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106 South Hemingway Court Lot 24Davie County, NC 9 Tax Parcel Report Tuesday, November 29, 2016 WARNING: THIS 1S NOT A SURVEY Parcel Information Parcel Number: H806OA0024 Township: Shady Grove NCPIN Number: 5789142785 Municipality: Account Number: 82525982 Census Tract: 37059-804 Listed Owner 1: HANKINS ADAM G Voting Precinct: EAST SHADY GROVE Mailing Address 1: 106 SOUTH HEMINGWAY 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 24 COVINGTON CREEK PHASE TWO Fire Response District: ADVANCE Assessed Acreage: 0.69 Elementary School Zone: SHADY GROVE Deed Date: 3/2006 Middle School Zone: WILLIAM ELLIS Deed Book / Page: 006500871 Soil Types: We13,PcB2 Plat Book: 0007 Flood Zone: Plat Page: 139 Watershed Overlay: DAVIE COUNTY Building Value: Outbuilding & Extra Freatures Value: Land Value: Total Market Value: Total Assessed Value: 10:1 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, Impliedwamntles of merchantability or lftness for a particular use. All 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 ail 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 I i(21 P. O. Boa 848/210 Hospital Street Q Mocksville, NC 27028 (336)751-8760 IMPROVEMENT/OPERATION PERMIT Account M 989900141 Tax PIN/EH M 5789-14-9555.24 Billed To: Michael Wayne Myers, Inc. Subdivision Info: Covington Creek Sec.3 Lot # 24 Reference Name: Mike Myers Location/Address: Hwy. 801 S.-27006 Proposed Facility: Residence Property Size: 290 x 96.54 ATC Number: 2180 **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 p os #People #Bedrooms 3 #Baths 2• S;' Dishwasher: Er"� Garbage Disposal: [" Washing Machine: Er"' Basement w/Plumbing: ❑ Basement/No Plumbing: ET" -- Commercial Specification: Facility Type #People #People/Shift #Seats Industrial Waste: ❑ Lot Size' •.y9 Type Water Supply Design Wastewater Flow (GPD) X00 Site: New D�Repair ❑ System Specifications: Tank Size 1000 GAL. Pump Tank GAL. Trench Width "Rock Depth 12-- Linear Ft. Other: I �e &)-Tiff T2M Required Site Modifications/Conditions: IrlS- Ll- ora C 1'C 4, F- t" 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 of installation. Telephone # is (336)751-8760.**** 20` Environmental Health Specialist's DCHD 05/99 (Revised) 15;0X—Z(-0 X-12 ' io'M„J, DAME COUNTY HEALTH DEPARTMENT Environmental Health Section P. O. Boz 848/210 Hospital Street Mocksville, NC 27028 (336)751-8760 Account M 989900141 Billed To: Michael Wayne Myers, Inc. Reference Name: Mike Myers Proposed Facility: Residence ATC Number: 2180 Tax PIN/EH M 5789-14-9555.24 Subdivision Info: Covington Creek Sec.3 Lot # 24 Location/Address: Hwy. 801 S.-27006 Property Size: 290 x 96.54 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 SewageTreatment and Disposal Systems). THIS AUTHORIZATION FOR WAST C ION S V FOR A PERIOD OF FIVE YEARS. 91 Environmental Health Specialist's Signa e: 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 given period of time. i' oo / 'Ta..3V--D1Ta Septic System Installed By: Environmental Health Specialist's Signature: DCHD 05/99 (Revised) Date: -2-Z c APPUCATION FOR SITE EVAUtATION/IMPROVEMENT PERMTT A ATC Davis County Health Department 1 Envim mened Han/th SaWan 1.0. Box 940/210 Hospital street Mooksville, MC 27029 (336)751-9760 �C�C�ONII� SEP 2 01999 ***1ilP=nXTk** sits I►irsLScklsott cam= aB mcaasszD U=ss Am Tea P.ZQUsnau � i UM1i'HRMICM 16 IROVIDID. Refer to the 1M1i' PM210M SULL1921H for iastruotions. r r t. Maas to bo XLU%d 4W4%t6L j 14YOk" Ll `� Contact parson waiting Aadreea Je�/11 11 a#lJ) am* ptwne 4T�e-�;� � �- City/.tate/sz. /I (��&4Z '111i '2 200 C twinges whoas _ :Z�f b v✓ a. Masa on rtasaitlk= U Different than above WULag Address CitZ/s /sip a. Appiioatioa tor: O Bite >tvalnatioa esprovesseat permit/>4TC Both a. 8"tes to asrvioes "*use 0 Mabile Home 0 Business 0 Madustn 0 other a. 1f Residences a leapt. a Bedrooms 3 e 8atbrooms ehmeber ti Barba" Disposal Ao Bashing Waddse 0 aseassat/al+sibisq Wifteaaant/Mo plwbiaq 6. Zf stains../zadwtcf/.there spaoifY too i people + sign. Commodes 1 sho"We 6 urinals i hater Coolara 1t 1=833 MC! s # seats Intimated water Usage (gallons par dayi 7. Type of Kates supply: 9'160unty/City O well 0 Commuaity 6. no you anticipate addition or expansions of the beWty this system Is Intended to serve? 