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121 Roxbury Court Lot 49Davie County, NC � . • 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: TIiIS IS NUT A SURVEY Parcel Information H8060A0049 Township: Shady Grove 5789231931 Municipality: 82526503 Census Tract: 37059-804 LAWSON TERRY R Voting Precinct: EAST SHADY GROVE 121 ROXBURY COURT Planning Jurisdiction: Davie County ADVANCE Zoning Class: DAVIE COUNTY R -A NC Zoning Overlay: 27006-0000 Voluntary Ag. District: LOT 49 COVINGTON CREEK PHASE ONE Fire Response District: 0.70 Elementary School Zone: 5/2006 Middle School Zone: 006640570 Soil Types: 0007 Flood Zone: 057 Watershed Overlay: Outbuilding & Extra Freatures Value: Total Market Value: No ADVANCE SHADY GROVE WILLIAM ELLIS PcB2,PcC2 DAVIE COUNTY F—al Ail data is provided as Is without warranty or guarantee of any Idnd either expressed or implied including but not limited to theDavie County, Impliedwarranties ofmerchantabutty ornbwm for a particular use. Ali users of Davie County's GIS websfte 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 arising out of the use or Inability to use the GIS data provided by this website, DAVIE COUNTY HEALTH DEPARTMENT Environmental Health Section P. O. Boz 848/210 Hospital Street Mocksville, NC 27028 (336)751-8760 Account #: 989900323 Billed To: Vogler's Construction, Inc. Reference Name: Dick Vogler Proposed Facility: Residence ATC Number: 2168 Tax PIN/EH #: 5789-23-1931 Subdivision Info: Covington Creek Sec.1 Lot # 49 Location/Address: Covington Drive -27006 Property Size: 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 Treatment and Disposal Systems). THIS AUTHORIZATION FOR WASTEWAMR C NSTRUCTION IS VALID FOR A PERIOD OF FIVE YEARS. Environmental Health Specialist's Signature: Date: CERTIFICATE 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 G.S. Chapter 130A, Section .1900 "Sewage Treatment and Disposal Systems," but shall in NO WAY be taken as a guarantee that the system will function satisfactorily for any oiven of -.And nftime M Septic System Installed By: Environmental Health Specialist's Signature: I ' I , g " DCHD 05/99 (Revised) 4-tX*e 3 Date: . 00 DAVIE COUNTY HEALTH DEPARTMENT Environmental Health Section P. O. Boz 848/210 Hospital Street Mocksville, NC 27028 (336)751-8760 IMPROVEMENT(OPERATION PERMIT Account #: 989900323 Billed To: Vogler's Construction, Inc. Reference Name: Dick Vogler Proposed Facility: Residence Tax PIN/EH #: 5789-23-1931 Subdivision Info: Covington Creek Sec.1 Lot # 49 Location/Address: Covington Drive -27006 Property Size: ATC Number. 2168 **NOTE** This Improvement/Operation Permit DOES NOT authorize the construction of a 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 �LL #People #Bedrooms #Baths_ Dishwasher: 5 Garbage Disposal: ❑ Commercial Specification: Facility Type Washing Machine: Basement w/Plumbing: ❑ Basement/No Plumbing: ❑ #People #People/Shift #Seats Industrial Waste: ❑ Lot Size 0X 16z) Type Water Supply Design Wastewater Flow (GPD)240-0- Site: New 0 -'Repair ❑ System Specifications: Tank Size 1608 GAL. Pump Tank GAL. Trench Width " Rock Depth c� � Linear Ft,�CQ Other: Required Site Modifications/Conditions: 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 installation. Telephone # is (336)751-8760.**** 40 Environmental Health Specialist's DCHD 05/99 (Revised) Date: / f 7-2�� r DAVIE COUNTY HEALTH DEPARTMENT Environmental Health Section SECTION _,/_ LOT-�-L Soil/Site Evaluation APPLICANT'S NAME '!5A/9 DATE EVALUATED OF t2 d� PROPOSED FACILITY .,!PROPERTY SIZE -�� �Ae SUBDIVISION _1f / i /! / Oi✓67e eA ROAD NAME S� % Water Supply: On -Site Well Community, Evaluation By: Auger Boring Pit t_� Public Cut FACTORS 1 2 3 4 5 6 7 Landscape position Sloe % HORIZON I DEPTH Texture group Consistence Structure Mineralogy HORIZON II DEPTH Texture group C C Consistence Structure it Mineralogy / HORIZON III DEPTH Texture group Consistence Structure Mineralogy HORIZON IV DEPTH Texture group Consistence Structure Mineralogy SOIL WETNESS RESTRICTIVE HORIZON SAPROLITE CLASSIFICATION LONG-TERM ACCEPTANCE RATE SITE CLASSIFICATION: jl EVALUATION BY: A6/ LONG-TERM ACCEPTANCE RATE: OTHER(S) PRESENT: REMARKS: �a/� !�JC'�yytGliT 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 ois 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 ' vi (U (61-96) - APPLICATION FOR SITE EVALUATIONAMPROVEMENT PERMIT Davie County Health Department @ D Environmental Health Section P.C. Box 848 Mocksville, NC 27028 (704) 634-8760 ****IMPORTANT**** THIS APPLICATION CANNOT BE PROCESSED UNLESS ALL THE RE UIRED INFORMATION IS PROVIDED. 