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177 Redmeadow Drive Lot 27Applicant: Chris Collins Address: 177 Red Meadow Drive City: Advance State/Zip: NC 27006 Phone #: (336) 462-6581 *CDP File Number 197338 -1 County ID Number: Evaluated For: EXPANSION �ownship: Property Owner: Chris Collins Address: 177 Red Meadow Drive City: Advance State/Zip: NC 27006 Phone #: (336) 462-6581 Address/Road #: Subdivision: Redland Place Phase: Lot: h1 7 177 Red Meadow Drive •C Advance NC 27006 Directions Structure: SINGLE FAMILY Hwy 158 Left on Redland Rd, 1st left into development lot at end # of Bedrooms: 5 # of People: *Water Supply: N/A *IP Issued by: 2140 - Nations, Robert *CA issued by: 2140 - Nations, Robert Design Flow: 6 0 0 Soil Application Rate: 0 3 *System Classification/Description: TYPE III A. CONV SYSTEM > 480 GPD (EXCLUDING SFD) Saprolite System? O Yes (9 No *Distribution Type: GRAVITY - PARALLEL (eq. d -box) Pump Required? Q Yes gNo *Pre -Treatment: Nitrification Field OPERATION PERMIT • ' Davie County Health Department s Y� 210 Hospital Street tX P.O. Box 848 4 •``°~ ^"• Mocksville NC 27028 Total Trench Length: Phone: 336-753-6780 Fax: 336-753-1680 Applicant: Chris Collins Address: 177 Red Meadow Drive City: Advance State/Zip: NC 27006 Phone #: (336) 462-6581 *CDP File Number 197338 -1 County ID Number: Evaluated For: EXPANSION �ownship: Property Owner: Chris Collins Address: 177 Red Meadow Drive City: Advance State/Zip: NC 27006 Phone #: (336) 462-6581 Address/Road #: Subdivision: Redland Place Phase: Lot: h1 7 177 Red Meadow Drive •C Advance NC 27006 Directions Structure: SINGLE FAMILY Hwy 158 Left on Redland Rd, 1st left into development lot at end # of Bedrooms: 5 # of People: *Water Supply: N/A *IP Issued by: 2140 - Nations, Robert *CA issued by: 2140 - Nations, Robert Design Flow: 6 0 0 Soil Application Rate: 0 3 *System Classification/Description: TYPE III A. CONV SYSTEM > 480 GPD (EXCLUDING SFD) Saprolite System? O Yes (9 No *Distribution Type: GRAVITY - PARALLEL (eq. d -box) Pump Required? Q Yes gNo *Pre -Treatment: Nitrification Field 3 0 0 Sq. ft. No. Drain Lines 4 Total Trench Length: a 0 0 ft. Trench Spacing: 9 _Inches RFeet O.C. O.C. Trench Width: 3 _ InchesFeet Aggregate Depth: inches Minimum Trench Depth: a 4 Inches Minimum Soil Cover: 1 a Inches Maximum Trench Depth: 3 6 Inches Maximum Soil Cover: a 4 Inches *System Type: INFILTRATOR QUICK 4 STANDARD Installer: *McDaniel Grading Certification #: 1118-1 *EHS: 2325 - Mitchell, Brittany Date: 0 5/ a 0/ a 0 1 6 Approval Status ® Approved ❑ Disapproved c;utr rile Ivumoer ' Manufacturer: EXISTING TANK Lounty lu IvumDer: Selatic Tank STB: Gallons: Date: Valves Accessible ❑ *Filter Brand: ❑ ST Marker: ❑ Yes ❑ NO Reinforced Tank: ❑ Yes ❑ No 1 Piece Tank: ❑ Yes ❑ NO Manufacturer: Lat. Long: , Installer: 'McDaniel Grading Certification #: 1118-1 *EHS: 0 PT: Gallons: Valves Accessible ❑ Yes ❑ _ Date: Flow Adjustment Valve ❑ Yes Riser Sealed ❑ Yes ❑ No Riser Height: ❑ Yes ❑ NO (Min. 6 in.) nforced Tank: ❑ Yes ❑ No 1 Piece Tank: ❑ Yes ❑ NO Su / Pipe Size: inch diameter Pipe Length: feet *Schedule: Pressure Rated ❑ Yes ❑ No Approved fittings ❑ Yes ❑ NO Certification #: 1118-1 *EHS: Date: Approval Status ❑ Approved ❑ Disapproved pply Line Installer: 'McDaniel Grading Certification #: 1118.1 *EHS: Date: Approval Status ❑ Approved ❑ Disapproved Pump Type: Installer: 'McDaniel Grading / Dosing Volume: - Gal Certification #: 1118-1 Draw Down: Inches *EHS: *Chain: Date: Valves Accessible ❑ Yes ❑ No Flow Adjustment Valve ❑ Yes ❑ NO Check -valve ❑ Yes ❑ NO Approval Status PVC unions El Yes ElNo El Approved El Disapproved Vent Hole ❑ Yes ❑ No Anti -siphon Hole 11 Yes ❑ No CDP File Number I y 10130 - I County ID Number: NEMA 4X Box or Equivalent ❑ Yes ❑ No Installer: 'McDaniel Grading Box 12 inches Above Grade ❑ Yes ❑ NO 1118-1 Certification #: Box Adj. To Pump Tank ❑ Yes ❑ NO Conduit Sealed ❑ Yes ❑ No *EHS: Pump Manually Operable ❑ Yes ❑ No / *Activation Method: Date: Approval Status Alarm Audible ❑ Yes El No ❑ Approved ❑ Disapproved Alarm Visible ❑ Yes ❑ No 2325 - Mitchell, Brittany *Operation Permit completed by: Authorized State Agent: Date of Issue: 0 5/ a 0/ a 0 1 6 Owner/Applicant Signature: This system has been installed in compliance with applicable NC General Statutes: Article 11, Chapter 130A, Rules for Sewage Treatment and Disposal, 15A NCAC 18A .1900 et. Seq., and all conditions of the Improvement Permit and Construction Authorization. This property is served by a TYPE Ill A. sewage septic system. Rule .1961 requires that a Type TYPE 111 A. septic system meet the following criteria: Minimum System Review By The Local Health Department: N/A Management Entity: OWNER Minimum System Inspection/Maintenance Frequency By Certified Operator: N/A Reporting Frequency By Certified Operator: N/A Rule .1961 requires that a Type IV and V septic systems designed for a home/business owner must maintain a valid contract with a public management entity with a certified operator or a private certified operator for the life of the septic system. Rule .1961 requires that Type VI septic systems designed for a home/business owner must maintain a valid contract with a public management entity with a certified operator for the life of the septic system. Rule. 1961 (2) (e) requires a contract shall be executed between the system owner and a management entity prior to the issuance of an Operation Permit for a system required to be maintained by a public or private management entity, unless the system owner and certified operator are the same. The contract shall require specific requirements for maintenance and operation, responsibilities of the owner and systems operator, provisions that the contract shall be in effect for as long as the system is in use, and other requirements for the continued proper performance of the system. It shall also be a condition of the Operation Permit that subsequent owners of the systems execute such a contract. Hand Drawing O Import Drawing **Site Plan/Drawing attached.** vrMMA 11UN rCPUYII I Davie County Health Department 210 Hospital Street P.O. Box 848 Mocksville NC Drawing Drawing Type: Operation Permit CDP File Number: 197338 - 1 County File Number: 27028 Date: / / O Inch Scale: O Block O N/A •- CONSTRUCTION ` AUTHORIZATION ° Davie County Health Department Y 210 Hospital Street P.O. Box 848 Mocksville NC 27028 Phone: 336-753-6780 Fax: 336-753-1680 Applicant: Chris Collins Address: 177 Red Meadow Drive / For Office Use Only 1 *CDP File Number 197338-1 County ID Number. Evaluated For: EXPANSION �, Township: I VALIU UN I IL: 1 0/ 1 