409 Cedar Creek Rd (2) Davie County,NC Tax Parcel Report Thursday, December 15, 2016
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WARNING: THIS IS NOT A SURVEY
Parcel Information
Parcel Number. D500000039 A Township: Farmington
NCPIN Number:. -i5832829920 Municipality:
Account Number: Census Tract: 37059-802
Listed Ownerl:;;_ < POTTS DIANE H Voting Precinct: FARMINGTON
Mailing Address-1: POTTS ROY L FAMILY TRUST SHARE Planning Jurisdiction: Davie County
City: ADVANCE ; ` Zoning Class: DAVIE COUNTY R-A
State: NC ;:: ' Zoning Overlay: DAVIE COUNTY QD
Zip Code: 27006-0000 Voluntary Ag.District: Yes
Legal Description: - -8.144 AC CEDAR CREEK RD Fire Response District: FARMINGTON
Assessed Acreage: 8.23 Elementary School Zone: PINEBROOK
Deed Date- --. - __2/2000 Middle School Zone: NORTH DAVIE
Deed Book/Page: 2000E0057 Soil Types: GnB2,GnC2,GaD,MsC,ChA,MsD
Plat Book: Flood Zone:
Plat Page: Watershed Overlay: DAVIE COUNTY
Building Value: Outbuilding&Extra
Freatures Value:
Land Value: Total Market Value:
Total Assessed Value:
QA11, 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, Implied warranties of merchantability or fitness for a particular use.All users of Davie County's GIS website shall hold harmless the
/-r County of Davie,North Carolina,Its agents,consultants,contractors or employees from any and all claims or causes of action due to
' SOU ty4 NC or arising out of the use or Inability to use the GIS data provided by this website.
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DAVIE COUNTY HEALTH DEPARTMENT
IMPROVEMENT PERMIT'and OPERATION PERMIT
IMPROVEMENT AERMIT
This improvement permit DOES NOT authorize the construction or installation of a septic tank system or any wastewater
system. . AN AUTHORIZATION FOR WASTEWATER SYSTEM CONSTRUCTION must be obtained from this Department prior to the
construction/installation of a system or the issuance of a building permit.
(In compliance with Article 11 of G.S. Chapter 130A, Wastewater Systems, Section .1900 Sewage Treatment and Disposal Systems)
NAME 1A P,9 / PROPERTY ADDRESS (/ 1"--� /1U^:ai v�dDATE /1
LOCATION
SUBDIVISION NAME LOT NUMBER � eP'F SEC./BLOCK NUMBER
RESIDENTAL SPECIFICATION: BUILDING TYPE # BEDROOMS-.,? # BATHS ,oma , # OCCUPANTS _GARBAGE DISPOSAL: Yes/M0
COMMERCIAL SPECIFICATION: FACILITY TYPE # PEOPLE # PEOPLE/SHIFT # SEATS INDUSTRIAL WASTE: Yes/No
LOT SIZE , �� _ TYPE WATER SUPPLY �/l�� DESIGN WASTEWATER FLOW (GPD> „f NEW SITE REPAIR SITE
SYSTEM SPECIFICATIONS: TANK SIZE APPOIGAL. PUMP TANK GAL. TRENCH WIDTH S ROCK DEPTH ALINEAR FT.
OTHER
r
REQUIRED SITE MODIFICATIONS/CONDITIONS:
***THIS PERMIT IS SUBJECT TO REVOCATION IF SITE PLANS OR THE INTENDED USE CHANGE. YOUR WASTERWATER SYSTEM CONTRACTOR MUST
SEE THIS PERMIT BEFORE INSTALLING THE SYSTEM.
1J
IMPROVEMENT PERMIT BY /T
**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 THE DAY OF INSTALLATION. TELEPHONE # IS (704) 634-8760.
1 '
OPERATION PERMIT � SYSTEM INSTALLED BY
fio'
1
F
AUTHORIZATION N0. O �2 V7 OPERATION PERMIT BY DATE ,b
**THE ISSUANCE OF THIS OPERATION PERMIT SHALL INDICATE THAT THE SYSTEM DESCRIBED ABOVE HAS BEEN INSTALLED IN COMPLIANCE WITH
ARTICLE 11 OF G.S. CHAPTER 130A, SECTION .1900 'SEWAGE TREATMENT AND DISPOSAL SYSTEMS', BUT SHALL IN NO WAY BE TAKEN AS A
GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORILY FOR ANY GIVEN PERIOD OF TIME.
