254 Montclair Drive Lot 6Davie County, NC Tax Parcel Report Wednesdav, October 19. 2016
WA"IIN T: THIS 1S NUT A SURVEY
Parcel Information
Parcel Number:
F7120B0006
Township: Shady Grove
NCPIN Number:
5870052763
Municipality:
Account Number:
82532345
Census Tract: 37059-803
Listed Owner 1:
WASHBURN EDWARD R
Voting Precinct: WEST SHADY GROVE
Mailing Address 1:
254 MONTCLAIR DRIVE
Planning Jurisdiction: Davie County
City:
ADVANCE
Zoning Class: DAVIE COUNTY R -A
State:
NC
Zoning Overlay:
Zip Code:
27006-0000
Voluntary Ag. District: No
Legal Description:
LOT 6 BALTIMORE HEIGHTS PHASE 2
Fire Response District: ADVANCE
Assessed Acreage:
0.78
Elementary School Zone: SHADY GROVE
Deed Date:
10/2010
Middle School Zone: WILLIAM ELLIS
Deed Book / Page:
008400302
Soil Types: MrC2,GnB2,PcB2
Plat Book:
0008
Flood Zone:
Plat Page:
016
Watershed Overlay: DAVIE COUNTY
Building Value:
180920.00
Outbuilding & Extra 14510.00
Freatures Value:
Land Value:
36000.00
Total Market Value: 231430.00
Total Assessed Value:
231430.00
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 s particular use. All users of Davie County's GIS website shall hold harmless the
�o UNC
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 website.
Account #: 990002736
Billed To: David Gordon
Reference Name:
Proposed Facility: Residence
DAVIE COUNTY HEALTH DEPARTMENT
Environmental Health Section
P. O. Boz 848/210 Hospital Street
Mocksville, NC 27028 C
(336)751-8760
IMPROVEMENT/OPERATION PERMIT
�, i -v 3
Tax PIN/EH #: 5860-95-1543.06DG
Subdivision Info: Baltimore Heights Lot # 06
Location/Address: Montclair Drive -27006
Property Size: see map
ATC Number: 3587
**NOTE** This Improvement/Operation Permit DOES NOT authorize the construction of 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 141 #People #Bedrooms If -I #Baths cx-?/iZ
Dishwasher: X"" Garbage Disposal: ❑ Washing Machine Basement w/Plumbing: ❑ Basement/No Plumbing: ❑
Commercial Specification: Facility Type #People #People/Shift #Seats Industrial Waste: ❑
Lot Size Type Water Supply Design Wastewater Flow (GPD) -'1'4 Site: New' Repair ❑
System Specifications: Tank Sizer GAL. Pump Tank GAL. Trench Width s Rock Depth i�� Linear Ft. yAd or
Other:
Required Site Modifications/Conditions:
IMPROVEMENT/OPERATION PERMIT LAYOUT - APPROVED EFFLUENT FILTER. RISER(S) IF 6 " BELOW
FINISHED GRADE. ****NOTICE: Contact a representative of the 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.m. on the day of installation. Telephone # is (336)751-8760.****
Ll
0
/I
Environmental Health Specialist's Signature: o/ `ZDate: 1-11il
DCHD 05/99 (Revised)
' DAME COUNTY HEALTH DEPARTMENT
Environmental Health Section
P. O. Boz 848/210 Hospital Street
Mocksville, NC 27028
(336)751-8760
Account #: 990002736 Tax PIN/EH #: 5860-95-1543.06DG
Billed To: David Gordon Subdivision Info: Baltimore Heights Lot # 06
Reference Name: Location/Address: Montclair Drive -27006
Proposed Facility: Residence Property Size: see map
ATC Number: 3587
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 CONSTRU TION IS VALID FOR A PERIOD OF FIVE YEARS.
Environmental Health Specialist's Signature: Date:
CERTIFICATE OF COMPLETION
**NOTE** The issuance of this Certificate of Completion shall indicate the system described on Improvement/Operation Permit
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 gua that the system will function satisfactorily for any
given period of time. 7S
�0 7t'
io s' �DDIi3 ?C/ Y
r
Septic System Installed By:
Environmental Health Specialist's Signature: 64( Date:
DCHD 05/99 (Revised)
n
i
Al) TION FOR SITE EVALUATION/IMPROVEMENT PERMIT & ATC
L JO3 Davie County Health Department
r
Environmenta/Hea/th Section
EtMRONMENTAL HEALTH P.O. Box 848/210 Hospital Street
DAVIECOUNTY Mocksville, NC 27028
(336)751-8760
***IMPORTANT*** THIS APPLICATION CANNOT BE PROCESSED UNLESS ALL THE REQUIRED
INFORMATION IS PROVIDED. Refer to the INFORMATION BULLETIN for instructions.
