113 Roxbury Court Lot 51Davie Countv, NC I I Tax Parcel Report Wednesday. November 30. 2016
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:
Land Value:
Total Assessed Value:
WARNING: T111h 1S 1VUT A SUKVEY
Parcel Information
H806OA0051
Township: Shady Grove
5789235907
Municipality:
8306983
Census Tract: 37059-804
LEWIS CARL
Voting Precinct: EAST SHADY GROVE
113 ROXBURY COURT
Planning Jurisdiction: Davie County
ADVANCE
Zoning Class: DAVIE COUNTY R -A
NC
Zoning Overlay:
27006
Voluntary Ag. District: No
LOT 51 COVINGTON CREEK PHASE ONE
Fire Response District: ADVANCE
0.76
Elementary School Zone: SHADY GROVE
10/2016
Middle School Zone: WILLIAM ELLIS
010310610
Soil Types: PcB2
0007
Flood Zone:
057
Watershed Overlay: DAVIE COUNTY
Outbuilding 8r Extra
Freatures Value:
Total Market Value:
161
7�TAll 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 fitness for a particular use. Ali users of Davie County's GIS website shall hold harmless the
County of Davie, North Carolina, Its agents, consultants, contractors or employees from anyandagdaimsorcausesofactiondueto
l� C or arising out of the use or Inability to use the GIS data provided by this website.
tea: r' .?P \ �.1�tlb✓&dl.
j7:-AD
AVIE,IEM UNTY HEALTH DEPARTMENT
• �,F,- - IMPROENTAND OPERATION PERMITS PROPERTY INFORMATION
;Tet.
147'Subdivision Name. r'
Directions to property: r !%.%�lC •.'�''�
Section: L' ot:
IMPROVEMENT
PERMIT Tax Office PIN:__
Road Name: t r •Zip: �'d
**NOTE** This Improvement Permit DOES NOT authorize the construction or installation of a septic tank system or any; wastewater system. An t
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)
***NOTICE***:THIS PERMIT IS SUBJECT TO REVOCATION IF SITE
PLANS OR THE INTENDED USE CHANGE. YOUR WASTEWATER
SYSTEM CONTRACTOR MUST SEE THIS PERMIT BEFORE
,ENVIRONMENTAL HEALTH SPECIALIST DATE ISSUIJD +
IN
STALLING THE SYSTEM.::`
RESIDENTIAL SPECIFICATION: BUILDING TYPE _ # BEDROOMS 7 # BATHS __ # OCCUPANTS GARBAGE DISPOSAL: Yes or No
COMMERCIAL SPECIFICATION: FACILITY TYPE # PEOPLE # PEOPLE/SHIFT # SEATS IND~USTRIAL WASTE: Yes or No
LOT SIZE TYPE WATER SUPPLY DESIGN WASTEWATER FLOW (GPD) �� NEW SITE :i REPAIR SITE
SYSTEM SPECIFICATIONS: TANK SIZFID On GAL. PUMP TANK GAL. TRENCH WIDTH ROCK DEPTH �� ' LINEAR FT. ,T019/
OTHER
REQUIRED SITE MODIFICATIONS/CONDITIONS:
DCHD 05/96 (Revised)
#.9 #,,a
Pot
A TI R CATION NO:9'87 HAVIE C UNTY HEALTH DEPARTMENT
nvironmental Health Section PROPERTY INFORMATION,
Permittee s , �r'!�i P.O. Box 848
Name: ' -" Mocksville, NC 27028 Subdivision -Name: +�
Phone # 336-751-8760 "
Directions to property: /"l% Section:
AUTHORIZATION FOR
WASTEWATER. Tax Office PIN:#
SYSTEM CONSTRUCTION
Road Name: • Zip. r µ"
**NOTE** This Authorization for Wastewater System Construction MUST BE ISSUED by the Davie County Environmental Health Section prior
to issuance of any Building Permits. This Form/Authorization Number should be presented to the Davie County Building Inspections
Office when applying for Building Permits.
