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135 Richmont LnDav ?016 WARNING: THIS IS NOT A SURVEY All data Is provided as Is without warranty or guarantee of any kind either expressed or Implied Including but not limited to the implied warranties of merchantability or fitness for a particular use. All users of Davie County's GIS website shall hold harmless the Parcel Information County of Davie, North Carolina, Its agents, consultants, contractors or employees from any and all claims or causes of action due to Parcel Number: F80000014007 Township: Shady Grove NCPIN Number: 5870994880 Municipality: Account Number: 8303650 Census Tract: 37059-803 Listed Owner 1: GOOD STEVEN J Voting Precinct: EAST SHADY GROVE Mailing Address 1: 135 RICHMONT LANE Planning Jurisdiction: Davie County City: ADVANCE Zoning Class: DAVIE COUNTY R -A State: NC Zoning Overlay: Zip Code: 27006 Voluntary Ag. District: No Legal Description: 2.262 AC OFF NC HWY 801 Fire Response District: ADVANCE Assessed Acreage: 2.21 Elementary School Zone: SHADY GROVE Deed Date: 6/2014 Middle School Zone: WILLIAM ELLIS Deed Book/ Page: 009610414 Soil Types: GnB2,EnC Plat Book: Flood Zone: Plat Page: Watershed Overlay: DAVIE COUNTY Building Value: 229460.00 Outbuilding & Extra Freatures Value: 1640.00 Land Value: 24210.00 Total Market Value: 255310.00 Total Assessed Value: 255310.00 Davie County, All data Is provided as Is without warranty or guarantee of any kind either expressed or Implied Including but not limited to the 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 causes of action due to ropty4; NC or arising out of the use or inability to use the GIS data provided by this website. DAVIE COUNTY HEALTH DEPARTMENT IMPROVEMENT PERMIT and OPERATION PERMIT r PROPERTY ADDRESS ��(?Y�-S'/ �/'. R�7ee6' DATE_"., l�-� 1 fN�O Yl / SUBDIVISION NAME ,. LOT NUMBER SEC./BLOCK NUMBER IMPROVEMENT PERMIT **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 6.5. Chapter 130A, Wastewater Systems, Section .1900 Sewage Treatment and Disposal Systems) NAME r^il! LOCATION /�/� �!7� �C s !//1� /�l �S ✓ PROPERTY ADDRESS ��(?Y�-S'/ �/'. R�7ee6' DATE_"., l�-� 1 fN�O Yl / SUBDIVISION NAME LOT NUMBER SEC./BLOCK NUMBER RESIDENTAL SPECIFICATION: BUILDING TYPE # BEDROOMS # BATHS # OCCUPANTS GARBAGE DISPOSAL ( Ye /No COMMERCIAL SPECIFICATION: FACILITY TYPE # PEOPLE # PEOPLE/SHIFT # SEATS INDUSTRIAL WASTE: Yes/No LOT SIZE TYPE WATER SUPPLY DESIGN WASTEWATER FLOW (GPD) �r /'� NEW SITE _L REPAIR SITE SYSTEM SPECIFICATIONS: TANK 5IZE�11f�19 SAL. PUMP TANK GAL. TRENCH WIDTH ROCK DEPTH -�.'� •� LINEAR FT. OTHER REQUIRED SITE MODIFICATIONS/CONDITIONS: ***THIS PERMIT IS SUBJECT TO REVOCATION IF SITE PLANS OR THE INTENDED USE CHANGE. YOUR WASTERWATER SYSTEM CONTRACTOR MUST SEE THIS PERMIT BEFORE INSTALLING THE SYSTEM. V J \ PL S� LA G' IMPROVEMENT PERMIT BY **CONTACT A REPRESENTATIVE OF THE DAVIE COUNTY HEALTH DEPARTMENT FOR FINAL INSPECTION OF THIS SYSTEM BETA 8:30-9:30 A.M. OR 1:00-1:30 P.M. ON THE DAY OF INSTALLATION, TELEPHONE # IS (704) 634-8760. s' OPERATION PQ�I lAdD�� /,Yn�ro��ab SYSTEM INSTALLED BY AIJ ik WX r AUTHORIZATION NO. OPERATION PERMIT BY N CX DATE **THE ISSUANCE OF THIS OPERATION PERMIT SHALL INDICATE THAT THE SYSTEM DESCRIBED BEEN INSTALLED IN I 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 FLNCTION SATISFACTORILY FOR ANY GIVEN PERIOD OF TIME. , DCHD 10/95 -" Davie County Health Department { .