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134 Fox Run Drive Lot 4Davie County, NC f t Tax Parcel Rennrt Thursday, December 29, 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: WAKNMG: '1'Mh 1S 1VU'1' A,UKV- Y Parcel Information E611 OA0004 Township: Farmington 5851830712 Municipality: 8305289 Census Tract: 37059-802 WATSON AMBER Voting Precinct: SMITH GROVE 134 FOX RUN DRIVE Planning Jurisdiction: Davie County ADVANCE Zoning Class: DAVIE COUNTY R-20 NC Zoning Overlay: DAVIE COUNTY QD 27006 Voluntary Ag. District: LOT 4 FOX RUN Fire Response District: SMITH GROVE 0.47 Elementary School Zone: PINEBROOK 7/2015 Middle School Zone: NORTH DAVIE 009950911 Soil Types: GnB2,PcB2 Land Value: Total Assessed Value: 0005 Flood Zone: 182 Watershed Overlay: DAVIE COUNTY Outbuilding & Extra Freatures Value: Total Market Value: 7R EO 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 themCounty of Davie, North Carolina, its agents, consultants, contractors or employees froany and all claims or causes of action due to NC or arising out of the use or inability to use the GIS data provided by this website. 22. DAVIE COUNTY HEALTH DEPARTMENT IMPROVEMENT PERMIT and OPERATION PERMIT IMPROVEMENT PERMIT **NOTE** This iaprovement 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 11 of G.S. Chapter 130A, Wastewater Systems, Section .1900 Sewage Treatment and Disposal Systems) NAME �%r•AAr PROPERTY ADDRESS h- r• DATE LOCATION • �`37 Folly ?UA) SUBDIVISION NAME 1 C /� ir/ LOT NUMBER SEC./BLOCK NUMBER i RESIDENTAL SPECIFICATION: BUILDING TYPE # BEDROOMS I # BATHS # OCCUPANTS GARBAGE DISPOSAL.: Yes COMMERCIAL SPECIFICATION: FACILITY TYPE # PEOPLE # PEOPLE/SHIFT # SEATS INDUSTRIAL WASTE: Yes/No LOT SIZE 0WX&) TYPE WATER SUPPLY DESIGN WASTEWATER FLOW (GPD) 2,1 e NEW SITE 1,--"' REPAIR SITE SYSTEM SPECIFICATIONS: TANK SIZE � d GAL. PIMP TAM( GAL. TRENCH NIDTH ROCK DEPTH LINEAR FT. OTHER REQUIRED SITE MODIFICATIONS/CONDITIONS: ***THIS PERMIT IS SUBJECT TO REVOCATION IF SITE PLANS OR THE INTENDED USE CHANGE. YOUR WASTERWATER SYSTEM CONTRACTOR LAST SEE THIS PERMIT BEFORE INSTALLING THE SYSTEM. IMPROVEMENT PERMIT BY t **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 INSTALLED BY (Q A �- �-D &V AUTHORIZATION NO. 0116 OPERATION PERMIT BY /Q� DATE Jhd!P **THE ISSUANCE OF THIS OPERATION PERMIT SHALL INDICATE THAT THE SYSTEM DESCRIBED ABOVE HAS BEEN INSTALLED IN COMPLIANCE WITH ARTICLE it 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. DOHD 10/95 _^ d Davie County Health Department ENVIRONMENTAL HEALTH SECTION -_ P.O. Box 665 Mocksville, N.C. 27028 AUTHORIZATION FOR WASTEWATER SYSTEM CONSTRUCTION Y " ,r'.'(Issued in compliance with Article 11 of R / G.S. .Chapter 13OA, Wastewater Systems) ***This Authorization For Wastewater System Construction must be issued b the D ie County Environmental Health Section prior to issuance of.any Building Permits. This Form/Authorization Number sWWbe tjWenj�dA-iJthe Davie County Building Inspections Office when a plying for Building Permits.*** NAME �� � DATE 16 �.��s�i�I�� b AUTHORIZATI��NUMBER MIME ON IMPROVEMENT PERMIT (If different than above) SITE LOCATION Vol— l a lj COMMENTS/CONDITIONS ON AUTHORIZATION TO CONSTRUCT WASTEWATER SYSTEM *HNITTICE*** THIS AUTHORIZATION FO 5 WATER 5Y5TEM CONSTRUCTION IS VALID FOR A PERIOD OF FIVE (5) YEARS. - ENVIROMENTAL HULTHIPECIALIST DATE DCHD 10/95 r APPLICATION FOR SITE EVALUATION/IMPROVEMENTS PERMIT Davie County Health Department Environmental Health Section P O Box 665 Mocksville, NC 27028 1. Application/Permit Requested By / "e-�A r -c( Mailing Address � be oc 3-3-S- Home Phone h a % S 111 / le Business Phone 2. Name on Permit if Different than Above /C C S A OA- C LLS4,-- /" e S 3. Application for: "_C) General Evaluation eptic Tank Installation Permit 