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1002 Eatons Church Road Lot 4Davie County, NC r. i Tax Parcel Rennrt Tuesdav, November 29, 2016 Zip Code: 07081-2407 Voluntary Ag. Distract: Legal Description: LOT 4 COUNTRYSHIRE WAY Fire Response District: Assessed Acreage: Deed Date: Deed Book / Page: Plat Book: Plat Page: Building Value: Land Value: Total Assessed Value: 1.70 Elementary School Zone: 12/2003 Middle School Zone: 243770000 Soil Types: 0006 Flood Zone: 051 Watershed Overlay: Outbuilding & Extra Freatures Value: Total Market Value: WILLIAM R. DAVIE WILLIAM R DAVIE NORTH DAVIE Mr132 DAVIE COUNTY No E01All data is provided as is without warranty or guarantee of any ldnd either expressed or Implied Including but not limited to the Davie County, Impliedwanai. es of merchantability or fitness for a particular use. Ag users of Davie Countys 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 1� 7�T C or arising out of the use or Inability to use the GIS data provided by this website. WAK14114G: '1'H S 1S 140'1' A SURVEY Parcel Information Parcel Number: D312OA0004 Township: Clarksville NCPIN Number: 5822624422 Municipality: Account Number: 82524381 Census Tract: 37059-801 Listed Owner 1: SCHLEUPNER LILLIAN Voting Precinct: CLARKSVILLE Mailing Address 1: 9 LAUREL DRIVE Planning Jurisdiction: Davie County City: SPRINGFILED Zoning Class: DAVIE COUNTY R-20 State: NJ Zoning Overlay: Zip Code: 07081-2407 Voluntary Ag. Distract: Legal Description: LOT 4 COUNTRYSHIRE WAY Fire Response District: Assessed Acreage: Deed Date: Deed Book / Page: Plat Book: Plat Page: Building Value: Land Value: Total Assessed Value: 1.70 Elementary School Zone: 12/2003 Middle School Zone: 243770000 Soil Types: 0006 Flood Zone: 051 Watershed Overlay: Outbuilding & Extra Freatures Value: Total Market Value: WILLIAM R. DAVIE WILLIAM R DAVIE NORTH DAVIE Mr132 DAVIE COUNTY No E01All data is provided as is without warranty or guarantee of any ldnd either expressed or Implied Including but not limited to the Davie County, Impliedwanai. es of merchantability or fitness for a particular use. Ag users of Davie Countys 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 1� 7�T C or arising out of the use or Inability to use the GIS data provided by this website. ' - APPLICATION FOR SITE EVALUATION/IMPROVEMENTS PER Davie County Health Department Environmental Health Section �. P. O. Box 665 Mocksville, NC 27028 i` 1. Application/Perry Mailing Address Home Phone yq8 # 717 Business Phone OR 16 'Sy3 2. Name on Permit if Different than Above 3. Application/Permit for: 4. System to Serve: ❑ House ❑ Mobile Home ❑ Place of Public Assembly ❑ Business ❑ Industry ❑ Other ❑ Unknown 5. If house, mobile home: Subdivision „�1 u-� , Section _Z Lot # No. of People No. of Bedrooms No. of Bathrooms Dwelling Dimensions 6. If business, industry, place of public assembly, other: Specify type No. of People Served - No. of Commodes No. of Lavatories No. of Sinks No. of Urinals No. of Water Coolers No. of Showers Water Usage Figures 7. Type of water supply: V/p"ublic ❑ Private 8. Property Dimensions /, a Sewage Disposal Contractor 9. Do you anticipate additions/expansion of the facility this sytem is intended to serve? ❑ Yes ❑ No ❑ Basement/Plumbing ❑ Basement/No Plumbing ❑ Washing Machine ❑ Dishwasher ❑ Garbage Disposal If yes, what type? ❑ 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: , 44t - 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. OWAA&L 15; 4993 DAfEE ` SIGNATURE CONSENT FOR SITE EVA6UATION TO BE DONE QN ABOVE DESCRIBED PROPERTY MUST CHECK ONE: 1. I OWN the property, ❑ 2. 1 DO NOT OWN the property. If you checked Box #2, the rest of this form MUST be completed by the owner or a person authorized by the owner: 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 procedures as necessary to determine said site's suitability for a ground absorption sewage treatment If disposal system. DATE SIGNATURE DCHD (12.90) ' DAVIE COUNTY HEALTH DEPARTMENT Environmental Health Section Soil/Site Evaluation. ADDRESS PROPOSED FACIILTYi,[�` DATE EVALUATED. PROPERTY SIZE l SAI' LOCATION OF SITE Water Supply: On -Site Well Community Public L_,-,� Evaluation By: Auger Boring Pit Cut FACTORS 1 2 3 4 Landscape position Slope % `— r HORIZON I DEPTH Texture groupL SL— Consistence Structure Mineralogy HORIZON II DEPTH Texture groupC G Consistence Structure 6 Mineralogy/.' HORIZON III DEPTH Texture group Consistence Structure Mineralogy HORIZON IV DEPTH Texture group Consistence Structure Mineralogy SOIL WETNESS RESTRICTIVE HORIZON SAPROLITE CLASSIFICATION IVT LONG-TERM ACCEPTANCE RATE SITE CLASSIFICATION: � / LONG-TERM ACCEPTANCE RATE: �/ REMARKS: DCHD(01-901 EVALUATED BY: 171X 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 ■E■■ ■■ ■■