1358 Underpass RdDavie County, NC , ` Taa� Parcel Report Wednesday, October 12, 2016
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WARNING: THIS IS NOT A SURVEY
Parcel Information
Parcel Number: E80000001707 Township: Shady Grove
NCPIN Number: 5881238025 Municipality:
Account Number: 82516738 Census Tract: 37059-803
Listed Owner 1: JONES JOHN R Voting Precinct: EAST SHADY GROVE
Mailing Address 1: 1358 UNDERPASS ROAD Planning Jurisdiction: Davie County
City: ADVANCE Zoning Class: DAVIE COUNTY R-A
State:
Zip Code:
Legal Description:
Assessed Acreage:
Deed Date:
Deed Book / Page:
Plat Book:
Plat Page:
Building Value:
Land Value:
Total Assessed Value:
NC Zoning Overlay:
27006-0000 Voluntary Ag. District: No
10.000 AC UNDERPASS RD Fire Response District: ADVANCE
9.73 Elementary School Zone: SHADY GROVE
°"�'� Davie County,
���N�� NC
5/2001 Middle School Zone: WILLIAM ELLIS
003680729 Soil Types: ApB,GnB2,GnC2,RvA,ChA,WATER
Flood Zone:
Watershed Overlay: DAVIE COUNTY
461870.00 Outbuilding 8� Extra 24840.00
Freatures Value:
172420.00 Total Market Value: 659130.00
659130.00
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�'""���'�,,; �r � DAVIE COUJTY �ALTH RTMENT
"'�•'�"'�"� IMPROVEMFM PEAPIIT an RATION PERMIT
IMPROVQ�NT PERPIIT ' �/
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t+�NDTEf+ This i�prove�ent per�it OOES N0T authoriie the construction ' statlatian er
syste�. RN NUTHOAIiRTI�I FOA WR5TEWRTER SYSTEM CANSTRUCTION �uat be �s Depart�ent prior to the
construction/installation of a syste� or the issuance of a building per�it.
IIn co�pliance Nith Rrticle 11 of 6.5. Chapter 130A, Nastewater Syste�s� Section .1900 5ewage Treat�ent and Disposal 5yste�s)
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WAFE �a tn k J o A r N � n K�++ A N PROPEi(TY RDDRE5S v`�rt� t' }7Gi 5 S�� . DATE oC ��.� -
LOCATION ��`d F_ �� Qh cb �� S � �1� a'+� Usn��rr`+a.u... 1�.c� '�.�� <isar�a.�
SUBDIVISION NAME � LOT IAMBER SEC./BLOCK NLMBER
RESIDENTRL SPECIFICATION: BUILDING iYPE � o" SQ t BEDRDOMlS � t BATF15 � i t OCqJPRNTS � 6ARBR6E DISPDSRL: Ye /No
CUMI�RCIGk SPECIF1CpT�ONt"6FI�ILITY TVPE;� i PEOPLE _ ii PEDGLE/SHIFT _ i SERT5 _ It�USTRIW. WPSTE:.k es/Na
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LOT SIZE I� �� TYPE NATER SI�P�Y ��'� ,. ,DESI6N WRSTEWATEA FLOW,f6PD> � gl% ' NEH SITE''` REPAIR_SITE _
SYSTDI 5PECIFICNTIDNS: THNt �SIZE �dOO 6AL. Pll6� TRrBi 6AL. TREN(�� WIDTH J� ROp( DEPTH ��� ' L1N�AR FT. ..5�0'
OTHER �' � .a
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REf�UIRED S1TE qODIFICATIONS/CONDITIONS:
+�tTHI5 PERMIT IS S11�7ECT TO REVOCNT[ON IF SITE P�FlNS OA T}� INTENDED 11SE CHRNGE. YOUR NA5TERWATER SYSTEM C�ONTRRCTOA lfl1ST
SEE THIS PEHMIT BEFORE INSTALLIN6 THE SYSTEM. " , �`
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(�j „ � y IMPROVEMENT PERMIT EY �--�c�s� � C=��>�� �.5.
f�CONTRCT R REPRESENTFTIVE OF TF� DRVIE TY F�RL.TH UEPRATMENT FOA F1NAL INSPECTIO!! OF TNIS SYSTEM BEiWfQJ
8:30-9:30 R.M. OR 1:00-1:38 P.M. OM Tk�';�DAY OF INSTALLATION. TELEPHONE i IS 1704) 634-8760.
