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121 North Hemingway Court Lot 22Davie Countv. NC Tarr ParrPl RPtlnri Tuesday, November 29, 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: THIS 1S NOTA SURVEY Parcel Information H806OA0022 Township: Shady Grove 5789152087 Municipality: 38399270 Census Tract: 37059-804 HUMPHREY T MICHAEL Voting Precinct: EAST SHADY GROVE 121 NORTH HEMINGWAY COURT Planning Jurisdiction: Davie County ADVANCE Zoning Class: DAVIE COUNTY R -A NC Zoning Overlay: 27006-7313 Voluntary Ag. District: No LOT 22 COVINGTON CREEK PHASE TWO Fire Response District: ADVANCE 1.02 Elementary School Zone: SHADY GROVE 3/2004 Middle School Zone: WILLIAM ELLIS 005420902 Soil Types: PcB2 0007 Flood Zone: 139 Watershed Overlay: DAVIE COUNTY Outbuilding & Extra Freatures Value: Total Market Value: 161 7�7 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 tltness for a particular use. All users of Davie Countys 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 1� C or arising out of the use or inability to use the GIS data provided by this website. Account #: 990001296 Billed To: Michael Myers Reference Name: DAVIE COUNTY HEALTH DEPARTMENT Environmental Health Section P. O. Boz 848/210 Hospital Street Mocksville, NC 27028 (336)751-8760 Tax PIN/EH #: 5789-15-2087 Subdivision Info: Covington Ck two Lot # 22 Location/Address: N. Hemingway Court -27006 Proposed Facility: Residence Property Size: 1.00 acres ATC Number: 3139 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 WASTEWATE NST IO IS VA=ate: ERIOD OF FI YEARS. Environmental Health Specialist's Signature: i� 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 WAYS t��cen as a guarantee that the system will function satisfactorily for any given period of time. _ t �' L' �d Idi t K3la�X-t'2" S q©� T .tA QtJ1L J)NTe (0— 1-7 r Septic System Installed By: `1 Environmental Health Specialist's Signature: ate: 2, DCHD 05/99 (Revised) DAVIE COUNTY HEALTH DEPARTMENT Environmental Health Section P. O. Boz 848/210 Hospital Street Mocksville, NC 27028 (336)751-8760 **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 Q0G1r #People_ #Bedrooms 3 #Baths -�2 'Sr Dishwasher: Garbage Disposal: ❑ Washing Machine: Basement w/Plumbing: ❑ Basement/No Plumbing: Commerc al Specification: Facility Type #People #People/Shift #Seats Industrial Waste: ❑ Lot Size c. - Type Water SupplydwtZy Design Wastewater Flow (GPD) :�� Site: New L'S Repair ❑ System Specifications: Tank Siz4C( 0 GAL. Pump Tank GAL. Trench Width Rock Depth IV_Linear Ft---500� Other: i I- U 1"(01 In. LWkF's 1'o • C. 1kt Q, Required Site Modifications/Conditions: KEep 15 egFr _ { 1C}' ID few Lie -ice., 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.**** Z Ipp'k3(„'xt2�� I F-1) �ST I DC) iDO MIN, I Enviro> ental Health Specialist's Signature: Date: 511 9CHD 05/99 (Revised) IMPROVEMENT/OPERATION PERMIT Account #: 990001296 Tax PIN/EH #: 5789-15-2087 Billed To: Michael Myers Subdivision Info: Covington Ck two Lot # 22 Reference Name: Location/Address: N. Hemingway Court -27006 Proposed Facility: Residence Property Size: 1.00 acres ATC Number: 3139 **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 Q0G1r #People_ #Bedrooms 3 #Baths -�2 'Sr Dishwasher: Garbage Disposal: ❑ Washing Machine: Basement w/Plumbing: ❑ Basement/No Plumbing: Commerc al Specification: Facility Type #People #People/Shift #Seats Industrial Waste: ❑ Lot Size c. - Type Water SupplydwtZy Design Wastewater Flow (GPD) :�� Site: New L'S Repair ❑ System Specifications: Tank Siz4C( 0 GAL. Pump Tank GAL. Trench Width Rock Depth IV_Linear Ft---500� Other: i I- U 1"(01 In. LWkF's 1'o • C. 1kt Q, Required Site Modifications/Conditions: KEep 15 egFr _ { 1C}' ID few Lie -ice., 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.**** Z Ipp'k3(„'xt2�� I F-1) �ST I DC) iDO MIN, I Enviro> ental Health Specialist's Signature: Date: 511 9CHD 05/99 (Revised) TAPP � ON FOR SITE EVALUATION/IMPROVEMENT PERMIT & ATC d G U Davie County Health Department Environmental Health Section ip._' APR 2 6 P.O. Box 848/210 Hospital Street t Mocksville, NC 27028 (336) 751-8760 Ef' ni:C Jt F; t;LiH DA0E C9LINTY ***IMPORTANT*** THIS APPLICATION CANNOT BE PROCESSED UNLESS ALL THE REQUIRED INFORMATION IS PROVIDED. Refer to the INFORMATION BULLETIN for instructions. a 1. Name to be Billed/ � / S i Contact Person Mailing Address ie/2y ' ()X d^MffV Home Phone City/State/ZIP %tGl'(%G---4.P �/ w(�J Business Phone 2. Name on Permit/ATC if Different than Above Mailing Address 3. Application For: ❑ Site Evaluation 4. System to Service: House ❑ Mobile Home 5. If Residence: # People_ City �/State/zip W-,-; provement Permit/ATC ❑ Both ❑ Business ❑ Industry ❑ Other # Bedrooms_ # Bathrooms U Dishwasher U Garbage Disposal U Washing Machine 1.1 Basement/Plumbing 6. If Business/Industry/Other: Specify type # Commodes # Showers # Urinals # People �R Basement/No Plumbing / \ # Sinks # Water Coolers IF FOODSERVICE: # Seats Estimated Water Usage (gallons per day) 7. Type of water supply: j County/City ❑ Well ❑ Community 8. Do you anticipate additions or expansions of the facility this system is intended to serve? ❑ Yes ❑ No If yes, what type? ***IMPORTANT*** CLIENTS MUST COMPLETETHE REQUIRED PROPERTY INFORMATION REQUESTED BELOW. Either a PLAT or SITE PLAN MUST BE SUBMITTED by the client with THIS APPLICATION. Property Dimensions: /'P)D Tax Office PIN: #-5— Property 5Property Address: Road Name c " //" U City/Zip , eVL- J WRITE DIRECTIONS (from Mocksville) to PROPERTY: If in a Subdi ' ion provide information, as follows: Name• ��` e�lJ �kx Section: Block: Lot: a6-�r\ 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 use change, or if the information submitted in this application is falsified or changed. I, also, understand that 1 am responsible for all charges incurred from this application. I, hereby, give consent to the Authorized Representative of the Davie County Health 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 suitability. DATE / tQ_© SIGNATURE 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). Site Revisit Charge Datc(s Client Notification Date: EHS: Revised DCHD (07/99) Account No. Invoice No. r - APPLICATION FOR SITE EVALUATIONAMPROVEMENT PERMIT •M• Davie County Health Department D Q Q Environmental Health Section V �` P.O. Box 848 JAN 3 0 Mocksville, NC 27028 (704) 634-8760 1 ****IMPORTANT**** THIS APPLICATION CANNOT BE PROCESSED UNLESS ALL THE RE UIRED INFORMATION IS PROVIDED. Ls' ko� c�s� o r -N 1. Name to be Billed +-.A Contact Person / ► e- t►f Mailing Address ?8 t) X ')-,3 d Home Phone City/State/Zip .)I uzlij E -e- A2 . 27666, Business Phone ?IS'"y77a- 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 SIA &44 y, S ADA) 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? EITHER A PLAT OR SITE PLAN PROPERTY INFORMATION REQUIRED: *** IMPORTANT *** " OF THE PROPERTY MUST BE pp SUBMITTED WITH THIS APPLICATION. Property Dimensions: A)a D`t' GtG , 104C Ce- WRITE DIRECTIONS (from Mocksvillle) TO PROPERTY. Tax Office PIN: # S" 78� - - Y-,3 S!� ; o 26 1 Sa ui l% aL0 Ad V 4 +u 4,e Property Address: Road lame .AA- 2?o0 � c 6'd011 mers City/Zip , ; If in Subdivision provide information, as follows: Name: b 1 i/ I'd Ai O re e k. i/ ? -;-w used Section: / Lot #: A'' .212— This stoZ 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 by. of the Davie County Health Department to enter upon above described property located in Davie County and owned MENE.WOR Revised DCHD (06-96) all testing process as necessary to determine the site suitability. THIS AREA MAY $E USED FOR DRAWING YOUR SITE PLAN: r DAVIE COUNTY HEALTH DEPARTMENT C ao2 Environmental Health Section SECTION �� LOT Soil/Site Evaluation APPLICANT'S NAME j A DATE EVALUATED PROPOSED FACILITY PROPERTY SIZE-S�lAls SUBDIVISION Water Supply: On -Site Well Community Evaluation By: Auger Boring Pit ROAD NAME 2da 1Z 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 Consistence r Structure tC 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 e SITE CLASSIFICATION: LONG-TERM ACCEPTANCE RATE: REMARKS DCHD (01-90) EVALUATION BY: OTHER(S) PRESENT: l/ 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 Mineraloey 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) LIAR - Long-term acceptance rate - gal/day/ft2 — , N 89026'28"E 246.80' �- I I I I I I � I I I I I ° I I I o I I N NI rnl �� �1 rnl Ip. o co , I t 27.00• O � N Z PROPOSED HOUSE = o co m o a \ n a n --------------------133 ---- .13---------------- 27.00. I 33' -- - - - - - - - - - ------ (� Ln I I I ' I I I � �N � ' I ' I N 84O_28"W 132.79' S 87054'32"LV 115.00' I e I \\\\���\\\ll/1���/// I 23 �� <<,; Yz' 20 pQ UFEs3�C `< L• SITE PLAN ONLY =:q "9 THIS WAS MAPPED FROM A DEED OR = SEAL ' �- � L-28Qp RECORD PLAT AND NOT FROM A SURVEY os :;ti e I BY ME. ''%,'T' .....0 Fl CHAS �`�= �� �� I zU n I a oRalop I I t3 Oi y o COMNGTON CREEK DR N ci 0 LOCATION MAP 1 � 20 rO110, / T V I w I � I W E O 0 I S 30 0 30 60 90 GRAPHIC SCALE — FEET MAP MICHAEL WAYNE MYERS INC. FOR SCALE TOWNSHIP COUNTY STATE DATE,s 1" = 30' SHADY GROVE DAME N. C. 4-26-02 LOT 22 P.B. 7 PG. 139 COVINGTON CREEK PHASE TWO HOWARD SURVEYING JOB NO. JOHN RICHARD HOWARD PLS 02042 P.O. BOX 276 ADVANCE, N.C. (336) 998-5396