132 South Hemingway Court Lot 27Davie County, NC r Tax Parcel Report Tuesday. November 29. 2016
WAK1VMU: TMS 1S IV0'1' A SUKVEY
Parcel Information
Parcel Number:
H8060A0027
Township: Shady Grove
NCPIN Number:
5789142494
Municipality:
Account Number:
8304060
Census Tract: 37059-804
Listed Owner 1:
JONES STEVEN PERRY
Voting Precinct: EAST SHADY GROVE
Mailing Address 1:
132 S HEMMINGWAY COURT
Planning Jurisdiction: Davie County
City:
ADVANCE
Zoning Class: DAVIE COUNTY R -A
State:
NC
Zoning Overlay:
Zip Code:
27006
Voluntary Ag. District: No
Legal Description:
LOT 27 COVINGTON CREEK PHASE TWO
Fire Response District: ADVANCE
Assessed Acreage:
0.67
Elementary School Zone: SHADY GROVE
Deed Date:
8/2014
Middle School Zone: WILLIAM ELLIS
Deed Book / Page:
009670229
Soil Types: WeB,Pc132
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:
101
Davie County,
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All data Is provided as Is without warranty or guarantee of any kind either expressed or implied Including but not limited to the
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County of Davie, North Carolina, Its agents, consultants, contractors or employees from any and all claims or causes of action due to
or arising out of the use or Inability to use the GIS data provided by this website
DAVIE COUNTY ENVIRONMENTAL HEALTH
P.O. Box 848/210 Hospital Street
Mocksville, NC 27028
(336)753-6780 / Fax # (336)753-1680 ri
REPAIR OPERATION PERMIT rnAZtiN�lG(L�t�e
Account #: �r Acct: # 124876
Billed To: Martin Frantz
Reference Hattie: 132 S Hemingway Ct
Proposer! Facility: V..,.------ ID -w .+
Tax PINIEH #:
Subdivision Info:
LocationiAddress:
Propel#.y Size:
H8 -070 -AO -027
Covington Creek Section 2 Lot 27
132 S. Hemingway Ct
0.73 Ac.
ATC Number:
**NOTE** The issuance of this Operation Permit shall indicate the system described on the ATC 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.
System Type: U S.T. Manufacturer `' S� lank Date Tank Size
Pump Tank Size_ BearoomsLl_
System Installed By:i&vt� ,I" s -erq I staller#: (a"� Dater
GPS Coordinate:
a?Q
Ott 3i
r 7$ f Gy`�'`
Environmental Health Specialist:
DCHD 11/06 (Revised)
1 _A. Date: ( � � /
DAVIE COUNTY ENVIRONMENTAL HEALTH
P.O. Box 848/210 Hospital Street
Mocksville, NC 27028
(336)753-6780 / Fax # (336)753-1680
REPAIR IMPROVEMENT PERMIT
AUTHORIZATION FOR WASTEWATER SYSTEM CONSTRUCTION
Account #:
Billed To: /, ar v. Fr a y r -
Reference Name:
Proposed Facility: 971cpak 5Cove o Se
PJtc_
Tax PiN!EH #1: t+80 f ok 0 Gal S -e. l
Subdivision info: Co U�.'OtA cr
LocationiAddress: ( 3a 14emPtA%'v►5""ar Cl -f
Property Size: Q , Z 3
ATC Number: Site Type: ❑New ❑Repair 6dExpansion
**NOTE** This IP/ Authorization to Construct (ATC) MUST BE ISSUED by the Davie County Environmental
Health Section prior to issuance of any building permit(s), (in compliance with Article 11 of G.S. Chapter 130A
Wastewater Systems, Section .1900 Sewage Treatment and Disposal Systems). THIS IP/ AUTHORIZATION TO
CONSTRUCT IS VALID FOR A PERIOD OF FIVE YEARS. This ATC is subject to revocation if site plans, plat
or the intended use change. f IJ & J eon n^ S
-to r��._.. I -
Residential Specifications: # Bedrdoms� # Bathrooms # People Basement❑ Basement plumbing❑
Non -Residential Specifications: Facility Type # People # Seats
Square Footage(or Dimensions of Facility)
Lot Size Type of Water Supply: TACounty/City ❑Well ❑Community Well
System Specifications: Design Wastewater Flow (GPD) D-6 Tank Size ( JAL. Pump Tank AGAL.