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OPERATION PERMIT `"" ~� SY5TEM IN5TALLED BY � �` ��9s�
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ADTHORIZAT N N0. � I S� OFERATION DERMIT BY � d�-�/�-x DATE L-�•�
*1}�E ISSIIANCE OF 1HIS OPERRTION PEi�IIT SHALL INDICATE T}IRT TF� SYSTEM DESCRIBE➢ ABOVE tIRS BEEN INSTAI.LED IN COFIPLIANCE WITH
ANTICLE 11 OF G.S. (�PTEA 130A, SECTI� .1900 'SEIIAGE TRFATMF1dT WdD UISPOSi�. SYSTEMS', BUT SHfY.I. IN NO WAY BE TW{E11 AS R
f�YIRAANTEE THRT THE 5Y5TEM WILL FIAJCTION SATISFRCTORILY fOR RNY 6IVEN PEAIOD OF TIME.
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' DRVIE COUNTY HEflLTH DEPARTMENT
IMPROVEMEN'T PEAMIT and OPERATIQN PEAMIT
IMPROVEI�NT PERMIT ��5� „/� �� �
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**NOTE�* This i�prove�ent per�it DOES NOT authorize the construction or installation of a septic tank syste� or any NasteNater
syste�. flN AUTHORI2ATIDN FOR WflSTEWATER SYSTEM CDN5TRUCTION �ust be obtained fro� this Depart�ent prior to the
construction/installation of a syste� or the issuance of a building per�it.
tIn corpliance with Article 11 of 6.5. Chapter 1�A, NasteNater 5yste�s, 5ertion .1900 Sewage 7reat�ent and Uisposal 5yste�s)
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IV� �a tn �- J oA r N � o�� q N PR�ERTY ADDRESS v� '1� r�� � S 1\� , DRTE �C "I� '�
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LOCATIDN � 5�� + R V a`c�. � � � 5 — �� o^� � rn�.�.rr..o.w�. �� '�► �'� ���
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SUBDIVISIDN NAME "" LDT NUMIBER SEC./BLDCf( MJMBER
RESIDENTRL SPECIFICATION: BUILOING TYPE � o° s Q �
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� BEDR�MS �� BATHS� i N OCCUF'ANTS � 6ARBA6E DISPOSAI: Ye /No
C�RCIflL 5PECIFICATI'ONs�"��ILITY TYR�.,�_ � PE�LE N PEDF'LE/SHIFT # SEATS It�DUSTRI� NASTE.;,UY,es/No
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LOT SIZE I a� TYP� WATER SII�pLY � '� , DESI6N V�STEWATER FLOW:(GPD) $�' 1�W SITE 'y REPAIR SITE
5YSTEM SPECIFICATIDNS: T�1K �SItE �000 6AL. PI�iP Tc�c 6RL. TRENCN WtDTH J RDCK DEPTH I 2 ' LINEAR FT. .,sov'
OTHER ._; ✓
REQUIRED SITE MODIFICATI�J5/CDtJDITIDNS:
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*��THIS PERMIT IS Sl1BJECT TO REVOCATI�i IF SITE �.ANS OR THE INTENDED U� CHAN6E. YDUR NASTERWATER SYSTEM CONTRACTOA I�.IST
5EE THIS PERMIT BffORE INSTALLING THE SYSTEM. " _�` .0
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�*CONTACT A REPAESENTATIVE � THE DAVIE C�1NTY HEAI.TH DEPARTMENT FOR FINAL INSPECTION OF THIS SYSTEM AETWEEN �
8:30-9:30 A.M. OR 1:�-1:30 P.M. ON T�Ifr,DAY OF INSTALLATION. TEIEPHONE � IS (7041 E34-87E0.
