194 Plowman Ln Davie County,NC Tax Parcel Report �� Wednesday, October 5, 2016
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WARNING: THIS IS NOT A SURVEY
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� Parcel Information
Parcel Number: D600000051 Township: Farmington
NCPIN Number: 5862131386 Municipality:
Account Number: 81388000 Census Tract: 37059-802
Listed Owner 1: YORK JOHNNY G Voting Precinct: FARMINGTON
Mailing Address 1: 194 PLOWMAN LANE Planning Jurisdiction: Davie County
City: ADVANCE Zoning Class: DAVIE COUNTY R-20
State: NC Zoning Overlay: DAVIE COUNN QD
Zip Code: 27006-6657 Voluntary Ag.District: No
Legai Description: 7.50 AC OFF RAINBOW RD Fire Response District: SMITH GROVE
Assessed Acreage: 6.79 Eleme�tary School Zone: PINEBROOK
Deed Date: 9M972 Middle School Zone: NORTH DAVIE
Deed Book/Page: 000880405 Soil Types: Gn62,MsC,MsB
Plat Book: Flood Zone:
Plat Page: Watershed Overlay: DAVIE COUNN
Building Value: 164890.00 Outbuilding 8 Extra 7320.00
Freatures Value:
Land Value: 58500.00 Totai Market Value: 230710.00
Totai Assessed Value: 230710.00
9�,�A Alt dah Is provided as Is wRhout wsrranty or yuanntee of any Idnd ekher exprcased or Implled Including but nat IlmFted to the
Davie County� Implled wamMlea of inercMantability or Mneas Tor a particulu usa All users o(Davfe Courrt�ls GIS webs(te�all hoW ha�mleas the
7�7 County of Davie,North CaroUna,its agmts,conwih�,rnMracton or employees fiom any end a9 daims or causes of action due to
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AU'rt�oRIZA'rIOrf NO:, DAVIE COUNTY HEALTH DEPARTMENT
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..� , ,-.1 ti � Environmental Health Section PROPERTY INFORMATION
Permittee's� � P.O:;Box$48 •
Name: ``---�'/ � � Mocksville;NC 27028 Subdivision Name:
� j �, �L2�,� Phone#:704-634-8760
Directions to r pert : . > �� +� >'' ` .' Section: Lot: �
,� � ,/ AUTHORIZATION FOR /�7 J
'� f' /.t`�a. � /�".,S"� WASTEWA'I'ER Tax Office PIN:#��fDoc_ +► ,� _ '���
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**NOTE**This Authorization for Wastewater System Constnaction MUST BE ISSUED by the Davie County Environmental Health Section prior
to issuance of any Building Pemuts:This Form/AuthorizationNumber should be presented to the Davie County Building Inspections
O�ce when applying for Building Permits. ` '
(In compliance with Article l l of G:S.,Chapter 130A,Wastewater Systems,SecUon.1900 Sewage Treatment and Disposal Systems)
,. , � -
f ~ Q�`**NOTICE***.THIS AUTHORIZATION FOR WASTEWATER CONSTRUCTION
'. �1�� f ' '� �~�- .U IS VALID FOR A PERIOD OF FIVE YEARS.
. `ENVIRONMENTAL HEALTH SPECIALIST,, ,DATE ISSUED � `.'.. , .:: �
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�,. �;%� ��� � �-� DAVIE COUNTY HEALTH DEP �I�_ E T � ,
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, +�n:�.�� IMPROVEMENT AND OPE�RATION PE�IT� PROPERTY INFORMATION
•Permi�tee s � .
";, Name: �`�`t ��,,..� �.' ti` ��` Subdivision Name:
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Directions to ro ert�: ���'3.,�,�,'���f ��t ,� . ., ` _ . .�.
