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115 Woodburn Place Lot 50Davie County, NC ,, Tax Parcel Report Tuesday, December 6, 2016 —106 Y f r r `637 I` 801 `--627 r � � t Ir if 116 115 607 ti_ rr 599 S� 587..___,` 579- 124 i -107 9Ab1/8 WARNING: THIS IS NOT A SURVEY M data is provided as Is withoutwamrdy or guarantee of any kind either expressed or implied Including but not limited to the Implied warranties of merchantability or Mines for a particular use All users of Davie County's GIS websIte shall hold harmless the ��UN'ta Parcel Information _ County of Davie, North Carolina, Its agents, consultants, contractors or employees "in any and all claims or causes of action due to the Inability to use the GIS data by this Parcel Number C714000028 Township: Farmington NCPIN Number: 5862864676 Municipality: Account Number. 82526403 Census Tract 37059-802 Listed Owner 1: SHIELDS JOE R Voting Precinct: SMITH GROVE Mailing Address 1: P O BOX 24636 Planning Jurisdiction: Davie County City: WINSTON SALEM Zoning Class: DAVIE COUNTY R-20 State: NC Zoning Overlay: DAME COUNTY QD Zip Code: 27114-0000 Voluntary Ag. District: No 'Legal Description: LOT 50 CREEKWOOD ESTATES Fire Response District SMITH GROVE Assessed Acreage: 0.48 Elementary School Zone: PINEBROOK Deed Date: 5/2006 Middle School Zone: NORTH DAVIE Deed Book / Page: 006601040 Soil Types: GnB2,CeB2 Plat Book: 0004 Flood Zone: Plat Page: 171 Watershed Overlay: DAVIE COUNTY Building Value; Outbuilding & Extra Freatures Value: , Land Value: Total Market Value: Total Assessed Value: 9Ab1/8 Davie County, M data is provided as Is withoutwamrdy or guarantee of any kind either expressed or implied Including but not limited to the Implied warranties of merchantability or Mines for a particular use All users of Davie County's GIS websIte shall hold harmless the ��UN'ta NC NC County of Davie, North Carolina, Its agents, consultants, contractors or employees "in any and all claims or causes of action due to the Inability to use the GIS data by this or arising out of use or provided website ✓X a �• .�/ �`"" DAVIE COUNTY HEALTH DEPARTMENT v IMPROVEMENTS PERMIT AND CERTIFICATE OF COMPLETION -z 'NOTE: Issued In Compliance With Article II ofG.S. Chapter 130a anit ry Sewa a Systems 1 Permit Number Name � Date �SL�y N° 7 7 2 LocationdW Subdivision Name Lot Size House ✓ Mobile Home ;" — Business Industry No. Bedrooms No. Baths c�Z Np, in Family— Public Assembly Other Garbage Disposal YES ❑ NO ❑ Specifications for System: Auto Dish Washer YES ❑ NO ❑ Auto Wash Maohine YES ❑ NO ❑ Type Water Supply 'This permit Void if sewage system described below is not installed within 5 years from date of issue. This permit is subject to revocation if site plans or the intendedluse change. .,fl. 2, f Improvements perLy"_--_ 'Contact a representative of the Davie County Health Department for final inspection of this system between 8:30-9:30 A.M., 1:00-1:30 P.M. or 4:30-5:00 P.M. on day of completion. Telephone Number: 704.634-5985. Final Installation Diagram: System Installed by op 'Contact a representative of the Davie County Health Department for final inspection of this system between 8:30-9:30 A.M., 1:00-1:30 P.M. or 4:30-5:00 P.M. on day of completion. Telephone Number: 704.634-5985. Final Installation Diagram: System Installed by Certificate of Completion R.� — Date \–)3 )3 'The signing of this certificate shall indicate that the system described above has been installed in compliance with the standards set forth in the above regulation, but shall in NO way betaken as a guarantee that the system will function satisfactorily for any given period of time. r , Certificate of Completion R.