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115 Potts Rd Davie County,NCS Tax Parcel Report Wednesday, February 8, 2017 421 Q� __ __ ______-_ -115 IN & OUT LNrr' r' Gj 397 { Q f l ................................... . .......... ................................................................................_....................... ............................................. . ........................................... WARNING: THIS IS NOT A SURVEY . , . ParcelInformation Parcel Number: F80000011107 Township: Shady Grove NCPIN Number: 5880271424 Municipality: Account Number: 82529515 Census Tract: 37059-803 Listed Owner 1: BEVERLY MARK Voting Precinct: EAST SHADY GROVE Mailing Address 1: 429 POTTS 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: 1.334AC BEVERLY S/D Fire Response District: ADVANCE Assessed Acreage: 1.28 Elementary School Zone: SHADY GROVE Deed Date: 4/2008 Middle School Zone: WILLIAM ELLIS Deed Book/Page: 007530873 Soil Types: PcB2,PcC2,RnD Plat Book: 0009 Flood Zone: Plat Page: 321 Watershed Overlay: DAVIE COUNTY Building Value: 0.00 Outbuilding&Extra 4500.00 Freatures Value: Land Value: 22020.00 Total Market Value: 26520.00 Total Assessed Value: 26520.00 161 1\ l 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 �T County of Davie,North Carolina,Its agents,consultants,contractors or employees from any and all claims or causes of action due to Cor arising out of the use or Inability to use the GIS data provided by this website. DAVIE COUNTY HEALTH DEPARTMENT Apf? .. .,l IMPROVEMENTS PERMIT AND CERTIFICATE OF COMPLETION *NOTE:Issued in Compliance With Article II of G.S.Chapter 130a Sanitary Sewage Systems ` ) Permit Number Name �t> >' t';� r7 N �+ `: Date r�� ' ! �� N2 Location _ r, Subdivision Name Lot No. ec. or Block No. Lot Size ��{ `1 ��_ House ,Mobile Home Business Speculation No. Bedrooms r No. Baths ��� No. in Family Garbage Disposal YES ❑ —.NG—D/ Specifications for System: Auto Dish Washer YES ❑ NO Q Auto Wash Machine YES Q NO ❑ -� 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 re cation 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 (4\ILI ,1 � v o� 0 Ce ificate of Completion `_ — Date I ``� The signing of this certificate shalrindicate tha tQsystem described above has been installed in compliance with the standards set forth in-the above reg'tilation, b�t`� dll in NO way be taken as a guarantee that the system Will function satisfactorily for any given period of time. `� 'ti APPLICATION FOR SITE EVALUATION/IMPROVEMENTS PERMIT Davie County Health Department 6 y Environmental Health Section P. 0. Box 665 REC Mockaville, NC 27028 1 . Application/Permit Requested By 'i)e kzc Mailing Address(_�� A Boy �'0- 0' R6\(6C)0e_ (V— A rl ons p Home Phone Pig- q4()' Q 1 1111J Business Phone q 1q• q rin" Aln,(qa_ 2. Name on Permit if Different than Above 3. Property Owner if Different than Above _ 4. Application/Permit For: C) General Evaluation 2`S/Tank Installation S. System to Serve: [] House Mobile Home 0 Business Industry u Other 0 Unknown 6. If house, mobile home: Subdivision Sec. Lot# No. of People Dwelling Dimensions Int Y r10 (Y)nh dP bnmpa' No. of Bedrooms Basement/Plumbing No. of Bathrooms Basement/No Plumbing Washing Machine Dishwasher 0 Garbage Disposai 7. If business, industry, 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 ` v 8: Type of water supply : C Public ) Private a Community 9. Property Dimensions -10. Sewage Disposal Contractor 11 . Do you anticipate additions/expansions of the facility this system 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 plane or the intended use change. Effective October 1, 1989. This is to certify treat the information provided is correct to the best of my knowledge, and I understand I am responsible for all charges incurred from this kation. y- � a. go Date Signature - ee - zal :an P-01h KCL Directions to Property : C 4_)m,e o�'Z_ DCHD (10-89) DAVIE COUNTY HEALTH DEPARTMENT D ENVIRONMENTAL HEALTH SECTION AUG SITE EVALUATION CONSENT FORM 1. Complete the form below and return to the Davie County Health Departmen . 2. Carefully follow the procedures as outlined in the enclosed "Information Bulletin." NOTE: THE ABOVE MUST BE COMPLETED BEFORE A SANITARIAN WILL BE ABLE TO BEGIN THE REQUESTED EVALUATION. DETACH HERE AND RETURN TO: Davie County Health Department, Environmental Health Section, P. O. Box 665, Mocksville, N.C. 27028 Davie County Health Department Environmental Health Section Site Evaluation Consent Form LOCATION OF PROPERTY: DATE RECEIVED (office use only) yes no 1. I am the owner of the above described property. yes no 2. 1 am not the owner of the above described property,however, I certify that I have consent from owner to obtain a owner's name site evaluation by the Davie County Health Department for the purpose of determining the suitability for a ground absorption sewage treatment and disposal system. ( yeDsno 3. 1 hereby give consent to the authorized representative of the Davie County Health Department to enter upon the above described property and conduct all testing procedures as necessary to determine its suitability for a ground absorption sewage treatment and disposal system. DATE SIG URE 4. 1 hereby authorize the Davie County Health Department to release site evaluation results from the above described property to the following: �Owner only — Owners designated representative —Anyone requesting results — Only those listed below ,a Ck vs DATE SIGNATURE DCHD(11/84) DAVIE COUNTY HEALTH DEPARTMENT • Environmental Health Section Soil/Site Evaluation NAME ,, e>, Only DATE EVALUATED ADDRESS S K1 mp PROPERTY SIZE PROPOSED FACIILTY LOCATION OF SITESd Water Supply: On-Site Well Community Public Evaluation By:C' �L Auger Boring // Pit Cut FACTORS 1 1 2 3 4 Landscape position S S —5- Slope Slo a 7. s- 41 HORIZON I DEPTH 6 Texture group C-1— Consistence 1,Z 1u FT_ Structure C C Mineralogy : ► 11 ) , I J. 1 HORIZON II DEPTH qt4l` Texture groupC C Consistence Structure S D S 7t S PT S Mineralogy ) : ► ;1 HORIZON III DEPTH Texture group Consistence Structure Mineralogy HORIZON IV DEPTH Texture group Consistence Structure Mineralogy SOIL WETNESS 5 155 SS RESTRICTIVE HORIZON — — SAPROLITE CLASSIFICATION LONG-TERM ACCEPTANCE RATE SITE CLASSIFICATION: Q S EVALUATED BY: C LONG-TERM ACCEPTANCE RATE: O OTHER(S) PRESENT:`� REMARKS: � �-� s1,� Jcc�U� ,ir n=,, W4L) 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-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(01-901