p p�'� � ,,� � f : Section• Lot:
�( ,�! ��� :Il�IPROVEMENT I ���r+�- I� _ �'�'��
� l� ��'",•�!,;-'•f� "�� ,,.�'.,,, .��.� PERMIT . Tax Office PIN:#
t';��p,,�� ,�G �1�;% �C• �� 7�'�"'s� � � t. Road Name: 13+,r? ti-�.,r��"pr . r�l� .P'�il ,
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**NOT'E**This Improvement Pernut DOFS NOT authorize the construction or installation of a septic tanlc system or any wastewater system.An
AiTTHORIZATION FOR WASTEWATER SYSTEM CONSTRUC'ITON must be obtained frc�m ttus Department prior to the
construction/installation of a system or the issuance of a building pernut. �
(In compliance with Article 11 of G.S.Chapter 130A,Wastewater Systems,Section.1900 Sewage Treatment an�l�Disposal,Systems)
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f � �,�,N ...� ` ,� , ;Fa �,/"'� ~' / . ***NOTICE***THIS PERNIIT IS$YJBJECT TO REVOCATION IF SITE
��;;,�.�,. t, '.,:.� �'' ,/ .c. $k F� � �� t
,�- ��,.� ,� �, J�:�;t�{�, ;oY' PLANS OR Tf�INTENDED US CHANGE.YOUR WASTEWATER
ENVIRONMENTAL HEALTH SPECIALIST DATE ISSUED SYSTEM CONTRACTOR MUST/�EE THIS P�RMIT BEFORE
� �:,.,.; '. INSTALLING TI�SYSTEM. �/ t, , ;
. , . ''
,RESIDENTIAL SPECIFICATION:BUILDING TYPE� #BEDROOMS � #BATHS_�#OCCUPANTS � GARBAGE DISPOSAL:Yes or No
COMMERCIAL SPECIFICAITON: FACILTTY TYPE #PEOPLE #PEOPLE/SHIFT #SEATS INDUSTRIAL WASTE:Yes or No
LOT Sli�f��Z�dV/b TYPE WATER SUPPLY ��DESIGN WASTEWATER FLOW(GPD)�l� NEW SITE_ /��REPAIR SITE
/ / !i �� . /.
SYSTEM SPECIFICATIONS: TANK SIZF/�� GAL. PUMP TANK GAL. TRENCH WID��v ROCK DEP'TH� LINEAR FT.�Qa
OTHER [.� � 1C/_ ��P-r'' "'
�•�"'REQUIRED SITE MODIFICATIONS/CONDITIONS: ��I-S����! �m- ' GS�CJ �i
IMPROVEMENT PERMIT LAYOUT
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"`*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 �
SYSTEM INSTALLED BY: � �
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ALITHORIZATION NO. �1�OPE N PERMIT BY: /���� DATE: CJ !O 7
**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 GNEN PERIOD OF TIME.
DCHD OS/96(Revised)
� �' p� APPLICATION FOR SITE EVALUATION/IMPROVEMENT PERMIT = "�"x`�
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� y, � � � Davie Count Health De artment ; '�� � � " '� '
Y��` �• � , vironmental Health Section � � � � ��� � "
� Jp �\'a , ' ��� P.O.Box 848 MAY
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p\ � � � � " (336J751-8760 ENViRONA9ENTA�.v«,�
_ � `0 x��x�� ��x�� AVIE CQUi1TY �;i�
IMPORTANT TffiS APPLICATION CANNOT BE PROCESSE
ALL THE REQUIRED INFORMATION IS PROVIDED.
1. Name to be Billed ���w� Contact Person '
Mailing Address ,�,,�� ,�,/�,��,�� � Home Phone
City/State/Zip �c��ii�� � Business Phone 3�(���S"�-' ��!/�
2. Name on PermidATC if Different than Above �/'0/) ���r�
MailingAddress ��J�(,�i �i���,ti �.-��,(�� City/State/Zip��i�l'n.0('D , /V� �(�(z�j
3. Application For: �Site Evaluation ❑ Improvement Permit&ATC � Both
4. System to Serve: ❑ House � Mobile Home ❑ Business ❑ Industry ❑ Other
5. If Residence: # People � # Bedrooms � # Bathrooms
Dishwasher ❑ Garbage Disposal � Washing Machine ❑ Basement/Plumbing ❑ Basement/No Plumbing
�
6. If Business/Other: Specify type # People # Sinks
# Commodes # Showers # Urinals # Water Coolers
If Foodservice: # Seats Estimated Water Usage(gallons per day)
7. Type of water supply: ❑ County/City �Well ❑ Community
8. Do you anticipate additions or expansions of the facility this system is intended to serve? ❑ Yes � No
If yes,what type?
EZ H
PROPERTY INFORMATION REQUIRED: ***IMPORTANT***A P,���'THE PROPERTY MUST BE
SUBMITTED WITH THIS APPLICATION.
