117 River Court Lot 6Davie Countv, NC 1 Tax Parcel Report Tuesdav, February 7, 2017
161 All data Is provided as is without warranty or guarantee of any kind 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
County of Davis, North Carolina, Its agents, consultants, contractors or employees from any 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.
Parcel Information
Parcel Number:
E8110B0016
Township:
Shady Grove
NCPIN Number:
5881153153
Municipality:
Account Number:
8301010
Census Tract:
37059-803
Listed Owner 1:
DRIVER ERNEST T III
Voting Precinct:
EAST SHADY GROVE
Mailing Address 1:
PO BOX 1887
Planning Jurisdiction:
Davie County
City: CLEMMONS
Zoning Class: DAVIE COUNTY R-20
State:
NC
Zoning Overlay:
Zip Code:
27012
Voluntary Ag. District:
No
Legal Description:
LOT 6 GREENWOOD LAKE
Fire Response District:
ADVANCE
Assessed Acreage:
1.63
Elementary School Zone:
SHADY GROVE
Deed Date:
5/2012
Middle School Zone:
WILLIAM ELLIS
Deed Book / Page:
008910964
Soil Types: GnB2,GnC2,RvA,ChA,WATER
Plat Book:
0003
Flood Zone:
Plat Page:
053
Watershed Overlay:
DAVIE COUNTY
Building Value:
0.00
Outbuilding & Extra
0.00
Freatures Value:
Land Value:
45530.00
Total Market Value:
45530.00
Total Assessed Value:
45530.00
161 All data Is provided as is without warranty or guarantee of any kind 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
County of Davis, North Carolina, Its agents, consultants, contractors or employees from any 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.
Davie County Environmental Health
P.O. Box 848/210 Hospital Street
Mocksville, NC 27028
(336)753-6780 / Fax (336)753-1680
IMPROVEMENT PERMIT
Account #: 990005846 Tax PIN/EH #: E8110B0016
Billed To: Ernest Driver Subdivision Info: Greenwood Lakes Lot # 6
Address: P.O. Box 1887 Location/Address: 117 RivertCourt-27006
City: Clemmons, Property Size: 1.63 Acre
Reference Name:
PropgA (5.90t0s10091ent Permit DOES NOT authorize the construction of a wastewater system. An
Authorization To Construct a wastewater system must be obtained from this office prior to the
construction/installation of a wastewater system or the issuance of a building permit(in compliance with
Article 11 of G.S. Chapter 130A, Wastewater Systems). This Improvement Permit is subject to
revocation if site plans, plat or the intended use change.
3�
Permit Type: XNew ❑Repair ❑Expansion Permit Valid for: X5 Years ❑No Expiration
Residential Specifications: # Bedrooms_ # Bathrooms % # People 2 Basement[] Basement plumbing❑
Non -Residential Specifications: Facility Type # People # Seats
Square Footage(or Dimensions of Facility)
Design Flow(GPD):_'� Type of Water Supply: %County/City ❑Well ❑Community Well
Site Modifications/Permit Conditions:
System Type LTAR
Initial Q
Repair $
Environmental Health Specialist
i.p. 11-06
Ca /Ier-fi
APPLICATION FOR SITE EVALUATION/IMPROVEMENT PERMIT & ATC
Davie Count Environmental Health
ECE'VE y �".�1.1EDQ'
P.O. Box 848/210 Hospital Street P P I
APR 0 201D Mocksville, NC 27028 A ApR / p
' I (336)753-6780/ Fax (336)753-1680 D D
RR N BY:
Ap i ation or: tte valuation/Improvement Permit ❑ Authorization To Construct (ATC ❑ of
Type of Application: ❑New System ❑Repair to Existing System ❑Expansion/Modification of Existing System or Facility
'IMPORTANT'" THIS APPLICATION CANNOT BE PROCESSED UNLESS ALL OF THE -REQUIRED
INFORMATION IS PROVIDED. Refer to the INFORMATION BULLETIN for instructions.
APPLICANT INFORMATION
Name ��IvN;GS \ � ��� Contact Person S 1 rt&�
Address p $ Home Phone
City/State/ZIP &M;VI D, 5 C Z--)Ol: Business Phone
Ce Vt_ 33(0 --100!5-
Name
-1005
Name on Permit/ATC if Different than Above
Mailing Address
/State/Zi
PROPERTY INFORMATION *Date House/Facility Corners Flagged L - 4/— 0 -
NOTE: A survey plat or site plan must accompany this application. Included: ❑ Site Plan ❑Plat(to scale)
(Permit is valid for 60 months with site plan; no expiration with complete plat.)
