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206 Fork Bixby RdCity: ADVANCE WARNING: THIS IS NOT A SURVEY DAVIE COUNTY R-20 State: :=--Parcel Informaffori— Parcel Number: J7050B0005 Township: Fulton NCPIN Number: 5777293575 Municipality: FORK Account Number: 8304258 Census Tract: 37059-804 Listed Owner 1: MANZELLA ANDREW ROBERT Voting Precinct: FULTON Mailing Address 1: 206 FORK BIXBY ROAD Planning Jurisdiction: Davie County City: ADVANCE Zoning Class: DAVIE COUNTY R-20 State: NC Zoning Overlay: Zip Code: 27006 Voluntary Ag. District: No Legal Description: 1.053 AC FORK BIXBY RD Fire Response District: FORK Assessed Acreage: 1.01 Elementary School Zone: CORNATZER Deed Date: 10/2014 Middle School Zone: WILLIAM ELLIS Deed Book / Page: 009710568 Soil Types: PcB2,PcC2 Plat Book: Flood Zone: X Plat Page: Watershed Overlay: WS -IV -P Building Value: 108660.00 Outbuilding & Extra 0.00 Freatures Value: Land Value: 20650.00 Total Market Value: 129310.00 Total Assessed Value: 129310.00 141 Davie County, NC All data is provided as is without warranty or guarantee of any kind either expressed or implied including but not limited to the 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 or arising out of the use or inability to use the GIS data provided by this website. CU DAVIE COUNTY HEALTH DEPARTMENT IMPROVEMENTS PERMIT -AND CERTIFICATE OF COMPLETION 'NOTE: Issued in Compliance With Article II of G.S. Chapter130a a 6 � Harz,/ ;klb ' Sanitary/Sewage Syste,,Lms ,C 4vr � " /ry / Permi7I Number Name r/, c7 �r ! /;/ v G. ,•. Date ;!l//l�'�5 N o 1 4 38 Location �� i �� % fir /r;" !.,f 1_ - hdurf �:; 4: f" t / xe,-- Subdivision Name Lot No. Sec. or Block No. Lot Size ,� House Mobile Home — Business -- Industry No. Bedrooms No. Baths No. in Family_— Public Assembly Other Garbage Disposal YES ❑ NO po Specifications for System: Auto Dish Washer YESNO ❑ Auto Wash Ma shine YES [J] NO ❑ /GC F 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. F Improvements permit by *Contact a representative of the Davie County Health Department for final Inspection of this system between 8:30-9:30 A.M., 1:00-1:30 P.M. or 4:30-5:00 P.M. on day of completion. Telephone Number: 704-634-5985. Final Installation Diagram: E" E-11 System Installed by —) s `�,�>' Certificate of Completion Date 1 - 'The signing of this certificate shall indicate that the system described above has been installed in compliance with the standards set forth in the ahova rannlminn h..r h.0 i. Ain..... ��. -- - - -..--• DAVIE COUNTY HEALTH DEPARTMENT IMPROVEMENTS PERMIT AND CERTIFICATE OF COMPLETION 1 J p as�8 A *NOTE: Issued in Compliance With Article I I of G.S. Chapter 130a " Sanitary Sewage Systems,:" /yu Permit Number Name / Date N- 'I 4 3 8 Location e' •/iy ' �1 Y' r�r '/ 'Sl. �L ss,�cF � ✓ ,_i 1`J SubdiVision Name Lot No. Sec. or Block No. Lot Size — House Mobile Home _ Business _— Industry No. Bedrooms f --.No. Baths — S _ No. in Family Public Assembly Other Garbage Disposal YES ❑ NO [' Specifications for System: Auto Dish Washer YES NO ❑ Auto Wash Ma;hine YES NO ❑ 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. Improvements permit by *Contact a representative of the Davie County Health Department for final inspection of this system between 8:30-9:30 A.M., 1:00-1:30 P.M. or 4:30-5:00 P.M. on day of completion. Telephone Number: 704-634-5985. Final