1. Name to be Billed 1yA ^'AES Contact Person �1 �-ry <►f Mailing Address ?1 ,At) >! '-L'3 o l) Home Phone City/State/Zip ! t�UaiJ C.e N� . %Ove Business Phone 2. Name on Permit/ATC if Different than Above Mailing Address City/State/Zip 3. Application For: Plite Evaluation [ ] Improvement Permit & ATC [ ]] Both 4. System to Serve: [ ] House [ -] Mobile Home [ ] Business [ ] Industry [ ] Other 5. If Residence: # People # Bedrooms # Bathrooms [ ] Dishwasher [ ] 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 [ ] Community 8. Do you anticipate additions or expansions of the facility this system is intended to serve? [ ] Yes L�'11`l0 If yes, what type? PROPERTY INFORMATION REQUIRED: *** IMPORTANT ***`A FLAT OF THE PROPERTY MUST BE SUBMITTED WITH THIS APPLICATION. Property Dimensions. OAsrc-C' 'WRITE DIRECTIONS (from Mocksville) TO PROPERTY. Tax Office PIN: # 789 - -44_ - y 3 y [ �i� �SIl tri 1,tZ Ad tl R w c.e Property Address: Road Damegot ©��,r{ / m `i — City/Zip ,� i) • 27vo4t If in Subdivision provide information, as follows: Name:,bt)/n -asi reek- y)rt�raoczcL ; Section: 1 Lot #:- 7 1 This is to certify that the information provided is correct to the best of my knowledge. I understand that any permit(s) issued hereaf:Pr 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. 1, also, understand that I am responsible for all charges incurred from this application. I, hereby, give consent to the Authorized of the Davie County Health Department to enter upon above described property located in Davie County and owned by = 11et rs DATE f SIGNA all testing proce0u;es as nepessary to determine the site suitability. Revised DCHD (06-96) 1111; :trr.t wib Lir li Ft) )-cel; 1)1?A11'IN(i !µ0111; S111: PIAN: 46 \'o, N 87°1'31 "W 290.00' I ` I `.BO• 1 ` to ` IN I� I I s 30 0 30 60 90 GRAPHICLLL-i SCALE — FEET IT 06n - u R� 3¢ F s• unurr �'a� N m v c� v WD- APPLICATION FOR SITE EVAWATION/IMPROVEMENT PERMR & (2 "'� �. . S Davie County Health Department L5 �% Env�immenfal Hee/th Se�cdon P.O. Box 94e/210 Hospital street SEP 1 4 1999 liocksville, NC 27026 (836)781-0760 I***IiVMnNT*** TRIS AppLICATIOM MIMM » mom= =W88 _—Y� IM>f'OMMIOM IS MWIDBD. Rotor to the iM><'OIiMIITIOM BULL&TIM for instructions. 1. wane to be SLUed 1 l JS. he V Contaot "coon , 4 / : I:eixLvq address '3%iii/_ao*t "09-ttV. none phone WO 7 eLtt/stet./a:p 1 _e x.�•� ,..eve e--92 4 S'" aaeia... phone ���— �/ G - 3 a 3 2. Ileam on perait/M it Ditterant than above Nailinq address city/state/sip a. Application tor: 13 Site ivaluation B'fmprovement permit/ATC 0 Both e. stetsn to servioei Boase 0 Mobile Home 13 Business 0 Industry O Other _ a. If��Residence: i people5 � 1 Bedrooms ,_ # Bathrooms 9�Dishwaah r 0 Garbage Oieposal a'Ifss/machine o au•rnt/vIumbinq 0 aas"ont/mo pluabiaq 6. it 3ueines8/2aduetrt/0ther: apeoitt type I people I sLWW # Commodes I showers ! urinals i water coolers It 1=89MCK: d Seats estimated )rater Usage toallona per day) 7. TWO of Water supply: &-aunty/City 0 Well 0 Community a. Do you anticipate additions or expansions of the facWty this system Is intended to serve? 0 Yea alro— If yes, what type? ***IMPORTANT*** CLIENTS MUST COMPtETETHE REQUIRED PROPERTY INFORMATION REQUESTED j BELOW. Either a PLAT or SITE K AN MUSTTBESUBMITTED by the client with THIS APPWCATION. J Property Dimensions: S�� �`► tea` C fW 9/ 'y 1 014J WRITE DIRECTIONS (from Mocicsville) to PROPERTY: Tax Oflice PINI # 01 �;"% Ir 1431 G rt) �e P Property Address: Road Noma citylzIp )4 z 4A•N .- �C C9 7�0 e. If in a Subdivision provide Information, as follows: Names 6,4e t k rAV ., • wt Section: -+- Bloch Lot: Date Property Flagged: 9 This is to certify that the information provided Is correct to the best of my knowledge. I aadecstand that any permit(.) Issued hereafter are subject to suspension or revocation, lithe site plans or intended we change, or if the Information submitted In this application is Wfied or changed. 1, also, understand that I am responsible for all charges lncarred, jirom this appUcadom I, hereby, give consent to the Authorized Representative of the Davis Coupty Deal Department to enter upon above described property located In Davie Canty and owned by to conduct all testing procedum as necessary to determine the site sultabWty. DATE SIGNATURE THIS AREA MAY BE USED FOR DRAVMG YOUR SITE PLAN (Include all of the following: Existing and proposed property Tines and dimensions, structures, setbacks, and septic locations). ' �ee-y{�c/,v— pjz4-�kJ Revised DCHD (07/99) Site Revisit Charge I Dsh(s): I Client Notification Date: ZEAS: Account No. L?-` l Invoice No. ��