128 Covington Drive Lot 4Davie County, NC Tax Parcel Report Wednesday, November 30, 2016
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COVINGTON D
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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, 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 any and all claims or causes of action due to
F -a NC or arising out of the use or Inability to use the GIS data provided by this website.
WARNING: THIS IS NOT A SURVEY
Parcel Information
Parcel Number.
H806OA0004
Township: Shady Grove
NCPlN Number:
5789342379
Municipality:
Account Number:
82514795
Census Tract: 37059-804
Listed Owner 1:
GIBB LARRY L
Voting Precinct: EAST SHADY GROVE
Mailing Address 1:
128 COVINGTON DRIVE
Planning Jurisdiction: Davie County
City:
ADVANCE
Zoning Class: DAVIE COUNTY R -AR -20
State:
NC
Zoning Overlay:
Zip Code:
27006-7866
Voluntary Ag. District: No
Legal Description:
LOT 4 COVINGTON CREEK PHASE ONE
Fire Response District: ADVANCE
Assessed Acreage:
0.74
Elementary School Zone: SHADY GROVE
Deed Date:
5/2000
Middle School Zone: WILLIAM ELLIS
Deed Book! Page:
003340442
Soil Types: WeB,PcB2
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:
the
u
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, 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 any and all claims or causes of action due to
F -a NC or arising out of the use or Inability to use the GIS data provided by this website.
DAME COUNTY HEALTH DEPARTMENT
Environmental Health Section
P. O. Boa 848/210 Hospital Street
Mocksville, NC 27028
(336)751-8760
Account #:
989900035
Tax PIN/EH #:
5789-34-2379
Billed To:
Richard Short
Subdivision Info:
Covington Creek Sec.1 Lot # 4
Reference Name:
Richard Short
Location/Address:
Hwy 801 S.-27006
Proposed Facility:
Residence
Property Size:
155 x 270
ATC Number: 2185
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 WASTE qf.UON IS ALID FOR A PERIOD OF FIVE YEARS.
AllEnvironmental Health Specialist's Signa 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. Chapt MA, Section .1900 "Sewage Treatment and
Disposal Systems," but shall in NO WAY be taken as a guar tee at the system will function satisfactorily for any
given period of time.
11
Septic System Installed By:
Environmental Health Specialist's Signature:
DCHD 05/99 (Revised)
Q
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"awl
Date:
DAVIE COUNTY HEALTH DEPARTMENT
Environmental Health Section tl 11
P. O. Boz 848/210 Hospital Street
Mocksville, NC 27028
(336)751-8760
IMPROVEMENT/OPERATION PERMIT
Account M 989900035 Tax PIN/EH #: 5789-34-2379
Billed To: Richard Short Subdivision Info: Covington Creek Sec.1 Lot # 4
Reference Name: Richard Short Location/Address: Hwy 801 S.-27006
Proposed Facility: Residence Property Size: 155 x 270
ATC Number: 2185
**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 �Ol- #People #Bedrooms�•5
f S #Baths
Dishwasher: ER'- Garbage Disposal: u Washing Machine: Basement w/Plumbing: ❑ Basement/No Plumbing: ❑
Commercial Specification: Facility Type #People #People/Shift #Seats Industrial Waste: ❑
Lot Size Type Water Supply C*tJ-Tl? Design Wastewater Flow (GPD) Site: New Repair ❑
,i I r
System Specifications: Tank Size �C)COGAL. Pump Tank GAL. Trench Width 3.o Rock Depth 12 Linear Ft. -6
Other: 2 Vrn:5tP,-SOT ioZ , LL- L -i 910-(2,,
Required Site Modifications/Conditions: s, Cf�C 1400sz. �4� 10' rcr_ MOP. I XS''�
.- •-rod 2
IMPROVEMENT/OPERATION PERMIT LAYOUT - APPROVED EFFLUENT FILTER RISERS) 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.****
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Environmental Health Specialist's Signature:
DCHD 05/99 (Revised)
F -Uv lsz--b 3lyg':.o
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Date:/Z�V F
' DAVIE COUNTY HEALTH DEPARTMENT
Environmental Health Section SECTION_, LOT
Soil/Site Evaluation
APPLICANT'S NAME �i 8 6' DATE EVALUATED "
PROPOSED FACILITY PROPERTY SIZE J�figG�
SUBDIVISION
Water Supply: On -Site Well
Community
Evaluation By: Auger Boring Pit L�
ROAD NAME _ t Z
Public t /i
Cut
FACTORS 1 2 3 4 5 6 7
Landscape position
Slope %
HORIZON I DEPTH
Texture group
Consistence
Structure
Mineralogy
HORIZON II 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: f�
LONG-TERM ACCEPTANCE RA
REMARKS:
DCHD (01-90)
EVALUATION BY:
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 - 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
Mineraloay
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 PERMIT
Davie County Health Department
Environmental Health Section V
P.O. Box 848 AV `f
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 14b rw% P S Contact Person / kf
Mailing Address ?///) yo t) )Y C� Home Phone
City/State/Zip 00q Uaid Ce— NL. 2706( Business Phone �8/3,39/9''(�"�ibl�,
2. Name on Permit/ATC if Different than Above
Mailing Address City/State/Zip
3. Application For:V� 4ite Evaluation [ ] Improvement Permit & ATC [ ] Both
4. System to Serve: [ ] House [ •] Mobile Home [ ] Business [ ] Industry [ l Other c2 a 10+ 51-L&41 vis /O'J
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
If yes, what type?