5/ a 0 a 0 Property Owner: Chris Collins Address: 177 Red Meadow Drive City: Advance City: Advance State(Lip: NC 27006 State2ip: NC Phone #: (336) 462-6581 Phone #: (336) 462-6581 ✓Address/Road #: 177 Red Meadow Drive Advance NC 27006 Structure: SINGLE FAMILY # of Bedrooms: 5 # of People: *Water Supply: N/A 27006 Subdivision: Redland Place Phase: Lot: All Directions Hwy 158 Left on Redland Rd, 1st left into development lot at end \Site Classification: Provisionally Suitable Minimum Trench Depth: a 4 Inches Saprolite System? OYes QNo Minimum Soil Cover. 1 a Inches Design Flow: 6 0 0 Maximum Trench Depth: 3 6 Inches Soil Application Rate: 0 3 Maximum Soil Cover: a 4 Inches *System Classification/Description: *Distribution Type: GRAVITY- PARALLEL (eq. d -box) TYPE III A. CONY SYSTEM > 480 GPD (EXCLUDING SFD) Septic Tank: 1 a 5 0 Gallons *Proposed System: 25% REDUCTION 1 -Piece: OYes ®No Pump Required: OYes QNo OMay Be Required Nitrification Field 3 0 0 Sq. ft. Pump Tank: Gallons No. Drain Lines a 1 -Piece: OYes ONo Total Trench Length: a 0 0 ft GPM—vs— ft. TDH Trench Spacing: — 9 Olnches O.C. Dosing Volume: _ Gallons • Feet O.C. Trench Width:Inches 3 - Feet Grease Trap: Gallons Aggregate Depth: inches Pre Treatment: ONSF OTS -1 OTS -11 Septic Tank Installer Grade Level Required: 01 011 0111 OIV Da^^ 1 ^f'2 CDP File Number 197338-1 County ID Number. , T ❑ Open Pump System Sheet :V t CS LiIYU LJIMU, UUL II db /1Yd11dU1C 0 *Site Classification: Provisionally Suitable Design Flow: F A VI Soil Application Rate: 0 3 *System Classification/Description: TYPE III E. PPBPS GRAVITY DOSED SYSTEM *Proposed System: 50% REDUCTION Nitrification Field a 0 0 0 Sq. ft. No. Drain Lines 7 Total Trench Length: 3 3 3 ft. Trench Spacing: Q Inches O. . 9 (*)Feet O.G. Trench Width: _ 0Inches 3 e Feet Aggregate Depth: inches Minimum Trench Depth: a g Inches Minimum Soil Cover. 1 a Inches Maximum Trench Depth: 3 6 Inches Maximum Soil Cover: a a Inches *Distribution Type: GRAVITY- PARALLEL (eq. d -box) Pump Required: OYes @No OMay Be Required Pre Treatment: ONSF OTS -1 OTS -II *Site Modifications No grading or construction activity is allowed in areas designated for system and repairwithout approval of Health Department. -Pump out old tank and crush. Install 1250 gallon tank. Tie into existing system and then add 200 feet of 25% reduction system to the end of the existing system. *Permit Conditions The issuance of this permit bythe Health Department in no wayguarantees the issuance of other permits.The permit holder is responsible for checking with appropriate governing bodies in meeting their requirements. ; This Authorization for Wastewater System Construction shall be valid for a person equal to the period of validity of the Improvement Permit, not to exceed five years, and maybe issued at the sametlme the Improvement Permit issued (NCGS 130A-336(15)� If the Installation has not been completed during the period of validity of the Construction Permit, the information submitted in the application for a permit or Construction Authorization is found to have been incorrect, falsified or changed, or the site is altered, the permit or Construction Authorization shall become Invalid, and maybe suspended or revoked (.1937(g)). The person owning or controlling the system shall be responsible for assuring compliance with the laws, rules, and permit conditions regarding system location, installation, operation, maintenance, monitoring, reporting and repair (1938(b)). Applicant/Legal Reps. Signature Required? Oyes ONo ApplicanVtvgal Reps. Suture: Date: *Issued By: 2140 - Nations, Robert Date of Issue:. 