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126 Laurens Ct, Lot 9 Davie County,NC Tax Parcel Report Tuesday, October 18,2016 140 I I 126 1 110 I r I � I I I I I I ' L.AURENS CT ' I i I ; I I 1 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. �0 '4 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: Ji r 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 ✓