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320 Blevins Rd Davie County,NC Tax Parcel Report Wednesday, February 8, 2017 I Q 1, 3?0 Z wy W 322 I 1 `_ -_.----------------- ------------- -------- -- ""� 4 I 1 l WARNING: THIS IS NOT A SURVEY Pat celInformation , Parcel Number: B300000099 Township: Clarksville NCPIN Number: 5823099490 Municipality: Account Number: 82532137 Census Tract: 37059-801 Listed Owner 1: OLAND LISA Voting Precinct: CLARKSVILLE Mailing Address 1: 2805 WYO ROAD Planning Jurisdiction: Davie County City: YADKINVILLE Zoning Class: DAVIE COUNTY R-A State: NC Zoning Overlay: Zip Code: 27055-0000 Voluntary Ag.District: No Legal Description: 1.847 AC BLEVINS RD Fire Response District: COURTNEY Assessed Acreage: 1.73 Elementary School Zone: WILLIAM R DAVIE Deed Date: 7/2010 Middle School Zone: NORTH DAVIE Deed Book/Page: 009320515 Soil Types: MnB2 Plat Book: Flood Zone: Plat Page: Watershed Overlay: DAVIE COUNTY Building Value: 71500.00 Outbuilding 8r Extra 3510.00 Freatures Value: Land Value: 23280.00 Total Market Value: 98290.00 Total Assessed Value: 98290.00 O(.t tip AN 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 Davis,North Carolina,Its agents,consultants,contractors or employees from any and all claims or causes of action due to nDUN'� NC or arising out of the use or Inability to use the GIS data provided by this website. Davie County Health Depar 'i Environmental Health Sec ;W 3 � P.O. Box 818 " 210 Hospital Street : 1' ENVIRONMENTAL H ` Courier# : 09-40-06 DAME COUNTY ,. = Mocksville, NC 27028 Plimie:(336)-753-6780 Fm:(336)-753-1680 ON-SITE WASTEWATER CERTIFICATION FOR DWELLING (Check One) Replacement Remodeling Reconnection Name: �- t41 ��ff 4 Phone Number 7" OrJ 5 �+ (Home) Mailing Address: Work) Detailed Directions To Site: ®� 70W',.4y— � l,6 � V,`y� 0lil f`e O /?7 C aCV /'/1V5 42:dl 114 I�'a' Ut bl-,� f Property Address: 10 61^Gl1-//1-,5 Qin# 503-ol-106 Please Fill In The Following Information About The EXISTING Facility: Name System Installed Under: PP 7 n Of Facility: Date System Installed(Month/Date/Year): l ! b Number Of Bedrooms: �4 Number Of People: Is The Facility Currently Vacant? Yes No If Yes,For How Long? J _ ` Any Known Problems? Ye 00) If Yes,Explain: -F C ,I�VAI O lit Please Fill In The Following Information About The NEW e- Facility: C � GH Type Of Facility: eeJ� '�`a �Q GQ �'t L Number Of edroom : Number of People Requested By: X. Date Requested:�Z V16 Signature) For Environmental Health Office Use Only Approved Disapproved Comments: Environmental Health Specialist Date: *The signing of this form by the Environmental Health Staff is in 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 --D Money Order # Amount:$ Date: -- &�PLO t a Paid By: (� fSeA. ,A l ` 4 Lt-n9 Received By: kb)n CC-t't 6 VL S Account#.: .5�2-� Invoice h DAVIE COUNTY HEALTH DEPARTMENT Environmental Health Section P.O.Boz 848/210 Hospital Street Mocksville,NC 27028 s\`qttj (336)751-8760 Account #: 990000924 Tax PIN/EH#: 5823-29-1104.02 Billed To: Texie West Subdivision Info: Reference Name: Angie West Location/Address: Blevins Road-27028 Proposed Facility: Residence Property Size: 5 Acres ATC Number: 2295 AUTHORIZATION FOR WASTEWATER SYSTEM CONSTRUCTION **NOTE** This Authorization for Wastewater System Construction MUST BE ISSUED by the Davie County Environmental Health Section prior to issuance of any building permit(s). This