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238 Montclair Drive Lot 3Davie County, NC Tax Parcel Report 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: Land Value: Total Assessed Value: WARAIAG: THIS 1S AUT A SURVEY Parcel Information F7120B0003 Township: Shady Grove 5870052420 Municipality: 8305330 Census Tract: 37059-803 AEUGLE TORSTEN Voting Precinct: WEST SHADY GROVE 238 MONTCLAIR DRIVE Planning Jurisdiction: Davie County ADVANCE Zoning Class: DAVIE COUNTY R -A NC Zoning Overlay: 27006 Voluntary Ag. District: LOT 3 BALTIMORE HEIGHTS PHASE 2 Fire Response District: 0.81 Elementary School Zone: 7/2015 Middle School Zone: 009960793 Soil Types: 0008 Flood Zone: 016 Watershed Overlay: 203900.00 Outbuilding & Extra Freatures Value: 34200.00 Total Market Value: 242760.00 No ADVANCE SHADY GROVE WILLIAM ELLIS GnB2 DAVIE COUNTY 4660.00 242760.00 FDIAll data is provided as is without warranty or guarantee of any Idnd either expressed or implied including but not limited to the Davie County, Implied warrantles of merchantability or fitness for a particular use. All users of Davie Countys GIS website shall hold harmless the County of Davie, North Carolina, its agents, consultants, contractors or employees from any and all claims or causes of action due to NC ora rising out of the use or inability to use the GIS data provided by this website. • DAVIE COUNTY HEALTH DEPARTMENT Environmental Health Section P. O. Boz 848/210 Hospital Street Mocksville, NC 27028 (336)751-8760 Account #: 990002736 Tax PIN/EH #: 5860-95-1543.03 DG Billed To: David Gordon Subdivision Info: Baltimore Heights Lot # 03 Reference Name: Location/Address: Montclair Drive -27006 Proposed Facility Residence Property Size: see map ATC Number: 4045 AUTHORIZATION FOR WASTEWATER SYSTEM CONSTRUCTION **NOTE** This Authorization for Wastewater System Construction MUST BE ISSUED by the Davie County Environmental Health Section prior to issuance of any building permit(s). This Form/Authorization Number should be presented to the Davie County Building Inspections Office when applying for building permit(s) (in compliance with Article 11 of G.S. Chapter 130A, Wastewater Systems, Section .1900 Sewage Treatment and Disposal Systems). THIS AUTHORIZATION FOR WASTEWATER CONSTRUCTION IS VALID FOR A PERIOD OF FIVE YEARS. Environmental Health Specialist's Signature: I e& 41 Date: - /),s CERTIFICATE OF COMPLETION **NOTE** The issuance of this Certificate of Completion shall indicate thsystem described on Improvement/Operation Permit has been installed in compliance with Article 11 of G. apte 130A, Section .1900 "Sewage Treatment and Disposal Systems," but shall in NO WAY be taken as g arant a that the system will function satisfactorily for any given period of time. Septic System Installed By: Environmental Health Specialist's Signature: DCHD 05/99 (Revised) .- /4V7 Date: ~ Environmental Health Section�� / /s..~ v � P. O. Boz 848/210 Hospital Street (7 Mocksville, NC 27028 i (336)751-8760 IMPROVEMENT/OPERATION PERMIT Account #: 990002736 Tax PIN/EH #: 5860-95-1543.03 DG Billed To: David Gordon Subdivision Info: Baltimore Heights Lot # 03 Reference Name: Location/Address: Montclair Drive -27006 Proposed Facility Residence Property Size: see map ATC Number: 4045 **NOTE** This Improvement/Operation Permit DOES NOT authorize the construction 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 130A, Wastewater Systems, Section .1900 Sewage Treatment and Disposal Systems). THIS PERMIT IS SUBJECT TO REVOCATION IF SITE PLANS OR THE INTENDED USE CHANGE. YOUR WASTEWATER SYSTEM CONTRACTOR MUST SEE THIS PERMIT BEFORE INSTALLING SYSTEM. Residential Specification: Building Type #People #Bedrooms �_? #Bat_ Dishwasher Garbage Disposal: El Commercial Specification: Facility Type Washing Machine Basement w/Plumbing: ❑ Basement/No Plumbing: #People #People/Shift #Seats Industrial Waste: 11 Lot Size Type Water Supply �O _ Design Wastewater Flow (GPD) Site: New ❑ Repair �� i System Specifications: Tank Size&0 GAL. Pump Tank GAL. Trench Width �` Rock Depth 1�— Linear Ft.