130 Springdale Court Lot 7Davie County. NC Tax Parcel Report Thursdav, October 20. 2016
Parcel Plumber:
NCPIN Number:
Account Plumber:
Listed Otmer 1:
Mailing Address 1:
City:
State:
Zip Code:
Legal Description:
Assessed Acreage:
Deed Date:
Deed Book / Page:
Plat Book:
Plat Page:
Building Value:
IiVARN -IN'U:11. IS NOTA SURVEY
-puce! lnform-Ition
G8060A0007 Tv nship: Shady Grove
5880002558 l:lunicipality:
8301636 Census Tract: 37059-804
GROUT DONALD DUANE Voting Precinct: EAST SHADY GROVE
130 SPRINGDALE COURT Planning Jurisdiction: Davie County
ADVANCE Zoning Class: DAVIE COUNTY 1-1,R-20
Land Value:
Total Assessed Value:
NC
Zoning Overlay:
27006
Voluntary Ag. District:
LOT 7 BENTBROOK
Fire Response District:
1.36
Elementary School Zone:
11/2012
Middle School Zone:
009090518
Soil Types:
0006
Flood Zone:
112
Watershed Overlay:
215280.00
Outbui!ding 8. Extra
Freatures Value:
40000.00
Total Market Value:
262360.00
ADVANCE
SHADY GROVE
1MLLIAM ELLIS
WeC
DAVIE COUNTY
7080.00
262360.00
No
pY r
p ,ti
uct
I
Davie County, j
1 "1
NC
All data is provided as is without warranty or guarantee of any kind either expressed or implied Including but not limited to the j
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 Ca( ma its agents consuftants, contractors or employees from any and all claims or causes of action due to 4
or arising out of the use or inability to use the GIS data provided by this website.
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Davie County Health Department
Environmental Health Section
P.O. Box 848/210 Hospital Street
Mocksville, NC 27028
(336)751-8760/ Fax (336)751-8786
Improvement Permit
September 27, 2006
M & M Construction
159 Hickory Tree Road
Mocksville, NC 27028
Re: Bent Brook: Lot #7
Tax PIN# 5880-00-2558
Dear Mr. McKnight,
This Improvement Permit DOES NOT authorize the construction of a wastewater system. An
Authorization To Construct a wastewater system must be obtained from this office prior to the
construction/installation of a wastewater system or the issuance of a building permit(in compliance with
Article 11 of G.S. daptdr 130A, Wastewater Systems). This Improvement Permit is subject to revocation if
site plans or the intended use change.
System To Serve: Wastewater Design Flow(GPD) x�& 6 Valid: ❑ Years ❑No Expiration
System Type: ❑ Conventional X-A"ccepted
❑Innovative ❑Alternative ❑Other
Site Modifications/Permit Conditions: As stated in 15A NCAC 18A.
Systems may also be use
Environmental Health Specialist
i.p.letter 7/06
Date
DAVIE COUNTY HEALTH DEPARTMENT
Environmental Health Section
P. O. Boa 848/210 Hospital Street
Mocksville, NC 27028
(336)751-8760
Account #: 990004119 Tax PIN/EH #: 5880-00-2558
Billed To:
M & M Construction
Subdivision Info:
Bentbrook Lot # 7
Reference Name:
Mark McKnight
Location/Address:
Spring Dale Court -27006
Proposed Facility:
Residence
Property Size:
1.26 acre
ATC Number: 4508
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 WASTEWATE=SUCT S VALID FOR A PERIOD OF FIVE YE S.
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 guarantee that the system will function satisfactorily for any
given period of time.L
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Septic System Installed By:
Environmental Health Specialist's Signa V
Date: —12-7-B
DCHD 05/99 (Revised)
DAVIE COUNTY HEALTH DEPARTMENT VOW
Environmental Health Section
r P. O. Boz 848/210 Hospital -Street
Mocksville, NC 27028
(336)751-8760
IMPROVEMENT/OPERATION PERMIT
Account #:
990004119
Tax PIN/EH #:
5880-00-2558
Billed To:
M & M Construction
Subdivision Info:
Bentbrook Lot # 7
Reference Name:
Mark McKnight
Location/Address:
Spring Dale Court -27006
Proposed Facility:
Residence
Property Size:
1.26 acre
ATC Number: 4508
**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 C #Bedrooms � #BathsO`�
Dishwasher: ??, Garbage Disposal: 0 Washing Machine: F Basement w/Plumbing: i] Basement/No Plumbing:
Commercial Specification: Facility Type #People #People/Shift #Seats Industrial Waste:
Lot Size Type Water Supply _ Design Wastewater Flow (GPD) S� 6— Site: New M Repair
l 1�
System Specifications: Tank Size//GAL. Pump Tank GAL. Trench Width' Rock Depth � Linear F
Other: As
Required Site Modifications/Conditions: accepted Systems may also be use
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.**
%P V .