TrenchWidth Max. Trench Depth 36 Rock Depth Linear Ft. ( b 0 of
Site Modifications/Conditions/Other: a' � t ���y.��
Contact the Davie County Environmental Health Section for final inspection of this system between
8:30 — 9:30a.m. on the day of installation. Telephone # (336)753-6780.
aa`
• v3
LOW
Soo
.7q
• c�
Environmental Health Specialist s Date: 710
DCHD 11/06 (Revised)
Ir
DAVIE COUNTY HEALTH DEPARTMENT
Environmental Health Section
P. O. Boa 848/210 Hospital Street
Mocksville, NC 27028
(336)751-8760
J3Z S',�le`vr�i/l9Gt�zc'��
5789-14-2494
COVINGTON CK Section II Lot # 27
South Hemingway Ct.-27006
102x310
Account #:
989900093
Tax PIN/EH #:
Billed To:
Shelton Construction Services
Subdivision Info:
Reference Name:
Con Shelton
Location/Address:
'roposed Facility:
Residence
Propertv Size:
ATC Number: 4295
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 fCONSTRUCTION IS VALID FOR A PERIOD OF FIVE YEARS.
Environmental Health Specialist's Signature: 114 W// fDate: 'Z9/e�
CERTIFICATE OF COMPLETION
**NOTE** The issuance of this Certificate 0 'on shall indicate the system d,sctibed�mprovement/Operation Permit
has been installed in compliance with Article 11 o pter 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.
Septic System Installed By:
Environmental Health Specialist's Signature:
DCHD 05/99 (Revised)
Date:
DAVIE COUNTY HEALTH DEPARTMENT
` Environmental Health Section
P. O. Boz 848/210 Hospital Street
Mocksville, NC 27028
(336)751-8760
IMPROVEMENT/OPERATION PERMIT
Account #: 989900093
Billed To: Shelton Construction Services
Reference Name: Con Shelton
Proposed Facility Residence
Tax PIN/EH #: 5789-14-2494
Subdivision Info: COVINGTON CK Section II Lot # 27
Location/Address: South Hemingway Ct.-27006
Property Size: 102x310
ATC Number: 4295
**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 Typehp— #People_ #Bedrooms _'l #Baths
Dishwasher: Z Garbage Disposal: l/ Washing Machine: Z� Basement w/Plumbing: ❑ Basement/No Plumbing: ❑
Commercial Specification: Facility Type #People #People/Shift #Seeatts173s Industrial Waste:
Lot Size Type Water Supply _ Design Wastewater Flow (GPD) '1 c Site: New C� Repair ❑
System Specifications: Tank Size /,#MGAL. Pump Tank
Other:
Reauired Site Modifications/Conditions:
GAL. Trench Width ��Rock Depth Alk Linear Ft?