Form/Authorization Number should be presented to the Davie County Building Inspections Office when applying for building permit(s)(in compliance with Article 11 of G.S.Chapter 130A,Wastewater Systems, Section .1900 Sewage Treatment and Disposal Systems). THIS AUTHORIZATION FOR WASTEWATE ONSTRUCTION IS VALID FOR A PERIOD OF FIVE YEARS. Environmental Health Specialist's Signature: Date: CERTIFICATE OF COMPLETION **NOTE** The issuance of this Certificate of Co pletion shall indicate the system described on Improvement/Operation Permit has been installed in com lian wit Article 1 I of G.S.Chapter 130A,Section.1900"Sewage Treatment and Disposal Systems,"but s 11 i NO AY be taken as a guarantee that the system will function satisfactorily for any given period of time. 17 t Septic System Installed By: ZLl " Environmental Health Specialist's Signature: � � i (/t � Date: DCHD 05/99(Revised) DAVIE COUNTY HEALTH DEPARTMENT Environmental Health Section P.O.Boa 848/210 Hospital Street Mocksville,NC 27028 (336)751-8760 IMPROVEMENT/OPERATION PERMIT Account #: 990000924 Tax PIN/EH#: 5823-29-1104.02 Billed To: Texie West Subdivision Info: Reference Name: Angie West Location/Address: Blevins Road-27028 Proposed Facility: Residence Property Size: 5 Acres **NOTE*ViIsbgmprovement/Operation Permit DOES NOT authorize the construction of a septic 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). THIS PERMIT IS SUBJECT TO REVOCATION IF SITE PLANS OR THE INTENDED USE CHANGE. YOUR WASTEWATER SYSTEM CONTRACTOR MUST SEE THIS PERMIT BEFORE INSTALLING SYSTEM. Residential Specification: Building Type #People #Bedrooms_'z #Baths d Dishwasher: Z� Garbage Disposal: ❑ Washing Machine: 2f Basement w/Plumbing: ❑ Basement/No Plumbing: Commercial Specification: Facility Type #People #People/Shift #Seats Industrial Waste: Lot Size Type Water Supply lell( Design Wastewater Flow(GPD) Site: New le Repair System Specifications: Tank Size/W GAL. Pump Tank GAL. Trench Width;L'� Rock Depth /Linear Ftp Other: fir/ Required Site Modifications/Conditions: IMPROVEMENT/OPERATION PERMIT LAYOUT- APPROVED E#FLUENT FILTER RISER(S)IF 6 u BELOW FINISHED GRADE. ****NOTICE: Contact a representative of the Davie County Health Department for final inspection of this system between 8:30 a.m.to 9:30 a.m.or 1:00 p.m.to 1:30 p.m. on the day of installation. Telephone#is(336)751-8760.**** Environmental Health Specialist's Signature: Date: DCHD 05199(Revised) DAVIE COUNTY HEALTH DEPARTMENT Environmental Health Section P.O.Boz 848/210 Hospital Street S,`'�Z Mocksville,NC 27028 j (336)751-8760 'y Account #: 990000924 Tax PIN/EH#: 5823-29-1104.02 Billed To: Texie West Subdivision Info: 2'Q 3 4V Reference Name: Angie West Location/Address: Blevins Road-27028 Proposed Facility: Residence Property Size: 5 Acres ATC Number: 2295 AUTHORIZATION FOR WASTEWATER SYSTEM CONSTRUCTION **NOTE** This Authorization for Wastewater System Construction MUST BE ISSUED by the Davie County Environmental Health Section prior to issuance of any building permit(s). This Form/Authorization Number should be presented to the Davie County Building Inspections Office when applying for building permit(s)(in compliance with Article 11 of G.S.Chapter 130A,Wastewater Systems,Section.1900 Sewage Treatment and Disposal Systems). THIS AUTHORIZATION FOR WASTEWATERFONSTRUCTION IS VALID FOR A PERIOD OF FIVE YEARS. Environmental Health Specialist's Signature: Ada