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Environmental Health Specialist's Signature: Date:
I A�z
DCHD 05/99 (Revised)
09/20/2006 20'
.. '_ ser
uat,os
33699887BO M&M CONSTRUCTIDN
141a etevti• oouclttv envhealth 4ib 155 rleee
TION FOIt MITE EVALUATION/IMPROVEMENT PERMIT & ATC
Davie County Health Department
Ewltir6mmew d Heakh Vecoow
P.O.9es 3411 110 Hospital Sheet
Mocl ansa, NC 270:.8
(336)7SW6W Fax (336)75114171%
For 0 sire Evalumloollrltpt V'=Cot Pwndl ty, ewhorisation To Cautruci(ATC) proth
nZ••-impmTAm— THIS ArrucAnaN ZAAmr SB pRocimm)11h-Lm Au OF Tiff Racimin
ORMATION IS ►NOVWW, It lm b the WPORMATTON BULLEMN for iaNrvctlis
r•�
Nam to be Billed tl'1 + r .._t
Billing Addms j!.)S,l►r aRa Heide Phone �.
City/Stattinp fl f � 9ulit�eaa Plweee
Marto on PvnniVATC if Different than Above.
NOTE: A survey pb1 or sits pias aw+.se .ccompenr this application
--
(Pamir is valid for 60 months "')k &its plan no ettpitation with complete plat.)
SMO Addreel• city h a La r:&'
Subdivision Namej pn� Seetiattuo
Direction/To Site. __ S AAr4r�_� __��i1`L�re d m ► L��
Tu PI
Sine
Date Hewse(Facility Comers FinWd„9 0T_ ...
If the mawar to say of the followirtIl quest wo u "yes % suppormS documemation be
dm attached.
Are dany eais� wsstewuar systema on the site? Utas
Does s site cotteua jueiadiotim a watsads? clYes l X4
lb
Am III= any esaemeau or rider-:,r-lYaya an rhe mise? 11Ye1 ffiw
Is n1e site subject to oppmvil by :soother public agency! UYas
Witt westtwstw othar "a Mms.tic sowage be seanasa!? CGYes W:o
IF RESIDENCE FIU OUT ng EC
M People LA — N Bedroon s
Baletrsettt: Qwha rINo Besenmil
Garden TublWhiripool eI iJIVo
ff NON-MIDENCII FML OUT' TIE BOX BBLOW
Type of PaciiityllInsines _ Total Square FooftV of Buildim _ N People
N Sings _ _ N Commodes _ _ _ N Showes N Unmb _
fistimuted Water U6ape (yalltns per dt.y) _ (Attach doamtrntstion ofsimilar thcility water owwn ptinn)
FOODSERVICE ONLY,.N Seats
Type system requesw! (/Caevaatioaal 1 -Accepted al awrative OAItwW ve OOtbw_
Waren Supply Type! txotulry/City Water a Neo W11 OF_xistin;c Wo1l O Commt•e•ky Well
Uo You taltiCgrste additieKas os espanitieln •.f aha 6seility tits /valent b itltsadei en Imvdl U Ysa tyl%
If yes, what type- _
This ii b e:elofy that the ia[i»eas pmYlrted ns � applieatiea is site led aer:sct b 158 bey of lay lotowisd�s. I sedatehtd ltwl
any pemliga) or ATC(s) issued hmeaRel ata subject to alspeosion or mvoeation :f da site is alwed. the ilrtaeded use changes, or if
the inforrratien sllbltittcd is mitis application is fill iRad a rltanpd. f andm(me i tkar low rearonrihfaJw aN c oza i r—rar
jute dks applrcetton. 1 %emby ltioat ftht • 4 eitty to the AW100 mad Repasmlative of Ibo Davis Ceoaty Haaldt Aepsarmad to
meccuseyin cdomm delenlrMe cam4diamm with aPP1is Iowa aed rufo ea the nbow daestl m d psopaty lecated io
IT
ot+ntY and
t
i
Sha Ra~ chow
maplesCheat Nutiftatiod Date:
Sign given DYes ONO r awtw ZIA
Revised 1106 la. oics I
JUL 14,2005 06:53 NCSG ITS CALDNE 336 751 8186
PAGE 01
1 44 ZG 10c58a cfavis counzts *nvhealzh 336 7S1 8785 10.1
APPLICATION FOR SITE EVALUATION&NIPROVEMENT PERMIT & ATC
Davie County Health Department
linvjrnamexW Hea&Jf Section
P.O. Bore 848/210 Hospft:ttl Street
Mo&sviile, NC 29028
(336)751-8760/ Fax 03M751-8786
Application For:VeE
lntpm P {d94athorLation To Construct(ATC) Q Both
04-'IMPORTANP-1 THIS AWLIC C3BE PROCESSED I.RNLESS ALI. OP THE REQUIRED
_SNFoxmATION 1S PROvwzD. 8.:fa to the 114FORmnoN SULLE TIN for instructions.