� ENVIRONMENTAL HEALTH SECTION LSI h e P.O. Box 665 Mocksville, N.C. 27EL AUTHORIZATION FOR WASTEWATER SYSTEM CONSTRUCTION (Issued in compliance with Article 11 of G.S. Chapter 130A, Wastewater Systems) ***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 shogl.d-he pres mt_eo� to the Davi County Building Inspections Office when applying for Building Permits.*** X6/1 6-10 ti 1AUTHORIZATION NUMBER NAME a 7 /' DATE I% , ' — �� ,, 2 ,i " C NAME ON IMPROVEMENT PERMIT (If, different than above) ; SITE LOCATION W1 1II&I COMMENTS/CONDITIONS ON AUTHORIZATION TO CONSTRUCT WASTEWATER SYSTEM ***NOTICE*** THIS AUTHORIZATION FOR W TE TER SYSTEM CCOO�NSTRUCTION IS VALID FOR A PERIOD OF FIVE (5) YEARS. J ENVIROl1EN1AL HEALTH SPECIALIST DATE DCHD 10/95 • �, v �n� APPLICATION FOR SITE EVALUATION/IMPROVEMENTS n Davie County Health Department Environmental Health Section �" P. O. Box 665 !/ Mocksville, NC 27028 1'. Application/Permit Requested By ��+<En-1• �Sh4"�Cf� Mailing Address 1(,0 0 i (1S,� o (1- S v0 S OA N -C - 27104 2. Name on Permit if Different than Above 3. Application for: 4. System to Serve ❑ Business ❑ General Evaluation J9 House ❑ Industry 5. If house, mobile home: Subdivision No. of People 3 No. of Bedrooms 3 No. of Bathrooms Dwelling Dimensions 3C, X C I JAN 2 41996 Home Phone ( `k t o ) %coo - III (d, Business Phone Ola ) -727- 91S;4 XSeptic Tank Installation Permit ❑ Mobile Home ❑ Place of Public Assembly ❑ Other 6. If business, industry, place of public assembly, other: Specify type No. of People Served No. of Commodes No. of Lavatories No. of Showers No. of Sinks No. of Urinals No. of Water Coolers Water Usage Figures 7. Type of water supply: X Public ❑ Private 8. Property Dimensions 216. Z'x ''t • Sewage Disposal Contractor ❑ Unknown Section Lot # El Basement/Plumbing ❑ Basement/No Plumbing X Washing Machine Dishwasher Garbage Disposal 9. Do you anticipate additions/expansion of the facility this sytem is intended to serve? ❑ Yes 9 No If yes, what type? ❑ Community t 'NOTE: Improvements Permits shall be valid for a period of 5 years from date issued. Improvement3 Permits are subject to revocation, if site plans or the intended use change. Effective October 1, 1989. YKUYLKI Y LA11UKL1A1.LU1V KLLJu.Lx a: Directions to Property: H + e \ 801 } o Tax Office PIN # N I 1 Cr E5i Rd 1�� P.n R� �hi Road Name 8a I i S D w<c 90. -OF -r S .,.V - S CA 10 n Z(- n Box # (if available) ihE "Ck P+AIrK r S.,.-St�•tion ero��cA tS lac-c—tEu� Airectly 6f-%Ni"L City A�VHi1GE / If yon r� /��sE M� * r8/q0-<:)q Cn� �0G2C T-%'ACvl\y Q�.;�y o f �.J�S��a e CAcjEr —1 Z.4-on72— r-,\ \1 2— M\Io", ot\ acr%*i oft {c� ��k Ee 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. I- Ivi DATE �� SIGNATURE CONSENT FOR SITE EVALUATION TO BE DONE ON ABOVE DESCRIBED PROPERTY Ey MUST CHECK ONE: 1. I 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 representat^i ,<a of the Davie Cougqty Health epartment to enter upon above described property located in Davie County and owned by �Vla� A LfndA to conduct all testing procedures as necessary to determhi4 said site's suitability for a ground absorption sewage treatment and disposal system. DATE SIGNATURE DCHD (1/93) DAVIE COUNTY HEALTH DEPARTMENT Environmental Health Section Soil/Site Evaluation c� NAME / /l �,Lr��✓ DATE EVALUATED 1-1911 ADDRESS PROPERTY SIZE PROPOSED FACIILTY Z"4 aS LOCATION OF SITE ,,11,/h"r Water Supply: On -Site Well Community Public L -- Evaluation By: Auger Boring // Pit Cut FACTORS 1 2 3 4 Landscape position L Slope % ^— HORIZON I DEPTH Texture group Consistence