(1n compliance with Article 11 of G.S. Chapter 130A, Wastewater Systems, Section .1900 Sewage Treatment and Disposal Systems)
/ ***NOTICE*** THIS AUTHORIZATION FOR WASTEWATER CONSTRUCTION
IS VALID FOR A PERIOD OF FIVE YEARS.
ENVIRONMENTAL HEALTH SPECIALIST DATE ISSUED
(,'OVlN(iTON CREEK t' U l URE PHASE 2
/
FUTURE PHASE 3 / I
I �. • 7
200.00'
a'
100" 7
4-1233 \\ '►,�.\
7 �gef . 35, \\ �\\ �a c1� �\ \ '�'\ \ �4 g
6.
\
\ \\V 1 4 \ oBLI
�
./C6
6
_�:7D \C,
JA
44
80
�
L7 y �- --- /moo // SO \\�'�`� \ \\� \v cbf
77
2 290.00'
FUTURE PHASE 1 310.00' — — — - zo i _
LOT 36.01, MAP H-8 120. oo'
W.J. ELLIS &
WIFE HAZEL L. ELLIS
DB 49, PG 425
4a� 1
— --- �N�IRONM�"NiA�jYAI�N
nnv�� COU
. = " DAVIE COUNTY HEALTH DEPARTMENT
• Environmental Health Section SECTION_/ Lo�
Soil/Site Evaluation
APPLICANT'S NAME ill DATE EVALUATEDe2 d�
PROPOSED FACILITY PROPERTY SIZE Z/4/ �Ae
SUBDIVISION --s; Cll i /I a �2 i✓ 67e BA ROAD NAME 6 %
'Water Supply: On -Site Well
Community
Evaluation By: Auger Boring Pit
Public !�
Cut
FACTORS 1 2 3 4 5 6 7
Landscape position
Slope %
HORIZON I DEPTH
Texture group
Consistence
Structure
Mineralogy
HORIZON Il DEPTH
Texture group
Consistence r r
Structure
Mineralogy
HORIZON III DEPTH
Texture group
Consistence
Structure
Mineralogy
HORIZON IV DEPTH
Texture grou
Consistence
Structure
Mineralogy
SOIL WETNESS
RESTRICTIVE HORIZON
SAPROLITE
CLASSIFICATION jys 61
LONG-TERM ACCEPTANCE RATE 'X I
SITE CLASSIFICATION: EVALUATION BY:�/�
LONG-TERM ACCEPTANCE RATE: OTHER(S) PRESENT:
REMARKS: zs(e mom, /,1
"4/, �✓/i�C�'Yl� -� /
[*X" RON]
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 EF1- Extremely firm
Md
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
Mineralga
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 (01-90)
APPLICATION FOR SITE EVALUATIONAMPROVEMENT PERMI
Davie County Health Department
Environmental Health Section
P.O. Box 848
Mocksville, NC 27028
(704) 634-8760 1
****IMPORTANT**** THIS APPLICATION CANNOT BE PROCESSED UNLESS ALL
I
THE RE UIRED INFORMATION IS PROVIDED.
Name to be Billed ^4 e C Contact Person
Mailing Address ?L) X o 7 Home Phone
City/State/Zip UaaJ Ce— NC . —2766 Business Phone 919--V -7 7.4
2. Name on Permit/ATC if Different than Above
Mailing Address City/State/Zip
3. Application For: allite Evaluation [ ] Improvement Permit & ATC ,� [ ]] Both
4. System to Serve: [ ] House [ •] Mobile Home [ ] Business [ J Industry [ ]Other`est. �O+ irit� {/ yi.SiO�J
5. If Residence: # People # Bedrooms # Bathrooms [ 1 Dishwasher [ J Garbage Disposal
[ ] Washing Machine [ ] Basement/Plumbing [ ] Basement/No Plumbing
6. If Business/Other: Specify type # People #Sinks # Commodes
# Showers # Urinals # Water Coolers
If Foodservice: # Seats Estimated Water Usage (gallons per day)
7. Type of water supply: County/City [ ] Well [ 1 Community
8. Do you anticipate additions or expansions of the facility this system is intended to serve? [ ] Yes
If yes, what type?