1 0 / 1 5 / a 0 1 5 Authorized State Agept; Malfunction Log OYeS OHand Drawing Olmport Drawing **Site Plan/Drawing attached.** Page 2 of 3 CONSTRUCTION AUTHORIZATION Davie County Health Department 210 Hospital Street P.O. Box 848 Mocksville NC 27028 Drawing Drawing Type: Construction Authorization CDP File Number: 197338 -1 County File Number: Date: 10/ 1 5/.1 0 1 5 Qlnch Scale: ` . QBlock QNIA VIII IJI II' I I II I i i I_ II_ CONSTRUCTION AUTHORIZATION Davie County Health Department 210 Hospital Street P.O. Box 848 Mocksville NC 27028 CDP File Number: 197338 -1 County File Number: Date: _ 10/ 1 5/ 2 0 1 5 Click below to Import an image from an external location: Drawing Type: Construction Authorization r APPLICATION FOR SITE EVALUATIONdMPROVEMENT PERMIT & ATC Davie County Environmental Health RECE G P.O. Box 848/210 Hospital Street V[�I� X15 Mocksville, NC 27028 DOW (336)753-6780/ Fax (336)753-1680 Application For: ❑ Site Evaluation/Improvement Permit ❑ Author tion To Construct (ATC) ❑ Both Type of Application: ❑New System ❑Repair to Existing System xpansion/Modification of Existing System or Facility * * *IMPORTANT* * * THIS APPLICATION CANNOT BE PROCESSED UNLESS ALL OF THE REQUIRED INFORMATION IS PROVIDED. Refer to the INFORMATION BULLETIN for instructions. APPLICANT INFORMATION Name K7 L r, .f C A% Address Ili -7 is ,P.4 ^A n n_ ria w � r Email r_ k r-; Se ro I I :n r Name on Permit/ATC if Different Mailing Address rKUrr,K1 Y 11MIURN1A11UN 2700 Above Contact Person L' .- : S (p /I 1 n x Home Phone rj -�(, S cF I Business Phone 'Date House/.Facility Corners NOTE: A survey plat or site plan must accompany this application. Included: ❑ Site Plan ❑Plat(to scale) (Permit is valid for months with si e plan, no expiration with complete plat.) Owner's Name Phone Number_ Owner's Address City/State/Zip Property Address City Lot Size Tax PIN# Subdivision Name(if applicable) Section/Lot# Directions To Site: If the answer to any of the following questions is "Yes",supporting documentation must be attached: Are there any existing wastewater systems on the site? _Yes No Does the site contain jurisdictional wetlands? _Yes _No Are there any easements or right-of-ways on the site? _Yes No Is the site subject to approval by another public agency? _Yes No Will wastewater other than domestic sewage be generated? Yes No IF RESIDENCE FILL OUT THE BOX BELO'F� �`"'� b! -Cr 1� W;.Ih OM Z y 3Sed oOn4 # People # Bedrooms # Bathrooms Garden Tub/Whirlpool ❑Yes ❑No Basement: ❑Yes ❑No Basement Plumbing: ❑Yes ❑No (6"6- l IF NON -RESIDENCE FILL OUT THE BOX BELOW Type of Facility/Business Total Square Footage of Building # People # Sinks # Commodes # Showers # Urinals Estimated Water Usage (gallons per day) (Attach documentation of similar facility water consumption) FOODSERVICE ONLY: # Seats Type system requested: ❑Conventional ❑Accepted ❑Innovative ❑Alternative ❑Other Water Supply Type: ❑ County/City Water ❑ New Well ❑Existing Well ❑ Community Well Do you anticipate additions