155 Brockland Drive Lot 66Davie Countv. NC
1,
Tax Parr Pl R Pnnrt
Tuesday. January 3, 2017
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:
WAK1V11VU: 1111)1J1VVI AJUKVEI
Parcel Information
H7020A0003
Township:
5769864691
Municipality:
57294000
Census Tract:
POINDEXTER ELLA MAE
Voting Precinct:
155 BROCKLAND DRIVE
Planning Jurisdiction:
ADVANCE
Zoning Class:
Land Value:
Total Assessed Value:
NC Zoning Overlay:
27006-0000 Voluntary Ag. District:
LOT 66 GREEN BRIER Fire Response District:
9 PIE
0.89 Elementary School Zone:
8/1989 Middle School Zone:
001500341 Soil Types:
0005 Flood Zone:
099 Watershed Overlay:
Outbuilding & Extra
Freatures Value:
Total Market Value:
Shady Grove
37059-804
WEST SHADY GROVE
Davie County
DAVIE COUNTY R -A
ADVANCE
SHADY GROVE
WILLIAM ELLIS
EnB
DAVIE COUNTY
ire
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County of Davie, North Carolina, its agents, consultants, contractors or employees from any and all claims or causes of action due to
nOU Nva
NC f or arising out of the use or Inability to use the GIS data provided by this website.
DAVIE COUNTY HEALTH DEPARTMENT'
IMPROVEMENTS PERMIT AND CERTIFICATE OF COMPLETION
"NOTE: Issued in Compliance with G.S. of North Carolina Chapter 130 Article 13c
Sewage Treatment and Disposal ules (10 NCfAC 10A .193 - 1968) Permit Number
Name ��- �� �^,�� ,� � � <s F� Date
Location
Subdivision Name Lot No. Sec. or Block No.
Lot Size House Mobile Home Business Speculation
No. Bedrooms — No. Baths =27 No. in Family —:L
Garbage Disposal YES ❑ NO Q-- Specifications for System:
Auto Dish Washer YES NO ❑
Auto Wash Machine YES NO ❑
Type Water Supply __—
*This permit Void if sewage system described below is not installed within 36 months from date of issue.
Improvements permit by /4`z
*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: SystewA talled by4—A
1 91
io 'I 16v
0
Certificate of Completion Date �� U
"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.
Address
U—UNSUITABLE S—SUITABLE P�visionaliy Suitable
Recommendations/Comments:
Described by , �1 / Title �"'� Date r
SITE DIAGRAM
DAVIE COUNTY HEALTH DEPARTMENT
Environmental Health Section.
R O. Box 665
Mocksville, N.C. 27028
)
SOIL/SITE EVALUATION
4, le v le-
PAr.TnRC
AREA 1 ARFA 9
Date ell S
Lot Size
AREA 3 ARFA 4
1) Topography/ Landscape Position
2)
3)
4)
5)
6)
7)
8)
9)
A.
f
1
Address
U—UNSUITABLE S—SUITABLE P�visionaliy Suitable
Recommendations/Comments:
Described by , �1 / Title �"'� Date r
SITE DIAGRAM
DAVIE COUNTY HEALTH DEPARTMENT
Environmental Health Section.
R O. Box 665
Mocksville, N.C. 27028
)
SOIL/SITE EVALUATION
4, le v le-
PAr.TnRC
AREA 1 ARFA 9
Date ell S
Lot Size
AREA 3 ARFA 4
1) Topography/ Landscape Position
2)
3)
4)
5)
6)
7)
8)
9)
A.
(S�
-D
��
PS
U
U
U
U
Soil Texture (12-36 in.) Sandy,
S
�£p
S
<n-)
SS-
�
-
Loamy,
Loamy, Clayey, (note 2:1 Clay)
Com'
U
U
U
U
Soil Structure (12-36 in.)
