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221 Fantasia Ln Davie County,NC Tax Parcel Report Thursday, December 15, 2016 167 21G---- 298--, 16 _,298--, 5 221 1\245 ; t J r I ' t J J r r i._...__........... ......_................................._._.................................._....._ ._.__.__..�._....._......_.—_..._.............................._..........._................-----...................._............................................_...._.._..._......._....................---..... � s WARNING: THIS IS NOT A SURVEY a Parcel Number: 190000000905 Township: Fulton NCPIN Number: 5788862075 Municipality: Account Number: _ 45619750 Census Tract: 37059-804 Listed Owner-1: -� LEWIS PHYLLIS BARNES:,. Voting Precinct: FULTON Mailing-Address 1: C/O PHYLLIS TURNER. '; Planning Jurisdiction: Davie County -- City: ADVANCE -- -, Zoning Class: DAVIE COUNTY R-A --,State:-- `- NC Zoning Overlay: Zip Code: 27006-7554 Voluntary Ag.District: No Legal Description: OFF BURTON RD Fire Response District: ADVANCE Assessed Acreage: — 2.02 Elementary School Zone: SHADY GROVE Deed Date:. -4/1997 Middle School Zone: WILLIAM ELLIS Deed Book/Page: 001930638 Soil Types: PaD,PcB2 Plat Book: Flood Zone: Plat Page: Watershed Overlay: DAVIE COUNTY Building Value: Outbuilding&Extra Freatures Value: Land Value: Total Market Value: Total Assessed Value: All 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�p� NC or arising out of the use or Inability to use the GIS data provided by this website. ��r v'��a�.y.sz�ixs,�_TSk ,.-,w ;'�,,`,;:; x7 .r,rr'_ his}vYti;ti,y i,�.s.;. Y °:',kh't k�..r� o."'\:-7:`.y� ! 'i,::�-I s � ;Y.f i$iTLf'" ,. •.Y ..s.'?�y)� r r i,.�..y •.r-, P._kr 17 C ;�w%� AUTHORI ATIONNO: 085-3 DAVIE COUNTY HEALTH DEPARTMENT Environmental Health Section PROPERTY INFORMATION Permittee's ' P.O' Box 848 Name: Mocksville,NC 27028 Subdivision Name: S ,� / Phone#:704-634-8760 Directions to property:�z'f a�_r7 l:3. r - Section: Lot: AUTHORIZATION FOR 07r WASTEWATER Tax Office PIN:# �- SYSTEM CONSTRUCTION _/ Road Name: p: **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 11 of G.S.Chapter 130A,Wastewater Systems,Section.1900 Sewage Treatment and Disposal Systems) ***NOTICE***THIS AUTHORIZATION FOR WASTEWATER CONSTRUCTION IS VALID FOR A PERIOD OF FIVE YEARS. ENVIRONMENTAL HEA&fH SPECIALIST DATE ISSUED r' 'DAVIE COUNTY HEALTH DEPARTMENT F ...�� . IMPROVEMENT AND OPERATION PERMITS PROPERTY INFORMATION Permittee's,� ,r f ti Name: Subdivision Name: Directions to ptpperty: -'Section: Lot- IMPROVEMENT' ot-IMPROVEMENT �M t %;t PERMIT Tax Office PIN:#4r,°rM- ; r - f t. Road Name: U f V **NOTE**This Improvement Permit DOES NOT authorize the construction or installation of aseptic tank system or any wastewater system.An AUTHORIZATION FOR WASTEWATER SYSTEM CONSTRUCTION must be obtained from this Department prior to the construction/installation of a system or the issuance of a building permit. (In compliance with Article 11 of G.S.Chapter 130A,Wastewater Systems,Section.1900 Sewage Treatment and Disposal Systems) ***NOTICE***THIS PERMIT IS SUBJECT TO REVOCATION IF SITE PLANS OR THE INTENDED USE CHANGE.YOUR WASTEWATER ENVIRONMENTAL HEALTH SPECIALIST DATE ISSUED SYSTEM CONTRACTOR MUST SEE THIS PERMIT BEFORE INSTALLING THE SYSTEM. RESIDENTIAL SPECIFICATION:BUILDING TYPE A� #BEDROOMS _#BATHS_,=V_#OCCUPANTS DISPOSAL:Yes or No COMMERCIAL SPECIFICATION: FACILITY TYPE #PEOPLE #PEOPLEISHIFT #SEATS INDUSTRIAL WASTE:Yes or No LOT SIZE TYPE WATER SUPPLY Awe, DESIGN WASTEWATER FLOW(GPD) NEW SITE .,-"_ REPAIR SITE SYSTEM SPECIFICATIONS: TANK SIZE r r GAL. PUMP TANK GAh TRENCH WIDTH ROCK DEPTH 0 LINEAR FT. OTHER REQUIRED SITE MODIFICATIONS/CONDITIONS: IMPROVEMENT PERMIT LAYOUT r I I "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(704)6348760. OPERATION PERMIT SYSTEM INSTALLED BY: /1n )ad Ilemowd T. . go AUTHORIZATION NO OPERATION PERMIT BY: �!. �'L�i/� DATE:/ "THE ISSUANCE OF THIS OPERATION PERMIT SHALL INDICATE THAT THE SYSTEM DESCRIBED ABOVE HAS BEEN INSTALLED IN COMPLIANCE WITH ARTICLE 11 OF G.S.CHAPTER 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 05/96(Revised) f APPLICATION`FOR SITE EVALUATIONAMPROVEMENT PERIM - a Davie County Health Department D i Environmental Health Section P O.Box 848 MAY — 1 1997 Mocksville, NC 27028 (704) 634-8760 ****IMPORTANT**** THIS APPLICATION CANNOT BE PROCESSED UNLESS ALL THE REQUIRED INFORMATION IS PROVIDED. 1. Name to be Billed 1 1 1�A�1 �`'� `� Contact Person Mailing Address 9q Home Phone .r�';&S� City/State/zip4UGl1( � �L 2�0 - Business Phone 9��y /&6 ' 13qK 2. Name on Permit/ATC if Different than Above Mailing Address City/State/Zip 3. Application For: [ ] Site Evaluation Improvement Permit&ATC [ ]Both 4. System to Serve: [ ]House Mobile Home [ ]Business [ ]Industry [ ] Other 5. If Residence:' #People #Bedrooms #Bathrooms [trKishwasher[ ]Garbage Disposal i [ .]Washing Machine [ ]Basement/Plumbing [ ]Basement/No Plumbing 1 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?14Yes [ ]No If yes,what type? Z xK>[:�, �o- a � ��'2 �`U, � r1 646g+ '� \/M CJ EITHER A PLAT OR SITE PLAN PROPERTY INFORMATION REQUIRED:***IMPORTANT***AXIWCOF THE PROPERTY MUST BE y SUBMITTED WITH TMIS APPLICATION. CProperty Dimensions:- 1 ' �C �S WRITE DIRECTIONS(from Vi ocksville)TO PROPERTY. Tax Office PIN: - # \ •- O L,r Y1 Property Address: Road NameFC-rIA-c-&i a l�r- . On Sd city/zip (JyQnce , KSc_ r If in Subdivision provide information,as follows: i f T ct n g�a- Name: 5{- Section: Lot#: C-60 This is to certify that the information provided is correct to the best of my l�nowledge. I understand that any permit(s) issued hereafter are subject to suspension or revocation,if the site plans or intended use changd or if the information submitted in this application is falsified or changed. I, also, understand that I am responsible for all charges incur d 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 �11��t,�(�W,�� to conduct all testi procedures as necessary to determine the site suitability. DATE SIGNATURE t/J Revised DCHD(06-96) THIS-AREA-AtAy--13E--USED-Fol?.T I)RAIV I NCS-YOUR-SITE'PLAN: 5 A4 �� 2av ' APPLICATION FOR SITE EVALUATION/IMPROVEMENTS PERMIT u e Davie County Health Department ��t-�Y p�/ S Environmental Health Section t1 +� P. O. Box 665 SEP 10 1993 / Mocksville, NC 27028 rrr 1. Application/Permit Requested By Mailing Address _`Zt- t QVl-nV L-4: ` ��(1��' L 7.21 CD Home Phone Business\� (�(1� Business Phone 2. Name on Permit if Different than Above 3. Application/Permit for: ❑ General Evaluati n eptic Tank Installation 4. System to Serve: C5 House obile Home ❑ Place of Public Assembly ❑ Business ❑ Industry ❑ Other ❑ Unknown 5. If house, mobile home: Subdivision Section Lot # ❑ Basement/Plumbing No. of People �2 ❑ Basement/No Plumbing No. of Bedrooms %Washing Machine No. of Bathrooms [ 'Dishwasher Dwelling Dimensions, Garbage Disposal 6. If business, industry, place of public assembly, other: Specify type No.of People Served No. of Sinks No. of Commodes No. of Urinals No. of Lavatories No. of Water Coolers No. of Showers Water Usage Figures 7. Type of water supply: ❑ Public Private ❑ Community 8. Property Dimensions a1CXQ,,k-e-S Sewage Disposal Contractor 9. Do you anticipate additions/expansion of the facility this sytem is intended to serve? ❑ Yes ANo 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: - qt:) -vt> To QWl 4Q,&t 4_0 � ' cL; 4 5 � 5� on Q,�)o <?R r\,\, � �e 5 A_e) Zb -�aY� ck- �-Q# I n 2 CS Or, k4-,Q- Q_\get c, 0,�o A Q_ 0_0 �t a� This is to certify that the information provided is coquadtco ft best of my knowledge, and I understpm I am responsible for all charges incurred application. , q-::D , W) k 'k Lfl.