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170 Jarvis Rd 3avie County, NC Tax Parcel Report Friday, September 23, 201 f jt _ �At , 153 2 26 213 l 160 I y� •, 1, E CDQ-'l�' r 159 161 ; ,; �Cr�2- f% t ) ' f i ..............._............._............................,................................._...._.............._............................................._�....M......_..:.....................................:...^..^.�1......�...........................................................,................... .........,......_....<.......,_..,_............_..,.....,.,.!...._...7,....._......._.._......_... WARNING: THIS IS NOT A SURVEY Parcel Number: F800000130 Township: Shady Grove NCPIN Number:' 5880466589 Municipality: Account Number: 55987250 Census Tract: 37059-803 Listed Owner 1: PEEBLES LAWRENCE B JR Voting Precinct: EAST SHADY GROVE Mailing Address 1: 170 JARVIS ROAD Planning Jurisdiction: Davie County City: ADVANCE Zoning Class: DAVIE COUNTY R-A State: NC Zoning Overlay: Zip Code: 27006-0000 Voluntary Ag.District: No Legal Description: 2.00 AC JARVIS RD Fire Response District: ADVANCE Assessed Acreage: 1.59 Elementary School Zone: SHADY GROVE Deed Date: / Middle School Zone: WILLIAM ELLIS Deed Book/Page: Soil Types: PcB2,PcC2 Plat Book: Flood Zone: Plat Page: Watershed Overlay: DAVIE COUNTY Building Value: 47430.00 Outbuilding&Extra 1530.00 Freatures Value: Land Value: 37090.00 Total Market Value: 86050.00 Total Assessed Value: 86050.00 9l; t� Alldata 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 /-� County of Davie,North Carolina,its agents,consultants,contractors or employees from any and all claims or causes of action due to �ovN c� NC or arising out of the use or Inability to use the GIS data provided by this website. r J Davie County Health Department Environmental Health Section �.. D P.O. Box 848 jVE 210 Hospital Street ry off;.. : �� Courier# : 09-40-06 Mocksville, NC 27028 Phone:(336)-758-6780 Fav:(336)-753-1680 ON-SITE WASTEWATER CERTIFICATION -(Check One) Replacement Remodeling Reconnection Nance{� Phone Number 3No n b5 ^- g (Home) : t*�r1C�Q^ - ���CS • -_ - / Mailing Address: 1 ) J�lJ is Iq C� n/I� (Work) &ya nCe _N 1 0—• cg nmo Email Address: �} _ D -,-DetailedDirections To Site: ' ren. $�,�ver 'ire 0. L- rte_ -�sar N _--rno -- _Property Address:J_W. S;&cu($ Aolia ' Ctl� P� iV r C- _Please Fill.I:n The Following Information About The EXISTING Facility: � L _ Name System Installed Under.( 1�7 f'C;nC Q P'e_('b 14,,6 Type Of Facility Date System Installed(Month/Date/Year): )d Number Of Bedrooms: � Number Of People: Is The.Facility Currently Vacant? Yes._ No if Yes,For How Long? Any Known Problems? Yes No If Yes,Explain: Flease Fill In The/F'�ollloowing Information About The NEWFacility: Type Of Facility: C2 ; fq.. Number Of Bedrooms:—t— —Number of People pool Size: Garage Size:S0kL15k110 Other: Requested By: Date Requested: L5 O�b ignature) For Environmental Health Office Use Only Approved Disapproved Comments: Environmental Health Specialist 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: Received By: Account#: 3 bG Invoice#: fL'1&a01$ ' C 20.d l7 i 'Pastels: • i ' K i.•,. J: � '�:u SSS �,•t r/ 170 F`. „ 1f•\• i 1s I Sults E�rbperl � Fih GaUN'TY! Deed: -' r'. foo Buffer Reference APE Pro ,. ,._nd_..... w.--15..... perty! . Creaite E= red; .LA ,Zoom• E3ufifer i=sOb001�" m* C64 Report Adjvineis ReferenceMINI =' :':Fi '•, '` ,,: 8. �.er.wwmytn.3f6ld! �a,Mon x•i vw• " MipiAna�s2:reaUecti•r►eWavlEnc_gmdl# U1 k. _ r, .