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143 Brookhaven LnDavie Countv. NC Tov AorrF+l T2 c+r�nrf Wednesdav, October 12. 2016 Parcel Number: NCPIN Number: Account Number: Listed Owner 1: Mailing Address 1: City: State: Zip Code: Legal Description: Assessed Acreage: Deed Date: Deed Book / Page: Plat Book: Plat Page: Building Value: WARNING: THIS IS NOT A SURVEY Parcel Information E600000086 Township: Farmington 5851977145 Municipality: 81337000 Census Tract: 37059-802 YOUNCE JOHN ROBERT JR Voting Precinct: SMITH GROVE 143 BROOKHAVEN LANE Planning Jurisdiction: Davie County ADVANCE Zoning Class: DAVIE COUNN R-20 NC Zoning Overlay: DAVIE COUNTY QD Land Value: Totat Assessed Value: 27006-6761 Voluntary Ag. District: 5.00 AC HWY 158 Fire Response District: 4.89 Elementary School Zone: 12/1994 Middle School Zone: 001770858 Soil Types: Flood 2one: Watershed Overlay: 182310.00 Outbuilding & Extra Freatures Value: 62920.00 Total Market Value: 260470.00 SMITH GROVE PINEBROOK NORTH DAVIE EnB,MsC DAVIE COUNTY 15240.00 260470.00 [�C•7 9l.�I� A�i daU Is provtded as Is wlthout wamnty or guarantee of any Idnd either expressM or Impiied Including but not limked to the Davie County� Implfed warranties of inerchaMability or fttneu for a particular use. All users of Davle CouMy's GIS website shall hold harmless the CouMy of Davie, North Grollna, tts aymts, consultaMs, contrador� or employees trom any and all claims or causes oT actlon due to �'p� �.�� NC or arising out of the use or InabilHy to use fhe GIS data provided by thfs webska �� i . � .^,,�1 . 1 . .. . . , - . . . , � , . . . .._ .. �; `, � *r��"' �P' �'E�✓�'�.. . \,,..' :; � �,..�,�`�, , � �-~�i r.:� .. DAVIE COUNTY HEALTH DEPARTMENT �. , �. -. � IMPROVEMENTS PERMIT AND CERTIFICATE OF COMPLETION * NOTE: Issued in Compliance With Article I I of G.S. Chapter 130a � Sanitary Sewage Systems Permit Number Name �7o1�n Jonce � 1�-3 tirookliaven Ln. � Advnit�ate 1`-2�_�1r �� 7 8 3 3 - LOC8tI0f1 158E. � Left on Si�al loc:+brook� Left o Sroolc)taven; 'st house on the ricfht Not i►i CountrJ Govc, but have ta go throti�7h subctivisiori to get to properYy. Subdivision Name Lot No. Sec. or Block No. Lot Size ��� House ��'� Mobile Home _ Business �— Industry No. Bedrooms � No. Baths �� No. in Family `�/� _ Pubtic Assembly Other Garbage Disposal YES NO � Specifications for System: r���' � /�/,, Auto Dish Washer YES NO ❑ /�,./ �- � �� `f ��"' j�" " ! �L` (-� r'' �v` /��� f". Auto Wash Ma :hine YES NO � ,� Type Water Supply � .G'�/��✓/ ---- C�GG%,� �,�f� , �� /..� ���k,f �_ '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 intended use change. i �,..�.-,>- Improvements permit by _Ut��L— *Contact a representative of the Davie Counry 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: � Certificate of Completion ^1��-' �%��� Date ����1� '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 regutation, but shall in NO way be taken as a guarantee that the system will function satisfactorily for any given period of time. /• � i � M � � ' ' n f + '� �� �U r .�� /r l,� / e� � ) l6 /� � ��� �` f � ���- a J�� 1. Application/Permit Requ� Mailing Address ►`T Home Phone �8 - APPLICATION FOR SITE EVALUATION/IMPROVEMENTS PERMIT Davie County Health Department � Environmental Health Section , P. O. Box 665 Mocksville, NC 27028 , �"' :' j 19� By SIS � U a�� , ua,� ?� �� -� Business Phone � p ���-�� 2. Name on Permit if Different than Above J oh � on c�. Sr d- i�'1'1 �lG ��vl7�'�. 