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206 Bentbrook Drive Lot 16Davie County, NC Tax Parcel Report 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 Information G8060A0016 Township: Shady Grove 5880113400 Municipality: 82521420 Census Tract: 37059-804 PACE JOHN W Voting Precinct: EAST SHADY GROVE 206 BENTBROOK DRIVE Planning Jurisdiction: Davie County ADVANCE Zoning Class: DAVIE COUNTY R-A,R-20 NC Zoning Overlay: 27006-0000 Voluntary Ag. District: LOT 16 BENTBROOK Fire Response District: ADVANCE 2.18 Elementary School Zone: SHADY GROVE 9/2003 Middle School Zone: WILLIAM ELLIS 005100481 Soil Types: WeC,WeB,PcB2 0006 Flood Zone: 112 Watershed Overlay: DAVIE COUNTY 212860.00 Outbuilding & Extra 1350.00 Freatures Value: No Land Value: 40000.00 Total Market Value: 254210.00 Total Assessed Value: 254210.00 All data Is provided as is without warranty or guarantee of any Idnd either expressed or Implied Including but not limited to the Davie County, 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 r'p UNq E NCI or arising out of the use or Inability to use the GIS data provided by this website _____...._.,__.1 _____.___._ ... ...._,- __._.._.m_._.._ ___ _._______._____.._.._.__.._.._.__m.__. _ .__...,_._._._.__.._ _,. AUTHORIZATION NO: 13 1 3 DAVIE COUNTY HEALTH DEPARTMENT ' a Environmental Health Section PROPERTY INFORMATION Permittee'.,; 7 r P.O. Box 848 Name: a �'E'� -'t' a :u� Mocksville, NC 27028 Subdivision Name: rJ i !.,, c:y Phone #: 704-634-8760, le- Directions o Directions to property: � ' -tp f� ,Section: ' Lot: Uc l (oll T \ AUTHORIZATION FOR Mlu`5FrWASTEWATER Tax Office PIN:# ��)_ SYSTEM CONSTRUCTION - s � Road Name: _� rr, ,t_L CST Zip: Z--kc xo **NOTE** This Authorization for Wastewater System Construction MUST BE ISSUED by the Davie County Environmental Health Section prior to issuance of any Building Permits. This Form/Authorization Number should be presented to the Davie County Building Inspections Office when applying for Building Permits. (In compliance with Article 11,6f G.S. Chapter 130A, Wastewater Systems, Section .1900 Sewage Treatment and Disposal Systems) ***NOTICE*** THIS AUTHORIZATION FOR WASTEWATER CONSTRUCTION ✓/ 1' IS VALID FOR A PERIOD OF FIVE YEARS. ENVIRONI IE TAI HEATTFYSPECLALIST DA E ISSUED DAVIE COUNTY HEALTH DEPARTMENT ' :�--' - ,�•._ . a° 9 IMPROVEMENT AND OPERATION PERMITS PROPERTY INFORMATION Permittce Name:' , �' . t "a x.' i + nw l :::.w`1: 3', Subdivision Name. �'° e,'} i» t c..• 1 Directi6as to property: -= ( .; i Section: l Lot: IMPROVEMENT' wr PERMIT Tax Office PIN:# Road Name i + di1. i �-T Zip: �7 **NOTE** This Improvement Permit DOES NOT authorize the construction or installation 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 1 I of G.S. Chapter 130A, Wastewater Systems, Section .1900 Sewage Treatment and Disposal Systems) ***NOTICE*** THIS PERMIT IS SUBJECT TO REVOCATION IF SITE PLANS OR THE INTENDED USE CHANGE. YOUR WASTEWATER ENVIIFONMENTAL HEALTH SPECkIyALIST DATE ISSUED SYSTEM CONTRACTOR MUST SEE THIS PERMIT BEFORE INSTALLING THE SYSTEM. RESIDENTIAL SPECIFICATION: BUILDING TYPE BEDROOMS 4 # BATHS Z + -5# OCCUPANTS GARBAGE DISPOSAL: Yes or 10 COMMERCIAL SPECIFICATION: FACILITY TYPE # PEOPLE # PEOPLE/SHIFT # SEATS INDUSTRIAL WASTE: Yes or No LOT SIZE Z'Z�C.t:t=�YPE WATER SUPPLY 1 DESIGN WASTEWATER FLOW (GPD) t NEW SITE /r' REPAIR SITE SYSTEM SPECIFICATIONS: TANK SIZE I GAL. PUMP TANK GAL. TRENCH WIDTH 1 ROCK DEPTH 1;Z " LINEAR FT.,qU , 1 sz (2,0-, ur— c Q REQUIRED SITE MODIFICATIONS/CONDITIONS: �''` h'LL- IMPROVEMENT PERMIT LAYOUT /35 ' � a'v•e. q 01 ti p "CONTACT A REPRESENTATIVE OF THE DAVIE COUNTY HEALTH DEPARTMENT FOR FINAL INSPECTION OF THIS SYSTEM BETWEEN 8:30 - 9:30 A.M. OR 1:00 - 1:30 P.M. ON THE DAY OF INSTALLATION. TELEPHONE # IS (704) 634-8760. OPERATION PERMIT SYSTEM INSTALLED BY: alp IN Ufa orb 110 AUTHORIZATION NO. , OPERATION PERMIT BY: DATE: "THE ISSUANCE OF THIS OPERATION PERMIT SHALL INDICATE THAT THE SYSTEM DESCRIBED ABOVE 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. DCHD 05/96 (Revised) 1. 