1. Name to be BilledQ� (j (a L . ( 7 Q'r'C%� Contact Person(ay
Mailing Address a (�?j e s r rU� t. C�We Home Phone J^d+�
City/State/ZIP �+, U'\ (/V t% t � Business Phone 3 3C,
-�J
2. Name on Permit/ATC if Different than Above
Mailing Address �( City/State/Zip
3. Application For: ite Evaluation Improvement Permit/ATC ❑ Both
4. System to Service: /////y House ❑ Mobile Home ❑ Business ❑ Industry ❑ Other
5. Type system requested: Mt Conventional ❑ conventional modified ❑ innovative (/
6. If Residence: # People # Bedrooms_ # Bathrooms 2-/ 2—
dishwasher ❑Garbage Disposal 19Washing Machine ❑Basement/Plumbing ❑Basement/No Plumbing
7. If Business/Industry /Other: verify type # People 11 Sinks
# Commodes # Showers # Urinals b # Water Coolers
IF FOODSERVICE:. ## Seats Estimated Water Usage (gallons per day)
8. Type of water supply: 0 County/City ❑ Well ❑ Community
i .
9. Do you anticipate aditions or expansioIls of the facility this system is intended to serve? ❑ Yes MNo
it T'
If yes, what type? - F
***IMPORTANT#** CLIENTS MUST COMPLETE THE REQUIRED PROPERTY INFORMATION REQUESTED
BELOW. Either a PLAT or SITE PLAN MUST BE SU6MITTED by the client with THIS APPLICATION.
Property Dimensions: ` (10 X WRITE DIRECTIONS (froin Mo&sville) to PRO41:RTY:
Tax Office PIN: # g -le a - i s l 5 L/ 3, . 60���_ (T -c V' �7
Property Address: RoadName IerC (i10 LL-Ld c-aLt
city/zip A Auct N c -e o O u
If in a Subdivision provide information{, as follows
Name: GL it �"1'LC� � � l4 E -C! L-ts
Section: .rte Block: Lot:_
Date home corners flagged: 25-- (D
This is to certify that the information provided is correct to the best of my knowledge. I understand that any pernlit(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. 1, also, understand that 1 ain responsiblefor all charges incurred from
this application. I, hereby, give consent to the Authorized Representative of the Davie County IIealth Deparlmen(
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 _ ( — 2 -Li - ()' ) - SIGNATURE � ) , J �/ ( rN'n
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).
tv
•
Sign given
Revised DCHD (05/03
Site Revisit Charge
Date(s):
Client Notification Date:
EHS:
Account No. 2z�
Invoice No. a F-`
APPLICANT INFORMATION
Account #: 990002736
Billed To: David Gordon
Reference Name:
Proposed Facility: Residence
Water Supply: On -Site Well
DAVIE COUNTY HEALTH DEPARTMENT
Environmental Health Section
Soil/Site Evaluation
Property Size:
PROPERTY INFORMATION
Tax PIN/EH #: 5860-95-1543.06DG
Subdivision Info: Baltimore Heights Lot # 06
Location/Address: Montclair Drive -27006
see map Date Evaluated:
Community
Evaluation By: Auger Boring Pit
Public
Cut
FACTORS 1 2 3 4 5 6 7
Landscape position
Sloe %
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
CLASSIFICATION
LONG-TERM ACCEPTANCE RATE
SITE CLASSIFICATION:
LONG-TERM ACCEPTANCE RATE:
REMARKS:
LEGEND
Landscane Position
EVALUATION BY:
OTHER(S) PRESENT:
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)
�ce�-
�. APPLICATION FOR SITE EVALUA7IGN/IR 111011BIENI :ERith a /', i
Davie County Health Department
Environmental Health Section f ff f
AM!I
P.O. Box 848/210 Hospital Street ` $-
'
Mocksville, NC 27028
(336)751-8760 MIVIR0?-'!i:i;:iilhl !f!hCii)
Dl1V1[: LIUfd?'�' J T.1
***IMPORTANT*** THIS APPLICATION CANNOT BE PROCESSED UNLESS ALL THE REQUIRED
INFORMATION IS PROVIDED. Refer to the INFORMATION BULLETIN for instructions.
