334 River Road Lot 711
Davie County. NC
Tax Pnrnel R ennrt
Wednesday, January 11, 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:
WARN IIN G:THIS 1S 1VUT A SURVEY
Parcel Information
E8110B0013
Township:
5881045670
Municipality:
8304081
Census Tract:
LARUE STERLING RICHARD
Voting Precinct:
334 RIVER ROAD
Planning Jurisdiction:
ADVANCE Zoning Class:
NC Zoning Overlay:
27006 Voluntary Ag. District:
LOT 7 GREENWOOD LAKE Fire Response District:
Land Value:
Total Assessed Value:
1.24 Elementary School Zone
9/2014 Middle School Zone:
009670796 Soil Types:
0003 Flood Zone:
053 Watershed Overlay:
Outbuilding A Extra
Freatures Value:
Total Market Value:
Shady Grove
37059-803
EAST SHADY GROVE
Davie County
DAVIE COUNTY R-20
ADVANCE
SHADY GROVE
WILLIAM ELLIS
Gn132
DAVIE COUNTY
[Me
q 1'm�li`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
County of Davie, North Carolina, its agents, consultants, contractors or employees from any and all claims or causes of action due to
NCor arising out of the use or Inability to use the GIS data provided by this website.
DAVIE COUNTY HEALTH DEPARTMENT
Environmental Health Section
P. O. Boa 848/210 Hospital Street
Mocksville, NC 27028
(336)751-8760
Account #: 989900215
Billed To: J. Franck Construction, Inc.
Reference Name: Joe Franck
Proposed Facility: Residence
ATC Number: 2400
33L{ Ri de , 12d
Tax PIN/EH #: 5881-04-5670.07
Subdivision Info: Greenwood Lakes Sec.4 Lot # 7
Location/Address: Underpass Road -27006
Property Size: 1.3 Acres -
AUTHORIZATION FOR WASTEWATER SYSTEM CONSTRUCTION
**NOTE** This Authorization for Wastewater System Construction MUST BE ISSUED by the Davie County Environmental
Health Section prior to issuance of any building permit(s). This Form/Authorization Number should be presented to
the Davie County Building Inspections Office when applying for building permit(s) (in compliance with Article 11 of
G.S. Chapter 130A, Wastewater Systems, Section .1900 Sewage Treatment and Disposal Systems). THIS
AUTHORIZATION FOR WASTEWATER CONSTRUCTION IS VALID FOR A PERIOD OF FIVE YEARS.
Environmental Health Specialist's Signature:
3 Pedeoom , &n&
CERTIFICATE OF COMPLETION
**NOTE** The issuance of this Certificate of Completion shall indicate the system described on Improvement/Operation Permit
has been installed in compliance with Article 11 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.
Septic System Installed By:
Environmental Health Specialist's Signature:
DCHD 05/99 (Revised)
—CSG Z//—
/
Awd
&M
4
Date: 3 —00
DAVIE COUNTY HEALTH DEPARTMENT
Environmental Health Section /
r P. O. Boa 848/210 Hospital Street
Mocksville, NC 27028
(336)751-8760
IMPROVEMENT/OPERATION PERMIT
Account #:
989900215
Tax PIN/EH #:
5881-045670.07
Billed To:
J. Franck Construction, Inc.
Subdivision Info:
Greenwood Lakes Sec.4 Lot # 7
Reference Name:
Joe Franck
Location/Address:
Underpass Road -27006
Proposed Facility:
Residence
Property Size:
1.3 Acres
**N `f' b (Pent/Operation Permit DOES NOT authorize the construction 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 1 l of G.S. Chapter 130A, Wastewater Systems, Section .1900 Sewage Treatment and Disposal Systems). THIS
PERMIT IS SUBJECT TO REVOCATION IF SITE PLANS OR THE INTENDED USE CHANGE. YOUR
WASTEWATER SYSTEM CONTRACTOR MUST SEE THIS PERMIT BEFORE INSTALLING SYSTEM.