or expansions of the facility this system is intended to serve? ❑ Yes If yes, what type? ❑ No 0— IrO S This is to certify that the information provided on dis application is true and correct to the best of my knowledge. I understand thato� any permit(s) or ATC(s) issued,hereafter are subject to suspension or revocation if the site is altered, the intended use charges, or if the information submitted in this application is falsified or changed I hereby grant right of entry to the Authorized Representative of the Davie County Health Department to conduct necessary inspections to determine compliance with applicable laws and rules I understand that I am resDonsible for the proper identification and labeling of property lines and corners and locating and flagging or staking the house/ f ' ity tion, roposed well location and the location of any other amenities. Site Revisit Charge Pr perty ow er's or o 's legal representative signature Date(s): Client Notification Date: ate EHS: Sign given ❑Yes ❑No Revised 11/06 Account # l 1 13 30 Invoice # DAVIE COUNTY HEALTH DEPARTMENT ' Environmental Health Section P. O. Boz 848/210 Hospital Street Mocksville, NC 27028 (336)751-8760 IMPROVEMENT/OPERATION PERMIT Account #: 989900635 Tax PIN/EH #: 5861-38-2199.27 WF Billed To: Wayne Frye Subdivision Info: Redland Place Lot # 27 Reference Name: Location/Address: Wed Meadow -27006 Proposed Facility: Residence Property Size: see map ATC Number: 3665 **NOTE** This Improvement/Operation Permit DOES NOT authorize the construction of 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 f LOCEE #People #Bedrooms 3 #Baths 2� Dishwasher: l' Garbage Disposal: ❑ Washing Machine: Basement w/Plumbing: ❑ Basement/No Plumbing: 0 -11 Commercial Specification: Facility Type #Peopple #People/Shift #Seats Industrial Waste: ❑ Lot Size 1.04 W6Type Water Supply LM((esign Wastewater Flow (GPD) 31� Site: New M Repair ❑ System Specifications: Tank Size I COGAL. Pump Tank GAL. Trench Width 3 Rock Depth 12—Linear Ft. LkDb Other: + 15M1b)TI0.3 t ^S Required Site Modifications/Conditions: 1151_ Q� 602, J� , AFF i /""� '"" �O S 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.**** Environmental Health Specialist's Signature: ,� DCHD 05/99 (Revised) Ips Mt rt• �1� �--Fe:-P u ,-�,-S 1,3 Oe�ee, 2 Account #: 989900635 Billed To: Wayne Frye Reference Name: Proposed Facility: Residence ATC Number: 3665 DAVIE COUNTY HEALTH DEPARTMENT Environmental Health Section P. O. Bog 848/210 Hospital Street Mocksville, NC 27028 (336)751-8760 Tax PIN/EH #: 5861-38-2199.27 WF Subdivision Info: Redland Place Lot # 27 Location/Address: Red Meadow -27006 DZ v&' Property Size: see map 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 reatment and Disposal Systems). THIS AUTHORIZATION FOR WASTEWATE ON I VA R A PERIOD OF FIVE YEARS. Environmental Health Specialist's Signature: L Date: rX TE 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 GrrS. Chapter 130A, Section .1900 "Sewage Treatment and Disposal Systems," but shall in NO WAYbye gpa$� guar�Aa ee that the system will function satisfactorily for any given period of time. I lc V- 14 5 T D C-", I Septic System Installed By: Environmental Health Specialist's Signature: DCHD 05/99 (Revised) -S. tea, 5a-RSCZ` t,)ATe-e— -bV0 I t of APPLICATION FOR SITE EVALUATION/IMPROVEMENT PERMIT Davie County Health Department Environmental Health Section DtC P.O. Box 848/210 Hospital Street 3 %Q�2 Mocksville, NC 27028 (336) 751-8760 ENtgRpNNj BAVIfCO(AC Nfg17H IV ***IMPORTANT*** THIS APPLICATION CANNOT BE PROCESSED UNLESS ALL THE REQUI INFORMATION IS PROVIDED. Refer to the INFORMATION BULLETIN for instructions. 