143 Brookhaven LnDavie Countv. NC
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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
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�-~�i r.:� .. DAVIE COUNTY HEALTH DEPARTMENT
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� 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.
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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)
, � '� ,
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•- '� � 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
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� Davre Counly .�lealffr� �e artmenf
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ancl �lome .tleal y cy
210 H05PITAL STREET I P.O. 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 `
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