Owner's Name 'rSSI E W tr'-A41t S Phone Number
Owner's Address ZOBO 1--pP j_ C k- ,,jl ct4 1ZA City/State/Zip S 4,(�,kv, 7.1 kz:1
Property Address J(-1 Tz1v42C,'�.1 fUT Liz -tom City NL
Lot Size t.G 2 AC Tax PIN# S:RSc 11`x'3153 rg1tom6lb
Subdivision Name(if applicable) G(LS (E43 W ooh s Section/Lot,# C,,
Directions To Site: 1 SR "TD voAm5 cook �J
If the answer to any of the following questions is-"Yes",supporting documentation must be attached:
Are there any existing wastewater systems on the site? _Yes VKo ✓N
Does the site contain jurisdictional wetlands? _Yes _ o
Are there any easements or right-of-ways on the site? Yes •✓No
Is the site subject to approval by another public agency? ^_Yes ✓No
Will wastewater other than domestic sewage be generated? _ Yes VNo
IF RESIDENCE FILL OUT THE BOX BELOW
# People —_ # Bedrooms 1# Bathrooms `� Garden Tub/Whirlpool ❑Yes o
Basement: Oyes ❑No Basement Plumbing: 0< es ❑No
IF NON -RESIDENCE FILL OUT THE BOX BELOW
Type of Facility/Business Total Square Footage of Building # People
# Sinks # Commodes # Showers # Urinals
Estimated Water Usage (gallons per day) (Attach documentation of similar facility water consumption)
FOODSERVICE ONLY: # Seats
Type system requested: ❑Conventional ❑Accepted ❑Innovative ❑Alternative- ❑Other.
Water Supply Type: County/City Water ❑ New Well ❑Existing Well ❑ Community Well
Do you anticipate additions or expansions of the facility this system is intended to serve? ❑ Yes ❑ No
If yes, what type?
This is to certify that the information provided on this application is true and correct to the best of my knowledge. I understand
that any permit(s) or ATC(s) issued hereafter are subject to suspension or revocation if the site is altered, the intended use
changes, or if the information submitted in this application is falsified or changed. I hereby grant right of entry to the Authorized
Representative of the Davie County Health Department to conduct necessary inspections to determine compliance with applicable
laws and rules. I understand that I am responsible for the proper identification and labeling of property lines and corners and
locat, nd a ing or staking the house/facility location, proposed well location and the location of any other amenities.
Site Revisit Charge
Property owner's or owner's legal representative signature
i Date(s):
\2 Client Notification Date:
Date EHS:
Sign given ❑Yes ❑No Account #
Revised 11/06 Invoice #
1 I —1 )ZAv e1Z C
k-!,Dj r-w-� cF- N C-
yv d c rD�D 800R1.i.tL.YAGi.Lry �
Mai1To: •" � i.
WARRANTY DEED—Form WD -601 Printed and (or ask by James Williams a Co., Inc., Yadkuiville. N. C.
STATE OF NORTH CAROLINA, __Dayla County.
THIS DEED, Madc this __._ __day of — , 1983 , by std betwrsn Bradford M. Dixon
and wife, Carolyn Cr Dixon tui Davie County
and itatc of North Carolina, hereinafter called Grantor, and Rufsoa Vwgo]eymyars and wife,
—Jesse g_Wa._1 41.Ca.--- )$yj.4 County and State of Monk Cardw,hereinafser
called Grants•, who, penman n,nuilinttaddress'ds—_._..,_.._,.�.....__:....... .___..___ ,�,. '
WITNESSETH: Tlut the Grantor, for and in consideration of the sem uf
and otter good and valuable considerations to Not in hand paid by the Granter, the receipt whereuf is hereby acknuwledaed, has given, granted, bargained, sol
,
and conveyed, and by these presents does rive, grant, bargain, sell, convey and confirm unto the Grantee, his heirs and successors and assignspremises in
_.__...Dav18_--__-:—_County. North Carolina, described u fellows:
BEING LOT Six (6) Block five (5) Greenwood Lakes Subdivision according to a,
plat recorded in Map Book 3, Page 53, Davie County Regiatty to Which reference,
is hereby made for a more particular description as if fully set forth herein.
F
NoAAT[ lC[[TAT[
AX [XCI[[ TalX
0 _ .*5.00
a
Thr above land was conveyed to Grantor by - —.3" Adult No. , Page
TO HAVE AND TO HOLD The about deu6bed premises, with all the appurtemacts thereunto belonging, or M amy wise apptrtaknin& tmto the Gramw, hiss
heirs andlor successors and assigns furver.
Attd the Grantor covenants that he is wired of mid promises in fee. and has the riot to convey the sates in its slmple) that said ptasaises are free from em-
cumbrances (with the exceptions above stated, if any); and that he will wa r r a a t and defend the said title to the wee agaMut the la v6sl claims *fall penorn
whmnn,ever. '
i Whef 'r0.rujulik to the Grant u , Grantee. the singular shall include the plural and the masculine sW include the feminine th
or e neuter.
IN ITNES 1 1 ') Gr sur is reutttu see his hand and wA. de day and year fust above written.
