190 James Smile LnParcel #: G800000068
Davie County, NC - Basic Estate Search
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Parcel #: G800000068
Account #:25110000
Owner Information
75,340
Tax Codes
FAULKNER KENNETH EUGENE& FAULKNER DARNELL J
Land:
ADVLTAX - COUNTY TA
PO BOX 2113
96,410
IREADVLTAX - FIRE TAX
ADVANCE, NC 27006
Deferred:
Property Information
Townshi
Land (Units/Type): 0.350 AC
SHADY GROVE
[Address: 190 JAMES SMILE LN
Deed Information
Local Zonin
Date: 11/2012 Book: 00907 Page: 0457
Plat Book: Page:
Legal Description
PIN
1.40 AC OFF HWY 801
5880223753
Property Values
Building:
75,340
OBXF:
14,180
Land:
6,890
Market:
96,410
Assessed:
96,410
Deferred:
0
Sales Information
No. Book Page Month Year Instrument Qual/UnQual Improved Price
1 00153 0205 03 1990 WD Unqualified Vacant 0
2 00907 0457 11 2012 WD Unqualified Improved 1,000
3 00143 0246 05 1988 WD Qualified Vacant 1000
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Davie County Web Site
All Information on this site is prepared for the Inventory of real property found within Davie County. All data is compiled from recorded deeds,
plats, and other public records and data. Users of this data are hereby notified that the aforementioned public Information sources should be
consulted for verification of the information. All information contained herein was created for the Davie County's internal use. Davie County,
its employees and agents make no warranty as to the correctness or accuracy of the Information set forth on this site whether express or
Implied, In fact or in law, Including without limitation the Implied warranties of merchantability and fitness for a particular use.
If you have any questions about the data displayed on this website please contact the Davie County Tax Office at (336) 753-6120.
1.5.9
http://maps.daviecountync.gov/itsnetNiew.aspx?prid=1457838 9/29/2016
�; • r
Davie County Health Department
18 j� Environmental Health Section
P.O. Box 848
210 Hospital Street
Courier #.: 09-40-06 1911
Mocksville, NC 27028
Phone: (336) - 753 - 6780 ("ON-SITE WASTEWATER CERTIFICATION Fax: (336) - 753-1680
(Check One) Replacement Remodeling Reconnection'
Name: f`1 L/V h 6q 1d kn EiQ Phone Number 336 - 90a - ,5V60/ , (Home)
Mailing Address: 'PQ�8OX-2l!3 A'AVAA2--P-11.C- 7006 336-11d7`189a (Work)
NO ;TFmcs 51.4; I E [�,,(7 Email Address - „ 6At
Detailed Directions To Site: b 1V/G 6 cvQ o D b O
sRP 7M7`1:kg N a W 911) P %113
Property Address:' f'(D ZTAM#—=65m;k LA)
Please Fill In The Following Information About The EXISTING Facility:
Name System Installed Under: Type Of Facility
Date System Installed (Month/Date/Year): / Number Of Bedrooms Number Of People:
Is The Facility Currently Vacant? Yes No If Yes, For How.Long?
Any Known Problems? Yes 1So If Yes, Explain:
Please Fill In The/jFollo, �Jnformation About The NEW Facility:
Type Of Facility:_Number Of Bedrooms:_g/a2Number of People
Pool Size: Garage Size: (,, Other:
Requested By&/ :d- . C�`. W,1jt 4 (2Al A% Date Requested: 10h'7/12
(Signature)
For Environmental, Health Office Use Only
Approved Disapproved
Comments:
Environmental Health Specialist{ .1•,c.J 1 ,� Date:
*The signing of this form by the Enyironmental Health Staff is in'no way intended, nor should be taken as a guarantee
• (extended or limited) that the on-site wastewater system,willfunction properly for any given period of time.
Payment(Casq Check , Money Order •# Amount:$ Date:loll-dla
Paid By: Received By: .