®a
IMPROVEMENT/OPERATION PERMIT LAYOUT - APPROVED
FINISHED GRADE. ****NOTICE: Contact a representative of the D
system between 8:30 a.m. to 9:30 a.m. o
Cu/vzrt7\
)wA.c.,
J
T FILTER RISERS) IF 6 " BELOW
Health Department for final inspection of this
tion. Telephone # is 36)751-8760,****
y ,
i Y/��' Date: J T
Environmental Health Specialist's S Signature:
DCHD 05/99 (Revised)
DAVIE COUNTY HEALTH DEPARTMENT
• • ; y Environmental Health Section 'I��,
' P. O. Boz 848/210 Hospital Street I I
Mocksville, NC 27028
(336)751-8760
IMPROVEMENT/OPERATION PERMIT
Account #:
989900093
Tax PIN/EH #:
5789-14-2494
Billed To:
Shelton Construction Services
Subdivision Info:
COVINGTON CK Section II Lot # 27
Reference Name:
Con Shelton
Location/Address:
South Hemingway Ct.-27006
Proposed Facility:
Residence
Property Size:
102x310
**NOR'l�*q�gqgprolaPnt/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 H #People 7 #Bedrooms 3 #Baths 2
Dishwasher: X 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 eQ Design Wastewater Flow (GPD) ,� 0. . Site: New M"' Repair ❑
System Specifications: Tank Size /00 GAL. Pump Tank
Other: As
Required Site Modifications/Conditions:
GAL. Trench Width A,"/ Rock Depth Linear FtSdd
,5A NCAC 18A.1969(5)
IMPROVEMENT/OPERATION PERMIT LAY - VED EF
FINISHED GRADE. ****NOTICE: Contact a repr ea ive o e 5a
vie
between 8:30 a.m. to 9:30 a.m. or 1:00 p.m. to 1:30 p. . on ie aye
0� deer IdP
T FILTER RISER(S) IF 6 " BELOW
Health Department for final inspection of this
tion. Telephone # is (336)751-8760.****
Environmental Health Specialist's Signature: , Date:
DCHD 05/99 (Revised)
APPLICATION FOR SITE EVALUATION/1hiPROVEM ENT PER TL Q� C;
Davie County Health Department
Environmental Healtly Section L/A/v
P.O. Box 848/210 Hospital Stre 9
Mocksville, NC 27028 406
(336) 751-8760 �I�ENTAI
***IidPORTANT*** THIS APPLICATION CANNOT BE PROCESSED UNLESS ALL THE R ED
INFORMATION IS PROVIDED.Refer
to the INFORMATION BULLETIN for
/iinnstruction . 1
1. Name to be Billed /7 1 �— L_ — . T � � � 4-, Contact Person.—
Mailing Address 12 's % L/ Home Phone
Ci.ty/State/ZIP f'✓%� /( �.., l C nJ_ C _ Z -7U2 G Business Phone
2. Name on Permit/ATC if Different than Above
Mailing Address City/State/Zip
3. Application For: Site Evaluation ❑ Improvement Permit/ATC ❑ 130th
4. system to Service: Buse ❑ Mobile Home ❑ Business ❑ Industry ❑ Other
S. Type uystem requested:onventional ❑ conventional modified ❑ innovative t3aCCepted
6. if -Residence: it People # Bedrooms 3 #t Bathrooms
9161 smasher 1darbage Disposal thing Machine ❑Basement/Plumbing ❑Basement/No Plumbing
7. If Business/Industry /other: verify type # People # Sinks
# Commodes # Showers # Urinals # Plater Coolers
IF FOODSERVICE: It Seats Estimated Water Usage (gallons per day)
8. Type of water supply: Lit-County/City ❑ Well ❑ Community
9. Do you anticipate additions or expansions of the facility this system is intended to serve? ❑ Yes n-I'fi'S__
If yes, tivliat type?
***LJ1'0R7;AN7-*** CLIENTS MUST COdfPLETETHE REQUIRED PROPERTY INFORMATION REQUESTED
BELOW. Either a PLAT or SITE PLAN MUST BE SU6bfITTED by the client with THIS APPLICATION.
1 F
Property Dimensions: % b 2 X 3 f U
Tax Office VIN: it S% k%/ y Z9 9 y
Property Address: Road Namc
City/Zip 70"(�
If in a Subdivision provide information, as follows:
Name: /`
Section: Block: Lot: —
WRITE DIRECTIONS (frons Mocksvillee) to PROPERTY:'
gu/ 4 /e,
Date home corners flagged: /A /e>
This is to certify that the information provided is correct to the best of my knowledge. I understand that any permil(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 ani responsiblefor all charges incurred frons
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 . SIe / < _ C
to conduct all testing procedures as necessary to determine the site suitability.
