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110 Brook Rose Ln Davie County,NC Tax Parcel Report Monday, September 26, 2016 z E t` 0� t i L,r -*'!C! 110 2911 JI o 0 - — �L < G4E . Z W J � t WARNING: THIS IS NOT A SURVEY _. ParcelInformation Parcel Number: J70000007703 Township: Fulton NCPIN Number: 5767896002 Municipality: Account Number: 82523006 Census Tract: 37059-804 Listed Owner 1: SANDERS WILLIE JAMES JR Voting Precinct: FULTON Mailing Address 1: 110 BROOKE ROSE LANE Planning Jurisdiction: Davie County City: MOCKSVILLE Zoning Class: DAVIE COUNTY R-20 State: NC Zoning Overlay: Zip Code: 27028-7471 Voluntary Ag.District: No Legal Description: 1.147 AC HWY 64 Fire Response District: FORK Assessed Acreage: 1.02 Elementary School Zone: CORNATZER Deed Date: 3/2004 Middle School Zone: WILLIAM ELLIS Deed Book/Page: 005410436 Soil Types: PcB2 Plat Book: Flood Zone: Plat Page: Watershed Overlay: DAVIE COUNTY Building Value: 61390.00 Outbuilding&Extra 0.00 Freatures Value: Land Value: 21470.00 Total Market Value: 82860.00 Total Assessed Value: 82860.00 Zvi All data Is provided as Is without warranty or guarantee of any kind either expressed or Implied including but not limited to the Davie County, Implied warranties of merchantability or fitness for a particular use.All users of Davis County's GIS website shall hold harmless the County of Davis,North Carolina,Its agents,consultants,contractors or employees from any and all claims or causes of action due to �C N�� NC or arising out of the use or inability to use the GIS data provided by this website. DAVIE COUNTY HEALTH DEPARTMENT Environmental Health Section d �' 63 P.O.Boa 848/210 Hospital StreetS l0 D . Mocksville,NC 27028 jrq./�-) (336)751-8760 C� IMPROVEMENT/OPERATION PERMIT Account #: 990002837 Transfer Tax PIN/Eh 5767-89-6002 Billed To: wi i t ie J. Sanders,Jr Subdivision Info: Reference Name: Location/Address: Highway 64-27K8 Proposed Facility: Residence Property Size: see map ATC Number: 3506 **NOTE** This Improvement/Operation Permit DOES NOT authorize the construction of 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 J #Bedrooms #Baths Dishwasher:;?-**" 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 Design Wastewater Flow(GPD) Site: New❑ Repair System Specifications: Tank Size 4!L'�10 03AL. Pump Tank GAL. Trench Width j Rock Depth ,Linear Ft.Z d Other: Required Site Modifications/Conditions: IMPROVEMENT/OPERATION PERMIT LAYOUT- APPROVED EFFLUENT FILTER RISER(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.**** 4 � c Environmental Health Specialist's Signature: Date: DCHD 05/99(Revised) DAVIE COUNTY HEALTH DEPARTMENT Environmental Health Section P.O.Boa 848/210 Hospital Street Mocksville,NC 27028 (336)751-8760 Account #: 990002837 Transferred to: Tax PIN/EH#: 5767-89-6002 Billed To: V^�--e Wi 11 ie J. Sanders,Jr. Subdivision Info: Reference Name: Location/Address: Highway 64-27028 Proposed Facility: Residence Property Size: see map ATC Number: 3506 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 ST UCTION IS VALID FOR A PERIOD OF FIVE YEARS. Environmental Health Specialist's Signature: Date: 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. C� C�141 77 ri Septic System Installed By: Environmental Health Specialist's Signature: ,4�� Date: DCHD 05/99(Revised) Ull ' AI 1' TION FOR SITE EVALUATION/1MPROVEAIENT PERMITS STC u `) Davie County Health Department ` "` .3 Environmenta/Hea/th Section \` P.O. Box 848/210 Hospital Street �N�M---.___�� _ ENTAL HEALTH `'yi,`1��1,t�' g1�►� Mocksville, NC 27028 DAVIECOUNN F.y pp111 (336)751"8760 IMPORTANT*** THIS APPLICATION CANNOT BE PROCESSED UNLESS ALL THE REQUIRED 1 INFORMATION IS PROVIDED. Refer to the INFORMATION BULLETIN for instructions. 