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125 Laurens Ct, Lot 3 Davie County,NC Tax Parcel Report Tuesday, October 18,2016 I ; � I , I , I 1 I I LAURENS CT + I I i , � 1 r I + , ; 1 � r I 5 1 I 5 + I t i 1 141 - �r 109--- 125 r� •� I l 1 Jf. I I rr WARNING: THIS IS NOT A SURVEY Parcel Information Parcel Number. E70000011103 Township: Farmington NCPIN Number: 5861749726 Municipality: Account Number: 82522153 Census Tract: 37059-803 Listed Owner 1: MALCOM CHARLES E Voting Precinct: SMITH GROVE Mailing Address 1: 125 LAURENS COURT Planning Jurisdiction: Davie County City: ADVANCE Zoning Class: DAVIE COUNTY R-20-S,R-20 State: NC Zoning Overlay: DAVIE COUNTY QD Zip Code: 27006-7899 Voluntary Ag.District: No Legal Description: LOT 3 ARMSWORTHY ACRES Fire Response District: SMITH GROVE Assessed Acreage: 0.68 Elementary School Zone: SHADY GROVE Deed Date: 1/2004 Middle School Zone: WILLIAM ELLIS Deed Book/Page: 005320340 Soil Types: GnB2,GnC2 Plat Book: 0007 Flood Zone: Plat Page: 186 Watershed Overlay: DAVIE COUNTY Building Value: 185850.00 Outbuilding 8r Extra 4140.00 Freatures Value: Land Value: 50000.00 Total Market Value: 239990.00 Total Assessed Value: 239990.00 101 All data Is provided as Is without warranty or guarantee of any ldnd 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 Coun y's GIS website shall hold harmless the rCounty of Davie,North Carolina,its agents,consultants,contractors or employees from any and all claims or causes of action due to NC or arising out of the use or inability to use the GIS data provided by this website. DAVIE COUNTY HEALTH DEPARTMENT Environmental Health Section P.O.Boz 848/210 Hospital Street MocksAlle,NC 27028 (336)751-8760 Account #: .990003380 Tax PIN/EH#: 5861-74-9726 Billed To: Charles Malcom Subdivision Info: Armsworthy Acres Lot#3 Reference Name: Location/Address: Laurens Court-27006 Proposed Facility Residence Property Size: 195'x 152' ATC Number: 3900 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 WASTEWATER CON TRUCTION IS VALID FOR A PERIOD OF FIVE YEARS. Environmental Health Specialist's Signature: Date: CERTIFICATE OF COMPLETION **NOTE** The issuance of this Certificate of Completion shall indicate the system described on Improvement/Operation Permit 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. io` w pJ a 1b Septic System Installed By: TDv Environmental Health Specialist's Signature: Date: DCHD 05/99(Revised) DAVIE COUNTY HEALTH DEPARTMENT / • Environmental Health Section �U-� P.O.Boz 848/210 Hospital Street Mocksville,NC 27028 12j_ (336)751-8760 IMPROVEMENT/OPERATION PERMIT Account #: 990003380 Tax PIN/EH#: 5861-74-9726 Billed To: Charles Malcom Subdivision Info: Armsworthy Acres Lot#3 Reference Name: Location/Address: Laurens Court-27006 Proposed Facility Residence Property Size: 195'x 152' ATC Number: 3900 **NOTE** This Improvement/Operation Permit DOES NOT authorize the construction 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). 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 d #People_2- #Bedrooms #Baths J, Dishwasher:Xf Garbage Disposal: ❑ Washing Machine:PT"" 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) O O Site: New Repair❑ System Specifications: Tank Size GAL. Pump Tank Ag6AL. Trench Width Rock Depth/� Linear Ft-SW 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 0 a.m. 9:30 a.m.or 1:00 p.m.to 1:30 p.m.on the day of installation. Telephone#is(336)751-8760.**** ise A4� � .c .�7Slr3Xi2" ' ,a / S74 � ol Environmental Health Specialist's Signature: Date: DCHD 05/99(Revised) LICATION FOR SITE EVALUATION/IMPROVEMENT PERMIT& —� Davie County Health Department _ Environmental Heath Section i P.O. Box 848/210 Hospital Street OCT Mocksville, NC 27028 �. �I�iAIHTM (336)751-8760 , 2044 IRON,� T'f THIS APPLICATION CANNOT BE PROCESSED UNLESS ALL RE yid INFORMATION IS PROVIDED. Refer to the INFORMATION BULLETIN for instruc •, � �� 1. Name to be Billed `/ I� �/S h-• U U 'QZ4w o / Contact Person �,/�✓J�� Mailing Address �/�/{� Q(�/�//�J�i�/� D2/'✓�� Home Phone City/State/ZIP !J(!//�.