�.7+. �,tia rt t a ,z zJ'•i, z ?'�� r t� i L;.^:a'., .a".'.�.:i _.a-.r,. .n ._ �...-d 7 r ^* ... .._. o-._, Td., ., S � t 3 DAVIE COUNTY HEALTH DEPARTMENT - IMPROVEMENTS PERMIT AND CERTIFICATE OF COMPLETION *NOTE:Issued in Compliance With Article I I of G.S.Chapter 130a Sanitary Sewage Systems \ Date Permitp L be r ' �•, N Va 1� e t�c e y Q o S�� �� � + i� ���� Name N ocation �J 4'. Subdivision Name Lot No. , Sec. or Block No: Lot Size House Mobile Home Business __ Speculation No. Bedrooms No. Baths the No. in Family _ Garbage Disposal YES Q NO ❑ S ecificatiow for S stem Auto Dish.Washer YES p, NO ❑ g ' �" Auto Wash Ma:hive YES [� NOy c,u ' k t x .�1 t PuSA, Type Water Supply __— *This 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. Improvements permit by *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 day of completion. Telephone Number 704-634-5985. Final Installation Diagram: System Installed by 0 �. rf� e r� TT �rl 6 a 1' f� Certificate of Completion Date 1\ 'The signing of this certificate shall indicate that the system described 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 PERMIFRECEOVED Davie County Health Department Environmental Health SectionP. O. Box 665 Mocksville, NC 27028 M.UAL2N NO A 1. Application/Permit Requested �Byy� `-1 Mailing Address 1��y % (�w l.(J/ WV/ . �.l 1! l�� 7 VnnC '4?• C - 0 116 Home Phone "� )U4U� Business Phone`-+)'? -ala lUag 2. Name on Permit if Different than Above 3. Application/Permit for: ❑ General Evaluation Septic Tank Installation 4. System to Serve: ❑ House Y Mobile Home ❑ Place of Public Assembly ❑ Business ❑ Industry ❑ Other. ❑ Unknown 5. If house, mobile home: Subdivision Section Lot # ❑ Basement/Plumbing No.of People 3 ❑ Basement/No Plumbing No. of Bedrooms 3 Washing Machine No. of Bathrooms Dishwasher Dwelling Dimensions Garbage Disposal 6. If business, industry, place of public assembly, other: Specify type No. of People Served .3 No. of Sinks No. of Commodes No. of Urinals o2 No. of Lavatories No. of Water Coolers No. of Showers °L Water Usage Figures 7. Type of water supply: /PJ uubllicc� W Private El Community 8. Property Dimensions c /t V l o Sewage Disposal Contractor 9. Do you anticipate additions/expansionof the facility this/s/yltem is intended to serve? NJ Yes ❑ No If yes,what type? (_+ lam( h Cy'/� ll 1C��Qfl '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: t!Q C l FO/ ut6 60APCt .JOJa Lan VIAL JJL &J-a r ont Mt 1 r v�.- 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 t 's application. P'�' DATE SIGt#TURE CONSENT FOR SITE EVALUATION TO BE DONE ON ABOVE DESCRIBED PROPERTY ["anddisposal CK ONE: ❑ 1. 1 OWN the property. ❑ 2. 1 DO NOT OWN the property. ked Box #2, the rest of this form MUST be completed by the owner or a person authorized by the owner: ve consent to the authorized representative of the Davie County Health Department to enter upon above described cated in Davie County and owned by all testing procedures as necessary to determine said site's suitability for a ground absorption sewage treatment al system.0. 4 ?