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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 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 i 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 ■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■M■ No MEN ■■M■O■■ ■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■ ■■■■■■■//■�■//■///■■/■■■■■/■■■■■ ■■■■■■■■■■/■■■■■■■■■■■■■■■■■■■■■■■■■■■■//■// ■■■/■MMMMMMM■■■■■■■e■ ■■■■■■■■■■■■■■■/■■■■■■■■■■■/■■■■■■■■ ■■■/■■� ■MO■M■■ ■■■■■■/■■■M■■ ■■■■■■■■■■MMMMO■■■//■■■//■/■■■■■ H■■■//■�/MM■M■/■ ■■■M■■■■■■■■■■ ■■■■■■■■■■■■■■■■■■■■■■■■■■/■■■■■ MM■■■M■M ■MMO■■M■�■■■M■■/■OM■■■M ■■■■■■■■■■■■■/■■■■■■■■■■■■■ ■■■■■■■■■■■■■■■■■■■ ■■■ MM■■ M■■■■■■■ ■■■■■■■■■■/■■■■■■■■■■■■■■■■ ■■■■■■■MMMMMMMMMMMM�■MM■�MONO�■M■■■■■■ ■■OMOOMMMM■■■■DOOM■■■■OM■■MOMOMMMOOOMOMOO■DODO MOMMMON MMMOOOMM■ ■/■■■■■■■■■■■■■■■OO■MM■MOO■■O■O■■■/■/■//�MM■=�iMMEMMEMMEMEMMEENO 0 Elmo MENNEN on ■ ■■■■■■■■■MM■■■■■■■■/■■■■■■■■■■■///■//■/DODO■/MMM ■■■■■■■■■■■■■■■■ ■■■■■■/■//■M■■MM/■■■■M■MOOMOOOM ■■�O�O■DOM■■■�O�O■MMMMMMO■■■■■M■ ■■/■■■■■■■■■■■■■■■■■■■■■■■■■■■■ ■■■■■■■H/■/■■■/■■■■■■■■■MOM■MM■ ■■■MO■■■■MM■■MM■■■■■M■■■MMMO■■■■OO■■MO■■OMOHMM�=�■■■■OOH■■■■■MM■ ■■■■■■■■■/■■■■M■O■MOO■/O■■■■■■■■■■■M�MNM■�O■MMMM�MM■MM�■OO■MM■N ■■■■■■■■MM/MM■OMM■///■■■■/■■■■■■■■ ■ ■■MOM■ ■ ■H ■■■O■■ ■ ■■■■■ ..................................�..........�OO�CMI■■M■■�■■I■■�_ ................/.........................■■.RH■O . ■■O.■■.■ ■■ ■/■■■■■■■■MMOMOM■/■■■■O■■■■/■■/■ M■M■M■M■ ■■ HMMOMM■■■■■■■■■■■ ■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■//■N■■■■■■■■■ MOM■ ■■■M■■■■MO ■■■■■■■■N■■■■■■■■■■■■■■■■■■■■■■■■■/■■■■■■■MM■MMEMO OM■■■■ ■■■■■■OMMOMMMOOO■MOOOO■■BOOM■OMM■■OOOMMOO■OM■■■ �M ■HOOD■OM� ■■■■■■■■■OOMM■OO■■MOON■■DMO■■OO■■■■■MMMMM ■■MM■ ■ ■■ ■■ MMMOMO■ .....■M......N.......................■0.�..... .O ■■■■OM■■■■■■■ ................/■■OMHO■MMMOON■ .NOH..■O/H H...... ........ ■MHMMM■■■■■■MMMM■■■■/DOM/DOM/■M�M■MMHMMMM■■ SEEN ■HM■M■ MMOMMM■M HM ■■ O■MM■■■ ■O■■ MOMMM■OMOOO■M�/OrOOMOOO■MOOOMMMMM ■ MO■■O ■■M I■■MMM■ MOOD■MMM■MOMMM■MM,►\fO■=NM■■M■■■MMHE �O �� � MENNEN MEN 5A ��■::O ■M■■M■MOMMM■M■M■M M5M■■■M■M ■■■■/MMMMO■■MMM■/.OMM■\'\\��MMMO ■■M ■■ ■ ■M ■ ■M■■■MO ■/■O■O ■■■■/// Mi\■O■ O.\MOO ■O■■ ■ ■ ■ ■M■■■■ . ■■OOOMO■■MHN■/IOD■Mi1l�iHMe��i■■M■MMM■■■ MINN ■■MM■■ ■■■■MM■■■■■M �IMMMMrMMMMH/MMMOMMMNO■O ■ MOM■M■M■ EMMENEW EMME MM■■M■M ■■■1r•K,M■MHo■■ uu■u _ No M■■■MM mom ■■MMOMMMM�OO■IMO■M■■■ MMM MMM ■��_ _ �M MNMM■M■ ■■■M■■■OO OOO,\I>•\1 1t■■r� _�-��ai s �\ ■ M■■■■■ M■O■M■DOOM■ M\�9M���1■O�I■■iOOOO�M�OMO H `BOO O ■MME H ■ ■MMM■OOOOM■�■M►�Mr�■■tIM■■■■ O■■■ ■ ■ G► ■■■MEN ■M■ ■NONE ME■■■MM■H M■■MMUMINIMUNIMMOMMEMEE Mu:L� m ■O■■M■■ M■■ M!'.�rOO� OMM ■■ MOEN No Ion 0 NOME ON ■ ■ ■■■11OOMI!:..�ii.ii����n !it an ■ MMEN ME ■e■■MMMMMNMMO■IIMr1OO■MOMMMMMMMOMM■OL1N ■O■MHS/MMM■■■MIIMN\MMM/MMM■■lO�M���O ■ ■ Mll■■r�r!■■■►l■■■■ ■■■■■■■/MMM/■■M�IOO■■■/►■MMMMI�\��M■ /MM f►MM■ItOOO ■ SM■■■■■■HM SIM■■■MM■MBSM■MOMM MMM■M HI\OM�►'OOO\1OM ■ M■M■MM � C � ■ ■I1H MMM1M■ ■ mom O ■1 ■ U■H■■ ■ M■■MM ■■■MH■t■ ■ ■ ■aIMMMMEMMM■ M ■■/■■■ ■ ■M■■MM ■\I■■MIONMEHM■M ■OM■ ■ ■■■■MO■MMM■M■MMM►S! 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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