1. Name to be Billed C / 1A• (j�NJA 71` 2� 2 J!,21. Contact Person
Mailing Address 3 M o /y •i -c /u •,t Piz Home Phone
City/State/ZIP �� � /� N C- � /y, C. 2;7 oD t! Business Phone y C/ � _ T- u 3 1
2. Name on Permit/ATC if Different than Above
Mailing Address
City/State/Zip
3. Application For: mite Evaluation ❑ Improvement Permit/ATC 1-1 Both
4. System to Service: W,"House U Mobile Home f_I Business fl Industry 1-1 Other
5. If sidence: 41 People # Bedrooms # Bathrooms
Dishwasher LI Garbage Disposal ashing Machine LI Basement/Plumbing II Basement/No Plumbing
6. If Business/Industry/Other: Specify type
# Commodes # Showers
# Urinals
# People # Sinks
it Water Coolers
IF FOODSERVICE: # Seats Estimated Water Usage (gallons per day)
7. Type of water supply: 'er County/City U Well 1.1 Community
a. Do you anticipate additions or expansions of the facility this system is intended to serve? ❑ Yes )hNo
If yes, what type?
'IMPORTANT*** CLIENTS MUST COMPLETE -THE REQUIRED PROPERTY INFORMATION REQUESTED
BELOW. Eithcr a PLAT or SITE PLAN MUST BESUBMITTED by the client with THIS APPLICATION.
Property Dimensions: WRITE DIRECI'IONS (from Mocksville) to PROPERTY:
Tax Office IN: # " S V3
Property Address: Road Name IKOr�k- Ur ✓ I
City/Zip _ 4dd• 2 loo L
If in a Subdivision provide information, as follows:
Name: I12 -A i>`
Section: Block: Lot:
Date Property Flagged:
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 ant responsible for all charges incurred from
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).
r
Revised DCHD (07/99)
Site Revisit Charge
Datc(s
Client Notification Date:
EHS:
Account No. 2�� �—
Invoice No.
DAVIE COUNTY HEALTH DEPARTMENT
Environmental Health Section
Soil/Site Evaluation
APPLICANT INFORMATION
Account M 990002232
Billed To: Guy Comatzer
Reference Name:
Proposed Facility: Residence
Water Supply:
Evaluation By:
PROPERTY INFORMATION
Tax PIN/EH #: 5860-95-1543.06
Subdivision Info: Baltimore Heights Lot # 06
Location/Address: Montclair Drive -27006
Property Size: see map Date Evaluated: 7' ;_
On -Site Well Community
Auger Boring Pit L/
Public LI -11
Cut
FACTORS
1 2 3 4 5 6 7
Landscape position
,L
Slope %
HORIZON I DEPTH
Texture group
Consistence
Structure
Mineralogy
HORIZON II DEPTH
Texture groupG
Consistence
Structure
,
Mineralogyl
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: fIV
LONG-TERM ACCEPTANCE RATE:
REMARKS:
LEGEND
Landscape Position
EVALUATION BY:
OTHER(S) PRESENT:
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)
■
■eee■■■eee■eee■■e■■■■■�e■■e■■■■■■■■■■■eeee■■■■■■■te■e■■
■■■ee■■■■■■■e■■eee■■■■■■■■ee■■■■■e■e■■e■■■e■eeee■■■eee■■
■ecce■■■■■■■ee■■■■■■ce■■■■■■■■eceece■e■■c■eeeeeee■eeeee■
■eee■■■■c■■e■■c■■■■c■■■■■■■■■■■e■■e■■e■■■■■■■■■■■■■■■■■■
■■e■■e■■■■■e■■e■■■■■■■■■■■■■■■■et■■■■■tee■t■tt■t■tteett■
