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155 Daye Ln�avie Cauntv, %1C • Tax Parcel Report Wednesday, October 12, 201 E WARIVINU: TH1S 1S NU'1' A SU1ZVl+:Y .—� e .�� � .��. � . , � , Parcel Information , , �,..���.� �..� �.���,�._ �����..�.���.� ov� ��.� Parcel Number: D70000010701 Township: Farmington NCPIN Number: 5862401916 Municipality: Account Number: 58158000 Census Tract: 37059-802 Listed Owner 1: POTTS REAL ESTATE INC Voting Precinct: SMITH GROVE Mailing Address 1: C/O DIANE H POTTS Planning Jurisdiction: Davie County City: ADVANCE Zoning Class: DAVIE COUNTY R-20 State: NC Zoning Overlay: DAVIE COUNTY QD Zip Code: 27006-0498 Voluntary Ag. District: No Legal Description: OFF REDLAND ROAD Fire Response District: SMITH GROVE Assessed Acreage: 1.46 Elementary School Zone: PINEBROOK Deed Date: 1/1996 Middle School Zone: NORTH DAVIE Deed Book / Page: 001780311 Soil Types: Gn62 Plat Book: Flood Zone: Plat Page: Watershed Overlay: DAVIE COUNTY Building Value: 0.00 Outbuilding & Extra 4500.00 Freatures Value: Land Value: 21840.00 Total Market Value: 26340.00 Total Assessed Value: 26340.00 9`�s'A Davie County, °�UN�'' NC _ �. , " .,�_ ,.t; , ,4 ,}�,_� �.� ' ,,, ,;. e:$ �7:. ,�� , ��vo, o�� �'�Xb ,. �-.�L]�„yaRt7�A'r1oN No. DAVIE COUNTY � ALTH DEPARTMENT ;.� .;� ,° Environmental Health Section PROPERTY INFORMATION Permitt�e'�'S }�, P.O. Box 848 Name: "� `�� � Mocksville, NC 27028 Subdivision Name: --"� Directions to property: ��-a [� �: '�.�� �,� Phone #: 704-634-8760 Section: Lot:�^"" 4 4. ` �,' �� r.�` AUTHORIZATTON FOR ` � � . �`�,�-�._.�_x.,�T ��."s`. �\„ �Sr* �> C� v� `� WASTEWATER �(� . - e�� fi' - `��'B -�-�� SYSTEM CONSTRUCTION Tax Office PIN:# R i�:� r� _ f,S's�. \��t�� r�.�s i�''�` J 1`1" {_ ��-=--- Road Na� Zlp:.-C �_)� � **NOTE** This Authoriza6on for Wastewater System Construcdon MUST BE ISSLJED by the Davie County Environmental Health Secdon prior to issuance of any Building Pernuts. This Form/Authorization Number should be presented to the Davie County Building Inspections Office when applying for Building Pernuts. (In compliance with Article 11 of G.S. Chapter 130A, Wastewater Systems, Section .1900 Sewage Treatment and Disposal Systems) �� :•� ***NOTICE*** THIS AUTHORIZATION FOR WASTEWATER CONSTRUCTION ' � - � '� - 1°.. � �,�.,;�� �`�R ��. _*, �,�`: � CEti '�� �`' IS VALID FOR A PERIOD OF FIVE YEARS. ENVIRONMENTAL HEALTH SPECIALIST ` DATE ISSUED .. _ ;;�r< . . . _: . �'� i d, „�..�,"`��y �, .. � ��-µj ,�,;i�, X a�.;.� �� '��� �� . . � •;:... . �. � �4� . � � �» � . .` `- " DAVIE COUNTY �EALT� DEPARTMENT � , .. v. .. ° y �'� �'. ` �' �� �' ' =-' " � �MPROVEMENT AND OPERATION PERMITS I ^ M y �Permifte�'s,',.�-� �` . � , . ,.,� , � � � , 1 T . r+f � �'. , �, �. PROPERTY INFORMATION �'1t��#:l +. � Name: ' `'�'� '1 �' °t; (�� r' Subdivision Name: """ `"._ , � ,:^ . _ ` � 1 � _.__..._ _: Directions to property: � t�� f�'- r. t'-�`•- Section: Lot: '"'"` Il�IPROVEMENT ,,r � � ' "`,� '';�,, '� �} ::., PERMIT Tax Office PIN:# .'�a ��l �e r"� ,�',�., � _ � `� l �.� �� ��_ ''• � '' . c� �,-. . _ i. � . . �� :� Road Name: ���4 ; :�• �.,t� ni E� Zip: �'� i '�[� �, , **NOTE** This Improvement Permit DOFS NOT authorize the construction or installation of a septic tank system or any wastewater system. An ' ALTTHOWZATION FOR WASTEWATER SYSTEM CONSTRUCTION must be obtained fn�m this Department prior to the • construction/installation of a system or the issuance of a building pernut. (In compliance with Article 11 of G.S. Chapter 130A, Wastewater Systems, Section .1900 Sewage Treatment and Disposal Systems) � . ,� { - � ,.: - ' ***NOTICE*** THIS PERMIT LS SUBJECT TO REVOCATION IF STI'E ``', �� � '"{ "��•. '.' ; PLANS OR Tf� INTENDED USE CHANGE. YOUR WASTEWATER ENVIRONMENTAL HEALTH SPECIALIST DATE ISSUED SYSTEM CONTRACTOR MUST SEE THLS PERNII'1' BEFORE INSTALLING T'HE SYSTEM. RESIDENTIAL SPECIFICATION: BUILDING TYPE �'^n # BEDROOMS �_ # BATHS � # OCCUPANTS �'�'_ GARBAGE DISPOSAL: Yes r No COMMERCIAL SPECIFICATION; FACILTTY TYPE # PEOPLE # PEOPLFJSHIFT # SEATS INDUSTRIAL WASTE: Yes or No , 1., , LOT SIZE �+� X 1� TYPE WATER SUPPLY �� DESIGN WASTEWATER FLOW (GPD) �=-> �`� NEW SITE � REPAIR SITE . -� i y � J SYSTEM SPECIFICATIONS: TANK SIZE ��-A GAL. PUMP TANK GAL. TRENCH WIDTH -� ROCK DEPTH � LINEAR FI'.