&JO Other: 1D.—;—A Citn Mrvli�rotinnc/('nnrlitinnc• IMPROVEMENT/OPERATION PERMIT LAYOUT - PRRVED EFFLUENT FILTER. RISER(S) IF 6 " BELOW FINISHED GRADE. ****NOTICE: Contact a represe ativ f thv, Davie County Health Department for final inspection of this system between 8:30 a.m. to 9:30 a.m. or 1:00 p.m. to 1:30 p. on e y of installation. Telephone # is (336)751-8760.**** I lb r Environmental Health Specialist's Signature: Date: V `l5— - 0-1 /&/ DCHD 05/99 (Revised) rRl U [CATION FOR SITE EVALUATION/IAIPROVE&IENT PERMIT & ATC DDavie County Health Department EnvironmentaiHeaith Section 2 20 �PR P.O. Box 848/210 Hospital Street Mocksville, NC 27028 EINiRONh;iM�Hflt (336) 751-8760 ** *** THIS APPLICATION CANNOT BE PROCESSED UNLESS ALL THE REQUIRED INFORMATION IS P(ROOVIDED. Refer to the INFORMATION BULLETIN for instructions. 1. Name to be Billed \( ) A U f �QQ l9 d r �(i (� / Contact Person \ c,y Com` Mailing Address .l (( 3 Cid (� c!` cJ L 4./ Home Phone -3 3/6 ` _( /G`�q� 3 0 2-7 City/State/ZIP �C� �c, % V (I F (�l . C• Z-# l Business Phone 2. Name on Permit/ATC if Different than Above Mailing Address City/State/Zip 3. Application For: ❑ Site Evaluation YImprovement Permit/ATC ❑ Both 4. System to Service: IF House ❑ Mobile Home ❑ Business ❑ Industry ❑ Other 5. Type system requested: EY Conventional ❑ conventional modified ❑ innovative 6. If Residence: # People # Bedrooms 3 # Bathrooms J Dishwasher ❑Garbage Disposal VfWashing Machine ❑Basement/Plumbing ❑Basement/No Plumbing 7. If Business/industry /Other: verify type # People # Sinks # Commodes # Showers # Urinals # Water Coolers IF FOODSERVICE: #1 Seats Estimated Water Usage (gallons per day) 8. Type of water supply: i!�r County/City ❑ Well ❑ Community 9. Do you anticipate additions or expansions of the facility this system is intended to serve? ❑ Yes 15No If yes, what type? ***IMPORTANT*** CLIENTS MUST COMPLETE THE REQUIRED PROPERTY INFORMATION REQUESTED BELOW. Either a PLAT or SITE PLAN MUST BE S1IBdfITTBD by the client witli THIS APPLICATION. Property Dimensions: Tax Office PIN: # �o 0 — c[ �— Property Address: Road Name 0 "J -r C( C'( i(- city/zip AA -/0' C e WRITE` D�IRECTIONS (from Mocksville) to PROPERTY: 1 a (+ r O (N �R:7. ex C--rp- V - If in a Subdivision provide information, as follows: (�C�CQ t U 5 L e PT Name: IM 4 r C 14 e n 5 h f 5 Section: Block: Lot: 3 Date home corners !lagged: Z4— j2, CJ (7 - This is to certify that the information provided is erect to the best of my Imowledge. 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 nn: responsible for all charges incurred frons this application. I, hereby, give consent to the Authorized Representative of the Davie County Health Department to enter upon above described properly located in Davie County and owned by to conduct all testing procedures as necessary to determine the site suitability. DATE Gf -" C) SIGNATURE C)/ 0 TIIIS AREA MAY BE USED FOR DRAWING YOUR SITE PLAN (Include all of the following: Existing and proposed property lines and dimensions, structures, setbacks, and septic locations). 50 O ci Sign given A)� l V Revised DCHD (05103 , Site Revisit Charge Datc(s): Client Notification Date: EHS: Account No. D-:736:1 Invoice No. �_ 6 3 JJ' 1. Name to be Billed r-7 1,t y 1/yie'N41-1 2-e' 2 TR • Contact Person G 11 y Mailing Address M O Aj f t /U .,t �/z Home Phone C, rj City/State/ZIP �� / /l N C• 2 /V I (. 