(SEAL) (SEAL)
(SEAL) ` (SEAL)
• STATE OF NOr .�—RTH CA )LI A— �aJ COUNTY.
t. ___T�.=!'._-... -. 'tG�..."7rs.'.+xt.—_.�_._.., a Notary Public of saW County, do hereby t:rrd43bit ;...:::_•
Srad,(ord.?(,—Dixon. rad w e4xon t,7&
Grautot, personally appeared before the this day and acknowletdWil the execution of the foregoing deed t _ �+r� • - d
Witness tohand and notadal mal, this the ___.
y / p �.�__day of
My Comntissinn Expires:131
STATE OF NORTH CAROLINA—_..._._COUNTY, ••rirrho.•:`'„a ,..
i,Notary Public of mid County. do hereby certify that _._.
Grantor. personally appeared before me this day and acknowledged the execution *(the foregoing decd. —_
Wit,,Ls my hand and nutuial seal, this the. day of
My Commission Expires: _._. _____—_...._._ , N. P. (SEAL)
SPATE OF NORTH CAROLINA,_.,__ Dav:Lf3_.__..____.coUNTY.
The fa,rcgoing certifkate(11j uf__ ei__._ ...,. _ _ sM,P+ ry P�,u.G_�W2 to -
Is (XXcertified to lee correct.. This inurwnent was p—med for registration this-7th-_ day of 1 Ism.
XM, P. M., and duly recorded in the office of the Rvgister of Deeds of I�nYie _County
North Carolina, in souk ._119_, Page
Thi; the _ 7th _.day nr---- i1._.� __ . A. D.. )983.J--
__—_ J,._K.._.511tith.__—._-'----- —
Register of Deeds slsunt.j111M Reghter ofDetda
This Deed drawn b- iGeorge W. Martin, -Martin b Van Hoy Attorneys -
y
APPLICANT INFORMATION
Account #: 990005846
Billed To: Ernest Driver
Reference Name:
Proposed Facility: Residential
DAVIE COUNTY HEALTH DEPARTMENT
Environmental Health Section
Soil/ Site Evaluation
PROPERTY INFORMATION
Tax PIN/EH #: E8110B0016
Subdivision Info: Greenwood Lakes Lot # 6
Location/Address: 117 RivertCourt-27006
Property Size: 1.63 Acre Date Evaluated:
Water Supply: On -Site Well Community Public
Evaluation By: Auger Boring % Pit Cut
FACTORS
1 2 3,
4 5
6 7
Landscape position
'
Sloe %
o
HORIZON I DEPTH
- -
- -
Texture group
G G
Consistence
Structure
''(0.'-A/-- -AX e
N-
Oe
Mineralogy
HORIZON R DEPTH
lb -
Texture group
G
C -L
Consistence
-
-
Structure
G
Cly
Mineralogy
17
1
HORIZON III DEPTH
-
Texture group
14f ,H
Consistence
Structure
Mineralogy
HORIZON IV DEPTH
Texture group
Consistence
Structure
Mineralogy
SOIL WETNESS
L 2 ;0"
RESTRICTIVE HORIZON
SAPROLITE
CLASSIFICATION
P S
LONG-TERM ACCEPTANCE RATE
q
SITE CLASSIFICATION: 25
LONG-TERM ACCEPTANCE RATE:
REMARKS:
LEGEND
EVALUATION BY:
OTHER(S) PRESENT:
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
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
lYates
Horizon depth - In inches
Depth of fill - In inches
Restrictive horizon - Thickness and inches from land surface i
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 05105 (Revised)
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•- ' `} ` ' DAVIE COUNTY HEALTH DEPARTMENT
(Septic Tank) Improvements Permit and Certificate of Completion
(Ground Absorption Sewage Disposal System - G.S. Chapter 130 -Article 13C)
OWNER R CONTRACTOR f„� PERMITDT
N
LOCATION r 573
o )
_ a � 1l re.,.� t 'i',_ 4 � ,n . ^�) ..- "'iJr:/ ":. `? 'F� cYe: r� �
S.R. NO.
SUBDIVISION NAME j LOT NO. SECPON OR BLOCK NO. ~
kcS ti
HOUSE W MOBILE HOME ❑ BUSINESS
NO. BEDROOMS �4 NO. BATHROOMS
GARBAGE DISPOSAL UNIT YES 9' NO ❑
AUTO. DISHWASHER YES 00' NO ❑
AUTO. WASH. MACHINE YES JRr NO ❑
SITE SUITABLE YES ffK NO ❑
SIZE OF TANK 1e -,D gal.
NITRIFICATION FIELD sq. ft.
DEPTH OF STONE IN LINES:
WATER SUPPLY: Individual Public ❑
IMPROVEMENTS PERMIT BY
House Trailer
800 Gal.
400
Sq. Ft.
Two Bedroom House
800 Gal.
600
Sq. Ft.
Three Bedroom House'
(�1O�OOGal120Four Bedroom House0
Sq. Ft.
1.1.,5 C. k
INSTALLED
CERTIFICATE OF COMPLETION
By Date _"'
(8/16/73) *Construction must compl it 11'0 appl ca lehate and local regulatFi$ns
LOT AREA
1� "I