178 Evergreen LnDavie County, N.0 , Tax Parcel Report ' 5 Wednesday, September 28, 2016
141
Parcerinformation`"'
All data is provided as is without warranty or guarantee of any kind either expressed or implied including but not limited to the
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
Parcel Number:
F90000000310
Township:
Shady Grove
NCPIN Number:
5880686676
Municipality:
Account Number:
62527000
Census Tract:
37059-804
Listed Owner 1:
ROTH ROCK STEVEN G
Voting Precinct:
EAST SHADY GROVE
Mailing Address 1:
397 OAK GROVE CHURCH RD
Planning Jurisdiction:
Davie County
City:
MOCKSVILLE
Zoning Class:
DAVIE COUNTY R -A
State:
NC
Zoning Overlay:
Zip Code:
27028
Voluntary Ag. District:
No
Legal Description:
5.15 AC OFF UNDERPASS RD LOT 6
Fire Response District:
ADVANCE
Assessed Acreage:
5.10
Elementary School Zone:
SHADY GROVE
Deed Date:
7/1989
Middle School Zone:
WILLIAM ELLIS
Deed Book f Page:
001490621
Soil Types:
PaD,WeC,PcB2
Plat Book:
0005
Flood Zone:
AE,X
Plat Page:
214
Watershed Overlay:
-
Building Value:
7700.00
Outbuilding & Extra
900.00
Freatures Value:
Land Value:
54310.00
Total Market Value:
62910.00
Total Assessed Value:
62910.00
141
Davie County, NCimplied
All data is provided as is without warranty or guarantee of any kind either expressed or implied including but not limited to the
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 or arising out of the use or inability to use the GIS data provided by this website.
DAVIE COUNTY HEALTH DEPARTMENT J . r)
OF COMPLETION
Permit Number
= No Gc350
Location —
\, -. }.^�.y_...'.-i"+. •" �*..� � �lS -..y; :Y' � 1 L �. C.y...�j'r ,-K �1` f'... ,. ..' ..3 :. • •� � .\ J:."'v ... .,1 �,'`i
Subdivision Name Lot No. Sec. or Block No.
Lot Size -. House Mobile Home Business -- Speculation
No. Bedrooms .No. Baths — I No. in Family —
Garbage Disposal YES ❑ NO [Ey'
Specifications for Syste (�
Auto Dish Washer YES E] NO [ /000 U - —'g 61(
Auto Wash Ma,,hine YES d NO q0 0(1 _
Type Water Supply — __—
'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.
r
A(r '
s
Improvements permit by
-
` IMPROVEMENTS PERMIT AND CERTIFICATE
'NOTE: Issued in Compliance With Article I I of G.S. Chapter 130a
Sanitary Sewage Systems
Name--` �_r= �..� , ;�...; Date .
'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 b
v - -
Z�r
Certificate of Completion _'s. 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 be taken as a guarantee that the system will function
satisfactorily for any given period of time.
APPLICATION FOR SITE EVALUATION/IMPROVEMENTS PERMIT
Davie County Health Department \ ��
Environmental Health Section
P. O. Box 665
d
Mocksville, NC 27028
1. Application/Permit Requested By S 1
1-e ve "' P
Mailing Address PC l t1 be L4." S (/t t1o, 64 Um`}'i 19
Home Phone ?/ 5 76 6 a T� Business Phone .
2. Name on Permit if Different than Above
3. Application/Permit for: ❑ General Evaluation
4. System to Serve: ❑ House obile Home
❑ Business ❑ Industry ❑ Other
5. If house, mobile home: Subdivision
No. of People /
No. of Bedrooms
No. of Bathrooms
Dwelling Dimensions A- X b 1
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
-J-roC- 1<�,
S i Clemn0 AS, /V C.
a7Ul
No. of Water Coolers
Septic Tank Installation
❑ Place of Public Assembly
❑ Unknown
Section ---� Lot #
❑ Basement/Plumbing
❑ Basement/No Plumbing
ashing Machine
❑ Dishwasher
❑ Garbage Disposal
No. of Showers Water Zrivate
Figures
7. Type of water supply: ❑ Public ' El Community
8. Property Dimensions �' /SQ �Y'2S Sewage Disposal Contractor ! . F (. lq SSC OGK
9. Do you anticipate additions/expansion of the facility this sytem is intended to serve? ❑ Yes
If yes, what type?
*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:
15 r E-4 9� �D i somal,
7 urti L.e�f�
A to % d
y
1 e-F�r� YUP
ere, qo
r)'�' S h'1 G rod
-ro ye ( (o w
This is to certify that the information provided is correct to
incurred from
this ap lication. 5-G)
DTE�'��•
r
SS .moo h QS �v�S
�D /
best of my knowledge, 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 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
to conduct all testing procedures as necessary to determine said site's suitability for a ground absorption sewage treatment
and disposal system.
DATE
DCHD (12-90) J
SIGNATURE
DAVIE COUNTY HEALTH DEPARTMENT
Environmental Health Section
Soil/Site Evaluation
NAME DATE EVALUATED�-
ADDRESS s P'C� Q PROPERTY SIZE
PROPOSED FACIILTY LOCATION OF SITE �.
Water Supply: On -Site Well Community Public
Evaluation By:t� L_ Auger Boringy Pit
Cut
FACTORS
1
2
3
4
Landscape position
-5
S
—S
Slope %
-
4 —150
HORIZON I DEPTH
,2"
2 u
a
l ''
Texture group
L
S L
S L
.� L
Consistence
`P,
F,
�7 P_
}_
Structure
rpm
(`
C
MineralogX
HORIZON II DEPTH
3b`
36°
Texture group
S 11-
5 C L
C4 -
Consistence
F L
Structure
R
Mineralogy
HORIZON III DEPTH
Texture group
Consistence
Structure
Mineralogy
HORIZON IV DEPTH
Texture group
Consistence
Structure
Mineralogy
SOIL WETNESS
N S
QJS
s
N s
RESTRICTIVE HORIZON
--
--
SAPROLITE
—
—
—
—
CLASSIFICATION
S
S
s
LONG-TERM ACCEPTANCE RATE
.L{
SITE CLASSIFICATION: V S EVALUATED BY:
LONG-TERM ACCEPTANCE RATE: OTHER(S) PRESENT:
REMARKS: t � s� Si, � g �9 camA �a+_
c — -, 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
Mi neralopy
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 wate►' 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
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