2 ULA Business Phone 2. Name on Permit/ATC if Different than Above Mailing Address City/State/Zip 3. Application For: Erite Evaluation ❑ Improvement Permit/ATC fl Both 4. System to Service: JJ -House ❑ Mobile Home ❑ Business f.7 Industry 1-1 Other 5. If esidence: it People # Bedrooms # Bathrooms h- 7Dishwasher II Garbage Disposal "I.. ng Machine II Basement/Plumbing II Basement/No Plumbing 6. If Business/Industry/Other: Specify type # Commodes # Showers # Urinals # People # Sinks # Water Coolers IF FOODSERVICE: # Seats Estimated Water Usage (gallons per day) 7. Type of water supply: fr County/City CJ Well 1.7 Community a. Do you anticipate additions or expansions of the facility this system is intended to serve? ❑ Yes )�No If yes, what type? ***IMPORTANT*** CLIENTS MUST COMPLETE TIIE REQUIRED PROPERTY INFORMATION REQUESTED BELOW. Either a PLAT or SITE PLAN MUST BESUB3117-FED by the client with THIS APPLICATION. Property Dimensions: WRITE DIRECTIONS (from Mocksville) to PROPERTI': Tax Office^ IN: # S 6 S 1 y3 -0 3 Property Address: Road Name fir--t-c(u , Drt,/; City/Zip '4d✓. 27006 If in a Subdivision provide information, as follows: Name: Imo'+ �' I r�- • e� ]_,� e {�, i T Section: Block: Lot -!111�3 Date Property Flagged: L---)'( 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 fr•unr this application. 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 the site suitability. DATE - G SIGNATURE THIS AREA MAY BE USED FOR DRAWING YOUR SITE PLAN (Include all of the following: Existing and proposed property lines and dimensions, structures, setbacks, and septic locations). Revised DCHD (07/99) r it Site Revisit Charge Datc(s): Client Notification Date: EI -IS: Account No. 2 Invoice No. 0 O DAVIE COUNTY HEALTH DEPARTMENT - Environmental Health Section Soil/Site Evaluation APPLICANT INFORMATION Account #: 990002232 Billed To: Guy Comatzer Reference Name: Proposed Facility: Residence Water Supply: On -Site Well PROPERTY INFORMATION Tax PIN/EH #: 5860-95-1543.03 Subdivision Info: Baltimore Heights Lot # 3 Location/Address: Montclair Drive -270061 Property Size: see map Date Evaluated: ;�_/_ F7_9__Z_ Community Evaluation By: Auger Boring Pit Public L_�" Cut FACTORS 1 2 3 4 5 6 7 Landscape position Sloe % HORIZON I DEPTH Texture groupS 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 CLASSIFICATION 77 LONG-TERM ACCEPTANCE RATE < < SITE CLASSIFICATION: LONG-TERM ACCEPTANCE RATE: REMARKS: EVALUATION BY: OTHER(S) PRESENT: 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 05/99 (Revised) no ME on ■ ■ ■ ■ ■EEM■■■■ ■■■E■M■■ ■MEE■ME■ ■■■■■■■■ ■NMEM■M■ ■EMEMME■ ■■MEMO■■ ■EEE■■■■ ■■MEMEM■ ■■■■■■■■ ■M■■■■M■ ■■EMM■■■ ■■M■■■■■ ■EE■EEE■ ■■■■■■■■ ■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■ ■■■■■■■■■■■■■■■■■■■■■■ ■■■■■■■■■■■■■■■ ■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■ ■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■ ■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■ ■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■ ■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■ ■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■ MENNENmommonEMEMEM MEMENEMENNEN� ■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■ ■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■ ■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■ ■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■ ■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■ ■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■ ■■■■■■■■■■■■■■■■■■■■■■ ■■■■■■■■■■■■■■■ ■ SEEN NONE MEMO SEEN MEMO MEMO MEMO MEMO SEEN ■■N■ ■■N■ ■■■■ SEEN SEEN ■■■■■■■■■■■■■■ ■■OO■■■■SMMMM■ ■■■MM■■M■■EM■■ ■■■M■M■■■M■■M■ ■■■■■■■M■M■■M■ ■■■■■■■■■■■■■■ ■E■M■M■M■M■E■■ ■■■■■■■■■MMM■■ ■M■■E■■■■■■M■■ ■■■■■■■■■■■■■■ ■■■■M■■■■M■■■■ ■■■■E■EM■■E■■■ ■■■■MME■■■■■E■ ■M■■M■■■■■■M■■ ■■■■■■■■■■■ME■ ■E■■■M■MEM■■E■ ■■■■■■■■MMM■■■ ■■■■■■■EEE■■■■ ■MMM■■MSMM■M■■ ■■E■■■SE■■■■■■ ■■MM■M■M■MM■■■ ■■■EM■■E■EME■■ ■E■■E■■■■■■EM■ ■■■EE■■N■EMEM■ ■■■■■■E■■■■■■■