Residential Specification: Building Type M #People � #Bedrooms �BathS
Dishwasher: M ----Garbage Disposal: 131--V--ashing Machine: t9 ----"Basement w/Plumbing: ❑ Basement/No Plumbing: ❑
Commercial Specification: Facility Type #People #People/Shift #Seats Industrial Waste: ❑
//d:�>v —
Lot Size . 14 S Type Water Supply Design Wastewater Flow (GPD) *,Site: New L3"/ Repair ❑
rI n
System Specifications: Tank Size/ GAL. Pump Tank GAL. Trench Widt}� Rock Depth � Linear Ft. 00
Other: /W47 VoeI
C]
Required Site Modifications/Conditions:
RE
IMPROVEMENT/OPERATION PERMIT LAYOUT - APPROVED EFFLUENT FILTER RISER(S) IF 6 " BELOW
FINISHED GRADE. ****NOTICE: Contact a representative of the Davie County Health Department for final inspection of this
system between 8:30 a.m. to 9:30 a.m. or 1:00 p.m. to 1:30 p.m. on the day of installation. Telephone # is (336)751-8760.****
• j'(J�l .A� /1 I
l/ 0
0
Environmental Health Specialist's Signature:
DCHD 05/99 (Revised)
(� 0
(146,
Date: — / J "Cp
9 q � ki .eDAVIE COUNTY HEALTH DEPARTMENT lf
(Septic Tank) Improvements Permit and Certificate of Completion
(Ground Absorption Sewage Disposal System - G.S. Chapter 130 -Article 13C)
OWNER OR CONTRACTOR rt I `C—& .ISE Y jC- ff h e w J _ DATE 7-:L,0— J at, PERMIT
LOCATIONS! f/ ttr ,�° ` ��' _ N°- 178
CERTIFICATE OF COMPLETION r '1 c
By :�u L— '.'•'�.6�,.. ta-` Date
�O'
(8/16/73) *Construction must c mply with all other applicable State and local regulations
LOT AREA'
s
i
s''
S. R.
NO.
SUBDIVISION NAME f 're'3; �_.�«."sc
iCk"BLOT
N0. SECTION OR
BLOCK NO.
HOUSE ❑ MOBILE HOME BUSINESS ❑
House Trailer 800
Gal. 400 Sq.
Ft.
NO. BEDROOMS +,. N0. BATHROOMS
Two Bedroom House 800
Gal. 600 Sq.
Ft.
GARBAGE DISPOSAL UNIT YES ❑ NO
❑
Three Bedroom House 900
Gal. 900 Sq.
Ft.
AUTO. DISHWASHER YES ❑ NO
❑
Four Bedroom House 1000
Gal. 1200 Sq.
Ft.
AUTO. WASH. MACHINE YES ❑ NO
❑
SITE SUITABLE YES ❑ NO
❑
:►,.
SIZE OF TANK gal.
NITRIFICATION FIELD 44W
sq. ft.
DEPTH OF STONE IN LINES: _
00
WATER SUPPLY: Individual Public ❑
IMPROVEMENTS PERMIT BY C
I INSTALLED BY
CERTIFICATE OF COMPLETION r '1 c
By :�u L— '.'•'�.6�,.. ta-` Date
�O'
(8/16/73) *Construction must c mply with all other applicable State and local regulations
LOT AREA'
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15K 3 Pb 53
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APPUCATION FOR SITE EVA111AT10N/IMPROVEMFM PFAMR & Al D N @ R 0 W1 R
Davie County Health Department
Envfiunmental Hesifh Serdon
ta
P.O. Box 848/210 Rospil Street 2 5 no
Mockaville, NC 27028
(336)751-8760 E IV1R0NP,IEyTAL HEALTH
***nfP01RTAXT*** THIS APPLICATION CRMWT BZ PX=8811D U1M888 ALL THE REQ D
IN>M M1►TION 18 PROVIDED. Rater to the M=MATICN BULLETIN for instructions.
i.
