1382 Underpass RdParcel #: E80000001702
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Parcel#:E80000001702 Account #:82529809
Owner Information Tax Codes
ROWELL JANE BOSTIC TRUST ADVLTAX - COUNTY T
O LOUISE COE FIREADVLTAX - FiRE TAX
INSTON SALEM NC 27127
Pro e Information Townshi
nd (Units/Type): 16.560 AC SHADY GROVE
ddress: 1382 UNDERPASS RD
Deed Information Local 2onin
Date: 06/2012 Book: 00894 Page: 0826
Plat Book: Pa e:
Le al Descri tion PIN
17.279 AC UNDERPASS RD 5881221974
Pro e Values
Buildin : 39141
BXF: 57 12
Land: 243 20
Market: 691 73
ssessed: 691 73
Deferred•
Sales Information
No. Book Page Month Year Instrument Qual/UnQual Improved Price
1 00121 0503 01 1984 WD Unqualified Vacant 0
2 00894 0826 06 2012 ED Unqualified Improved 0
3 2007E 0070 03 2007 WD Unqualified Improved 0
� 2007E 0071 03 2007 WD Unqualified Improved 0
5 00190 0740 10 1996 WD Qualified Vacant 73,500
View Pronertv Record for this Parcel View Map for this Parcel View Tax Bill Information
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Davie County Web Site
All information on this site is prepared for the inventory of real property found within Davie County. All data is compiled from recorded deeds,
plats, and other public records and data. Users of this data are hereby notified that the aforementioned public information sources should be
consulted for verification of the information. Ali information contained herein was created for the Davie County's internal use. Davie County,
its employees and agents make no warranty as to the correctness or accuracy of the information set forth on this site whether express or
Implied, in fact or in law, including without limitation the implied warranties of inerchantability and fitness for a particular use.
If you have any questions about the data displayed on this website please contact the Davie County Tax Office at (336) 753-6120.
1.5.9
http://maps.daviecountync.gov/itsnet/View.aspx?prid=958524 10/11/2016
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, A,UT�TC�IZATION NO. O� 3 9 DAVIE COUNTY HEALTH DEPARTMENT� �� /�� ' U� ,
-= _ , � Environmental Health Section p �y �- YKOPERTY INFORMATION � �' ��
Permittee' `� \ P.O. Box 848 ,{���«
Name: ��Y1A��� � VJ �'h` Mocksville, NC 27028 Subdivision Name:
1 �, ,� �- Phone #: 704-634-8760
Directions to property: �-`~ Nr +- "�',t � t�� �� AUTHORIZATION FOR
�.. � c: <�. ^U .'ni w`.� :ru�� �eun i`� �,. - � ��..Pv.� WASTEWATER
SYSTEM CONSTRUCTION
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� ''1s;''�r'1�k'-�'T `-.3r. CsZ'. '.Y^'�r�J\ .
Section: Lot:
Tax Office PIN:#,�� -._ � -��
Road Name:lh�tl,2."%D��r-�,S�iv:,� ! U_v_�p_
**NOTE** This Authorization for Wastewater System Construction MUST BE ISSUED by the Davie County Environmental Health Section prior
to issuance of any Building Pernuts. 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)
` 4� ��::.:>•,� � ***NOTICE*** THIS AUTHORIZATION FOR WASTEWATER CONSTRUCTION
,
` . �� �:� �.� ° - :�;, ,�-�,: � a , �,.
� ��� �' � �„ _ _ _, , � � ���,o IS VALID FOR A PERIOD OF FIVE YEARS.
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ENVIRONMENTAL HEALTH SPECIALIST DATE ISSUED
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a =� ' _ �,�� � . �.--` DAVIE COUNTY HEALTH DEPARTMENTn �� � �'� � �' '`' y�� o
� "� - ~ - ` IM�ROVEMENT AND OPERATION PF„RN�ITS�' �'��ROPERTY INFORMATION � �' �'�
" �;/ K1,._.�.
:Permittee;s- • _ ---- "� �s ~
_�,Name:�r Y'�-�'�Q��'����a � 0 L� ��� �rSubdivision Name: .
