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276 Montclair Drive Lot 9Davie Countv, NC Tnv Pnrr.Pl R Pnnrt Thursday. October 20. 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 / Page: Plat Book: Plat Page: Building Value: Land Value: Total Assessed Value: WARNING: THIS 1S NOT A SURVEY Parcel Information F7120B0009 Township: Shady Grove 5870062073 Municipality: 8301161 Census Tract: 37059-803 PRICE CAROLYN E Voting Precinct: WEST SHADY GROVE 276 MONTCLAIR DRIVE Planning Jurisdiction: Davie County ADVANCE Zoning Class: DAVIE COUNTY R -A NC Zoning Overlay: 27006 Voluntary Ag. District: LOT 9 BALTIMORE HEIGHTS PHASE 2 Fire Response District: 0.78 Elementary School Zone: 612012 Middle School Zone: 008940240 Soil Types: 0008 Flood Zone: 016 Watershed Overlay: 164310.00 Outbuilding & Extra Freatures Value: 36000.00 Total Market Value: 204910.00 No ADVANCE SHADY GROVE WILLIAM ELLIS GnB2,PcB2 DAVIE COUNTY 4600.00 204910.00 O t•� �F Davie County, A7 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 County of Davie, North Carolina, Its agents, consultants, contractors or employees from any and ail claims or causes of action due to �o 1` C or arising out of the use or inability to use the GIS data provided by this website. t 91 ' DAVIE COUNTY HEALTH DEPARTMENT Environmental Health Section P. O. Boa 848/210 Hospital Street Mocksville, NC 27028 (336)751-8760 Account #: 990002831 Tax PIN/EH #: 5860-95-1543.09MB Billed To: McKnight Builders Subdivision Info: Baltimore Heights Lot # 09 Reference Name: Location/Address: Montclair Drive -27006 Proposed Facility: Residence Property Size: see map ATC Number: 3510 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:4�z Date:y`7%� 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 guaranXee 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) vP Date: DAVIE COUNTY HEALTH DEPARTMENT Environmental Health Section- P. O. Boz 848/210 Hospital Street Mocksville, NC 27028. v (336)751-8760 IMPROVEMENT/OPERATION PERMIT Account #: 990002831 Tax PIN/EH #: 5860-95-1543.09MB Billed To: McKnight Builders Subdivision Info: Baltimore Heights Lot # 09 Reference Name: Location/Address: Montclair Drive -27006 Proposed Facility: Residence Property Size: see map ATC Number: 3510 **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 � #Baths Dishwasher: 4Z 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) Site: New Repair ❑ System Specifications: Tank Sizew GAL. Pump Tank GAL. Trench Width �S G ' Rock Depth IVl Linear Ft;�6 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 of installation. Telephone # is (336)751-8760.**** Environmental Health Specialist's Signature: GZ"r'C, Date: DCHD 05/99 (Revised) APPLICATION FOR SITE EVALUATION/IMPROVEAIENT PERMIT S: ATC Davie County Health Department Environments/Hes/th Section P.O. Box 848/210 Hospital Street Mocksville, NC 27028 (336) 751-8760 �O U Ro X00 ***IMPORTANT*** THIS APPLICATION CANNOT BE PROCESSED UNLESS ALL THE REQUIRED --� INFORMATION IS PROVIDED. Refer to the INFORMATION BULLETIN for instructions. //// ! r 1. Name to be Billed /U / �'I� Contact Person / 1 �-SZa�....-- ... Mailing Address /a— f %/i i Home Phone City/State/ZIP Business Phone QL� Z 7LS 2. Name on Permit/ATC if Different than Above Mailing Address City/State/Zip 3. Application For: ❑ Site Evaluation ✓C! Improvement Permit/ATC El Both .0 l 4. system to service: ❑ House ❑ Mobile Home ❑ Busine8s ❑ Industry ❑ Other 5. Type system requested: ❑ Conventional ❑ conventional modified ❑ innovative 6. If Residence: It People # Bedrooms 3 11 Bathrooms �- LZDishwasher ❑Garbage Disposal WWashing Machine ❑Basement/Plumbing ❑Basement/No Plumbing 7. If Business/Industry /Other: verify type It People 11 Sinks It Commodes It Showers 11 Urinals 11 Water Coolers IF FOODSERVICE: # Seats Estimated Water Usage (gallons per day) 8. Type of water supply: ❑ County/City ❑ Well ❑ Community 9. Do you anticipate additions or expansions of the facility this systeIn is intended to serve? ❑ Yes ❑ No If yes, what type? k**IDIPORTANT*** CLIENTS MUST COdIPLETETHE REQUIRED PROPERTY INFORMATION REQUESTED QELOW. Eitlier a PLAT or SITE PLAN MUST BESUBiIIITTE•D by the client witli THIS APPLICATION. Property Dimensions:— Tax Office PIN: # S6,4 /'"-y3• " 9 Property Address: Road Namt' City/Zip If in a Subd- ivision provide information, as follows: Nannc: _ (`j Section: Block: Lot:_ WRITE DIRECTIONS (from t1•loclim ille) to PRON"RTY: Date home corners flagged: i -? This is to certify that the information provided is correct to the best of nny knowledge. I understand that any peruiit(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. Jr, also, understand that I atn responsible for all charges incurred from this application. I, hereby, give consent to the Authorized Representative of the Davie County IIcallh 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 SIGNATURE i%��L^./��•�= ". 