Mame to b. Allied - r��Czl? G /�
��vsT_L,G Contact person or cr
Hailing Aero.. CP w 'Oe
.e some shone
City/stat•/azo //e+t .C'S e! i� .0 P il/
.2? O an ftone /757, h '/ 7 - --2,0
6 6-
2.
Z.
Mama on ?erait/nTC it Different than &bon
Nailing Address
Ci ty/ Mite/nip
a.
Applioation For: 0 Bite Evaluation
C'iZrovement Permit/ATC
0 Both
e.
system to service: ErRouse 0 Mobile Boma 0 Business 0 Industry 0 other
S.
ifResidence: # People
i Bedrooms Z4 # Bathrooms
3
A oiahrseher 0earbage Disposal V -'Washing Hobine ? o masa nt/plunhing 0 nasuant/Mo plumbing
6. zf ausiness/Industry/other: specify type
# Commodes
# people # sinks
# showers # urinate # Rater Coolers
I1' r=SERVICE: / Seats Estimated Rater Usage (wazons per day)
7. Type of rater supply: 0 County/City 0 Well 0 Community
9. Do you anticipate additions or expansions of the faeWty this system is Intended to serve? 0 Yes eNo
If yes, what type?
***IMPORTANT*** CLIENTS MUST COMPLEW THE REQWRED PROPERTY INFORMATION REQUESTED
BELOW. Either a PLAT or SITE PLAN MUST BESVBW77ED by the client with TUN APPUCATION.
Property Dimensions:.25�/
Tai Office PIN:
Property Address: Road NameZ/ We,,, s
City/Llpoluczne e /fl G
Ii In a Subdivision provide Information, as follows:
Name: Ze7 ke.r
Section: -5e— Block: Lot: 2_
WRITE DIRECTIONS (from ModuMlle) to PROPERTY:
o
Date Property Flagged: _r % 00 -
This is to certify that the information provided Is cornet to the best of my knowledge. I understand that any permit(s)
Issued hereafter are subject to suspension or revocation, if the dee plans or intended use change, or if the Information
submitted in this application Is falsified or changed I, also, understand that I am responsible for all charges Incurredfrom
this application. 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 y 5 -
to
to conduct aU testing procedures as necessary to determine the site suitability.
DATE :LlZa SZ 0 SIGNATURE
THIS AREA MAY BE USED FOR DRAWING YOUR SITE LAN (Include all of the following: Existing and proposed
property Uses and dimensions, structures, setbacks, and septic locations).
Site Revisit Charge
Date(s):
Client Notification Date: ,r
EHS:
Revised DCHD (07/99)
Account No.
Invoice No.
+ APP,UCATION FOR SITE EVALUATION/IMPROVEMENT PERMIT & ATC
G� Davie County Health Department
Environmental Hee1W Seciftr
P.O. Box 848/210 Hospital Street
Ci �J Mockeville, NC 27028
a/ (336)751-8760
C 9WR
, .2319%
VIVIRONNIEWAL HEALTH
DAVIE COUNTY
***IMl?O1tTAN`T*** THIS APPLICATION CANNOT BE PIWMSSZD UNLESS ALL THE REQUIRED
INFORMATION IS PROVIDED. Refer to the INFORMATION BULLETIN for instructions.
1. Llama to be Billed Contact Person
Mailing Address,,�� (� C�IUI� Home Mone
%%�
City/state/L2P I�-a LL ka- I N � 02 � Business Phone
2. Name on Permit/ATC if Different than
Mailing Address City/State/sip
3. Application For: 9 -9 -its Evaluation ❑ Improvement Permit/ATC ❑ Both
4. system to service: use ❑ Mobile Rome ❑ Business ❑ Industry ❑ Other
s. If Residence: i People t Bedrooms 3 • Bathrooms _
8't shwashew El -Garbage Disposal thing Machine ❑ Basement/Plumbing ❑ Basement/No plumbing
S. Zf Business/Industry/other: specify type f People 4 sinks
* Commodes f showers i Urinals + Water Coolers
IF FOODSERVICE: # Seats Estimated Yater Usage (gallons per day)
7. Type of Nater supply: aunty/City ❑ Well ❑ Community
9. Do you anticipate additions or expansions of the facility this system is intended to serve? ❑ Yes 9-K0—
If yes, what type?
