255 Livengood Rd Davie County,NC Tax Parcel Report Friday, September 30, 2016
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WARNING: THIS IS NOT A SURVEY
Parcel Information
Parcel Number: 180000000101 Township: Fulton
NCPIN Number: 5778479904 Municipality:
Account Number: 57315000 Census Tract: 37059-804
Listed Owner 1: POINDEXTER GENE A Voting Precinct: FULTON
Mailing Address 1: 255 LIVENGOOD ROAD 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: 20.00 AC LIVENGOOD RD Fire Response District: FORK
Assessed Acreage: 19.54 Elementary School Zone: CORNATZER
Deed Date: 6/1996 Middle School Zone: WILLIAM ELLIS
Deed Book/Page: 001870813 Soil Types: PcB2,PcC2
Plat Book: Flood Zone:
Plat Page: Watershed Overlay: DAVIE COUNTY
Building Value: 324020.00 Outbuilding&Extra 28460.00
Freatures Value:
Land Value: 174240.00 Total Market Value: 526720.00
Total Assessed Value: 526720.00
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, Implied warranties of merchantability or fitness for a particular use.All users of Davie County's GIS website shall hold harmless the
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Countyof Davie,North Carolina,Its agents,consultants,contractors or employees from any and all claims or causes of action due to
N`' or arising out of the use or Inability to use the GIS data provided by this website.
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AUTHORIZATION NO: 0788. DAVIE COUNTY HEALTH DEPARTMENT
Environmental Health Section PROPERTY INFORMATION
Pennittee's P.O.Box 848.
Name: ,P.,)7e doh Mocksville,NC 27028 Subdivision Name:
Phone#:704-634-8760 . t �"
Directions to property:
elyAUSection: N
AUTHORIZATION FOR
;ZZWASTEWATER
Tax Office PIN:#
SYSTEM CONSTRUCTION
J�r rjr c•..t" Road Name: A43 it):
**NOTE**This Authorization for Wastewater System Construction MUST BE ISSUED by the Davie County Environmental Health Section prior
to issuance of any Building Permits.This Form/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)
f` i ***NOTICE***THIS AUTHORIZATION FOR WASTEWATER CONSTRUCTION
y° ,110 d IS VALID FORA PERIOD OF FIVE YEARS.
ENVIRONMENTAL HE LTH SPECIALIST DATE ISSUED.,
R
✓ #yy. '{ d � : ;tA^iv �y ,.4fi# p # :.i 4 ;x. , �,+ t � .s r�.y`. � -. `•""�y1.4rk`+Q�`".�y�F��..{}-J,�,�,. a.w�t+( t ih '.,v
/r
: 'v DAVIE COUNTY HEALTH DEPARTMENT
IMPROVEMENT AND OPERATION PERMITS PROPERTY INFORMATION '
Peniniteei=Sa
Name �� �'�f Wit /c�Y Subdivision Name:
Directions to property: ' . r r :` l
Section: d.K7t'"'.
IMPROVEMENT �n.,t' s,a'-x� 'c�<. �
PERMIT Tax Office PIN:# - ^ - ���
Road Name: ' ,e� ,-w" zip: 7/)o
**NOTE**This Improvement Permit DOES NOT authorize the construction or installation 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)
a ***NOTICE***TILS PERMIT IS SUBJECT TO REVOCATION IF SITE
y" nu,,isr� . sja '�` - > a7 PLANS OR THE INTENDED USE CHANGE.YOUR WASTEWATER
ENVIRONMENTAL HEXLTH SPECIALIST DATE ISSUED SYSTEM CONTRACTOR MUST SEE THIS PERMIT BEFORE
INSTALLING THE SYSTEM.
RESIDENTIAL SPECIFICATION:BUILDING TYPE #BEDROOMS #BATHS #OCCUPANTS GARBAGE DISPOSAL:Yes or No
COMMERCIALSPECIFICATION: FACILITY TYPE #PEOPLE- #PEOPLE/SHIFT #SEATS INDUSTRIAL WASTE:Yes or No
LOT SIZE TYPE WATER SUPPLY ✓J/ DESIGN WASTEWATER FLOW(GPD) `/%�� NEW SITEy REPAIR SITE
SYSTEM SPECIFICATIONS: TANK SIZE/'& GAL. PUMP TANK GAL. TRENCH WIDTH_fir, ROCK DEPTH XI / LINEAR Fr.
OTHER
REQUIRED SITE MODIFICATIONS/CONDITIONS:
IMPROVEMENT PERMIT LAYOUT
r.
"CONTACT A REPRESENTATIVE OF TH DA CO Y >J�L7EPARTMENT FOR FINAL INSPECTION OF THIS SYSTEM
BETWEEN 8:30-9:30 A.M.OR 1 - .30 P.M N THENSTALLATION.TELEPHONE#IS(704)634-8760.
