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122 Roxbury Court Lot 48Davie County, NC ' Tax Parcel Report Wednesday, November 30, 2016 WAKNILNG: '1'1llb 1, 1VV'1' A JUKVEY Parcel Information Parcel Number: H8060A0048 Township: Shady Grove NCPIN Number: 5789139928 Municipality: Account Number: 34374180 Census Tract: 37059-804 Listed Owner 1: HELTON BRENT W Voting Precinct: EAST SHADY GROVE Mailing Address 1: 122 ROXBURY COURT Planning Jurisdiction: Davie County City: ADVANCE Zoning Class: DAVIE COUNTY R -A State: NC Zoning Overlay: Zip Code: 27006-0000 Voluntary Ag. District: No Legal Description: LOT 48 COVINGTON CREEK PHASE ONE Fire Response District: ADVANCE Assessed Acreage: 1.55 Elementary School Zone: SHADY GROVE Deed Date: 2/1999 Middle School Zone: WILLIAM ELLIS Deed Book I Page: 002090803 Soil Types: PaD,PcB2,PcC2 Plat Book: 0007 Flood Zone: Plat Page: 057 Watershed Overlay: DAVIE COUNTY Outbuilding & Extra Building Value: Freatures Value: Land Value: Total Market Value: Total Assessed Value: 101 All data Is provided as Is without warranty or guarantee of any Idnd either expressed or implied Including but not limited to the Davie County, Impliedwarwat. es of merchantability or fltness for a particular use. All users of Dae 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 arising out of the use or Inability to use the GIS data provided by this website. ... .r.....�Gi ayn.,3.y V"«sMa N'"'S.a:1.'�i.:'n!.'1f-J'".:fJ .: r. •.;j aY--.w�.. atiae pro ..'j✓�- x'rr.s.Y-y i a. '.�G k"r .-ryvw-�JEe �.. - +o:'..K;Y.M?!- ,.4 �tO,RIZATION No: �} DAVIE,C LINTY HEALTH DEPARTMENT 1 nvironmental Health Section PROPERTY INFORMATION.. ' Permittee'~ P.O. Box 848 L116 Name. /�it•�".�'�°" Mocksville, NC 27028 Subdivision Name: d.' Phone # 336-751-8760 D�, civ' , .Directions to property: � Section: .e"' Lot: AUTHORIZATION FOR WASTEWATER Tax Office PIN:#` SYSTEM CONSTRUCTION Road.Name: !l C%Zi **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. (In 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 H0AI 4 SPEC ALIST DATE ISSUED l I RICHARD C. SHORT COW NGTON CREEK RICHARD C. SHORT i ' FUTURE PHASE 2 COVINGTON CREEK FUTURE PHASE 3 200.010s, N�• i� N �7.35�•r`�'' \\ �\\ leZ-�l�' �\ E\ cT \ \ 45 0 \ \ -- G \ G� P % 6` Q• aD ko �.`,Q/\ w r—'350 ��' � -/,w� �� \\ "i�\ \\ \•� 290.00' �Ins)- 310.00' 120.00' FUTURE PHASE 1 LOT 36.01, MAP H-8 W.J. ELLIS & WIFE HAZEL L. ELLIS ' DB 49, PG 425 r DAVIE COUNTY HEALTH DEPARTMENT r • h � Environmental Health Section SECTION--/ LOTe Soil/Site Evaluation APPLICANT'S NAME ��-14 DATE EVALUATED PROPOSED FACILITY PROPERTY SIZE SUBDIVISION/!/.1�/ C PA ROAD NAME% Water Supply: On -Site Well Community. Evaluation By: Auger Boring Pit v Public l� Cut FACTORS 1 2 3 4 5 6 7 Landscape position Slope % HORIZON I DEPTH Texture group Consistence Structure Mineralogy HORIZON I1 DEPTH Texture group Consistence r Structure 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: , LONG-TERM ACCEPTANCE RATE: REMARKS: DCHD (01-90) EVALUATION BY: A // OTHER(S) PRESENT: '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 - Finn 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 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 THE RE UIRED INFORMATION IS PROVIDED. 