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2123 Hwy 801S Davie County,NC ' Tax Parcel Report 4 14b Wednesday,September 28,2016 Jt V 2054 X20531725 4631 s1� X2062'2 0 110 2072067 131721 1627 .: ' 2083 X137 g f� 3 , - 1 .a 21105 191 Shutt Rd - 163.., _ aA a 120 .� .-,-•,�..-__..,.. '. X167 i 21 d8 L1 ,2155 249 t s �28 .. 42184 2192 �u 2200 145 208 j2207 163 a _. �7' 1 a WARNING:THIS IS NOT A SURVEY Parcel fnformatton Parcel Number: G8120B001601 Township: Shady Grove NCPIN Number: 5789390064 Municipality: Account Number: 61922000 Census Tract: 37059-804 Listed Owner 1: ROBERTSON CHARLES RONALD Voting Precinct: EAST SHADY GROVE Mailing Address 1: PO BOX 162 Planning Jurisdiction: Davie County City: ADVANCE Zoning Class: DAVIE COUNTY R-20 State: NC Zoning Overlay: Zip Code: 27006-0162 Voluntary Ag.District: No Legal Description: 1 LOT HWY 801 Fire Response District: ADVANCE Assessed Acreage: 0.37 Elementary School Zone: SHADY GROVE Deed Date: 3/1995 Middle School Zone: WILLIAM ELLIS Deed Book/Page: 001790740 Soil Types: PcB2 Plat Book: Flood Zone: X Plat Page: Watershed Overlay: WS-IV-P Building Value: 72210.00 Outbuilding&Extra 0.00 Freatures Value: Land Value: 14830.00 Total Market Value: 87040.00 Total Assessed Value: 87040.00 141 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,NC 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 or arising out of the use or inability to use the GIS data provided by this website. DAVIE COUNTY HEALTH -DEPARTMENT IMPROVEMENTS PERMIT AND CERTIFICATE OF COMPLETION *NOTE:Issued in Compliance With Article I I of G.S.Chapter 130a Sanitary Sewage Systems ;; Permit Number Name Date f` < l _ 0 r;. Location qo 15 Subdivision Name Lot No. Sec. or Block No. Lot Size f House Mobile Home — Business __ Speculation No. Bedrooms No. Baths _ ` No. in Family ✓� Garbage Disposal YES ❑ NO ❑ Specifications for System: Auto Dish Washer YES ❑ NO ❑ - f Auto Wash Machine YES ❑ NO ❑ Type Water Supply __— *This permit Void if sewage system described below is not installed within 5 years from date of issue. This permit is subject to revocation if site plans or the intended use change. t 1- C Improvements permit by -- �� 4"; *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 day of completion. Telephone Number: 704-634-5985. Final Installation Diagram: System installed by i r t_1 {- 1� Certificate of CompletionDate *The signing of this certificate shall indicate that the system described above has been installed in compliance with the standards set forth in the above regulation, but shall in NO way be taken as a guarantee that the system will function satisfactorily for any given period of time. '' DAVIE COUNTY HEALTH DEPARTMENT _s Environmental Health Section Soil/Site Evaluation NAME DATE EVALUATED ADDRESS PROPERTY SIZE ' 't) - PROPOSED FACIILTY �5 f LOCATION OF SITE Water Supply: On-Site Well Community Public s✓ Evaluation By: Auger Boring 1// Pit Cut FACTORS 1 1 2 3 4 Landscape position 2- G- Zi L- Slope % 10 _ 41 C/ HORIZON I DEPTH Texture group -5- Consistence Structure Mineralogy HORIZON II DEPTH Texture group Consistence :- Structure /,,r� -.<',,/il J G,e b/ Mineralogy ' HORIZON III DEPTH Texture group Consistence Structure Mineralogy HORIZON IV DEPTH Texture group Consistence Structure Mineralogy SOIL WETNESS RESTRICTIVE HORIZON SAPROLITE CLASSIFICATION s✓ LONG-TERM ACCEPTANCE RATEI el I SITE CLASSIFICATION: _ �a 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-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(01-901 ■■■■■■■■.■■■■..■■■.■■■..■.■.■■.■■■■■■■■■■i■■■■■.■■■■.■.■■■■■■■ ■■■ ■■■..■■■.■...■■.■■.■.■.........■ ■■■.■■■■■.....■■■■■.....■■■■�■■■ ��\��\CNCCN�INCCN�C■■�CNCCN�'■�NCCCC�CCNNNNNCCNNNCCC�C NNNNCN MENNENNNCNNNi'1NNNNEN MENNEN MENNENMENNENME 0 .................................................................. NNNN�NNN�NNN�NNNNNNNNNNNNNNNNNNN�~��\N��.NONE ■NNS NNS■ ■■■..■.■■■■■■■■.■■■■■.■■.■■■.■■■■■.■■i\■..■■■■■.■■■■■■..■i.■■■�■■■■ CCCCCCCCCNCCNC:CCCCCCCCCCCCCCCC:CCCCCCCCCCCCC=:�CCC:CCCCCCCCCCC NCCCCCCCC■. . ::CC:CCCCCCCCCCCCCNCCCCCC: CCCCC:CCCC=CCCCC:CNCCCCC:CCC ■■■■■■ ■....■■.■■■■■■■■■■■■■■■■ ■.■!1■■■■■■■■■■ ■■■.■■■■■.■.■.■■■ NCCCNNC�CCC�iCCNNNNN=NCCCCCCNNNNNCNNCCCNiiiiiiiiiCiiiiiiiiiii'■NiC :CNNNN:CCNCCC:N:CCN:C:CCNNCCCCNCCNC:NNCCN:CC:N:N::�CCNNCCN:NN':::' CNNNNCNNNN�:NNNNCNNNNCCNNNNCCCN�.�NCNNNNCCNNCNCCCNCNCNNCNN:NC:CNNN .................................................................. .................................................................. .................................................................. .................................................................. .................................................................. APPLICATION FOR SITE EVALUATION/IMPROVEMENTS PERMIT Davie County Health Department Environmental Health Section P. 0. Box 665 Mocksville, N.C. 27028 CONSTRUCTION SHALL NOT BEGIN UNTIL IMPROVEMENTS PERMIT HAS BEEN ISSUED. Home Phone 1. Permit Req ted By WBusiness Phone ON 221 to 2. Address Y, _ `� 0� cLo 3. Property Owner if Different than Above Address 4. Permit To: a) Install Alter Repair b) Privy Conventional Other Type Ground Absorption c) Sub-Division Sec. Lot No. 5. System used to serve what type facility: House ✓ Mobile Home Business IndustryOther b) Number of people 6. ay If house or mobile home, state size of home and number of rooms. House Dimensions Bed Rooms -�3 Bath Rooms_Den w/Closet b) If Business, Industry or Other, State: Number of persons served What type business, etc. Estimate amount of waste daily (24 hours) l 7. Number and type of water-using fixtures: commodes cz, urinals garbage disposal / lavatory a. showers a washing machine dishwasher sinks 8. a) Type water supply: Public. L,—,**' Private Community b) Has the water supply system been appro ? Yes No — 9. a) Property Dimensions b) Land area designated to building site - c) Sewage Disposal Contractor 10. Do you anticipate any additions or ex o o ility this sewage end d to serve? 6 O What type? A 06 This is to certify that the information is cor ct to thPe t of my owledge. Date Owner Signature OWNER IS SOLELY RESPONSIBLE FOR COMPLIANCE WITH ALL STATE AND LOCAL LAWS Allow 5 days for processing Directions to property: �--- 1 3 , D\ -Al