131 Eastridge Court Lot 5 Davie County,NC Tax Parcel Report Tuesday,December 20, 2016
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WARNING: THIS IS NOT A SURVEY
Parcel Information
Parcel Number: E8110D0005 Township: Shady Grove
NCPIN Number: 5881140284 Municipality:
Account Number: 56330460 Census Tract: 37059-803
Listed Owner 1: PETERSON CHARLES STEVEN Voting Precinct: EAST SHADY GROVE
Mailing Address 1: 131 EASTRIDGE COURT Planning Jurisdiction: Davie County
City: ADVANCE Zoning Class: DAVIE COUNTY R-20
State: NC Zoning Overlay:
Zip Code: 27006-0000 Voluntary Ag.District: No
Legal Description: LOT 5 EASTRIDGE Fire Response District: ADVANCE
Assessed Acreage: 1.80 Elementary School Zone: SHADY GROVE
Deed Date: 1111997 Middle School Zone: WILLIAM ELLIS
Deed Book/Page: 001980728 Soil Types: Gn62
Plat Book: 0005 Flood Zone:
Plat Page: 220 Watershed Overlay: DAVIE COUNTY
Building Value: Outbuilding 8r Extra
Freatures Value:
Land Value: Total Market Value:
Total Assessed Value:
E01
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 the
County of Davie,North Carolina,Its agents,consultants,contractors or employees from any and all claims or causes of action due to
NCor arising out of the use or Inability to use the GIS data provided by this website.
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AUTHOR No:
q �y 0 DAVIE COUNTY HEALTH DEPARTMENT
' Environmental Health Section PROPERTY INFORMATION
l?ermiieeS-, , P.O.Box 848
Name: V Ake-K-5,0 HSubdivision Name:
Mocksville,NC 27028
fie"„ ,CRs f�
Phone#:704-634-8760
Directions to property: �''� `
�S'�' +�T� Section: � Lot:
AUTHORIZATION FOR
WASTEWATER SYSTEM CONSTRUCTION Tax Office PIN:
Road Name: iZ p: Z-:94)(p
**NOTE**This Authorization for Wastewater System Construction MUST BE ISSUED by the Davie County Environmental Health Section prior
to issuance of any Building Pen-nits.This Form/Authorization Number should be presented to the Davie County Building Inspections
Office when applying for Building Permits.
(In compliance with Article 11 of G.S.Chapter 130A,Wastewater Systems,Section.1900 Sewage Treatment and Disposal Systems)
r' ***NOTICE***THIS AUTHORIZATION FOR WASTEWATER CONSTRUCTION
A/wa tGX IS VALID FOR A PERIOD OF FIVE YEARS.
ENVIRONMENTAL HEALTH SPECIALIST DATE ISSUED
6 ,-a�i�' � �. ,.�,� . y_-e+: +v ;,ri:t s. ys d'`. r.p'' re.y,l. . r w� ,;.s.-'.s F � -r. • .. ...,. -... � /�V
DAVIE COUNTY HEALTH DEPA t�`TMENT
IMPROVEMENT AND,OPERATION PERMITS PROPERTY INFORMATION
Perin
,r
Nanie J, s� �' �� Subdivision Name:
Directions to property:,/1;:✓ * w�,r` Section: Lot:
IMPROVEMENT
PERMIT Tax Office PIN:# - -_
Road Name Zip: l (�
**NOTE**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 G.S.Chapter 130A,Wastewater Systems,Section.1900 Sewage Treatment and Disposal Systems)
***NOTICE***THIS PERMIT IS SUBJECT TO REVOCATION IF SITE,
PLANS OR THE INTENDED USE CHANGE.YOUR WASTEWATER
ENVIRONMENTAL HEALTH SPECIALIST DATE ISSUED SYSTEM CONTRACTOR MUST SEE THIS PERMIT BEFORE
INSTALLING THE SYSTEM.
