274 Sandy Ln Davie County,NC Tax Parcel Report Tuesday,November 8, 2016
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WARNING: THIS IS NOT A SURVEY
- Parcel Information
Parcel Number:;: 170000004302 Township: Fulton
NCPIN Number: 5778057606 Municipality:
Account Number:-- --.-782528918 Census Tract: 37059-804
Listed Owner 1: BLEDSOE SHANNON DALE' Voting Precinct: FULTON
Mailing Address 1: 6824 BRECKINGRIDGE LN ; Planning Jurisdiction: Davie County
City: - _ CLEMMONSZoning Class: DAVIE COUNTY R-A
State: - NC Zoning Overlay:
Zip Code: ' 27012-9004 Voluntary Ag.District: No
Legal Description: 0.975 AC WILLIAMS RD OFF. Fire Response District: FORK
Assessed Acreage: 0.97 Elementary School Zone: CORNATZER
Deed Date: 1/2011 Middle School Zone: WILLIAM ELLIS
Deed Book/Page: 008500812 Soil Types: Pc132
Plat Book: Flood Zone:
Plat Page: Watershed Overlay: DAVIE COUNTY
Building Value: 54750.00 Outbuilding&Extra 700.00
Freatures Value:
Land Value: 14150.00 Total Market Value: 69600.00
Total Assessed Value: 69600.00
0�MlE 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
County of Davis,North Carolina,Its agents,consultants,contractors or employees from any and all claims or causes of action due to
�oUN NC or arising out of the use or Inability to use the GIS data provided by this website.
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AUTHORIZATION NOt g��rDAVIE COUNTY HEALTH DEPARTMENT
Environmental Health Section PROPERTY INFORMATION
Perniittee's ` P.O.Box 848
Name: ` -� Cu1)E l)NL% "� �=�� Mocksville,NC 27028 Subdivision Name:
� Phone#:704-634-8760
Directions to property: (,11a 7e. f-ce-t�t Section: Lot:
AUTHORIZATION FOR c)
�Q (_Cocr �,,;� ��,� WASTEWATER Tax Office PIN:#5'2?e� Q&o - 712-7
SYSTEM CONSTRUCTION
Road"Wale• �.MY. y E rj Zip: 2
**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)
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***NOTICE***THIS AUTHORIZATION FOR WASTEWATER CONSTRUCTION
.r - IS VALID FOR A PERIOD OF FIVE YEARS.
ENVIR,NM>✓ AL HE I'SPE IALI T D rE I UED
DAVIE CQUNTY HEALTH DEPARTMENT
4ttee's
JMPROV,EMNT AND OPERATION PERMITS PROPERTY INFORMATION
Name: j -.�4 r •' "r .0-c�c�� Subdivision Name:
.Directions to property: 6Section: Lot:
IMPROVEMENT
&C-C7
C-C7, C. J<A J01 PERMIT Tax Office PIN:#��
Jadal: .rw 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/ristallation 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)
***NOTICE***THIS PERMIT IS SUBJECT TO REVOCATION IF SITE
G.� PLANS OR THE INTENDED USE CHANGE.YOUR WASTEWATER
ENVIRONME AL HEAEI1 SPE IALIST DA I UEI SYSTEM CONTRACTOR MUST SEE THIS PERMIT BEFORE
r INSTALLING TIE SYSTEM.
RESIDENTIAL SPECIFICATION:BUILDING TYPE MIA #BEDROOMS-_#BATHS�_#OCCUPANTS—4q GARBAGE DISPOSAL:Yes or No
COMMERCIAL^_SPECIFICATION: FACILITY TYPIE' #PEOPLE #PEOPLE/SHIFT #SEATS INDUSTRIAL WASTE:Yes or No
LOT SIZE I/iULe TYPE WATER SUPPLY 1/u-I"'.DESIGN WASTEWATER FLOW(GPD) c O NEWS ✓ REPAIR SITE
SYSTEM SPECIFICATIONS: TANK SIZE GAL. PUMP TANK GAL. TRENCH WIDTH t ROCK DEPTH j Z I'LINEAR FT.
OTHER �IS7L)+BJTi a•� .
REQUIRED SITE MODIFICATIONS%CONDMONS: /l lQ LLQ O �A/l 012? .( Ll=�} U4 5 L-Q 044 e 1(T lox
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.
