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230 Hwy 801N
Davie Countv, NC , � Tax Parcel Renort Wednesdav, October 12, 2016 WAK1VllVli: �1�ti1�J' l�J' 1VV1 A �J'UKVl�:Y Parcel Information Parcel Number: D700000230 Township: NCPIN Number: 5872354440 Municipality: Account Number: 82533126 Census Tract: Listed Owner 1: ZOOBIE HOLDINGS LLC Voting Precinct: Mailing Address 1: ATTN: SHIRLEY SMITH Planning Jurisdiction: City: WINSTON SALEM Zoning Class: State: NC Zoning Overlay: Zip Code: 27103 Voluntary Ag. District: Legal Description: .84 ac HWY 801 Fire Response District: Assessed Acreage: 0.84 Elementary School Zone: Deed Date: 12/2011 Middle School Zone: Deed Book / Page: 008770230 Soil Types: Plat Book: 10 Flood Zone: Plat Page: 369 Watershed Overlay: Buiiding Value: Land Value: Total Assessed Value: 9" �'F Davie County, `��vN�c� NC 20170.00 Outbuilding & Extra Freatures Value: 411640.00 Total Market Value: 576890.00 Farmington BERMUDA RUN 37059-802 HILLSDALE BERMUDA RUN BERMUDA RUN CM SMITH GROVE PINEBROOK NORTH DAVIE EnB,MsB BERMUDA RUN 145080.00 576890.00 No _ , •, .,.; --, r�,�,_, ,_....,. . , , `' r .., ` .,,, ... , . , -. � , , : = = a' _ y�1UTH�RIZATION NO: O S 5 9 � DAVIE COUNTY HEALTH DEPARTMENT // �d I y - ' '. Environmental Health Section PROPERTY INFORMATION 5� � Pernuttee's � � P.O. Box 848 Name: f!%�_r/;i;'<�/ �,,/Jt��it %�.� �'� `!J Mocksville, NC 27028 Subdivision Name: �� � r; Phone #: 704-634-8760 b J� Directions to property: ,�'�'� � �' � �„ % i> �• Section: Lot: /�,- ��;� AUTHORIZATION FOR �,�,����� �'� � WASTEWAT'ER Tax Office PIN:# ��rl� �'.� - �f�,�� SYSTEM CONSTRUCTION `,�� � RoadName:,l��..Fs�l���cZ��e�''�p:�"�j � ilf��> **NOTE** This Authorization for Wastewater System Construction MUST BE ISSUED by the Davie County Environmental Health Section prior to issuance of any Building Pernuts. This Forn�/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) ,� .� j -'� �;� ***NOTICE*** THIS AUTHORIZATION FOR WASTEWATER CONSTRUCTION !,'']��. �J j.,�✓-�';�i.�j/ /�! '� �£�,% IS VALID FOR A PERIOD OF FIVE YEARS. ' ENVIRONMENTAL HEALTH SPECIALIST DATE ISSUED ' - .. , � - .._ - _ :_. , ,.. ,. . . : _, . _ ; .. ,, .. ._ , , ;.-�� . -. _ .�,. � , . `- '� . .� � ;. d DAVIE COUNTY HEALTH DEPARTMENT �'� �� -�' f � �"nf^ �{ � c`"'�-• IMPROVEMENT AND OPERATION PERMITS PROPERTY INFORMATION a��bl Perri�ttee s� - , � Name:� � � ���'r a .�`:�`r%:-/ -'r" ;r � � �- Subdivision Name: �E�' �-. - -._ ' ��,, Directions'to property: �•� Section: Lot: �%�-.��' �� •� ' IlVIPROVEMENT ;,, ,-. .r , Gf�,�� r�J� ,l 1 �. PERMIT ,t'`•'. � � ''�a, _ .L.',,��� .i� ,! Tax Office PIN:# �- � ��= �� � a � /` Road Name: �� �:�.