163 Bentbrook Drive Lot 4Davie Countv. NC
Tax Parcel Rt'nnri
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:
WARNING: THIS 1S NOT A SURVEY
Parcel Infonnation
G8060A0004
Township:
5880008739
Municipality:
51261000
Census Tract:
MITCHELL A PATRICK
Voting Precinct:
163 BENTBROOK DRIVE
Planning Jurisdiction:
ADVANCE
Zoning Class:
Land Value:
Total Assessed Value:
NC
Zoning Overlay:
27006-7287
Voluntary Ag. District:
LOT 4 BENTBROOK
Fire Response District:
0.99
Elementary School Zone:
12/1995
Middle School Zone:
001840589
Soil Types:
0006
Flood Zone:
112
Watershed Overlay:
184090.00
Outbuilding & Extra
Freatures Value:
40000.00
Total Market Value:
224570.00
Shady Grove
37059-804
EAST SHADY GROVE
Davie County
DAVIE COUNTY R-20
ADVANCE
SHADY GROVE
WILLIAM ELLIS
WeC, WeB, PcB2
DAVIE COUNTY
480.00
224570.00
No
9 to eta All data Is provided as is without warranty or guarantee of any kind either expressed or implied including but not limited to the j
n t b Davie County, Implied warranties of merchantability or fitness for a particular use. All users of Davie County's GIS website shall hold harmless the i
County of Davie, North Carolina, Its agents, consultants, contractors or employees from any and all claims or causes of action due to
o q NC ( or arising out of the use or Inability to use the GIS data provided by this webs@e. j
s,
ca, o0
DAVIE COUNTY HEALTH DEPARTMENT
IMPROVEMENTS PERMIT AND CERTIFICATE OF COMPLETION
t' %va�5
'NOTE: Issued in Compliance With Article 11 of G.S. Chapter 130a
Sanitary Sewage Systems Permit Number
8073
Name 1 < —Date _ N�
Location —
i
Subdivision Name `--� �> > ` `� Lot No. ' Sec. or Block No.
Lot Size t", ---House — Mobile Home --_— Business -- Industry
!�
No. Bedrooms - L No. Baths = "" —No. in Family 4 — Public Assembly Other
Garbage Disposal YES p NO p' Specifications for System:
Auto Dish Washer YES C NO p C ;;
Auto Wash Ma':hine YES [� NO []
Type Water Supply
This 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
ATTENTION: YOUR SEPTIC SYSTEM CONTRACTOR MUST SEE THIS PERMIT/LAYOUT BEFORE INSTALLING THIS
SYSTEM.
Improvements permit by ---
•Contact a representative of the Davie County Health Department for final inspection of this system betwieen-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 —_u ' _Q S'_ c-
/e�a �
i
ba
0
C
Certificate o completion
'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 ,
i
/ I
i
,0
c Q
Improvements permit by ---
•Contact a representative of the Davie County Health Department for final inspection of this system betwieen-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 —_u ' _Q S'_ c-
/e�a �
i
ba
0
C
Certificate o completion
'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 P
Davie County Health Department
Environmental Health Section
P. O. Box 665
Mocksville, NC 27028
2. Name on Permit if Different than Above
Business Phone
!M@[EDWIE I
-- D
3. Application for: ❑ General Evaluation ❑ Septic Tank Installation Permit
4. System to Serve: X House ❑ Mobile Home ❑ Place of Public Assembly
❑ Business ❑ loustryElOther El Unknown
5. If house, mobile home: Subdivision - (2 h, Section Lot #
No. of People 7
No. of Bedrooms Z
No. of Bathrooms :2
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 Showers
No. of Sinks
No. of Urinals
No. of Water Coolers
Water Usage Figures
❑ Basement/Plumbing
X Basement/No Plumbing
Washing Machine
&1 Dishwasher
❑ Garbage Disposal
7. Type of water supply: Public ❑ Private ❑ Community
8. Property Dimensions �Z. / �CrtC' Sewage Disposal Contractor
9. Do you anticipate additions/expansion of the facility this sytem is intended to serve? ❑ Yes i 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: /$� f0 rl �' / �%/1 i'i�" ' /40 /�L!"Vd,7vIV/
a.� oo f re X/1 1`kc ' ,-„ •' /, f o /sv yq�� fern �/' 1�-�'
/a a�e�/�/o�om�n�� .�� // J�eL
/ �" / Jr do lYr- 6,0-r i e--
kihPrr, ekle pv� f%�c, �ibus
area's 6 ham' er-e-
This is to certify that the information provided is correct to a best of
incurred from this application.