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). L4 f14 -CL - Sign given Revised DCHD (05/03 Site Revisit Charge Datc(s): Client Notification Date: EHS: Account No. Invoice No. .3 7 f 1. Name to be Billed(nn we'N� -12� 2 2 J. Contact Person Mailing Address d�3 M o Aj 4 c I ct • it �/2 Home Phone City/State/ZIP �� / ✓} /V C. 2 A,11 ( 2 7 UU Business Phone 2. Name on Permit/ATC if Different than Above Mailing Address City/State/Zip 3. Application For: C"Site Evaluation ❑ Improvement Permit/ATC 11 Both 4. system to Service: WYHouse ❑ Mobile Home ❑ Business 0 Industry 1] Other s. If esidence: t# People ;# Bedrooms # Bathrooms Dishwasher [I Garbage Disposal U asking Machine 1.1 Basement/Plumbing II Basement/No Plumbing 6. If Business/Industry/Other: Specify type # Commodes # Showers IF FOODSERVICE: # Seats 7. Type of water supply # Urinals # People # Sinks i# Water Coolers Estimated Water Usage (gallons per day) 'County/City U Well ❑ Community s. Do you anticipate additions or expansions of the facility this system is intended to serve? If yes, what type? ❑ Yes )&NO ***IMPORTANT*** CLIENTS MUST COMPLETETHE REQUIRED PROPERTY INFORMATION REQUESTED BELOW. Eithcr a PLAT or SITE PLAN MUST BESUAVITTED by the client with THIS APPLICATION. Properly Dimensions: WRITE DIRECTIONS (from Mocksville) to P1t0' PER'11': Tax Office IN: # ' " S ' ef S 1 .5 13 ' Property Address: Road Name pr• , ✓: City/Zip /4oly Z Toa G If in a Subdivision provide information, as follows: Name: Imo- 1_,4-1 ()` Section: Block: Lot: ` Date Property Flagged: (.J l �� Q (` C - This is to certify that the information provided is correct to the best of my knowledge. 1 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 ain responsible for all charges ineurred 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 — 0 Z 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) Site Revisit Charge Datc(s Client Notification Date: EHS: Account No. -2-ZS Invoice No. zo U DAVIE COUNTY HEALTH DEPARTMENT • - Environmental Health Section } - Soil/Site Evaluation APPLICANT INFORMATION PROPERTY INFORMATION Account #: 990002232 Tax PIN/EH #: 5860-95-1543.09 Billed To: Guy Comatzer Subdivision Info: Baltimore Heights Lot # 09 Reference Name: Location/Address: Montclair Drive -27006 Proposed Facility: Residence Property Size: see map Date Evaluated: Water Supply: On -Site Well Community Evaluation By: Auger Boring Pit Public l/ Cut FACTORS 1 2 3 4 5 6 7 Landscape position Slope % HORIZON I DEPTH Texture group U 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 Egj I I I SITE CLASSIFICATION: LONG-TERM ACCEPTANCE RATE: REMARKS: LEGEND Landscaae Position EVALUATION BY: fe_ // 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) ■ ■■■■■■■■■■■■ ■■■■■■■■■■■■ ■■■■■■■■■■■■ ■■■■■■■■■■■■ ■■■■■■■■■■■■ ■■■■■■■■■■■■ ■■■■■■■■■■■■ ■■■■■■■■■■■■ ■■■■■■■■■■■■ ■E■■■■E■■■■■ ■■■■■■■■■■■■ ■■■■■■■■■■■■ ■■■■■■■■■■■■ ■■■■■■■■■■■■ ■■■■■■■■■■■■ ■■■■■■■■■■■■ ■■■■■■■■■■■■ ■■■■■■■■■■■■ ■■■■■■■■■■■■ ■■■■■■■■■■E■ ■■■■■■■■■■■■ ■■■■■■■■■■■■ ■■■■■■■■■■■■ ■■■■■■■■■■■■ ■ ■■ MONSOON ■■ MEMO ■MM■ ■E■■ ■MM■ ME■■ ■■M■ ■■■■■■■■■■■■■■■■■■■■■■ ■■■■■■■■■■■■■■■■■■■■■■ ■■■■■■■■■■■■■■■■■■■■■ ■■■■■■■■■■■■■■■■■■■■■■ ■■■■■■■■■■■■■■■■■■■■■■ ■■■■■■■■■■■■■■■■■■■■■■ ■■■■■■■■■■■■■■■■■■■■■■ ■■■■■■■■■■■■■■■■■■■■■■ ■■■■■■■■■■■■■■■■■■■■■■ ■■■■■■■■■■■■■■■■■■■■■ ■■■■■■■■■■■■■■■■■■■■■■ ■■■■■■■■■■■■■■■■■■■■■■ ■■■■■■■■■■■■■■■■■■■■■■ ■■■■■■■■■■■■■■■■■■■■■■ ■■■■■■■■■■■■■■■■■■■■■■ ■ ■ ■ on ■ ■ ■■■■■■■■■■■■■■ ■■■■■■■■■■■■■■ ■■■■■■■■■■■■■■ ■■■■■■■■■■■■■■ ■■■■■■■■■■■■■■ ■E■■■■■■■■■■■■ ■■■■E■■■■■■■■■ ■■■■■■■■■■■■■■ ■■■■■■■■■■■■■■ ■■■■■■■■■■■■■■ ■■■■■■■■■■■■■■ ■■■■■■■■■■■■■■ ■■■■■■■■■■■■■■ ■■■■■■■■■■■■■■ ■■■■■■■■■■■■■■ ■■■■■■■■■■■■■■ ■■■■■■■■■■■■■■ ■■■■■■■■■M■■■■ ■■■■■■■■■■■■■■ ■■■■■■■■■■■■■■ ■■■■■■■■■■■■■■ ■■■