126 Laurens Ct, Lot 9 Davie County,NC Tax Parcel Report Tuesday, October 18,2016
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WARNING: THIS IS NOT A SURVEY
Parcel Information Y
Parcel Number: E70000011109 Township: Farmington
NCPIN Number: 5861749936 Municipality:
Account Number: 82524898 Census Tract: 37059-803
Listed Owner 1: BLEDSOE DONALD F Voting Precinct: SMITH GROVE
Mailing Address 1: 126 LAURENS COURT Planning Jurisdiction: Davie County
City: ADVANCE Zoning Class: DAVIE COUNTY R-20-S
State: NC Zoning Overlay: DAVIE COUNTY QD
Zip Code: 27006-7899 Voluntary Ag.District: No
Legal Description: LOT 9 ARMSWORTHY ACRES Fire Response District: SMITH GROVE
Assessed Acreage: 0.69 Elementary School Zone: SHADY GROVE
Deed Date: 7/2005 Middle School Zone: WILLIAM ELLIS
Deed Book/Page: 006160709 Soil Types: GnB2,GnC2
Plat Book: 0007 Flood Zone:
Plat Page: 186 Watershed Overlay: DAVIE COUNTY
Building Value: 176710.00 Outbuilding&Extra 2660.00
Freatures Value:
Land Value: 50000.00 Total Market Value: 229370.00
Total Assessed Value: 229370.00
101 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 website shall hold harmless theCounty 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 GtS data provided by this website.
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y APPUCATION FOR SITE EVALUATION/IMPROVEMENT PERMIT&
. t.. s Davie County Health Department
Environmental Health Section
P.O. Box 848/210 Hospital Street
Mocksville, NC 27028 ENYiI pi1d'� E LAS !=AH14
(336)751-8760
***I2dPORTANT*** 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 G �' Contact Person 1
_ 7
7 �
Hailing Address C Home Phone
City/state/ZIP 7W , Business Phone
2. Name on Permit/ATC if Different than Above
Hailing Address S,4/"( C— City/state/Zip
3. Application For: ite Evaluation ❑ Improvement Permit/ATC 0 Both
4. System to Service: House 0 Mobile Home ❑ Business [1 Industry n Other
5. If Residence: # People # Bedrooms 13 # Bathrooms
11 Dishwasher II Garbage Disposal II Washing Machine II Basement/Plumbing II Basement/No Plumbing
6. If Business/Industry/Other: Specify type # People # Sinks
I Commodes # Showers # Urinals # Water Coolers
IF FOODSERVICE: # Seats Estimated Water Usage (gallons per day)
7. Type of water supply: County/City ❑ Well ❑ Community
e. Do you anticipate additions or expansions of the facility this system is intended to serve? 0 Yes kr o
If yes,what type?
***181PORTANT***CLIENTS MUST COAWLETETHE REQUIRED PROPERTY INFORMATION REQUESTED
BELOW. Either a PLAT or SITE PLAN MUST BESUBA11TTED by the client with TIIIS APPLICATION.
Property eusiL2�n t A4ik WRITE DIRECTIONS(from Mocksville)to PROPERTY:
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Tax Office PIN: #,Slf��-71�'`-����,( '�l/ � &�� 7
Property Address: Road Name I7i 't172 !l{1 � �4 09
City/Zip / G//I/11rC ?uC s ,L// z L•
If in a Subdivision provide information,as follows:
Na
Section: Block: Lot: �f 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(tic information
submitted is this application is falsirted or changed. 1,also,understand that 1 am responsible fur all charges incurred from
this application. I,hereby,give consent to the Authorized Representative of the Davie County Ilcalth Department
to enter upon above described property located in Davie County and owned by
to conduct all testing procedures as necessary to determin'h s-Inn'I Ibilit .
DATE!f l S 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:
GU
EHS•
Account No. 0
Revised DCHD(07/99) Invoice No. ����
4APPLICATION FOR SITE EVALUATION/IMPROVEMENT PERMIT&ATC
Davie County Health Department4
Entrirlvnmenta/Health Section 1�1 �
R
P.O. Box 848/210 Hospital Street t
Mooksville, NC 27028 1,11.:1 Ii3,1110
(336)751-8760
***IMPORTANT*** THIS APPLICATION CANNOT BE PROCESSED UNLESS ALL THE REQUIRED
INFORMATION IS PROVIDED. Refer to the INFORMATION BULLETIN for just cts
1. Name to be Billed Contact Person
4en U
Nailing Address � Home Phone J/�• � �Q
City/state/ZIP 7 Business Phone 3/L/,J�/ r J
2. Name on Permit/ATC it Different than Above
Nailing Address J P^a Al L City/state/Zip
3. Application For: U-tf—te Evaluation ❑ Improvement Permit/ATC ❑ Both
4. system to service: House n Mobile Home ❑ Business 11 Industry n Other
5. If Residence: # People # Bedrooms 13 # Bathrooms _7
II Dishwasher (I Garbage Disposal 11 washing Machine 11 Basement/Plumbing it 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
a. Do you anticipate additions or expansions of the facility this system Is intended to serve? ❑Yes
If yes,what type?
