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166 Green Grass RdQ' Davie County, NC Tax Parcel Report 0 6 ( Wednesday, September 28, 2016 8824 , M o 4883 co '~ ,, LO i n � rn "' 0870 N o X151 3820 � rt_ r k 0 214 i °= 3629 513 i o f7 -77l 3640 4670'? .__ s WLu. 7595 --- 32) ; i CD00 f N 3460 J .� X173 177. 80 .: vivre 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, NC 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 °net causes of action due to or arising out of the use or inability to use the GIS data provided by this website. WARNING: THIS IS NOT A SURVEY Me - Parcel Number. N50000007001 Township: Jerusalem NCPIN Number. 5744897595 Municipality: Account Number. 45616500 Census Tract: 37059-807 Listed Owner 1: LEWIS MICHAEL E Voting Precinct: JERUSALEM Mailing Address 1: 166 GREEN GRASS ROAD Planning Jurisdiction: Davie County City: MOCKSVILLE Zoning Class: DAVIE COUNTY R -20,H -B State: NC Zoning Overlay: DAVIE COUNTY CZOD Zip Code: 27028-6647 Voluntary Ag. District: No Legal Description: 3.984 AC OFF PINE RIDGE Fire Response District: JERUSALEM Assessed Acreage: 4.08 Elementary School Zone: COOLEEMEE Deed Date: 6/2007 Middle School Zone: SOUTH DAVIE Deed Book f Page: 007171110 Soil Types: PaD,WeC,WeB,PcB2 Plat Book: Flood Zone: x Plat Page: Watershed Overlay: - Building Value: 120550.00 Outbuilding & Extra 28800.00 Freatures Value: Land Value: 21750.00 Total Market Value: 171100.00 Total Assessed Value: 171100.00 vivre 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, NC 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 °net 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 ,t *NOTE: Issued in Compliance With Article II of G.S. Chapter 130a Sa ' itary Sewage ystems Permit Number f. r; fj. ,y �,..r�>"x'�r ", d"fir Date '' � N28016 Name — — Location Subdivision Name Lot No. Sec. or Block No. Lot Size -__.— House _�� Mobile Home ---_ Business __ Industry dY No. Bedrooms _No. Baths- No. in Family_— Public Assembly Other Garbage Disposal ` YES p NO p1 Specifications for System: Auto Dish Washer YES 0 NO Auto Wash Ma^hine YES [Q NO O ,Type Water Supply --- '� r ---- --- ,�✓ f 'Thi$ -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 ATTENTION: YOUR SEPTIC SYSTEM CONTRACTOR MUST SEE THIS PERMIT/LAYOUT BEFORE INSTALUNG THIS SYSTEM. t a 1" l f Improvements permit by _IL�/Z -uoniaci a represemauve or ine uavie Vouniy maim wuptuunum wi nnni nwNouuun ui uuo oyatv11 vvL►+avii v.vv-a.. V n.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: System Installed by _ _c 1) I Certificate of Com letionI Date Vl 'The signing of this certificate shall indicate that the system describ 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 PERMI Davie County Health Department !. l�{{cc Y Environmental Health Section ,L P. O. Box 665 OCT % 6 lql7 Mocksville, NC 27028 1. Application/Permit Requested By �///0,,��� Mailing Address i-�D� r'le �� J�� Home Phone a�y-yy� 7 � Ic��S✓�'//t, /j/G �,? %U a Business Phone 9/6 - 71 .k- 7.31.2 2. Name on Permit if Different than Above 3. Application for: 4. System to Serve: General Evaluation ❑ House ❑ Business ❑ Industry 5. If house, mobile home: Subdivision No. of People 7 No. of Bedrooms -3 No. of Bathrooms ❑ Septic Tank Installation Permit ❑ Mobile Home ❑ Place of Public Assembly ❑ Other * Unknown Dwelling Dimensions �2Z D DO 2244. 4. 6. If business, industry, place of public assembly, other: Specify type No. of People Served No. of Commodes No. of Lavatories No. of Showers 7. Type of water supply: Public No. of Sinks No. of Urinals No. of Water Coolers Water Usage Figures ❑ Private 8. Property Dimensions yaer ens Sewage Disposal Contractor Section Lot # ABasement/Plumbing ❑ Basement/No Plumbing Washing Machine Dishwasher ❑ Garbage Disposal 9. Do you anticipate additions/expansion of the facility this sytem is intended to serve? ❑ Yes * No If yes, what type? ❑ 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: n e i�E'n �e-P4 on o �� 6�mSS Pd. X , -le claw,. on 'tJ 6-0c{.Q C Lg-c'-- . This is to certify that the information provided is correct to the best of my knowledge, and I understand I am responsible for all charges incurred from this application. 