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4775 Hwy 801SDavie County, NC r Tax Parcel Report �Ibl Tuesday, September 27, 2016 N 4213 5149 5 18 4858 j-83 ---------- ----------------- 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 101 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 n Vic - Parcel Information " ` `" Parcel Number: Parcel K70000005607 Township: Fulton NCPIN Number: 5776295908 Municipality: Account Number: 82513410 Census Tract: 37059-804 Listed Owner 1: BLACK MICHAEL J Voting Precinct: FULTON Mailing Address 1: 4775 NC HIGHWAY 801 SOUTH Planning Jurisdiction: Davie County City: ADVANCE Zoning Class: DAVIE COUNTY R -A State: NC Zoning Overlay: Zip Code: 27006-7124 Voluntary Ag. District: No Legal Description: 0.61 AC OFF HWY 801 Fire Response District: FORK Assessed Acreage: 0.64 Elementary School Zone: CORNATZER Deed Date: 12/1999 Middle School Zone: WILLIAM ELLIS Deed Book I Page: 003210010 Soil Types: PcB2 Plat Book: Flood Zone: x Plat Page: Watershed Overlay: Building Value: 113510.00 Outbuilding & Extra 590.00 Freatures Value: Land Value: 9220.00 Total Market Value: 123320.00 Total Assessed Value: 123320.00 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 101 causes of action due to or arising out of the use or inability to use the GIS data provided by this website. I Improvements permit by —� *Contact a representative of the Davie County Health Department for final inspection of this system between 8:30-9:30 A.M., 1:00-1:30 P.M. or 4:30-5:00 P.M. on day of completion. Telephone Number: 704-634.5985. r Final Installation Diagram: System Installed by 9r vie, Certificate of Completion Date 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 'IMPROVEMENTS PERMIT AND CERTIFICATE OF COMPLETION %•NOTE: Issued in Compliance With Article II of G.$ apter 130a – Sanitary Sewage Systems ✓;; t t' Permit Number Name's j.///7`�t - ! �_ Date" / -r �� N2 8104 Location'! Subdivision Name Lot No. Sec. or Block No. Lot Size — House _ Mobile HomeL'� _ Business =— Industry �a No' Bedrooms LS—_ No. Baths No. in Family — Public Assembly Other f Garbage Disposal YES Auto Dish YES NO .i Specifications for System: 4 Washer �-1 NO Q ,r Auto Wash Ma -hive YES M NO ❑ X0Lq Type Water Supply *This permit Void if sewage system described below is not installed within 5 years from date t of issue. t This permit is subject to revocation if site plans or the intended use change ATTENTION: YOUR SEPTIC SYSTEM CONTRACTOR MUST SEE THIS PERMIT/LAYOUT BEFORE INSTALLING THIS SYSTEM. I Improvements permit by —� *Contact a representative of the Davie County Health Department for final inspection of this system between 8:30-9:30 A.M., 1:00-1:30 P.M. or 4:30-5:00 P.M. on day of completion. Telephone Number: 704-634.5985. r Final Installation Diagram: System Installed by 9r vie, Certificate of Completion Date 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. APPLICATION FOR SITE EVALUATION/IMPROVEMENTS PERMIT Davie County Health Department Environmental Health Section P. O. Box 665 Mocksville, NC 27028 ft CZ 1. Application/Permit Requested By 19 1 1 1--17frkk v n w i72,4� Mailing Address 11,2y �� 101.4.�i� Home Phone�A�".5��� AN t, jl/.� . Business Phone 2. Name on Permit if Different than Above 3. Application for: ❑ General Evaluation 0 Septic Tank Installation Permit 4. System to Serve: ❑ HouseMobile Home ❑. Place of Public Assembly ❑ Business ❑ Industry ❑ Other ❑ Unknown 5. If house, mobile home: Subdivision Section Lot # /f ❑ Basement/Plumbing No. of People 't' 4— ❑ Basement/No Plumbing No. of Bedrooms .3 ❑ Washing Machine No. of Bathrooms — ❑ Dishwasher Dwelling Dimensions ❑ 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 WaterUsageFigures 7. Type of water supply: ❑ Public Private /��/ torU I e 8. Property Dimensions & Sewage Disposal Contractor 9. Do you anticipate additions/expansion of the facility this sytem is intended to serve? ❑ Yes i If yes, what type? ❑ Community ❑ No '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: Aa -C /17,61 Ile, V'rI/Ac/l This is to certify that the information provided is correct to the best of my knowledge nd I underst d I am responsible for all charges incurred from this application. DATE S ATURE i CONSENT FOR SITE EVALUATION TO BE DONE ON ABOVE DESCRIBED PROPERTY MUST CHECK ONE: ❑ 1. 1 OWN the property. ❑ 2. 1 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 Davie County Health Department to enter upon above described property located in Davie County and owned by to conduct all testing procedures as necessary to determine said site's suitability for a ground absorption sewage treatment and disposal system. DATE DCHD (1/93) SIGNATURE DAVIE COUNTY HEALTH DEPARTMENT Environmental Health Section Soil/Site Evaluation NAME w'% ADDRESS PROPOSED FACIILTY A0_&, Water Supply: On -Site Well DATE EVALUATED PROPERTY SIZE rfe'��C U LOCATION OF SITE dWCrJ`i Community Public Evaluation By: Auger Boring ;/ Pit Cut FACTORS 1 2 3 4 Landscape position L L Sloe Z HORIZON I DEPTH Texture group Consistence Structure Mineralogy HORIZON II DEPTH 1/29 - Texture group C Consistence i Structure % 1 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: EVALUATED BY: l4z! 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 ;lay loam, SIL -Silty loam CL -Clay loam SCL-Sandy clay loam SC -Sandy clay SIC -Silty clay C -Clay CONSISTENCE Moist VFR- V+ --.-y 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 3C -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 ■■■■■■■■■■■■■■■■MMM■■■■■■■■■■■■E ■■■■■■■MOM■■■■■■■■■■■■■■■■■■■■E■ ■■■■■■■■■■■■■■■■■/■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■ ■■■M■■■■MMM■■ ■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■/_ M■MN■M■MMMM■■ ■■/■■■■■■/■■■■■■■■■■■■■■■■■■■■■■ ■■■■■■■■■■■■■■■■■ ■■MNM■■M■MM■■■ iiiii=i====iii=iii�iiiiiiii'ilii■Miiiii=�M===i'i MEMEMMEMEMMEii==ii ......................................... ... . . ... ...... ■■ ...............■..................■..... 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