195 Bentbrook Drive Lot 13Davie Countv. NC
Tax PnrrPl 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 I Page:
Plat Book:
Plat Page:
Building Value:
WARNING: THIS 1S NOT A SURVEY
Parcel Information
G8060A0013 Township: Shady Grove
5880017385 Municipality:
45082340 Census Tract: 37059-804
LE BLEU CORPORATION Voting Precinct: EAST SHADY GROVE
PO BOX 2093 Planning Jurisdiction: Davie County
ADVANCE Zoning Class: DAVIE COUNTY 1-1,R-20
Land Value:
Total Assessed Value:
NC
Zoning Overlay:
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 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 all claims or causes of action due to
arising out of the use or Inability to use the GIS data provided by this website.
27006-0000
Voluntary Ag. District:
No
LOT 13 BENTBROOK
Fire Response District:
ADVANCE
1.63
Elementary School Zone:
SHADY GROVE
10/1998
Middle School Zone:
WILLIAM ELLIS
002060268
Soil Types:
WeC,WeB
0006
Flood Zone:
112
Watershed Overlay:
DAVIE COUNTY
0.00
Outbuilding & Extra
0.00
Freatures Value:
36000.00
Total Market Value:
36000.00
36000.00
1:01
Davie County,
NCor
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 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 all claims or causes of action due to
arising out of the use or Inability to use the GIS data provided by this website.
I
APPLICATION FOR SITE EVALUATION/IMPROVEMENTS PERMIT
` Davie County Health Department
Environmental Health Section
P. O. Box 665
Mocksville, NC 27028
Mailing Address
2. Name on Permit if Different than Above
3. Application for.General Evaluation ❑ Septic Tank Installation Permit
4. System to Serve: Houses ❑ Mobile Home ❑ Place of Public Assembly
❑ Business ❑dustry L ❑ Other ❑ Unknown
5. If house, mobile home: Subdivision 114410 " Section Lot # ! 1.
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 Sinks
No. of Commodes
No. of Urinals
No. of Lavatories No. of Water Coolers
❑ Basement/Plumbing
❑ Basement/No Plumbing
❑ Washing Machine
❑ Dishwasher
❑ Garbage Disposal
No. of Showers Water Usage Figures
7. Type of water supply: 01 -public ❑ Private ❑ Community
8. Property Dimensions �% -44z 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.
DATE
MUST CHECK ONE: ❑ 1. 1 OWN the property. p 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
OCHO (lip
-9
DAVIE COUNTY HEALTH DEPARTMENT
Environmental Health Section
Soil/Site Evaluation
NAME ///J�,`� ��c�.Y �'�✓ DATE EVALUATED l�
ADDRESS // PROPERTY SIZE
PROPOSED FACIILTY ,��/.1l[ f i� LOCATION OF SITE
Water Supply:
On -Site Well
Community
Public 41__�
Evaluation By:
Auger Boring
Pit ���
Cut
HORIZON I DEPTH
FACTORS
1
23 4
Landscape position
Slope
HORIZON I DEPTH
Texture group
Consistence
Structure
Mineralogy
HORIZON II DEPTH
Texture group
Consistence
Structure
S/ 1F'
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: EVALUATED BY:����
LONG-TERM ACCEPTANCE RA
REMARKS: ZY'-ay,�vZICZ1141 04!55
DCHD(01-901
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
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