Account #:[v V Invoice #:
a, x .
2
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co
CD
20 m
50 ft
DAVIE COUNTY HEALTH DEPARTMENT n Cep
IMPROVEMENTS PERMIT AND . CERTIFICATE OF COMPLETION
*NOTE: Issued in Compliance With Article 11 of G.S. Chapter 130a Vo- 4 � � �3 o
/Sanitary Sewage Systems �A Permit Number
Namei/f>/-'-r);'
,.-/i,.%�, 1,, , _✓�� � dr�'�/ � 1r9^ 0_ %�i ,•tr' 7'.
�' `✓.r.�li~ ��>M �� t / Date
�a�te/
fi'/r�;lA/�µN�I J2 �
(?ai.✓)Location 1. ,/r1;i"- 1Irl 7,—
Subdivision
-
Subdivision Name
Sec. or Block No.
Lot Size �`�� House /✓ Mobile Home _T Business Speculation
No. Bedrooms No. Baths __ No. in Family
Garbage Disposal YESLiNO p' Specifications for; System:
Auto Dish Washer. YES [� NO ❑
Auto Wash Ma shine 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.
❑it
f�
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. or 1:00-1:30 P.M. on day of completion. Telephone Number 704-634-5985.
Final Installation Diagram:
System Installed by
Jmz3� a"
r�—
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.
1. Application/Perm
Mailing Address
Home Phone
APPLICATION FOR SITE EVALUATION/IMPROVEMENTS PERMIT
Davie County Health Department
Environmental Health Section
P. O. Box 665
Mocksville, NC 27028
2. Name on Permit if Different than Above
3. Application/Permit for:
4. System to Serve: House
❑ Business ❑ Industry
5. If house, mobile home: Subdivision
No. of People
No. of Bedrooms --�
No. of Bathrooms
Dwelling Dimensions /
❑ General Evaluation
❑ Mobile Home
❑ Other
6. If business, industry, place of public assembly, other: Specify type
No. of People Served
No. of Commodes
No. of Sinks
No. of Urinals
No. of Lavatories No. of Water Coolers
No. of Showers Water Usage Figures
7. Type of water supply: ❑ Public ePrivate ry El Community
8. Property Dimensions ///22ei t Sewage Disposal�Contractor
9. Do you anticipate additions/expansion of the facility this sytem'is intended to serve? ❑ Yes 9'No
t
If yes, what type?
,peptic Tank Installation
_.r
❑ Place of Public Assembly
❑ Unknown
Section Lot #
❑ Basement/Plumbing
asement/No Plumbing
"ashing Machine
Dishwasher
❑ Garbage Disposal
*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:
�/�M/ �'
D Zellf
�. Li
This is to certify that the information provided is correct to the best of my knowledge, and I understand I am responsible for all charges
incurred from this application.
DATE SIGNATURE
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 D v' C unty Health Departm t to enter upon above described
property located in Davie County and owned by XS��� r7
to conduct all testing procedures as necessary to determine said site's suitability for a ground absorption sewage treatment
and disposal system.
DATE SIG ATURE
DCHD (12-90)
NAME
ADDRESS
DAVIE COUNTY HEALTH DEPARTMENT
Environmental Health Section
Soil/Site Evaluation
PROPOSED FACIILTY ��uSP
DATE EVALUATED 2111
PROPERTY SIZE
LOCATION OF SITE
Water Supply:
On -Site Well
Community
Public
Evaluation By:
Auger Boring `/
Pit
Cut
HORIZON I DEPTH
FACTORS 1
2 3
4
Landscape position
L
L
Sloe Z
HORIZON I DEPTH
Texture group
Consistence
Structure
MineralogX
HORIZON II DEPTH
-!5�'��
Texture group
Consistence
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: _ �/
LONG-TERM ACCEPTANCE RATE:
REMARKS:
DCHD(01-901
EVALUATED 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
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
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