/•r.11 OR ",III llkr'?
PROPERTY INFORMATION REQUIRED: *** IMPORTANT ***'A FLAT OF THE PROPERTY MUST BE
SUBMITTED WITH THIS APPLICATION.
Property Dimensions: A)or+ c4- 4.6 &c, parce WRITE DIRECTIONS (from Mocksville) TO PROPERTY:
Tax Office PIN: # 7c4`3 - 94/— &11 2.61 ,ST aA k n�c Ad V 4 w ue
Property Address: Road lame 801 5'ldQ of
City/Zip fA U - 2 ?v o ; (' _ �_=Or-Am M U e rs l -
If in Subdivision provide information, as follows:
Name E tZwee
i
Section: 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 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 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
SIGN
all testing procedures as nepessary to determine the site suitability.
Revised DCHD (06-96)
71118 YMEA ,k[,Ill 13E 11SEU 1"01%' NMIHNG 1011R SITE 1'1_.1N:
DAVIE COUNTY, NORTH CAROLINA
I, o Notary of the County and State aforesaid,
certify thot John C. Grty and G. Rogert Stone
Registered Land Surveyors, personally appeared
before me this day and ooknowledged the q.ecution
of the foregoing instrument. Withess my hand and
official stomp
or seal,
this -a day of November. 1998.
My commission eepires / +;.2— a00
Notary Public
BAILEY R
NA SER J�c�' ill
ADVANCE
UNINCORPORATED
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\ LOT 20, MAP H-8 �� o �� SAILEyS CNAPE� R� o
LEWIS M. CARTER & v1 `O
\ WIFE DOROTHY P. CARTER y 2Q z
\ DB 59. PC 393 G N� --
N�
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\ FUTURE PHASE 1 ' fr
T07 L 3 3. T S T 44' Y3"
153.27' 6 �, 0
240.00' Z
RICHARD C. SHORT - ' - - - - - - T-B6R(CAP
COVINGTON CREEK O ;.
FUTURE PHASE 2 r` 3 NX
CONTROL $ I � � �.�� �
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CORNERI
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128.00' 587' 55,27-
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04 ! FUTURE
TENNISU a
0,;a I COURTS
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IWPUUAIION FOR SII E EVAWAInON/IMPROVEMENT PERMIT & ATC
Davie County Health Department
Envhnmental Health Section
P.O. Box 848/210 Hospital Street
Mocksville, NC 27028
(336) 731-8760 -
SEP 2,1999 II
***DWCRTM"** THIS APPLICATION CRIUM BS PROCESSED MUSSS ALL THS RSQUIRSD
INFORMATION IS PROVIDED. Refer to the IIIFORMATION BULLETIN for instructions.
1. rams to be silted / C L- -
aa � x�(
hailing Address
City/state/EIp 4ZL k 't-e't,
Z. :tams on permit/ATC it Different than Above
Contact person
am@ phone
Business phone
l0a411409 Address City/state/sip
9. Application ror: l] Site Evaluation 015�provement Permit/ATC
p`' MY
cb - l
-
- 6 wer
0 Both
4. Systea to services i�Honse 0 Mobile Home O Business O Xndustsy O Other
S. If Residence: f People t Bedrooms_ i Bathrooms
ishwashar P. as0" rbage Disposal DSS lfaobine 0 asseesnt/pIw"no 0 2"ementiVa, plumbing
6. If susinses/Industry/other: specify type
# Canmodas f showers + Urinals
f paople i sinks
# Yater Coolers
IF FOODSERVICE: d Seats Estimated Water Usage (gallons per day)
7. Type of Mater supply: R-t`ounty�/City 0 Well 0 Community
s. Do you anticipate additions or expansions of the fecWty this system Is intended to serve? 0 Yes
If yes, what type?
***IMPORTANT*** CLIENTS MUSTCOMPLEM THE REQUIRED PROPERTY INFORMATION REQUESTED
BELOW. Either a PLAT or SITE PLAN MUST BESUBMITZED by the elieat with THIS APPLICATION.
Property Dimensions: &.l
Tax Office PIN: # �'%�9' �� S% "7-3 7`t
Property Address: Road Name
City/Zip
If in a Subdivision provide information, as follows:
Name:f C�ewk
Section: Block: Lot:
WRITE DIRECTIONS (from MocluvWe) to PROPERTY:
Date Property Flagged:
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 ase change, or if the information
submitted in this application Is falsified or changed 1, also, understand that I an responsible for all charges Incurredfrom
this application. I, hereby, give consent to the Authorized Representative of the C9au: H th Department
to enter upon above described property located in Davie County and owned by.
to conduct all testing procedures as necessary to determine the site salb
DATE - c;1 %- �7 SIGNATURE
THIS AREA MAY BE USED FOR DRAWING YOUR SITE PLAN (Include all of the follawing: Faisting and proposed
property lines and dimensions, structures, setbacks, and septic locstious .
Revised DCHD (07/99)
I
Site Revisit Charge
Da"):
I Client Notification Date:
I EAS:
Account No.
Invoice No.