�2s DATE SIGNATURE CONSENT FOR SITE EVALUATION!_Q BE DONE ON ABOVE DESCRIBED PROPERTY MUST CHECK ONE: ❑ 1. I OWN the property. 4 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 represent 've of the Davie0.Cou ty H alth D rtment�to enter upon above described property located in Davie County and owned by `eJ�IJ V to conduct all testing procedures as necessary to Bete in s id site's suitability for a gro absorption sewage treatment and1;r7,, stem. DATE i IG URE DCHD(12-90) ` DAVIE COUNTY HEALTH DEPARTMENT Environmental Health Section Soil/Site Evaluation NAME DATE EVALUATED - ADDRESS PROPERTY SIZE 4YIe PROPOSED FACIILTY LOCATION OF SITE SL1 tGr 7y�✓L `l Water Supply: On-Site Well 1/ Community Public Evaluation By: Auger Boring li Pit Cut FACTORS 1 2 3 4 Landscape position 41, Slope % — HORIZON I DEPTH Texture group Consistence Structure Mineralogy HORIZON II DEPTH �/ f Texture groupL 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 RATEJ (` SITE CLASSIFICATION: `J EVALUATED BY: .It/ 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-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 Mineraloity 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 ■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■ ■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■ ■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■ iiiiiiiiiiiiiiiiii■�iiiii�iiiiii�iiiiii■i'i�iiii■'iiiiiiiiiiiiiMiii ■■..■■./...■.■■■■■■.■NM■E■■■■■■■.■N■■■.■■■■..N■■.■=■■......■/■I ::_:...................................[iii............■...........■■.■. ■■/■■■■■■.■■■■■■.■■■■■s.■.■.■■■■■■■■■■■/■■■■■■fie■■.■t■■■s�■■■M■■■ iii■''iiiiiiiiii�■■i'iiiiiiwi■ :iii■'�iiiiii iiiiii%viii=iiii■Eiii'ii■'i ■■■■■■■.■■■■■■■■■■■■■■■/t1.■■M■■■ ■■■■■■■MEMENU �■.■/.■/1■.■.■.■■■■■M.■■■■. �iiiiii■MMUMMEM MEEMEM1' EMMONS ............u.■..■......�.......M..■..0■�■MEM■■. M..MMM. MMMMMM■■ ■■■■■■■■■■■.■.■M/■■.■■■/r1■■■M■■s.■■■.■ ■� ■■/■MAN ■MMMM■M■■■■■■■■■ MENNOMMEMEMEMONO iiiiiiiiiiiiiiiiiiiiiiiiiiiii�i"e� i=iiii■'Qii■'�i�i ii�i�iiiI=MMEMME iiiiiiiii'ii■iiiiiiiiiiiiiiiiiiiii■�iiiiiiiiiii.i ■� iiiiMM■iiiiiMiiii ■■■■.■■■..■■■.■■.N■M■■■■M.■■■■■■■■■■■.MOMMEREM ■u■■a■ ■■■■■■ ■ HEME ■E.. . �. ■�N■■.■■■ : �:� :is:l■c:::OMMMOR:. ................................ ■■■■■■■■■.■..■■■.■■■■■■■■■■.■.■■ MMEMEMOMIN i .■.■...■■....MEMO MMEMEME -sammumommom----ONE ■■..MM. MJIMMIMMMMMMM M sommms moommom MEN mom NIMWMMMMMMMMMMMM No MEN= MMMMMMMMMMMMMMMMM ................................ .■■■■■■M■■■M■■■■N■■■.■■■■■�■■■■ ................../...... ■■■■■■.■■O■ME■■E■■■■/■■■■■■■■.■N■■■M■■■ ................................ 1........................■■...■■■ .................................................................. MOON ■.■■■.■■.■■■■■■■■■■■■■■■■■■ ..........................■■.... ■'iii'e��i'■�%��■■��i�� Davie Caun .�fealt�i ?'�`artment and .dame .7lealtIf yency 210 HOSPITAL STREET/P.O. BOX 665 MOCKSVILLE.N.C. 27028 PHONE:(704)634-5985 September 14, 1993 Phyllis Lewis Rt. 1, Box 41 Advance, NC 27006 Re: Site Evaluation Burton Road Dear Ms. Lewis: As requested, a representative from this office visited the aforementioned site on September 13, 1993. Based upon the information provided on the application for a site evaluation and after an evaluation was completed, the site was found to be provisionally suitable for the installation of an on-site sewage disposal system. If you have any questions, please feel free to contact this office. Sincerely, Robert B. Hall, Jr., R.S. Environmental Health Section RH/wd Enclosure cc: Jesse Boyce