183 Palomino Road Lot 3Davie County, NC I Tax Parcel Report Thursday. January 26. 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:
WARNING: TtllS 1S NOTA SURVEY
Parcel Information
H9090A0003
Township:
5789757094
Municipality:
82528305
Census Tract:
SUTTON TIMOTHY T
Voting Precinct:
183 PALOMINO ROAD
Planning Jurisdiction:
ADVANCE
Zoning Class:
NC
Zoning Overlay:
27006-0000
Voluntary Ag. District:
TRACT 3 HIDDEN MEADOW
Fire Response District:
Land Value:
Total Assessed Value:
5.14 Elementary School Zone
6/2007 Middle School Zone:
007170336 Soil Types:
0007 Flood Zone:
238 Watershed Overlay:
Outbuilding & Extra
Freatures Value:
Total Market Value:
Shady Grove
37059-804
EAST SHADY GROVE
Davie County
DAVIE COUNTY R -A
ADVANCE
SHADY GROVE
WILLIAM ELLIS
PcB2,PcC2,ChA
DAVIE COUNTY
.rk
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gouty �� 1\ C or arising out of the use or Inability to use the GIS data provided by this webske.
DAVIE COUNTY HEALTH DEPARTMENT
Environmental Health Section
P. O. Bog 848/210 Hospital Street
Mocksville, NC 27028
(336)751-8760
Account #: 990002855 Tax PIN/EH #: 5789-75-7094
Billed To: Cambridge/Isenhour Homes Subdivision Info: Hidden Meadow Lot # 3 0k11SS64j'II)
.€;ierence Name: Mike Sloane Location/Address: Palomino Road -27006
r � oposed Facility: Residence Property Size: 5.122 Acres
ATC Number: 3520
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 .190 atment and Disposal Systems). THIS
AUTHORIZATION FOR WASTE C ION I ALI FOR A PERIOD OF FIYE YE S.
Environmental Health Specialist's Signature: e:
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 N W Y be taken as a guarantee that the system will function satisfactorily for any
given ertod of time.
Via.
Vfjol IT
P'l1
_ M
Septic System Installed By:
Environmental Health Specialist's Signature:
DCHD 05/99 (Revised)
'-WK_ 10--/a
r
DAVIE COUNTY HEALTH DEPARTMENT
Environmental Health Section
P. O. Boz 848/210 Hospital Street
Mocksville, NC 27028
(336)751-8760
IMPROVEMENT/OPERATION PERMIT
Account #: 990002855
Billed To: Cambridge/Isenhour Homes
Reference Name: Mike Sloane
Proposed Facility: Residence
d /-z-?'O�
Tax PIN/EH #: 5789-75-7094
0Subdivision Info: Hidden Meadow Lot#305Sha �-V)
`�3 ocation/Address: Palomino Road -27006
Property Size: 5.122 Acres
ATC Number: 3520
**NOTE** This Improvement/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 11 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 0Nr-,Z-,- #People :5 #Bedrooms q #Baths 3, J
Dishwasher: G3/ Garbage Disposal: 121" Washing Machine: Basement w/Plumbing: ❑ Basement/No Plumbing: ❑
Commercial Specification: Facility Type #People #People/Shift #S�e)attss Industrial Waste: ❑
`S
Lot Size ' 1L ype Water Supply (k--LLDesign Wastewater Flow (GPD) _ I r AV Site: New Repair ❑
System Specifications: Tank Size -1(. 0GAL. Pump Tank GAL. Trench Width Rock Depth Z Linear Ft.C�
Other:) LJ � Q 11 I (�r� i I t,)25i 4V— L) Jj Ism 9 O.0- - m,-) j .
Required Site Modifications/Conditions: I ��� LL. 0,) ?-4E lac� Oa -L-, GC-" Q ,
IMPROVEMENT/OPERATION PERMIT LAYOUT - APPROVED EFFLUENT FILTER. RISER(S) IF 6 " BELOW
FINISHED GRADE. ****NOT CE: o act a representative of the Davie County Health Department for final inspection of this
system between 8:30 a.m. o 9:30 .m. 1: 0 p.m. to 1:30 p.m. on the day of installation. Teleph ne # is (336)751-8760.****
-P7-ue,1 1 A FoaD Lla•1u`S
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Environmental Health Specialist's Signature:
DCHD 05/99 (Revised)
11)
-'L
5y
>236'
'Date•
A!2w
5WSTL711�
07--Z/2003 16:46 KT ISENHOUR CONSTRUCTION COMPANY 4 7518786 N0.18? 1702
cul, 07 03 1,2:55p
davie oounty tnvhealLh 336 751 9786 pO2
A1'111-ti:AT(ON FOR SITE GVALUATIONJURPROV1161ENT I'LltMtl' & NI't%
Davin County Health Department
EgY/lr�rri�anenta/Herd/moi seetivn
P.O. !tax 840/210 BQSV:Lttal StXoet
Mockov111e, nC 27028
(336)7$1-8760
f e*XAFJV0R7'AIYT•++ THIO AI?PLXC&TXC 7 CANY407- DT PROCESSLD UNLESS JILL VIR lZ&QLrIRED
ZNFORrA►TIOW is PROVIDDU. Refer to the INFOR�W-ATZ01t DVLLETXW for inctrua:L•iono.
i. Naac to be D111cd ��I ` DV" LS _J1[, Con COCC Pnrnon Q �[�I),`
stai1inD addroao 3� I t N' O St1� t� HOMO Dpgno
C1ir/3Lato/iZr W - S N 1. C.� 0 UUala J7 phone
2. Mase OA Aerw1!/ATC 1t D11torani than, Abown
M413ing Addreas ciittyy/statq/LLD ...._—.__ ....._._.