■■■■■c■cc■e■■■ecce■■■■■■■■■■■■■■■ece■■■■■■eec■e■ce■■■■
■■■■■■■■■■■e■■■■■■■■■■�■■eee■■ee■■■■ee■■■e■■■e■■■■■eee■
■eeeee■■■■■e■e■■ee■e■eee■■eee■■e■■■■ee■■e■■■eeeee■■ecce■
■■■■te■■■ee■■ee■eee■■■■■■■■■■■■■■■■■■■■■■■■■■■■■t■e■eee■
■■ecce■■■■■c■■■■■■■■ee■■e■■■■ceee■■■■■■■■eeeeece■e■■■e■■
■■■■e■■■■e■■■■■■■■■e■■ee■■■■■ce■e■■e■■■■■eeee■■eee■■eec■
■■■e■e■■■■■■e■■■eee■■■■■■■■■■■■■■■■■e■■■■■■■■t■tt■■■t■■■
■ee■■■■e■e■■■eee■ee■■■ ■■■eeeeee■■e■■ec■e■■c■■■eee■■e■■
■■ee■e■■eee■eee■■■■■■■e■■■e■e■■ee■■eeee■■ecce■■■■■■■ee■■
■■ecce■■e■■ee■■■e■■■■■■■■■■eeeeee■■ce■ee■eeee■■■■■cc■ee■
■■■■■■■■■■■■e■eee■■■■■■■■■■■ee■■■■■■■■eeeeaee■■■■■■e■■e■
■■■ee■■■■ee■ee■e■■■■s■■■■e■■■■e■■ecce■■eeeee■■■■■ceeee■■
■■eee■■■■■e■e■■eeee■■■ ■e■■eee■ee■■■c■■■eec■■■ee■■■■■■■
■■eee■■■■■■■■e■e■■■■■■■■■■■■ce■■■■■ce■ec■■eec■■■■e■■■■e■
■■■■■■ee■eee■eee■■■■e■■■■■■■e■■■e■■■■e■■■■e■■ee■■ee■■■e■
■■■■■■■e■■ee■■■■■■■■e■■■ee■■■e■■eee■e■■ee■■e■■■e■■■■■■e■
■e■■■■■■■■■■e■■e■■■■ee■■ee■■■eee■■■■■■ee■■eee■e■■■■■■■■■
■■■■■■■■e■■ee■eee■■■■■■■■■■■eee■■■ee■■e■■eee■ee■■■■■■■■■
■■■■■■■■■■■■■■eee■e■■■■■■■■■■e■■e■■ec■e■■■■■■ecce■■■■e■■
■■■■■e■■■■■eee■■e■■cee■■■■■■■e■ee■■■■■e■■ce■■■cecc■■■ee■
MONSONMONSONMEMNONiiiiii
■■■■■■eee■■tt■■■■■■■■■■■■■■e■■■t■■■■■■■■■■■ee■■■■■■■ee■■
■■e■■ceee■■ec■■■■■■■■■■■■■■ee■■■e■e■■■ec■ee■■■e■■eee■■■■
■■■ecce■■■■ec■■■■■■■■■■e■e■ee■■■■■■■ee■■■■eee■■■■■■■■■■■
■■■ee■■■■ccc■■■■■■■■c■■■■■■eee■■c■■■■■e■■■ec■■■■■■c■■ec■
■■■■■e■ecce■■■■■■■■■�%e■■e■■■■■■■■■■■■■■■■■■■■■eee■■■■■■
■■■■■■■■■■■■■■■■■e■■�■e■■■■■eee■■eee■■■■■■■■■■■■■■■■■■■■
■■■■■e■■■■■■■■■■■■■■■■■eee■■■■■■■■■■■■■■■e■■e■■■■■■e■■■■
■■■■■■■■■■■■■■■c■■■■■■■■■■■eee■■■■■■■■■■■■■■■■■■■■■eee■■
■■eee■■■■■e■eee■■■■■e■eee■■eee■t■■eee■■■■e■■■■■■ecce■■■■
■■■■■■■■■■■■■■eee■■■■■■eee■■ecce■■■ecce■■■■■e■■ecce■■■e■
■■eee■■■■■■■e■■■■■■■■■■e■■■e■■■■■eee■■■■■■■■■■■■■■■■■■■■
■■■■ecce■■■■eee■■■■■■■■e■■■e■■■■■■e■■e■■■■■■■■■e■■■■■■■■
■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■
■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■
■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■
■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■
■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■
■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■
■■■■■■■■■■■■■■ ■■■■■■■■■■■■■■■■■■■■■
■■■■■■■■■■■cam■■■■■■■■■■■■■■■■■■■■■■■■
■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■
GoMaps GIS
Pagel of 8
r
r
http://maps.co.davie.nc.us/GoMaps/map/map.cfin?CFID=50956&CFTOKEN=94315220 5/29/2009
Map Frame
Davie County, NC - GIS/Mapping System
Page 1 of 1
Zoom To Scale: GO
Click Here To Start Over
'--•, Quick Search:(County ID or Owner Name) Ci0
f ` .� Active Layer. r Use f+fap Tips
01119`` Map Layers I Tools I Help I Links•
; ' F, ----Select Layer- ---------] ZI Address/Name/Parcel Search I Results
http://maps.co.davie.nc.us/GoMaps/map/mapframe.cfm?CFID=50956&CFTOKEN=94315220 5/29/2009