203 Montclair Drive Lot 5Davie County. NC
Tax Parcel R ennrt
Wednesday, October 19, 2016
Parcel Number:
NCPIN Number:
Account Number:
Listed Owner 1:
Mailing Address 1:
City:
State:
Zip Code:
Legal Description:
Assessed Acreage:
Deed Date:
Deed Book I Page:
Plat Book:
Plat Page:
Building Value:
WARNENG: THIS IS 1VUT A SURVEY
Parcel Information
F712OA0005
Township:
Shady Grove
5860955686
Municipality:
WILLIAM ELLIS
82520756
Census Tract:
37059-803
NEWSOM ALLAN
Voting Precinct:
WEST SHADY GROVE
203 MONTCLAIR DRIVE
Planning Jurisdiction:
Davie County
ADVANCE
Zoning Class: DAVIE COUNTY R -A,1 -2-S
NC
Zoning Overlay:
Freatures Value:
27006-0000
Voluntary Ag. District:
No
LOT 5 BALTIMORE HEIGHTS
Fire Response District:
ADVANCE
Land Value:
Total Assessed Value:
0.99
Elementary School Zone:
SHADY GROVE
412003
Middle School Zone:
WILLIAM ELLIS
004780069
Soil Types:
MrC2,GnB2
0006
Flood Zone:
076
Watershed Overlay:
DAVIE COUNTY
158760.00
Outbuilding G Extra
250.00
Freatures Value:
36000.00
Total Market Value:
195010.00
195010.00
Davie County,
All data is provided as is without warranty or guarantee of any Idnd 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 webshe shall hold harmless the
F—W
j� C
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 wcbsite.
.51
DAVIE COUNTY HEALTH DEPARTMENT
IMPROVEMENTS PERMIT AND CERTIFICATE OF COMPLETION
*NOTE: Issued in Compliance With Article 11 of G.S. Chapter 130a
Sanitary Sewage Systems ,�i�7,.r-'.1��,r ez j- r " Permit Number
Name .% r rate' // N2 7641
Location=%�;:
Subdivision Name Lot No. Sec. or Block No.
Lot Size �f!G House _._ Mobile Home _� Business Industry
No. Bedrooms 2— —.No. Baths _ 2 No. in Family _ Public Assembly Other
Garbage Disposal YES NO ❑
Specifications for System:
Auto Dish Washer YES NO ❑
Auto Wash Ma -hive YES NO ❑
Type Water Supply—
permit
upply—permit Void if sewage system described below is not installed within 5 years from date of issue.
This permit is subject to revocation if site plans or the intended use change.
L�
r
Improvements permit by
*Contact a representative of the Davie County Health Department for final inspection of this system between 8:30-9:30 A.M.,
1:00-1:30 P.M. or 4:30-5:00 P.M. on day of completion. Telephone Number: 704-634-5985.
Final Installation Diagram:
System Installed by V -Z
00
/00
Certificate of Completion Date
'The signing of this certificate shall indicate that the system described above has been installed in compliance with
the standards set forth in the above regulation, but shall in NO way be taken as a guarantee that the system will function
satisfactorily for any given period of time.
1. Application/Perm
Mailing Address
APPLICATION FOR SITE EVALUATION/IMPROVEMENTS PERMIT���
Davie County Health Department
Environmental Health Section
P. O. Box 665
Mocksville, NC 27028
2. Name on Permit if Different than Above
3. Application for: ❑ General Evaluation B -Septic Tank Installation Permit
4. System to Serve: douse
❑ Mobile Home ❑ Place of Public Assembly
❑ Business ❑ Industry ❑ Other ❑ Unknown
5. If house, mobile home: Subdivision - ,mur'+e- e � -c Section Lot # —
No. of People
No. of Bedrooms _.
No. of Bathrooms
Dwelling Dimensions
6. If business, industry, place of public assembly, other: Specify type
No. of People Served
No. of Commodes
No. of Lavatories
No. of Sinks
No. of Urinals
No. of Water Coolers
No. of Showers Water Usage Figures _
7. Type of water supply: tom' Public ❑ Private
8. Property Dimensions Ata --e- Sewage Disposal Contractor
9. Do you anticipate additions/expansion of the facility this sytem is intended to serve?
If yes, what type?
❑ Basement/Plumbing
❑ Basement/No Plumbing
ErWashing Machine
E'bishwasher
E�Garbage Disposal
❑ Yes Er No
❑ 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:
&14 �r-e-
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.
9't- 2(�X Z k )h =. &��Z
DATE SIGNATURE
CONSENT FOR SITE EVALUATION TO BE DONE ON ABOVE DESCRIBED PROPERTY
MUST CHECK ONE: ❑ 1. 1 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 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 said site's suitability for a ground absorption sewage treatment
and disposal system.
DATE
DCHD (1193)
SIGNATURE
. ,. 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
Z>'IP16 C- y
Mailing Address / ? � '1'_��1�7�>� C��Ll.�ir-� IU_- ZZ21�C.e
.V'C.
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 //i
1: %//>ic
Section,,.
_Z Lot #
❑ Basement/Plumbing
No. of People
❑ Basement/No Plumbing
No. of Bedrooms
❑ Washing Machine
No. of Bathrooms
❑ Dishwasher
Dwelling Dimensions
❑ Garbage Disposal
6. If business, industry, place of public assembly, other: Specify type
No. of People Served
No. of Commodes
No. of Lavatories
No. of Sinks
No. of Urinals
No. of Water Coolers
No. of Showers Water Usage Figures
7. Type of water supply: 24"u,
❑ Private
8. Property Dimensions /-c l�Sewage Disposal Contractor
9. Do you anticipate additions/expansion of the facility this sytem is intended to serve? ❑ Yes
If yes, what type?
N' •
❑ 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:
i /'! G A-7- e
This is to certify that the information provided is correct to the -116 f my knowledge, anc
incurred from this application.
DATE
f
TURE
t:
I am responsible for all charges
CONSENT FOR SITE EVALUATION TO BE`DONE ON ABOVE DESCRIBED PROPERTY
MUST CHECK ONE: ❑ 1. 1 OWN the property. D "2. I 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 pf 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, ite's suitability Jo d absorption sewage treatment
and disposal syst m.
ATEmay---- ATURE
DCHD (12.90)
i
DAVIE COUNTY HEALTH DEPARTMENT
+ ` Environmental Health Section
Soil/Site Evaluation
NAME '&._'z4
IV
ADDRESS
PROPOSED FACIILTY fit°
DATE EVALUATED/ Y
PROPERTY SIZE
LOCATION OF SITE Z �
Water Supply: On -Site Well Community Public �-
Evaluation By: Auger Boring Pit ZI-1, Cut
FACTORS 1
2 3 4
Landscape position .Lr
.4 -
Slope %
HORIZON I DEPTH
Texture group
Consistence
Structure
Mineralo
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
CLASSIFICATION
LONG-TERM ACCEPTANCE RATE
SITE CLASSIFICATION: 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
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
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