***IMPORTANT*** CLIENTS MUSTCOMPLETETHE REQUIREB PROPERTY INFORMATION REQUESTED
BELOW. Either a PLAT or SITE PLAN MUST BE SUBMITTED by the client with THIS APPLICATION.
Property Dimensions:
Tax OHlce PIN: # , ^O C// —.52;70
Property Address: Road Name ' 4rh�5
City/Zip 'UcQ
If in a Subdivision provide Information, as
follows:
Name: all f�-dQ-e--5
Section: Block: Lot: k
WRITE DIRECTIONS (from MockrAlle) to PROPERTY:
/'-Fr F cm/s
Ili W/ tWA
Date Property Flagged:
This Its to certify that the information provided Is correct to the best of my knowledge. I understand that any permit(s)
Issued hereafter are subject to suspension or revocation, if the site pians or Intended use change, or if the Information
submitted in this application Is falsified or changed. I, also, understand that I am responsible for all charges Incurred from
this appllcallom 1, hereby, give consent to the Authorized Representative of the Davie C un Heslt Department
to enter upon above described property located In Davie County and owned by iZ
to conduct all testing procedures as necessary to determine the site sults llity.
DATE � kL-L J/, / Rqq SIGNATURE �I/�,�,ll,(� r4
THIS AREA MAY BE USED FOR DRAWING YOUR SITE PLAN (Include aR of the following: Existing and proposed
property lines and dimensions, structures, setbacks, and septic locations).
Site Revisit Charge
Date(s):
Client Notification Date:
I EHS:
Revised DCHD (07/99)
Account No.
Invoice No. ��
k4w
IW VMM'-.
APPLICANT INFORMATION
Account #:
990000692
Billed To:
Bob Tiller
Reference Name:
Bob Tiller
Proposed Facility:
Residence
DAVIE COUNTY HEALTH DEPARTMENT
Environmental Health Section
Soil/Site Evaluation
PROPERTY INFORMATION
Tax PIN/EH #: 5881404-5670
Subdivision Info: Greenwood Lakes Sec. 4 Lot # 7
Location/Address: Underpass Road -27006
Property Size: 1.3 Acres Date Evaluated:')
Water Supply: On -Site Well Community
Evaluation By: Auger Boring d/ Pit
Public
Cut
FACTORS
1 2 3 4 5 6 7
Landscape position
Sloe %
HORIZON I DEPTH
Texture group
Consistence
Structure
Mineralogy
HORIZON II DEPTH
Texture group
Consistence
Structure
Mineralogyl
'
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:
EVALUATION BY: WO,
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 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 05/99 (Revised)
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BAYIE COUNTY HEALTH D���TIGI�NT
ENVIRONMENTAL HEALTH SECTION
P. O. Box 848/210 Hospital Street
Courier #09-40-06
Mocksvilie, NC 27028
Phone #: (336)751-8760
August 10, 1999
Mr. Bob Tiller
333 River Road
Advance, NC 27006
Re: Site Evaluation/Underpass Road, 1.3 Acre
Tax Office PIN: #5881-04-5670
Dear Mr. Tiller:
As requested, a representative from this office visited the aforementioned site on
August 10, 1999. Based upon the information provided on the Application for Site
Evaluation and after an evaluation was completed on the site, the site was found to be
provisionally suitable for the installation of an on-site sewage system.
Before an Improvement Permit/Authorization to Construct can be issued the appropriate
application must be filled out and the house/mobile home location staked off.
If you have any questions, please feel free to contact this office.
Sincerely,
Robert B. Hall, Jr., R.S.
Environmental Health Specialist
RH/mp
Enclosure(s)