119 Camden Court Lot 2 Davie County,NC Tax Parcel Report Wednesday,November 9,2016
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WARNING: THIS IS NOT A SURVEY
Parcel Information
Parcel Number: G703OA0002 Township: Shady Grove
NCPIN Number: 5860837544 Municipality:
Account Number: 8305695 Census Tract: 37059-803
Listed Owner 1: LAIL JASON PATRICK Voting Precinct: WEST SHADY GROVE
Mailing Address 1: 119 CAMDEN COURT Planning Jurisdiction: Davie County
City: ADVANCE Zoning Class: DAVIE COUNTY R-20
State: NC Zoning Overlay:
Zip Code: 27006 Voluntary Ag.District: No
Legal Description: LOT 2 CAMDEN YARDS Fire Response District: ADVANCE
Assessed Acreage: 0.71 Elementary School Zone: SHADY GROVE
Deed Date: 10/2015 Middle School Zone: WILLIAM ELLIS
Deed Book/Page: 010030908 Soil Types: Gn132
Plat Book: 0006 Flood Zone:
Plat Page: 169 Watershed Overlay: DAVIE COUNTY
Building Value: 111750.00 Outbuilding&Extra 3740.00
Freatures Value:
Land Value: 30000.00 Total Market Value: 145490.00
Total Assessed Value: 145490.00
All data Is provided as is without warranty or guarantee of any Idnd either expressed or Implied Including but not limited to the
Davie County, Implied warranties of merchantability or fitness for a particular use.Ali 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
NC or arising out of the use or inability to use the GIS data provided by this website.
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AUTHORIZATION NO: 0 6 19' DAVIE COUNTY HEALTH DEPARTMENT
Environmental Health Section PROPERTY INFORMATION
Permlltee's”. ,>J P.O.Box 84$
....Name .• , ;" lFni✓
a;.
Mocksville,NC 27028 Subdivision Name:
Phone#:7047634-8760 ,,-
"Directions to property: ,- Section: Lot:
AUTHORIZATION FOR rf
WASTEWATER Tax Office PIN:#.,5,9,
SYSTEM CONSTRUCTION
Road Name: QW 7/lYjO £. Zip:
**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)
***NOTICE***THIS AUTHORIZATION FOR WASTEWATER CONSTRUCTION
IS VALID FOR A PERIOD OF FIVE YEARS.
ENVIRONMENTAL HEALTH SPECIALIST DATE ISSUED
1�Y V� �,yti'Kt H:,*.t,.��,Y-fit=r¢ _;�..�*: r i+v i'w4�l K7. y� ei r - , .,r ..� ..6._ •.k.,v,H" .. _ ._ ,T..;.:.�.. .+.1.,. .. �N��i• , r
y ,:= ,,' •� DAVIE COUNTY HEALTH DEPARTMENT
Yom " IMPROVEMENT AND OPERATION PERMITS PROPERTY INFORMATION
Permittees�.. e.
.t
-Mem " Subdivision Name: S
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j
Directions to property: �r . 1 /' f Section: Lot:
EWPROVEMENT
rt
PERMIT Tax Office PIN:
Road Name: L TI W dL-: Zip:
**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/mstallation of a system or the issuance of a building permit.
(In compliance with Article.I I of G.S.Chapter 130A,Wastewater Systems,Section.1900 Sewage Treatment and Disposal Systems)
> i % ***NOTICE***THIS PERMIT IS SUBJECT TO REVOCATION IF SITE
PLANS OR THE INTENDED USE CHANGE.YOUR WASTEWATER
ENVIRONMENTAL HEALTH SPECIALIST DATE ISSUED SYSTEM CONTRACTOR MUST SEE THIS PERMIT BEFORE
INSTALLING THE SYSTEM.
