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890 Georgia RdDavie Countv, NC fTax Parcel Report D'a 10 Thursday. September 29, 2016 WAK 0IU: '1'lila 1J 1VU'1' A SURVEY Parcel Information Parcel Number: E20000003801 Township: Clarksville NCPIN Number: 5811256284 Municipality: Account Number: 82526623 Census Tract: 37059-801 Listed Owner 1: ELLER CHADWICK W Voting Precinct: CLARKSVILLE Mailing Address 1: P 0 BOX 1848 Planning Jurisdiction: Davie County City: YADKINVILLE Zoning Class: DAVIE COUNTY R -A State: NC Zoning Overlay: Zip Code: 27055-0000 Voluntary Ag. District: No Legal Description: 5.006AC OLD GEORGIA ROAD Fire Response District: WILLIAM R. DAVIE Assessed Acreage: 4.67 Elementary School Zone: WILLIAM R DAVIE Deed Date: 6/2006 Middle School Zone: NORTH DAVIE Deed Book / Page: 006680184 Soil Types: MnB2,WATER Plat Book: 0008 Flood Zone: Plat Page: 284 Watershed Overlay: DAVIE COUNTY Building Value: 470130.00 Outbuilding & Extra Freatures Value: 61170.00 Land Value: 43400.00 Total Market Value: 574700.00 Total Assessed Value: 574700.00 O uwrAAll �OUrt� Davie County, �T 1� C data is provided as 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 �8r� Environmental Health Section 4 1 P.O. Boz 848 i, 210 Hospital Street 'PAW O � 1<1 _ Courier # : 09-40-06•_ Gj - - ! j —13 Mocksville, NC 27028 rtf Phone: (336) - 753 - 6780 Fax: (336) - 751- 8786 ON-SITE WASTEWATER CERTIFICATION FOR DWELLING (Check One) Replacement Remodeling Re onnectiop0 Name: a(_. �`�-e r Phone Number Z- C3 3 93 (Home) Mailing Address: - Work) MGC -4-1 �r"LLQ Email Detailed Directions To Site: The EXISTING Facility: Name System Installed Under: �I�L�CO( L'ter Type Of Facility: S t Date System Installed (Month/Date/Year): V 7! 0 Q Number Of Bedrooms:_Number Of People: T, Is The Facility Currently Vacant? Yes No If Yes, For How Long?, Any.Known Problems? Yes No If Yes, Explain: Please Fill In The Following Information About The NEWFacility: 7 c� ' e 111 �k Type Of Facility: OJ � �.. �, t rk Number Of Bedrooms: O Number of People (� Requested By: Date Requested: % Z `/� J Signa e) For Environmental Health Office Use Only pproved Disapproved Co e Environmental Health Specialist Date: 7 / 2GY3 0 *The signing of this form by the EnvironMenfarAealin Staff is inway intended, nor should be taken as a guarantee (extended or limited) that the on-site wastewater system willEction properly for any given period of time. Payment: Cash Check oney Order # Amount:$ Q Date: K Paid By:,M; d 5*D q_ffk rrj t' piq Received By: Account #: ' Invoice #: p1V = f�o6DeeO3g0 c j t �L576?2:841 t2��1 Apr 19131157p TNvas �' 4 �s 0 Phone: (336) - 753 - 678 Artistic Pools, Inc 704-892-0415 p.1 (Aq s iti 29e 6v ed PA# � a ��1 t: ec n' County Health Department onmental Health Section )?.0. Box sous 210 Hospital Street Courier # : 09-40-06 By piIiu C<< Mocksvillc, NC 27028 0 Fac (336) - 753-1680 ON-SITE WASTEWATER CERTIFICATION (Check One) Replacement Remodeling Reconnection l•,r-,j Name: r�`Sf. L Pd,.^�s �sLr •J� Phone Number 70q k,21 -'I (Home) Mailing Address:, (Work) +ter. l �4S , Ave-, J., - 3 i Detailed Directions To Site.