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167 South Hemingway Court Lot 32Davie County, NC Tax Parcel Report Tuesday, November 29, 2016 WARNIN is 1'Mh IN NOTA SURVEY Parcel Information Parcel Number: H806OA0032 Township: Shady Grove NCPIN Number: 5789135944 Municipality: Account Number. 8303435 Census Tract: 37059-804 Listed Owner 1: MOUSHEY CORRIE LYNN Voting Precinct: EAST SHADY GROVE Mailing Address 1: 10022 BLACKWELL DR Planning Jurisdiction: Davie County City: RALEIGH Zoning Class: DAVIE COUNTY R -A State: NC Zoning Overlay: Zip Code: 27617 Voluntary Ag. District: No Legal Description: LOT 32 COVINGTON CREEK PHASE TWO Fire Response District: ADVANCE Assessed Acreage: 0.94 Elementary School Zone: SHADY GROVE Deed Date: 5/2014 Middle School Zone: WILLIAM ELLIS Deed Book / Page: 009560932 Soil Types: PaD,PcB2,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: 9 tw.�AAll 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 Mess for a particular use AN 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 ciaims or causes of action due to NC or arising out of the use or inability to use the GIS data provided by this website. r ` DAVIE COUNTY HEALTH DEPARTMENT Environmental Health Section P. O. Boa 848/210 Hospital Street Mocksville, NC 27028 (336)751-8760 Account #: 990001296 Tax PIN/EH #: 5789-13-5944.32 Billed To: Michael Myers Subdivision Info: COVINGTON CK Sect.2 Lot # 32 Reference Name: Location/Address: S. Hemmingway-27006 Proposed Facility: Residence Property Size: see map ATC Number: 2912 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 CONS UCTION IS VALID FOR A PERIODOF FIVE YEARS. Environmental Health Specialist's Signature: Date: / `o l 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. Septic System Installed By: Environmental Health Specialist's Signature: DCHD 05/99 (Revised) 1f Dcv- 15 POT °` Poos,'5" ,, I�-Atjt,� q Nk► L�� t f-3 P I cw-A-rte- .t Date: C D i,t.SG7 Account #: 990001296 Billed To: Michael Myers Reference Name: Proposed Facility: Residence (336)751-8760 IMPROVEMENT/OPERATION PERMIT Tax PIN/EH #: 5789-13-59".32 Subdivision Info: COVINGTON CK Sect.2 Lot # 32 Location/Address: S. Hemmingway-27006 Property Size: see map ATC Number: 2912 **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 #People #Bedrooms Q #Baths09 • Dishwasher: 7 Garbage Disposal: 711" Washing Machine Basement w/Plumbing: ❑ Basement/No Plumbing: ❑ Commercial Specification: Facility Type #People #People/Shift #Seats Industrial Waste: ❑ :See �a►4-/.i�lrw Lot Size Type Water Supply Design Wastewater Flow (tt�PD�_ Site: NewRepair ❑ System Specifications: Tank Size" GAL. Pump Tank Other: Required Site Modifications/Conditions: GAL. Trench Width�Rock Depth,/ QU Linear F � i IMPROVEMENT/OPERATION PERMIT LAYOUT - APPROVED EFFLUENT FILTER. RESER(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.**** J(D Environmental Health Specialist's Signature: Date: l k--., Q3HEALTH. UCATION FOR SITE EVALUATION/IMPROVEMENT PERMIT & ATC Davie County Health Department 9 Environmental Health Section JUN 2P.O. Box 848/210 Hospital Street Mocksville, NC 27028 (336)751-8760 ***IIJPORTANT*** THIS APPLICATION CANNOT BE PROCESSED UNLESS ALL THE REQUIRED INFORMATION IS PROVIDED. Refer to the INFORMATION BULLETIN for instructions. 1. Name to be Billedmontact Person Mailing Address Home Phone qi7 City/State/ZIP Business Phone 2. Name on Permit/ATC if Different than Above Mailing AddressCity/ to/Zip 3. Application For: ❑Site Evaluation Improvement Permit/ATC ❑ Both 4. system to Service: ❑ House ❑ Mobile Home ❑ Business ❑ Industry ❑ Other 5. If Residence: # People # Bedrooms # Bathrooms -VV ishwasher ;LTGarbage Disposal 4`i'Washing Machine ❑ Basement/Plumbing ❑ Basement/No Plumbing 6. If Business/Industry/Other; Specify type # Commodes # Showers # Urinals # People # Sinks # water Coolers IF FOODSERVICE: # Seats Estimated Water Usage (gallons per day) 7. Type of water supply: Et County/City 0 Well ❑ Community e. 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 BESUBMITTED by the client with THIS APPLICATION. Property Dimensions: 1 • AT/ 4 / M WRITE DIRECTIONS (from Mocksville) to PROPERTY: Tax Office PIN: # �� —'�' "`/7 �Sg ! Property Address: Road Nam City/Zip If in a Subdivision provide information, as follows: Name: Section Block: Lot: 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 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 to conduct all testing procedures as necessary to determine the site suitability. DATE 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). EHS: Account No. _ Invoice No. � i�o �� 51 APPLICATION FOR SITE EVALUATIONAMPROVEMENT PERMIT Davie County Health Department Environmental Health Section P.O. Box 848 