Structure Mineralogy HORIZON II DEPTH r - Texture groupG Consistence / Structure S /� Mineralogy HORIZON III DEPTH Texture group Consistence Structure Mineralogy HORIZON IV DEPTH Texture group Consistence Structure Mineralogy SOIL WETNESS RESTRICTIVE HORIZON SAPROLITE CLASSIFICATION i LONG-TERM ACCEPTANCE RATE SITE CLASSIFICATION: LONG-TERM ACCEPTANCE RATE: REMARKS: DCHD(01-901 EVALUATED BY: (C -1a 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 -lay loam, SIL -Silty loam CL -Clay loam SCL-Sandy clay loam SC -Sandy clay SIC -Silty clay C -Clay CONSISTENCE Moist VFR- ory 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 5C -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 ■■��\��\��■��■�\■��■��■ ■0 ■ ■■��■■��■��\��/��n��■��■�� ■�■�■��■��■�■��■ ■��r��\��■�0��■ ■��■��■��/��/�� ■■�■��■��■■�■��■■��■■��■��■��■■ ■��i�■��■��■ ■��\■��\��■��■r■�\��\■ ...........................................�.................■..■. .......................................... ...................... .■....................■..........■..■...■.■■■..■■■■..■■..■.■..■■.. ............................�... ....................■........... .....■.......................■..i�........■■■..■■.■■■■■..■...■..■. ..................�........ ................... ..■............... ...■.■..■..................C.....■......■......�..■■■■■.■■...■.■■■ ........■.■....■..........■......■.....■■.....�■■.■■■.■�■■.■.■..■. ......................................... .... . .■...■ ...... ■. ..■.■■■.■■■.■..■...■....■....■..■■■.■.■■.�■■..■■�■■■■■■■■■■■■■:�■■ ■■...■...■..■.............■..■■..■..■....■.■.■.■■■■■■■■..■.■■■.■■■ ................................ ......■..■...■..■..■■.■■......■■ .............................■..�......■..■.......■.■■..■...■..■■ .■.........................................■...■.■.■..■.■■...■..■. .■.............■...............................■.■_......■......■. .....■................■........................... ...■.■■....... .....■..■■..■■.................... ........■.■....■...■...■..■.. � ..■..■.■■.■.■■■■.■■■■■■■..■..■..■■_■■■..■■■■■..■■■■■�■■■■■■■■■■■_■ .................................................... ........■ .■. :::�:::::::::::::::::::�:C:CC�3:::::::::5::::::::::::::�_::: ....................................��................ ........... ...................................��................_.......... � ■■��■��■��w��u��■��CM��t�■��_� ■��■��■��■��■�� t�� ■��■�■��■��■��■��■��■��■�■�� ■�■��■ ■��■��■��■��■��il\��■��■��\��■■��\ ■��■��u ��n��u�� ■ ■��■��■��■��r:��iu�� ■��■��■ ��■��n��■��■��n��C��■��■ ■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■„■■■■■■■■■■■■■..■■■■■■■ ::::::::::::::::::::::::::::::'�:::�:'::::�:C�:5:�:■.::::::: iiiiiiiiiiiiiiiiiiiiiiiiii�iiii:=:::=��n��■��■�� ---::��t��■�� ■ �■�iiii�iiiiii�i��iii�iiiiiiii ' iiiiii�i�i�ii i�iiii�iiiiii� ■��■��i�� ■��■��■ :C::::::::C::C::C:::::::�C::C:C:C::C:::�':�:::::.....::::C:::C�:: ..........................�............ ..E;;:::� �::�::�:::::�:: ..........................�............ �:::::�:�::::::::::::C::�::::::":::: :.:�' ' ::C:�::�_::::::� ■��■��I��I�� at��\�n � ��\�� ■��■��I�■��■�!��/�� \�Ve� �� ■ ��I��u��n��l��\��/� �� ■��■��II��I��:�n �� ■��■�� ::�::::::::::::::::::::::::::�:::5:'C='=:: ' ■ C'::0::::�: .............�................... _.....�..�. �.�.�............ .....►...........................�3..... .... .. ............. ■a�i�i�.a�� i ■ u��■ ��/�i'l��O�r��l��i��N�.■� �� ...,..►�:�i...C��............��................ .. 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