Clayey Soils
S
&311
S
d§�
S
P7
V
-6
U
U
U
Soil Depth (inches)
S
'
U
U
U
U
Soil Drainage: Internal
S
U
U
U
External
S
(SS
S
Restrictive Horizons
Available Space
S
PS
S
PS
S
PS
S
PS
U
U
U
U
Other (Specify)
S
PS
S
PS
S
PS
S
PS
U
U
U
U
Site Classificationi
DCHD (6.82)
1
APPLICATION FOR SITE EVALUATION/IMPROVEMENTS PERMIT
Davie County Health Department
Environmental Health Section
P. O. Box 665 RECEIVED AUG
Mocksville, N.C. 27028
CONSTRUCTION SHALL NOT BEGIN UNTIL IMPROVEMENTS PERMIT HAS BEEN ISSUED,
Home Phone
`Business
t. Permit ReyuslePhone
d By ��n.�A��-----.�---ti.x9.�,. _�`�-� s
2. Address
3. Property Owner if Different than Above ___ �ci i�4b�. _ � _ __ __._.___
Address _.. �`� • _ - - - ---------- - -----
4. Permit To: a) Install-- Alter-_. Repair___
b) Privy Conventional— Other Type -_.-
Ground Absorption �(
c) Sub-DivisionSec.____-_-- Lot No._66- �.-.Y� I ��
5. System used to serve what type facility: House—_ Mobile Home_. -X, Business-__.
Industry.____ Other__—
b) Number of people _
' . a) If house or mobile home, state size of home and number of rooms.
House Dimensions 10
Bed Rooms— Bath Rooms13Den 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.
ours)_ _..-_.._7. Number and type of water -using fixtures:
commodes-. ..----_- urinals_..__.. __ ___- garbage disposal
lavatory showers _____._._ _.__ _.___ ___ washing machine -.-
dishwasher ___-__ sinks
8. a) Type water supply: Publics—_ Private..---.-_ Community
b) Has the water supply system been approved? Yes__.K__ No. -
0. a) Property Dimensions__ -
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? -IND__
What type? - -- -- - -- -
This is to certify that the information is correct to the best of my knowledge.
9a-11 211_
Date/Owner Signat re
OWNER IS SOLELY RESPONSIBLE FOR COMPLIANCE WITH ALL STATE AND LOCAL LAWS
Allow 5 days for processing
Directions to property:k l 1� -- �� p j� j�,�ur�gr,s1� C a
j k M's. ?b'-VJK4A.
DOID (6.82)
L 40
�• o•� t1
r{. -'f, ��� .' VS fes; - . c=..�-•--ad'N,?`,y'.d� "j... ".•♦r�.v'6-.t ,f `: � V ,
'+ DAVIE COUNTY HEALTH DEPARTMENT
.T ;IMPROVEMENTS PERMIT AND CERTIFICATE OF. COMPLETION
r
-*NOTE: Issued in Compliance With Article 11 of G.S. Chapter,130a
Sanitary Sewage Systems !' (( p' Permit Number
Name'�C���. Date t / NO
- 8060
Location t ,� i' �r a �. � +lsc �� 6 u �t :ra . �r
log f;
Subdivision Name !'E'e �` /�1 �' Lot'No. �_ 'Sec. or Block No.
_ 't
Lot Size House Mobile -Home ___' Business. Industry
No: Bedrooms ' 'No;,Bat ' — __t.No. in Family. Public Assembly Other
Garbage Disposal `YES 0 NO r 's[ j�` '
Specifications for System:
Auto Dish Washer. YES ❑ NO [.4 r, -
Auto Wash'Ma^hine YES -p N0 ;0
"Type Water Supply'=- =-- --- j�
This permit Void if se'wage 'system des,cribe&below is not installed.within, 5'years,from.date of issue.'
This,permit is subject to revocation if site plans or the intended use,change
ATTENTION: YOURSEPTICSYSTEM CONTR6
CTOR MUST SEE THIS PERMIT/LAYOUT BEFORE INSTALLING THIS
-SYSTEM.
a
:. 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.,
1:00-1:30 P.M, or 4:30-5:00.P:M. on day of completion. Telephone Number: 704-634-5985.
Final Installation DiagramSystem Installed by
i
t t VF'N.
/00 • n
m • 116.,. �.P ' iY
Certificaterof"Cbmpl{etion Date _
'The signing of this certificate shall indicate that, the system described above has been installed in compliance with
the standards set forth in theabove regulation; bute,shall in,NO.way be as a guarantee that the system will function
satisfactorily for any given period of.time: -. :?