�ST�—�✓�GG�'!i /�� LX��,SBusiness Phone 2. Name on Permit/ATC if Different than Above Mailing Address City/State/Zip 3. Application For: l ite Evaluation 0 Improvement Permit/ATC ❑ Both 4. System to Service: louse ❑ Mobile Home ❑ Business ❑ Industry ❑ Other S. Type system requested: M Conventional ❑ conventional modified ❑ innovative 6. If Residence: # People # Bedrooms _ # Bathrooms XDishwasher ❑Garbage Disposal lashing Machine ❑Basement/Plumbing ❑Basement/No Plumbing 7. If Business/Industry /Other: verify type # People # Sinks # Commodes # Showers # Urinals # Water Coolers IF FOODSERVICE: # Seats Estimated Water Usage (gallons per day) e. Type of water supply: K,County/City ❑ Well ❑ Community 9. Do you anticipate additions or expansions of the facility,this system is intended to serve? ❑Yes XNO If yes,what type? 'IMPORTANT'CLIENTS MUST COMPLETE THE REQUIRED PROPERTY INFORMATION REQUESTED BELOW. Either a PLAT or SITE PLAN MUST BE SUBMITTED by the client with THIS APPLICATION. Property Dimensions: WRITE DIRECTIONS(from Mocksville)to PROPERTY: T x Office PIN: # �r��! �`d "l 7 � � Property Address: Road NamfIGL2 ,�6 City/zip !7d!✓A.d ':� T If in a Subdivision provide information,as follows: Name: Section: Block: Lot: Date home corners flagged: 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 front 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 to conduct all testing procedures as necessary to determine the site suittaa�biliitt DATE SIGNATURE ?L-�^ '`'�`i2 ✓✓G ,-`� THIS AREA MAY BE USED FOR DRAWING YOUR SITE PLAN(Include all of the following: Existing and proposed property lines and dimensions, structures, setbacks, and septic locations). Site Revisit Charge Client Notification Date: EHS• o C— Sign given U Account No. a3>U 0 C;— Revised DCHD(05/03 �"� Invoice No. S ✓ APPLICATION FOR SITE EVALUATION/IMPROVEMENT PERMIT & Davie County Health Department 2mm 11 Environmenfa/Hea/tfi Section P.O. Box 848/210 Hospital Street Mocksville, NC 27028 ENVY Qp F L h)11 (336)751-8760 ***IMPORTANT*** THIS APPLICATION CANNOT BE PROCESSED UNLESS ALL THE REQUIRED INFORMATION IS PROVIDED. Refer to the INFORMATION BULLETIN for i struct' ns, 1. Name to be Billed �' Contact Person Mailing Address � .� � Home Phone City/State/ZZP 7 Business Phone 2. Name on Permit/ATC if Different than Above /y Mailing Address .5.4�"1 � City/State/Zip 3. Application For: ite Evaluation ❑ Improvement Permit/ATC ❑ Both 4. system to service: House ❑ Mobile Home ❑ Business 11 Industry n Other 5. If Residence: # People # Bedrooms J ! Bathrooms 11 Dishwasher 11 Garbage Disposal 11 Washing Machine II Basement/Plumbing II Basement/No Plumbing 6. If Business/Industry/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 S. Do you anticipate additions or expansions of the facility this system is intended to serve? ❑Yeso If yes,what type? ***IMPORTANT***CLIENTS MUST COMPLETE THE REQUIRED PROPERTY INFORMATION REQUESTED BELOW. Either a PLAT or SITE PLAN MUST BE SUBMITTED by the client with THIS APPLICATION. Property ' ensions: �fi 1 4:�) A4i a WRITE DIRECTIONS(from Mocksville)to PROPERTY: Tax Office PIN: #J ��l-'7e Fp f Property Address: Road Name 0ALN072 f City/Zip If in a Subdivision provide information,as follows: Na 1Sl �� Section: Block: Lot _ Date Property Flagged: 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 to conduct all testing procedures as necessary to determin'`�a the i bili DATE!fn— 3�� r NATURE THIS AREA MAY BE USED FOR DRAWING YOUR SITE PLAN(Include all of the following: Existing and proposed property lines and dimensions, structures, setbacks, and septic locations). Site Revisit Charge Date(s): Client Notification Date: EHS: Account No. !U gLl Revised DCHD(07/99) Invoice No. 115 W t DAVIE COUNTY HEALTH DEPARTMENT Environmental Health Section SECTION__C LOT,— Soil/Site Evaluation APPLICANT'S NAME DATE EVALUATED PROPOSED FACILITY1ft PROPERTY SIZE SUBDIVISION � ll,S?��r}�il� �/ ROAD NAME Water Supply: On-Site Well Community Public Evaluation By: Auger Boring Pit I / Cut FACTORS 1 2 3 4 5 6 7 Landscape position L .z Slope% HORIZON I DEPTH Texture group Consistence Structure Mineralogy HORIZON II DEPTH Texture group Consistence r 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: a' / 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 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(0I-90) sem!- IS2 � 1 � � `