RESIDENTIAL SPECIFICATION:BUILDING TYPE_ & #BEDROOMS f#BATHS 3 #OCCUPANTS << GARBAGE DISPOSAL:Yes or No
COMMERCIAL SPECIFICATION: FACILITY TYPE #PEOPLE #PEOPLE/SHIFT #SEATS , INDUSTRIAL WASTE:Yes or No
LOT SIZE ,TYPE WATER SUPPLY DESIGN WASTEWATER FLOW(GPD) % NEW SITE v REPAIR SITE
SYSTEM SPECIFICATIONS: TANK SIZE ��y'�� �
<' L _74, ROCK DEPTH
GAL. PUMP TANK GAL. TRENCH WIDTH /yo"" LINEAR
OTHER
REQUIRED SITE MODIFICATIONS/CONDITIONS:
IMPROVEMENT PERMIT LAYOUT
**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 BY:
D �
AUTHORIZATION NO. / OPERATION PERMIT BY: /L Y DATE: /
**THE ISSUANCE OF THIS OPERATION PERMIT SHALL INDICATE THAT THE SYSTEM DESCRIBED ABOVE 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.
DCHD 05/96(Revised)
APPLICATION FOR SITE EVALUATIONAMPROVEMENT PE RDMT& ATC
' Davie County Health Department l5 @ [5 Q W
Environmental Health Section D
P.O. Box 848 JAN 2 7 ISS
Mocksville,NC 27028
5�2p' (704) 634-8760
****IMPORTANT**** THIS APPLICATION CANNOT BE PROCESSED UNLESS ALL
THE REQUIRED INFORMATION IS PROVIDED.
1. Name to be Billed wt'e-- Pk wryer Contact Person V
Mailing Address 3700 . lau rgq C4 Home Phone
City/State/Zip C. vyynon'S C 7U2 Business Phone W� 3770
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 Serve: [kJ ffouse [ ]Mobile Home [ ]Business [ ]Industry [ ]Other
5. If Residence: #People #Bedrooms _ #Bathrooms ' FTbishwasher[:l-Garbage Disposal
[ } Gashing Machine [i-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 [t]'N'o
If yes,what type?
EITHER A PLAT OR SITE PLAN
PROPERTY INFORMATION REQUIRED:***IMPORTANT OF THE PROPERTY MUST BE
SUBMITTED WITH THIS APPLICATION.
Property Dimensions: �� a � 02/3 �i� WRITE DIRECTIONS(from Mocksville)TO PROPERTY:
Tax Office PIN: #-3-gwl Sb`' 74D fj'O l $ f d
Property Address: Road lame ,f1/te,JE
city/zip f�Or/�ir/Gr1 �700� ; a t�i9S�"��Sr� o"a L/*�-
If in Subdivision provide information,as follows:
Name:
,
,
Section: Lot#: ;
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 C1_i,[c3 S �c'�'�JJ'A--, to onduct 1 sting ro ures as necessary to determine the site suitability.
DATE /' ,97 SIGNATURE
Revised DCHD(06-96) i
THIS AREA MAY $E USED FOR DRAWING YOUR SITE PLAN: 0,
r
�rITH RESPECT TO CRITERIA AND CONDI IONSi C1 F ,r `-' COLNYY OF DAME
ESTABLISHED BY STATE LAW OR PROMULGATED t r My Commiu,,jo espw" MAR. 24)1990
T HEREUNDER AND THE SAME IS FOUND TO ` SEAL _ I I
COMPLY WITH SUCH CRITERIA AND CONDTITONS ZL-28901-el z
EXCEPT AS SET FORTH IN SUCH EVALUATION. Z '
FOR DETAILS OF THIS EVALUATION AND FOR 9, s ^ r�Q ;
LIMITATIONS. SEE THE WRITTEN REPORT ON
FILE AT THE SAID DEPARTMENT. CH fts"o loo ' co�
NOTICE IMPORTANT: THIS CERTIFICATE DOES
IF
NOT CONSTTU O
IN I USMISION FOR
11•W " 287. 19 _ Lft
�,�E►R
OLi lip
S
INSTALLATILIN Ur' )tYvA-U-r- r--'L-1 9 _ 'N
I 5g 6 -
ff
DATE C UNTY HEALTH OFFICEFt RESERVED FOR ACCESS _ . - �' �
TO REMAINDER 58. �' c
22s' � t 1
J. M. BOWDEN OF PROPERTY 0•W „ _ ,Y 1 0
PG. 278 23' 1 I I 3 a 1
D.B. 42 S g0' �1 LOCATION MAP
I co
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40 CD
S 69.08' 54•W —�' 1 ,
� - -, �- p � U840 ACRE
1009.01' of r ✓
w
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66.