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OPERATION PERMIT
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AUTHORIZAT' N N0. ��� DPERATION PE�IT BY � c�—�.�/�� DATE - -%�
f+�THE ISSURWCE OF THI5 OPERATIOM RERMIT SHAtL INDICATE TF�T THE 5Y5TEM DESCRIBED ABOUE HAS BEEN INSTi�LED IN COh�I.IANCE WITH
ARTICLE 11 OF G.S. CHAPTER 130A, SECTION .19� "SE4IAGE TREATl1ENT AND DI�OSAL SYSTEM5°, BUT 5FIALL IN NO WAY 6E TAKEFI AS A
6UAA�NITEE T}WT TF� SYSTEM NILL FIqJCTI�I SATISFACTORILY FOR RNY 6IVEN PERIOD � TIMIE.
DCHD 10/95
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Davie County Health Depart�ent
' ENVIRONMENTflI. HEflLTH SECTIDN� _
' P. 0. Box 6b5 � J�� �
� �� Mocksville, N.C. 270�8
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, AUTHDRIZATION FDR WASTE�WTER SYSTEM LXNSTRUCTI�M!
tIssued in co�pliance with Article 11 of
G.S. Chapter 130A, Wastewater Syste�sl ;
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**+�7his Authorization For Wastewater 5yste� Construction �ust be issued by the Davie County Environ�ental Health 5ecf'ion prior to
issuance of any Building Pereit5. This For�/Authorization Nusber should be presented to the Davie County Building Inspections
Dffice when applying for Puilding Ger�its.+�*+�
C AIfTF�RIZNTION t�MBER �
tdAME �G t�cv, �-�c� � N t� � a F� fcn P.N DATE � Y � � " 7 � � :,� Q ; ; �� �. '�
M1AlE ON IIPROVEIEI�(i PERMIT IIf different than above)
SITE LOCATIW V;��-z•.>�' � v A d
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COM�ENT5/IXII�ITIaVS ON RUT}I�RIZRTI�1 TD (X1N5TRLICT WASTEWNTER SYSTEM
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�NDTICE� TNIS AUTHDRITATION FOR WA5TEWATER 5Y5TEM CDNSTRUCTI�N I5 VALID fOR R RERIDD OF FIUE (5) YEAR5.
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� ENVIROI�I�NTAL FEALTH SPECIALIST DATE
DCHD 10/95 ' � '
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APPLICATION FOR SITE EVALUATION/IMPROVEMENTS PER
Davie County Health Department
Environmental Health Section
P. O. Box 665
Mocksville, NC 27028
1. Application/Permit Requested By
Mailing Address � � f�
2. Name on Permit if Different than Above
3. Application for:
4. System to Serve:
p Business
Home Phone � � �° ' ����
Business Phone ��p' �%1��
❑ General Evaluation �Septic Tank Installation Permit
� House ❑ Mobile Home O Place of Public Assembly
p Industry
5. If house, mobile home: Subdivision
❑ Other
No. of People �
No. of Bedrooms I ��
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No. of Bathrooms G 2 ���� ��'1''�'" �' �%�� ��'�
Dwelling Dimensions �/ ' JS'e�
6. If business, industry, place of public assembly, other: Specify type
No. of People Served
No. of Commodes _
Nb. of Lavatories _
No. of Showers
No. of Sinks
No. of Urinals
No. of Water Coolers
Water Usage Figures
❑ Unknown
Section Lot #
[�BasemenUPlumbing
❑ Basement/No Plumbing
�'Washing Machine
Dishwasher
Gd" Garbage Disposal
7. Type of water supply: 1�t� Public ❑ Private ❑ Community
8. Property Dimensions / � QC�-n � Sewage Disposal Contractor �;f�^�-' -�''rre,r'��'�
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 irom date issued. Improvements Permits are subject to
revocation, ii site plans or the intended use change. Eftective October 1, 1989.