Property Dimensions: , WRITE DIRECTIONS(from
�6 2 /3 _ os, � Mocksville)TO PROPERTY:
Tax Office PIN: # - d � �
, �c-� !�'�o�1�sv,1/e �.�=�o �
Property Address: Road Name p�,/y�,��_(��,0 � �
� � �/�e �-�f a � Ca rM i� ��n
�� � /�0� � /'Krfi�?�rn �e-F�on o w�r Is'�
Cliy�.lp �,�1 w! �T• �v- � �-i �9
� Tfk�e� o /�i�dow IQ�•
If in Subdivision provide information,as follows: � �v�� 1ef�o��{o .Q -
1 e (Mt�
Name: �%' � `The� �lCe a le on D ,
� ��i�bo,.� ,p�_ 1,�� r� ��'
� 0 n o �law�n S.. ^�-
Section: Lot #: � J ��t�� • 1' ��th
� c{ D Qc�. Cn C� �f(G Ur
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This is to certify that the information provided is correct to the best of my knowledge.I understand that any permit(s)issued hereafter
are subject to suspension or revocation,if the site plans or intended use change,or if the information submitted in this application is
falsified or changed.I,also,understand that I am responsible for all charges incurred from this application.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 .S�P�QN P i�h��( to conduct all testing procedures
(
as necessary to determine the site suitability.
DATE SIGNATURE� �..-� .-:��
Revised DCHD(06-96)
1�OU M�4 i�J USE THE $ACK O� TH Z S �O1ZM �OR b2Zt1W I NC.� l�OUR S Z TE PLAN.
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Parcel 52 � � E�p
Steven Clay Grubb �
D.B. 145 — P. 598 �
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Parcel 64.05
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r � Parcel 64.Od, D.B. t 34—t 00
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new line p
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Parcel 51 � ;
� Johnny G. York S., N
. D.B. 88 — P. 405 p� �
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� APPLICATION FOR SITE EVALUATION/IMPROVEMENTS PERMIT�`�� !��
1� ��� D vi nt Health De artment
� �(p . ' a e Cou y p
� �� n I� Environmental Health Section ����,5'�
y � � / � P. O. Box 665
, Mocksville, NC 27028
�,��1 ��� `� .
�G i uested B ���r� � �u NN
1. Application/Perm t Req y
Mailing Address���� �• ���Q��� �a � � Home Phone 7 �� — O9'�f 3
�jC.���rl�O✓L-- S a l e l� � (u �; 71�3 Business Phone ���— 3 3 � 9
2. Name on Permit if Different than�Above
3. Application for: ❑General Evaluation �Septic Tank Installation Permit
4. System to Serve: L�'Rouse ❑ Mobile Home D Place of Public Assembly
❑ Business ❑ Industry ❑ Other ❑ Unknown
5. If house, mobile home: Subdivision Section Lot #
❑ BasemenUPlumbing
No. of People � ❑ BasemenVNo Plumbing
No. of Bedrooms J ❑ Washing Machine
No. of Bathrooms � � Dishwasher
Dwelling Dimensions � D , x � � / ❑ Garbage Disposal
6. If business, industry, place of public assembly, other: Specify type
No. of People Seroed No. of Sinks
No. of Commodes No. of Urinais
No. of Lavatories No. of Water Coolers
No. of Showers Water Usage Figures
7. Type of water supply: �Public ❑ Private ❑ Communiry
8. Property Dimensions 3 . 3 �.P aC�'e -S Sewage Disposal Contractor � �"� �e /��l'Y'%� d
9. Do you anticipate additions/expansion of the facility this sytem is intended to serve? ❑ Yes �lo �
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: F��m (�(�p G,I�j S V i��.� ; �.� � � S 8' `�--�yt�Rl d S w S qr/e �
� ��.�.)aN d �.a � -�U �-►� l�e��) A p�- � �t�1 � 1� �-w� �
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1-e. ��- �,� �.����ow
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This is to certify that the information provided is correct to e b st of my knowled , d I understand I am responsible for all charges
incurred m this application.
/� �.T Q
DATE SIGNATURE
CONSENT FOR SITE EVALUATION TO BE DONE ON ABOVE DESCRIBED PROPERTY
MUST CHECK ONE: � I OWN the property. p 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 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 SIGNATURE
DCHD(7/93)
,
' � Sf,��-
~ .J�p C�� �f APPLICATION FOR SITE EVALUATION/IMPROVEMENTS PERMIT � �Q���
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�}, ^' � Davie County Health Department
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9 V' Environmentat Health Section 6
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F1AY t9�3
,(�` P. O. Box 665 ---- ---- -
SU � i Mocksville, NC 27028
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1. Application/Permit Requested By _h„4�ENC� �LlN�� .�., _ ,. ,.,��.
// ��x,t �; 7'�v,� .
