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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 ■■■.■■■..■■■.■■■■■■■■■■■■■■■■■■■■.■SSSS...■i.....■■■...i.....■.■.■ CCCCCCCCCCCC:■CCCCC�CCCCCCC�.CCCCCCCCCCCC■NONE M SEEMENCCCCCCMMOM ■....■.■.....■■.............■.■■�....■....�.S..N.■.......... .EN .................................................. ............... ................................................■......... .■■■.■■ .................................■.......■.......■........C..MENE■ ................................ 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