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151 Sam Cope RdDavie County, NC Tax Parcel Report b 3 t� Thursday, October 6, 2016 Parcel Number: NCPIN Number: Account Number: Listed Owner 1: Mailing Address 1: City: State: Zip Code: Legal Description: Assessed Acreage: Deed Date: Deed Book / Page: Plat Book: Plat Page: Building Value: WARNING: THIS IS NOT A SURVEY Parcel Information G8130B0007 Township: Shady Grove 5789379758 Municipality: 82530914 Census Tract: 37059-804 NELSON SEAN C Voting Precinct: EAST SHADY GROVE 151 SAM COPE ROAD Planning Jurisdiction: Davie County ADVANCE Zoning Class: DAVIE COUNTY R -A Land Value: Total Assessed Value: NC Zoning Overlay: 27006-0000 Voluntary Ag. District: 0.6887AC LT 1 SAM COPE RD Fire Response District: 0.68 Elementary School Zone: 10/2000 Middle School Zone: 2000E0249 Soil Types: 0009 Flood Zone: 352 Watershed Overlay: 105380.00 Outbuilding & Extra Freatures Value: 19740.00 Total Market Value: 125120.00 ADVANCE SHADY GROVE WILLIAM ELLIS PcB2,PcC2 DAVIE COUNTY 125120.00 No 0.00 9hel«�E,All 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 County of Davie, North Carolina, Its agents, consultants, contractors or employees from any and all claims or causes of action due to C+p C,N�i NC or arising out of the use or Inability to use the GIS data provided by this website. DAVIE COUNTY HEALTH DEPARTMENT IMPROVEMENT PERMIT and OPERATION PERMIT IMPROVEMENT PERMIT **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 B.S. Chapter 130A, Wastewater Systems, Section .1900 Sewage Treatment and Disposal Systems) NAME XZ14 e PROPERTY ADDRESS �� m C8— e d - ` A DATE LOCATION v SUBDIVISION NAME LOT NUMBER SEC./BLOCK NUMBER vX0 RESIDENTAL SPECIFICATION: BUILDING TYPE 114"1 jr,- # BEDROOMS ­,� # BATHS -:2 # OCCUPANTS __!�/ GARBAGE DISPOSAL: Yes/No COMMERCIAL SPECIFICATION: FACILITY TYPE # PEOPLE # PEOPLE/SHIFT # SEATS INDUSTRIAL WASTE: Yes/No LOT SIZE s` TYPE WATER SItY-(ice// DESIGN WASTEWATER FLOW )GPD) �G NEW SITE -'� REPAIR SITE 441' 119 00 SYSTEM SPECIFICATIONS: TANK SIZE c GAL. PUMP TAW GAL. TRENCH WIDTH I,z ROCK DEPTH ''' LINEAR FT. j! OTHER C 8 - fy - 5L REI)IIfED SITE MODIFICATIONS/CONDITIONS: ***THIS PERMIT IS SUBJECT TO REVOCATION IF SITE PLANS OR THE INTENDED USE CHANGE. YOUR WASTERWATER SYSTEM CONTRACTOR MUST SEE THIS PERMIT BEFORE INSTALLING THE SYSTEM. IMPROVEMENT 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 THE DAY OF INSTALLATION.`a TELEPHONE # IS (704) 634-8760. OPERATION PERMIT SYSTEM INSTALLED BYsL3c= osc�• M AUTHORIZATION NO. (; 0s P 4--u a )J OPERATION PERMIT BY DATE % ' I I A **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 10/95 ti'4# Davie County Health Department ENVIRONMENTAL HEALTH SECTION P.O. Box 665 Mocksville, N.C. 27028 AUTHORIZATION FOR WASTEWATER SYSTEM CONSTRUCTION (Issued in compliance with Article 11 of G.S. Chapter 130A, Wastewater Systems) ***This Authorization For Wastewater System Construction must be issued by the Davie County Environmental Health Section prior to issuance of any Building Permits. This Fore/Authorization Number should be presented to the Davie County Building Inspections Office when a lying for Building Permits.