132 Camden Court Lot 3 Davie County,NC, Tax Parcel Report Wednesday,November 9,2016
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WARNING: THIS IS NOT A SURVEY
Parcel Information
Parcel Number: G703OA0003 Township: Shady Grove
NCPIN Number: 5860839512 Municipality:
Account Number: 34065000 Census Tract: 37059-803
Listed Owner 1: HEDRICK MATTHEW EDWARD Voting Precinct: WEST SHADY GROVE
Mailing Address 1: 132 CAMDEN COURT Planning Jurisdiction: Davie County
City: ADVANCE Zoning Class: DAVIE COUNTY R-A,R-20
State: NC Zoning Overlay:
Zip Code: 27006-0000 Voluntary Ag.District: No
Legal Description: LOT 3 CAMDEN YARDS Fire Response District: ADVANCE
Assessed Acreage: 0.70 Elementary School Zone: SHADY GROVE
Deed Date: 2/1998 Middle School Zone: WILLIAM ELLIS
Deed Book/Page: 002000718 Soil Types: GnI32
Plat Book: 0006 Flood Zone:
Plat Page: 169 Watershed Overlay: DAVIE COUNTY
Building Value: 109850.00 Outbuilding&Extra 2250.00
Freatures Value:
Land Value: 30000.00 Total Market Value: 142100.00
Total Assessed Value: 142100.00
All data is provided as Is without warranty or guarantee of any ldnd either expressed or implied Including but not limited to the
Davie County, implied warranties of merchantability or fitness fora particular use.Ali users of Davie Countys GIS website shall hold harmless the
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County of Davie,North Carolina,Its agents,consultants,contractors or employees from any and all claims or causes of action due to
n0 NS� NC or arising out of the use or Inability to use the GIS data provided by this website.
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`AU4HaRizATION NO: ;-O 5 51 DAVIE COUNTY HEALTH DEPARTMENT
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Environmental Health Section PROPERTY INFORMATION
Permittee'sP.O.Box 848
Name: ,* f' ►
Mocksville,NC 27028 Subdivision Name: �
Phone#:704-634-8760 dr
Directions to property: �t�t/.3/ :il/t" � Section: Z Lot:
AUTHORIZATION FOR
WASTEWATER Tax Office PIN:#
SYSTEM CONSTRUCTION
Road Name:
**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 Fonn/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
IS VALID FOR A PERIOD OF FIVE YEARS.
ENVIRONMENTAL HEALT9 SPECIALIST DATE ISSUED
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`� r • '' DAVIE COUNTY HEALTH DEPARTMENT g
'"- IMPROVEMENT AND OPERATION PERMITS PROPERTY INFORMATION
`Penmlttee' ,� ,,�• -/
Name '-^ Name:
Directions to property: % 'r'� �� ' Section: 1 Lot:
IMPROVEMENT
PERMIT Tax Office PIN:#
Road Name:
**NOTE**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)
***NOTICE***THIS PERMIT IS SUBJECT TO REVOCATION IF SITE
PLANS OR THE INTENDED USE CHANGE.YOUR WASTEWATER
ENVIRONMENTAL HEALTH SPECIALIST DATE ISSUEDSYSTEM CONTRACTOR MUST SEE THIS PERMIT BEFORE
INSTALLING THE SYSTEM.
RESIDENTIAL SPECIFICATION:BUILDING TYPE #BEDROOMS yL_#BATHS #OCCUPANTS GARBAGE DISPOSAL:Yes or No
COMMERCIAL SPECIFICATION: FACILITY TYPE #PEOPLE #PEOPLE/SHIFT #SEATS INDUSTRIAL WASTE:Yes or No
LOT SIZE TYPE WATER SUPPLY ( n DESIGN WASTEWATER FLOW(GPD) -Y�/ NEW SITE L--' REPAIR SITE
SYSTEM SPECIFICATIONS: TANK SIZE�'l?a GAL: PUMP TANK GAL. TRENCH WIDTH .� r� ROCK DEPTH LINEAR FT. /,)b
OTHER
REQUIRED SITE MODIFICATIONS/CONDITIONS:
IMPROVEMENT PERMIT LAYOUT
**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.
OPERATION PERMIT , a
SYSTEM INSTALLED BY:
F
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10c)
AUTHORIZATION N05� 6: 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 NO WAY BE TAKEN AS A
GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORILY FOR ANY GIVEN PERIOD OF TIME.
DCHD 05/96(Revised)
APPLICATION FOR SITE EVALUATION/IMPROVEM
Davie County Health Department V!
Environmental Health Section
P. O. Box 665 ;, M Q {996
Mocksville, NC 27028 Jay`
1..Application/Permit Requested By. G
Mailing Address )Z�� �1 Home Phone Gh B' Z ZP
GK�U/ LLg , Business Phone
2.''Name'on Permit if Different lan Above
3. Application for: General Evaluation ❑Septic Tank Installation Permit
4. System to Serve: [House ❑ Mobile Home ❑ Place of Public Assembly
❑ Business ❑ Industry F1 Other ❑ Unknown
5. If house, mobile home: Subdivision �Q e,h S Section Lot #
❑ Basement/Plumbing
No.of,People ❑ Basement/No Plumbing
No. of Bedrooms ❑ Washing Machine
No. of Bathrooms ❑ Dishwasher
Dwelling Dimensions ❑ Garbage Disposal
6. If business, industry, place of public assembly, other: Specify type 1.
' z
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
• t.
7. Type of water supply: tKPubli ❑ Private ❑ Community
8. Property Dimensions t✓f �� . P Sewage Disposal Contractor
9. Do you anticipate additions/expansion of the facility this sytem is intended to serve? ❑ Yes KNo
If yes,what type?
t
*NOTE: Improvements Permits are subject to
revocation, if site plans or the intended use change. Effective October 1, 1989.
;
Directions to Property: PROPERTY INFORMATION RE/QUIRED:
Tax Office PIN #
Road Name
a - Box # (if available)
City CSL
t
{ This is to certify that the information provided is correcttoMte o le -e a d I understand I am responsible for all charges
incurred from this application. i
DATE SIGNATURE
+
_. i.
CONSENT FOR SITE EVALUATION TO BE DONE ON ABOVE DESCRIBED PROPERTY
I MUST CHECK ONE: ❑ 1. 1 OWN the property. P-'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 hereby give consent to the authorized representative of th avie Coy ty Health Pepartment to enter upon above described
property located in Davie County and owned by .
to conduct all testing procedures as necessary to determing said si ui bili y for a ground absorption sewage treatment
x and disposal system. —
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DATE SIGNATURE
DCHD(1/93)
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' DAVIE COUNTY HEALTH DEPARTMENT
Environmental Health Section
Soil/Site Evaluation r�3/
NAME C 15<r! Ll' DATE EVALUATED
ADDRESS PROPERTY SIZE
PROPOSED FACIILTY f' LOCATION OF SITEr��/�4'. '� �/( /�iY4l �Qn—
Water Supply: On-Site Well Community Public ✓
Evaluation By: Auger Boring Pit_ / Cut
FACTORS 1 2 3 4
Landscape position 4 L
Slope '
HORIZON I DEPTH
Texture group [.
Consistence
Structure
Mineralogy
HORIZON II DEPTH Y "
Texture group
Consistence /
Structure
Mineralogyi
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 j'- //
SITE CLASSIFICATION: K EVALUATED BY: A",
LONG-TERM ACCEPT NCf RATE: / L/ OTHERS) PRESENT:
REMARKS: �'Zezf ��-_/</ l/
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-V^-y 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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