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1655 Hwy 801SDavie County, IAC Tax Parcel Report 36 o f Tuesday, September 27, 2016 1624 \ ri 22646 ` 323 �. X1641 \ 784 3549 55'V\1 - z X16 5 3551 ° J 6561. 7366 % ' 6,7 1666 0o \p PB12 PG97 LOT 1 �\ 26 N 101 All data is provided as is without warranty or guarantee of any kind either expressed or implied including but not limited to the Davie County, NCimplied 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 or arising out of the use or inability to use the GIS data provided by this website. WARNING: THIS IS NOT A SURVEY Y uarcelInformation Parcel Number: G80000003303 Township: Shady Grove NCPIN Number: 5880046561 Municipality: Account Number: 82525983 Census Tract: 37059-803 Listed Owner 1: MABE KEVIN L Voting Precinct: EAST SHADY GROVE Mailing Address 1: 1655 NC HIGHWAY 801 SOUTH Planning Jurisdiction: Davie County City: ADVANCE Zoning Class: DAVIE COUNTY R -A State: NC Zoning Overlay: Zip Code: 27006-0000 Voluntary Ag. District: No Legal Description: 0.882 AC HWY 801 Fire Response District: ADVANCE Assessed Acreage: 0.72 Elementary School Zone: SHADY GROVE Deed Date: 3/2006 Middle School Zone: WILLIAM ELLIS Deed Book f Page: 006500895 Soil Types: WeB,PcB2 Plat Book: Flood Zone: X Plat Page: Watershed Overlay: - Building Value: 98180.00 Outbuilding & Extra 1130.00 Freatures Value: Land Value: 23290.00 Total Market Value: 122600.00 Total Assessed Value: 122600.00 101 All data is provided as is without warranty or guarantee of any kind either expressed or implied including but not limited to the Davie County, NCimplied 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 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 2702.8 (336)7.51-8760 IMPROVEMENT/OPERATION PERMIT Account #: 990002821 Billed To: Earlie Beauchamp Reference Name: Crystal Trivette Proposed Facility: Residence Tax PIN/EH #: 5880-14-0218 B Subdivision Info: Location/Address: 1655 Hwy 801 S-27006 Property Size: 0.88 Acres ATC Number: 3507 **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 #People 3 #Bedrooms 3 #Baths Dishwasher: 0"4 Garbage Disposal: ❑ Washing Machine: 0"� Basement w/Plumbing: ❑ Basement/No Plumbing: ❑ Commercial Specification: Facility Type , 1 #People #People/Shift #13,Seats Industrial Waste: Lot Size �'� Type Water Supply CAL TDesign Wastewater Flow (GPD)--2_l�D Site: New ET Repair ❑ „ I% System Specifications: Tank Size "01'iAL. Pump Tank GAL. Trench Width 3(.o Rock Depth 12 Linear Ft.!� Other: ` 'JI S ��JTIa� ►X►.r'S Required Site Modifications/Conditions: J5 Wit_ Z) -3 C_-�1�1009.1, kt'� SI c [at VI- IMPROVEMENT/OPERATION PERMIT LAYOUT - APPROVED EFFLUENT FILTER RISER(S) IF 6 " BELOW EWIISSH_ED GRADE. ****NOTICE: Contact a representative of the Davie County Health Department for final inspection of this system between -840-a Ljo 9:30 a.m. or 1:00 p.m. to 1:30 p.m. on the day of installation. Telephone # is (336)751-8760.