DATE _!-7 A C ' SIGNATURE G_ ---
THIS AREA MAY BE USED FOR DRAWING YO I�se'ptic
property lines and dimensions, structures, setbacics, and
IV z.
Sign given
Revised DC11D (05/03
ncl de all of the following: Existing and proposed
oni.
Site Revisit Charge
Datc(s):
Client Notification Date:
EI -IS•
Account No. g lg 000 V
Invoice No.61 Go
' 3
APPLICATION FOR SITE EVALUATIONAMPROVEMENT PERMIT
Davie County Health Department 0
Environmental Health Section
P.O. Box 848
Mocksville, NC 27028
(704) 634-8760 1
****IMPORTANT**** THIS APPLICATION CANNOT BE PROCESSED UNLESS ALL
THE RE UIRED INFORMATION IS PROVIDED.
fie.
1. Name to be Billed 144 .•+4 E S Contact Person et e— r'�
Mailing Address ?I) tl >e -La3 d e-') Home Phone
City/State/Zip _ Uaid Ca N( _ 2700C Business Phone ��-'ti�77.- �8/3-�`�.'8'
2. Name on Permit/ATC if Different than Above
Mailing Address City/State/Zip
3. Application For: ite Evaluation [ ] Improvement Permit & ATC C [ ] Both
4. System to Serve: [ ] House [ •] Mobile Home [ ] Business [ ] Industry [ ]Other -390 -1 --la
ut�.l ui.S�On1
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 [y'No
If yes, what type?
1 11n If 4. 1-1-11 !'r: 1 1 + 1'1 l
PROPERTY INFORMATION REQUIRED: *** IMPORTANT ***'A FLAT OF THE PROPERTY MUST BE
SUBMITTED WITH THIS APPLICAVON.
Property Dimensions: eI o 68 a.0 , ctC-e WRITE DIRECTIONS (from Mocksville) TO PROPERTY:
Tax Office PIN: # 94/— - y 3 u� _ J[1 a D i SSA t�'� �� Gi1Ja Pu
Property Address: Road Dame O l �Di r n 1(VV
/ m ► — [ LS Slat' e _
�
• Z?oo
City/Zip ,�d ,� ; C_.e'-�S�_fLm nde ll iwuf't'S
If in Subdivision provide information, as follows:
Name: e ;
r
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 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 Authoriz
of the Davie County Health Department to enter upon above described property located in Davie County and owne
---f7,N- 04M
SIGN
Revised DCHD (06-96)
all testing procSouFs as necessary to determine the site suitability.
I III Iq :t IT4 Al 1.11 I;F. II I:C) I`olt WMIPIN6 !/0I I/? .SI IF MAN:
' DAV IE COUNTY HEALTH DEPARTMENT /
' Environmental Health Section SECTION ---,T-- LOT.
Soil/Site Evaluation
APPLICANT'S NAME �h$ i DATE EVALUATED
PROPOSED FACILITY PROPERTY SIZE
SUBDIVISION
Water Supply: On -Site Well
Community,
Evaluation By: Auger Boring Pit
ROAD NAME _211aZ
Public L�
Cut
FACTORS 1 2 3 4 5 6 7
Landscape position .14 11
Slope %
HORIZON I DEPTH ( u G
Texture group
Consistence
Structure j
Mineralogy
HORIZON II DEPTH p
Texture group G
Consistence ,
Structure
Mineralogy
HORIZON III DEPTH
Texture group
Consistence
Structure
Mineralogy
HORIZON IV DEPTH
Texture group
Consistence
Structure
Mineralogy
SOIL WETNESS
RESTRICTIVE HORIZON
SAPROLITE
CLASSIFICATIONVP
LONG-TERM ACCEPTANCE RATE r G L ,
SITE CLAS :CA i'ION: O�
LONG-TERM ACCEPTANCE RATE:
REMARKS:
DCHD (0)-90)
V �EVALUATION BY:
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
,BK - Subangular blocky PL - Platy PR - Prismatic
Mineralogy
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
K