***IAIPORTANT***CLIENTS MUST COMPLETETIIE REQUIRED PROPERTY INFORMATION REQUESTED
FLOW. Either a PW or SITE PLAN MUST BE SUBMITTED by the client with THIS APPLICATION.
x lear
Prop rty Dimensions: WRITE DIRECTIONS(from Mocksville)to PROPERTY:
Tax Office PIN: #���1,-7 =�t�to f� xsy liIV7
Property Address: Road Name
City/Zip A#w'c KX.t�
If in a Subdivision provide Information,as follows: _ AJ 1 t7
Na "��
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 deteriuin`"e then bili
DATE' �'� 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:
if
EHS:
Account No. (1 a t
Revised DCHD(07/99) invoice No. Iia
DAVIE COUNTY HEALTH DEPARTMENT
Environmental Health Section SECTION---/ LOT
Soil/Site Evaluation
APPLICANT'S NAME L _C/L�� DATE EVALUATED ����? ✓Gi l�
PROPOSED FACILITY PROPERTY SIZE
SUBDIVISION �lf/�/B�f ROAD NAME ��G1! ✓�?/�✓F
Water Supply: On-Site Well Community Public
Evaluation By: Auger Boring Pit Cut
FACTORS 1 2 3 4 5 6 7
Landscape position
Slope% <-
HORIZON I DEPTH.
Texture group
Consistence
Structure
Mineralogy
HORIZON II DEPTH
Texture group
Consistence r
Structure S
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
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)
> DAVIE COUNTY HEALTH DEPARTMENT
' Environmental Health Section ��
• P.O.Boz 848/210 Hospital Street y/ - y
Mocksville,NC 27028
' (336)751-8760
IMPROVEMENT/OPERATION PERMIT
Account M 990000758 Tax PIN/EH#: 5861-74-8864
Billed To: Ronnie Foster Subdivision Info: Armsworthy Acres Lot#9
Reference Name: Location/Address: Baltimore Road-27006
Proposed Facility: Residence Property Size: 10.5 acres
ATC Number: 3573
**NOTE** This Improvement/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 STTE PLANS OR THE INTENDED USE CHANGE. YOUR
WASTEWATER SYSTEM CONTRACTOR MUST SEE THIS PERMIT BEFORE INSTALLING SYSTEM.
Residential Specification: Building Type A✓ #People #Bedrooms #Baths
Dishwasher: Garbage Disposal: ❑ Washing Machine:0 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) --?/0 Site: New 00"Repair❑
System Specifications: Tank Size jjGAL. Pump Tank GAL. Trench Width T6"Rock Depth �Linear Ft._&�
Other:
Required Site Modifications/Conditions:
IMPROVEMENT/OPERATION PERMIT LAYOUT- APPROVED EFFLUENT FILTER RISER(S)IF 6 i°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.****
r
Environmental Health Specialist's Signature: Date:
DCHD 05/99(Revised)
r
. " DAVIE COUNTY HEALTH DEPARTMENT
• Environmental Health Section
P.O.Boa 848/210 Hospital Street
Moclksville,NC 27028
(336)751-8760
Account #: 990000758 Tax PIN/EH#: 5861-74-8864
Billed To: Ronnie Foster Subdivision Info: Armsworthy Acres Lot#9
Reference Name: Location/Address: Baltimore Road-27006
Proposed Facility: Residence Property Size: 10.5 acres
ATC Number: 3573
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 CONS UCTION IS VALID FOR A PERIOD OFF FIVE YEARS.
Environmental Health Specialist's Signature: Q' Date: ! & La
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.
E51
Septic System Installed By: J;;,�J�l �r�
Environmental Health Specialist's Signature: Date:
DCHD 05/99(Revised)
�diift GL! 1
rION FOR SITE EVALUATION/IMPROVEMENT PERMIT&ATC
Davie County Health Department
L SEP --18 2003 Environmentaif/eaithSeCNOV7
P.O. Box 848/210 Hospital Street
Mocksville, NC 27028
ENVIRONMFNTA!Hl� (336)751-8760
DAVIF COUNTY
***IMPORTANT*** —T—H—IrT. PLICATION CANNOT BE PROCESSED UNLESS ALL THE REQUIRED
t INFORMATIO17 IS PROVIDED. Refer to the INFORMATION BULLETIN for instructions.
J �
1. Name to be Billed_7�QD(i in /_ Q, ' v Contact Person _
Mailing Add_ess ��� Q _C Home Phone
0 -7 3 G-
City/State/ZIP �� t��S ✓ �� -C_ Business Phone
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 Service: ❑ House El Mobile Home ❑ Business ❑ Industry 11 Other
S. Type system requested: id_Conventional ❑ conventional modified ❑ innovative
6. If Residence: # People # Bedrooms _ # Bathrooms Z�
e25ishwasher []Garbage Disposal b1ashing Machine ❑Basement/Plumbing ❑Basement/No Plumbing
7. If Business/Industry /Other: verify type # People # Sinks
# Commodes # Showers # Urinals 1) Water Coolers
IF FOODSERVICE: # Seats Estimated Water Usage (gallons per day)
8. Type of water supply: County/City ❑ Well ❑ Community
9. Do you anticipate add tions or expansions of the facility this system is intended to serve? ❑Yes L 60
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'III1S APPLICATION.
Property Dimensions: '�Cc�t�� WRITE DIRECTIONS(from Mocksville)to PROPERTY:
Tax Office PIN: #�y —' J e /�
Property Address: Road Name ..p-L+\. Ice- h'%I--
City/Zip
If in a Subdivision provide information,,as follows:
Name: AK&S
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 permi (s)
issued hereafter are subjecf 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 ain responsible for all charges incurred from
this application. I,hereby,give consent to the Authorized Representative of the Davie County Health DeparUuci
to enter upon above described property located in Davie County and Tymby
to conduct all testing procedures as necessary to determine the site ab' ty.
DATE J -" C> SIGNATURE
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
Datc(s):
Client Notification Date:
EHS:
b -7 S g'
Sign given Account No. /
Revised DCHD(05/03 Invoice No. ! 9 7 ✓