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124 Gemstone LnDavie County, NC ' � t Parcel Number: NCPIN Number: Account Number: Listed Owner 1: Mailing Address 1: City: MOCKSVILLE State: Zip Code: Legal Description: Assessed Acreage: Deed Date: Deed Book / Page: Plat Book: Plat Page: Building Value: Land Value: Total Assessed Value: t��a� Tax Parcel Report Tuesday, September 27, 201E r cV4 z n 'File �R 1 WARNING: THIS IS NOT A SURVEN Parcel Information L70000001205 Township: 5766281794 Municipality: 34144000 Census Tract: HEGE KEITH B 187 LEVITY LANE NC 27028-7316 8.74 AC HWY 801 10.53 3/1992 001620816 1130.00 79160.00 89290.00 Fulton 37059-807 Voting Precinct: JERUSALEM Planning Jurisdiction: Davie County Zoning Class: DAVIE COUNTY R -A Zoning Overlay: Voluntary Ag. District: Fire Response District: FORK,JERUSALEM Elementary School Zone: CORNATZER Middle School Zone: WILLIAM ELLIS Soil Types: PcB2,PcC2,RnD,ChA,WATER Flood Zone: Watershed Overlay: DAVIE COUNTY Outbuilding & Extra 9000.00 Freatures Value: Total Market Value: 89290.00 Pyr 9 i9'F Davie County, �OtJy NC All data is providedas is without warranty or guarantee of any kind 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 County of Davie, North Carolina, its agents, consultants, contractors or employees from any and all claims or causes of action due to or arising out of the use or inability to use the GIS data provided by this website. DAVIE COUNTY- HEALTH DEPARTMENT IMPROVEMENTS PERMIT AND . CERTIFICATE OF COMPLETION *NOTE: Issued in Compliance With Article II of G.S. Chapter 130a Sanitary Sewage Systems Permit Number Name Date t..� j` 0 Location • ( , .1 , � '- ' , (e.r� � U \ \\.S 1 .`v^ �:.• ... 1.. . ` Vit: __ C- 1 . I Subdivision Name Lot No. Sec. or Block No. Lot Size L House Mobile Home r--/ Business Speculation No. Bedrooms s .No. Baths No in Family h: Garbage Disposal YES ❑ NO [ff Specifications for System: Auto Dish Washer. YES E] NO ©' Auto Wash Ma .hive YES Er NO ❑ r, , r Type Water Supply *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. v\. i 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. D 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. APPLICATION FOR SITE EVALUATION/IMPROVEMENTS PERMIT 4 Davie County Health Department Environmental Health Section P. O. Box 665 Mocksville, NC 27028 y 1. Application/Permit Mailing Address _ Home Phone J ,49 1 2. Name on Permit if Different than Above 3. Application/Permit for: 4. System to Serve: ❑ House ❑ Business ❑ Industry 5. If house, mobile home: Subdivision less Phone IR /1e�– b ay_- C—� ❑ General Evaluation Q-1 bile Home ❑ Other IfJ-ogeptic Tank Installation ❑ Place of Public Assembly ❑ Unknown Section Lot # ❑ Basement/Plumbing No. of People ❑ Basement/No Plumbing No. of Bedrooms Ellashing Machine No. of Bathrooms ❑ Dishwasher Dwelling Dimensions % `f ,7P ❑ Garbage Disposal 6. If business, industry, place of public assembly, other: Specify type No. of People Served No. of Sinks No. of Commodes No. of Urinals No. of Lavatories No. of Water Coolers No. of Showers Water Usage Figures 7. Type of water supply: ublic ❑ Private 8. Property Dimensions DL Sewage Disposal Contractor 9. Do you anticipate additions/expansion of the facility this sytem is intended to serve? ❑ Yes If yes, what type? RM ❑ 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 incurred from this application. DATE and I understand I am responsible for all charges CONSENT FOR SITE EVALUATION TO BE DONE ON ABOVE DESCRIBED PROPERTY MUST CHECK ONE: l 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. `� �D-CATTESIGNATURE DCHD (12.90) r DAVIE COUNTY HEALTH DEPARTMENT Environmental Health Section Soil/Site Evaluation NAME \� e ` \ c, e- DATE EVALUATED 3 Q\' ADDRESS PROPERTY SIZE PROPOSED FACIILTY LOCATION OF SITE �S S Water Supply: On -Site Well Community Public )� Evaluation By t�,L Auger Boring Pit Cut FACTORS 1 2 3 4 Landscape position S Sloe % 7 d - T -.30T HORIZON I DEPTH g' ' 8 '' V. Texture group v, C L I -- Consistence Consistence Rte. -`S 1- V___T Structure C C R R Mineralogy HORIZON II DEPTH 4D Lq U'' �}0 " L40 " Texture groupC C Consistence Structure (11 R 2 (Z. R G Z Mineralogy'. \ �'. 1'•1 HORIZON III DEPTH Texture group Consistence Structure Mineralogy HORIZON IV DEPTH Texture group Consistence Structure Mineralogy SOIL WETNESS 55 SS Ss ss RESTRICTIVE HORIZON SAPROLITE -- - - _ CLASSIFICATION S. �. S. .S LONG-TERM ACCEPTANCE RATE 9 SITE CLASSIFICATION: '_� ' �> LONG-TERM ACCEPTANCE RATE: REMARKS: DCHD(01-901 - S_1.11- C EVALUATED BY: \: C� OTHER(S) PRESENT: \5�_. .9 - 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 SCISingle 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