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118 Eatons Church RdThursday, September 29, 2016 Davie County, NC Tax Parcel Report Gl�� WAR1V11VG: '1'H1S 1S 1VU'1' A SURVEY 9 vtAAll data Is provided as Is without warranty or guarantee of any kind 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 no Uq� NC or arising out of the use or inability to use the GIS data provided by this website. Parcel Information Parcel Number: E40000001101 Township: Clarksville NCPIN Number: 5831243556 Municipality: Account Number: 82521207 Census Tract: 37059-801 Listed Owner 1: BIVINS JOHN F Voting Precinct: CLARKSVILLE Mailing Address 1: 118 EATONS CHURCH ROAD Planning Jurisdiction: Davie County City: MOCKSVILLE Zoning Class: DAVIE COUNTY R-A,R-20 State: NC Zoning Overlay: Zip Code: 27028-4732 Voluntary Ag. District: No Legal Description: 4.016 AC EATONS CHURCH RD Fire Response District: WILLIAM R. DAVIE Assessed Acreage: 3.60 Elementary School Zone: WILLIAM R DAVIE,PINEBROOK Deed Date: 7/2003 Middle School Zone: NORTH DAVIE Deed Book / Page: 004980403 Soil Types: EnB,MsD Plat Book: Flood Zone: Plat Page: Watershed Overlay: DAVIE COUNTY Building Value: 180480.00 Outbuilding & Extra Freatures Value: 28980.00 Land Value: 36860.00 Total Market Value: 246320.00 Total Assessed Value: 246320.00 9 vtAAll data Is provided as Is without warranty or guarantee of any kind 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 no Uq� NC or arising out of the use or inability to use the GIS data provided by this website. �l d ✓� ,�i Vc (if Davie County Health Department 18 Environmental Health Section - P.O. Box 848 0 1 , �„ 210 Hospital Street O U �'� Courier # : 09-40-06 1911 Mocksville, NC 27028 Phone: (336) - 753 - 6780 ON-SITE WASTEWATER CERTIFICATION Fax: (336) - 753-1680 (Check One) Replacement Remodeling Reconnection Name: �l�1 �✓t't� �� Phone Number �3�T % �! �% (Home) Mailing Address: /jq �yA%eI� P)' jJ6 �4D (Work) c�-�-�A �dU0 / (5 z -7cal? Email Address: Detailed Directions To Site: 0 / Al R6 nR 6e* AU' S- aA Lr6 Property Address: %% g am - 42A L'V—C'k R6,4n Please Fill In The Following Information About The EXISTING Facility: /-k _ Name System Installed Under: `1, �l �i I Type Of Facility(,CS�- Date System Installed (Month/Date/Year) /q,2 Z Number Of Bedrooms: � Number Of People: Is The Facility Currently Vacant? Yes - Any s If Yes, For How Long? Any Known Problems? YesNo If Yes, Explain: Please Fill In The Following Information About The NEW Facility: Type Of Facility: �.[_✓UGl�6l �66 l Number Of Bedrooms:_f_Number of People, Pool Requested By: (Signature) ize: Other: Requested: For Environmental Health Office Use Only Approve Disapproved Comments: Environmental Health Specialist, Date: The signing of this form by the Environmental Health Staff idin no way intended, nor should be taken as a guarantee (extended or limited) that the on-site wastewater system will function properly for any given period of time. Payment: Cash Che A Money Order # .10 Ur --7 Amount:$ 1061 Date: Paid By: Al Received By: (46 Account #: 555 Invoice #: .Z Z/ DAVIE COUNTY HEALTH DEPARTT� IMPROVEMENTS PERMIT AND CERTIFICATE OF COMPLETION 'NOTE: Issued in Compliance With Article 11 of G.S. Chapter 130a Sanitary Sewage Systems Permit Number Name�•�7/.�ir�.� - �;y;,i�- ��-�?�_'%��r �,'' !