210 Little John Drive Lot 17Davie Countv. NC
f
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:
Land Value:
Total Assessed Value:
WARNING: THIS 1S NUT A SURVEY
Parcel Information
D701 OA0017 Township: Farmington
5862454320 Municipality:
38369000 Census Tract: 37059-802
HUGHES RICHARD K JR Voting Precinct: SMITH GROVE
210 LITTLE JOHN DRIVE Planning Jurisdiction: Davie County
ADVANCE Zoning Class: DAVIE COUNTY R-20
NC Zoning Overlay: DAVIE COUNTY QD
27006-0000
Voluntary Ag. District:
LOT 17 FOX MEADOW
Fire Response District:
0.57
Elementary School Zone:
7/1992
Middle School Zone:
001640731
Soil Types:
0004
Flood Zone:
134
Watershed Overlay:
Outbuilding & Extra
Freatures Value:
Total Market Value:
SMITH GROVE
PINEBROOK
NORTH DAVIE
GnC2
DAVIE COUNTY
No
Davie County,
All data Is provided as Is without warranty or guarantee of any ldnd 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 theCounty
161
of Davie, North Carolina, its agents, cansuttards, contractors or employees from any and afi claims or causes of action due to
NC
or arising out of the use or inability to use the GIS data provided by this webstte.
DAVIE COUNTY HEALTH DEPARTMENT
IMPROVEMENTS PERMIT AND . CERTIFICATE OF COMPLETION
*NOTE: Issued in Compliance With Article II of G.S. Chapter 130a -
Sanitary Sewage Systems Permit Number
Name �� .�, u \- 1 3- ��� ,V �i Date M t 4 f ND
6576
Location �;; �� �'ti v V�,'yJ �' <:) U Co
Subdivision Name n k u� _c, Lot No. / Sec. or Block No.
Lot Size �t '� �,`� 1 House Mobile Home �� Business Speculation
No. Bedrooms No. Baths No. in Family' _
Garbage Disposal YES ❑ ` NO Q/ Specifications for System:
Auto Dish Washer YES gO NO QJ
Auto Wash Ma .hine YES p/ N0 ❑ '
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'cliange.
5 f
Q
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' S:
Improvements permit by
*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 day of completion. Telephone Number 704-634-5985.
Final Installation Diagram:
1Z
Certificate of Completion
-�4 y/
Date
'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.
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, ,5-h7,� L LL --L L /-� -7L R1 C- U J2
2 S
Mailing Address ,9 4- VC, -C - 7. oz 7,1) d,4
Home Phone t1- ` JT Business Phone
2. Name on Permit if Different than Above
3. Application/Permit for: ❑ General Evaluation 9�'septic Tank Installation
4. System to Serve: f�/House ❑ Mobile Home ❑ Place of Public Assembly
❑ Business ❑ Industry ❑ Other ❑ Unknown
5. If house, mobile home: Subdivision Section Lot #
No. of People
No. of Bedrooms
No. of Bathrooms e�
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 Sinks
No. of Urinals
No. of Water Coolers
❑ Basement/Plumbing
❑ Basement/No Plumbing
Er Washing Machine
❑ Dishwasher
❑ Garbage Disposal
No. of Showers Water Usage Figures
7. Type of water supply: O'Public ❑ Private ❑ Community
8. Property Dimensions f/b X Sewage Disposal Contractor ELL 11 4-L pZ1 N /V
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:
�� 1`''j
11 2;2�
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 a lication.
DATE SIGNATURE
CONSENT FOR SITE EVALUATION TO BE DONE ON ABOVE DESCRIBED PROPERTY
MUST CHECK ONE: �1. I OWN the property. ❑ 2. I 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 representativof the avis Cealth 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 (12.90)
or
DAVIE COUNTY HEALTH DEPARTMENT
Environmental Health Section
Soil/Site Evaluation
NAME DATE EVALUATED I Li 1 _
ADDRESS S PROPERTY SIZE 1 I U
PROPOSED FACIILTY `A LOCATION OF SITE F
Water Supply: ' On -Site Well Community Public
Evaluation By:Q, ,I- Auger Boring ✓ Pit Cut
FACTORS
1
2
3 4
Landscape position
s
.S
__c
Sloe Z
- o
- --a
- L I - bo
HORIZON I DEPTH
SICL-Silty clay loam, SIL -Silty loam CL -Clay loam
SCL-Sandy clay loam
SC -Sandy clay SIC -Silty clay C -Clay
Texture groupCL
CONSISTENCE
L- L
Consistence
VFR-Very friable FR -Friable FI -Firm VFI-Very firm
EFI-Extremely firm
_
Structure
NS -Non sticky SS -Slightly sticky S -Sticky. . VS -Very Sticky
NP -Non plastic SP -Slightly plastic P -Plastic VP -Very plastic
Structure
Mineralogy
SC -Single grain M -Massive CR -Crumb GR -Granular
ABK-Angular blocky
SBK-Subangular blocky PL -Platy PR -Prismatic
HORIZON II DEPTH
Texture group
Consistence
_
Structure
�
k
Mineralogy
`A�l
I 'I
HORIZON III DEPTH
Texture group
Consistence
Structure
Mineralogy
HORIZON IV DEPTH
Texture group
Consistence
Structure
Mineralogy
SOIL WETNESS
S S
S
S S
RESTRICTIVE HORIZON
---
r-- --
SAPROLITE
—
CLASSIFICATION
S
5 S
LONG-TERM ACCEPTANCE RATE
S - l;
.3 0
—Lj
SITE CLASSIFICATION: _--s EVALUATED BY: Q4
LONG-TERM ACCEPTANCE RATE: •31 OTHER(S) PRESENT:
REMARKS:
C�
EGEND
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 - gal/day/ft2 .
DCHD(01-901
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APPLICATION FOR SITE EVALUATION/ IMPROVEMENTS PERMIT
Davie County Health Department
Environmental Health Section
P. O. Box 665
Mocksville, N.C. 27028
CONSTRUCTION SHALL NOT BEGIN UNTIL IMPROVEMENTS PERMIT HAS BEEN ISSUED.
Home Phone !ag_ y
1. Permit Requested By Ezjz� Business Phone me -
2. Address V_ 179, p 22 C_- 2.7v61-
3. Property Owner if Different than Above
Address
4. Permit To: a) Install Iter Repair
b) Privy Conventional Other Type
Ground Absorption
c) Sub -Division FOX Me -410W Sec. Lot No. 17
5. System used to serve what type facility: Housed Mobile Home Business
IndustryOther
b) Number of people
6. a) If house or mobile home, state size of home and number of rooms.
House Dimensions %2 6t5
Bed Rooms Bath Rooms Den w/Closet
b) If Business, Industry or Other, State: Number of persons served
What type business, etc.
Estimate amount of waste daily (24 hours)
7. Number and type of water -using fixtures:
commodes `Z^ urinals garbage disposal
lavatory showers. washing machine
dishwasher / sinks 1
8. a) Type water supply: Public Private Community
b) Has the water supply system been approved? Yes V No
9. a) Property Dimensions //0 J., xls
b) Land area designated to building site
c) Sewage Disposal Contractor
10. Do you anticipate any additions or expansions of the facility this sewage system is intended to serve? f�
What type?
This is to certify that the information is correct to the best of my knowledge.
Date Owner Signature
OWNER IS SOLELY RESPONSIBLE FOR COMPLIANCE WITH ALL STATE AND LOCAL LAWS
Allow 5 days for processing
Directions to property:
DCHD (6-82)
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DCHD (6-82)
DAVIE COUNTY HEALTH DEPARTMENT
Environmental Health Section
P. O. Box 665
Mocksville, N.C. 27028
SOIL/SITE EVALUATION
Names ' `u-s&^l
Address 1,97' 41 /,;W (7f'
kPV'*'4 r-- SVG -7-7o-P6
FA r..TO P.q
Date /7 " 2 3
Lot Size
116 X 2 ZS
AREA 1 AREA 2 AREA 3 AREA 4
Topography/ Landscape Position
9)
S
S
S
S
®
®
PS
PS
U
U
U
U
!) Soil Texture (12-36 in.) Sandy,
S
S
S
S
Loamy, Clayey, (note 2:1 Clay)
d!P
d!5>
PS
PS
U
U
U
U
1) Soil Structure (12-36 in.)
S
S
S
S
Clayey Soils
(5m
C�m
PS
PS
U
U
U
U
1) Soil Depth (inches)
®PS
S
S
PS
PS
PS
U
U
U
U
) Soil Drainage: InternalS
&
PS
S
PS
U
U
U
U
External
S
S
S
S
c9p
IP�
PS
PS
U
U
U
U
1) Restrictive Horizons
Available Space
S
PS
S.
PS
S
PS
S
PS
U
U
U
U
1) Other (Specify)
S
PS
S
PS
S
PS
S
PS
U
U
U
U
Site Classification
U—UNSUITABLE
Recommendations/Comments:
Described by
SITE DIAGRAM
DCHD (6-82)
S—SUITABLE �S—Provisionally Suitable
Title 51Date/ '- /7-