**** w Environmental Health Specialist's DCHD 05/99 (Revised) .5 ole'' i �Q��S P�'o-e- ►SSv�� tJu�4l�-1 D,.D-'S 0 DAVIE COUNTY HEALTH DEPARTMENT • Environmental Health Section •' P. O. Boa 848/210 Hospital Street �._..,. F Mocksville, NC 27028 (336)751-8760 IMPROVEMENT/OPERATION PERMIT Account #: 990002821 Tax PIN/EH'#: 5880-14-0218 B Billed To: Earlie Beauchamp Subdivision Info: Reference Name: Location/Address: Potts Road -27006 Proposed Facility: Residence Property Size: see map ATC Number: 3507 **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 HQ—S % F, #People - _ #Bedrooms ---:S_ #Baths 2 . Dishwasher: Ef Garbage Disposal: ❑ Commercial Specification: Facility Type Washing Machine: Ef� Basement w/Plumbing: ❑ Basement/No Plumbing: ❑ #People #People/Shift #Seats Lot Size •� —Q`'S Type Water Supply ODDesign Wastewater Flow (GPD) Industrial Waste: ❑ Site: New Repair ❑ System Specifications: Tank Size (GAL. Pump Tank1000GAL. Trench Width"Rock Depth -1� Linear Ft.�� Other: �1STQIGono-3 '3i;5XaS Required Site Modifications/Conditions:TAi.L- o.� ��Q� �%� V-046� CC -Er (� . 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.**** 10'tAIJ . 1 �,x1 ,� 2 jo K 1 c0� Environmental Health Specialist's DCHD 05/99 (Revised) 1 4- VyAl Fvox 6 0�» Flo s' 01W M Date: DAME COUNTY HEALTH DEPARTMENT Environmental Health Section ' P. O. Bog 848/210 Hospital Street Mocksville, NC 27028 (336)751-8760 Account #: 990002821 Billed To: Earlie Beauchamp Reference Name: Tax PIN/EH #: 5880-14-0218 B Subdivision Info: Location/Address: Potts Road -27006 Proposed Facility: Residence Property Size: see map ATC Number: 3507 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 WASTEW O UCT N IS ALID FOR A PERIOD OF FIVE YEARS. Environmental Health Specialist's Signatur Date: r% Lo -3 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. \ Septic System Installed By: Environmental Health Specialist's Signature: DCHD 05/99 (Revised) V APPLICATION FOR SITE EVALUATION/Ih1PROVEhlENT PERMIT S Davie County Health Department JUN 3 0 2a E7Yironmenta/Hea/th Section P.O. Box 848/210 Hospital Street Mocksville, NC 27028 Qillu�iFlVTj{I (336) 751-8760 MVtFCOUNrytIH ***IMPORTANT*** THIS APPLICATION CANNOT BE PROCESSED UNLESS ALL THE REQUIRED INFORMATION IS PROVIDED. Refer to the INFORMATION LETIN for instructions. •-i / 1. Name to be Billed �C.rhe %PCUC1�1r+� � U� ��Contact Person Mailing Address 137�PY)-V /4a m e- Home Phone City/State/ZIP /-/yuan c el, Ve 2 706 Business Phone I7 J 2. Name on Permit/ATC if Different than Above Mailing Address City/State/Zip 3. Application For:'A1-"site Evaluation improvement Permit/ATC ❑ Both .t 4. system to service: 0 H,.ouuse El Mobile Home� 13 Business ❑ Industry ❑ Other 5. Type aystem requested: �tJ Conventional ❑ conventional modified ❑ innovative 6. If Residence: II People it Bedrooms 3 11 Bathrooms Zr E Dishwasher ❑Garbage Disposal MWashing