�"�v //. Date 'i- ! ,�,�� NO - 6 7') 8 Location i%�%f ./ ll,�- s ,�,: t� �-? /i Y '✓ Y-;„� Cil / �~ Subdivision Name Lot No. Sec. or Block No. Lot Size `�� r'%%'�- House �� Mobile Home _ Business Speculation No. Bedrooms �' No. Baths No. in Family -- Garbage Disposal YES. ❑ NO D- Specifications for System: Auto Dish Washer. YES p NO ❑ Auto Wash Ma shine YES h NO ❑ ��Jv/ Type Water Supply ///A// YP PP Y � — *This permit Void if sewage system described below is not installed within 5 years from date of issue. This permit is subject to revocation if site plans or the intended use change. ' � �`� CEJ-�� • --------- Improvements permit b *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 day of completion, Telephone;Number 704-634-5985. Final Installation Diagram: System Installed by r Certificate of Completion I ��.� Date 'The signing of this certificate shall indicate that the system described above has been installed in compliance with the standards set forth in the above regulation, but shall in NO way betaken as a guarantee that the system will function satisfactorily for any given period of time. _ y ' DAVIE COUNTY HEALTH DEPARTMENT Environmental Health Section Soil/Site Evaluation .c+/ NAME i �//`rl DATE EVALUATED ADDRESS PROPERTY SIZE '�////� 2 PROPOSED FACIILTYLOCATION OF SITE Water Supply: On -Site Well Community Public Evaluation By: Auger Boring tl--^ Pit Cut FACTORS 1 2 3 4 Landscape position Slope % -' — — HORIZON I DEPTH Texture grou r Consistence Structure Mineralogy HORIZON II DEPTH �/ 0?6" 1O" •�Q`� 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 _27 LONG-TERM ACCEPTANCE RATE SITE CLASSIFICATION: X4/Z. �'`/fl (/ EVALUATED BY: A111 LONG-TERM ACCEPTCE RAT REMARKS: �.'�� :��j✓ DCHD(01-901 PRESENT: '0 e 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 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 ■N■ ■N■ ■■MEM■MOMM■ ■EMEM■MMEN■ ■N IMMEMEN■■ ■E■M■■■M■■■ ■E■■ .' V APPLICATION FOR SITE EVALUATION/IMPROVEMENTS P Davie County Health Department Environmental Health Section P. O. Box 665 0 i72 Mocksville, NC 27028 1. Application/Permit Requested By Mailing Address %( pn°• Home Phone 9* -63`l -,sow J11O Business Phone 4!!!�'-13y 2. Name on Permit if Different than Above —e ►�9— 3. Application/Permit for: ❑ General Evaluation Septic Tank Installation 4. System to Serve: House ❑ Mobile Home ❑ Place of Public Assembly ❑ Business ❑ Industry ❑ Other ❑ Unknown 5. If house, mobile home: Subdivision No. of People 2 No. of Bedrooms 3 No. of Bathrooms Dwelling Dimensions � 2;5-�J. � 1AAO,•-�v�c�,,,,+� k)C-%Me"4- 6. If business, industry, place of public assembly, other: Specify type No. of People Served No. of Commodes No. of Lavatories No. of Sinks No. of Urinals No. of Water Coolers No. of Showers Water Usage Figures _ 7. Type of water supply: ❑ Public X Private 8. Property Dimensions !!� oLk� �4cS�S Sewage Disposal Contractor 9. Do you anticipate additions/expansion of the facility this sytem is intended to serve? If yes, what type? Section Lot # ABasement/Plumbing ❑ Basement/No Plumbing Washing Machine Dishwasher ❑ Garbage Disposal ❑ Yes [ No ❑ 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: 6t)\ +t. �.�� nit S Cusco,, �,'�4Z, C u,\fA. 6-o A\\ Ate. vx.-/ -,Aa f4,4t.- 2v`o a'%;-s�- This is to certify that the information provided is correct to the best of my incurred from this application. DAT and I understand I am responsible for all charges SIGNATURE CONSENT FOR SITE EVALUATION TO BE DONE ON ABOVE DESCRIBED PROPERTY MUST CHECK ONE: 1. 1 OWN the property. ❑ 2. 1 DO NOT OWN the property. If you checked Box #2, the rest of this fox MUST be completed by the owner or a person authorized by the owner: I hereby give consent to the authorized representative of Davie Coun He Department to enter upon above described property located in Davie County and owned by ep , ww < to conduct all testing procedures as necessary to determine said site' suitability for a gro nd absorption sewage treatment and disposal system. DATE NATURE DCHD (12-90)