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251 Country Circle Lot 11Davie County, NC I TTax Parcel Report Wednesday, November 23, 2016 WA1<-NM T: '1'Mb 1J 1VV'1" A lUKVEY Parcel Information Parcel Number: E8140A0011 Township: Shady Grove NCPIN Number: 5881124902 Municipality: 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 State: Zoning Overlay: Zip Code: Voluntary Ag. District: Legal Description: LOT 11 COUNTRYSIDE Fire Response District: ADVANCE Assessed Acreage: 2.56 Elementary School Zone: SHADY GROVE Deed Date: 8/2009 Middle School Zone: WILLIAM ELLIS Deed Book I Page: 008020731 Soil Types: GnB2 Plat Book: 0005 Flood Zone: Plat Page: 210 Watershed Overlay: DAVIE COUNTY Building Value: 247590.00 Outbuilding 8n Extra Freatures Value: 24930.00 Land Value: 52500.00 Total Market Value: 325020.00 Total Assessed Value: 325020.00 No W Ag 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 f Mess for a particular use. Ati users of Davie County's GIS website shall hold harmless theCounty of Davie, North Carolina, its agents, consultands, contractors or employees from any and ad claims orcauses of action due to NC or arising out of the use or Inability to use the GIs data provided by this webstte. VY 0 DAVIE COUNTY --HEALTH DEPARTMENT - IMPROVEMENTS PERMIT AND CERTIFICATE OF COMPLETION *NOTE: Issued in Compliance With Article 11 of %$. Chapter 130a — -- J pSanitary Sewage Systems �n '�7ddo 1�,,,,,,, 7�Z q Permit Number Name 1�.�•jy�ld�z�.s 3�c ZDate- 11' 1!� N' 7433 Location `' f (� S\ S - z) .1,.:. r? ° Cs �. ��� . o Subdivision NameLot No. Sec. or Block No. ;3 Lot Size:''I X'V"�y 154 X o House 1" Mobile Home Business -- Industry No. Bedrooms H No. Baths 3 No. in Family — Public Assembly Other ,i Garbage Disposal YES gf NO p Auto Dish Washer YES 21 NO S ecifications for, System: Auto Wash Ma^hine YES [i NO ❑ t Type Water Supply *This permit Void if sewage system described below is not installed within 5 years from date of issue. This permit is subject to revocation, if.site plans or the intended use change. s" in Improvements permit byy>.� J�- *Contact a representative of the Davie County Health Department 1:00-1:30 P.M. or 4:30-5:00 P.M. on day of completion. Telephone Final Installation Diagram: F— 1 spection of this system between 8:30-9:30 A.M., 704-634-5985. i I stalled by S� 170 f Certificate of Completion --Date *The signing of this certificate shall indicate that the system described above has been installed in compliance with the standards set forth in the above regulation, but shall in NO way be taken as a guarantee that the system will function satisfactorily for any given period of time. 3, APPLICATION FOR SITE EVALUATION/IMPROVEMENTS PERMIT Davie County Health Department Environmental Health Section P. O. Box 665 Mocksville, NC 27028 1. Application/Permit Requested By YJ (ZV dy /J TUU 1 CA u , I/ -8&=. Mailing Address J-)/ b Cod J 0-rA�, Q0P. 're ,,�Q 3,0 - a Home Phone All,(" A C. a-7/ 0-3 Business Phone �71-0)2dX e -R-3 8 2. Name on Permit if Different than Above 3. Application for: 4. System to Serve: "M House C] General Evaluation Septic Tank Installation Permit ❑ Mobile Home ❑ Place of Public Assembly ❑ Business ❑ Industry /❑ Other ❑ Unknown 5. If house, mobile home: Subdivision Oca� r le Section Lot # Z� ❑ Basement/Plumbing No. of People /C3Basement/No Plumbing No. of Bedrooms `1 ')S� Washing Machine No. of Bathrooms �3 Dishwasher Dwelling Dimensions 6aX,3 P \Q, Garbage Disposal 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: Public ❑ Private 11 '' ❑ Community S. Property Dimensions �`oy%� aOx ZS�f x tf 3 ' Sewage Disposal Contractor pan Lu, 9. Do you anticipate additions/expansion of the facility this sytem is intended to serve? ❑ Yes -s} No If yes, what type? '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: 16 -7 -.-9-14 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. DATE CONSENT FOR SI VALUATION TO BE DONE ON ABOVE DESCRIBED PROPERTY MUST C, E K ONE: 1..10 N property. ❑ 2. 