�� REQUIRED SITE MODIFICATIONS/CONDITIONS: ` �. � I IMPROVEMENT PERMIT LAYOUT **CONTACT A REPRESENTATIVE OF THE DAVIE COUNTY HEALTH DEPARTMENT FOR FINAL INSPECTION OF THIS SYSTEM BETWEEN 830 - 930 A.M. OR 1:00 - 1:30 P.M. ON THE DAY OF INSTALLATION. TELEPHONE # IS (704) 634-8760. OPERATION PERMIT , SYSTEM INSTALLED BY: DdX� X/2 � AUTHORIZATION NO. � OPERATION PERMIT BY: DATE: � /� **THE ISSUANCE OF THIS OPERATION PERMTT SHALL INDICATE THAT THE SYSTEM DESCRIBED ABOVE HAS BEEN INSTALLED IN COMPLIANCE WITH ARTICLE 11 OF G.S. CHAP"TER 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. DCHD OS/96 (Revised) ; APPLICATION FOR SITE EVALUATION/IMPROVEMENT ' � Davie County Health Department Environmental Health Section P.O. Box 848 Mocksville, NC 27028 (704) 634-8760 p �v�itttr,l� r:.. _ _ AUG I I 1997 "''''MENTAI HEALTN E..__—.. .__ .. :'� ��JNTY �'�'�*IMPORTANT**** THIS APPLICATION CANNOT BE PROCESSED UNLESS ALL THE REQUIRED INFORMATION IS PROVIDED. 1. Name to be Billed � i. Contact Person � dt.� �� Mailing Address � � 0-,� /� Home Phone City/State/Zip r/!+v A M G� 11%L. �.7 trD G Business Phone �QJ' �� � 2. Name on PermidATC if Different than Above Mailing Address City/State/Zip 3. Application For: [] Site Evaluation [] Improvement Permit & ATC oth 4. System to Serve: ['] House Mobile Home [] Business [] Industry [] Other 5. If Residence: # People T # Bedrooms�_ # Bathrooms � [ ishwasher [] 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: [ County/City [] Well [] Community 8. Do you anticipate additions or expansions of the facility this system is intended to serve? [] Yes � If yes, what type? PROPERTY INFORMATION REQUIRED: *** IMPORTANT *** A PLAT OF THE PROPERTY MUST BE A� /� � SUBMITTED WITH THIS APPLICATION. Property Dimensions: .� �S 0��B'O � WRITE DIRECTION5 (from Mocksville) T PROI Tax Of�ce PIN: #_n� -�- J/7 l rD ; ��� �• L. D�-•� K�etX.i/� Property Address: Road Name ��Kl V E L N� � , �s�✓ 6� L.. �f CitylZip ��� NL�, �-�De�6 ; �e�-�" 3 rdl. B-�CIN If in Subdivision provide information, as follows: � Name: � � � Section: Lot #: ; TY: � This is to certify that the information provided is conect 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 by D'y L t nduct al ures as necessary to determine the site suitability. DATE��'/�' g 7 SIGNATURE Revised DCHD (06-96) . ` . DAVIE COUNTY HEALTH DEPARTMENT . ,- • Environmental Health Section SECTION LOT SoiUSite Evaluation APPLICANT'S NAME �G� \ �� DATE EVALUATED O \� � 1� PROPOSED FACILITY \� ��� � � � PROPERTY SIZE � � � � � �-� O I SUBDIVISION — ROAD NAME ���I �2. �� N`� Water Supply: On-Site Well Community EvaluationBy:C�.�-- AugerBoring V Pit FACTORS 1 2 Landsca e osition � Slo e % �(,' IS - I � HORIZON I DEPTH " Texture rou Ct- L Consistence - � � $ Structure C� C e. �',� �, II DEPTH 2.,`� ': Texture group Consistence Structure Mineralogy HORIZON III DEPTH Texture group Consistence Structure Mineralogy HORIZON IV DEPTH Texture group Consistence Structure SOIL WETNESS 5� „� RESTRICTIVE HORIZON — — SAPROLITE — CLASSIFICATION ► , LONG-TERM ACCEPTANCE RATE � � SITE CLASSIFICATION: � S ' LONG-TERM ACCEPTANCE RATE: • ` °� i \ C REMARKS: �� �V�� � � �� DCHD (01-90) Public V Cut 3 4 5 6 7 EVALUATION BY: OTHER(S) PRESENT: ���'� �S .�3va.���..a-- v v 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 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 Mineraloev 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 - 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