APPLICANT INFORMATION K
Name to be Bill"nrI., Iy N i• t;c P1t arson .�r.^; �t oJ.1n.,
O
•Billin.g Address . �Y i�4w�4-901 5., ,.1 t, i•:ttme Phone
_
City/StatdZD' sr' °- _ _t%,} , . Z o d(o UL.,tiness Phone `_ ?7 5 - .2 1
Ntune an PcrnuVATC if Differe>!t than Above
Mailing Address— City/S atemp
NOTE: A survey plat or site plan mut accompany this application.
(Perrnir is valid for 60 months evith site plan, no expiration witbcoripleto plat.)
Street Address _ City Tax PIN
Subdivision Name-' 1e Sectitm/I.otti Lot Size
Directions To Sitr. /h, v t t'v r r?b/ ra..;4— 1„ : /
.Date House/Facility Comers Flagged :2-,21
If the answer to any of the following questions is W'. Supporting doemnen mutt be4dacbcd.
Are there any existing wastewater systams on the site? Uyts
Does the site contain Judsdict.onat wetlands? OYtS @itlo
Aro there guy casements or delft -of -ways on the site? UYes� �a •
Is the site subject to approval by another public agency? Dyes l3lvo
Will wastewatcrodier than domestic sewage be genaated•1 0 13iQo
IF RESIDENCE FILL OUT THE BOX BELOW
# People # Bedeootns� # Bathe oom. Tnb/Wltirlpoof C1 es LtNo
Basement: OYes QNo Basen=t Plumbing: QYes ONO
Type of Facility/Basincss Tota► Square Footage otBuild444 # People _
# Sinks # C=nntodct 11 Showers* Urinals
Estimated Water usage (gallons per day) (Attach documentntion of similar facility water consumption)
FOODSERVICE ONL��Y# Seats
Type syctcmrequested: SC,5`_nventionai OAccepted Olnnovative CAltenmtive OOther„�,
Water Supply Type: aunty/City Wat sr O New Well OE is:ing Well OCU rnunity Well
Do you anticipate additions of expansions of the faeility this system is intends d to serge? 0 Yes fd.Nt>"
If yes, what type?
This is to certify that the information provided on this application is tette and correct to the best of ttty knowledge. I understand that
any pennit(s) or ATL'(s) issued hereattet are subject to suspension or revocation if the site is altered, the intended me changes, or if
flee information submitted in chi: applies locals Ltlsifted or elsanged {vm1m,nvtd*w tam rexponsibtefor all charter incurred
front chis applicadan I hereby grant right of entry to the Authorized Reprise stative of the Davie County Health Deparnnont to
conduct necessary imspeetions to dc1 rte ttKnpliance with applicable laws :nd rules on the abon: described property located in
1'1avie.Counryaod ou%ed by _,,{c Y't 5 ,.,, : J t,
Proptoty o er's orownEr'st �ftler.-8-2w
Date
Sign given rJYes ONO
Revised V06
Site Revisit C#mrge
Datc(s).
Client Notification Date:
ERS:
Account N -64
tnvoide #
Z00/104 d0d VKII093 allliEd 600 866 9H IV WIT HU 9002/81/L0
Nord Carolina
O 0.
