE #PEOPLE #PEOPLE/SHIFT #SEATS INDUSTRIAL WASTE:Yes or No
LOT SIZE I'� `N` TYPE WATER SUPPLY �DESIGN WASTEWATER FLOW(GPD)INC NEW SITE REPAIR SITE
SYSTEM SPECIFICATIONS: TANK SIZE GAL. PUMP TANK GAL. TRENCH WIDTH,gam ROCK DEPTH J LINEAR FT. C�
OTHER 1 r/ISTf�It�VTII�� �C
REQUIRED SITE MODIFICATIONS/CONDITIONS: �('�.J�rAI-?i- C}J Q *'�� ��y "1�►-LL (� �� C���.
IMPROVEMENT PERMIT LAYOUT ,�. ��', Ss1"
-KAY, i2e-uoiLc-
1-fou -.
INN C�
l�Nb ��IJ�►�A�
**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 (336)751-8760..
OPERATION PERMIT
S I STALLED BY: r�N, l L'Fhl
1 D
` a
flow
�n 1 r
AUTHORIZATION NO..WA' OPERATION PERMIT BY: DATE:
**THE ISSUANCE OF THIS OPERATION PERMIT SHALL INDICATE TH E SYS SCR 0 H S N INSTALLED IN COM LIANCE
WITH ARTICLE 11 OF G.S.CHAPTER 130A,SECTION.1900"SEWAGE TREATMENT A AL SYSTEMS",BUT SHALL IN NO WAY BE TAKEN AS A
GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORILY FOR ANY GIVEN PERIOD OF TIME.
DCHD 02102(Revised)
1130
-Pennit fs' cYDAVIE COUNTY HEALTH DEPAXfftFjT
Environmental Health Section PROPERTY INFORMATION
P.O. Box 848
Di}�lpns to property: " + , I{= ►�-i F n+ `,+ Mocksville,NC 27028 Subdivision Name:
-^ Phone#:336-751-8760
I: f 1t:, r+1 L•,% ; :w� E �e:y EISo.-: Section: Lot:
AUTHORIZATION FOR
WASTEWATER
SYSTEM CONSTRUCTION Tax Office PIN:#
lei
�a! ter �.,
AUTHORIZATION NO: Ile l A Road Name i �. # �;� €�p ,i Yee �•�. K
**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 I I of G.S.Chapter 130A,Wastewater Systems,Section.1900 Sewage Treatment and Disposal Systems)
�'• �. i ***NOTICE***THIS AUTHORIZATION FOR WASTEWATER CONSTRUCTION
IS VALID FOR A PERIOD OF FIVE YEARS.
"ENVIRONMENTAL HEALTH H SPECIALIST' DATEISSUED
RESIDENTIAL SPECIFICATION:BUILDING TYPE. BEDROOMS #BATHS 3' #OCCUPANTS "' GARBAGE DISPOSAL:_Yes or No
COMMERCIAL SPECIFICATION: FACILITY TYPE #PEOPLE #PEOPLEISHIFT #SEATS INDUSTRIAL WASTE:Yes or No
LOT SIZE '� ""t TYPE WATER SUPPLYi L0JIYDESIGN WASTEWATER FLOW(GPD) NEW SITE REPAIR SITE
SYSTEM SPECIFICATIONS: TANK SIZE GAL. PUMP TANK GAL. TRENCH WIDTH- ROCK DEPTH - LINEAR FT.
OTHER �.� ,'I I ! tC, T<o V-61
REQUIRED SITE MODIFICATIONS/CONDITIONS: � � _ .:,^�7 r � �= �' �''�^" �-�'-I-�-f k:....tc L=4` c f-r
IMPROVEMENT PERMIT LAYOUT l�A � °�`ti- -=�-- -��" , �7IC
t TUi >r ��1 1 ��I iti j) �_?(` i�1 I L L. t
1
' r
KAY
AL:„yr
i
VS
.�.... I
f
**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 (336)751-8760.
OPERATION PERMjITCA
�
�/ �' lj-�' SYST I STALLED BY: J� ' �A,IS
�,.
v
":i�
AUTHORIZATION NO. OPERATION PERMIT BY:
**THE ISSUANCE OF THIS OPERATION PERMIT SHALL INDICATE TH E SYS LSCR BO E HaEN INSTALLED IN COM LIANCE
WITH ARTICLE 11 OF G.S.CHAPTER 130A,SECTION.1900"SEWAGE TREATMENT A A SYSTEMS" HALL IN NO WAY BE TAKEN AS A
GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORILY FOR ANY GIVEN PERIOD OF TIME.
