167 Pebble Valley Way (2) Parcel#: F80000011106A ' Page 1 of 1
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Davie County, NC - Basic Estate Search � ' r;'
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View Propertv Record for this Par�,el Vlew Mao for this Parcel Vfew Tax Bill Information
Parcei#: F80000011106A Account#: 100000251
Owner Information Tax Codes
YERS JAMES&MYERS BEffY ADVLTAX-COUNTY T
167 PEBBLE VALLEY WAY READVITAX-FIRE TAX
DVANCE NC 27006
Pro e Information Townshi
nd(Units/Type): 5.210 AC SHADY GROVE
ddress: 167 PEBBLE VALLEY WY
� Deed Information Local2onin
ate: Ol/2009 Book: 00779 Page: 0781
lat Book: Pa e:
Le ai Descri tion PIN—�
5.213 AC OFF POTTS RD LIFE ESTATE 5880170645
Pro e Values
uildin :
BXF• 9 00
nd• 47 84
arket• 56 84 �
ssessed: 56 84
Deferred•
Sales Information
No. Book Page Month Year Instrument Qual/UnQual Improved Price
00111 OU69 06 1980 WD Unqualified Vacant 0
00329 0056 03 2000 WD Unqualified Improved 0
00779 0781 O1 2009 QC Unqualified Improved 0
00200 0784 03 1998 WD ualified Vacant 35 000
Vi�w Propertv Record for this Parcel View Ma�for this Parcel View Tax Bili Information
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All Information on this site is prepared for the inventory of real property found within Davie County. All data is compiled from recorded deeds,
plats, and other public records and data. Users of this data are hereby notified that the aforementioned pubiic information sources should be
consulted for veriflcation of the information.All information contained herein was created for the Davie County's internal use. Dav(e County,
its emptoyees and agents make no warranty as to the correctness or accuracy of the information set forth on this site whether express or
(mplled, in fact or 1n law, including w(thout limitation the implied warranties of inerchantability and fitness for a particular use.
If you have any questions about the data displayed on this website please contact the Davie County 7ax Office at(336) 753-6120.
1.5.9
http://maps.daviecountync.gov/itsnetlView.aspx?prid=1463607 10/5/2016
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�JTHORIZATION NO: " r� DAVIE COUNTY HEALTH DEPARTMENT
�. ..y� .�; - � "�� � Environmental Health Section PROPERTY INFORMATION �
"�ermittee-s�.,�►'+"'"' , P.O.$ox 848
Name:=� � m�� � c�.��� Mocksville,NC 27028 Subdivision Name:
, . : f� f Phone#:704=634-8760 �j 1
Directions to property• �f�'�S '�tY Section: Lot:
,,,,...—., / /� /� 7- AUTHORIZATION FOR d !,�/�
�U -�rr�'� ,/�'',� l `` 1°'L�� �.�d�` / wASTEwaTER Tax Office PIN:#��C�� ,�� - �t{�"T� ':
SYSTEM CONSTRUCTION'
CG•��7� � Road Name: T_.S �. Qofo
Zip:�,�
**NOTE**This Authorization for Wastewater System Constniction MUST BE ISSUED.by the Davie Counry Environmental Health Section prior
to issuance of anyBuilding Pernuts.This Form/Authorization Number should be presented to the Davie County Building Inspecdons :
; O�ce when applying for Building Permits. ` ; ' ' ' �
(In com�ance with Article 11 of G.S:Chapter 130A,Wastewater Systems,Section.1900 Sewage Treatment and Disposal Systems)
l,f�, � �,�/ r ***NOTICE***THIS AUTHORIZAITON FOR WASTEWATER CONSTRUCTION '
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r,��it,�^/� �"' .,�`� ���'��r r o LS VALID FOR A PERIOD OF FIVE YEARS. . '
ENVIRONMENTAL HEALTH SPECIALIST DATE ISSUED ' .