I
OPERATION PERMIT
l SY INSTALLED BY:
AUTHORIZATION NO.
a�OPERATION PERMIT BY: DATE:
"THE ISSUANCE OF THIS OPERATION PERMIT SHALL INDICATE THAT THE SYSTEM DESCRIBED ABOVE HAS BEEN INSTALLED IN COMPLIANCE
WITH ARTICLE i I 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.
DCHD 05/96(Revised)
APPLICATION FOR SITE EVALUATION/IMPROVEMENTS PERM ,
Davie County Health Department MAY Z �yyb
y Environmental Health Section
7 P. O. Box 665 0
fin' EpLTH
Mocksville, NC 27028 �� �A � �11t0ryMUnAIH
�lh P�f� AvtEcou
1. Application/Permit Requested By oe
Mailing Addres � -2D Q
Home Phone(( rt) 9��Y" Oy7�5 Business Phone(�1 7 `�'E:+n�,
2. Name on Permit if Differet than Above
3. Application/Permit for: P. -)�--S�- KGeneral Evaluation Septic Tank Installation
4. System to Serve: House ❑ Mobile Home ❑ Place of Public Assembly
❑ Business ❑ Industry ❑ Other ❑ Unknown
5. If house, mobile home:S bdivision -Z Section , Lot #
PX32 c• lei f— v�Y Z 9 �
Cd1�in�'¢t71�to, �SP2 ,/)�Gia� _ "'7_5 "� lii�'� �asemenUPlumbing (S/,0,0No. of People 2 ! ❑ Basement/No Plumbing
No. of Bedrooms Washing Machine
No. of Bathrooms a-Dishwasher
Dwelling Dimensions����X � X �S� '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 Water Usage Figures
7. Type of water supply: ❑ Public %c7r Private ❑ Community
8. Property Dimensions 53-3 '7 a QC' FS Sewage Disposal Contractor
9. Do you anticipate additions/expansion of the facility this sytem is intended to serve? ❑ Yes XNO
If yes, what type?
'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: (Oro jZe— � 3 u/y . SOc7k-c e) �
b�xb� �d- 7U i n�P�-S�c�re� p� J- Y'90 Oma' l�'1
a� rt �v-✓A 171 L� �%r� �o ' �
f jz yYl ;�e U-n C / . (L;1/Fc� ,
so VOCk Cc)— Y� Y ;�O
ok .w-Ye)
This is to certify that the information provided is c ect o the best of m dge, and I understand I am responsible for all charges
incurred fr m t 's application.
DATE SIGNATURE
CONSENT FOR SITE EVALUATION TO BE DONE ON ABOVE DESCRIBED PROPERTY
MUST CHECK ONE: (� 1. I OWN the property. ❑ 2. I 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�ounty H alt Depart en to enter on above described
property located in Davie County and owned by f\OJV — b, �
to conduct all testing procedures as necessary to d rmine said site's suitability for a gr and absorption ewage treatment
and disposal system.
DATE SIGNATUAE I t
DCHD(12.90) `C
MAYNARD JONES
D8.123 PG.845
DB 65 PG-566
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T` DAVIE COUNTY HEALTH DEPARTMENT
Environmental Health Section p
Soil/Site Evaluation
NAME :n�r°j/�C�r DATE EVALUATED
ADDRESS PROPERTY SIZE �R�
PROPOSED FACIILTY �8/�t' LOCATION OF SITECV
Water Supply: On-Site Well Community Public
Evaluation By: Auger Boring Pit Cut
FACTORS 1 2 3 4
Landscape position
Sloe 7.
HORIZON I DEPTH
Texture group
Consistence
Structure
Mineralogx
HORIZON II DEPTH <
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: EVALUATED BY:
LONG-TERM ACCEPTANCE RATE: c� OTHER(S) PRESENT:
REMARKS:
LEGEND
Landscape Position
R-Ridge S-Shoulder L-Linear slope FS-Footslope 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
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
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Davie County Xealtfr Department
and .Nome NealtFi ffyency
210 HOSPITAL STREET/P.O. Box 665
MOCKSVILLE.N.C. 27028
PHONE:(704),634-5985
May 28, 1996
Gene & Glenna Poindexter
5860 Woodsway Dr.
Pfafftown, NC 27040
Re: 2 Site Evaluations
Livengood Road/20 Acres
Dear Mr. & Mrs. Poindexter:
As requested, a representative from this office visited the aforementioned
site(s) on May'23, 1996. Based upon the information provided on the
application for a site evaluation and after the evaluation was completed on
this tract, the site was found to be provisionally suitable for the
installation of on—site sewage 'disposal system(s).
If you have any questions, please feel free to contact this office.
Sincerely,
Robert B. Hall, Jr. , R. S.
Environmental Health Section
RH/wd
Enclosure(s)