,
"" Directions to property: + �� �- �� Section: � Lot:
IMPROVEMENT
; ; , ` p•;. � ... PERMIT Tax Office PIN:#��� � - r�,=� Q �� �'l
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, . � �, �, , Road Name: - r��,.�, c� �(,'�� � �.,� ��- ip•` � (1 j�
**NOTE** This Improvement Pernut DOES NOT authorize the construction or installatian of a septic tank system or any wastewater system. An
AUTHORIZATION FOR WASTEWATER SYSTEM CONSTRUCTION must be obtained from this Department prior to the
construcrion/installation of a system or the issuance of a building pemut.
(In compliance with Article 11 of G.S. Chapter 130A, Wastewater Systems, Section .1900 Sewage Treatment and Disposal Systems)
.� � �, � � _, ***N01TCE*** THLS PERNIIT LS SUBJECT TO REVOCATION IF SITE
�.- , t � i;: PLANS OR T'�� INTENDED USE CHANGE. YOUR WASTEWATER
ENVIRONMENTAL HEALTH SPECIALIST ' DATE ISSUED SYSTEM CONTRACTOR MUST SEE THLS PERMTI' BEFORE
INSTALLING THE SYSTEM.
RESIDENTIAL SPECIFICATION: BUILDING T'YPE�'i o US2 .# BEDROOMS �# BATHS � # OCCUPANTS � GARBAGE DISPOSAL: 'espr No
COMMERCIAL SPECIFTCATION: FACILITY TYPE # PEOPLE # PEOPLE✓SHIFT # SEATS INDUSTRIAL WAS1'E: Yes or No
LOT SIZE ��� TYPE WATER SUPPLY � DESIGN WASTEWATER FLOW (GPD) 1�� NEW SITE r REPAIIt SITE
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SYSTEM SPECIFICATIONS: TANK SIZE fl� � GAL. PUMP TANK � d 0� GAL. TRENCH WIDTH '-% ROCK DEPTH �� LINEAR FI'. �
Q �� C_ �% `
� � -� ��,� Q
OTHER � � ti 0 �?� (;..�ia..'`i �.. � ^ J-��. JJ..:1-yt., � \ -a,?sa�!1 ^ �}�:t..,tT;:�Tcv�
C id�'PS� �. %' `��
REQUIRED SITE MODIFICATIONS/CONDITIONS:
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**CONTACT A REPRESENTATIVE OF THE DAVIE COUNTY HEALTH DEPARTMENT FO�R �AL �I$p�L'F�FAP��' THIS SYSTEM
BETWEEN 8:30 - 9:30 A.M. OR 1:00 - 1:30 P.M. ON THE DAY OF INST �N�'TELEPHONE # IS (704) 634-8760.
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OPERATION PERMIT j,'� n. ������
SYSTEM I STAL D �r�
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AUTHORIZATION NO. � OPERATION PERMIT BY: /` Y DATE: �C l'
**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 WII.L FUNGTION SATISFACTORII.Y FOR ANY GIVEN PERIOD OF TIME.
DCHD OS/96 (Revised)
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APP.�ICATIDN FOR SITE EVALUATION/IMPROVEMENTS PER
Davie County Heaith Department
Environmental Health Section
P. O. Box 665
Mocksville, NC 27028
Application/Permit Requested By ��j r!� 5 /I O C� ��� -
Mailing Address �Ld� ��D 1� � 1� v�� _ —_.__ Homo Phone �7���D�
I�l i rvi' ��v �i4 /�P!}i i��,� %%�% 8usiness Phone
2. Name on Permit if Different than Above
3. Application for:
4. System to Serve:
p Busfness
❑ General Evaluation
L�House
❑ Industry
5. Ii house, mobile home: Subdivision
�
� S ptic Tank Installation Permit
❑ Mobiie Home ❑ Place of Public Assembiy
❑ Other
No. of People _ �
No. of Bedrooms
No. oi Bathrooms
Dwelling Dimensions _--
6. If business, industry, place of pubiic assembly, other: Specity type
No. oi Peopie Served _
No. of Commodes _
No. oi Lavatories
No. of Showers _..