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OPERATION PERMIT
SYSTEM INSTALLED BY:
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AUTHORIZATION NO. 1 OPERATION PERMIT BY: DATE:
**THE ISSUANCE OF THIS OPERATION PERMIT SHALL INDICATE THAT.THE SYS1 CRIBED ABOVE S EEN 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 WELL FUNCTION SATISFACTORILY FOR ANY GIVEN PERIOD OF TIME.
DCHD 05/96(Revised)
APPLICATION FOR SITE EVALUATIONAMPROVEMENT PERMIT&ATC
'' Davie County Health Department
Environmental Health Section a
P.O. Box 848
Mocksville,NC 27028 SEP 1 7 1997
(704) 634-8760
****IMPORTANT**** THIS APPLICATION CANNOT BE PROC ��� ''
L THE REQUIRED INFORMATION IS PROVIDED.
1. Name to be Billed C QCa1 iP 1'uJ D C- n O Contact Person Gina"Q(w P c
Mailing Address 331a US"&i.T Home Phone
City/State/ZipdVC -C U, VJ L a�)MnL-o Business Phone 60
2. Name on Permit/ATC if Different than Above
Mailing Address City/State/Zip
3. Application For: E)d5l'te Evaluation [ ]Improvement Permit&ATC [1I/Both
4. System to Serve: [ ]House [u}'Mobile Home [ ]Business [ ]Industry [ ]Other
5. If Residence: #People_ #Bedrooms 3 #Bathrooms a [1, ishwasher[ ]Garbage Disposal
[-,�aching 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 [vJ'*el1 [ ]Community
8. Do you anticipate additions or expansions of the facility this system is intended to serve?[ ]Yes L-1-No
If yes,what type?
EITHER A PLAT OR SITE PLAN
PROPERTY INFORMATION REQUIRED:***IMPORTANT**AAT OF THE PROPERTY MUST BE
SUBMITTED WITH THIS APPLICATION.
Property Dimensions: _ac (( P . WRITE DIRECTIONS(from Mocksville)TO PROPERTY:
Tax Office PIN: #-"\'I-7$—- OkO - _ ; ��101 F +o *r k- 1 e—
Property Address: Road Tame 1_n �:JJl.P
City/Zfip Qd�0 Q fJ C O fJ
If in Subdivision provide information,as follows: Q
ri
Name:
Section: Lot#: ;
'5 Q di
g1)u'I( -au Q bid calx 4"e, - upLkir -ire.-�
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 to conduct all testing procedures as necessary to determine the site suitability.
DATE SIGNATURE-�ac-q" Lnn�1L G-s 5L 1
Revised DCHD(06-96)
THIS AREA MAY BE USED FOR DRAWINC7 YOUR SITE PLAN:
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DAVIE COUNTY HEALTH DEPARTMENT
Environmental Health Section SECTION LOT
Soil/Site Evaluation
APPLICANT'S NAME J5V1�Ir,C.--t;RQ0fJ DATEEVALUATED
PROPOSED FACILITY M ODA.. PROPERTY SIZE /�I - /
SUBDIVISION ROAD NAME 5W pY �1V
Water Supply: On-Site Well t/ Community Public
Evaluation By: Auger Boring Pit Cut
FACTORS 1 2 3 4 5 6 7
Landscape position t, *-
Slope% 'Z 91471,
HORIZON I DEPTH —u -
Texture group ,L1_ G
Consistence
Structure Li6A
Mineralogy 4
HORIZON II DEPTH
Texture group 5 e—
Consistence • <_
Structure 6 It— S
MineralogyI; 1
HORIZON III DEPTH ZD+ 20-;;Z
Texture group ±
Consistence F;
Structure 5 k
Mineralogyt
HORIZON IV DEPTH 4 +
Texture group
Consistence
Structure
Mineralogy
SOIL WETNESS
RESTRICTIVE HORIZON
SAPROLITE 5
CLASSIFICATION $ is
LONG-TERM ACCEPTANCE RATE O. d• V.3K
SITE CLASSIFICATION: P5 EVALUATION BY:
LONG-TERM ACCEPTANCE RATE. ���� OTHER(S)PRESENT:
REMARKS: �i 9 4 TZ-_ 1_� SAY
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
DCHD(01-90)