*** NAME � P DATE b �AUT}ORIZAT O NUDBER NAME ON IMPROVEMENT PERMIT (If different than above) SITE LOCATION -dT e i ��, 1e -,5K111 COMMENTS/CONDITIONS ON AUTHORIZATION TO CONSTRUCT WASTEWATER SYSTEM *HNOTICE*** THIS AUTHORIZATION FOR WqSTEWATER SYSTEM CONSTRUCTION IS VVIDF A ERIOD OF FIVE (5) YEARS. ENVIRONMENTAL HEALL CIALIST DATE DCHD 10/95 1. Application/Permit Mailing Address ;APP ATION FOR SITE EVALUATION/IMPROVEMENTS PI Davie County Health Department Il Environmental Health Section P. O. Box 665 Mocksville, NC 27028 2. Name on Permit if Different than Above Home Phone 9 / F � / 7— Al, Business ,I,bW - Ne 3. Application for: ❑ General Evaluation Septic Tank Installation Permit 4. System to Serve: [�' bu' se mckta(Ii�nMobile Home ❑ Place of Public Assembly ❑ Business ❑ Industry ❑ Other Th Unknown IhLAT3 RL 5. If house, mobile home: Subdivision" 13. Section Lot # f C) No. of People No. of Bedrooms No. of Bathrooms !21= Tom►) Dwelling Dimensions 6. If business, industry, place of public assembly, other: Specify type No. of People Served No. of Commodes No. of Lavatories No. of Showers 7. Type of water supply: ❑ Public 8. Property Dimensions No. of Sinks No. of Urinals No. of Water Coolers Water Usa-Figures Private ❑ Basement/Plumbing ❑ Basement/No Plumbing ashing Machine ishwasher ❑ Garbage Disposal Sewage Disposal Contractor 9. Do you anticipate additions/expansion of the facility this sytem is intended to serve? ❑ Yes If yes, what type? ❑ Community "o '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:�7 .09 %7 9.0 /(%,, e = �o m Cote F(f City / 4dlak � ea' v - O This is to certify that the information provided is correct to the best o my knowledge, and I understand I am responsible for all charges incurred fro this application s- Z � � SIGNAVRE CONSENT FOR SITE EVALUATION TO BE DONE ON ABOVE DESCRIBED PROPERTY MUST CHECK ONE: 1. 1 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 disposals stem. �!?-6 DATE SIGNATURE DCHD (1/93) T�` 14 70� 4E oc t DAVIE COUNTY HEALTH DEPARTMENT Environmental Health Section Soil/Site Evaluation NAME DATE EVALUATED ADDRESS PROPERTY SIZE PROPOSED FACIILTY __T ��s-� LOCATION OF SITE JrJ✓�_ C ���i �� Water Supply: On -Site Well �� _ Community Public_ Evaluation By: Auger Boring v Pit Cut FACTORS 1 2 3 4 Landscape position L L Slope % HORIZON I DEPTH Texture group Consistence Structure Mineralogy HORIZON II DEPTH -� Texture group Consistence Structure _5�/ . 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 , SITE CLASSIFICATION: /// t� LONG-TERM ACCEPTANCE RATE: REMARKS: DCHD (01-901 EVALUATED BY: /`Va 11 OTHER(S) PRESENT: 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 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 MinernloEfy 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 ■�������������������������������������� ������� �������� ve����� ■�����������_�������■�N�����������■���� �_�����■ ���������������� iiiiiiiiiiiiiiii�iiuiiiii�iiiiii�iiiiii�� ��i�iii ii�iiiii�ii�°iii ii�iiiiiii�iiii�iiii�iiiiiiiiiiiiiiiii�i��iiii�i��=����������■����� ■���u■������� ���� ��������������������������u��������_�����n=�=������������������� ■����H���������/������������������������������■��������������� ■��/����������������������������i�■ ��� ■���/������\�����/����������/��\���� �����/���������v�u������ ■����������������������������//� . 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