Mailing Address �� /� v�' l�_yy�s'7�GW/�f��EM. ��. �'7/OSL
Home Phone__� 7�5�.3�6 Business Phone ���- �-3�/
2. Name on Permit if Different than Above ��C
3. Application/Permit for: ❑ Generai Evaluation ❑ Septic Tank Installation
4. System to Serve: �House ❑ Mobile Home O Place of Public Assembly
❑ Business ❑ Industry ❑ Other ❑ Unknown
5. If house, mobile home: Subdivision Section Lot#
[IYBasemenUPiumbing
No. of People ' ❑ BasemenUNo Plumbing
No. of Bedrooms �
[�Washing Machine
No. of Bathrooms ��� L�YDishwasher
Dwelling Dimensions �� w�o� ,� �� ��� ❑ Garbage Disposal
6. If business indust lace of ublic assembl other: S eci t �
� �Y� P P Y, P fY YP
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/,�- ❑ Private O Community
0 /
8. Property Dimensions��� -� � l���.F� Sewage Disposal Contractor
9. Do you anticipate additions/expansion of the facility this sytem is intended to serve? ❑ Yes J�No
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 il 1989.
h�w . �S"� F�5'r i3��I Y/
Directions to Property: '�„�,�J7iy�, c:� � � %�..2�� 2 fa h � ��`-�"'�- d 'Yj 7�'cr �l/�(�,
/�'d ._. c����� �'��� �R- �, ��� �� -��.:►'�•- �c�/�- f /c'c�d..� t�
^ �L /�[9� c? �� ''� �'�c_ e. �, d: �./��~-c. -�--c, r."t. 7'�iZd...�.��..�� c�t)
l4�I �<, �- �- . , �
�,.� �l-c-,,,�- f?��,�,,4,,,.�� �/��u..�-c. ���-�= (l�'r � �� ��'.�s, .,c�,
l� �
�� ���IS/�✓j/�'� �'�'Y�/�"'•/ _�✓✓r'� f � �� � srs� ���
d� O�"�''u�,s.� � �-. . "L���/�.°�- � '�i' �-c.,� �-�^- �� �/ ' ..�.:
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«.-t� �`----�-�.�9 � 7`�...�.� - . •.
�z2e�c.�- �- �'a �/�c.�� �z��. r.�-�� ..�'.�'�/-�-� �'
,�/��r-'�-L. G�x-ricti�- �, � • -
4
This is to certify that the information provided is correct to the best of my knowledge, �nd I understand I am responsible for all charges
incurred from this application.
�� � � �'S �� _���.����
� DATE SIGNATURE
i
CONSENT FOR SITE EVALUATION TO BE DONE ON ABOVE DESCRIBED PROPERTY .
MUST CHECK ONE: �. 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 o 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 SIGNATURE
�
DCHD(12-90)
. ,L• j. . .• .
- ; • . DAVIE COUNTY HEALTH DEPARTMENT
. ;_• � Environmental Health Section
Soil/Site Evaluation
NAME ( A/,/�i��J DATE EVALUATED 4, ���/l�-�
ADDRESS PROPERTY SIZE ��G
PROPOSED FACIILTY „��y�� LOCATION OF SITE ,�i9.�/�0w ��
Water Supply: On-Site Well �✓. Community Public
Evaluation By: AugerBoring _ Pit Cut
FACTORS 1 2 3 4
Landsca e osition .�.� �--
Slo e 7. — -� —"
HORI ZON I DEPTH �� C�t G" G�
Texture rou L .f-C- �"�1- r
Consistence
Structure
Mineralo
HORIZON II DEPTH '� �Q �' � �' 1/ 'G
Texture rou �
Consistence � � � �
Structure h
Mineralo �
HORIZON III DEPTH
Texture rou
Consistence
Structure
Mineralo
HORIZON IV DEPTH
Texture rou
Consistence
Structure
Mineralo
SOIL WETNESS
RESTRICTIVE HORIZON
SAPROLITE
CLaSSIFICATION
LONG-TERM ACCEPTANCE RATE
SITE CLASSIFICATION: EVALUATED BY:
LDNG-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-Tenace 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-AnQular blocky
SBK-Subanguler blocky PL-Platy PR-Prismatic
Mi neraloey
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(nnsuitable)
Soil wetness - Inches from land surface to free wate�' 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/ftz
DCHD(01-901
1
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� � ' � � �avie Courr�jv .1�ealtFr �e arfinent
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210 HOSPITAL STREET I P.O. BOX 865
MOCKSVILLE.N.C. 27028
PHONEi(704)834•8988
' May 25, 1993
Lawrence Dunn
406 Kyle Rd.
Winston—Salem, NC �7104
Re: Site Evalu�tion
Rainbow Raad
Dear Mr. Dunn:
As r•equested, a repr�esentative from this office visited the aforementioned
site on May 24, 1993. The site was found provisionally suitable for the
installation of a modified—oversized, gr,o�md absarption sewage system.
If you have any questions, please feel free to contact this office.
Sincerely,
� . .... ��SO.����
.Robert B. Hal l, Jr. , R.S.
Environmental Health Section
RH/wd
Enclasure