� — Date \–)3 )3 'The signing of this certificate shall indicate that the system described above has been installed in compliance with the standards set forth in the above regulation, but shall in NO way betaken as a guarantee that the system will function satisfactorily for any given period of time. APPLICATION FOR SITE EVALUATION/IMPROVEMENTS PERMIT Davie County Health Department Environmental Health Section r P. O. Box 665 I Mocksville, NC 27028 1. Application/Permit Requested By n b ra G Q l0 Mailing Address l0 VJ00 bu(Y1 Plpce Str 12 1994 Home Phone Oyo)1 40—afa-L/ M 0 2a nL C, NL of 10 U (11) Business Phone 2. Name on Permit if Different than Above r �'eS $ . (Vl a 2l d v� 3. Application for: I] General Evaluation 4. System to Serve: W House 1A Septic Tank Installation Permit ❑ Mobile Home ❑ Place of Public Assembly ❑ Business ❑ Industry ❑ Other ❑ Unknown 5. If house, mobile home: Subdivision C f- e Ic WOdi ES+Q'LS Section Lot # _ No. of People 3 No. of Bedrooms 3 No. of Bathrooms a Dwelling Dimensions I 6. If business, industry, place of public assembly, other: Specify type No. of People Served No. of Commodes No, of Lavatories No. of Showers No. of Sinks No. of Urinals No. of Water Coolers Water Usage Figures 7. Type of water supply: ❑ Public ❑ Private 8. Property Dimensions 11�L a C 2 Sewage Disposal Contractor ❑ Basement/Plumbing M-B-asement/No Plumbing Oti-Washing Machine 216ishwasher ❑ Garbage Disposal 9. Do you anticipate additions/expansion of the facility this sytem is intended to serve? ❑ Yes [� No If yes, what type? P Community *NOTE: Improvements Permits shall be valid for a period of 5 years from date issued. Improvements Permits are subject to revocation, if site plans or the Intended use change. Effective October 1, 1989. Directions to Property: T 1- 1 -F•' q -o Ea4 sD (�fa rc{ CleMw`p''iS L�Ic2 rta nq /l'HJJ tto� +D w-oq <vD 'Gunn IAF+ a4- et� of r'am�, 11Ga �p��xlrra'kf� I rn� I� gni s . �pf✓� l��{ d�"�v w00db&Irn Place, ) �s� L Ft(zs� hogs P o -n +he Ie This is to certify that the Information provided is correct to the best of my knowledge, and I understand I am responsible for all charges incurred from this application.— ci `1 l elbf W a4 IM, DATE SIGNATURE CONSENT FOR SITE EVALUATION TO BE DONE ON ABOVE DESCRIBED PROPERTY MUST CHECK ONE: ❑ 1. 1 OWN the property. ❑ 2. 1 DO NOT OWN the property. If you checked Box #2, the rest of this form MUST be completed by the owner or a person authorized by the owner: 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 said site's suitability for a ground absorption sewage treatment and disposal system. TURE DCHD (1193) A ADDRESS PROPOSED FACIILTY DAVIE COUNTY HEALTH DEPARTMENT Environmental Health Section Soil/Site Evaluation DATE EVALUATED _ PROPERTY SIZE _ LOCATION OF SITE Water Supply: On -Site Well Community Public Evaluation BY: Auger Boring Pit Cut FACTORS 1 2 3 4 Landscape position Slope b 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: EVALUATED BY: LONG-TERM ACCEPTANCE RATE: OTHER(S) PRESENT: REMARKS: 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 stickySS-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 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 watet 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 DCHD(0t-901 DAVIE COUNTY HEALTH DEPARTMENT .N� (SBptic Tank) Improvements Permit and Certificate of Completion (Ground Absorption Sewage Disposal System - G.S. Chapter 130 -Article 13C) ER OR CONTRACTOR DATEPERMIT y + LOCATION ri OF tkr rnunli E storm LJ zu6i Vhbb U S.R. NO. SUBDIVISION NAME LOT NO. !70 SECTION OR BLOCK NO. ri OF tkr rnunli E storm LJ zu6i Vhbb U n' Trailer 800 Gal. 400 Sq. Ft. NO. BEDROOMS NO. BATHROOMSHouse Two Bedroom House 800 Gal. 600 Sq. Ft. GARBAGE DISPOSAL UNIT YES ❑ NO ©' Three Bedroom House 900 Gal. 900 Sq. Ft. AUTO. DISHWASHER YES © NO ❑ Four Bedroom House 1000 Gal. 1200 Sq. Ft. AUTO. WASH. MACHINE YES NO ❑ SITE SUITABLE %/X.fiA YES 0 . NO ❑ �Ptik Ra�c u 1 /�FS.on�,n".•le's, SIZE OF TANK gal. NITRIFICATION FIELD J sq. ft. DEPTH OF STONE IN LINES: y , to ' WATER SUPPLY: Individual: .Li ;Public ❑ IMPROVEMENTS PERMIT BY r o tti\�... ,� INSTALLED BY �. P,, CERTIFICATE OF COMPLETION ('� BY@L �il�+Date-7-76 (8/16/73) *Construction must com`IV}y with all other applicable State and local regulations LOT AREA 1.5Vrb- ( !�Vii?q S eqL