DCHD 02/02(Revised) ,
_ oevie county Onyhealth 336 751 0706 P.3
APFLlGtiTtGtl FOtt SRE i IALtL17lO./th1P90valEhir PERMIT&ATG
` Davie C aunty Health Department
FnB= 8l»drtaC 8osp-tatIfeeth �cst
O ltookeville, NC 27023
(336)781-6760
+ZM'WZWr**• TICS Ap➢LICA4:0'..r' C&MOT as PXt7t:?iSSZD tRf=m A.S, TSL 1tBQ==
Zn'C5t1Lt:S0N rS PROV==- Refer do tha IlllmAl". im B^_Lz= for lautructions. t
. �...�. M►rw :o he 2111+d ,,r- .��1I1 S - Cont*et Pam% S
"'ka.lUV Addreaa _3 ( A/C 11+V L(�111 S Aora Those ✓ � qq f3
"+C1ty/9tats,^rSJ /ANC�� A/t' t7 t.t'(V D.:stass■lbw 33 tE' tt f �..11 (�lg-r�r. .
.i1. rice on Perait"ATC if aLfteract them Above
—�NdzLog Muss a "Lr/state/alp
`7. A j�xicati= Pori Cl Fits Rvaluation Firit/ATC 13 Bath
a.s. erstar:a sarv%ras X Rouse d I:obile ?foam ❑ eusirtmms 0 Industry C; Other
S. T'Ve ayatan xupestsd+ X Oonvvmttonal comvsatlonal a44U:144 •v lraoratlw �j. .
RsPlCeuaes #8eopis 1 Dadra= r Bathroo=mLl
J /L
✓ *ehrasuT Do.—bas Disposal 4R1"hls}r"chino =sessm*nr/rlumb"a P&-mmant/Mo slwaing
T. It Puslnsoelis+dtstay/othor, :srlly type 1 7soplm / atako
1 Casiwtlse r mWers / nriaalm a hater eooasms
Ili' PO MMIJIL"At # Seats _ _ 8atimattd Water Usage tgalloas per Gari
✓j, TnVQ rf rater afcgr+y I X caumrrlt;i,ty ❑ Orel. Q Cotrmunity
_,—I. Do yoj anticipate addit—I ms or t'tllawiotu air tac(2:0..1 INS s}7trm lv laieaded to icm?C3 Yes P111
0
11yrs,ghat t
( z X37 COOP/.BP 71ir Wl2b7=PROkERTY I1YOMIA710M UQUBBTttD
ne 0 tJeraP Pt.AN6fL1STC%SU9AJi77'FD§ ttedieot svilbT111SAPPUCATIOK
rr'1'rayarrlytli: 1 '
L,�VRM DIREMIDlS(from hlocktvU)toPROPEaTY:
ISS ,
Tae OtYtu:TLY: A
✓ t'toptttyrltlarpi: Road ftam,lLnn ' ► Onl BiAiO�[ 1�
cj�rmp AcIaNc . tic.2--),- rJ 8 A t:,',/p A ff
kiln a Sabdiristoaprorldc it:tora:atMa,at fetlaws: Y /y} � SC. ✓ i+�d�t h T
aau: -( CHILI
,i BCeti tl: Uloc Lot: c—Wto ko`au corners tls:Zar:
'f leis is to cealty ibst the laroraWlan provided Is earml to the bast or ray knowledte.I understand that niy parmit(s)
lu ncd hcre0ter ore tabl oet to raptruior or revoeati oa,if thesite plam or Intended at den=t~o r if the Information
salmUted In Uls application is talstl1od or chanScd. !,also,an tterstamW Marl am:raponrtbla Ir all ekarger imarrad/iuw
thiaappQcntiaa 1.hereby,give consent to Ilia Atrthorlad Rcpresuacativa er clic Devic County Health Deglartmaa t
to enter upca suuve described prolIerly localetl In Davie County and owned Ly
to coadmat all IeWng procedura as ucceuary to dctornsioc the sib AjUI L'ltr.
DATE - '(J �,►1cllAruiiE- -i=•`J ,
71315 ARBA MAY 8E USID FO;;DRAW NG YOUR SITE PLAN(Ltdude all of the fWavrkt;t l;:ttillttr rtrd prepmd
pruptrtyltael and dbuttsiM ttratinrts,stlhatics, an aptle lceations).
Site Rcvidt Charts
f Datc(s): -
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11t.4sedDCFI (t15/O3 Invoice Yo• - - � Z'—'
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' DAVIE COUNTY HEALTH DEPARTMENT
Environmental Health Section
+ Soil/Site Evaluation
APPLICANT INFORMATION PROPERTY INFORMATION
Account #: 990003336 Tax PIN/EH#: 5861-93-6939
Billed To: Ricky Davis Subdivision Info:
Reference Name: Location/Address: 1339 Beauchamp Rd-27028
Proposed Facility: Residence Property Size: 1.47 acres Date Evaluated:
Water Supply: On-Site Well Community Public
Evaluation By: Auger Boring Pit Cut
FACTORS 1 2 3 4 5 6 7
Landscape position
Slope%
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: EVALUATION BY:
LONG-TERM ACCEPTANCE RATE: OTHER(S)PRESENT:
REMARKS:
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
SICL-Silty clay loam SIL-Silty loam CL-Clay loam SCL-Sandy clay loam
SC-Sandy clay SIC-Silty clay C-Clay
CONSISTENCE
oist
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 05/99(Revised)