to " O
P�� P, ol IO I C �tD
N b1
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SIGHT
2.6528 ACRES - EASEMENT
2 1
D N�1 1.0000 ACRE c 1
6.8758 ACRES >D �` 1 ''1 Q�
246.00 i
r N 62' 2 23. E (PUBLIC)
30R 266•9
l 2
60' RIW e W 1
G i GE GOVT •22 W �. 232.g 1 `'off Z 7 SIGH
-• N 720 06' 2 8'E E AST R D $ 62 _ ---C
'Q` 7 EASEMENT
907. 89. 60R` -w_,%TER 0.00- �1 25 \
` F C g0x (a)
•p1. 1 w \
tit0 / 2° Uf 1.0000 ACRE
' % 39 •
5.6075 ACRES ti9� �� 1 `- N 57. 44
't3r'
w 1 253' N
a `ry• N to 1 ' °'
° � cm4
Z Z m 0 L8041 ACRES
W N IA000 ACRE
A i 6 1 �' ��pNUMEN 1 U
3 I
� 1.7493 ACRES
� E 8. CON R
080
5.0000 ACRES
502• ,
3 � NOTES
Z`3T IRONS AT ALL CORNERS
EXCEPT AS NOTED. ,
O 28.8859 ACRES TOTAL . . '.
od o,4 loo 0 100 200 300
\\ 22 \ ,N�OpoO 53
1 APPLICATION FOR SITE EVALUATION/IMPROVEMENTS PERMIT
Davie County Health Department
Q� �J Environmental Health Section 's I 0V
/ P. 665 AUG 2 0 Wr7�7
Mocksvill,ille, N NC 27028
1. Application/Permit Requested By—_ Th 0 M ig S C Y eS
Mailing Address LOeeA rq Nry U e , &L', ,2 S-
1
Home Phone 9 S Business Phone
2. Name on Permit if Different than Above
3. Application/Permit for: ® General Evaluation ❑ Septic Tank Installation
4. System to Serve: House ❑ Mobile Home ❑ Place of Public Assembly
❑ Business ❑ Industry ❑ Other ❑ Unknown
5. If house, mobile home: Sut�d m sion 5�ri�r Section_ Z _ Lot # r
❑ Basement/Plumbing
No. of People ❑ Basement/No Plumbing
No. of Bedrooms /71 ❑ Washing Machine
i
No. of Bathrooms 3 ❑ Dishwasher
Dwelling Dimensions ::2 G0 f .S�r PV ❑ Garbage Disposal
6. If business, industry, place of public assembly, other: Specify type
No. of People Served No. of Sinks
No. of Commodes No. of Urinals
No.of Lavatories No.of Water Coolers
No. of Showers Water Usage Figures
7. Type of water supply: 0 Public ❑ Private ❑ Community
8. Property Dimensions' Sewage Disposal Contractor
9. Do you anticipate additions/expansion of the facility this sytem is intended to serve? ❑ Yes (S No
If yes, what type?
"NOTE: Improvements Permits shall~be valid for a period of 5 years from date issued. Improvements Permits are subject to
revocation, if site plans or the intended use change. Effective October 1, 1989.
Directions to Property: /Sg E,4SQAt 9,9l �e�f o N 1491,:10.1t9 SS
/V Dpte- 0XI AJ
This is to certify that the information provided is correct to the b st of my knowledge an I understand I am responsible for all charges
incurred from/this application. p ,
DATE SIGNATYF
CONSENT FOR SITE EVALUATION TOB DONE ON AB VE DESCRIBED PROPERTY
MUST CHECK ONE: ❑ 1. I OWN the property. ®'2. I DO NOT OWN the property.
If you checked Box#2,the rest of this form MUST be completed by the owner or a person authorized by the owner:
I hereby give consent to the authorized representative of the [QaovCp�my Health Department to enter upon above described
property located in Davie County and owned by -�. b d 11/
to conduct all testing procedures as necessary to deter ine said site's suitability for a ground absorption sewage treatment
If
disposal system.