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,�..�..i wz-�' `� ;' TMPROVEMENT AND�OPERATION PERMITS PROPERTY INFORMATION
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.A�ame,�� ;-�l,�1"�'r'"�'' ,�'���,�+�'�� �.:'`'� � ` . Subdivision Name:
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r Directions to property;�r"✓r>��f`� r""'~�� 'Section: Lot ` .��
�r'�,,' .,f' ��',e'`�- ,�`�'�^�° fTM �1���`,� �r�°I�X�,+'� �ERMTI' Tax Office PIN:#���5��-�_�!!''d ...�
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**NOTE**This Improvement Petnut DOFS NOT suthorize the construction or installatipn of a septic tanlc system or any wastewater system.An °
' AUTHORTZATION FOR WASTEWATF.R SYSTEM CONSTRUGTION must be obtained frcim this Department prior to the
construction/installation of a sysfem oi the issuance of a building pernu� . -'
(In compliance with Article 11 of G.S.Chapter 130A,Wastewater Systems,Section.1900 Sewage Treatment and Disposal Systems)
,., ;;. �;'„,, : ,� ,,�,,, +.,� .�� *ssNOTICE*s*THIS PERMIT bS SUBJECT TO REVOCATION IF STI'E
f � � � r ��
�'! `rt� /�,,✓ ..Y::`;.„.�` ;'�'�,�'"y� � t 'f � PLANS OR Tf�IlVTENDED USE CHANGE.YOUR WASTEWATER
ENVIRONMENTAL HEALTH SPECIALIST DATE ISSUED SYSTEM CONTRACTOR MUST SEE T�S PERNIIT BEFORE;"
_ -._ INSTALLING Tf�SYSTEM. ;. . ` _
. ,. ,;.
RESIDENTIAL SPECIFTCATION:BLTILDING T'YPE �� #BEDROOMS�-� #BATHS � #,OCCUPANTS�GARBAGE DISPOSAL:Yes or No
COMMERCIAL SPECIFICATION: FACILITY TYPE #PEOPLE #PEOPLFJSHIFT #SEATS INDUSTRIAL WASTE:Yes or No � -
LOT SIZE� TYPE VJATER SUPPLY �i�//`DESIGN WASTEWATER FLOW(GPD)� NEW SITE �t/ REPAIR STfE
SYSTEM SPECIFICATIONS: TANK SIZE�� GAL. PUMP TANK GAL. TRENCH WIDTH� ROCK DEPTH �io� /LINEAR FT.���.
' OTHER �'� �•
REQUIRED SITE MODIFICATIONS/CONDTITONS: _ � ' , •
IMPROVEMENT PERMIT LAYOUT
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**CONTACT A REPRESENTATIVE OF THE DAVIE COUNTY HEALTH DBPARTMENT FOR FINAL IIVSPECTION OF THIS SYSTEM
BET'WEEN 8:30-9c30 A.M.OR 1:00-1:30 P.M.ON TI-IE DAY.OF INSTAL T'ION.TELEPHONE#IS(704)634-8760.
OPERATION PERMIT _
SYSTEM INSTALLED BY: �� `
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AUTHORIZATION NO._,��OPERATION PERMIT BY: DATE:` J -eL,L;{'` � .
�'+THE ISSUANCE OF THIS OPERATION PERMIT SHALL INDICATE THAT THE SYSTEM DESCRIBED ABOVE HAS BEEN INSTALLED IN COMPLIANCE
WITH ARTICLE 11 OF G.S.CHAP'TER.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.
DCHD OS/96(Revised) _ .
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. • _ , APPLICATION FOR SITE EVALUATION/IMPROVEMENT PE
' Davie Count Health De artment �
..- ::. Y P � C � � .�, ;� ;.