Machine ❑Basement/Plumbing ❑Basement/No Plumbing 7. If Business/Industry /Other: verify type 4 People It sinks # Commodes 0 Showers # Urinals It Plater Coolers IF FOODSERVICE: #1�Seeats Estimated Water Usage (gallons per day) E 8. Type of water supply: County/City ❑ Well ❑ Conununity 9. Do you anticipate additions or expallsioiis of the facility tills systen, is intended to serve? ❑ yes Cil\( If ycs, iviiat type? '111IPORTANT*** CLIENTSd1USTC0AIPLETETHE REQUIRED PROPERTY INFORMATION REQUIs5'1'IsD BELOW. Eitlier a PLAT or SITE PLAN t11USTBESUX1177ED by the dicot witli TIIIS APPLICATION. Properly Dimensions: 4an-& 11"� Tax Office PIN: # Property Address: Road Nainc Pa ft*--, Po CIC/ City/Gip 0 F qc n C G' 2166, If in a Subdivision provide information, as follows: Nanlc: Section: Block: WRITE DIRECTIONS (from Alocksville) (o PRUPI-I*RTY: bit feV /'orne r o d ✓y-fis l<oacy/ Lot: Date !ionic corners !lagged: This is to certify that the information provided is correct to the best of my knowledge. I understand lliat any perniii(s) issued hereafter are subject to suspension or revocation, if the site plans or intended use cliange, a• if (lie information submitted in this application is falsified or clianged. I, also, understand that 1 and responsible far all charges facurred fron, this application. I, licreby, give consent to the Authorized Representative of [lie Davie County IIealtli Depar(niciil 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 G 0.3 SIGNATURE ;y ,X9 t t TIIIS AREA MAY BE USED FOR DRAWING YOUR SITE PLAN (Include all of the following: Existing :old proposed property lines and dimensions, structures, setbacks, and septic locations). e � Sign given __*�� Revised DCHD (05/03 EUS: Account No. Invoice No. DAVIE COUNTY HEALTH DEPARTMENT Environmental Health Section Soil/Site Evaluation APPLICANT INFORMATION . PROPERTY INFORMATION Account #; 990002821 Tax PIN/EH #: 5880-14-0218 B Billed To: Earlie Beauchamp Subdivision Info: Reference Name: Location/Address: Potts Road -27006 Proposed Facility: Residence Property Size: see map Date Evaluated: Water Supply: On -Site Well - Community Public Evaluation By: Auger Boring Pit Cut •• ®®®0®0® Landscape position HORIZON I DEPTH Consistence Mineralogy Texture • .Consistence mar«r�■®��®®' III DEPTH AWOUR UA_ KNOW Texture group M d ConsistenceHORIZON ®rte , �Timm � Mineralogy HORIZON IV DEPTH Texture group Consistence Mineralogy • ••• ��r��®■o�� ' • tGi��rsw��®®�O ;SITE CLASSIFICATION: EVALUATION BY: w LONG-TERM ACCEPTANCE RATE: D OTHER(S) PRESENT. -}—f (.< 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 GRA 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 05/99 (Revised) ■■ ■■O■■■ ■■MENS ■■■■■E■■■E■■■■■■■ ■■M■■■■■■■■Mo■■■■ ■■■■■■■■■OO■E■■■■ ■■■■O■■E■■■■E■■■■ ■■■ME■■■■■E■■OE■■ ■■■M■■■■■■■OOE■E■ ■■■MM■■E■■E■■■E■■ ■E■■■E■■ No ME NoZilommoliiMEMENOME ■■l1�!