4. System to Serve: House ❑ Mobile Home ❑ Place of Public Assembly ❑ Business ❑ Industry ❑ Other [3 Unknown 5. If house, mobile home: Subdivision /6y 2u� Section Lot # No. of People No. of Bedrooms No. of Bathrooms 11 ,Z: 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 ❑ BasementlPlumbing ❑ Basement/No Plumbing &'V�lashing Machine ishwasher ❑ Garbage Disposal 7. Type of water supply: j ❑ Public ❑ Private ®'Community 8. Property Dimensions Sewage Disposal Contractor 9. Do you anticipate additions/expansion of the facility this sytem is intended to serve? ❑ Yes ®'1q01_, If yes, what type? ) `NOTE: Improvements Permits shall be valid for a period of 5 years from date issued. Improvementst Permits are subject to revocation, if site plans or the intended use change. Effective October 1, 1989. PROPERTY INFORMATION REQ Directions to Property: Tax Office PIN # _5_2S-1 -__� - 67/-2— Road 7/-2—Road Name *FGA( 12L„J 7V Box # (if available) city 3 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 SIGNATURE 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 determine said site's suitability for a ground absorption sewage treatment and disposal system. DATE SIGNATURE DCHD (7193) _ DAVIE COUNTY HEALTH DEPARTMENT Environmental Health Section Soil/Site Evaluation NAME fJr DATE EVALUATED ADDRESS PROPERTY SIZE ldDY2BO PROPOSED FACIILTYLOCATION OF SITE fDY' A(,J Water Supply: On -Site Well _ Community Public.. 1/ Evaluation By: Auger Boring Pit Cut FACTORS 1 2 3 4 Landscape position Slope % ^— HORIZON I DEPTH Texture group Consistence Structure MineralogX HORIZON II DEPTH Texture group Consistence Structure /C 3G I& 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: LONG-TERM ACCEPTANCE RATE: REMARKS: DCHD(01-901 EVALUATED BY: -A e 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 ;lay loam, SIL -Silty loam CL -Clay loam SCL-Sandy clay loam SC -Sandy clay SIC -Silty clay C -Clay CONSISTENCE Moist VFR- V+ ---y friable FR -Friable FI -Finn 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 ■..■■■■■/■■■■■■■/■■■■■■■■■■■■■/■■/■■■■.■.■......■ ■■.■■■■■ ■MOOS.■ ■■/■/■■■.■.. ■■■..■■■.■.■■■.■■■■■■■.■■■■■■■■■■■■■ ■EMMEMOM■O■M■■■■ ■■.■.■..■..........■■■.■■■..■..■................................■. ■■■■■■■■■.■■■■■■■■■■■■■■■■■■■■■■■■■■■■■..■■ .......■ ■EM■MEMMMEMM■ ■.......■.■.......■■■...■■■..■...■■.....■.�■..■■... ■■■■■.■■E■■E■ ■.■■■■■■■■■■■■■■.■■.■■■.■■■■■■.■■........■.....■■■■_ ■■■■■M■■■■S■■ ■..■■■.............■.......■■... .......■...■■...■ .■■.■■.■■■■.■■ ■■■■■■.■..■.■■.■.■.■■■■.■■.■■■.. ■MEE.MS■./...NS ■ NONSENSE ME ■■■■■...........■■■.■....■.C...■■■■..a...M..■N■=■ ■d NOON■■■■.■.■■ ■■■■■■■■■■■■■■■■■■■■■■■`7•■■ ■■■■■■■■■■■■■■■■■■■ 0N ■■■■■■■■■■■■■ ■..■■■.■■■■■.■■■■■■....rzza■■■.a.■..E■■■E.M.■■E .■■■■.HM■ ■■■N■E.■. ■.■.■.....■..■...■.■.■.■l�JE..E/Em.00..a. ■■■I MI■I■M.� ■.M■MNMMMM ■■...■■.■■.■■..■■■.■■■.■........■..■■■.■ M■■ ■ ■MM mom.■■n .■ ■■..■.■.■..■■■..■.■■■■.■■■.■■■..■■...■..........■ ■■MS■■■■ME.■■■■. ■■■■■.■..■■■.■.■■.■■..■■■.■...■ ...■...■...■■■....■.■.■■■OMENS ■■ ■.■.■.■■■■■■■■■..■■■■■■■...■■■■■■M......■■■■1.N■ ■ MOMMEME■son ■■■M■ ■.■.■....■■■..■■■■M■■■■■■■■.■■■N■■�■�■■■■■■�■Cmn■OmMME■=.N MEMO NOONMMEMMEMMEN ■M=■� ■■■■■■■■■■■■■■■■■■■■■■■EE.EEEEE.EEEE.E....N... om MEAN ■ ■■■MEMS■ =■N ■E..OEEHE■■■..■■■..■■■■/■■■■■■■ ■■■■EMEH ■E■■Hu■EE■■■■■■■ ■■■ ■■■■■■■■■..■■....■■.......■.■..N�■M.■o■MM.�■ ■.S■M.■■.■■■■.■M.. ■■..■■■■.aEEE■aNE■■■■H■■■■■■■.■■■■■.■■■■...■.. .mom .■.■■EEEa. ................E..E.EH..■...■..........MMS..■ mom '■■.CME.mom '�■� ........NE■N■■EE■.............................�. .■■■ Emommm ■■■SS■■M■■■MMMS.■M■■■..SMS...■■..S.M��■... .■■N.E� M.■MN■ N■■■M.■ ■■....■......■......aN.►■EEaa.EE�.N.l1..■ mmommom MM■MM....MOMMEM SOMME.■. ■.O.N..■.N....■■...E.■..I■■EE■■.■ m.mm\.m■■.m. 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