-�-: �'� �. �i ,:.a_ � 1= -�Lip �"� "� . **NOTE** This Improvement Pernut DOFS NOT authorize the construction or installation of a septic tanlc system or any wastewater system. An AiTTHORiZATION FOR WASTEWATER SYSTEM CONSTRUCTTON must be obtained from this Department prior to the construc6on/installation of a system or the issuance of a building pemut. (In compliance with Article 11 of G.S. Chapter 130A, Wastewater Systems, Section .1900 Sewage Treatrnent and Disposal Systems) t �• ***NOTICE*** THIS PERNIIT IS SUBJECT TO REVOCATION IF SITE � : ,� C; ',` ; '; ,, , � r',; �" ,i , ;r' i r" ; PLANS OR Tf� INTENDED USE CHANGE. YOUR WASTEWATER ENVIRONMENTAL HEALTH SPECIALIST DATE ISSUED SYSTEM CONTRACTOR MUST SEE THIS PERNIIT BEFORE INSTALLING TI� SYSTEM. RESIDENTIAL SPECIFTCATION: BUII..DING TYPE �_/t # BEDROOMS # BATHS �# OCCUPANTS _�� GARBAGE DISPOSAL: Yes or No . .. _. . .. COMMERCIAL SPECIFICATION: FACILTTY TYPE # PEOPLE # PEOPLE/SHIFT # SEATS INDUSTRIAL WASTE: Yes or No �J / LOT SIZE �" TYPE WATER SUPPLY '_� DESIGN WASTEWATER FLOW (GPD) .��! NEW SITE ��''r REPAIR SITE SYSTEM SPECIFICATIONS: TANK SIZE ��' GAL. PUMP TANK GAL. TRENCH WIDTH .r �= ��ROCK DEPTH � LINEAR Ff. �%%-' � r-�--- OTHER REQUIRED SITE MODIFICATIONS/CONDITIONS: _ IMPROVEMENT PERMIT LAYOUT �r� **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: J` �� � ` AUTHORIZATION NO. D�� OPERATION PERMIT BY: f�- ' � DATE: LS /,��/ �� **THE ISSUANCE OF THIS OPERATION PERMIT SHALL INDICATE THAT THE SYSTEM DESCRIBED ABOVE HAS BEEN INSTALLED IN COMPLIANCE WITH ARTICLE 11 OF G.S. CHAP'TER 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 OS/96 (Revised) APPLICATI01�1 FOR SITE EVALUATION/IMPROVEMENT PEP Davie County Health Department Environmental Health Seclion P.O. Box 848 i� Mocksville, NC 27028 , ; � (704) 634-8760 � M �� �R'� 81991 '�'�'�*IMPORTANT**** THIS APPLICATION CANNOT BE PROCESSED UNLESS THE REQUIRED INFORMATION IS PROVIDED. 1. Name to be Billed . ��, ;.��� �,�� Contact Person ly raV ;� c�cw�� Mailing Address Home Phone gg�� �� �� - City/State/Zip ��.�-� 2 7 � /�. 7Z0-877/ /h.pi�.w� Business Phone 2. Name on PermidATC if Different than Above Mailing Address ��D City/State/Zip 3. Application For: ,E'�}-Site Evaluation [�mprovement Permit & ATC �i]$oth 4. System to Serve: [] House [] Mobile Home [l.J�usiness [] Industry [] Other 5. If Residence: # People_� # Bedrooms # Bathrooms� [] Dishwasher [] Garbage Disposal [] Washing Machine [] Basement/Plumbing [] Basement/No Plumbing 6. If Business/Other: Specify type �� ��,�,,,����ple�` #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 facili[y this system is intended to serve? [] Yes [] No If yes, what type? EZTHER ,4 YLtIT OR SZTE PLtIN PROPERTY INFORMATION REQUIRED: *** IMPORTANT *�* �it�cOF THE PROPERTY MUST BE SUBMITTED WITH T�iiItS APPLICATION. Property Dimensions: � L ,� � d a � WRITE DIRECTIONS (from }��locks� � � � Tax Office PIN: # �'s � 7�, � L;�! f�� ; Property Address: Road Name � � City/zip ��v• � G Z 7oa G � If in Subdivision provide information, as follows: � � kTT C- rnS � � Name: � � � Section: Lot #: ; TO PROPERTY: This is to certify that the information provided is correct to the best of my knowledge. I understand that any permit(s) issued hereafter aze 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 t onduct all testing procedures as DATE � SIGNATURE / � Revised DCHD (06-96) THZS AREA �tAl� $E USEb �OR bRtIWINC� JOUR SZTE PLAN: to determine the site