�'� Property Address: /Vl .t, Svi 11 �Ar— 12299 Please Fill In The Following Information About The EXISTING Facility: Ch A dw;Ck G lL '" Name System Instal led Under r _(r,Ar �t tri t e, Type Of Facility: J r"~- t afar 1,r Hcy5Se Date System Installed (Month/Date/Year): i OHIT Number Of Bedrooms.-__3_Number Of People: Is The Facility Currently Vacant? Yes No If Yes, For How Long? Any Known Problems? Yes No If Yes, Explain: Please Fill In The Following Information About The rNEWFacility: Type Of Facility: T— Tmvnr� S w%►w+ ,(^r �de i Number Of Bedrooms: Number of People Pool Size: X 5 Garage Size: Other. Requested By Date Requested or Environmental Health Office Use Only i prove ' Disapproved Comments: Environmental Health Specialist .f.�,�.c.�o ✓ Date: The signing of this form by the Environmental Health Staff is in no way intended, nor should be taken as a guarantee (extended or limited) that the on-site. wastewater system will function properly for any given period of time. Payment: Cash Check Money Order # Amount:$ Date: Paid By:_ Account #: 6. Ob ?N/f1Ai� Received By, Invoice #: W/j a AVT;IoizlzaTtoN No:: DAVIE COUNTY HEALTH DEPARTMENT,/' 10 Environmental Health Section PROPERTY INFORMATION Permit e `` 1 P.O. Boz 848 Name: L... �) 7. `E-�i-.% � Mocksville, NC 27028 Subdivision Name: Phone # . 336-751-8760 Directions to property: ��t iFl�� ... Section: Lot: _ '�.� ' AUTHORIZATION FOR pp = WASTEWATER Tax Office PIN:# -)0 � SYSTEM CONSTRUCTION tTAL:Q ' -<1T� Road Name: [ip:� '� G- t •, *.*NOTE** This Authorization for Wastewater System Construction MUST BBISSUED by the Davie County Environmental Health Section prior to issuance of any BuildingPennits. This Form/Authorization Number should be presented to the Davie County Building Inspections Office when applying for Building Permits. (In compliance with Article 1 I pf G.S. Chapter 130A, Wastewater Systems, Section :1900 Sewage Treatment and Disposal Systems) � I ' ***NOTICE*** THIS AUTHORIZATION FOR WASTEWATER CONSTRUCTION Z3 IS VALID FOR A PERIOD OF FIVE YEARS. ENYIIdt)N AHEALTH SPEC!LIST DA 1SS ED fI IDD^%DSI SUKrr DCD I Arr i A Vl%1 iT . l f nTflff"fl ��5 ,►� APPILICAiION FOR SHE EVAI..UAMON/IMPROVEMENT PERMIT & AT Dam County Health Depatfinent Envitvamental Healfh SmWon P.O. Box 848/210 Hospital Street FEB 2 5 1999 .Mocksville, NC 27028 (336) 751-8760 ENVIRONMENTAL HEALTH ***IMPORTANT*** THIS APPLICATION CANNOT BE PROCESSED UNLESS ALL THE REQUIRED INFORMATION IS PROVIDED. Refer to the INFORMATION BULLETIN for instructions. 1. Name to be Billed (�/1[t� G/. fY,Ca Flleel- Contact Person �,�/'!/�,✓ _ (/!�/' Mailing Address /Pl a Aw /16/ 'A / p Same Phone _ 336/ - City/State/ZIP _y4dly%(rl.y%I/e j o 2%O5r Business Phone 336/ - 1163 - 2. Name on Permit/ATC if Different than Above 'e Mailing Address e City/State/Zip 3. AVp,1::c:ation For: 94ite Evaluation Improvement Permit/ATC "oth 4. aysLaa = Sera' -e -Aa: b house 0 Mobile ;Home 0 Zusiness 0 Industry 0 other a. If residence: # People 7 # Bedrooms 3 # Bathrooms Fr"Dishwasher t] Garbage Disposal (Yxashing Machine 8"Basement/Plumbing 0 Basement/No Plumbing 6. If Business/Industry/other: Specify type �/� # People # Sims # Commodes # Showers # Urinals # Nater Coolers IF FOODSERVICE: # Seats Estimated hater Usage (gallons per day) 7. Type of water supply: 0 County/City 0 Community a. Do you anticipate additions or expansions of the facility this system is intended to serve! 