180 South CLaybon Drive Lot 8Davie Countv. NC Tax Parcel Report Thursday. December IS- 2016
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Ali dela is provided as is mahoutwarranty or guarantee of any ldnd ehher expressed or Implied Including but nal limited to the
Davie County, Implied mmantles of meroharltabilky orflNessfor a pargwlaruse. Ali users of Davie Countys GIS website shall hold hmaless the
CounfyMDavie, North Gamin;hsagents,wnsuhznb4 contnctms or employeesham anyandabdalmsoreausesofadlondue to NC orarlsing out ofthe use orinabllityto use the GIS data provided by this webshe.
WARNING: THIS IS NOT A SURVEY
Parcel Number:
D703000023
Township:
Farmington
NCPIN Number:
5862952489
Municipality:
Account Number:
67324000
Census Tract:
37059-802
Listed Owner 1:
SMITH HENRY CARL
Voting Precinct:
SMITH GROVE
Mailing Address 1:
180 SOUTH CLAYBON DRIVE
Planning Jurisdiction:
Davie County
City:
ADVANCE
Zoning Class: DAVIE COUNTY R-20
State:
NC
Zoning Overlay: DAVIE COUNTY QD
Zip Code:
27006-0000
Voluntary Ag. District
No
Legal Description:
LOT 8 DAVIE GARDENS SECTION 3
Fire Response District:
SMITH GROVE
Assessed Acreage:
0.45
Elementary School Zone:
PINEBROOK
Deed Date:
10/1998
Middle School Zone:
NORTH DAVIE
Deed Book / Page:
002060327
Soil Types:
GnB2
Plat Book:
Flood Zone:
Plat Page:
Watershed Overlay:.
DAVIE COUNTY
Building Value:
Outbuilding & Extra
Freatures Value:
Land Value:
Total Market Value:
Total Assessed Value:
[all
Ali dela is provided as is mahoutwarranty or guarantee of any ldnd ehher expressed or Implied Including but nal limited to the
Davie County, Implied mmantles of meroharltabilky orflNessfor a pargwlaruse. Ali users of Davie Countys GIS website shall hold hmaless the
CounfyMDavie, North Gamin;hsagents,wnsuhznb4 contnctms or employeesham anyandabdalmsoreausesofadlondue to NC orarlsing out ofthe use orinabllityto use the GIS data provided by this webshe.
�CCIZATION N0:1,1762 -DN LINTY HEALTH DEPARTMENT
Environmental Health Section i, PROPERTY INFORMATION' . , .
*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.
(Incompliance with Articled 1 of G.S. Chapter I30A, Wastewater Systems Section .1900 Sewage Treatment and Disposal Systems)
} :
**,*NOTICE*** THIS AUTHORIZATION FOR WASTEWATER CONSTRUCTION
Fj IS VALID FOR APERIODOF FIVE YEARS.
- _
'',�:ENVIRONME TALHEA HSPECIALISTDATE ISSUED
**THE ISSUANCE OF THIS OPERATION PERmrrsHALL, INDICATE THAT T
WITH ARTICLE 11 OFG.S. CHAPTER 130A,SECTION ;1900.-SEWACiETREX
GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORILY FOR
LL SYSTEMS"; BUT SH
OF TIME.
sl
**CONTACT A REPRESENTATIVE 4THLIJAVIE COUNTY HEALTH DEPARTMENT FOR FINAL INSPECTION OF -THIS SiSIliM.;'
100- 76
BETWEEN 830 -9:30 A.M. bk4i30 P.M. ON THE DAY OF INSTALLATION. TELEPHONE #IS (336)7518
OPERATION PERMIT
SYSTEM INSTALLED BY;
4,
p
AUTHORIZATIOI TIO PERMIT BY
11 NO llt;� OPE
DATE.
7 7_k�_J_
**THE ISSUANCE OF THIS OPERATION PERmrrsHALL, INDICATE THAT T
WITH ARTICLE 11 OFG.S. CHAPTER 130A,SECTION ;1900.-SEWACiETREX
GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORILY FOR
LL SYSTEMS"; BUT SH
OF TIME.
" APPLICATION FOR SITE EVALUATION/IMPROVEMENT PERMIT & AT n' K ly 9 U u R D
i Davie County Health Department
ILIJn"llfl
Environmental Health Section NAV -
P.O. Box 848/210 Hospital Street 5 1996
Mockaville, NC 27028
(336) 751-8760 ENVI ONVIEECOUNTYEALiH
-***IHPCRTANT*** THIS APPLICATION CANNOT BE PROCESSED UNLESS ALL THE REQUIRED
INFORMATION IS PROVIDED. Refer to the INFORMATION BULLETIN for instructions.
1. name to be Billed Cay l "O h k n 7(Y1 l \ Contact Person DnL S M) +1 )
Mailing Address I ri 4 S - C lo....., hon D r i V P . Some Perone 336-T-40 40 -
City/state/ZIP Ad\r(anC? .I INC,-aloo(,_ Business Phone -,;340- -7Htl-- 16')9
2. Name on Permit/ATC if Different than Above
Mailing Address
3. Application For: ❑ Site Evaluation
4. System to service: VHouse ❑ Mobile Home
City/State/Zip ..." n, N /,idT•
1 " t oeRrb A&
J Improvement Permit/ATC Soth
❑ Business ❑ Industry ❑ Other �Q�
5. If Residence: # PeopleH-� # Bedrooms 3 # Bathrooms T
Dishwasher 0 Garbage Disposal 0"Washing Machine - ❑ Basement/Plumbing 0 Basement/No Plumbing
6. If Business/Industry/Other: Specify type
# Commodes # Showers # Urinals
# People # Sinks
# Water Coolers
IF FOODSERVICE: # Seats Estimated Water Usage (gallons per day)
7. Type of water supply: IIf'county/City ❑ Well ❑ community
e. Do you anticipate additions or expansions of the facility this system is intended to serve? ❑ Yes X No
H yes, what type?