1"Wt S�nUt� Pyr .moi"' r � APPLICATION FOR SITE EVALUATIONAMPROVEMENT PERMI ee w` 1 Davie County Health Department " —= Environmental Health Section ���[p P. O. Box 848 WR 30 19% PV Mocksville, NC 27028 V (336)751-8760 'ITfll"'�` ****IMPORTANT**** THIS APPLICATION CANNOT BE PROCESSE ALL THE REQUIRED INFORMATION IS PROVIDED. G Name to be Billed Contact Person Mailing Address? % U. �A.f' �.�� Home Phone City/State/Zip •e �� �Business Phone 2. Name on Permit/ATC if Different than Above Mailing Address _ 3. Application For: 4. System to Serve: 5. If Residence: *( Dishwasher 6. If Business/Other: # Commodes _ If Foodservice: ❑ Site Evaluation City/State/Zip XImprovement Permit & ATC House ❑ Mobile Home ❑ Business # People ❑ Garbage Disposal Specify type _ # Showers # Seats 7. Type of water supply: # Bedrooms ❑ Industry ❑ Other # Bathrooms ❑ Both 0 Washing Machine ❑ Basement/Plumbing JQ Basement/No Plumbing County/City # People # Sinks # Urinals Estimated Water Usage (gallons per day) ❑ Well # Water Coolers 8. Do you anticipate additions or expansions of the facility this system is intended to serve? If yes, what type? ❑ Community ❑ Yes ❑ No PROPERTY INFORMATION REQUIRED: *** IMPORTANT *** A gb&W THE PROPERTY MUST BE SUBMITTED WITH THIS APPLICATION. Property Dimensions: �� Gtcl�P .s 1 WRITE DIRECTIONS (from 1 Mocksville) TO PROPERTY: Tax Office PIN: # J � 8-0 - �� - -� ��© 1 / L 1 Property Address: Road Name •C.� f �� ii ;>_fX 1 City/Zip /l•'. v Z262 1 If in Subdivision provide information, as follows: 1 1 1 Name: �fi /l i/'/202 1 1 1 Section: Lot #: h/ 1 1 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 am 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 /1 sy to conduct all testing procedures as necessary to determine the site suitability. DATE 2 -3 %/ '9Z SIGNATI Revised DCHD (06-96) YOU MAY USE THE BACK Of THIS FORM FOR DRAWING YOUR SITE PLAN. I • ' � � ~ r t � �,. 1 APPLICATION FOR SITE EVALUATION/IMPROVEMENTS PERMIT Davie County Health Department Environmental Health Section P. O. Box 665 Mocksville, NC 27028 Business Phone 2. Name on Permit if Different than Above 3. Application for. XGeneral Evaluation O Septic Tank Installation Permit 4. System to Serve: 0 Houses ❑ Mobile Home ❑ Place of Public Assembly ❑ Business Odustry / ❑ Other ❑ Unknown 5. If house, mobile home: Subdivision th�'�rOO� Section Lot # ❑ Basement/Plumbing No. of People ❑ Basement/No Plumbing No. of Bedrooms ❑ Washing Machine No. of Bathrooms ❑ Dishwasher Dwelling Dimensions ❑ Garbage Disposal 6. If business, industry, place of public assembly, other: Specify type No. of People Served No. of Commodes No. of Lavatories No. of Showers 7. Type of water supply: p' Public No. of Sinks No. of Urinals No. of Water Coolers Water Usage Figures ❑ Private 8. Property Dimensions__,l ��� �' Sewage Disposal Contractor 9. Do you anticipate additions/expansion of the facility this sytem is intended to serve? Cl Yes ❑ No If yes, what type? ❑ Community '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. 44=22-&? 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 hfiM 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 WHO (1193) SIGNATURE DAVIE COUNTY HEALTH DEPARTMENT Environmental Health Section ,,I �� Soil/Site Evaluation NAME )� ' "'2 Ale /l` ADDRESS PROPOSED FACIILTY Water Supply: On -Site Well DATE EVALUATED PROPERTY SIZE LOCATION OF SITE Community Public L/ Evaluation By: Auger Boring Pity— Cut FACTORS 1 2 3 4 Landscape position ,L I -/— Slope Z 'Y HORIZON I DEPTH Texture grOu2 Consistence Structure Mineralogy HORIZON II DEPTH Texture group Consistence r Structure 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: c EVALUATED BY: Ila ,// LONG-TERM ACCEPTANCE RATE: REMARKS: xe"3— . 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 i p,8.126 PG.328 - _ ZONING � - R 0 ZONING ., LI 00, 70 55 A N Sp 375' S 82.22.. E .821.90' i geel i.l ACRE± v m G_ r�. 1.7 ACRE± =� / �s _ RE± = •� r ,c� 1 4 f R = Go. - 420'— 'l 1.7 ACREt ; r Pow / �h.•R. / � .... • .+_ Ao 1.2 A 1.6 ACT' � 1 '' pJ`' �'� I ACRE ci of O' DRAINAGE EASE r ,6%ACE_ 20' .N T -TAYLOR HOWARD R NAGE AI EMEN / / h / ?y D 8.45 PG. 575 5 ACRE; ,yo, 'No, / + 19 ZONING .1.�O \ IACREt _ �� P y2Q` 1 c `rte. ti _/'`_ / .fl _ — ,_. a _ . "t4+:..,,C5' Sh '" "'.' -.k 4.• a `. ` \ �?T}c� X92 ♦ ` ~' - - / 20' DRAINAGqe V`< A ,� `� R F�� M NT SEWA DARDNELL ROBERTSON I9