1. Name to be BilledQ��Iil� /5l1 r+4 E S Contact Person Mailing Address f?' ,))�� . A [l_ )! � d Home Phone City/State/Zip !'t�uatu Ce– /VC 2766 ( Business Phone 2. Name on Permit/ATC if Different than Above Mailing Address City/State/Zip i 3. Application For: ite Evaluation C) rr [ ] Improvement Permit &ATC y [ ]Both 4. System to Serve: [ ] House (•] Mobile Home [ ] Business [ ] Industry [ ] Other % t + 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 1 ] Well [ ] Community 8. Do you anticipate additions or expansions of the facility this system is intended to serve? [ ] Yes H'No If yes, what type? 11 r �n ►; '. 1'1.11 !'r; t 1 r l r l:d PROPERTY INFORMATION REQUIRED: *** IMPORTANT ***`A FLAT OF THE PROPERTY MUST BE SUBMITTED WITH THIS APPLICATION. Property Dimensions: iDa a-( 68 at , 09-Ct-'e- /� WRITE DIRECTIONS (from M:ocksville) TO PROPERTY. Tax Office PIN: # 78`3 - - –=�` ] Y —�9t. a z ud tC &4 V a Pu L� Property Address: Road lame__ Adz) • 2?oo 4 � c City/zip If in Subdivision provide information, as follows: Name: �b11i. AJ 'reek ?rcQcced ' 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 Authoriz of the Davie County Health Department to enter upon above described property located in Davie County and owne Revised DCHD (06-96) all testing proc uFs as necessary to determine the site suitability. I III ,1 J;r.1 ,u 111 Lir; u" J) 1-011 L)IMIVIN6 !0111; .`'1 117 MAN: 1. 2. APPLICATION FOR SITE EVALUATION/IMPROVEMENT PERMIT ' Davie County Health Department .� Environmental Mea/ffi Secflon P.O. Box 848/210 Hospital Street Mockaville, NC 27028 (336)751-8760 FEB 2 5 1999 D ENVIRONMENTAL HEALTH ***ZW=rANr*** THIS APPLICATION CANNOT BE PROCESSED UNLE3S k,M 'i INFORMATION IS PROVIDED. Refer to the INFORMATION BULLETIN for instructions. Name to be Billed ��Q /1 / ,Ps Contact Person Mailing Address �/I Alf x oZ 30 O Bome Phone City/State/ZIP jq-�/kxg , / v G 2 %D//� Business Phone 4/7 7-2— Name on Permit/ASC it Different than Above Nailing Address 3. Application For: U Site Evaluation City/state/zip M improvement Permit/ATC D Both 4. system to service: House 0 Mobile Home 0 Business 0 Industry 0 Other s. If Residence: # People # Bedrooms 3 #B -a a /throoms "Vi Dishwasher ,�Oarbage Disposal VNashing Machine U Basement/Plumbing &Basement/No Plumbing 6. If Business/Industry/Other: Specify type # People # sinks # Commodes # Showers # urinals # Nater Coolers IF FOODSERVICE: # Seats,,�, Estimated stater Usage (gallons per day) 7. Type of Mater supply: O// County/City D Well ❑ Conmuunity e. Do you anticipate additions or expansions of the facility this system is intended to serve! D Yes 0 No If yes, what type' I***IMFIDRTANT*** CLIENTS AtUSTCOMPLETETHE REQUIRED PROPERTY INFORMATION REQUESTED I BELOW. Either s PLAT or SITE PLAN MUST BESUB11fITTED by the client with TINS APPLICATION. Property Dimensions: '� "Q X l(- WRITE DIRECTIONS (from MockrAlie) to PROPERTY: Tax Office PIN: # 571V Property Address: Road Name D - - e- City/Zip �zta . If in a Subdivision provide information, as follows: Name: U U/'�,��il� 6&:iL Section: T Block: Lot: Date Property Flagged: ;- — This is to certify that the information provided is correct to the best of my knowledge. I understand that any permit($) 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 oar responsible for all charges Incurred from this application. I, hereby, give consent to the Authorized Representative of the Da Co°pnty He#lth D artmen to enter upon above described property located in Davie County and owned by A!fh t r2 D to conduct all testing procedures as necessary to determine the site suitabilih. DATE 9 - a 5- — 9/a SIGNATURE Q� C 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 (07/98) Account No. Invoice No. �� /