suitability. � � DAVIE COUNTY HEALTH DEPARTMENT Environmental Health Section SECTION r.oT SoiUSite Evaluation APPLICANT'S NAME �� �' PROPOSED FACILITY � 1` f �'Cr SUBDIVISION Water Supply: Evaluation By FACTORS Slope % HORIZON I DEPTH Texture group Consistence HORIZON II DEPTH Texture group Consistence Structure HORIZON III DEPTH Texture group Consistence Structure HORIZON IV DEPTH Texture group Consistence Structure On-Site Well Community Auger Boring 1� Pit SOIL WETNESS RESTRICTIVE HORIZON SAPROLITE LONG-TERM ACCEPTANCE RATE SITE CLASSIFICATION: LONG-TERM ACCEPTANCE RATE: ,,�i� REMARKS: DCHD (O1-90) DATE EVALUATED S �.� �L17 PROPERTY SIZE � � c' ROAD NAME �,� � �� Public c� Cut 3 4 5 6 7 EVALUATION BY: OTHER(S) PRESENT: 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 Moist VFR - Very friable Wet NS - Non sticky NP - Non plastic FR - Friable FI - Firm VFI - Very firm EFI - Extremely firm SS - Slightly sticky S- Sticky VS - Very Sticky 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 Mineraloev 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 - gaUday/ft2 ■■■�■��■■■�■���������■ ■■■■■���■���■���■����■ ■���■�■��■■�■■■■■�■■■■ ■■■■■��■■■■�����■■���■ ■�■�■�■���■■■■��■����■ ■��■■��■����■■�■■��■�■ ■■�■�■���■��■■■■��■■�■ ■�������■�����■��■■��■ ■■■■■■■■��������■■�■■■ ■■■�■��■■■■■�■�������■ ■���■■���■■■■�■■■■■■■■ ■�■����■■■■�■■��■����■ ■■■■■■■■��■�■��■���■�■ ■���■■■���■�■�■■■�■■�■ ■�������■■��■������■�■ ■����■���■���■�■��■■�■ ■■�■■■■■������■■■■■■■■ ■■�����■■����■■��■��■■ ■�■�■��■■��■�■■�■■��■■ ■■■�■��■���■�■■��■��■■ ■�■�■�■■��■■�■■�■■��■■ ■■■■■���■■■�■■�������■ ■■���■■���■�■■■■■��■�■ ■■�■■■�■�����■■■■�■■�■ ■■�■■■■����■■■�■■�■■�■ ■■�■��■■�������■���■�■ ■��■�■��■■■■■�■■�■■■�■ ■■�■�■■�■■�����■■■■■■■ ■��■����■�■�■�■■�■■■■■ ■■����■■■�����■�■�■■■■ ■■■����■■��■■■■��■■�■■ ■�■�■������■�■■��■��■■ ■�■�■�■■���■�■��■■■�■■ ■■■■■������■�■■�■■��■■ ■�■�■�■�■■■■■���������■■■■■■�■ ■■�■�■■���■■■■■■�����■���■■■�■ ■■���■■■■�■�■��■���■�■���■�■�■ ■■■■�■■��■��■■■■■�■■�����■■■■■ ■�■■ ■��■ ■■��■■■■■�■■�����■■��■■�■ ■■■■■�����■■■■■■■■■�����■ ■��■��■■■�■��■■��■��■■■■■ ■�■■■�■�����■■■■■■■■■■��■ ■��l����■■�■■■■������■■ ■■���1■�■■■■■■■■■�■■■■���■ �I,���\■�■■��������■■■�■�■■ ■1■�����■■■■■��■�������■■■ ■I���■�■■�����■■■■■■�■■��■ ■I��■��■���■���■�■■�■■■■�■ ■1��■�C�■■■■■���■�■■■■■■■�■ ■11���1�■�■■���■�����■■�■■ ■�1■■�11���■■�■■■��■ ■■■■■ ■�1■�■I�■�■■��■■�■■■■■■��■■ ■�i�■■i���■■�■■��e���■■��■■ ■�������■■�■■■���t�■■■■■■■ ■■��■u�■_�=====•��■����■■■ ■��■■��■��������o�■�■���■ ■��■��■■�■■�■�������■■��■ ■��■■����■���■-:��■ ■��■■ ■�■■�►�■�■■■�■■�■■��i■■■■■ ■■����!�■■■■�■��■����•...■ ■■■■�■�����■�■■■i�i������■ ■■��■■11�■��■��■���I■��■■�■ ■■��■■ ■■�i��■ ■�■l��■ ■��11■■ ■�■\I■■ ■�■��■ ■���i\■ ■■■■1�■ ■■��\1■ ■■■�■ ■■�■■ ■�■■■ ■���■ ■■■■■ ■■■ ■■����■ ■�����■ ■�■��■■ ■��■■�■ �� �� ii ■■ ■■ ■�■■ ■�■■ ■■■■ ■■�■ _ _ _ - , - ---- - -- _ _ _ � _ -- — .__ - _ _ . _ _ _ _ � � � �� ! � „d � d R+ _ .4 . t A^�a $. , I � � �x� *� „ v , �� ?. .� �� � � ��"� ^� �` $ ' �.. � '' *� m »� �.°� � �`Y4� � � ��. ,�.;. 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