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PROPERT IN OR�IIATZON KE UII{Ev:
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��'�� ��,%'�fs: �,,Q� %,� ROPERTI� AbbRESS, as ,follows:
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��f�f C�/1/T���• �elZoad Name: �./,�i':%�is'T.3"��55
Cit-J: ��}f��"�/�'i1�G�-
L D�c u �� �� SU$MZT �l PLAT WITH THIS APPLICATION.
� D� �,�, tG�/ /�j���/��,�� IZevisions effective October� � 1995.
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This is to certify that the iniormation provided is correct to the best of my knowledge, and I understand I am responsible for all charges
incurred from this application.
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DATE SIGNATURE
CONSENT FOR SITE EVALUATION TO BE DONE ON ABOVE DESCRIBED PROPERTY
MUST CHECK ONE: ❑ 1. I OWN the property. C�3�2. I DO NOT OWN the property.
If you checked Box #2, the rest oi 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 C unty Health Depart e t to enter up a ove de�cribe¢
property located in Davie County and owned by �� .,- �.G�= %� o a� �, � � fi
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to conduct all testing procedures as necessary to de ermine said site's suitability for a ground orption sewage treatment
and disposal system. ,�
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DATE SIGNATURE
DCHD (1�93)
1
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NARTMAN LAND C0.
D8.121 PG.503
AREA = 17.279 ACRES
N 60° 49' S9" E.��,
Qf ��"�7h I� rE ��1���,j p� I� �(�, 1935.50
Fl��'d �W� �; �;�1-��G F�'M �t1A
�.'r1MUN�TY F'�N�� NU'�C �� ��0-�08 ���� .
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AREA =10.000 ACRES .
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2163.3,6 TOTAL
� 2011.07 TOTAL )
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N 59• 00' 43" E—�-- 2,060.6! TOTAL
1,982.61 _. _
AREA = 10.000 ACRES
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' � . DAVIE COUNTY HEALTH DEPARTMENT
• � � Environmental Health Section
Soil/Site Evaluation
NAME 1 � « `�' ����� ``►���" DATE EVALUATED � � I 3 � � �
ADDRESS ��`C�9 PROPER TY SIZE � d ��'
PROPOSED FACIILTY �` vSQ, LOCATION OF SITE � ��Ac�
Water Supply: On-Site Well _ Community Public
Evaluation By:�.�,�--- AugerBoring � Pit Cut
FACTORS 1 2 3 4
Landsca e osition 5 S S
Slo e R -1' '15 '15° -l5°
HORIZON I DEPTH '' �' iS�' �'�
Texture rou 1.. C
Consistence � i �. Z .1
Structure �,�
Mineralo `1 � �
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HORIZON II DEPTH v' O' b'' � 0�
Texture rou
Consistence -1
Structure �
Mineralo � i 1: I l: ; 1
HORIZON III DEPTH
Texture rou
Consistence
Structure
Mineralo
HORIZON IV DEPTH
Texture rou
Consistence
Structure
Mineralo
SOIL WETNESS SS Ss ,S
RESTRICTIVE HORIZON — -- —
SAPROLITE —� �- --
CLASS.LFICATION � .S •S. .S
L0�1G-TERM ACCEPTANCE RATE , p
SITE CLASSIFICATION: � •s • EVALUATED BY: �SL-�� �?�,���
LANG-TERM ACCEPTANCE RATE: �� OTHER(S) PRESENT: ���J �
REMARKS: ��.�s�t�V �� Q.���. ,��9Jv�.�.i9� � _ � �. `� P��.. S���C oV �i.t�t�
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-Silt.y alay loam• SIL-Silty loam CL-Clay loam SCL-Sandy clay loam
SC-Sandy clay SIC-Silty clay C-Clay
CONSISTENCE
Moiat
VFR- V+�.-y 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 "
,iC--Single grain M-Massive CR-Crumb GR-Granular ABK-MQular blocky
SBK-Subangular blocky PL-Platy PR-Prismatic
Mi nerala�ty
1:1, 2:1, Mixed
Notes
Fiorizon depth - In inches
Depth of fill - In inches
Restrictive horizon - Thickness and inches from land surface
Saprolite - S(suitable), U(unsuitable)
Soil w etness - 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/ft2
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