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128 Alexandria Court Lot 6Davie County, NC Tax Parcel Report Tuesdav, November 29, 2016 WAR .N.ILN T: '1'HRS 151V01' A SURVEY Parcel Information Parcel Number: H8060A0006 Township: Shady Grove NCPIN Number: 5789247343 Municipality: Account Number: 82521277 Census Tract: 37059-804 Listed Owner 1: COX JEFFREY D Voting Precinct: EAST SHADY GROVE Mailing Address 1: 128 ALEXANDRIA COURT Planning Jurisdiction: Davie County City: ADVANCE Zoning Class: DAVIE COUNTY R -A State: NC Zoning Overlay: Zip Code: 27006-7315 Voluntary Ag. District: No Legal Description: LOT 6 COVINGTON CREEK PHASE TWO Fire Response District: ADVANCE Assessed Acreage: 0.72 Elementary School Zone: SHADY GROVE Deed Date: 8/2003 Middle School Zone: WILLIAM ELLIS Deed Book / Page: 005020765 Soil Types: WeB,PcC2 Plat Book: 0007 Flood Zone: Plat Page: 139 Watershed Overlay: DAVIE COUNTY Building Value: Outbuilding 8r Extra Freatures Value: Land Value: Total Market Value: Total Assessed Value: 101 AN data Is provided as Is without warranty or guarantee of any Idad either expressed or Implied Including but not limited to the Davie County, Implied warranties of merchantabNity or fitness 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 allclaims or causes of action due to 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 IMPROVEMENT/OPERATION PERMIT Account M 989900317 Tax PIN/EH M 5789-24-7343 z Billed To: Glory Home Builders Subdivision Info: COVINGTON CKcae Lot #6 Reference Name: Location/Address: Alexander Court -27006 Proposed Facility: Residence Property Size: 103'x272' **NO TI✓**'TliibNproveeme nt/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 SIn PLANS OR THE INTENDED USE CHANGE. YOUR WASTEWATER SYSTEM CONTRACTOR MUST SEE THIS PERMIT BEFORE INSTALLING SYSTEM. Residential Specification: Building Type p g yp }A1 #People #Bedrooms _� #Baths Dishwasher Garbage Disposal"- Washing Machine: Basement w/Plumbing: ❑ Basement/No Plumbing: ❑ Commercial Specification: Facility Type #People #People/Shift #Seats Industrial Waste: ❑ Lot Size Type Water Supply Design Wastewater Flow (GPD) Site: New Repair ❑ .I System Specifications: Tank Size,/ ..X Pump Tank GAL. Trench Width 5;:� " Rock Depth / Linear Ft. � v `/,, C> Other: Required Site Modifications/Conditions: 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.**** Ile Environmental Health Specialist's Signature: Date: --- DCHD 05/99 (Revised) Account #: 989900317 DAVIE COUNTY HEALTH DEPARTMENT Environmental Health Section Billed To: Glory Home Builders Reference Name: Proposed Facility: Residence ATC Number: 2649 P. O. Boa 848/210 Hospital Street Moclksville, NC 27028 (336)751-8760 Tax PIN/EH #: 5789-24-7343 7— Subdivision Subdivision Info: COVINGTON CK oae Lot # 6 Location/Address: Alexander Court -27006 Property Size: 103'x272' 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 WASTEWATER CONSTRUCTION IS VALID FOR A PERIOD OF FIVE YEARS. Environmental Health Specialist's Signature: �y Date: CERTIFICA OF COMPLETION **NOTE** The issuance of this Certificate o om ion shall i irate the system described on Improvement/Operation Permit has been installed in compliance with i 11 of G.S. Chapter 130A, Section .1900 "Sewage Treatment and Disposal Systems," but shall in NO WA be en as a uarantee that the system will function satisfactorily for any given period of time. 2 Septic System Installed By: 17 13101YS/d it i Environmental Health Specialist's Signature: Date: DCHD 05/99 (Revised) APPUCATION FOR SITE EVALUATION/IMPROVEMENT PERMIT & ATCVffNOV2 Davie County Health DepartmentEnvironmental Hea/6h Section P.O. Box 848/210 Hospital Street Mocksville, NC 27028(336)751-8760 ***IMPORTANT*** THIS APPLICATION CANNOT BE PROCESSED UNLESS ALL THE REQUIREII— INFORMATION IS PROVIDED. Refer to the INFORMATION BULLETIN for instructions. 1. Name to be Billed Mailing Address Lf .