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 r,n E S Contact Person Mailing Address f�L� tl �l �� d Home Phone City/State/Zip &Udid Le Business Phone 2. Name on Permit/ATC if Different than Above Mailing Address City/State/Zip 3. Application For: 01fite Evaluation [ ] Improvement Permit & ATC C [ ] Both 4. System to Serve: [ J House [ •J Mobile Home [ 1 Business [ 1 Industry [ ]Other % O+ uub'W►yi.S �o.J 5. If Residence: # People # Bedrooms # Bathrooms [ ] Dishwasher [ J Garbage Disposal [ 1 Washing Machine [ ] Basement/Plumbing [ 1 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 [ J Community 8. Do you anticipate additions or expansions of the facility this system is intended to serve? [ 1 Yes H'Po If yes, what type? VI. ll ('f; : 11, It t:" PROPERTY INFORMATION REQUIRED: *** IMPORTANT ***'A FLAT OF THE PROPERTY MUST BE SUBMITTED WITH THIS APPLICATION. Property Dimensions: _SII [:+-F to.� ct.C: 'WRITE DIRECTIONS (from Mocksville) TO PROPERTY. Tax Office PIN: # Ad V a w e -e rt Property Address: Road Dame �D 1 ' _D r o 4 / m 1 — [SLS -� S t� e'r M) • Z?o o 4 ' City/ZipIf in Subdivision provide information, as follows: iI-o� eek % ' Name: b / rt�oSed ' i Section: Lot #: A Z- ' 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 er is I ararn .T'��Z� Revised DCHD (06-96) all testing proceouryes as necessary to determine the site suitability. 11I[ 1 MT -1 ,11111 br- 11 F;b I -Oft I)It IVINci Ih)111t I, IIF PIAN: f DAVIE COUNTY HEALTH DEPARTMENT Environmental Health Section SECTION_ LOT Soil/Site Evaluation APPLICANT'S NAME � DATE EVALUATED �J d PROPOSED FACILITY PROPERTY SIZE SUBDIVISION�,( /i /I 7�l%i✓ f� C P� ROAD NAME_(% �l Water Supply: On -Site Well Community v� Evaluation By: Auger Boring Pit Public Cut FACTORS 1 2 3 4 5 6 7 Landscape position Slope % VI HORIZON I DEPTH Texture group Consistence Structure Mineralogy HORIZON II DEPTH Texture group!�- Consistence Structure /G Mineralogy / -1 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 t SITE CLASSIFICATION: Q� LONG-TERM ACCEPTANCE RATE: < REMARKS: DCHD (0(-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 tru ture SC - Single grain M - Massive CR - Crumb GR - Granular ABK - Angular blocky SBK - 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 10/11/2001 08:37 6916 PAGE 02 LOA V 1k, COUNTY HEALTH DEPARTMENT Environmental Health Section . ` P. O. Bo: 848x210 Hospital Street ' Mocksville, NC 27028 4336)751-8760 IMPROVEMENT(OPERATION PERMIT Account #: 990[)01296 Tax PIN/EH #: 5789-13-5944.32 Billed To: Mirr ael Myers Subdivision Info: COVINGTON CK Sect.2 Lot # 32 Reference Name: Location/Address: S.140mmingway-27008 Proposed Facility: Res:oer-_ki Property Size: see map ATC Number: 29'2 •11NOTE"This Improvo-til•.,nt. Operation Permit DOES NOT authorize the construction of septic tank system or any wastewater system. An I rRITATION FOR WASTEWATER SYSTEM CONSTRUCTION must be obtained from this Department to ;he construction/installation of a system or the issuance of a building permit (in compliance with Article I I of-'- ,'liapter 130A, Wastewater Systems, Section .1900 Sewage Treatment and Disposal Systems). THIS PERMIT 1S tit MIUCT TO REVOCATION IF SITE PLANS OR THE INTENDED USE CHANGE. YOUR WAST•EW.n 3 vii SYSTEM CONTRACTOR MUST SEE THIS PERMIT BEFORE INSTALLING SYSTEM. Residential Specilicatiitt: iil:i�;tl; Type #People _ #Bedrooms �— !#Baths �S ;S. Dishwasher: 0 D:1r1.:: !:i •poral: Washing Machine ).all Basement w/Plumbing: ❑ Basement/No Plumbing: O Commercial Specificatna :•a ;l ty Type _ I$People•--_ #People/Shift _ #Seats_ Lot Size ! r.! Water Supply ' Design Wastewater Flow (GPD) System Specifientiorm '1 r.: /�p�1. GA1.. Pump Tank ( +1: • Required Site Modilicatiun i• 1.,Mlitions: Industrial Waste: n Site: Newo Repair 0 GAL. Trench Width 3Y7 01 Rock Depth/ Linear Ft,SI%cJ IMPROVEMF:N•I'/OPt'l� :. 11()N' PERMIT LAYOI!'r- APPROVED EFFLUENT FILTER. RISERS) 1F(. `' BELOW FINISItE:D (;ttADF, - - %4 r•1'ICE:: Contact a representative of the Davie County Health Department for final inspection of this system between >;: 10 a. -r a.m. or 1:00 p.m. to 1:30 p.m. on the day of installation. Telephone # is (336)751-87GU."" " f Environmental tlealth NI. 'r s Signature: l�% __ _� Date: DCHD 05/99 ('Revised) ^l 7� 10/11/2001 08:37 6916 October 1'. 1 P.O. Box 2V-4-) Advance, N * 27006 October 1 1, 2, x 1 Michael wa-cle Myers, Inc. PO Box 2(!." Advance, 006-2040 Davie CouniY flealth Dept. Environmental I fealth Section P.O. Box k-,; K.'2 I () Hospital St. Mocksvlllt:. %-'.0 27028 Attn: Mr ffo! Dear Sir: I would Ro- 1(i tise the "Infiltrator" chamber system on my Lot 32, Tax PIN/EH # 5789- 13-5944.1.-, !1 Covington Creek development in Advance. Thanks, Michael Ayers , f;*111`1 Michael Myers, Inc. PAGE 01