3. Application/Permit for: �General Evaluation C�J'�ptic Tank Instailation 4. System to Serve: ��use ❑ Mobile Home � ❑ Place of Public Assembly ❑ Business ❑ Industry ❑ Other ' �W ' ��, • � Unknown (�- 5. If house, mobile home: Subdivision /1 c� 11 -/'PS�/', G�-P� % Section Lot # asemenUPlumbing No. of People � ❑ BasemenUNo Plumbing No. of Bedrooms 3 C�'Gashing Machine a �,�. No. of Bathrooms �ishwasher Dwelling Dimensions � � x �� �Garbage Disposal 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: I� rublic ❑ Private � Community ��}C r2S Sewa e Dis osal Contractor '`' Ck" �ab e' 8. Property Dimensions g p 9. Do you anticipate additions/expansion of the facility this sytem is intended to serve? ❑ Yes � If yes, what type? ' *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. This is to certify that the information provided is correct to the best of my knowledge, and I understand 1 am responsible for all charges incurred from this application. DATE SIGNATURE CONSENT FOR SITE EVALUATION TO BE DONE ON ABOVE DESCRIBED PROPERTY MUST CHECK ONE: 1. I OWN the property. ❑ 2. I 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 ' e s' sit � sui bility��� ood absorption sewage treatment and disposal system. � � �—�9-�� � � � �- - DATE ,- ATURE �� DCHD (12-90) , � '� , �� , � , •- '� � DAVIE COUNTY HEALTH DEPARTMENT Environmental Health Section Soil/Site Evaluation NAME I/�7/%�� DATE EVALUATED [o���% � ADDRESS PROPERTY SIZE ��� PROPOSED FACIILTY t�G�SY LOCATION OF SITE -��r`�'`� �d� .BZ�i��'03K u Water Supply: On-Site Well Community Public 1� Evaluation By: AugerBoring � Pit Cut FACTORS 1 2 3 4 Landscape position G y l Slope 7. 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 � L _�p „ SITE CLASSIFICATION: d� /�l/� G�•� EVALUATED BY: �'ce �� LDNG-TERM ACCEPTANCE RATE: .�_ OTHER(S) PRESENT: REMARKS: LEGEND Landsbane 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 slop� 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-Finn 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-SYngle grain M-Massive CR-Crumb GR-Granular ABK-Mgular blocky SBK-Subangular blocky PL-Platy PR-Prismatic Mi neralogy 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 watefi 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(01-901 ■�������■����■�����/��������������■����������������������� ����/�� ■���������������■�■��■���������■���/�0�������■�����������������■■■ ■��■�����������■�����■���������� ■�������������■���������0�■����� ■����■■��■�■■��■�����■■�����/����■��������������■��������������■■ ■�■���■■�������■��■\������■■����������������■��������������������■ ■������������������������������������■�����������■�����■\�������\■ ■��■�������������������������������������������������������������■ ■■���E����������������■���������■���������� ■������■�������■\����■ ..........................................C...................... .■................................................................ ................................ ................................ ................................�................................ ...........................�...................