No. of Sinks
No. oi Urinals
No. oi Water Coolers
Water Usage Figures
❑ Unknown
Section _.___._ Lot #
C�BasemQnUPlumbing
❑ BasemenUNo Plumbing
p-Washing Machine
0-Dishwasher
C�"Garbage Disposal
7. Type ci water supp�y: L✓Pubhc ❑��ivate � ❑ Commu�iry
8. Property Dimensions _�.�-1 r� — Sewage Disposal Contractor �
9. Do you anticipate additions/expansion of the facility this sytem is intended to serve?
If yes, what type?
❑ Yes (� No
'NOTE: Improvements Permits shall be valid 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.sg Ll,�--s� 2,�� � ��l
G?�1/��r ��SS / ro f���b`
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This is to certify that the information provided is correct to the
incurred from this application.
/l>-�-�� _
DATE
�ctu:
Tax Of,fice PIN: #,����-��,j 9�7(0
PItOPERTIj AbbRESS, as f Ilows:
IZoad Name: �/%^�Q,eY,��S
City: %�[�l/��l�v�-�
SU$MIT A PLAT WZTH THIS APPLZCATION.
Revisions effective October 1� 1995.
my knop�ledge, and I
�- � V
SIGNATURE
I am responsj{�le�or all charges
CONSENT FOR SITE EVALUATION TO BE DONE ON ABOVE DESCRIBED PROPERTY
MUST CHECK ONE: ❑ 1. I OWN the property. C� I D N T QWN 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:
ph pebY give consent to the aut�orized repres � tativ,e o(, t,he Davie ounty,H�lth Department to enter upon above described
ro ert tocated in Davie Count and owned b���^��ni� �lf _�_
to conduct all testing procedures as necessary to determ'ne said site's uitabi�ty- a ground�absorptio sewage treatment
and disposal system. \ , j / ;
�// ����L� �/i ��j i
DATE SIGNAT'�JFi
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DCHD (1�93) �
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' � � „ D�VIE COUNTY HEALTH DEPARTMENT
.. � Environmental Health Section
' Soil/Site Evaluation
NAME ��� ����'����� DATE EVALUATED I b- I� ✓ I t�
ADDRESS 5-P'�`4 PROPERTY SIZE I�. �f'
PROPOSED FACIILTY �\dJ"� LOCATION OF SITE �U .��--`�'`�i� h� �a�
Water Supply: On-Site Well _ Community Public V
Evaluation By��, AugerBoring Pit Cut
FACTORS 1 2 3 4 7
Landscape position _�' S� , _ _ _
Slope 7.
HORIZON I DEPTH
Texture group
Consistence
Structure
Mineralogy
HORIZON II DEPTH
Texture group
Consistence
Structure
Mineralogy
HORIZON III DEPTH
Texture group
Consistence
Structure
Mineralogy
HORIZON IV DEPTH
Texture group
Consistence
Structure
Mineralogy
SOIL WETNESS
RESTRICTIVE HORIZON
SAPROLITE
CLaSS.LFICATION
LONG-TERM ACCEPTANCE RATEI —r— I ,`
SITE CLASSIFICATION: � � `� -
LDNG-TERM ACCEPTANCE RATE: '�
REMARKS: _ ��.,�r _� -� 'p�-� � Y
� � u c � v� '�. �r. �„ Is�END � ��re,N ,,,-� ` >� � � ��
�,
Landscape Position •
EVALUATED BY:
OTHER(S) PRESENT: \�' ���'�''
R-Ridge S-Shoulder L-Linearslope FS-Footslope 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 �:lay loam� SIL-Silty loam CL-Clay loam SCL-Sandy clay loam
SC-Sandy clay SIC-Silty clay C-Clay
CONSISTENCE
Moist
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-•Sin�le grain M-Massive CR-Crumb GR-Granular ABK-MQular blocky
SBK-Subangular blocky PL-Platy PR-Prismatic
Mineralc�icy
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 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
DCHD (01-901 ��/
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