DCHD 10/95
it t 01
rfx Davie County Health Department
zD
ENUIRONMENTRL HEALTH SECTION
. P.D. Box 665
Mocksville, N.C. 27028 OK
AUTHORIZATION FOR WASTEWATER SYSTEM CONSTRUCTION'
(Issued in compliance with Article 11 of
G.S. Chapter 130A, Wastewater Systems)
***This Authorization For Wastewater,System Construction must be issued by the Davie County Environmental Health Section prior to
issuance of any Building Permits. This Form/Authorization Number should be presented to the Davie County Building Inspections
Office when plying for Buil ing Permits.***
/ AUTHORIZATION NUV3ER
NAME P, DATE _ ti Q 0267
NAME ON IMPROVEMENT PERMIT (If different
�than
/above)
SITE LOCATION r
COM ENTS/CONDITIONS ON AUTHORIZATION TO CONSTRUCT WASTEWATER SYSTEM
**WICE*H THIS AUTHORIZATION FD AS ATER SYSTEM CONSTRUCTION IS VALID FOR; PE OD OF FIVE,(5) YEARS.
ENVIRON ENTAL HEALTH IALIST DATE ' '
DCHD.'I:16/95 ,
APPLICATION FOR SITE EVALUATION/IMPROVEMENTS PER
A Davie County Health Department
APR 419GC'
h Environmental Health Section
P. O. Box 665
f 7 Mocksville, NC 27028
d 1. Application/Permit Requested By Per(4
Mailing Address_ 1 � �� Home Phone
,1 Business Phone
I 2. Name on Permit if Different than Above
`I
3.'Application for:.'; ❑General Evaluation // Septic Tank Installation Permit
t+
i 4.:System to Serve: Ouse lq- obile Home ❑ Place of Public Assembly
❑ Business ❑ Industry ❑ Other ❑ Unknown
5. If house, mobile home: Subdivision - S 7 `�T Section �'� Lot #
❑ Basement/Plumbing
No. of People Basement/No Plumbing
No. of BedroomsJo/washing Machine
No.of Bathrooms 42 2ebishwasher
Dwelling Dimensions 0 ❑ Garbage Disposal
6.'1 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: ❑ Public ❑ Private ❑ Community
8. Property Dimensions !U � , Sewage Disposal.Contractor
a 9: Doryou anticipate additions/expansion of the facility this sytem is intended to serve? o
i.
If yes,what type?
'NOTE: Improvements Permits shall be valid rom date issued. Improvements Permits are subject to
revocation, if site plans or the intended use change. Effective October 1, 1989.
PROPERTi ZN ORMATION UI=:
Directions to Property: ( 3 Tax Office PjI'N 3# ,�Y 70 �4
PROPERTt�f AD15RESS`; as f 1171,0 OF �3
/� � �" � '
' �•�' D� Ci._a.dt6�+ C(', Road Name:
Y ' Cit 06L-5
r� SUBMIT A PLAT WITH THIS APPLICATION
Y ; r,r �7 Revisions effective October 1, 1995.
iF7-
s ;p,► 1�►'1 i `
This is to certify that the information provided is correct to the b f my kno a and I understand I am responsible for all charges
incurred from this p iica on
DATE SIGNATURE
i
FI CONSENT FOR SITE EVALUATION-TO BE DONE ON ABOVE DESCRIBED PROPERTY
MUST CHECK ONE: IWN 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 I hereby give consent to the authorized representative the Dav" C nt Health Department to enter upon above described
property located in Davie County and owned by
to conduct all testing procedures as necessary to deterrprne ite's suit t3i1' round absorption sewage treatment
and disposal system.
DATE SIGNATURE
DCHD(1193)
DAVIE COUNTY HEALTH DEPARTMENT
Environmental Health Section
Soil/Site Evaluation
NAME DATE EVALUATED ! Y
ADDRESS PROPERTY SIZE &)V
PROPOSED FACIILTY LOCATION OF SITE
Water Supply: On-Site Well Community Public
Evaluation By: Auger Boring Pit Cut
FACTORS 1 2 3 4
Landscape position Slope Z
HORIZON I DEPTH
Texture group
Consistence
Structure
MineralogX
HORIZON II DEPTH lif' b
Texture group
Consistence T
Structure /L
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 RATE
SITE CLASSIFICATION: EVALUATED BY:
LONG-TERM ACCEPTANCE RATE: ✓ OTHER(S) PRESENT:
REMARKS:
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 ;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
DCHD(01-901
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