0 Ya "a U yea, what type? �•*#IMPORTANT*#e CUVM UMrCOMPLEMTHZ REQMM PROPERTY INFORMATION REQUESTED BELOW. Elder a PIAT or SITE PLAN MEAU BE SUBJUTTED by the client with THIS APPUCATION. Property Dimenlooss 14. f 4 _ X2 Ta:08icePIN: N S?'g�-��„�_9rSt� -2 `f property Addreat Road Name ' / -I `y Lzy f Cltylzip If In a Subdivision provide information, as follows WRITE DIRECTIONS (from Moekwille) to PROPERTY: Name:j(j,�f��j Sections �_ Bloclu Trott Date Property luggedt This Is to certify that the Information provided d correct to the bat of my knowledge I understand that any permit(s) Issued benatter are subject to suspension or revocation, it the site plan or intended no cbsnge, or If the Information submitted to this application Is falaitied or cbsuged. I, &be, understand that 1 oat respoulble for all charges incurredpVM ibis opplkodon. % bereby, ghn consent to the Autborhed Representative of the Usvie County Haub Department to eater upon above described property located in Davie Canty and owned by to conduct ail testing procedures a necessary to determine the site sultabiUty. DATE T_ 9 SIONATURR4&rA M THIS AREA MAY U USED FOR DRAWING YOUR SITE PLAN (incl k all of the followings Existing and proposed property Ban and dimension, structures, setbacks, and septic locati Site Revisit Charge Date(s)s I Client Notification Dates EHSs Revised DCHD (07M) ,-741 Account No. Invoice No. 4 l 1 i' Metol Bor >...>:..,..t,by Stone 9.69.44'15E 325.21' 89'26' E 476-p'B' - -- ► 2 ti'=' EIR - - -- - Bent-", Set • I - I I I by Stone 1 '' ` + i i 1 i I It / - 1 '1 I ewai 21 1 j 1 I I I I I ------ --- 1 790 I• O t... ► I ► I ~1- .+ I - - I15 T—Bu JI at r • I r� �J 3 � h a �.. y - .ms-.µ �- - - Iry 40 3A 24 T 1 - t .'x9"-- W I44 I \ -_ - 3 I `t' am lies" 37V. ' 36 1. Q bT nl 4 ir / �..- 1� 3 � 1 /�i /'1�'�r• — �, .rte _ U 170 � 3 moi-. PWC I -- ` ROAD (PLAT DTtP. f! LENGTH .4 1680_ O TYP. P 44 . 2380 0 Tyf 870 4930 COW'), " . APPLICATION FOR SITE EVALUATIONAMPROVEMENT PERMIT Davie County Health Department ,Z @ Q Environmental Health Section P.O. Box 848 E jr� Mocksville, NC 27028 (704) 634-8760 ****IMPORTANT**** THIS APPLICATION CANNOT BE PROCESSED UNLESS ALL THE REQUIRED INFORMATION IS PROVIDED. Ze. SAbC+ �57�6 r" -/ 1. Name to be Billed t q b r+, e S Contact Person �t �- n <►r Mailing Address �� 98>e '1� d t) Home Phone City/State/Zip __,! t Ua�J Cta ty,10 . Business Phone rk-Y77:Z 1813-?Ylk 2. Name on Permit/ATC if Different than Above Mailing Address City/State/Zip 3. Application For: ite Evaluation [ ] Improvement Permit & ATC,� [ ] Both 4. System to Serve: [ ] House [ •] Mobile Home [ ] Business [ ] Industry [ ] Other"" 10+ i_it�11Ji.SiO�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 H'No If yes, what type? I I►'if R I.1.11 (1r: : III II t:; PROPERTY INFORMATION REQUIRED: *** IMPORTANT ***'A FLAT OF THE PROPERTY MUST BE SUBMITTED WITH THIS APPLICATION. Property Dimensions: A>a4 04 rob &C, ot-Ce ( —.'WRITE DIRECTIONS (from Mocksville) TO PROPERTY. Tax Office PIN: # S' 789 - -4-q - `�_3 �� U � c�� I ZtUL'}' Property Address: Road Dame 9101 O r n X / m ') — wLS SVe ,O P City/zip ,��y • 2,7o o ad'eli A4u e rS If in Subdivision provide information, as follows: Name: jl �'re e.IC �rcraosed ; q r Section: 1 Lot #: J01- ditIL 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 ve of the Davie County Health Department to enter upon above described property located in Davie County and owne rt v f t Gu'y� Revised DCHD (06-96) all testing proceaurps as necessary to determine the site suitability. IVIS APTA ,11111 Lir 11ST;.0 1-01; I)IMIUN6 110111? 51117 1'1-1N: DAVIE COUNTY HEALTH DEPARTMENT a� Environmental Health Section SECTION LOT Soil/Site Evaluation APPLICANT'S NAME �i $ a' DATE EVALUATED 0" PROPOSED FACILITY PROPERTY SIZE SUBDIVISION Water Supply: On -Site Well Community, ROAD NAME ��Z Public Evaluation By: Auger Boring Pit i Cut FACTORS 1 2 3 4 5 6 7 Landscape position L Slope % HORIZON I DEPTH Texture group Consistence Structure Mineralogy HORIZON II DEPTH Texture group Consistence 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: I L/ DCHD (01-90) EVALUATION BY: '& OTHER(S) PRESENT: 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 Mineraloav 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