PROPERTY INFORMATION REQUIRED: *** IMPORTANT ***'A FLAT OF THE PROPERTY MUST BE
SUBMITTED WITH THIS APPLICATION.
Property Dimensions. 1 ctC:. llGtrt-e ( 'WRITE DIRECTIONS (from Mocksville) TO PROPERTY:
Tax Office PIN: # S 789 - 9-41- y 3u� ; %� c 1� i Sb id 1\ o�C AAJ4 K: 4-e
Property Address: Road Dame geo O r n,cj / m �► — [uLS -] S'Ide of
City/Zip ,�B�U • Z?oo ��-n Am n► e 11 IUI uc' cS
If in Subdivision provide information, as follows:
,f-o�l
Name: b Il - reek,
rr
J�
Section• ,1 Lot #•
This is to certify that the information provided is correct to the best of my knowledge. I understand that any permit(s) issued hereafter ar
subject to suspension or revocation, if the site plans or intended use change, or if the information submitted in this application is falsified o
changed. I, also, understand that I am responsible for all charges incurred from this application. I, hereby, give consent to the Authorize
of the Davie County Health Department to enter upon above described property located in Davie County and owne
�.. .�a[346
Revised DCHD (06-96)
all
7111; APIA AI III t;F, I1, Ft) I"Uh I)IM111IN(i II0111% .S1 I1` PIAN:
as necessary to determine the site suitability.
- APPLICA710N FOR Davie County Health � PEAM17 do
H an
lth Depatfi
Envitvnmenfat Neaiffi SmWon
P.O. Box 848/210 Hospital Street FEB 2 5 1999
Mockaville, NC 27028
(336)751-8760
r►w�RnNMENTAt HEALTH
***IMPORTANT*** THIS APPLICATION CANNOT BE PROCESSED UNLESS ALL PL 18-MMUZUED I
INFORMATION IS PROVIDED./L RefLer to the INFORMATION BULLETIN for instructions.
1. Name to be Billed & C S//d/_7 . 4�!i O&X Contact Person/(Jf`7Q �� S�Oy'
Mailing Address Z!/_/'✓3 M a -3 ,O me Hophone 99 Y q0�
City/state/ZIP �tir� /V C� � )a Business phone 9 L .�Z 7 72,
2. Name on Permit/ATC if Different than Above
Mailing Address City/state/Zip
3. Application For: U Site Evaluation vinprovement Permit/ATC 0 Both
4. system to service: House ❑ Mobile Home ❑ Business ❑ Industry ❑ Other
a. If Residence: # People _1;? # Bedrooms . -3— / Bathrooms
`ji'Dishwasher oarbage Disposal Villashing Machine 0 Basement/Plusbing 0 Basement/No Plumbing
6. If Business/Industry/other: specify type # People # sinks
# Commodes f showers # urinals i Nater Coolers
IF FOODSERVICE: # Seats Estimated Nater Usage (gallons per day)
7. Type of water supply: County/City ❑ Well 0 Community
a. Do you anticipate additions or expansions of the facility this system is intended to serve! ❑ Yes ❑ No
If yes, what type'
I***IMPORTANT*** CLIENTS MUST COMPLETETHE REQUIRED PROPERTY INFORMATION REQUESTED I
BELOW. Either a PLAT or SITE PLAN MUST BESUBI HITED by the client with THIS APPLICATION.
Property Dimension': 7" X 470 Q47 V4
Tax office PIN: # 579' a3 - S yd
Property Address: Road Name /% g},
City/Zip 12,& G
If in a Subdivision provide information, as follows:
Name: (,1J //ir/1/GDKI eh -
WRITE DIRECTIONS (from MockrAlle) to PROPERTY:
Section: Block: Lot: l_� Date Property Flagged:
This Is to certify that the information provided is correct to the best or 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 ani ra ponsibie for all charges incurred from
this application. I, hereby, give consent to the Authorized Representative of the Davie County He ibDe artmen
to enter upon above described property located in Davie County and owned by �1�0
to conduct all testing procedures as necessary to determine the site suitability.
DATE -2 — 25-22 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).
Revised DCHD (07198)
Account No.
Invoice No. '16