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124 Montclair Drive Lot 8Davie County, NC I Tax Parcel Report Wednesday, October 19, 2016 Parcel Number: NCPIN Number: Account Number: Listed Owner 1: !'flailing Address 1: City: State: Zip Code: Legal Description: Assessed Acreage: Deed Date: Deed Book / Page: Plat Book: Plat Page: Building Value: WARNING: THIS !S NOT A SURVEY Parcel Information F712OA0008 Township: Shady Grove 5860855470 1. unicipality: 33132250 Census Tract: 37059-803 HARRIS MARK V Voting Precinct: WEST SHADY GROVE 124 MONTCLAIR DRIVE Planning Jurisdiction: Davie County ADVANCE Zoning Class: DAVIE COUNTY R-20 NC Zoning Overlay: 27006-0000 Voluntary Ag. District: LOT 8 BALTIMORE HEIGHTS Fire Response District: Land Value: Total Assessed Value: 1.01 Elementary School Zone: / Middle School Zone: Soil Types: 0006 Flood Zone: 076 Watershed Overlay: 267770.00 Outbuilding & Extra Freatures Value: 36000.00 Total Market Value: 310340.00 ADVANCE SHADY GROVE WILLIAM ELLIS EnB DAVIE COUNTY 6570.00 310340.00 Ira! 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 NC County of Davie, North Carolina, Its agents, consultants, contractors or employees from any and all claims or causes of action due to or arising out of the use or Inability to use the GIS data provided by this wcbsttc. DAVIE COUNTY HEALTH DEPARTMENT IMPROVEMENT PERMIT and OPERATION PERMIT r, 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 G.S. Chapter 13OA, Wastewater Systems, Section .1900 Sewage Treatment and Disposal Systems) NAME PROPERTY ADDRESS Z700(0 DATE s LOCATION �/�7',4/� SUBDIVISION NAME t�Q // IIID I e .C5'R Pel � LOT NUMBER SEC. /BLOCK NUMBER RESIDENTAL SPECIFICATION: BUILDING TYPE # BEDROOMS -'e/ # BATHS 9 # OCCUPANTS '�/ GARBAGE DISPOSAL: Yes/No COMMERCIAL SPECIFICATION: FACILITY TYPE # PEOPLE # PEOPLE/SHIFT # SEATS INDUSTRIAL WASTE: Yes/No LOT SIIE I& TYPE WATER SUPPLY DESIGN WASTEWATER FLOW (GPD) � NEW SITE !/TRREPAIR SITE SYSTEM SPECIFICATIONS: TANK SIIE /Z,�p GAL. PUMP TANK GAL. TRENCH WIDTH,, ROCK DEPTH .a !' LINEAR FT. SOU 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. IMPROVEMENT PERMIT BY Ak/ x **CONTACT A REPRESENTATIVE OF THE DAVIE COUNTY HEALTH DEPARTMD/JJ2 FINAL INSPECTION OF THIS SYSTEM BETWEEN 8:30-9:30 A. M. OR 1:00-1:30 P.M. ON THE DAY OF V6= ;� �ntir • tc r��t� e�� OPERATION PERMIT SYSTtM INSTALLED a AUTHORIZATION NO. g 41JIyl OPERATION PERMIT BYA�� DATE /' f **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 13OA, 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 GIVEN PERIOD OF TIME. DCHD 10/95 - Davie County Health Department ENVIRONMENTAL HEALTH SECTION P.D. Box 665 Mocksville, N.C. 27029 AUTHORIZATION FOR WASTEWATER SYSTEM CONSTRUCTION r (Issued in compliance with Article 11 of 1• G.S. Chapter 13OA, Wastewater Systems) l ***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.*** NAME �1//�9/'�C �/�� 1VAUTF�IRIZAT�NUMBER DATE z NAME ON IMPROVEMENT PERMIT (If different than above) SITE LOCATION /' - / 'r G� ?dlr . di j MWffS/CDNDITIDNS ON AUTHORIZATION TO CONSTRUCT WASTEWATER SYSTEM **WICE*** THIS AUTHORIZATION FOR WAS JF ATER SYSTEM CONSTRUCTION IS VALID FOR A PERIOD OF FIVE (5) YEARS. ENVIRONMENTAL HEALTH SPE ALIST DATE DCHD 10/95 APPLICA OR SITE EVALUATIONAMPROVEMENT PERMIT & ATC Davie County Health Department DEnvironmental Health Section .Jilt_ 2 41996 P.O. Box 848 _ Mocksville, NC 27028 9), TUV(704) 634-8760 a ****IMPORTANT**** THIS APPLICATION CANNOT BE PROCE THE REQUIRED INFORMATION IS PROVIDED. 1. Name to be Billed & 2 K V, P A -Pp 1 S Contact Person --� &r (5'r Mailing Address �Ar q �A o t3 1 r l.r Ai R e_ i U c Home Phone — 61r''tt3(n� S S� City/State/Zip Act V V\t� GE_ N' C �" %0 (3 (n Business Phone 9 L-' O " q d 6 �t, 2. Name on Permit/ATC if Different than Above Mailing Address City/State/Zip 3. Application For: W Site Evaluation [ ] Improvement Permit & ATC [ ] Both 4. System to Serve: YN House [ ] Mobile Home [ ] Business [ ] Industry [ ] Other 5. If Residence: # People # Bedrooms # Bathrooms 3 [`A Dishwasher [}],Garbage Disposal N, J Washing Machine [N 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 