243 Gordon Dr Lot 2 Davie County,NC Tax Parcel Report Tuesday, January 3, 2017
154 162.x' 168' •176 184 192 210'i !212 220
,140 134
f 128
- �,� 263 289
122 +
209 303 33-0
129 ---118 ; 267 299
111 ---114 251 259'
4
107 v 106 237
328j
107 ;48 X250
t-j ; � �
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-- 123-- - -- ------ - - 1 - - --- ---- - - -- - ------ ------ ---- - -- --14
WARNING: THIS IS NOT A SURVEY
Parcel Information
Parcel Number: D7010B0002 Township: Farmington
NCPIN Number. 5862448852 Municipality:
Account Number: 8300048 Census Tract: 37059-802
Listed Owner 1: WALTER JAYNE L Voting Precinct: SMITH GROVE
Mailing Address 1: 243 GORDAN DRIVE Planning Jurisdiction: Davie County
City: ADVANCE Zoning Class: DAVIE COUNTY R-20
State: NC Zoning Overlay: DAVIE COUNTY QD
Zip Code: 27006-0000 Voluntary Ag.District: No
Legal Description: LOT 2 GORDON HEIGHTS Fire Response District: SMITH GROVE
Assessed Acreage: 1.13 Elementary School Zone: PINEBROOK
Deed Date: 1/2011 Middle School Zone: NORTH DAVIE
Deed Book/Page: 008490773 Soil Types: Gn132
Plat Book: 0007 Flood Zone:
Plat Page: 085 Watershed Overlay: DAVIE COUNTY
Building Value: Outbuilding&Extra
Freatures Value:
Land Value: Total Market Value:
Total Assessed Value:
9 A1 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, warranties of merchantability or ffiness for a particular use.An users of Davie Countys 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
r'p pl7! 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
Mocksville,NC 27028
(336)751-8760
Account #: 990001527 Tax PIN/EH#: 586244-8852
Billed To: Leader Mobile Homes Subdivision Info: Gordon's Heights 44 Lot#2
Reference Name: Jennifer Smith Location/Address: Gordon Drive-27006
Proposed Facility: Residence
ATC Number: 2982
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 p it(s). This Form/Authorization Number should be presented to
the v�unty Building Inspections Office when a lyin for building permit(s)(in compliance with Article 11 of
G.S.Chapter 130A,Wastewater Systems,Section.19Q Sew a Treatment and Disposal Systems). THIS
AUTHORIZATION FOR WASTEWA CO U IS VALID FOR A PERIOD OF FIVE YEARS.
Environmental Health Specialist's Signatu Date: l /2 D/
CERTIFICATE OF CO L TION
**NOTE** The issuance of this Certificate of Completion shall indicate th syst m described on Improvement/Operation Permit
has been installed in compliance with Article 11 of G.S.Chapte 130 ,Section .1900"Sewage Treatment and
Disposal Systems,"but shall in NO WAY be taken as a guarant tha the system will function satisfactorily for any
given period of time.
tD
d�
�rza� r
Septic System Installed By:
Environmental Health Specialist's Signature:
DCHD 05/99(Revised) LIJ
DAVIE COUNTY HEALTH DEPARTMENT .v
. Environmental Health Section Q� -ZL-o2.
P.O.Boa 848/210 Hospital Street
Mocksville,NC 27028
(336)751-8760
IMPROVEMENT/OPERATION PERMIT
Account #: 990002084 Tax PIN/EH#: 5862-44-8852
Billed To: Betty Williamson Subdivision Info: Gordon's Heights Lot#2
Reference Name: Jennifer Smith Location/Address: Gordon Drive-27006
Proposed Facility: Residence Property Size: 1.273 acres
ATC Number: 2982
**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 SITE PLANS OR THE INTENDED USE CHANGE. YOUR
WASTEWATER SYSTEM CONTRACTOR MUST SEE THIS PERMIT BEFORE INSTALLING SYSTEM.