0 Yes 19-lq—o If yes, what type' ***IMPORTANT*** CLIENTS MUST CODIPLETETHE REQUIRED PROPERTY INFORMATION REQUESTED BELOW. Either a PLAT or SITE PLAN MUST BESUB1111TTED by the client with THIS APPLICATION. Property Dimensions: a `J WRITE DIRECTIONS (tram Mocksville) to PROPERTY: las riffice V' S: # S911 39 D b 8 3 6 d 000 ' W� too �%r/� Y-. G, Property Address: Road Name Ceorc ,c, ,E'cQ. &,yel %l�t pyo 7 o City/Zip Mods 014, 70.29 .Delo Crce i /%arab PJ fitrk- leP If in a Subdivision provide information, as follows: go t t, ° le hien 18741- -o-, Name: !U A -t Jarh IW , S,� G W, // he on 1 e -P f a,6o J 3/11 h—' leJw5f Section: Block: Lot: Date Property Flagged: L GO /WG This is to certify that the information provided is correct to the best of my knowledge. I understand that any permits) 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 frons this application. I, hereby, give consent to the Authorized Representative or the Da ie County Qe2Wriment 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 r i SIGNATURE G✓ G� �- THIS AREA MAY BE USED FOR DRAWING YOUR SITE PLAN (Include all of the following: Existing and proposed property lines and dimensions, structures, setbacks, and septic IocatiQns). 11� 14tr-ic L.o Revised DCHD (07/98) Account No. 417 Invoice No. r> TR._ (39.32 Ac.) A t C . 990 '.2519 y + pQ ¢if%jyj °. 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DAVIE COUNTY HEALTH DEPARTMENT Environmental Health Section SECTION LOT Soil/Site Evaluation / u-lL DATE EV LUATED r 23 1 APPLICANT'S NAME A PROPOSED FACILITY cL) PROPERTY SIZE -S SUBDIVISION ROAD NAME Ce"40L&14 20 Water Supply: On -Site Well Community Public Evaluation By: Auger Boring Pit Cut SITE CLASSIFICATION: 7 LONG-TERM ACCEPTANCE RATE: REMARKS: DCHD (01.90) 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 is 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 EVALUATION BY:''Siae�C�� OTHER(S) PRESENT: 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 Landscapeposition 1:1671 ZGTMMWR ---- Consistence HORIZON II DEPTH Consistence Mineralogy HORIZON III DEPTH MW ITM nowa WI—JIMA ConsistenceMine HORIZONDEPTH ®e�s��■�o�-i Consistence SOIL WETNESS • r•��ra�®��-� SITE CLASSIFICATION: 7 LONG-TERM ACCEPTANCE RATE: REMARKS: DCHD (01.90) 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 is 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 EVALUATION BY:''Siae�C�� OTHER(S) PRESENT: 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 ■ ■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■ ■■■■■■■■■■■■■■■■■■■■■■■■■■ ■■■■■■■■■ ■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■ ■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■ ■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■ ■■■■■■■■MOMMY:.