***IMPoRTAMI'***CLIENTS MUSTCOMPLETETHE REQUIRED PROPERTY INFORMATION REQUESTED
BELOW. Either a PLAT or SITE PLAN MUST BESUBMITTED by the client with THIS APPLICATION.
Property Dimensions: 16 Q e )( Z00 WRITE DIRECTIONS (from MocWlle) to PROPERTY: .
Ta:tH(icePIN: # SgCoa -95'"dN 89 �13t7o,�"��7 �v as>' f� X01 tll
Property Address: Road Name 0.111 /�
City/Zip {�(-@yW-q�2 � "UVC K/�. /AUK CO-n.f- !ter) i' 1/x$54
Min a Subdivision provide information, as follows:
Name: 04U' e C—*t Ce p pt 5'
Section: Block: Let:_
Date Property Flagged: ��% ��% / t?' --
This
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
to conduct all testing procedures as necessary to determine the site suitabil'
DATE ,O -.7` SIGNATURE M ✓Gty
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 (07/98)
Account No.
Invoice No. Sag
ION FOUND
IRON FOUND O
8
Ee
0
SCREEN PORCH
`.7;"
GARAGE
PROPOSED
HOUSE
NO 801
s
Z
o
' IRON FOUND z
SITE
eP
/ LOCATION MAP
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3 �
m
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/ �'vS ryp0
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M
IRON FOUND
/ / I
1
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� S
I JOHN RICHARD HOWARD certify that ••••'�� �'1A�0
/ this map was drawn from an actualf�. v
/ field survey under my direction and ° 1p6%
supervision, that the ratio of = SEAL s
precision is 1 L-7150
ek
19TNAR0 a'•
/ REGISTERED LAND SURVEYOR L-2890 y111060u"0046"•
/ 30 0 30 60 90
/ GRAPHIC SCALE — FEET
FOR HENRY C. & ANNETTE M. SMITH
SCALE TOWNSHIP COUNTY STATE
DATE,s
1 " = 30' FARMINGTON DAME N. C.
10-22-9
LOT 8 P.B. 4 PC. 21 DAME GARGENS
HOWARD SURVEYING
JOHN RICHARD HOWARD RLS
P.O. BOX 276 ADVANCE, N.C. (336) 998-5396
JOB NO.
98062
DAVIE COUNTY HEALTH DEPARTMENT
'Environmental Health Section SECTION % LOT -o
Soil/Site Evaluation
DATEEVALUATED
PROPERTY SIZE �FiO
ROAD NAME 4//�R I
Water Supply:. On -Site Well Community Public
Evaluation By: Auger Boring=4---� Pit Cut
••
• • . •
Si6i®®e��
nei-RUIR11197 •
lSli■�fr�®®Ses
---®®-�
Consistence
•
•
• •
SITE CLASSIFICATION: q )' EVALUATION BY:
LONG-TERM ACCEPTANCE RATE: OTHER(S) PRESENT: -
REMARKS:
LEGEND
Landscape Position
R - Ridge S - Shoulder L - Linear slope FS =Foot slope .. N -Nose slope
CC; Concave slope CV - Convex slope L 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 C - ClaySilty clay
CONSISTENCE
Most
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
tructur
SC - Single grain M - Massive CR - Crumb OR - 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(01-90)
M
Y L336��
Phone: (336) - 753 - 6780
Davie County Health Department
nvironmental Health Section
P.O. Box 848
210 Hospital Street
I Courier #: 09-40-06
Mocksville, NC 27028
:gONMQt+Rh^ti^ti ,J TEWATER CERTIFICATION FOR DWELLING
DANECCheck One) Replacement Remodeling Reconnection
gg
Far: (336) - 753-1680
Name: �/ `. Phone Number3,k_ �- 2495I, (Home)
Mailing Address: (Work)
i
Detailed Directions To Site: T
I .
Property
Please Fill In The Following Information
/About The EXISTING Facility: ver °
Name System Installed Under:/�li t� l�� Type Of Facility: i
Date System Installed (Month/Date/Year): zoO 0 Number Of Bedrooms: �,Z Number Of People: /
Is The Facility Currently Vacant? Yes If Yes, For How Long?
Any Known Problems? Yes If Yes, Explain:
Please Fill In
Type OfFacilit
Requested By:
Approved
Comments:
Following
About The NEW Facility:
rr6=13 — Number of People
Requested:
For Environmental Health Office Use Only
Environmental Health Specialist Date: /,-2 - =;,
*The signing of this form by the Environmental Health Staff is in no way intended, nor.should be taken as a guarantee
(extended or limited) that the on-site wastewater system will function properly for any given period of time.
Payment: Cash
Order #
Paid By: L" IC:;)r/77-f II Received
�-/
Account M -I o -z- / Invo