Residential Specification: Building Type 1JDFLEW106 M 1j #People 2 #Bedroom -
s 3 #Baths '2
Dishwasher: 111 iciGarbage Disposal: ❑ Washing Machine: Ey" Basement w/Plumbing: ❑ Basement/No Plumbing: ❑
Commercial Specification: Facility Type #People #People/Shift #Seats Industrial Waste: ❑
Lot Size 1.273 ACUS Type Water Supply "W Design Wastewater Flow(GPD)3(00 Site: New d Repair❑
System Specifications: Tank Size 10CD GAL. Pump Tank GAL. Trench Width 3(0"Rock Depth 12-" Linear Ft.30c
Other: 371 1 1tDNA � � e 10 A11`, (-1tJQj 9 tO•C. 0
Required Site Modifications/Conditions: jtsj'��STAu-- 6.-5 CAC-ITOJ(L , P �� �0 10' v(
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 8:30 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.****
N
y P Oj i Dl
ar
4!S To eDt
&-�F P4dtr.MwT
Environm tall Health Specialist's Signature: Date: n_J D
DCHD 05/99(Revised)
3367760053 1901.12-19 13:04 #249 P.01/01
FROM :mpiLBOXES ETC 33S9
x�75-i- P776
APPUCATION FOR SITE EVALIIATIt>nl/IINPROV MF PERMIT d:ATC
Davie County Health Department
• EOVIh /nenb//halfb settioll
P.o. Box 868/210 Hospital street 47
tsoCksville, HC 27026
(336)751-8760 D
***ZXPARTP-T*** THIS APPLICATION CANNOT BE PROCESSED UNLESS ALL THE REQUIRED F0 79
INS PmTION I8 PROVIDED• Haler to the INE•ORMUTON BULLETIN for instructions. 1'nO�
_ U
1. Naas to be Silted_ 11�' Contact ascan
Nailing address noes
city/state/zip-(0 N` :)-7 Q t a.. Business Phone "U�,r•l7
2. same on permit/A=cit Dirzorsne then
M"linq address C,l tea"O.c c "K city/star*/sip
3. Awlication ror: ❑ Site Evalu8 Oa Btmprovemant Permit/ATC ❑ Both
e. system to aarvio.. ❑ House le Homo ❑ Business ❑ Industry ❑ Other
S. It Residence: a People �J a Bedrooms J1 t Bathrooms ,2-
)(Dishwasher
2-
)(Dishwasher d Gerbaue Disposal Mashing Machine ri Basement/Plumbing IJ sasesent/No plumbing
6. If Business/Zadustry/other: specify type s People — N sinks "
6 Commodes N showers 1 Urinals a Mater Coolers
zr N=SLRVICE: M Seats — Estimated hater Usage (gallons per dey)
v. Type of water supply: County/City ❑ Well ❑ Coaununity
a. Do you anticipate additions or expansions of the facility this system Is Intended to serve? ❑Yes XNo
If yes,what type?
***IMPORTANT***CW ENTS MUSTCOMPLETETHE REQUIRED PROPERTY INFORMATION REOUESTED
BELOW. Usher a PLAT or SITE PLAN MUST RESUBMITTED by the client with THIS APPLICATION. - ..
Property Dimensions: /60 y 0 WRITE DIRECTIONS(from Modo ilk)to PROPERTY:
Ta=Office PIN: ti Gz' - 8t2! end
Property Address: RoadName G a l?pQk) 17 e r U-e
Cityrzip At ziAatre— lJC YA4.
a 7C06
If in a Subdivision provide iaformation,as follows: _
Name: j:;DRnal: tdl IiU TS
Section: Black: tat: Z Dale Property Flagged: O i;
This is to certify that the information provided is correct to the best of my knowledge. I understand that say permit(s)
issued hereafter are subject/o saxpeusion or revocation,if the site plans or intended use change,or if the information
submitted in this application is falsirmd or changed. I,stro,understand that I am rerponsib/efar all charges incurred from
this application. I,hereby,give consent to the Authorized Representative of the Davie County Health Department
to eater upon above described property located in Davie County and owne y
to conduct all testing procedures as necessary to determine the site suit
DATE la-/ -0 SIGNATURES -
THIS AREA MAY HE USED FOR DRAWING YOUR SITE PLAN c all orthe following: Existing and proposed
property lines and dimensions, structures, setbacks, and septic loeatioss).
�t- � Site Revisit Charge
� t�?008006 Z.1 Date(s):
'- act— Client Notificallos Dal,:
EHS:
PQt l'O� 5�C.Gt'�r*t-r►ti++•� �G Account No.