'�' Environmental Health Section
P.O. Box 848 �' . � — 5 ��
Mocksville,NC 27028
(704) 634-8760 ENVIRONMEMAL HEt;�e�
, DAVIE COUNTY
****IMPORTANT**** THIS APPLICATION CANNOT BE PROCESSED UNLESS ALL
THE REQUIRED INFORMATION IS PROVIDED.
1. Name to be Billed ��l"O�G� �. �GI E('S Contact Person o)t�'i`1+E 5 //I G1 Q f�
Mailing Address 3 � y " L Home Phone q'�/�" Z� ��
City/State/Zip I/ L' � 00�o Business Phone
2. Name on PermibATC if Different than Above
Mailing Address City/State/Zip
3. Applicadon For: [ ]Site Evaluation [ ]Improvement Permit&ATC [�-j'Both
4. System to Serve: [ ] House [�'1Globile Home [ ]Business [ ]Industry [ ]Other
5. If Residence: #People�_ #Bedrooms�_ #Bathrooms Z [ ]Dishwasher[ ]Garbage Disposal
[e�-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 [y'Well [ ]Community
S. Do you anticipate additions or expansions of the facility this system is intended to serve?[ ]Yes [+�]'No
If yes,what type?
�� E Z THER tt 1'LAT OR S Z TE PLttN
PROPERTY INFORMATION REQUIRED:***IMPORTANT**���T OF THE PROPERTY MUST BE
SUBMITTED WITH THIS APPLICATION.
Property Dimensions: f ��� �WRITE DIRECTIONS(from Mocksville)TO PROPERTY:
TaxO�cePIN: # �S�D - /�- D�v -.��_ ; ��{D �AsT o SO/� /Q�G�i�on g�/ Sd[��� -
Property Address: Road�ame 7�3 ��-�� � 5 �o�• /" 5
c�cyiz�P '� c�l r✓,�nce, /�� a'7oo� ; -� e�d o-� �de-s�c r
If in Subdivision provide information,as follows: � �ID Tr � N�u.s�� A-�ei���3 d7n /e-f-T - A o
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Name• � ' �/1c � 5 �
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Section: �ot�#'� � '
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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 t upon above described property located in Davie County and owned
by � �-' S 1 tesUng �ocedures as ecessary to detertnine the site suitability.
DATE 3 -S�"/ � SIGNATURE �
Revised DCHD(06-96)
THIS AREtt Mtl� $E USEb �OR bRAWINC� �OUR SZTE PLAN:
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- � DAVIE COUNTY HEALTH DEPARTMENT
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-�--' Environmental Health Section sECTioN LOT
SoiUSite Evaluation
APPLICANT'S NAME � DATE EVALUATED �5���?S
PROPOSED FACILITY PROPERTY SIZE .S�C,
SUBDIVISION ROAD NAME f`Q �/C
Water Supply: On-Site Well ✓ Community Public
Evaluation By: Auger Boring � Pit Cut
FACTORS 1 2 3 4 5 6 7
Landsca e osition
Slo e%
HORIZON I DEPTH
Texture rou
Consistence
Structure
Mineralo
HORIZON II DEPTH �` � ��
Texture rou
Consistence
Structure / /?
Mineralo
HORIZON III DEPTH
Texture rou
Consistence
Structure
Mineralo
HORIZON IV DEPTH
Texture rou
Consistence
Structure
Mineralo
SOIL WETNESS
RESTRICTIVE HORIZON
SAPROLITE
CLASSIFICATION
LONG-TERM ACCEPTANCE RATE
SITE CLASSIFICATION: � EVALUATION BY: l�'`
LONG-TERM ACCEPTANCE RATE: � � OTHER(S)PRESENT:
REMARKS: ��Y�'(�
Cad'�GL
LEGEND
Landscane 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
Mois
VFR-Very friable FR-Friable � FI-Firrri 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-Angulaz blocky
SBK-Subangular blocky PL-Platy PR-Prismatic
Mineraloev
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-gaUday/ft2
DCHD(01-90)
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