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332 Yadkin Valley Rd Lot D Davie County,NC Tax Parcel Report Thursday,December 29, 2016 113 ; 346 341 ,f r Q` ,�}-334 \ i 325 --1 W rF O t 332 Q� YO 293 ><- 304 169 r r i � I 287 't WARNING: THIS IS NOT A SURVEY Parcel Information Parcel Number: C80000000112 Township: Farmington NCPIN Number: 5872385203 Municipality: Account Number: 53857250 Census Tract: 37059-802 Listed Owner 1: NEWSOM STEPHEN PHILLIP Voting Precinct: HILLSDALE Mailing Address 1: PO BOX 24248 Planning Jurisdiction: BERMUDA RUN City: WINSTON SALEM Zoning Class: BERMUDA RUN RM State: NC Zoning Overlay: Zip Code: 27114-0000 Voluntary Ag.District: No Legal Description: 5.00 AC YADKIN VALLEY RD Fire Response District: SMITH GROVE Assessed Acreage: 4.85 Elementary School Zone: PINEBROOK Deed Date: / Middle School Zone: NORTH DAVIE Deed Book/Page: Soil Types: PaD,PcB2,PcC2,GnC2 Plat Book: Flood Zone: Plat Page: Watershed Overlay: BERMUDA RUN Building Value: Outbuilding&Extra Freatures Value: Land Value: Total Market Value: Total Assessed Value: 9bt�, 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 �v County of Davie,North Carolina,its agents,consultants,contractors or employees from any and all claims or causes of action due to r'OUNS NC or arising out of the use or inability to use the GIS data provided by this website. w.a 1-r, t,a`.t .ih y,.•yris sy.:•''^a.9''+' f �.v tv i...-;:e:., .a.,:��"� i46 a ' : - i >r,.cc ..• r." «.<,3: as ►t t �s .. 41 ZATION NO: 17,83 DAVIE COUNTY HEALTH DEPARTMENT ;Environmental Health Section PROPERTY INFORMATION Pennittee's ' P.O.Box 848 ..J.. Name: _ � !� �'� Mocksville,NC 27028 Subdivision Name: Phone# 336-751-8760. Directions to property. {�,�?�� - Section: f Lot: AUTHORIZATION FOR WASTEWATER Tax Office PIN:# + 4 SYSTEM CONSTRUCTION Road Name: WWNii 07666' **NOTE**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 applying for Building Permits. (In compliance with Article 11`of G.S.Chapter.130A,Wastewater Systems,Section.1900 Sewage Treatment and Disposal Systems) ***NOTICE***THIS AUTHORIZATION FOR WASTEWATER CONSTRUCTION ~ + /�✓�f IS VALID FOR A PERIOD OF FIVE YEARS. ENVIRONMENTAL HEALTH SPECIALIST DATE ISSUED 7 F". .,.�,/�/� .=1 •rr - 17 V DAVIE OUNTY HEALTH DEPARTMENT IMPROEMENT AND OPERATION PERMITS PROPERTY INFORMATION , . Permittee's Name: Subdivision Name: ri�i' ,j6J Directions to property: 1� 1 �' .j �" Section: f Lot: 00 IMPROVEMENT PERMIT Tax Office PIN:# ' '' - y'. ape Road Name: h -,Thus Improvement Permit DOES NOT authorize the construction or installation of a septic tank system m or any wastewater system.An AUTHORIZATION FOR WASTEWATER SYSTEM CONSTRUCTION must be obtained from thus Department prior to the construction/instalIation,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) )� ***NOTICE***THIS PERMIT IS SUBJECT TO REVOCATION IF SITE. ✓,�,,, c/, �l /�j•/ ' PLANS OR THE INTENDED USE CHANGE.YOUR WASTEWATER ENVIRONMENTAL HEALTH SPECIALIST DATE ISSUED SYSTEM CONTRACTOR MUST SEE THIS PERMIT BEFORE INSTALLING THE SYSTEM. RESIDENTIAL SPECIFICATION:BUILDING TYPE I7� #.BEDROOMS!_#BATHS #OCCUPANTS GARBAGE DISPOSAL:Yes or No COMMERCIAL SPECIFICATION:,FACILITY.TYPE #PEOPLE #PEOPLE/SHIFT #SEATS INDUSTRIAL WASTE:Yes orNo LOT SIZE,j`AC TYPE WATER SUPPLY DESIGN WASTEWATER FLOW(GPD) '�/�(I NEW SITE_ REPAIR SITE SYSTEM SPECIFICATIONS: TANK SIZE /)D GAL. PUMP TANK /.