• 0 R nier Parcefs',,7.,
z0ow ZoamOut
,,rch
Zoom Factor 12X 0 Radius S�(feet) rd
Ti
1AA
IV
7
14.56A
Map L
.41
Drew 6ak%l
60imiddry
Consul Tn
and-AAdining Parcels
• County Q 0806OA0007
• Account Number.000067399000
• J01N.'58W402558
• Legal 110T 7 BENTBROOK
• Owner'Neme: SMITH JACKIE WAYNE
• OwnarlAddiew 1. SMITH JACKIE WAYNE
• OwnerlAddress 2- SMITH SANDRA POLLARD
• OwnerlAddress 3: PO BOX 105
a CdyStab Zip: ADVANCE .NC 270011- 0000
e Lend Value: $35,000.00
. 80ding V000: $0.00
MI'E3 Arial Phot
rrfty 13*.,�nd
r-I&Y'Doual
1]cour*2 dir
Land UQ /Type: J LT
Egli Fun C
and-AAdining Parcels
• County Q 0806OA0007
• Account Number.000067399000
• J01N.'58W402558
• Legal 110T 7 BENTBROOK
• Owner'Neme: SMITH JACKIE WAYNE
• OwnarlAddiew 1. SMITH JACKIE WAYNE
• OwnerlAddress 2- SMITH SANDRA POLLARD
• OwnerlAddress 3: PO BOX 105
a CdyStab Zip: ADVANCE .NC 270011- 0000
e Lend Value: $35,000.00
. 80ding V000: $0.00
MI'E3 Arial Phot
j] Hood Pam
r-I&Y'Doual
•
Land UQ /Type: J LT
El Pares's
•
E3 school -D's,
0-M11 Ad.dn
•
Deed Dots: 1998104/09
Solis
,0 Town i0.11
Towfl:hlps
Muni §Y
Pmpedy Address:
YotIng Prot
Infrastructu
E3 brlwoiways
County Zoning., R-20
C) "I unes
•
E3 Cent
MAP -C
El usimc.mig,
and-AAdining Parcels
• County Q 0806OA0007
• Account Number.000067399000
• J01N.'58W402558
• Legal 110T 7 BENTBROOK
• Owner'Neme: SMITH JACKIE WAYNE
• OwnarlAddiew 1. SMITH JACKIE WAYNE
• OwnerlAddress 2- SMITH SANDRA POLLARD
• OwnerlAddress 3: PO BOX 105
a CdyStab Zip: ADVANCE .NC 270011- 0000
e Lend Value: $35,000.00
. 80ding V000: $0.00
MI'E3 Arial Phot
zoonoq dOd VNI10M OWN 630 966 9H IVA U11 RU 9002 RTM
r-I&Y'Doual
•
Land UQ /Type: J LT
Creeks and
•
Deed aaakovs:0020110673
0-M11 Ad.dn
•
Deed Dots: 1998104/09
Fire . DdPnrt
SAL -8 Fww; $0.00
•
Pmpedy Address:
000 130 000130 CT
•
County Zoning., R-20
•
Census Code:
MAP -C
•
City Code:
•
Fire Distift-AI)VANCE
TN3 mp is prep,
•
Flood Zone: ZONE X
Inventory of matt
•
Flood Community: 370308
•
Flood Penal: 0100 C
010ts.'and o"w( 9
and data. Users t
.6
Flood AW OW., 12-17-1M
hereby notliled th
zoonoq dOd VNI10M OWN 630 966 9H IVA U11 RU 9002 RTM
1.
' APPLICATION FOR SITE EVALUATION/IMPROVEMENTS PERMIT
Davie County Health Department
Environmental Health Section
P. 0. Box 665
Mocksville, NC 27028
Mailing Address
2. Name on Permit if Different than Above
3. Application for.General Evaluation C3Septic Tank Installation Permit
4. System to Serve: 0 Houses O. Mobile Home O Place of Public Assembly
O Business O �- �%/ / 4-100ddustryy / O Other ❑ Unknown
5. If house, mobile home: Subdivision 06 Section �LLot #
O Basement/Plumbing
No. of People ❑ Basement/No Plumbing
No. of Bedrooms ❑ Washing Machine
No. of Bathrooms O Dishwasher
Dwelling Dimensions ❑ Garbage Disposal
6. If business, industry, place of public assembly, other: Specify type
No. of People Served No. of Sinks
No. of Commodes No. of Urinals
No. of Lavatories No. of Water Coolers
No. of Showers Water Usage Figures
7. Type of water supply: 0 Public O Private ❑ Community
8. Property Dimensions Sewage Disposal Contractor
9. Do you anticipate additions/expansion of the facility this sytem is intended to serve? O Yes O No
If yes, what type?
'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:
This is to certify that the information provided is correct to the best of my knowledge, and 1 understand I am responsible for all charges
Incurred from this application.
DATE
CONSENT FOR ATE EV&..'JATION I4 5E DANE Q-tJ ABOVE gEaOIBL l� P190PERTY
MUST CHECK ONE: O :. 1 OWN the property. O 2. 1 DQ NOT OWN the property.
If you checked Box #2, the rest of this form WZ be completed by the owner or A person aL .horized by the owner:
1 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 stid sita's suitability for a ground absorption sewage treatment
and disposal system.
DATE SIGNATURE
WHO (110)
DAVIE COUNTY HEALTH DEPARTMENT J
Environmental Health Section�p�C (�Cn
Soil/Site Evaluation
NAME �/f 'q DATE EVALUATED
ADDRESS PROPERTY SIZE 3l7G
PROPOSED FACIILTY &�Ur_,f LOCATION OF SITE
Water Supply: On -Site Well
Community
Public cl
Evaluation By: Auger Boring Pit Cut
✓ 7
n
FACTORS 1 2
3
4
Landscape position G
Slope % 6
HORIZON I DEPTH
Texture group
L._ .!`c" -C '
Consistence
Structure
Mineralogy
HORIZON II DEPTH
Texture group
Consistence
Structure
Mineralogy r.' r
l
-
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: --3 e'!
DCHD(01-901
EVALUATED BY: /`J4'
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
'r -f.1 -
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
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