�— .�.� City/State/ZIP r 'V 2. Name on Permit/ATC if Different than Above Mailing Address 3. Application For: ❑ Site Evaluation 4. System to Service: Ouse ❑ Mobile Home 5. If Residence: # People Contact Person Home Phone Business Phone 336 6'4- City/State/Zip Improvement Permit/ATC ❑ Both ❑ Business ❑ Industry ❑ Other # Bedrooms # Bathrooms i3— ishvasher Garbage Disposal 11-Mirshing Machine ❑ Basement/Plumbing Basement/No Plumbing 6. If Business/Industry/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 a. Do you anticipate additions or expansions of the facility this system is intended to serve? ❑ Yes 5 -Nis -- yes, what type? k**IMPORTANT*** CLIENTS MUST COMPLETE THE REQUIRED PROPERTY INFORMATION REQUESTED BELOW. Either a PLAT or SITE PLAN MUST BE SUBMITTED by the client with THIS APPLICATION. Property Dimensions: /03 I x r,9-- //7,- / Tax Office PIN: # 5:7 73 Property Address: Road Name City/Zip If in a Subdivision provide information, as follows: WRITE DIRECTIONS (from Mocluville) to PROPERTY: 4� 7 � Name: Section: Block: Lot: �_ Date Property Flagged: This is to fy thaftl e a iinfo&(on irovided 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 Representative of the Davie County Health)Department to enter upon above described property located in Davie County and owned by � G„ 1 PSS 'Z M Fig to conduct all testing procedures as necessary to determine the site suitability. DATE / r Dl� 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). r - Revised DCHD (07/99) Site Revisit Charge Date(s): Client Notification Date: EHS Account No. 311 Invoice No. `0 '" 1 �- _ ,.--- z w� . ` APPLICATION FOR SITE EVALUATION/IMPROVEMENT PERMIT Davie County Health Department Environmental Health Section P.O. Box 848 J.�ly t1 Mocksville, NC 27028 (704) 634-8760 1 ****IMPORTANT**** THIS APPLICATION CANNOT BE PROCESSED UNLESS ALL THE REQUIRED INFORMATION IS PROVIDED. SJ�dr "- ks-i o r►-, 1-7-) , - 1. Name to be Billed b► -v% P- Contact Person / el e- Arg Mailing Address fy�i 11 Home Phone .AL City/State/Zip .� 61Q Ge 2706(3 Business Phone 919--4177Z 19/3-13y/k 2. Name on Permit/ATC if Different than Above Mailing Address City/State/Zip 3. Application For: V4iote Evaluation [ ] Improvement Permit & ATC [ ] Both 1 4. System to Serve: [ ] House [ •] Mobile Home [ ] Business [ ] Industry [ ] Other V2 0, 16+ SU at�l. I V? -S /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 S. Do you anticipate additions or expansions of the facility this system is intended to serve? [ ] Yes If yes, what type? 111111 P A PIAT (`R :,111 1'L•lld PROPERTY INFORMATION REQUIRED: *** IMPORTANT ***A FLAT OF THE PROPERTY MUST BE SUBMITTED WITH THIS APPLICATION. Property Dimensions: fir+ 04 66 4'c' OAf C'e WRITE DIRECTIONS (from Mocksville) TO PROPERTY: Tax Office PIN: # $" 789 - 9-q Property Address: Road lame So ! D r �( % m ► — [aa LS S Io�Q o t• f City/Zip ^A lJ . Z ?� o b ;. r er'A; _CCA m d e l Muer--5-2- If uersZIf in Subdivision provide information, as follows: i mai C' , Name: C, b I re e-�C,� 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 by h e y rS _-tra.�onduct all testing procSoWs as nefessary to determine the site suitability. DATE �y_Q"_�'i Revised DCHD (06-96) MIS M?EA %1,11/ BE IISEI) rok bIM111INC, I oul? SITE 1'L,1N: DAVIE COUNTY HEALTH DEPARTMENT Environmental Health Section SECTIONS LOT. Soil/Site Evaluation APPLICANT'S NAME �ii8 DATE EVALUATED PROPOSED FACILITY PROPERTY SIZE J�IAG� SUBDIVISION �y. _�,v (f�� ROAD NAME_2ffa Z Water Supply: On -Site Well Community Evaluation By: Auger Boring Pit 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 Structure S J Mineralogy A. 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 , L SITE CLASSIFICATION: /__� LONG-TERM ACCEPTANCE RATE: REMARKS: DCHD (01-901 EVALUATION BY: AU511 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 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