Revised DCH I(07/99) Invoice No.
r
DAVIE COUNTY HEALTH DEPARTMENT
Environmental Health Section
P.O.Boa 848/210 Hospital Street
Mocksville,NC 27028
(336)'751-8760
IMPROVEMENT/OPERATION PERMIT
Account #: 990001527 Tax PIN/EH#: 5862-44-8852
Billed To: Leader Mobile Homes Subdivision Info: Gordon's Heights 44 Lot#2
Reference Name: Jennifer Smith Location/Address: Gordon Drive-27006
Proposed Facility: Residence Property Size: 1.273 acres
ATC Number: 2982
**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 SITE PLANS OR THE INTENDED USE CHANGE. YOUR
WASTEWATER SYSTEM CONTRACTOR MUST SEE THIS PERMIT BEFORE INSTALLING SYSTEM.
Residential Specification: Building Type M• q 9 `O- #People 3 #Bedrooms #Baths 2-
Dishwasher: El Garbage Disposal: ❑ Washing Machine: Er' Basement w/Plumbing: ❑ Basement/No Plumbing: ❑
Commercial Specification: Facility Typenn- `- #People #People/Shift #Seats Industrial Waster 13Lot Size •�13�� Type Water Supply l�El� Design Wastewater Flow(GPD)< � Site: New� Repair❑
System Specifications: Tank Size 1000 GAL. Pump Tank GAL. Trench Width S Rock Depth 12
1Z Linear Ft.-
Other: 3 MI-Q l LoT1 O� �5 I r �./n
NSAu- k % D.C. A,,W.
Required Site Modifications/Conditions: WSTALL DrJ C aJ'700 , �'�/' ` � , f� ionPN,�
r-
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 8:30 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.****
T
TO Qu c
E vironme tal Health Specialist's Signature: Date:
kli
DCHD 05/99(Revised)
- �- P TION FOR SITE EVALUATION/IMPROVERIENT PERMIT&ATC
Davie County Health Department
9 EnvironmentaiIfealth Section
L��� �' P.O. Box 848/210 Hospital Street
Mocksville, NC 27028
EIdVf�Atlf COUN?Y t HE (336)751-8760
***IMPORTANT*** TH 'APPLICATION CANNOT BE PROCESSED UNLESS 'ALL THE REQUIRED
INFORMATION IS PROVIDED. Refer to the INFORMATION BULLETIN for instr
uc
tions. !
1. Name to be Billed L irtr— 5,,o L Contact Person L&I1 Lel
Mailing Address _I/0 L 3AL-i-s stj&� ", Home Phone 336 -99a-?.-637
City/State/ZIP �?pCdLt// N,C , 2-7n2.9 Business Phone 336-75/'-OSO 3
2. Name on Permit/ATC if Different than Above���')1J/�//F�� 1, .e.eg Vli C-14 s/YII T�
Mailing Address ZN,� 1 )(_ (),+i..LF';' A"' City/State/zip ,n/t a 270 06
3. Application For: ❑ Site Evaluation �Improvement Permit/ATC 1-1 Both
4. system to Service: ❑ House KMobile Home ❑ Business n Industry I I Other
5. If Residence: # People A'- 3 # Bedrooms 3 # Bathrooms
I] Dishwasher U Garbage Disposal X Washing Machine LI Basement/Plumbing II Basement/No Plumbing
6. If Business/Industry/Other: Specify type # People # Sinks
# Commodes # Showers # Urinals I) Water Coolers
IF FOODSERVICE: # Seats Estimated Water Usage (gallons per day)
7. Type of water supply: . County/City ❑ Well II Community
8. Do you anticipate additions or expansions of the facility this system is intended to serve? LI Yes I)K(Vo
If yes,what type?