DATE
knowledge, and I understand I am responsible for all charges
11
NATURE
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 determi
)D.eAaid site's suitability for a ground absorption sewage treatment
and dis osal system.
DATE SI URE
DCHD (1193)
DAVIE COUNTY HEALTH DEPARTMENT
Environmental Health Section
Soil/Site Evaluation
NAME
ADDRESS S A to fl
PROPOSED FACIILTY (3'u s e
DATE EVALUATED t. 2 3 - 9�
PROPERTY SIZE
LOCATION OF SITE 1? •�• �d�l
T
Water Supply: On -Site Well _ Community Public
Evaluation By:t tl_ Auger Boring ✓ Pit Cut
FACTORS
1
2
3
4
Landscape position
$
Slope Z
6
HORIZON I DEPTH
'
Texture groupC
L
L
L -
Consistence
Z
F
" �,-
Structure
Mineralogy
HORIZON II DEPTH
2``
Texture group
Consistence
F
Structure
Mineralogy
HORIZON III DEPTH
Texture group
Consistence
Structure
Mineralogy
HORIZON IV DEPTH
Texture group
Consistence
Structure
Mineralogy
SOIL WETNESS
K'75>
S
RESTRICTIVE HORIZON
SAPROLITECLASSIFICATION
S
LONG-TERM ACCEPTANCE RATE
1
,
SITE CLASSIFICATION: • > • EVALUATED BY:
LONG-TERM ACCEPTANCE RATE: �� OTHER(S) PRESENT: N Q
REMARKS: �`szr �• '�° -'
L
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 ;lay loam, SIL -Silty loam CL -Clay loam SCL-Sandy clay loam
SC -Sandy clay SIC -Silty clay C -Clay
CONSISTENCE
Moist
VFR- Vl---y 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
3C --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
■mm■
■■m■
-� APPLICATION FOR SITE EVALUATIONAMPROVEMENTS PERMIT
Davie County Health Department
Environmental Health Section
P. O. Box 665
Mocksvilie, NC 27028
1.
Mailing Address
2. Name on Permit if Different than Above
Business Phone
3. Application for. General Evaluation ❑ Septic Tank Installation Permit
4. System to Serve: 0 Houses ❑ Mobile Home ❑ Place of Public Assembly
❑ Business ❑kidustryll ❑ Other ❑ Unknown
5. If house, mobile home: Subdivision"�Ph7'�/"00� Section Z 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 Sinks
No. of Urinals
No. of Lavatories No. of Water Cool3rs
❑ Basement/Plumbing
❑ Basement/No Plumbing
❑ Washing Machine
❑ Dishwasher
❑ Garbage Disposal
No. of Showers � Wat3r Usage Figures
7. Type of water supply: 0 Public ❑ Private ❑ Community
8. Property Dimensions 1-44:z Sewage Disposal Contractor _
9. Do you anticipate additions/expansion of the facility this sytem is intended to serve? ❑ Yes ❑ 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 I understand I am responsible for all charges
Incurred from this application.
_,- -� 2
DATE
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 SIGNATURE
WHO (IMM
DAVIE COUNTY HEALTH DEPARTMENT
Environmental Health Section
t% Soil/Site Evaluation
NAME Uhf ll elwye'
ADDRESS
PROPOSED FACIILTY
DATE EVALUATED
PROPERTY SIZE
LOCATION OF SITE
Water Supply:
On -Site Well
Community
Public
Evaluation By:
Auger Boring
Pit J/_
Cut
4
HORIZON I DEPTH
Texture group
Consistence
FACTORS
1
2 3 4
Landscape position
L
.C.
Slope %
`f
4
HORIZON I DEPTH
Texture group
Consistence
Structure
Mineralogy
HORIZON II DEPTH
44CC-
Texture group�'
Consistence
Structure
j
Mineralogy'
HORIZON III DEPTH
Texture grou2
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:
DCHD (01-901
EVALUATED BY: 1%
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 - gat/day/ft2