132 Somerset Ct, Lot 5 Davie County,NC Tax Parcel Report Tuesday, October 18, 2016
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WARNING: THIS IS NOT A SURVEY
Parcel Information
Parcel Number: E713OA0005 Township: Farmington
NCPIN Number: 5871325271 Municipality:
Account Number: 82526500 Census Tract: 37059-803
Listed Owner 1: ROTHROCK WILLIAM T REV TRUST Voting Precinct: SMITH GROVE
Mailing Address 1: 4385 STYERS FERRY ROAD Planning Jurisdiction: Davie County
City: WINSTON SALEM Zoning Class: DAVIE COUNTY R-20
State: NC Zoning Overlay: DAVIE COUNTY QD
Zip Code: 271040000 Voluntary Ag.District: No
Legal Description: LOT 5 ALTON PLACE PHASE ONE Fire Response District: ADVANCE
Assessed Acreage: 0.71 Elementary School Zone: SHADY GROVE
Deed Date: 5/2006 Middle School Zone: WILLIAM ELLIS
Deed Book/Page: 006640462 Soil Types: Gn62
Plat Book: 0006 Flood Zone:
Plat Page: 161 Watershed Overlay: DAVIE COUNTY
Building Value: 137850.00 Outbuilding&Extra 3330.00
Freatures Value:
Land Value: 50000.00 Total Market Value: 191180.00
Total Assessed Value: 191180.00
91r� All data Is provided as Is without warranty or guarantee of any Idnd 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 webs@e 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
�0641'� NC or arising out of the use or Inability to use the GIS data provided by this website.
DAVIE COUNTY HEALTH DEPARTMENT
IMPROVEMENT PERMIT and OPERATION PERMIT
IMPROVEMENT PERMIT
**MOTE** This improvement permit DOES NOT authorize the construction or installation 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 B.S. Chapter 130A, Wastewater Systems, Section .1900 Sewage Treatment and Disposal Systems)
NAME 4lyl ! PROPERTY ADDRESS
LOCATION o �i�uG'/,Arn Aw
SUBDIVISION NAME r//,��P LOT NUMBER SEC./BLOCK NUMBER._
RESIDENTAL SPECIFICATION: BUILDING TYPE 1, # BEDROOMS, # BATHS���.# OCCUPANTS GARBAGE DISPOSAL: Yes/No
s'COMMERCIAL SPECIFICATION: FACILITY TYPE # PEOPLE # PEOPLE/SHIFT # SEATS INDUSTRIAL HASTE: Yes/No
LOT SIZE �.YPE WATER SUPPLY K DESIGN WASTEWATER FLOW (GPD) d NEW SITE L-- REPAIR SITE
SYSTEM SPECIFICATIONS: TANK SIZE laV GAL. PUMP TAME( GAL. TRENCH WIDTH ��� ROCK DEPTH LINEAR FT. l7b
OTHER
REQUIRED SITE MODIFICATIONS/CONDITIONS:
***THIS PERMIT IS SUBJECT TO REVOCATION IF SITE PLANS OR THE INTENDED USE CHANGE. YOUR WASTERWATER SYSTEM CONTRACTOR MUST
SEE THIS PERMIT BEFORE INSTALLING THE SYSTEM.