Date: J�' CERTIFICATE OF COMPLETION **NOTE** The issuance of this Certificate of Corppletion shall indicate the system described on Improvement/Operation Permit has been installed in corn lian wit Article 11 of G.S.Chapter 130A,Section.1900"Sewage Treatment and Disposal Systems,"buts 11 ' NO AY be taken as a guarantee that the system will function satisfactorily for any given period of time. inal 17 /33 Septic System Installed By: �/ •` Environmental Health Specialist's Signature: � � � Date: DCHD 05/99(Revised) DAVIE COUNTY HEALTH DEPARTMENT Environmental Health Section P.O.Boa 848/210 Hospital Street Mocksville,NC 27028 (336)751-8760 IMPROVEMENT/OPERATION PERMIT Account #: 990000924 Tax PIN/EH M 5823-29-1104.02 Billed To: Texie West Subdivision Info: Reference Name: Angie West Location/Address: Blevins Road-27028 Proposed Facility: Residence Property Size: 5 Acres O � hsm ov**Nprement/Operation Permit DOES NOT authorize the construction of a septic 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). THIS PERMIT IS SUBJECT TO REVOCATION IF SITE PLANS OR THE INTENDED USE CHANGE. YOUR WASTEWATER SYSTEM CONTRACTOR MUST SEE THIS PERMIT BEFORE INSTALLING SYSTEM. Residential Specification: Building Type #People � #Bedrooms '1 #Baths Dishwasher: F� Garbage Disposal: ❑ Washing Machine: Basement w/Plumbing: ❑ Basement/No Plumbing: ❑ Commercial Specification: Facility Type #People #People/Shift #Seats Industrial Waste: ❑ Lot Size Type Water Supply Design Wastewater Flow(GPD) !M Site: New e Repair❑ System Specifications: Tank Size GAL. Pump Tank GAL. Trench Widthjf,, Rock Depth (Linear Ft, � Other: Required Site Modifications/Conditions: IMPROVEMENT/OPERATION PERMIT LAYOUT- APPROVED EFFLUENT FILTER. RISER(S)IF 6"BELOW FINISHED GRADE. ****NOTICE: Contact a representative of the Davie County Health Department for final inspection of this system between 8:30 a.m.to 9:30 a.m.or 1:00 p.m.to 1:30 p.m.on the day of installation. Telephone#is(336)751-8760.**** Environmental Health Specialist's Signature: Date: DCHD 05/99(Revised) Davie County Health Department • Environmental MOM Safion !EQUI P.O. Box 848/210 Hospital street Mocksville, NC 27028 EC Z 9 i�99 (336)751-8760 AlTTHIS APPLIc1 mcu c nnor AE PROMS= UNLESSALL RERED1E COUNTY INI,ORMATION IS PROVIDED. Refer -to the�nUMMATION BULLETIN for ins otions.I� 1. name to be Billed =-e 1;A e_ C- %�e_41 -C� contact Person ��'I/nQ„ in) Nailing Address Ha.e Phone .��"i!�— I1f0� — c � `a City/State/ZiP Business/Phone �?,�"1L(� 121 $� 2. 11a an Pead t/ATC if Different than Above Mailing Address city/state/Zip 3. ]Application For: U site Evaluation 0 Improvement Pe=it/ATC �oth 4. system to service: 0 House )(1 To . Home 0 Business 0 Industry 0 Other S. If Residence: i People 5 i Bedrooms i Batbroomos k1shvasher 0 Garbage Disposal Washing Machine 0 Basement/Plumbing 0 Basement/no Plumbing s. if Business/Industry/other: specify 'type, i People i Sinks i Commodes ' i Shovers i urinals i slater Coolers IF FOODSERVICE: I Seats Estimated Water Usage (gallons per day) 7. type of water supply: 0 county/City Wal]. 0 Community s. Do you anticipate additions or eipanaiolu of the facility this system Is intended to serve? 