-�lI(/ GAL. TRENCH WIDTH C f ROCK DEPTH _ LINEAR FT. OTHER SP l REQUIRED SITE MODIFICATIONS/CONDITIONS: IMPROVEMENTPERMrrLAYOUT "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 (336)751=8760. OPERATION PERMIT SYSTEM INSTALLED BY:' � - G AUTHORIZATION NO. / OPERATION PERMIT BY: �% DATE: **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 NOWAY BETAKEN ASA GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORILY FOR ANY GIVEN PERIOD OF TIME. DCHD 05/96(Revised) l PLICATION FOR SITE EVAU AT10N/IMPROVEMENT PERM do ATC _GJ� Davie County Health Department Environmental Health SftWon P.O. Box 848/210 Hospital Street Mockaville, NC 27028 (336)751-8760 ***ZHPORTANT*** THIS APPLICATION CANMr BE PROCESSED UNLESS ALL THE REQUIRED INFORMATION IS PROVIDED. Refer �t/o the INFORMATION BULLETIN for instructions. Name to be Billed f� Y L�� (� Contact Person Mailing Address / 0'. Fj Rome phone 191ll City/state/Zip w'r%ripen (�z �71J Business Phone 2. Name on Permit/ATC if Different than Above Mailing Address City/state/Zip 3. Application For: U Site Evaluation ❑ Improvement Permit/ATC moth 4. system to Service: [r House 0 Mobile Home 0 Business 0 Industry 0 Other 65 If Residence: # People # Bedrooms i Bathrooms 0 Dishwasher 0 Garbage Disposal 0 Washing Machine 0 Basement/Plumbing 0 Basement/Ho Plumbing 6. if Business/Industry/other: Specify type # people # sinks # Commodes # Showers # Urinals # Water Coolers IF FOODSERVICE. # Seats _ Estimated Nater Usage (gallons per day) 7. Type of water supply: B-County/City 0 well 0 Conmunity e. Do you anticipate additions or expansions of the facility this system is Intended to serve? 0 Yes ❑No U yes,what type? ***IMAORTANT***CWENTSMUSTCOMPLETETHE REQUIRED PROPERTY INFORMATION REQUESTED BELOW. Either a PLAT or SITE PLAN MUST BESUBMITTED by the client with THIS APPLICATION. Property Dimensions: -w7 A� WRITE DIRECTIONS(from Mocksville)to PROPERTY: Tax Office PIN: # S-;y 7�2",-I lzA9,12 Property Address: Road Name 6/7 kh City/Zip If in a Subdivision provide information,as follows: Name: Ll /` s Section: Block: � Lot: Date Property Flagged: r 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 pians or intended use change,or if the information submitted in this application Is falsified or changed. I,also,understand that I am responslblefor all chs ges i rcarred from this applleado a I,bereby,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 n to determine the site suitabili . DATE SIGNATURE 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). Account No. al Revised DCHD(07/98) Invoice No. L716 �`• S> APPLICATION FOR SITE EVALUATION/IMPROVEMENTS PE C� C 0 M IE Davie County Health Department Environmental Health Section rM [[7 EC �l P. O. Box 665 Mocksville, NC 27028 f 1. Application/Permit Requested By Mailing Address �" 0304 Home Phone 9 'U D -633 AX C Z 7 00,�• 2/1/0 Business Phone �e-Q 2. Name on Permit if Different than Above 3. Application for: ❑General Evaluation ❑Septic Tank Installation Permit 4. System to Serve: D House ❑ Mobile Home ❑ Place of Public Assembly ❑ Business ❑ Industry ❑ Other ❑ Unknown 5. If house, mobile home: Subdivision OSection Lot # Er Basement/Plumbing No. of People ❑ Basement/No Plumbing No. of Bedrooms ❑lashing Machine No. of Bathrooms CR""Dishwasher Dwelling Dimensions___35-0 D sa 4�L4• /X/N/�n u.» 2 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: Gd Public ❑ Private ❑ Community 8. Property Dimensions ja /4C(p'S Sewage Disposal Contractor 9. Do you anticipate additions/expansion of the facility this sytem is intended to serve? ❑ Yes ❑ No If yes, what type? "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 my knowledge, and I understand I am responsible for all charges incurred from this plicati n. bATt SIGN URE CONSENT FOR SITE EVALUATION TO BE DONE ON ABOVE DESCRIBED PROPERTY MUST CHECK ONE: 1. I 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 syste . DATE SIGNATURE DCHD(1193) --- _-------------- 4A)1-r ---_.--.._---4A)1-r - `7vivo� � �V- 4 u tl� �• _ 1 - 1 i 1 Ram N � � _ "fit.::. ._ {��- }_•�r•`.r•e� l••.� 1 I- Acres S � / V � P ~' Qs ..:....... . . i - 1 rA J� . DAVIE COUNTY HEALTH DEPARTMENT Environmental Health Section Soil/Site Evaluation /� 111)'UN NAME �ryY?ljDATE EVALUATED `/� ADDRESS PROPERTY SIZE 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 4 L ,C L L Slope % HORIZON I DEPTH G Texture group Consistence Structure Mineralogy HORIZON II DEPTH ye y 4/9' Texture group r C Consistence i Structure Mineralogy HORIZON III DEPTH Texture group Consistence Structure Mineralogy HORIZON IV DEPTH Texture group Consistence Structure Mineralogy SOIL WETNESS RESTRICTIVE HORIZON SAPROLITE CLASSIFICATION .T LONG-TERM ACCEPTANCE RATE SITE CLASSIFICATION: GS 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 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-Nonplastic 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(01-901 CCCCCCCCCCCeCCCCCCC��C��C�CCCClCCCC�CCCC'CC�CCCCC'CCCCCCCCCCCNCC ■■■■■■■■■■■.■■■.■t.■■■■■■.■■■■■■ ■■.■■..■■e■■■■■■■■■e■■.■..■■■■■■ ■■■■■■■.■■■.■■■.■.■■■■■s■■..■■.■�eC■.■■■.■■■■nt■et..■■■■■.■■e■■■■ ■■■.■■■H.■■..■■■..■■■■■■■.■■■■raw■■.r.,■z.■1C■■■■■■■■■■■■■.■■■■C■■■ ■■■■■■■■■■■■■■■■■e■■■■■■■■■.■..I�. r� �r.■ems.■ ■■.■■.■.■■■■■■■■■■.■■■ MMMMMM r■■■.►===c�:-==■■.ems■■.■e�c�.■■�___.:.:-■��.■■■■.■fie...■t.1■■..■.■■ ■CCiiC�■CCCCCCCCCuiiiiiiC�■CCC''■CCCCrC■�CCCCCCCCCCCCCCCCC'CCCiiiiC I■�iiiiiiC.�iiCCCCC.��iiiiiC■■CCCCCCi�iiiiiiC■MMMMMMMiICCCCCCMOMMEMCCCCCC.�.�m MEMO CCCCCC.�■ ■■■■■.■...■..■...■...■■■.e..■..■..e...H. ■..■■.� H.■■■■C■■■■■.■■ I, ...................................... ..E■., .. ■M■■.■■■■■■■■■■. ■.■■■■■■.■■■■■.■■■!!t■■e.■■■■■■rn■■■■.■■ ■■W= ■ .■■■■■■■■■■■■■ :C:::C�CCCCCC:CCC IIC:CCCC�C::L"CGCG :::CC:CCC NCCCCCo OMMOCCCC ...............■■■■■■.■■■.■..■..�'i.■■■Cn..■■n ■..■■■. ■ ■■.■ ................................■■■■■■ ■■.■■e■CC H■ ■■■■■■■■■■■C■.■■ .......■■.■■■■■.■u■■.■■■■e.■■■■■.■■■. ■■■■CCC: C::CCCC:CCCCCC ................■........................... ........................................■■HN■■ .■■■.■■■■.■■■■■■ ■.■■..■■.■■..■..■■..■■.■■■■■.■■.■■.■■■ ■■� ■■ ■ ■ ■■■�H■■■■.. ■■■..■..D..■.■..■.■.■■■.■■.■■...■■CCCC■.CC.CCC' CC�CC�%■CCCCCCCC■ ■■■■■■.■riff■■■■..■■■.■■■■■..■■■■■ ..■..H..■. .■ ■■!Ii!7■■■■■■.■■ CCCCCCC ��ICCCCCCCC�CCCCCCCCCCCCCCCCC■�CCC� ■C'�C!'lwv'u■.0ME ■....■■.�/.iL'iiir■■■■■■■■...■■■■■■■t■■■■■.N..■ ■■■■� ■ ii■■■■■■■■■ ■..■..AII�L'i■■■■..■■■..■■..■..■■■■!■.■■H■■..CC.■■■.efIfIumomm■■u�■■■ ................................■........C..■..n.■■■H■■■■■■■■.■■ ■...■■.N■■■.■■■■.■■■..■■ .■■■.■■.■■■HNC■u■■■■■■■■■■■.C■■H■■■t ■■■■■.■.11�i►1,■.■..■..■ ■■■■■.■■■.■ ■./■■■■.../■.■■■■.■illi!■■.■■.■.■■■ ■■■■ ■■■■■■..■.■■■■■■■■■■■■■■■.■ ■■/■.■■■■■■.■.■■.■■■■■■■■■H■.e■ C�C�C��CC��CCC'■C��CC��CCCCCCC■■CCC�CiCCCCCCCCCCCCCC�CCCCCCCCCCC