Installation Diagram: E F -u System Installed by Ict�S ��- F Certificate of Completion �_ �- �- ��, _ _ Date 1- f7�0 *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 FtEI i 6 1994 P. 0. Box 665 Mocksville, N.C. 27028 �p CONSTRUCTION SHALL NOT BEGIN UNTIL IMPROVEMENTS PERMIT HAS BEEN ISSUED_ Q f"i j Pd . � - Home Phone 1. Permit Req ested By D A V ; j ayE, r k r� Business Phone 2. Address 3. Property Owner if Different than Above Address / 4. Permit To: a) Instally Alter Repair— b) epair b) Privy Conventional Other Type Ground Absorption _ c) Sub -Division J –�? SLot No.� 5. System used to serve what type facility: HouseSec. Mobile Home Business Industry Other b) Number of people 6. a) If house or mobile home, state size of home and number of rooms. House Dimensions D Bed Rooms Bath Rooms Den w/Closet b) If Business, Industry or Other, State: Number of persons served What type business, etc. Estimate amount of waste daily (24 hou 7. Number and type of water -using fixtures: commodes urin lavatory % showers / dishwasher / sinks 8. a) Type water supply: Public ` Private Community b) Has the water supply system been approved? Yes INo 9. a) Property Dimensions < e, '" � � b) Land area designated to building site c) Sewage Disposal Contractor 1 r e qv T 1- garbage disposal washing machine / �d 10. Do you anticipate any additions or expansions of the facility this sewage system is intended to serve? What type? This is to certify that the information is correct to the best of my knowledge. Date Owner Sign ure OWNER IS SOLELY RESPONSIBLE FOR COMPLIANCE WITH ALL STATE AND LOCAL LAWS Allow 5 days for processing Directions to property: or Vjr "'" LL e, DCHD (6-62) TO 6 f W �' ��J�11 ar 14 1�� 0A 2h 3Wrd`_ A I A M 0 0 iz UI) ell, 1 1 4j�;," cf) 4. o v 71 77 C) E• c 369. GO "fli. V4, 41' 0 0 co 41 CHC, St' col L01oo A Xe _-INN -7 88 369 2222 42 1w, 4* 01 V 1` to ml 0) co 4 rI) 4. 4 C, CJI fe) "i (1) OD 4. 711 tdv: , " lr - I N 1 2065 C\j --.N I . J? C\j D_ i�� 06.58 m .160b 260.0 I og 8t, 1 9£ a 0, CA 0< BIXBY �100 - ------ mo (0) 0 350 43 q, r I 4! U) DAVIE COUNTY HEALTH DEPARTMENT Environmental Health Section Soil/Site Evaluation NAME ��rDATE EVALUATED ADDRESS PROPERTY SIZE PROPOSED FACIILTY LOCATION OF SITE�'-`�y Water Supply: On -Site Well Community Public t� Evaluation By: Auger Boring Pit Cut FACTORS 1 2 3 4 Landscape position L Slope Z HORIZON I DEPTH Texture group J-2 Consistence Structure Mineralogy HORIZON II DEPTH Texture group Consistence Structure k1 /l 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: EVALUATED BY: JJ l� 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 Moist VFR-Very friable FR -Friable FI -Finn 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 ■./■..■.■..■..■..■■■.■..■../■■■.�.NOON/..■■■■...■.■■.■■../...NEON ■■■■■.■■■■.■■......■■..■■.■...■.■.■■■■.■■■■.■■■..■.■■■..■■.../NONE ..................■....................... ...................... ................................ .............................ENE .............................................. ........ .......... ......................................... .... . . .... ...... .. .....■........■.........................�■..■..�.�■■■■.■■.■.■ No ...................................■OO.■■.■■e■Om.O■mO.■.O.■.mso■0. ................................ ................................ 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