J,,�L No If yes, what type? PROPERTY INFORMATION REQUIRED: *** IMPORTANT *** A PLAT OF THE PROPERTY MUST BE SUBMITTED WITH THIS APPLICATION. Property Dimensions: c� �i' y '0 E WRITE DIRECTIONS (from Mocksville) TO PROPERTY: Tax Office PIN: # 1,S rt 1! ��. � � : «mr G': Pd Property Address: Road Name M o1JT C L (\� ! a i= �U Y t �, t0-4 e.,n n I r_c, A . City/Zip — A r1 U ri r. C. l t� ( f 7"Orz t, i e -A.. If in Subdivision provide information, as follows: Name: l7 i t s^ t2r r L t G f_S '1"" ; 1 Section: Lot #: ' i 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 Representativeff s�of the Davie County Health Department to enter upon above described property located in Davie County and owned by i" ale �'K.r n, E( t.� /IAF? '. '. t to conduct all testing procedures as cessary tp determine the site suitability. DATE Z frt 3 %96 SIGNATUR Revised DCHD (06-96) A APPLICATION FOR SITE EVALUATION/IMPROVEMENTS PERMIT Davie County Health Department Environmental Health Section P. O. Box 665 Mocksville, NC 27028 1. Application/Permit Requested By Mailing Address ? ' �� C��LI� (/fir/ �/�% Z, 7e 6 Home Phone 1 Business Phone 2. Name on Permit if Different than Above 3. Application/Permit for: ❑ General Evaluation ❑ Septic Tank Installation 4. System to Serve: ❑ House ❑ Mobile Home ❑ Place of Public Assembly ❑ Business ❑ Industry ❑ Other ❑ Unknown 5. If house, mobile home: Subdivision L}/> i %//ric».�'C%" cle T) Section Lot # ❑ Basement/Plumbing No. of People ❑ Basement/No Plumbing No. of Bedrooms ❑ Washing Machine No. of Bathrooms ❑ Dishwasher Dwelling Dimensions ❑ Garbage Disposal ; e 6. If business, industry, place of public assembly, other: Specify type 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: 241-ublic ❑ Private 8. Property Dimensions 4-c /2/-,: Sewage Disposal Contractor 9. Do you anticipate additions/expansion of the facility this sytem is intended to serve? ❑ Yes If voe what fvna9 =3 • ❑ Community '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: This is to certify that the information provided is correct to the -best f my knowledge, anc incurred from this application. DATE f TURE R 5 I am responsible for all charges CONSENT FOR SITE EVALUATION TO BE`6bNE ON ABOVE DESCRIBED PROPERTY MUST CHECK ONE: ❑ 1. 1 OWN the property. (E - 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 representative.Rif 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 a ermine said)site's suitability,jo d absorption sewage treatment and disposalsyst m. ATE URE DCHD (12.90) . ' DAVIE COUNTY HEALTH DEPARTMENT • Environmental Health Section Soil/Site Evaluation NAME Awl DATE EVALUATED ADDRESS %� PROPERTY SIZE PROPOSED FACIILTY Ae' e_ LOCATION OF SITE Water Supply: On -Site Well Community Public Evaluation By: Auger Boring Pit l---- Cut FACTORS 1 2 3 4 Landscape position Slope % HORIZON I DEPTH Texture group Consistence Structure MineralogX HORIZON II DEPTH Texture group Consistence l-- 717, Structure ok,,P 0117 Mineralogy HORIZON III DEPTH Texture group Consistence Structure Mineralogy HORIZON IV DEPTH Texture group Consistence Structure Mineralogy SOIL WETNESS RESTRICTIVE HORIZON SAPROLITE CLASSIFICATION LONG-TERM ACCEPTANCE RATE SITE CLASSIFICATION: 61R_5__ EVALUATED BY: LONG-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 -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(01-901 ■■■■■■■■■■/.■■■E■■■■■■■■■■■■■■■■■■■■■■.■■■..■■//.....■...■ ■■■■■■■■E■■■..■■■■...■■■...E■/■■■■..........■.■■■■.eMI..MIeOO.MEE.■ ■■..■■■...■■■■■.■■..■■.■./■■/...�..a��■�a■...■.Mee■■.■.■MIeeMIMIMIMIMI■■■ CCCCCCCCCCCCC► MEMO M NOMMEMCMUMEME EM ■..■■....■..■LIi■■■........■.■..MI■EEMI..MI.�..MIMIeeC■.■■■■■■e■.■■S■■ ■■■....■....■■...■.........■......■.MIME■■.......MI■■.MIEe......■■e.■ CCCCCCCCCCCCCCCCCCCCCiisiiiiiiiiiCCCCCCCCCCCCCC■iiiC=CCCCCiiiiiCC■ .................................................. ............■■■ .......................................................... ....... ................................ ■ENEEME■NOMEN ........._........ ..............MIMIue..eEMI.■.e.■.MIMI..■OMI■MI■MIMI■MIMI ■■■■MINI.■. 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