3_ Appilearloa pore �L3 SILO Evaluation tib 2mprovamont Penktit/ATC CI duel!
4. ajyoem to SOrvico: tV U.Ne ❑ Mobile Home Q Duainoaa CI Todunt:ry Q OL -)101-
S. TYRO oyetm roqu.nted: INKCouventlonal ❑ conventional moditiod Q lanovacive
G_ ,I�,C�Raaidegce: � 1 Peop2:� �� � _ 4 Hodroomp � 0 Datl,tOonu 3 ,�� _ .
L4DSolaraoher 11d4erbap. aiopss•1 ()?Iraelalnp Dcaonlno QHesouonC/rlumUln� C76aa o/aen C/Ho t•iv�aui q7
7. It nuIIihooc/Znduotrr /Other: verity Lypo_
# coomodoo N Me -ore
IF POODSXXV:rCE: tt Beata.
e. Typo of .racer a-pply: C3 Coul:ty/cl.ty
1t People U Dinka __•,
e Urinal• it Nater coaturu
Batimated Wator Usage (gallons par nay)
&Kwell
❑ Cotntttunity
Mo
a. Do you anttctpAta oeditlone or expunmous urtht facility rids slytttu is 1NIrnrJcr! to scra•u*Y Q Yea
If yes, what type?
`111AW04tTAfVT"• CWCIY'f::AtUS�
UELOW. EAther o PLATor Srl'E PLAN
Properly bimeucions:
Ta: Office PIN: ,
Property Address: Road !Paine
City/Zip
THE /C6Q(IXED PROPURTY IN ORAIATION IiL'Qill_1't'1;11
ifut a Subdivision provide lniormatic•a, oe fullom:
Name: C.LiC 4A1 frlLt �oW _
Section. Block: _ L.ot:.�_
WRITL UtR40*1014S (Yvon, H•Iuelzi.•illu) to 1'1lU/'iat'Pl':
Hwy, -ISR -42 901's f a.k t: JPJ _
Din Mt ykn tl... tit (LLe-,- 4f t.4i 00(— Gl-ds-6"
�{'t't� er>< �/�CCGt. illtl�eu► L /'b+� � A. 1Vt"t .
Dotc hotuc corners il:aggodi S
This is to certify that the tnfornsatlolt provided is correct to Ilse best of my knowledge. i uatdcrstam) [hut away perraait(s)
issued Acreafter arc subject to calslirlisio,t or revocation, If the site plana or intended use chmal:c, or it the iuformatlou
submitted in this applicalion is falsllivd •,r chanced. I, rasa, rNrdorsuurd lint l eras re3pvtlsiblc fear till clowV4v hicure-rel finis
this applicw!/orr. 1, hereby, rive couseur is IlleAalborizcd Representative of the Do is uuil t�c fltil ue),uru:,wn
to enter upon above described prupu•ty located ia1 Darie Couply and ....../ld.l�–
iu Cunduct all testing procedures its ticccisary to deturtn(ae the sttC suilablilt
naTIlS�DATE7 slctvarultZ
THIS AREA MAY DE USED FOR DRAWING YOUR SITE PLAN (Iududc all of tho tuliowmig: L>;WI,zg and propusod
property lines and dinionslotts, structyru:, setbacks, and scpue locations).
Site Revisit Charge
Dnlc(s): _ —
ClicutNotiflcatiuu batt:
Sirb'jvtD�–� Account No.
Revised 1aC1ID (05/03 Invoice No.
0
70,C04
pip
PK
S 4453'44"
65-53'
Centerline of Road
is Property Line.---__
rK
61
1)6'2x'27" 50,00,
PAOT 3
5. IFAOT 3
5. 1221 :,4C:RE'-5::
c
06!26'27-' -,.,
X29.65'
�,;CT 4
5. OL -t ACRES
0
3
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CO
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FOR SITE APP / in Ir G
. ..,� IJCli71l)f� �IALUA�iDVFtiiPROVEniiJllw 1�[ii IIT .Sc AT 1S
Davie County Health Department 11 JLC
Environmental Health Section
P.O. Box 848/210 Hospital Street DEC ,
Mocksville, NC 27028
(336)751-8760
RO ..—
***IMPORTANT*** THIS APPLICATION CANNOT BE PROCESSED UNLESS ALL THE RE UNIy
INFORMATION IS PROVIDED. Refer to the INFOORMATION BULLETIN for instructions.
