149 Laurens Ct, Lot 5 Davie County,NC Tax Parcel Report Tuesday, October 18, 2016
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WARNING: THIS IS NOT A SURVEY
Parcel Information _
Parcel Number: E70000011105 Township: Farmington
NCPIN Number: 5861745705 Municipality:
Account Number: 82529131 Census Tract: 37059-803
Listed Owner 1: BLACK DAVID LEE Voting Precinct: SMITH GROVE
Mailing Address 1: P O BOX 660 Planning Jurisdiction: Davie County
City: CLEMMONS Zoning Class: DAVIE COUNTY R-20-S,R-20
State: NC Zoning Overlay: DAVIE COUNTY QD
Zip Code: 27012-0000 Voluntary Ag.District: No
Legal Description: LOT 5 ARMSWORTHY ACRES REVISION Fire Response District: SMITH GROVE
Assessed Acreage: 0.75 Elementary School Zone: SHADY GROVE
Deed Date: 6/2007 Middle School Zone: WILLIAM ELLIS
Deed Book/Page: 2007EO176 Soil Types: GnB2,GnC2
Plat Book: 0007 Flood Zone:
Plat Page: 209 Watershed Overlay: DAVIE COUNTY
Building Value: 0.00 Outbuilding&Extra 0.00
Freatures Value:
Land Value: 50000.00 Total Market Value: 50000.00
Total Assessed Value: 50000.00
161 All data is provided as Is without warranty or guarantee of any Idnd 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
County of Davie,North Carolina,its agents,consultants,contractors or employees from any and all claims or causes of action due to
NC or arising out of the use or Inability to use the GIS data provided by this webs@e.
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APPUCATiON FOR SITE EVALUATION/IMPROVEMENT PERMIT& i
Davie County Health Department
Environmental Health Section
P.O. Box 848/210 Hospital Street
Mocksville, NC 27028 FNy1 Q, E lfli
(336)751-8760
***IMPORTANT*** THIS APPLICATION CANNOT BE PROCESSED UNLESS ALL THE REQUIRED
INFORMATION IS PROVIDED. Refer to the INFORMATION BULLETIN for i struct' ,{s.
1. Name to be Billed �` �" Contact Person
Mailing Address C G ^y Home Phone t, 9
City/state/2IP r Business Phone
2. Name on Permit/ATC if Different than Above
Mailing Address S�,"(� City/State/Zip
3. Application For: ite Evaluation ❑ Improvement Permit/ATC C] Both
4. system to service: House 11 Mobile Home ❑ Business ❑ Industry ❑ Other
5. If Residence: # People # Bedrooms 13 # Bathrooms ^�
11 Dishwasher II Garbage Disposal II Washing Machine it Baaement/Plumbing 11 Basement/No Plumbing
6. If Business/Industry/Other: specify type # People # Sinks
# Commodes # showers # Urinals # Water Coolers
IF FOODSERVICE: # Seats Estimated Water Usage (gallons per day)
7. Type of water supply: County/City ❑ Well ❑ Community
a. Do you anticipate additions or expansions of the facility this system is intended to serve? ❑Yes k,440
If yes,what type?
***IAfPORTANT***CLIENTS MUST COMPLETE THE REQUIRED PROPERTY INFORMATION REQUESTED
BELOW. Either a PLAT or SiTE PLAN MUST BESUBMITTED by[lie client with THiS APPLICATION.
2y� G P/
Property eusions: n i , WRITE DIRECTIONS(from Mocksville)to PROPERTY:
Tax Office PIN: #.SSBI-� / xsy
f�
Property Address: Road Name f / I7id72f��fZQL 12,1
City/Zip 6,7u �� Alt
If in a Subdivision provide information,as follows. i`l9'i
Na 6
Section: Block: Lot: Date Property Flagged:
This is to certify that the information provided is correct to the best of my knowledge. I understand that any permit(s)
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. 1,also,understand that 1 am responsible for aft charges incurred from
this application. 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 : TURE
DATE a NA
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 locations).
Site Revisit Charge
Date(s):
Client Notification Date:
EHS•
Account No. UL/
Revised DCHD(07/99) Invoice No. f�U o
DAVIE COUNTY HEALTH DEPARTMENT
Environmental Health Section SECTION LOT S
Soil/Site Evaluation
APPLICANT'S NAME L dGfD�� DATE EVALUATED
PROPOSED FACILITY PROPERTY SIZE
SUBDIVISION G%J / �Y'D!c� ROAD NAME
Water Supply: On-Site Well Community Public
Evaluation By: Auger Boring Pit Cut
FACTORS 1 2 3 4 5 6 7
Landscape position
Slope%
HORIZON I DEPTH
Texture group
Consistence
Structure
Mineralogy
HORIZON II DEPTH
Texture group
Consistence
Structure /� 2
Mineralogy
HORIZON III DEPTH
Texture group
Consistence
Structure
Mineralogy
HORIZON IV DEPTH
Texture group
Consistence
Structure
Mineralogy
SOIL WETNESS
RESTRICTIVE HORIZON
SAPROLITE
CLASSIFICATION =1 £'
LONG-TERM ACCEPTANCE RATE �/ c
SITE CLASSIFICATION: EVALUATION BY:
LONG-TERM ACCEPTANCE RATE: A OTHE (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 clay loam SIL-Silty loam CL-Clay loam SCL-Sandy clay loam
SC-Sandy clay SIC-Silty clay C-Clay
CONSISTENCE
oist
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
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(01-90)