1 DO NOT OWN the property." If you cher ed Box #2, the rest of. this form MUST be ompleted by the owner or a person authorized by the owner: �pI eby`give consent,i the authorized representative of the Davie County Health Department to enter upon above described le located in Dave County and owned by.,, to conduct all tosting procedures as necessary to determine said site's suitability for a ground absorption sewage treatment and disposal system. 1 DCHD (1 193) i SIGNATURE 0 } DAVIE COUNTY HEALTH DEPARTMENT f' Environmental Health Section Soil/Site Evaluation NAME W • - i ; - DATE EVALUATED eC [1 l L'I ADDRESS S AMS PROPERTY SIZE S,'y M DO X PROPOSED FACIILTY oyS`D LOCATION OF SITE Water Supply: On -Site Well Community Public Evaluation By:C1,1_ Auger Boring Pit Cut FACTORS 1 2 3 4 Landscape position S 5 s' <S -3- Slope % o-L_e_ o --t-" ©._ Po Q HORIZON I DEPTH �' Texture group L Consistence Structure R Mineralogy HORIZON II DEPTH Texture groupC Consistence Structure 6aE. -Z 6» K Mineralogy '. ! ' ; 1 HORIZON III DEPTH Texture group Consistence Structure Mineralogy HORIZON IV DEPTH Texture group Consistence Structure Mineralogy SOIL WETNESS SS 55; S RESTRICTIVE HORIZON — — — —' SAPROLITE r. - — -- CLASSIFICATION .S ,S — LONG-TERM ACCEPTANCE RATEJ ,3 i 3 .3 SITE CLASSIFICATION: ' EVALUATED BY: LONG-TERM ACCEPTANCE RATE: 3 OTHER(S) PRESENT: \�' N REMARKS: 1 \ C� - e WcoA. � � As�oN - Cn+ Sysy 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 :3C -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 DAVIE COUNTY HEALTH DEPARTMENT Environmental Health Section R O. Box 665 Mocksville, N.C. 27028 SOIL/SITE EEVALUATION X5/- Name " "L Qu'a Date Address Lot Sizci���l�?--a FACTOP.q AREA 1 ARFA 9 AREA:3 ARFA d 1) Topography/ Landscape Position d) 5) �) S) 9) S cgg)PS S S PS U U ?) Soil Texture (12-36 in.) Sandy, S S S S Loamy, Clayey, (note 2:1 Clay) (9>PS <P US U U S) Soil Structure (12-36 in.) Clayey Soils S pS S S PS S PS U U U Soil Depth (inches) �f ,( --15'S S PS S ' PS PS U U U U Soil Drainage: Internal S S q S PS S PS U U U External S S S PS S PS U U Restrictive Horizons Available Space S PS S S S PS S PS U U U U Other (Specify) S PS S PS S PS S PS U U U U Site Classification U—UNSUITABLE S—SUITABLE PS—Provisionally Suitable Recommendations/Comments: Described by ��/ Title SITE DIAGRAM MA DCHD (6-82) Date jZ t !1 IVIUy IV lu II.cVa uuulnlatwll OCIVIUM 800/0.510bu . p•1 ni 0 C. Davie Uounty Health Department En `F`'-�" on, mental Health Section ,� ;✓ .� t �, P.O. Bos 843 2 i 0 Hospital Street Rf, ' `i� 0 Courier # : 05-40-06 - ;P ocksville, NC 27028 Ione: (356) - 753 - 6: � F.. (238) - 753.1680 ON-SITE WAST Wr1TER CER - QN FOR DIYELLING . (Check One) Replacement emodeling') Reconnection: i Ivy Name: 1 t Vh Q/Yt ?11th . Phone Number 3 (, g �( r� I I (Home) Mailing Address: S l CoLtu rzy I C t..c _736— 7 7 c/S (Work) AMMOCL Detailed Directions To Site: Sol t 4 U1% c WL P Wro Lk N DE1t N SS R H OC4 s 1E o u N o tiiD C OL\'WrR 1 Property Address: COyqjrll CZ2t LFs Lox About The EXISTING Facility: Following Information Please Fill In The Name System Installed Under. Type Of Facility r Of People:_ Date System Installed (Month/Date/Year): LJ - Number Of Bedrooms: 3 Numbe I Is The Facility Currently Vacant? Yes No 1 iYes, For How Long? Any Known Problems? Yes. No If Yes, Exp] ain: Please Fill In The Following Information About TheNEW Facility: Type Of Facility ?t 1: ri(o i dumber Of Bedrooms: Numbe of People Requested By: I : Date Requested: (Signature) I I For Environmental Health Office Use Only �pprovedDisapproved Comments: Environmental Health Specialist I Date:(�/�o�o *The signing of this form by the Enviro WEI Health Staff is in no way intended, nor should be taken as a guarantee {ext d or limited) that the on -sit" wi;te water system will function properly for any given pe riod of time. n�cDate: Payme heck Money Order s/ I Amount:S �rb !Ld Pain By: ; Received By: Account #t: Y 2 Invoice #: 0