1. Name to be Billed M JLr Y-VJ0(F1 'Al J( ef't'. Contact Person )
Mailing Address )96. / , Home Phone I to - Ie 1 fl f
City/State/ZIP ��� 1%"M LE Z7 2�(0 Business Phone a
2. Name on Permit/ATC if Different than Above
Mailing Address City/State/Zip
3. Application For: P --site Evaluation ❑ Improvement Permit/ATC Il Both
4. System to Service: /House ❑ Mobile Home ❑ Business Ll Industry I] Other
5. If Residence: # People # Bedrooms L4 # Bathrooms —S
Dishwasher CI Garbage Disposal CI Washing Machine Ll Basement/Plumbing II Basement/No Plumbing
6. If Business/Industry/Other: Specify type
# People # Sinks
# Commodes # Showers # Urinals # Water Coolers
IF FOODSERVICE: # Seats Estimated Water Usa a (gallons per day)
7. Type of water supply: ❑ County/City v Well ❑ Community
e. Do you anticipate additions or expansions of the facility this system is intended to serve? ❑ Yes ❑ No
If yes, what type?
***IMPORTANT*** CLIENTS MUST COMPLETETHE REQUIRED PROPERTY INFORMATION REQUE'ST'ED
BELOW. Either a PLAT or SITE PLAN QMUST BESUBMITTED by the client with THIS APPLICATION.
Property Dimensions: ° �WRITE DIRECTIONS (front Mocksville) to PRON-'IR 1'1':
CG 22
Tax Office PIN: #
Property Address: Road Name
City/zip 27ypCP
If in a Subdivision provide information, as follows:
Name: P2 eP/Ps CK. ScL'T .
Section: Block: Lot:05 Date Property Flagged:
This is 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 plans or intended use change, or if the information
submitted in this application is falsified or changed. I, also, understand that I an: responsible for all charges incurred f om
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
to conduct all testing
—7•procedures as necessary to determine the site suitabi it .
1I2 !. 0
)ATE I 0( SIGNATURE
THIS AREA MAY BE USED FOR DRAWING YOUR SITE PLAN (Include all of the following: Existing and proposed
property lines and dimensions, structures, setbacks, and septic locations).
�n� �0 V�
i
Ll
MAY - 8 ,20 02
I
ENVIRONMENTAL HEALTH
DAME COUNTY
Revised DCHD (07/99)
Site Revisit Charge
Datc(s):
Client Notification Date:
EHS:
Account No.73 /
Invoice No. ]L `7 6 d `'
DAVIE COUNTY HEALTH DEPARTMENT
Environmental Health Section
Soil/Site Evaluation
APPLICANT INFORMATION
PROPERTY INFORMATION
Account #: 990002073 Tax PIN/EH #: 5789-83-2266.03
Billed To: Norman Building Subdivision Info: Peoples Ck. Farm Lot # 03
Reference Name: Location/Address: Peoples Creek Rd. -270P6
Proposed Facility: Residence Property Size: see map Date Evaluated: -7 2
Water Supply:
On -Site Well
/
Community Wald"-
`
Public
Evaluation By:
Auger Boring
5
Pit -**'
Cut
FACTORS
1
2 3 4 5 6 7
Landscape position
(�
Sloe %
5
(O
HORIZON I DEPTH
p •-
_ J
Texture group_
it --
Consistence
Consistence
SS
Structure
UL
Mineralogy`
HORIZON II DEPTH
,2
J
Texture group
Consistence
5
Structure
e
c
Mineralogy
HORIZON III DEPTH
2 3
Texture group
G k
Consistence
$S
Structure
1L
Mineralogy
HORIZON IV DEPTH
Texture group
Consistence
Structure
Mineralogy
SOIL WETNESS
Z2
RESTRICTIVE HORIZON
SAPROLITE
CLASSIFICATION
•S
LONG-TERM ACCEPTANCE RATE
I 'C?
SITE CLASSIFICATION: Es EVALUATION BY:l%��1"�I>
LONG-TERM ACCEPTANCE RATE: 0.3 — OTHER(S) PRESENT: `��^��
n r X A n vc . <") 'h-1 k %A -r tTY `t4� ��� / PlJ 1 _ �'x-n cY- 4 r" • �t W
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)
193 L3 S 45'28'35" E 126.70'
L4 S 65'18'47" E 109.98'
L5 S 08'58' 16" E 53.54' I
744.07' N 06'29'26" E 1313.73' L6 S 82'39'38" E 44.67
L7 S 35'13'55" E 108.74'
—`+ L8 S 63'48'43" E 76,51' I
r L9 S 43'26'30" E 127.50'
N I
\ Centerline of Creek 569.66'
\ is Property Line. I
(For Tracts 1 do 2) y /IPF e
\ / Stoma LJ
TRACT 2= � �
O CO
5.487 ACRES/'
�,o v 00
(16
OP �
G� L5 1
T -Iran
GQI Found
\.O Q W
Of O-
r �
CO
S 06'26'27" W 65p.0 No a, o
CO
�1
T -Iron
Found
TRACT 3
5.122 ACRES
C
v N
S 44'53'44" E CO6'26'27" W
65.53' 729.65'