1. Name to be Billed lkfl V Contact Person % Mailing Address ,-2f,-�31 '2'-"/� Home Phone yy1c[ J City/State/ZIP 4p�. ,�/L', %Q Business Phone 2. Name on Permit/ATC if Different than Above Mailing AddressCity/State/Zip 3. Application For: I�//Site Evaluation ❑ Improvement Permit/ATC ❑ Both 4. System to Service: ouse ❑ Mobile Home ❑ Business ❑ Industry ❑ Other 5. If Residence: # People # DisBedrooms `i # Bathrooms hwasher CI Garbage Disposal ❑ Washing Machine Basement/Plumbing ❑ Basement/No Plumbing 6. If Business/Industry/Other: Specify type # People # Sinks # Commodes # Showers # Urinals # Water Coolers IF FOODSERVICE: # Seats 7. Type of water supply: Estimated Water Usage (gallons per day) B�Gounty/City 8. Do you anticipate additions or expansions of the facility this system is intended to serve? If ycs, what type? ❑ Community B- yes ❑ No ***IMPORTANT' CLIENTS MUST COMPLETE THE REQUIRED PROPERTY INFORMATION REQUESTED BELOW. Either a PLAT or SITE PLAN MUST BESUBMITTED by the client with THIS APPLICATION. Property Dimensions: & , 5� IQ -C/ -a S Tax Office PIN: #_594i- ,*39' a / 9 72-1 Property Address: Road Name�, r City/Zip If in a Subdivision provide information, as follows: WRITE DIRECTIONS //(from Mocksvilllle) to PROPERTY: /5y �� -4 / /",, �l a�r� RzZeL,12 Je2� �4- Name:� �¢ S— Y- �/I &E i3 0 Section: Block: Lot: 1"�LOT2-% Date Property Flagged: Ir;2 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 am responsible for all charges incurred froln this application. 1, 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 _Z4U; ;` j ✓fit S to conduct all testing procedures as necessary to determine the site suitapility. 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). Site Revisit Charge Datc(s): Client Notification Date: EHS: Account No. i, Revised DCHD (07/99) Invoice No. Appraisal Card Page 1 of 1 DAVIE COUNTY NC 8/4/2014 10:16,46 AM OLLINS CHRISTOPHER A COLLINS SHAWN V Retum/Appeal Notes: Parcel: E7 -140 -AO -027 177 REDMEADOW DR PLAT: 0008/060 UNIQ ID 6731 2525397 BDII-5 ID NO: 5861278812 COUNTY TAX (100), FIRE TAX (100) CARD NO. I of 1 eval Year: 2013 Tax Year: 2014 LOT 27 REDLAND PLACE 1.000 IT SRC= Inspection Appraised by 19 on 04/17/2008 03108 REDLAND WAY TW -03 Cl- FR -15 EX- AT- LAST ACTION 20110712 CONSTRUCTION DETAIL MARKET VALUE DEPRECIATION CORRELATION OF VALUE Foundation - 3 1 Standard 0.0800 ontinuous Footing 5.0 Eff. BASE S MO Area UA RATE RCN EYB AYB REDENCE TO MARKET ub Floor System - 4 97 67.90 26963 200 200 % GOOD 1 92.0 EPR. BUILDING VALUE - CARD 248,07C lywood 8 00 01 1 01 3,949 Exterior Walls - 10 TYPE: Single Family Residential Single Family Residential 3EPR. OB/XF VALUE - CARD 8,38 luminum/Vin I Siding 31.00 4ARKET LAND VALUE - CARD 28,80 xterior Walls - 21 STYLE: 3 - 2.0 Stores rOTAL MARKET VALUE - CARD 285,25 ace Brick 0.0 Roofing Structure - 03 able 8.00 TOTAL APPRAISED VALUE - CARD 285,25 Roofing Cover - 03 OTAL APPRAISED VALUE - PARCEL 285,25 s half or Composition Shingle 3.0 nterior