***Id1PORTANT***CLIENTS MUST COMPLETE,THE REQUIRED PROPER'T'Y INFORMATION REQUESTED
BELOW. Eithcr a PLAT or SITE PLAN MUST BE SUBMITTED by the client with THIS APPLICATION.
wh�EI
Property Dimensions: / , 273 /4<-JL3 f, f7L t-4-3[! WRITE DIRECTIONS(from h1ocloville) (u PRO1'EIRTY:
cr
Tax Office PIN: # S,F6 Z Ll e f 88 Q Fi'VWN j► kine s"r i A&C- > of 97-
6 t;v,rj n*D 701 o pool Gon/hw
Property Address: Road Name t OF Z PC Ts 410, '76 12 gVL,4,,,:�p ALD , 6o, 4 BocTT' i'^i L 1-S
City/Zip A�I i/VtCa 2700( �sotiDAn�i 2lJ .-j /1-1, 1- or /J
If in a Subdivision provide information,as follows: P at)JT 2- Fri /LC 011-' L4�FT,
Name: Cv A-D �l(sffTS S ULiO/UAS�v-�
Section: S 86 Z Block: 'N Lot$85 Z Date Property Flagged: /0 -10 -01
This is to certify that the information provided is correct to the best of my knowledge. 1 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 fir all charges incurred from
this application. 1, hereby,give consent to the Authorized Representative of the Davie County Health Departlite u(
to enter upon above described property located in Davie County and owned by
to conduct all testing procedures as necessary to determine the site suitability.
DATE 10- 9-61 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:
Account No. 2
Revised DCHD(07/99) Invoice No.
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1 APPLICATIQN FOR SITE EVALUATIONAMPROVEMENT PERMIT&ATC
Davie County Health Department
N ,,� Environmental Health Section
P.O.Box 848
Mocksville NC 27028
(704) 634-8760
****IMPORTANT**** THIS APPLICATION CANNOT BE PROCESSED UNLESS ALL
THE REQUIRED INFORMATION IS PROVIDED.
1. Name to be Billed &A7/,4y cj Ad (:c 4s "7iwAContact Person l2 1c/C 5 7A.✓C L-`/
Mailing Address /o o CCL,/z7 Home Phone
Z7�
City/State/Zip L✓/A1 S� 3.✓ — S-,rrC.��, .v.['_ Business Phone 6) �7 Z
2. Name on Permit/ATC if Different than Above 5,4,771-!;r-
Mailing
Ah9LMailing Address City/State/Zip
3. Application For: Site Evaluation [ ]Improvement Permit&ATC [ ]Both q �S
4. System to Serve: [ ]House [ ]Mobile Home [ ]Business [ ]Industry [ ]Other AIMAle2 zE,�C Tri L� T,
5. If Residence: #People #Bedrooms #Bathrooms [ ]Dishwasher[ ]Garbage Disposal
[ ]Washing 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 1-4. o
If yes,what type?
EIT11ER A 1'Ltll Olt 517E PLAN
PROPERTY INFORMATION REQUIRED:***IMPORTANT**NN7A`FLAT OF THE PROPERTY MUST BE
l /}mit 5,]`4:F S CvSUBMITTED WITH THIS APPLICATION.
Property Dimensions: WRITE DIRECTIONS(from Mocksville)TO PROPERTY:
Tax Office PIN: # 5-06e— - - / .d'D"6: ,6J.. S Z&—:Ea
Property Address: Road dame 12 coeip 12�n -le C4 T�-1.�c Ae v d
City/Zip /�'Icxlls.•i/lr_ Al. C
If in Subdivision provide information,as follows:
r
Name: (—;v.t 41. dam'4r. &7J-
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 /? C4 — to conduct all testing procedures as necessary to determine the site suitability.
DATE —L ?— SIGNATURE
Revised DCHD(06-96)
11115 AREA A1,111 LST: 118TU VCR L)I AIVIN(i 1/0111? 817E PLAN:
I10
i
k4,7 _----
0� .
�1r
A i 1
• DAVIE COUNTY HEALTH DEPARTMENT
- Environmental Health Section SECTION--/-LOT �-
Soil/Site Evaluation
APPLICANT'S NAME 8A'/( YJ ,r / DATE EVALUATED
PROPOSED FACILITY
� PROPERTY SIZE / �7f ge
SUBDIVISION (Grp/? ROAD NAME �/d 4 h. i
Water Supply: On-Site Well Community Public L/
Evaluation By: Auger Boring L._� Pit Cut
FACTORS 1 2 3 4 5 6 7
Landscape position
Sloe%
HORIZON I DEPTH
Texture group
Consistence
Structure
Mineralogy
HORIZON II DEPTH jo
Texture groupC
Consistence i
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:
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)