• ". R , ` j� � � 1'f tl it
- APPLICATION FOR SITE EVALUATION/IMPROVEMENTS PER T
Davie County Health Department JUN —5 10
Environmental Health Section
P. O. Box 665
Mocksville, NC 27028 ENVI .1114ENTAt I T�H LTH
1. Application/Permit Requested By
Mailing Address Vr-IJ of �}�+c��N E L-, Home Phone h ti U
Business Phone 9 2 g 0agQ
2. Name on Permit if Different than Above
3. Application for: ❑ General Evaluation 5Y eptic Tank Installation Permit
4. System to Serve: ❑ House l vMoblle Home u riace OT ruooc f+ssemory
❑ Business ❑ Industry ❑ Other ❑ Unknown
5. If house, mobile home: Subdivision 6ccP7A 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 Sinks
No. of Urinals
No. of Lavatories No. of Water Coolers .
No. of Showers Water Usage Figures.
7. Type of water supply: Public ❑ Private
8. Property Dimensions w o "WT LIDO Sewage Disposal Contractor
9. Do you anticipate additions/expansion of the facility this sytem is intended to serve?
If yes, what type?
❑ Yes �K-No
❑ 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:
Ile IX
ria r dr<f - ,�r-oe%C l� h ,� r- o
tea- M e /0�-
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. p r� �% I.
(,s - I J JLC4- 1��
DATE SIGNATURE
F
ONSENT FOR SITE EV�ALLUATION TO BE DONE ON ABOVE DESCRIBED PROPERTY
CK ONE: CU 1. I OWN the property. ❑ 2. 1 DO NOT OWN the property.
ked Box #2, the rest of this form MUST be completed by the owner or a person authorized by the owner:
e consent to the authorized representative of the Davie County Health Department to enter upon above described
ated in Davie County and owned by
all testing procedures as necessary to determine said site's suitability for a ground absorption sewage treatment
al system.
DATE SIGNATURE
DCHD (1193)
DAVIE COUNTY HEALTH DEPARTMENT
Environmental Health Section
Soil/Site Evaluation
NAME S�a'��� \�. �a� DATE EVALUATED -n -cis
ADDRESS �"�� PROPERTY SIZE 1 b a x
PROPOSED FACIILTY ��"
LOCATION OF SITEN-
Water Supply:
On -Site Well _
Community
Public
Evaluation ByC
Auger Boring
Pit
Cut
Sloe %
4,- 5
��,
.it�Y l
FACTORS
1
2
3 4
Landscape position
Sloe %
4,- 5
HORIZON I DEPTH
"
1'
Texture group
Q_1V_
Consistence
`�
Structure
C�
C
Mineralogy,
\ �\
•�
HORIZON II DEPTH
LA
vsll2
Texture group
Consistence��-
Structure
�k
P
Mineralogy
`
HORIZON III DEPTH
Texture group
Consistence
Structure
Mineralogy
HORIZON IV DEPTH
Texture group
Consistence
Structure
Mineralogy
SOIL WETNESS
5
RESTRICTIVE HORIZON
/
SAPROLITE
CLASSIFICATION
.S
LONG-TERM ACCEPTANCE RATE
SITE CLASSIFICATION: �' EVALUATED 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 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 -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
DCHD(01-901
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i DAME COMM HEALTH DEP ART 1ENT
ENVI 0111.'EUTAL HEALTH SECTION
SOIL/SITE. EVALUATIO17
1?Alm f7o�c J4,�o�i��rCJ DATEZ-
ADDRE S S
LOT SIZE /6 G YV b
TOPOGRAPHY: ?S
SOIL TE:.TURE: is
SOIL STRUCTURE:^J
DEPTH: 3- 3 /z
RESTRICTIVE HORIZOI?S: 32"'
PERCOLATION PATE:
1.
2.
3.
LOCATI01
ee,,oe Zol -'x 6G
,&— 0
rrrvi{ ,O/.flf%c C /o y
Presoak Hark & time Drop Time Rate/ iir.. Inch
***CLASSIFICATI01?: `
Suitable Provisionally Suitable Unsuitable
C015JEUTS: p<,e,e ,C�l1a/,41 /h �'�� ,S<, . G 0. 7 /j 77
SAA?ITARIAN
SITE DIAGRAPi
X /z fax