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128 Covington Drive Lot 4Davie County, NC Tax Parcel Report Wednesday, November 30, 2016 -137 11 ) 2 YY 139 801 120 13 140 136 128 134-- If3 1 COVINGTON D L- ------- 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. 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 F "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.**** W28 -P, 0 1COr o _ Z. cy N. Environmental Health Specialist's Signature: DCHD 05/99 (Revised) F -Uv lsz--b 3lyg':.o PLjmbe>0T )Q Of- boos+ K a 7S LIrJc; PAtALLF;L-TO ZAC"- c7f- 00-0 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 L RD 01 RD /4cv o �P 4D U I ARKLA RD JIM rVicii � PROJECT LEs ac \ 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� \\ �ZG 04 \ 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 � � �.�� � CD CORNER N S \ 'a• ��� ,E CID s 'PAT R/W o- 2 1 � 5Jl 4 3 P �• � AES N CONTROL : ' I 3 4, b" CORNERI R \ 00 74 83.21' 44.79'\ IoM 23 35- W 00 128.00' 587' 55,27- A 5'27"3 r----- ---� d?!, �\ V� 1 N �Q • 9 04 ! FUTURE TENNISU a 0,;a I COURTS 8 3 I (� i < �I -------- ---- �/5 g _ a 5 a / � / � 62 Z , � 168.79' _ 4 9.19 N C 4,\ 4 100. q0' 98.00' 50.0 \ \ I w II I I 1s w I 1 I I W l C14 I I I chi I I N I 1 n 0 I oM I I I fTld d1 to I I I /� I 1" q4' 1 I I I I qq ti + \ 6 0 A o� I Ir4 ��. \ \ %? 1 tK e \ \ I - 7 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.