✓■I■■L��■■r■■■■■■■■■■■■■ iii■■■�� ■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■ ■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■ ■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■ ■■■■■■■ ■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■ ■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■ ■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■ ■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■ ■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■ ■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■ ■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■ ■ti■■■EEE■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■ ■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■ ■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■ ■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■ ■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■ ■■■■■■■ ■ ■ ■ ■■■■NM■■■■■■■■■■■■■■ ■■■■■■■■■■■■■N■■■■■■ ■■N■■■■M■■■■■■■E■■N■ ■■■■■■MM■■■■■N■EN■M■ ■■■■■■■■■■■■■M■■■■■■ ■■■■■■■■■■■■■■■■■■N■ ■■■■■■■N■■■■N■■■■■■■ ■■■■■MME■■■M■■■■■■E■ ■■SEES■■■■■■■■■■■■■■ ■■■■■■■■■■■■■■■MOSS■ ■■■■■■■■■■S■■■MM■M■■ ■■■E■■E■■MEM■M■■■E■■ ■■■■■■EM■M■ME■E■■EM■ ■■■■■■■■■■■■■■■■■■■■ ■■■■■■■■■■■■■■■■■■■■ ■iii■■■■■■■■■■■■■■■■ ■■■■■■■■■■■■■■■■■■■■ ■■■■■■■■■■■■■■■■■■■■ ■■■■■■■■■■■■■■■■■■■■ ■■■■■■■■■■■■■■■■■■■■ /■G►J■►115'■■■■■■■■■■■■ on�MEMEME�MENMEM ■EMMEM■■■ME■MEM■■■M■ ■■■■■■■■■■■ ■■■■■■■■■■■ ■■■■■■■■M■■ ■■■E■E■■M■■ ME■■■■M■■E■ Apr 28131 57.p Artistic -Pools, Inc 704-892-0415 p.1 1,q,q s iAJ 2ze et v eco PA# &C e 4,+y . (,eqorlts V19 County Health Department �G VZom-nental Health Section P.O. Box 848 210 Hosp ital Street gV: IVIAiliul C(G Phone: (336) - 753.6780 Courier 0 c 09-40-06 Mocksvillc, NC 27028 ON-SITE WASTEWATER CERTIFICATION Faye (3361 - 753-1680 (Check One) Replacement Remodeling Reconnection Name: C. Perms Tn,[1 TO Phone Number 70`7• 1121 eI (Home) Mailing Address: 2l `t SQ 6c,/n+ 1'b 41- %C q— Slgl,Z_ 0(_j 15 (Work) Detailed Directions To Site: G�r V �� J 60/ . (n7U PropertyAddress: Please Fill In The Following Information About The EXISTING Facility:A d (,V;C1Ll( Name System Installed Undecl _6&A F i itP, r Type Of Facility: Ffe"5& Date System Installed (Month/DatetYear): l 011T Number Of Bedrooms: Number Of People: Is The Facility Currently Vacant? Yes No If Yes, For How Long? Any Known Problems? Yes Na If Yes, Explain:. Please Fill In The Following Information About ThefNEWFacility: Type Of Facility: T_--% e a Vnj5 w. i�„'v.,tn _ C'do 1 Number Of Bedrooms: Number of People Pool Size: 7 k5 Garage Size: Other: II Requested By Date Requested: For Environmental Health Office Use Only prov Disapproved Comments: Environmental Health Specialist 61Date: *The signing of this form by the Environmental Health Staff is in no way intended, nor should be taken as a guarantee I (extended or limited) that the on-site wastewater system will function properly for any given period of time . Payment: Cash Check Money Order It. Paid By: Amount:$ Date: Received By Account #• Invoice u 6, oD :I/VAt4 l 7� Sq Z -d y/J Apr2913,01,:47p . ArtislicPools, Inc IIqlt�.�i�11'�+i�ol�r.lar.++�dom�e�b� �reRnn� . •�36 - H 6 �- �'� Jif ' a 741271 Ve IN =3510 -s, Jerry W. Ener N V47'107 db 195; pg. fi Z8'�s'Z�"E S&C N �'SWX17 704-892-0415 p• 1 l' { #atrutt l• ti. { aub;wt to the R/W w So 1313 F9 17`x3s # HOUSE (qppnw. lat4w"I it 19APPA %W W4 Jerry- X tiler � db 1.95�'.:pg.'�S,Sa41 Jerry W. Eli db .795. pg