0 Yea No If yes,what type. ***IMPORTANT"**CLIENTS 11tUSrcoupLETETHE REQUIRED PROPERTY INFORMATION REQUESTED BELOW. Either a PLAT or SITE PLAN MUST BESUBM1ZM b the dial with THIS APPLICATION. Property Dimensions: '' SSWRITE DIRECTIONS(from Mockwille)to PROPERTY: Tax Office PIN: to 5S 9 3 —et- I 11 Q-6 1 N • to Property Address. RoamI C Name (ZV1hS 1�t.1. O Y1 7b —y-n er-S l� . Cityalp m�S &6yikky.1�C .2 66 5 +0 ).P,4 /'Sr, I,ey i n S FA If In a Subdivision provide information,as follows: ,, LL t c 1 Name: A!'l 0 on Section: Block: Lot: Date Property Flagged: i3, c=�_ Cn This is to certify that the information provided Is correct 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 laformation submitted In this application Is falsified or changed. I,also,anAnwand that I am regwsible for all charges Incurred from this application. I,hereby,give consent to the Authorized Representative of theD vie County Health Dep rt cut to enter upon above described property located in Davie County and owned by 7r. I�'P_tr'r ran 4n i k aln to conduct all testing procedures as necessary to determine the site suitability. DATE �i7 9 /�f' SIGNATURE THIS AREA MAY BE USED FOR DRAWING YOUR SITE PLAN(include all of the following: Ezlsting and proposed,/f property lion and dimensions, structures, setbacks, and septic locations). –rh i 5 p rcpw 1it�1 ll n eXs�- pt-rc - r eL S n��e-t�,c � a. dao f e-bioU M6)JJ I e h0rX4 1 6L 0 psi h�.5 beta-i Account No. Revised DCHD(07/98) Invoice No. 1�� • y c } / J r � r w,` r r . t ;. DAME COUNTY HEALTH DEPARTMENT Environmental Health Section Soil/Site Evaluation APPLICANT INFORMATION PROPERTY INFORMATION Account #: 990000924 Tax PIN/EH#: 5823-29-1104.02 Billed To: Texie West Subdivision Info: Reference Name: Angie West Location/Address: Blevins Road-27028 4� Proposed Facility: Residence Property Size: 5 Acres Date Evaluated: Water Supply: On-Site Well Community Public Evaluation By: Auger Boring ✓ Pit` Cut FACTORS 1 2 3 4 5 6 7 Landscape position Slo e% �— HORIZON I DEPTH Texture group Consistence Structure Mineralogy HORIZON II DEPTH 0 " Texture groupC 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 RATE SITE CLASSIFICATION: EVALUATION BY: / 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 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-Long-term acceptance rate-gal/day/ft2 DCHD 05/99(Revised) ■/■■■■■■■■■ME■■/■■■E■E/E■■EE■/■E■■■■/NOON■■/NOON■■/■■■■■■■■■■■■■/■ ■/■■■■■■/■■■■■■s■■EEE■/■■■■■■/■■EE■■/■■■EE■/■■■■■■/■■■■■■/NOON■■/■ ■■■■■■■■/■■■■■M/s■E■■■■M■a■s■/MESE■■/■■■■■■/■■■■Es■Ee■■■■■■■■■■■/■ ■■■■■■■■■■■■MM■■■■■■■■■■M■■■■■■■■■■NOON■■■■■■■■■e■■■■■■■■■■e■■M■■■ ■■■■■■■■/■■■■■■/■■■■■■/■■■■■■/■■■■■■/NOON■■/■■■■■■e■■■■■■■■■■■■■/■ ■■■see■■■■■■■■■■■MM■■■■■■■■M■■■■M■■■■■■NOON/■■ME■■■■■■■■M■■■■■■M■■ ■■■■■■■■■■■■■■■■■■■■EEE■■■■■■■■■ ■■■■■■■■■/■■■■■■■■■■■■■■■■■■■■■■ ■■■■■■■■■ENE■■■■■M■■■■■■OE■■MOM■E■■NOON■Es■■■■■■■■■■■■■■■■■■■■■■■■ ■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■ ■NOON■■n■■■e■■M■E■■■O■■■■■■■■■■■ ■�■■■e■■■■■■■■■■■■■■■■■■■■■■■■■■ ■■■■■■■■■■■■■■■■■E■■■■■�■■■■■■■■EE■NOON■■■■■u■■■■■■■■■■■■■■■■■■■■■ ■■■■■■■■■■■■■■■E■■■M■■■M■■■■M■■M■■■■■■■■■■MME■■■■■■■e■■■■■■■M■■■■■ ■■■■■■■■■■■■■ENE■■■■■E■■■■■■■■E■■E■■■E■■■■■■■■e■■■■■■■■■■■MM■■■M■■ ■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■ ■NOON■■e■■■■■N■e■■■■■■■■■■■■■■■■ ■■■■■E■■ENE/■EE■■E/■■M■■■/■■E■■■�■■■■■■■■Me■■■■■■■■■■■■N■■■■■NM■■ ■t■■■■E■■E■/E■EE■■/■■■■ME/■E■M■EEM■NEON/■■■E■E/M■■■■■e■■■■■■■■■■se ■■■■/■■■■■■/■■■■■■/■■■■■■■■■■■■■/■■E■OO/■EOO■■/O■e■E■e■■■■■■/■NONE ■■■■■■■■■■■■■■■■■■■■■■■E■■■■■■M■ ■■■■■/■■■■■■■■N■N■Oe■■Ee■■■■MEMO ■■NOON■■■E■■■■■■■■■■■■■■■/■■■O■■■MEM■■N■■■■■■■/■E■■■■■■■■■■M■■N■N■