�Ab -DATE SIGNATURE DCHD(12-90) DAVIE COUNTY HEALTH DEPARTMENT Environmental Health Section Soil/Site Evaluation NAME DATE EVALUATED ADDRESS Che PROPERTY SIZE PROPOSED FACIILTY N tr� LOCATION OF SITE Water Supply: On-Site Well_ Community Public Evaluation ByCf-L Auger Boring Pit Cut FACTORS 1 2 3 4 Landscape position Sloe % �- - HORIZON I DEPTH �� `► `� Texture group L Consistence V V Fri. Structure Mineralogy HORIZON II DEPTH Texture group Consistence N IV -a- Structure Mineralogy `i HORIZON III DEPTH Texture group Consistence Structure Mineralogy HORIZON IV DEPTH Texture group Consistence Structure Mineralogy SOIL WETNESS - S RESTRICTIVE HORIZON — SAPROLITE �- CLASSIFICATION LONG-TERM ACCEPTANCE RATEI ► C l SITE CLASSIFICATION: / ' 11 EVALUATED BY: LONG-TERM ACCEPTANCE�RAS,TE: , `1' OTHER(S) PRESENT: REMARKS: %EGEND 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-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 Mineralo¢y 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 ■■■■■■/■■e■e■e■■ee■■t■■ee■■e■■■■■■il■/■/■■■■■e■■t■■■tt�e■!A■ ■■lttr,le■ ■■■■■■■■■■■e■■■■■■t■■ei.■■■■///■■■■Itte/..e./■■.e.l■■■.lee■■■■ilei.■ ■■e■e■/.eeee■■■/■e■e■■/ee■■■■■■■ ■/■/■./e.e■ei/■.ie.■e■ela■■/e/e■ ■■■■■■■ee■■ecce■e■■■cele■■eeeee■e■■■ei.ieee■.ee■l■i■.e..e.ee.ee.e■ ■■■■e■■le/■..■.■■■■■■■■■lee■■■■■/■■■■i.e■■eeeeeele.e.eee.e.eel.ie■ ■■.lel.■e.■■■■e.■e■e■■//■/■e.■■■ee■■.le.eee.e.eeeeee.eee■.■eele.e■ ■■■■ee■■ee■■.e■■■■■■■■■■.■.e■■■■e■■■e.e■■ee.eeeeleee■■.eeeeeele.e■ ■eeeeee■ee■e.eeeeeeeeleie■viii■■■■■■■e.eeee.e■■..i..e.■e■ee■ee.e. ■■■e■e.l.l■lee■■eeeee■■ei■■.eee■■■ee■eee.e■.e.eeeee■i■.e.eee■leee■ ■■.ee■eeeleeee.eeeeele.eee..l■.e ■eeleeee■e■..■..■■.e.■e.■■.e■■■■ ■■e.eeeeeeeeeee■■eecell■■■■■■eee ■lele.ee■.■eeeeee■i..e..ee■■.ee■ ■.■■..■e.ie.e■..eeee■eeeee■ ■■e■■■eeeleiee.■■■. ...■.e..e..■.ee■■■ ■■■■ecce■e.lee■e■■■■■■l.■e.�ieee■■■■■■l■leeeeeee�eelei■.e..■e■ee.e■ ■eee■e■ecce■■■■..eee■.■■i■■■■■.■ee■e.l.le eee■ ■x■e■■■e ■■e■.e..■i ■■■■■■■eee.....e■■■ecce■■■■■■.■■■.■■■eei.�.■■■■.■.■..■....■■.■■■■■ ■■.■■l.e....e.■.eeeee.ee■e■eee..■e■■.■■■..e.■.■■......■■■...■.■■.. ■e■■■e■e■■e■e■e■■eeeeeeeleee■■Nee.ee...■■.■.■.■■■....■.■■■..... ■eeeee■ecce■e.e■■e.■■■■■■■/eie■ ■■.l/lei■.eee.e.l■leiee■■eieele■ ■...e.eeee■eee■■.eeeeeeeleie.■■ee■eeeee.e.e■e■e■..e.ie...e.e.eee■e ■e..e■ecce■ee■■e..eeeeealel..ee■ecce...l■e.■e■ee.■=..e..e.■■■■■ee■ ■■eeeeeeeeeee■e■eeeee■eeeee.i..e■e.e.eeee■e■eeeee■ ele■e.eeeeeee■ iiiiiiiiiiiiiiiiiii■iiiisiiiiiiiiii=iiiiiiiiinuiliii iiiiiiiiii=i ■eee■■/lee.■.lees..■■■■.l■/.lee.■■■■.eelel.e.e■e■ee■�i.i■ee.e■e ee■ MEN ONE■■■■■eeeeeeeeeeeee.ecce■eel.ie.e.eeNe.iee■■.eei.■■■■ ■eeeee■e.ee ■■■■■■■..e.ee■.■ecce.eeeeeeeeeeeeeeeeeseeee■■eeeieiee=■e.■.e■eee 1� ........N■■■l.e..e.eeeeeele..ecce■...............�■■...........�. .................................................. .............■. ■e■.■■.■eee.ssseei■ee■..ee■■lei.�eeee■eee■se.e.e.e■e■e■.■..■e■e.e ■si.eseeeeeeeee.eeee■eee■ee■les■ ecce.s■■■i■e..e.e■■e■ei■e■ese.e■ iiiiiiiiiiiiieiiiiiiiiiiiiiiiii��iiiiii iiiiiiiiii:t�iiii■.iiiiiii iiiiiei■iiiiiiiiiiiiiiiiiiiiiieii�iiiii�iisiiiiiiiiiiiiie iii �iiiiiil�iiiiiil�iiiiiil�ii�■n■ii�' Iiiiiii�ii�eiei i■i�e■�il�iii�ei� ■eee..■.■e■e■■■e.geese■e.eeeeetre..eee■e■eeeee■e.�e=ee.eeesese■■.■ ■e.e...iii.■■■■.e■e■■e.■.........i..■...■..■...■.■.■.■.■.........■■ ■el.i.eeeeee■....■■.■ee■ee■■ecce.■■.e.Ne ■ee■■■.INN e..■e■■■■e■■eee■ ■.■■.■.■.■■...■■■■...■.■■.■..■■..■..■.■■.�■■■■■.■ ■O■■■■■■.■.■■■■■ ...............ee..................... ■%■■■. :.I:�::�_::::::M ................................ ..■. ■■■e NINE ■e■■■e ................................�...■i�■.■...n ■■■■.■euee ■■. ■■lees.a..■■■..■■■.■■■.e■■.eeee.l[�,s.■ ■ NONE! 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