1. Name to be Billed NV jYl I" -S, k Tie Contact Person c5`117 /__._. •_____., Mailing Address L�Q I-I-- ty� E 1 cc,o r' Home Phone 75/I /n 71i��(�7_ n City/State/ZIP Moe Sy 1 l le- •C. oC /0�� Business Phone 331,- 2. Name on Permit/ATC if Different than Above _ Mailing Address City/State/Zip _ 3. Application For: ❑ Site Evaluation ❑ Improvement Permit/ATC o 4. system to Service: Er House ❑ Mobile Home ❑ Businets ❑ Industry ❑ Other 5. Type system requested: lia'Conventional ❑ conventional modified ❑ innovative 6. If Residence: # People _ # Bedrooms 1k Bathrooms Lt7Dishwasher ❑Garbage Disposal [OWashing Machine ❑Basement/Plumbing ❑Basement/No Plumbing 7. If Business/Industry /Other: verify type # People It Sinks # Commodes It Showers # Urinals II Water Coolers IF FOODSERVICE: #i Seats Estimated Water Usage (gallons per day) 8. Type of water supply: laJCounty/City ❑ Well ❑ Community 9. Do you anticipate additions or expansions of the facility this system is intended to serve? ❑Yes l"No If yes,what type? 'IMPORTANT "CLIENTSBIUSTCOAIPLETL•THE REQUIRED PROPERTY INFORMATION REQUESTED BELOW. Either a PLAT or SITE PLAN MUST ITE SUBMITTED by the client witli THIS APPLICATION. Properly Dimensions: �_ WRITE DIREC170NS(from A-lockwille)to PROPERTY: Tax Office PIN: # 4-r-, rOCk Cntil14Ur11't-�/ Property Address: Road Name s"r r%� _] q ( Z r-, K+ 0, s4 L(Lc n -r I,l( City/zips-hcca.�l�� n e��-- 'If in a Subdivision provide information,as follows: <:�,L-4 ` no Namc: Section: BIock: Lot: Date !Ionic corners flagged: This is to certify that the information provided is correct to the best of my knowledge. I understand that any perniit(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 responsible fur all charges incurred fi•an this application. I,hereby,give consent to tile Authorized Representative of the Davie County IIealth 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 cJ I O 3 SIGNATURE ILQO� �„g THIS ARE USED FOR DRANVING YOUR SITE PLAN(Include all of the following: Existing and proposed property aytl dimensions, structures, setbacks, and septic locations). Site Revisit Charge �.�- "_•..<. �..._ Date(s): Client Notification Date: �t EHS: \ �0 Z- Sign given Account No. Revised DCH (05/03 Invoice No. P.G. 322. rG. 722 77 � - -------------------------- _ Z. ci�jlD zfsss 1 � ge r 1a59a9•V „k�7zr t '�� Z7+' o f *� AD.D l Cll,/LD ' r 3 z Pr T2s : . iA • �t __x'6'37•r_.. 1• "84 1 t f 26 rl �� ,6.77• � r ,' v E�GI• .,� 1 r OP'�E•77• .. D.D. ::p; COA,52 - r 1 DAVIE COUNTY HEALTH DEPARTMENT Environmental Health Section Soil/Site Evaluation APPLICANT INFORMATION PROPERTY INFORMATION Account #: 990002837 Tax PIN/EH#: 5767-89-6002 Billed To: Vaneessa Greer Subdivision Info: Reference Name: Location/Address: Highway 64-27028 Proposed Facility: Residence Property Size: see map Date Evaluated: —Cl- Water Supply: On-Site Well Community Public !� Evaluation By: Auger Boring Pit Cut FACTORS 1 2 3 4 5 6 7 Landscape position .L Slope% L HORIZON I DEPTH Texture groupL Consistence Structure Mineralogy HORIZON II DEPTH ' �! Texture group Consistence r- Structure / 7 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: icl EVALUATION BY: 4!% 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 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 DCHD 05/99(Revised) ■■■■■■■■■■■■■■■■■■■ee■■■■■■■■■■■�■■■■■■■■■■■e■■e■■■■■■■■ee■e■■eee■ MENNENMENNENiiiiiii EmmonsiiiiiiiiiiNEN Niiiii ■■■■■■■■■■■■■■■e■■eee■■■■■■■■■■■■■■■■■■■■e�,■■■■ee■■■■■■■■e■ee■■■e■ ■■■■■■■■■■■■■■■■■■■■■■■■■■�.:c:::::■■■ewe■■■■■■■■■■■■■■■■■■ee■■■■■ ■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■ ■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■ ■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■ ■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■ ■■■eee■■e■■■■■■■■■e■■■■■■■■■■■■■ ■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■ ■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■ ■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■ ■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■ ■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■