108 Underpass Road Lot 1Davie County, NC, Tax Parcel Report Wednesday, November 23, 2016
WAK.NMG: 'HHS 1S 14U'1' A SURVEY
Parcel Information
Parcel Number: E8140A0001 Township:
NCPIN Number: 5881039466 Municipality:
Shady Grove
Account Number:
Census Tract:
37059-803
Listed Owner 1:
Voting Precinct:
EAST SHADY GROVE
Mailing Address 1:
Planning Jurisdiction:
Davie County
City:
Zoning Class: DAVIE COUNTY R-A,R-20
State:
Zoning Overlay:
Zip Code:
Voluntary Ag. District:
No
Legal Description:
LOT 1 COUNTRYSIDE
Fire Response District:
ADVANCE
Assessed Acreage:
1.39
Elementary School Zone:
SHADY GROVE
Deed Date:
10/1993
Middle School Zone:
WILLIAM ELLIS
Deed Book / Page:
001710065
Soil Types:
Gn132
Plat Book:
0005
Flood Zone:
Plat Page:
210
Watershed Overlay:
DAVIE COUNTY
Building Value:
224130.00
Outbuilding & Extra
Freatures Value:
9680.00
Land Value:
52500.00
Total Market Value:
286310.00
Total Assessed Value:
286310.00
161 All data Is provided as Is without warranty or guarantee of any kind either expressed or implied including but not limited to theraDavie County, Implied warntles of merchantability or fitness for a particular use. Ag 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
NC or arlang out of the use or hrabitity to use the GIS data provided by this websHe.
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a E �' 611.99 ;?0AL j ` Z\ ` S 06029' 29" W
50' R/W.
Z
COUNTRYS I DE
k
:EK o. OWNERS DEVELOPERS
P�OTTS INVESTMENTS
ADVANCE N.C. 27006
+\PHONE =(919) 998-8816
7oz 50.00
;�* "4O0 SHADY GROVE TOWNSHIP
N
25056 ♦ p
W.
184.2 OTAL 4% 500° ., D AV I E COUNTY
N 09° 56' S1"E + Z
LIN 50°37'43"E (P'• NORTH CAROLINA
+
N 560 27' 12" W
N 34 51' 36" E ' Ft 5 +
N 29° 40' 53'E
N 31005' 46" W 64.54
N 59° 21' 22" W
S 84° 57' 467W N 770 59' 35" W
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DAVIE COUNTY HEALTH DEPARTMENT '
'`..
1U100nU=U= TQ DFRUUT A (%-FRT1F1r-ATF n1; r-nUDI PTIn�
*/N[TE:Issued inCompliance With Article |1mfKS�� Chapter 130a
Name Date No 70
Loc tiQn JZf Z-0
_
Nn -
Lot --- House-5�----M--�- Home Business --------Speculation
---------
No. Bedrooms NoNo in Family
Garbage Disposal . YEG �,Bths
NO [] .v `
Auto Dish Washer YES NO
Au�Wa�M��ine
YES NO
Type VVab»r Supply -
..
*This permit Void ifsewage system described be|mvv is not installed within 5years from date of issue.
.
This permitiosubject torevooution'ifsite plans orthe intended use change.
`
Ll-'
^
. /
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/
Improvements permit ^'
*Contact o representative of the Davie County Health Department for final inspection of this system between, 8:30-
9:30 A.M.
:'8:3OA.K8. or 1:00'1:30 P.M. on day of completion. Ta|ephoneNumber 704'634'6985.
Final Installation Diagram: System Installed by
/
` ~ -
ba-------'--
�
``' �~~���^-
Certificate of Completion Date
*The signing of this oartUUcab» shall indicate that the system described above hambeen |ed in compliance with
the standards set forth inthe above regulation,but shall inNO way be taken as eguo�onte�athat the system will function
satisfactorily for any given period oftime.
APPLICATION FOR SITE EVALUATION/IMPROVEMENTS PERMIT
Davie County Health Department
Environmental Health Section
P. O. Box 665
MocksvilleI NC 27028 9.3
.5 SBA
1. Application/Permit Requested By v `�
Mailing Address S v G,/ iSLi I1 C c�271af
/
Home Phone ��1 % f1 7 6r fl90 Business Phone /Q)7�p,. ref t� 71cP- d5�7 Aaf1P
-
2. Name on Permit if Different than Above fib j
3. Application/Permit for: ❑ General Evaluation Septic Tank Installation
4. System to Serve: .House ❑ Mobile Home ❑ Place of Public Assembly
❑ Business ❑ Industry ❑ Other ❑ Unknown
5. If house, mobile home: Subdivision CCYA -1*t-: I'd Section Lot #
ti
moi., Basement/Plumbing
No. of People
No. of Bedrooms
No. of Bathrooms �-
{
Dwelling Dimensions k
6. If business, industry, place of public assembly, other: Specify type
No. of People Served
No. of Commodes 3
No. of Lavatories
No. of Showers
7. Type of water supply:
8. Property Dimensions
`� Public
No. of Sinks_
No. of Urinals
No. of Water Coolers
Water Usage Figures
❑ Private
Sewage Disposal Contractor
9. Do you anticipate additions/expansion of the facility this sytem is intended to serve?
If yes, what type?
❑ Basement/No Plumbing
Washing Machine
� Dishwasher
\
`Q Garbage Disposal
❑ Yes
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.
r
Directions to Property: G4 „(leyV a P
This is to certify that the information provided is correct to the best of my
incurred fr9m this application.
3/1-f / ti
DATE
44 06`Mr q 1f4ftf1,0e
I understand I am responsible for all charges
SIGNATURE
CONSENT FOR SITE EVALUATION TO BE DONE ON ABOVE DESCRIBED PROPERTY
MUST CHECK ONE: ❑ 1. 1 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
and disposal system.
DATE
DCHD (12.90)
SIGNATURE
DAVIE COUNTY HEALTH DEPARTMENT
Environmental, Health Section
Q Soil/ -Site EValuation c�
NAME __ J�bd's�� \7b �� DATE EVALUATED �2' - 3
ADDRESS PROPERTY SIZE 1 0_'Zy -
PROPOSED FACIILTY SP " LOCATION OF SITEWater Supply: Supply: On -Site Well Community Public
Evaluation By:Cq_�_ Auger Boring ✓ Pit Cut
FACTORS
1
2
3
4
Landscape position
_
__S'
_5�'
s
Slope %
C.'__Z
^
6-q(b
0—
HORIZON I DEPTH
Ia
Texture group
C: L.
Consistence
Structure
Mineralogy1
1
HORIZON II DEPTH
Texture group
C-
C,
Consistence
�—
Structure
Mineralogy
!
/1
1:)
HORIZON III DEPTH
Texture group
Consistence
Structure
Mineralogy
HORIZON IV DEPTH
Texture group
Consistence
Structure
Mineralogy
SOIL WETNESS
Ss
RESTRICTIVE HORIZON
—
—
—
--
SAPROLITE
—
—
—
CLASSIFICATION
LONG-TERM ACCEPTANCE RATE
,u
SITE CLASSIFICATION: V� ,5 •
EVALUATED BY: �
LONG-TERM ACCEPTANCE RATE: .14 OTHER(S) PRESENT:
REMARKS:
EGEND
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(01-901
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Address
FA r..T0 R
DAVIE COUNTY HEALTH DEPARTMENT
Environmental Health Section
P. O. Box 665,
Mocksville, N.C. 27028
�S%OIL/SITE EVAALLUATTIION
A�i1d i