Wall Construction - 5 TOTAL PRESENT USE VALUE - PARCEL )rywall/Sheetrock 20.0 OTAL VALUE DEFERRED - PARCEL nterior Floor Cover - 12 TOTAL TAXABLE VALUE - PARCEL 285,25 ardwood 10.0c nterior Floor Cover - 14 PRIOR UILDING VALUE 281,33 :arpet 0.00 BXF VALUE 10,41 eating Fuel - 04 - - - - - - 4 6 - - - - - - + ND VALUE 28,80 Electric1.0 I F U S I RESENT USE VALUE eating Type - 30 I I DEFERRED VALUE eat Pump 4.00 I I TOTALVALUE 320,54( it Conditioning Type - 03 3 3 4.00 9 9 ms/Bath oms/Half-Bathrooms I I 13.00 I 1 1 0 1 I I 0 0 I +14-+ +--22--+ PERMIT CODE DATE NOTE NUMBER AMOUNT -2LL- 0 oms 1 FUS - 1 LL- 0 OUT: WTRSHD: athrooms +-16-+12-+ +-------56-------+ SALES DATA 1FEP 1WDD1 1PTO 1 INDICATE 1 FUS - 0 LL - 0 2 0 0 0 0 ECORD DATE DEED SAS +8+-16-+12-+-20--+ +-------56-------+ 0 AGE M R TYPE / PRICE iBAS I 1UBM 1 L POINT VALUE 107.00 5 1 5 1 0635 625 11 00 WD Q I ;1h 29000 BUILDING ADJUSTMENTS + - 2 0 - - + I +-20--+ I 0543 737 4 00 WD Q V 3850 3 Size 0.870 I F G D 8 3 I ++ 9 8 3 0457 082 12 200 WD X V ++ 9 3 AVG 1.0000 2 1 1 1 1 /Desig 4 FACTOR 4 1.050 4 1 I 1 I ADJUSTMENT FACTOR 0.91 1 6 I 5 1 L QUALITY INDEX 9 +--24--+30++-21--+ 8FOP8 +10+--22--+ HEATED AREA 3,516 +12-+ NOTES SUBAREA UNIT ORIG % ANN DEP % OB/XF .EPR. TYPE GS AREA % RPL CS ODE DESCRIPTION OU LTH H UNIT PRICE COND LDG# AYB EYB RATE V CON D VALUE BAS 1 630 100 11067 10 ON PAVING 9 2 1,90 4,0 _ 00 00 5 6 494 FEP 19 07 909 1 ORAGE 2 1 28 15.0 _ 007 00 S 8 344CA FGD 5 04 1663 OTAL OB XF VALUE 8,384 FOP 10 03 251 US 1.69 09 103 0 56 00 190 BM 1,63 02 2213 DO 120020 163 FIREPLACE 2 - Pre 1150 Fabricated USAREA 6147 269,63 OTALS BUILDING DIMENSIONS BAS=W20 WDD=N10W12S10E12$W12FEP=N12W16S12E16$W24S15 FGD=E20SBE4S16W24N24$ E20S8E4S15 FOPS1W1S8E32N8VAN1W30$ E10S1E22N39$ PTR -E15 UBM=SI5E2OS8E4S15EIOS1E22N39W56$ PTO=N10E56S10W56$W15N25 FUS-N39W46S39E14N10E10S10E22$ S25$. LAND INFORMATION HIGHEST THERADJUSTMENTS LAND TOTAL D BEST USE LOCAL FRON DEPTH / LND GOND NO NOTES OA UNIT LAND UNT TOTAL ADJUSTED LAND OVERRIDE LAND SE CODE ZONING TAGE EPTH SIZE MOD FACT RF AC LC TO OT TYPE PRICE UNITS TYP ADJST UNIT PRICE VALUE VALUE NOTES FR RES 0100 1 0 1 0 1 1.0000 110 0.8000 PW 36,000.0 1.00 IT 0.80 28,800.0 2880 SHP TOPO OTAL MARKET LAM DATA 28,80 OTAL PRESENT USE DATA Owns http://66.226.39.229//ITSNet/AppraisalCard.aspx?parcel=E714OA0027 8/4/2014 7c A ` I [+Q U K� Printed:Sep 10, 2015 All data is provided as is without warranty or guarantee of any kind either expressed or implied including but not limited to the 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 or arising out of the use or inability to use the GIS data provided by this website. Id Roy Sowers ,n do 'M. So wers ' 166, Pg. 92 plot by Michael F. Gizinski I November, 1986 used for Map Meridian) _zoned 1-3 GG. P -S. Sg4'12' S6„ W a6.20' 00t°I) 43,892 Sy. Ft. 1.008 Acres± �C3 �9'00� 5861 37 2453 Paul McGraw -hc1 &) ,Co m ECEUVE APPLICATION 17011 SITE EVALUATION/IMPIIOVEAiENT 1101h1 1IC Davie County Health Department JAN 2 EnvironInenta/He,71M Section ��04 P.O. Box 848/210 Hospital Street Mocksville, NC 27028 ENVIR0017ENTALIIE4LTH (336) 751-8760 DAVIECOUNTy. ***IMPORTANT*** TI1IS APPLICATION CANNOT BE PROCESSED UNLESS ALL TIIE REQUIRED INFORMATION IS PROVIDED. Refer to the INFORMATION BULLETIN for instructions. 