�.................. ........................... ................... .................. ::::::::::::::::::::::C:::CC::::::C::�.::'::::�:':':�:�::::::":: ■��■���������■��■���■�����������■�����������■����_������■���n�i �� ■����������������������������������������������������������������� ■�������■�■���������������������������■■���������������������■�■ ■�����������������������������■ ��������������������������i����■ ■■�������������■�■���■����■■�����■�������������������■��H�■������ ����������������������������������������������������������������� iiiiiiiiiiiiiiiiiiiii��siiiiiiiiii=iiiiiiii=iii�iiii�iiiiii��iii=i ....................................................C......... ... :C::::::C:C:C:::CC:C::::CCC::C:�3:C:::::::5:::':::::::::C::::=::C ■���■�■■�\����������■N/�����■�����N����������n���� ����������� ■�������■\��■■�/�■■���M���■����■����������■���/��������� ■����■ � ::::::::o:::::::::::C::C::::::C::::C::::C::::::C:::�::�:�i: .....�....�...................................... .........■...... ......�....�.....................................C................ 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BOX 665 MOCKSVILLE. N.C. 27028 PMONE: (704) 63A-5985 June 30, 199.� John Yonce Rt. 1, Box �09 Advance, NC �7006 Re: Site Evaluation Shallowbrook Drive Aear Mr. Yonce: As r�equested, a repr•esentative from this office visited the aforementioned site on June 29, 1993. The site was found provisi�nally s�_�itable for the installation of a modified—oversiied, ground absorption sewage aystem. If you have any questions, please feel free to contact this office. Sincerely, ���� �'�' � '�S Robert B. Hal l, Jr. , R. S. Envir•on�ental Health Sectian RH/wd Enclosure y �Davie Courrty .Jfealffi� �De artmerrt ' ltFr ��err and �lame ..i�ea y cy 210 HOSPITA� STREET J P.O. 80% 665 MOCKSVILLE. N.C. 27028 PHON[:17041 634•5fl6� June 30, 199: John Yonce Rt. i, Box 209 Advance, NC 27�D06 Re: Site Evaluation Shallowbr,00k Drive Dear Mr. Yonce: As r-eq�.�ested, a r�ept^esentative from this office visited the aforementioned site on June c9, 1993. The site was found pr�ovi:ionally suitable for the inst�llation of a nodified—oversized, ground absur•ptian sewage system. If you have any questions, please feel free to contact this office. Sincerely� ��.�`� �y� � �S Robert B. Hal l, Jr. , R. S. Environaental Health Section RH/wd Enclosure I'lia�e: (336) - 753 - 6780 Davie. County Health D� �nvironmental Health P.O. Box 8�1�8 210 Hospit�l Street Courier # : 09-4.0-06 Mocksville, NC 2702 � J tn1 �d 2 5 ZQ10 ENVIi,C��dPAENT{IL HEALTH i>;�; IE COUNTY ON-SITE WASTEWATER CERTIFICATION FOR DWELLING (Check One) Replacement Remodeling Reconnection � Pax: (336) - 753-1680 Name: 1 �. j (� {� _ Phone Number ������0 '/ �7 / (Home) Mailing Address: ��� /�/^C� �/►� (Work) G��.�C:e���— Please Fill In The Following Information About The EXISTING Facility: Name System Installed Under: ' Type Of Facility: �(�j(..�S.Q _ Date System Installed (Morith/Date/Year): . ' 1 J� Number Of Bedrooms:_�_Number Of People: Is The Facility Currently Vacant? Yes �No� If Yes, For How Long? Any Known Problems? Yes C'�_�/�f Yes, Explain: Please Fill In The Following Information About The NEW Facility: Type Of Facilitv• � l��Cf.C� �,�(n( � '1�y _ Number Of Bedrooms:-1=�-'�—Number of People � � A roved Disapproved Comments: Environmental Health Specialist Date Requested: For Environmental Health Office Use Only Date: *The signing of this form by the Envirorunental Health �taff is in no way intended, nor should be taken as a guarantee (extended or limited) that the on-site wastewater system wil] function properly for any given period of time. Payment:,� Cash � heck Paid By Order # S•Z,Zd Amount:$ i(`�� Received By: A��ot�»t #: SS3a ` Invoice #: '�3Sq ` �� �_tY'-�° 2�� CI� � '