DATE 8&NATuhE
DCHD(12.90)
• DAVIE COUNTY HEALTH DEPARTMENT
• Environmental Health Section
Soil/Site Evaluation / r
NAME DATE EVALUATED �,( )
ADDRESS / PROPERTY SIZE
PROPOSED FACIILTY .4/�s� LOCATION OF SITE
Water Supply: On-Site Well Community Public A.-'
Evaluation By: Auger Boring d/ Pit Cut
FACTORS 1 2 3 4
Landscape position .[, L •C,
Slope
HORIZON I DEPTH
Texture group
Consistence
Structure
Mineralogy
HORIZON II DEPTH
Texture group
Consistence i
Structure
Mineralogy
HORIZON III DEPTH
Texture group
Consistence
Structure
Mineralogy
HORIZON IV DEPTH
Texture grouo
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 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-Annular 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(01-901
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(Davie County AealtFr Department
and Ylome NealtFi Ayeney
210 HOSPITAL STREET/P.O. BOX 665
MOCKSVILLE,N,C. 27028
PHONE:(704)634.5985
August 25, 1993
Thomas A. Hires
401 Century Ct.
Kernersville, KC 27284
Re: Site Evaluation
Eastridge/Sec. 1-Lot 5
Dear Mr. Hires:
As requested, a representative from this office visited the aforementioned
site on August 25, 1993. Based upon the information provided on the
application for a site evaluation and after an evaluation was completed, the
site was found to be provisionally suitable for the installation of an on-site
sewage disposal system.
If you have any questions, please feel free to contact this office.
Sincerely,
Robert B. Hall, Jr. , R.S.
Environmental Health Section
RH/wd
Enclosure
Le-, 7llrn ,,¢ gyres a-1-96
•
' DAVIE COUNTY HEALTH DEPARTMENT
Environmental Health Section
PO Box 848/210 Hospital Street
Mocksville,NC 27028
Phone: (336)751-8760
ON-SITE WASTEWATER CERTIFICATION FOR DWELLING
(Check One) R LACEM-E,,NTT❑ REMODELING [3 RECONNECTION ❑
Name: "A' 'g ���" Phone Number7. ? ':�;Lb � (Home)
Mailing Address: (Work)
Detailed Directions To Site: 75 y
Property Address:
Please Fill In The Following Information About The Existing Dwelling.
Name System Installed Under: Type Of Dwelling:
Date System Installed(Month/Day/Year): y' /q /s/ Number Of Bedrooms:4_Number Of People:
Is The Dwelling Currently Vacant? Yes❑ No B' If Yes,For How Long?
Any Known Problems?Yes❑ No❑ If Yes,Explain:
Please Fill In The Following Information About The New Dwe ling:
Type Of Dwelling: I Number Of Bedrooms: ' Number Of People:
Requested By: Date Requested: / 2- 07-
(SiAare)
For Environmental Health Office Use Only
Approved0 Disapproved ❑
Comments:
Environmental Health Specialist �: 4?� 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❑ Check❑ Money Order❑ # Amount: $ Date:
Paid By: Received By:
Account #: Invoice #:
I
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Davie County Health Department
�P-161� Environmental Health Section ,
• . r' P.O. BOX 848
,�� ® 210 Hospital Strect `
O '� A Couricr# : 09-40-06 1911
— ��j `�U1►. Mocksville, NC 27028
r �P
Phone:(336)-7538 ' Fax:(336)-753-1680
Ty;�—��ON�-SITE WASTEWATER CERTIFICATION
(Check One) Replacement Remodeling Reconnection
Name: PhoneNumber (Home)
Mailing Address: �- � "S 1�'t E+ 1 G C. (Work)
t
Detailed
Directions To Site: /-j-&—r
Property Address: 13 x i 2)4 P t,6U r
Please Fill In The Following Information
/About The,1EXISTING Facility:
Name System Installed Under: c�� V.ZF/SGl iJ Type Of Facility: A25
Date System Installed(Month/Date/Year): Number Of Bedrooms: Number Of People:
Is The Facility Currently Vacant? Yes 0 If Yes,For How Long?
Any Known Problems? Yes ) If Yes,Explain:
�/ ��.1t t
lot
Please Fill In The Following Information About The NEW acili �' ��9 ;� A 0, dt' � � 0,411,
� r��
Type Of Facility: 0)( I N & !S i V DUNumber Of Bedrooms: Number of People
Pool Size: rage Size: Other:
Requested By: Date Requested:
(Sign tore)
For Environmental Health Office Use Only
Approved isapproved
Comments:
Environmental Health Specialis 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 Check Money Order # Amount:$ Date:
Paid By:.__._ _Received By: _
Account#: Invoice#: