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302 Lakeview Road Section 2 Lots 24-25Davie County, NC I I Tax Parcel Report Tuesday, January 17, 2017 WARNING: THIS IS NOT A SURVEY Parcel Information Parcel Number: 1614OA0026 Township: Shady Grove NCPIN Number: 5758844111 Municipality: - Account Number: 82532886 Census Tract: 37059-804 Listed Owner 1: WOOLDRIDGE DAVID M Voting Precinct: WEST SHADY GROVE Mailing Address 1: 302 LAKEVIEW ROAD Planning Jurisdiction: Davie County City: MOCKSVILLE Zoning Class: DAVIE COUNTY R-20 State: NC Zoning Overlay: Zip Code: 27028-0000 Voluntary Ag. District: No Legal Description: LOTS 24-25 HICKORY HILL SECTION 2 Fire Response District: CORNATZER - DULIN Assessed Acreage: 1.47 Elementary School Zone: CORNATZER Deed Date: 9/2011 Middle School Zone: WILLIAM ELLIS Deed Book / Page: 008680585 Soil Types: GnC2,GaD,WATER Plat Book: 0005 Flood Zone: Plat Page: 027 Watershed Overlay: DAVIE COUNTY Building Value: Outbuilding & Extra Freatures Value: Land Value: Total Market Value: Total Assessed Value: O AAll Davie County, data is provided as is without warranty or guarantee of any Idnd either expressed or Implied Including but not limited to the Implied warranties of merchantability or fitness for a particular use. All users of Davie County s GIS website shall hold harmless the �p NC County of Davie, North Carolina, Its agents, consultants, contractors or employees from any and all claims or causes of action due to U l'3'C•� or arising out of the use or inability to use the GIS data provided by this website. DA�1IE COUNTY HEALADEP%AFBTMENT - ;.,� Y ..::y t.,:.- n. _ IMPR;OAVEMENT$� PER°MIT AN,D:CER�TIFI�CATE OF CO.MPLaETI:O;N ` *NOTE Issued in Complian0"W,.*A`rticle 1l of G.S. Chapter 130a £ Sbnitary'-Sewage Systems r J Name ,%i Date_ Nk Location/,'r���! r'L ('.a.>, /. .'.�� Sub:divis o,, Name�'_ '- _ '- / Lot NO.lSec. or B ock No Lot Size House Mobile Home Business __ Speculation No. Bedroom's No, Baths No. inl,Family Garbage .Disposal YES 0 NO Specifications for System: Auto Dish Washer YES NO E] Auto Wash Machine YES Q NO ❑ '��` Type Water Supply *This permit Void'if sewage system described below isnot installed wifahi'n:5, years from date of iss.u.e This.,permi,, is subject to revocation its, te-plans, or'the�in,tended>use, clian.ge. 3 ,f r4 I -e4 11 Improvement"& ;permit by *Contacta, representative of the Davie County H'ealthrep�artment for, final, inspection .o:f this system between 9:30 A.M. or 1:00-1:30 P.M. on day of completion. T,.elephoneyNmbPr704-634 5985: Final Installation Diagram: System -Installed by R 1 * TL ti .rJ 10 ,o p a, Certificoi Cgmpletion Date cy- satistactoruytor any.given period ;of tite: r^ APPLICATION FOR SITE EVALUATION/IMPROVEMENTS PERMIT Davie County Health Department Environmental Health Section P. O. Box 665 Mocksville, NC 27028 Application/Permit Requested By. D e-:- J /'"` - 4-P cey" Mailing Address /f T �� �/ ?/ /00 V, 6Z & Home Phone Business Phone 2. Name on Permit if Different than Above 3. Application/Permit for: 4. System to Serve: M19ouse ❑ General Evaluation ❑ Mobile Home ❑ Septic Tank Installation ❑ Place of Public Assembly ❑ Business ❑ Industry� ❑ Other ❑ Unknown 5. If house, mobile home: Subdivision l) �C��•/ �Ct /� Section Lot # 2V-2 S D-8asement/Plumbing No. of People No. of Bedrooms -� No. of Bathrooms _ Dwelling Dimensions 491-1 6. If business, industry, place of public assembly, other: Specify type No. of People Served No. of Commodes No. of Lavatories No. of Sinks No. of Urinals No. of Water Coolers No. of Showers Water Usage Figures _ 7. Type of water supply: ❑' PublicI ❑ Private ,,�8. Property Dimensions - — / / /'116— Sewage Disposal Contractor 9. Do you anticipate additions/expansion of the facility this sytem is intended to serve? ❑ Yes If yes, what type? ❑ Basement/No Plumbing ❑ Washing Machine ❑ Dishwasher ❑ Garbage Disposal ❑ No ❑ 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: This is to certify that the information provided is correct to the best of my incurred from this application. DA'TE and I understand I am responsible for all charges ,TUBE 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. DATE SIGNATURE DCHD (12.90) NAME _ 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 % 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: LONG-TERM ACCEPTANCE RATE: REMARKS: DCHD(01-901 EVALUATED 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 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 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 D�ANfE CO"U,NTRY � 4J. A H DEPA�R�TM,EIVY : 1 IMYPR';OV�EMLE"NTS 'PERMIT AND 'CER�TIFI'CA�TE''OF s'C"O`M�PLE�TI N r `NOTE: Issued in Compliance-t'with G S. of North Carolina Chapter 130 Article 13c t Sewage Treatment and Di g Disposal Rules (10 NCAC 10A .1934-:1968) P�,ermtmber Name'r`t'''k€c�t/T:-'r.�fr — Date Location i ! Ir f 17 ? Z satisfactorily for any given-,,04—o=d skof time: "" " DAVIE COUNTY HEALTH DEPARTMENT IMPROVEMENTS PERMIT AND CERTIFICATE OF COMPLETION *NOTE: Issued in Compliance with G.S. of North Carolina Chapter 130 Article 13c Sewage Treatment and Disposal Rules (10 NCAC 10A .1934-.1968) Permit Number „Name# �' '° — Dates%'" Location 6 Z_< Subdivision Name Lot No. Sec. or Block No. Lot Size — House Mobile Home — — Business — Speculation No. Bedrooms �— No. Baths f — No. in Family — Garbage Disposal YES NO 2-' Specifications for System, Auto Dish Washer YES [] NO 0 I Auto Wash Machine YES Ep NO .0 � �- Type Water Supply *This permit Void 'if sewage system' -described below is not installed within 36 months from date of issue. 41 Improvements permit by 'Contact a representative of the Davie County Health Department for final inspection of this system between 8:30- 9:30 A.M. or 1:00-1:30 P.M. on day of completion. Telephone Number: 704-634-5985. Final Installation Diagram: System Installed by Certificate of Completion — Date "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 be taken as a guarantee that the system will function satisfactorily for any given period of time. DAVIE COUNTY HEALTH DEPARTMENT Environmental Health Section P. O. Box 665 Mocksville, N.C. 27028 SOIL/SITE EVALUATION Name Date Address Lot Size�(2C� F I FACTORS AREA 1 ARFA ? ARFA 3 APPA A 1) Topography/ Landscape Position �S U P U S PS U S PS U !) Soil Texture (12-36 in.) Sandy, Loamy, Clayey, (note 2:1 Clay),.� S S U S PS U S PS U l) Soil Structure (12-36 in.) Clayey Soils S S er�p U S PS U S PS U G) Soil Depth (inches) S S PS U S PS U ) Soil Drainage: Internal S U _S�? CI%Y_� !U S PS U S PS U External S U S PS U U S PS U �) Restrictive Horizons Available Space� � U U S PS U S PS U I) Other (Specify) S PS U S PS U S PS U S PS U 1) Site Classification U—UNSUITABLE S—SUITABLE / PS—Provisionally Suitable Recommendations/Comments: Described by`Title !y Date l SITE DIAGRAMS DCHD (6-82) APPLICATION FOR SITE EVALUATION/ IMPROVEMENTS PERMIT Davie County Health Department Environmental Health Section P. 0. Box 665 Mocksville, N.C. 27028 CONSTRUCTION SHALL NOT BEGIN UNTIL IMPROVEMENTS PERMIT HAS BEEN ISSUED. Home Phone 1. Permit Requested By ` C l� y `L - Business Phone 9 9 s-- - kk `71 2. Address Abe--eaky k, /-,t V1,16,u 47'43 /�6 4-K&'uvLCe Al 3. Property Owner if Different than Above Address 4. Permit To: a) Install �er Repair 1 p ,Zw— ?�(S b) Privy Conventional -L -1 -Other Type Z -G 7,'0 AJ- 4W Ground Absorption c) Sub -Division Sec. Lot No. 5. System used to serve what type facility: House Mobile Home Business Industry Other b) Number of people 'A 6. a) If house or mobile home, state size of home and number of rooms. House Dimensions Bed Rooms_ Bath Rooms— Den w/Closet b) If Business, Industry or Other, State: Number of persons served What type business, etc. Estimate amount of waste daily (24 hours) 7. Number and type of water -using fixtures: commodes urinals_ lavatory showers dishwasher sinks — 8. a) Type water supply: Public Private Community. b) Has the water supply system been approved? Yes 9. a) Property Dimensions b) Land area designated to building site garbage disposal washing machine c) Sewage Disposal Contractor 10. Do you anticipate any additions or expansions of the facility this sewage system is intended to serve? What type? This is to certify that the information is correct to the best of my knowledge. z4z Date Owner Signatufe OWNER IS SOLELY RESPONSIBLE FOR COMPLIANCE WITH ALL STATE AND LOCAL LAWS Allow 5 days for processing Directions to property: DCHD (6-82)