RESIDENTIAL SPECIFICATION:BUILDING TYPE h'_ #BEDROOMS _#BATHS #OCCUPANTS GARBAGE DISPOSAL:Yes or No
COMMERCIAL SPECIFICATION: FACILITY TYPE�1 #PEOPLE #PEOPLEISHIFT #SEATS INDUSTRIAL WASTE:Yes or No
LOT SIZE 6 �° TYPE WATER SUPPLY r DESIGN WASTEWATER FLOW(GPD) -71"/-)NEW SITE � REPAIR SITE
SYSTEM SPECIFICATIONS: TANK SIZE��u�C�GAL. PUMP TANK GAL. TRENCH WIDTH ;7C ROCK DEPTH LINEAR FT.r^""
OTHER
'^,;—REQUIRED SITE MODIFICATIONS/CONDITIONS: '
IMPROVEMENT PERMIT LAYOUT
**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 THE DAY OF INSTALLATION.TELEPHONE#IS(704)634-8760.
OPERATION PERMIT ? Ce..
SYSTEM INSTALLED BY:
N0 w-k
0C. ' eL
AUTHORIZATION NO.O�OPERATION PERMIT BY: DATE: ^ '
**THE ISSUANCE OF THIS OPERATION PERMIT SHALL INDICATE THAT THE SYSTEM DESCRIBED ABOVE 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.
DCHD 05/96(Revised) n ,p
- ' APPLICATION FOR SITE EVALUATION/IMPROVEM '
Davie County Health Department
Environmental Health Section
P. O. Box 6654 1996
Mocksville, NC 27028 J!�" tt
t
1. -Application/Permit Requested By A2�b C
Mailing Address 1227 /1 q I Home Phone
Business Phone
Name on Permit if Different than Above
3..Application for: General Evaluation a Septic Tank Installation Permit
System to Serve: E House ❑ Mobile Home ❑ Place of Public Assembly,
❑ Business ❑ Industry her ❑ Unknown f
' 5. if house, mobile home: Subdivision
Section Lot # �.
❑ Basement/Plumbing
No.,of People ❑ Basement/No Plumbing
No.of Bedrooms ❑ Washing Machine
No.of Bathrooms ❑ Dishwasher
Dwelling Dimensions ❑ Garbage Disposal ;
6. If business, industry, place of public assembly, other: Specify type }.
I
No. of.People Served No. of Sinks
r;
No. of Commodes No. of Urinals
r:
No.of Lavatories No. of Water Coolers t
No. of Showers Water Usage Figures �.
7. Type of water supply: fele �tKPubl' ❑ Private ❑ Community
�� .
8. Property Dimensions Sewage Disposal Contractor i
9. Do you anticipate additions/expansion of the facility this sytem is intended to serve? ❑ Yes KNo
If yeswhat type? `
i.
i
`NOTE: Improvements Permits are subject to ;>
revocation, if site plans or the intended use change. Effective October 1, 1989. 1
,i
PROPERTY INFORMATION REQUIRED: {:
Directions to Property:
Tax Office PIN #
N
t-77���,� Load Name d P'� .
Box # (if available) E
'
lTi�� F7City �UfyQ/k- '�--
This is to certify that the information provided is correcttoWteVo e a d I understand I am responsible for all charges
incurred from this application. _
DATE SIGNATURE
i
r
f.
CONSENT FOR SITE EVALUATION TO BE DONE ON ABOVE DESCRIBED PROPERTY s'
1 MUST CHECK ONE: ❑ 1. 1 OWN the property. P12. 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 th avie Cou ty Health Pepartment to enter upon above described
property located in Davie County and owned by
jw . to conduct all testing procedures as necessary to determi m said sl ui biliy for a ground absogAiqn sewage treatment
and disposal system. -
A
DATE SIGNATURE {
l DCHD'(i"
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R .,
DAVIE COUNTY HEALTH DEPARTMENT
Environmental Health Section
Soil/Site Evaluation /
NAME ��2f DATE EVALUATED 'Qb
ADDRESS PROPERTY SIZE JCC' �D OOU
PROPOSED FACIILTY6uf-e LOCATION OF SITE
Water Supply: On-Site Well _ Community Public t/
Evaluation By: Auger Boring Pit Cut
FACTORS 1 2 3 4
Landscape position ,L
Sloe %
HORIZON I DEPTH
Texture group
Consistence
Structure
Mineralogy
HORIZON II DEPTH ::zr r
Texture group --
Consistence
Structure iC
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: Lt'�
LONG-TERM ACC27w
CE RATE: o ��_ OTHER(S) PRESENT:
REMARKS: "h hack
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-Very friable FR-Friable FI-Firrn 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
Mi neraloey
1:1, 2:1, Mixed
Notes
Ilorizon 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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