1457-,2115;- :�y' _ DATE SIGNATURE CONSENT FOR SITE EVALUATION TO BE DONE ON ABOVE DESCRIBED PROPERTY MUST CHECK ONE: �1. 1 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 ab orpti n sewage treatment and disposal system. DATE SIGNATURE' DCHD (1193) DAVIE COUNTY HEALTH DEPARTMENT Environmental Health Section Soil/Site Evaluation NAME A/l/l/i') ADDRESS PROPOSED FACIILTY DATE EVALUATED 11'-' 2 PROPERTY SIZE �'�I 6 LOCATION OF SITE Cg�!2 Water Supply: On -Site Well Community Evaluation By: Auger Boring � Pit FACTORS 1 2 3 4 Landscape position G Slope % HORIZON I DEPTH Texture group Consistence Structure Mineralogy HORIZON II DEPTH �- Texture group Consistence ��- Structure _r4 /r, 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 RATEI SITE CLASSIFICATION: - % 1 EVALUATED BY: ,/Y� `z LONG-TERM ACCEPTANCE RATE: OTHER(S) PRESENT: REMARKS: DCHD(01-901 LEGEND Public C/ Cut 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 <:lay 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 3C -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 ■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■i%■■■■■■■■■■■■■■■■■■ ■■Y■■■■ ■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■ ■■■■■�■.f1►1^l'�Yr��\■■moi!■■■■■■■■■■■■■ ■■■■■■■■■■■■■■■■■■■■■■■■OO■O■■■■E■■017■f/■■[�■�I■11■/!'1l`31■e■e■e■■■e■■■■■■ ■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■I■■G■■/��^\Gil•■■■■■■■■■■■■■■■■■■ ■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■%■■I�i�■■■■■■■■■■■■■■■■■■■■■■■■■■ ■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■I■�%■■■■■■■■■■■■■■■■e■■M■Mee■■■■■■ ■■■■■ee■■■e■■■■■■■ee■■M■■■■ell■.le■■=■■■e■■ell■■eu■■■■■■■■■■■■■■Ee■■■ ■■■■■■■■■■■■■■■■■■■■■■■■■■■■11■.t■ ■■■■■■tri■ ■■■e■■■■■■■■■■■■■■■■■■ ■■■■■e■■■■eeeeeeeeE■■N■■■■■IIM[le■■■N■■M■■■■■■■■■■E■■�■■■■■■■e■e■� ■■■e■■■■■■■■■E■eE■eee■■ee■E■It■I.1■M■■■■■■■■■■■■■■\�L'�■■■■■■■e■e■■■eM ■■e■■■■■■■■■■■e■■e■■■e■■M■■Mt.Mie■■e■■■M■MMMEe■e■e■■■■■■e■■=M■M■EEE■ ■■■e■M■■■■■■e��e■■■■■■■■■■■■I.O.I■�E■■MOM■OO■M■e■e■■■e■e■■ MEMO MEN eee■■■■e■Mee■■■■Nee■■■■M■■�■(tiM■■■ee■■�■■■e■■■e■■■■e■e■eE■■■e■■■■ ■■e■O■■■■■■■■■■■■e■■■■■■■■■■■■LI■■■■M■O■■■■■■■■■■■■eO=e■■■ eM■Mee■ ■■■■■■■OO■■■■e■O■■■■■■■■M■■■■■11■OE■■■■■O�■■OM■■■/O�e ■O■■■■■e■■■■■ ■■■OO■■EM■■■■■■■e■■■■■e■■■■■■e1l■■eee■■■■_ ���GiiAM�■et.\■■■■eeOME■ ■■■■O■ee■■■e■■■■■■■■OOee■■■■i\■\�■M■■■■e��/■■■■e■■■■■■■■eM►\Oe■■Mee■ ■■■eeO ■eM■■■ ■■■■■■ ■MI.O■■N■/QMe■ eeMe■et,�eeO■■■ 11■■■■■ ■E■■■■ ■■■■■■"M■■■■■ ■ERM■M\#ME■EM■�wawww - -:z:gtim■■■E■■ ■eee■■■eMeee■■■■eMMee■■■■■■MI.■f GI■■■eM!�'�iMeMee■e.�ie■e■e\��,■■■■■■■ ............................t.......•..............■■■■■..p■■■■■■■■ O ...........■■■■■O■■M■■■e■E■■11■eEM/.Ie■MNe ....... 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MEMO■■■■■■■■■■■■■■■■■■■■■■■■■■.lu■■■■■■■■■■■■■■■■■■■■■■■■■■MEN■■■■ Davie County ealt1 De artment 4 ♦ ' and Aoine Nealtlf Mgerrcy 210 HOSPITAL STREET/ P.O. BOX 665 MOCKSVILLE. N.C. 27028 PHONE: (704) 634.5985 November 4, 1994 Norman Gray Allen, Jr. 508 pineridge Rd. Mocksville, NC 27028 Re: Site Evaluation Green Grass Road Dear Mr. Allen: As requested, a representative from this office visited the aforementioned site on November 2, 1994. Based upon the information provided on the application for a site evaluation and after the evaluation was completed, the site was found to be provisionally suitable for the installation of an on—site sewage disposal system. If you have any questions, please feel free to contact this office. Sincerely, A4't ��• Robert B. Hall, Jr., R.S. Environmental Health Section RH/wd Enclosure