►fie■(�■■■■■■■■■■■■■ ■■■■■■■■■■■■■■■■■■■■■■ ■■■■■■■■■■■■■■■■■■■■■■ ■■■■■■■■■■■■■■■■■■■■■■ ■■■■■■■■■■■■■■■■■■■■■■ ■■■■■■Mee■■■■■■■■■■■■■ ■■■■■■■■■■■■■■■■■■■■■■ ■■■E■ ■■■■■ ■ mM■■M■■M■MM■■■ ■■o■■■■■■■■■■■ ■■■M■■■■■■■M■■ ■■■E■■■■■■■O■■ ■■■ ■■■■■M■■■ ■■E�■■■■■■■O■ E■■■■■■■■■■m■■ ■■E■■■M■■■■M■■ mmmmeo■mmmmmmm MEMO MEMO ■O■ ■■■■■■ ■■■ ■■■�O■■■■■ M■■ ■EEO■■■■■■■■■■■■ ■■E■■■■E■■■■■O■■ ■■■■■■■■■■■■om2m ■■■■■■■■■■■■EEE■ ■■■■■■■■■■■ENEEM ■■■O■■■■■■■■RS■■ ■E■■M■■■NVENWE■■ ■EM■■■■■EW■■■■■■ ■e■■■■■■VNEEMUN■ ■■M■■■mommon■wsm ■■■■■■■■■■OO■MEM ■■■■■E■EMEM■■■a■ ■■■EMEM■MENOM■■■ NESE■■E■■O■■■■■■ ■■■■■■O■E■O■■EE■ ■■■EE■■■■O■■■E■■ ■E■OE■M■■■■■MEE■ ■E■E■■■E■■E■■E■■ ■■■■■■■E■■■■■■■■ ■E■■■■■■■■■■■E■■ ■■Erle■■■ ■OE■■■E■ ■■■■■omm ■■■■NEEM ■■■■NEEM ■EEE■E■■ ■■ ■■■■■■■■■■■■■■■■■■■■■■ ■■■■■■■■■■■■■■■■■■■■■■ ■■■■■■■■■■■■■■■■■■■■■■ ■■■■■■■■■■■■■■■■■■■■■■ ■■■■■■■■■■■■■■■■■■■■■■ ■■■■■■■■■■■■■■■■■■■■■■ ■■■■■■■■■■■■■■■■■■■■■■ ■■■■■■■■■■■■■■■■■■■■■■ ■■■■■■■■■■■■■■■■■■■■■■ ■■■■■■■■■■■■■■■■■■■■■■ MEMMEMri imom ■■■EEE■■■■■■■■■■■■■■■■ ■■■■E■■■■■■■■E■■■■■■■■ ■■■■■■■■■■■■■■■■■■■■■■ ■■■■■■■■■■■■■■■■■■■■■■ ■E■■ SOON ■■■■ NONE ■■■■■■■■■■■■■■■■■■■■■■■■■ ■■■■■■■■■■■■■■■■■■■■■■■■■ ■■■■■■■■■■■■■■■■■■■■■■■■■ ■■■■■■■■■■■■■■■■■■■■■■■■■ ■■■■■■■■■■■■■■■■■■■■■■■■■ ■■■■■■■■■■■■■■■■■■■■■■■■■ ■■■■■■■■■■■■■■■■■■■■■■■■■ ■■■■■■■■■■■■■■■■■■■■■■■■■ ■■■■■■■■■■■■■■■■■■■■■■■■■ ■■■■■■■■■■■■■■■■■■■■■■■■■ ■■■■■■■■■■■■■■■■■■■■■■■■■ ON ME ME ON ■■■■■■■■■■■■■■■■■■EEE■■■■■■■■■■■ ■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■ ■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■ ' ct� U'• U .,' rU11 '' l o I -P I •6', N IRpN 78p RF FOUND � �,, �S• S 8 0 -13 7 z l I ° oF��' 2<' �LP co 101V nri I FO I 'moo ''Vo N 61 000'28"E z ( Tp z 100.00' i RpN F l o 0 01 8� ti � w j 0 Ac ST� o I m w I) hIAl o to IR c(JISC °ti m = TOTAL A F I N 161004'22"E 197.98' ZE 07 ° !� il 25.5.5' I 172.43' °NFO W w r- j 0 �tio o �OT FIV i T n 0 50.1 �.w 260.57 1tov� 54021 l)$ OTAL- Z WILMA P. PHELPS D.B. 45 PG. 153 \ I o� \ \?'�'- N -89°03'29"E - \ IRON FOUND C-+-- 174.24 \ ALBI \ \\ MAR \ \ �o\r'�\ D.B. \ �\ `9\ \ IRON FOUND-) \ IRC -X STEPHEN A. MEYER I D.B. 114 PG. 564 D.B. 110 PG. 904 \ \ EUGENE POTTS \ D.B. 52 PG. 203 EUGENE POTTS \ ID.B. 45 PG. 136 \ S 89016'06"E \ EUGENE POTTS D.B. 45 PG. 135 0 VIRGIL POTTS D.B. 132 PG. 743 I ;IL POTTS 34 W 00 S E ;ATION MAP I JOHN RICHARD HOWARD certify that �M IRON FOUND this map was drawn from an actual field survey under my direction and supervision, that the ratio of precision is 1ANO l� PROFESSIONAL LAND SURVEYOR L-2890 MOCK ESTATE / D.B. 33 PG. 313 REVISED 5-5-03 REVISED TO CREATE A NEW LOT ON NC HWY 801 OF 0.8823 ACRE. 100 0 100 200 300 GRAPHIC SCALE — FEET MAP E. R. BEAUCHAMP FOR CHARLOTTE WILLIAMS SCALE TOWNSHIP COUNTY STATE DATE,s 1 " = 100' SHADY GROVE DAVIE N. C. 2-25-02 CHARLOTTE WILLIAMS PROPERTY D.B. 66 PG. 271 ABD D.B. 69 PG. 335 REVISED 5-5-03 HOWARD SURVEYING JOB NO. JOHN RICHARD HOWARD PLS 02002 P.O. BOX 276 ADVANCE, N.C. (336) 998-5396