IMPROVEMENT PERMIT BY
**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) 634-8760.
OPERATION PERMIT SYSTEM INSTALLED Y
J
L
p
o us e
r-l` U
ur-w b�
AUTHORIZATION NO. QS'-\% OPERATION PERMIT BY �• DATE �� 1
**THE ISSUANCE OF THIS OPERATION PERMIT SHALL INDICATE THAT THE SYSTEM DESCRIBED ABOVE HAS BEEN INSTALLED IN COMPLIANCE WITH
ARTICLE 11 OF B.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 10/95
-- s Davie County Health Department
` — :' -- ENVIRONMENTAL HEALTH SECTION
- P.O. Box 665
Mocksville, N.C. 27028
AUTHORIZATION FOR WASTEWATER SYSTEM CONSTRUCTION
(Issued in compliance with Article 11 of
G.S. Chapter 13OA, Wastewater Systems)
i
***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 a plying for Building Permits.***
AME ' ��ar
AUTHORIZATION NU NR
N DATE _ � N2 04811
NAME ON IMPROVEMENT PERMIT (If different than above)
SITE LOCATION �/2/✓. /��,�
C0*0TS/CONDITION ON AUTHORIIATION TO CONSTRUCT WASTEWATER SYSTEM
**WICE*** THIS AUTHORIZATION FOR WASTEWATER SYSTEM CONSTRUCTION IS VALID FOR A PERIOD OF FIVE (5) YEARS.
ENVIRONMENTAL
—]HEALTH SPECIALIST DATE
DCHD 10/95
APPLICATION FOR SITE EVALUATIONAMPROVEMENT PERMIT&ATC
Davie County Health Department n 22 a
Environmental Health Section L5
P.O. sox 848
Mocksville, NC 27028 AUG 2 2 1996
(704) 634-8760
****IMPORTANT**** THIS APPLICATION CANNOT BE PROCESSED UNL
THE REQUIRED INFORMATION IS PROVIDED.
1. Name to be Billed 7 o r4-- Contact Person 1, a.-
Mailing Address �d /3 33 S Home Phone / ' y-7 7
, City/State/Zip / "/cl--r a<'� 10V(- Business Phone 07"e.
2. Name on Permit/A�TCCiif Different than Above
Mailing AddressJ/,d UW741 ell n ra k"'( ity/State/Zip fJ
3. Application For: [ ]Site Evaluation [ r provement Permit&ATC [ ]Both
4. System to Serve: [��ouse [ ]Mobile Home [ ]Business [ ]Industry [ ] Other
i
5. If Residence: #People o� #Bedrooms #Bathrooms [&i6ishwasher[ Garbage Disposal
L.?<Vashing Machine [ ]Basement/Plumbing [ ]Basement/No Plumbing
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?[ ]Yes [Ar<o,-
If yes,what type?
PROPERTY INFORMATION REQUIRED:***IMPORTANT***A PLAT OF THE PROPERTY MUST BE
SUBMITTED WITH THIS APPLICATION.
Property Dimensions: /�'T1 S��m, c� �'t'd�✓ Me WRITE DIRECTIONS(from Mocksville)TO PROPERTY:
Tax Office PIN: # .�. _�
87
Property Address: Road Name �`"`�
City/Zip 4,044n/cL Ne- oz-740
If in Subdivi�sii n provide information,as follows:
Name: / ' ► UTy / .f G� ,
Section: Lot#: S
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 information submitted in this application is falsified or
changed. I, also, understand that I am responsible for all charges incurred 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 Lc ! o con u t,�11_testing procedure as necessary to determine the site suitability.;S44
DATE v7 -9 SIGNATURE
Revised DCHD(06-96)
DAVIE COUNTY HEALTH DEPARTMENT
Environmental Health Section
Soil/Site Evaluation
NAME DATE EVALUATED L
ADDRESS PROPERTY SIZE Odd S' ,7
PROPOSED FACIILTY LOCATION OF SITE
OF
Water Supply: On-Site Well _ Community Public L1__*'
Evaluation By: Auger Boring Pit t/ Cut
FACTORS 1 2 3 4
Landscape position L
Slope %
HORIZON I DEPTH .•
Texture group
Consistence
Structure
Mineralogy
HORIZON II DEPTHAe
Texture group
Consistence
Structure i
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:
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 :lay loam, SIL-Silty loam CL-Clay loam SCL-Sandy clay loam
SC-Sandy clay SIC-Silty clay C-Clay
CONSISTENCE
Moist
VFR-V,--7y 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
.3C--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(01-90)
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