1. Name to be Billed Mailing Address City/State/ZIP 2. Name on Permit/ATC if Different than Above Contact Person Home Phone Business Phone Mailing Address City/St to/Zip 3. Application For: 13 Site Evaluation Improvement Permit/ATC 4. system to service: EY/House ❑ Mobile Home ❑ Busine8n ❑ Industry ❑ Othcr ❑ Doth lk S. Type system requested: W Conventional ❑ conventional modified ❑ innovaLive 6. If Residence: it People It Bedrooms It Bathrooms of ;Pt) lllDishwasher ❑Garbage Disposal Mashing Machine ❑Basement/Plumbing L`lisasemenL/No Pluwbing 7. If Business/Industry /Other: verify type It People It Sinks # Commodes II Showers It Urinals II Water Coolers IF FOODSERVICE: 1#Seats Estimated Water Usage (gallons per day) 8. Type of water supply: M County/City ❑ Well ❑ Community 9. Do you anticipate additions or CXpansiolls of the facility this system is hileuded to serve? ❑ Yes EX If yes, what type? ***1h1P0RTANT*** CLIENTS AIUSTCOAIPLETE- THE RL•QUIRED PROPERTY INFORMATION RE'QUI.STI-A) BELOW. Either a PLAT or SITE PLAN,l1USTBESUBAlITTED by the client )i,itli'l'lllS AI'1'LICA'I'ION. Properly DiniCnsions: Tax Office PIN: u S7�� Property Address: Road Natne City/Zip If in a Subdivision provide information, as follows: Name: 46e� 4-2*y &ec_ Section: Block: Lot: lditl'I'E DIRECTIONS (from Mocliwiile) (o 1'ROPE'liTY: Date home corucrs flagged: A% 6 This is to certify that IIIc information provided is correct to the best of Iny knowledge. I understand dial any peruiit(s) issued hereafter are subject to suspension or revocation, if the site plans or intended use change, or if llie inforniation submitted in this application is falsified or changed. I, also, understand that I a,u responsible for all charges incurred.fi-ow this application. I, hereby, give consent to the Authorized Representative of [lie Davic County Ilcallli Delmr(uicnl to cuter upon above described property located in Davie County and owiicd by to conduct all t lesting procedures as necessal'y to dctertnine the site suitability. DATE /�� SIGNATURE �lJ relZ 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). Site Revisit cliar ;e Datc(s): Client Notification Date: EIIS: Sign given Account No. �(� )C 0 �� S Revised DCIID (05/03 Invoice No: DAVIE COUNTY HEALTH DEPARTMENT Environmental Health Section Soil/Site Evaluation APPLICANT INFORMATION Account #: 989900136 Billed To: Westview Development Co. Reference Name: Proposed Facility: Residence Property Size: PROPERTY INFORMATION Tax PIN/EH #: 5861-38-2199.29 Subdivision Info: Louise Smith Adams Lot # 29 Location/Address: Redland Road -27006 see map Date Evaluated: 2 2n Water Supply: On -Site Well Community Evaluation By: Auger Boring Pit Public Cut FACTORS 1 2 3 4 5 6 7 Landscape position L Slope % HORIZON I DEPTH O-cl 0-17-0 Texture group C GA_ Consistence S Structure Mineralogy )I') 1= I HORIZON II DEPTH ^ 32 1 Texture groupG Consistence Structure S Mineralogy HORIZON III DEPTH 2— Texture group -}fir Consistence 'S Structure Mineralogy HORIZON IV DEPTH Texture group Consistence Structure Mineralogy SOIL WETNESS RESTRICTIVE HORIZON SAPROLITE CLASSIFICATION LONG-TERM ACCEPTANCE RATE SITE CLASSIFICATION: t�s LONG-TERM ACCEPTANCE RATE: EVALUATION BY: IZZ7 t— _5EAU04 OTHER(S) PRESENT: REMARKS: S T - -' 'ro Qt.��r�, LU[- u,)1;7 q (•- 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)