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178 Underpass RdDavie County, NC Tax Parcel Report Wednesday, October 12, 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: Buiiding Value: Land Value: Total Assessed Value: WARNING: THIS IS NOT A SURVEY Parcel Information G8050B0025 Township: Shady Grove 5880311395 Municipality: 28950560 Census Tract: 37059-804 GASPARRINI ALICE JANE Voting Precinct: EAST SHADY GROVE 178 UNDERPASS ROAD Planning Jurisdiction: Davie County ADVANCE Zoning Class: DAVIE COUNTY R-A,R-20 NC Zoning OveMay: 27006-0000 Voluntary Ag. District: No 4.124 AC UNDERPASS RD LOTS 5-6 Fire Response Dist�ict: ADVANCE 4.08 Elementary School Zone: SHADY GROVE 4/1989 Middle School Zone: WILLIAM ELLIS 001480106 Soil Types: WeC,WeB,PcB2 Flood Zone: Watershed Overlay: DAVIE COUNTY 102100.00 Outbuilding & Extra 0.00 Freatures Value: 55690.00 Total Market Value: 157790.00 157790.00 9 Au �%` All data Is provided as Is wlthout warnMy or guanntee of any klnd either expressed or Implled including but not Ilmtted to the Davie County� Implied warrantles of inerchanWbility or fltness for a particular usa All uscrs of Davie CouMys GIS webstte shall hold hartnless the �T County of paWe, North Grolina, its ageMs, consultaMs, contracton w employees hom any and a9 claims or causes of actlon due to �o�ty�� 1\ C or arlsinp out of the use or Inability to use the GIS data prodded by thls websfta . .. .. << ; � •�- ,. � _ , , � r, , . ., . ��� AUTH0�:2IZATION NO: "O 5 5 5 DAVIE COUNTY HEALTH DEPARTMENT �.�(� -- ! , � , ' � ; Environmental Health Section PROPERTY INFORMATION `} ,� � Permitte�, s ' ',.,..:. , ; ! �` ��� i P.O. B ox 848 Name: �., t^�i/ r;��ii,'''7. �?" �lr��/ Mocksville NC 27028 Subdivision Name: � - J Phone #: 704-634-8760 Directions to property: � 7fr -�- f'�'�-� Section: Lot: x � AUTHORIZATION FOR SYSTEM CO S RUCITON Tax Office PIN:# ���� -�� - ���� -��. , Road Name: ✓� Z'i Ll.�r'�jLL�� Zip; � r!.� ��!; **NOTE** This Authorization for Wastewater System Construction MUST BE ISSUED by the Davie County Environmental Health Section prior to issuance of any Building Pemuts. This Form/Authorization Number should be presented to the Davie CountyBuilding Inspections Office when applying for Building Pernuts. � (In compliance with Article 11 of G.S. Chapter 130A, Wastewater Systems, Section .1900 Sewage Treatment and Disposal Systems) �,�% �,,/,, F� ��'^ ***NOTICE*** THIS AUTHORIZATION FOR WASTEWATER CONSTRUCTION � ji �.f : ' �z?r� ') � . ` /r`�'� .�"�� IS VALID FOR A PERIOD OF FIVE YEARS. ENVIRONMENTAL HEAL F�SPECIALIST DATE ISSUED ...: - .. . ,,. . ._. .r�.,; �...:tlt .,�Fr�_. . _� ., .. . .;;� . . s . 1+- . � ` ': ,. �. `' , , . . . . , � � . . . . , . . � � ` � ; .: � i DAVIE COUNT - . . . . , _ . -� a , ,� � � ,� . Y HEALTH DEPARTMENT r � �3�Jv + R �' � � � ` : 'IN�PROVEMENT AND OPERATION PERMITS PROPERTY INFORMATION `-: Peri�itte��J-;"�,, ��,-' . � =:S � � r Name: � *. � + Subdivision Name: � ._._ . � � Directions to property: � � � Section: Lot: IlVItPROVEMENT C' �A `' � "�-�' � _ ,� .- � � �� PERNIIT Tax Office PIN:# -a+� �� {•` - -�� ; , * �,, _.1., Road Name t � � � '„- � t z . � �`� Zip: �,' '� ^' �`' G^ **NOTE** This Improvement Pemut DOFS NOT authorize the construction or installation of a sepdc tanlc system or any wastewater system. An AUTHORIZATION FOR WASTEWATER SYSTEM CONSTRUCTION must be obtained from this Department prior to the construc6on/installation of a system or the issuance of a building pernut. • (In compliance with Article 11 of G.S. Chapter 130A, Wastewater Systems, Section .1900 Sewage Treatment and Disposal Systems) ,, :; , .. � #� t`E,!'A�� � y'r;`�''� '�� .ii',``� ENVIRONMENTAL HEAL'�'Ii SPECIALIST DATE ISSUED ***NOTICE*** THIS PERNIIT IS SUBJECT TO REVOCATION IF SITE PLANS OR TI� INTENDED USE CHANGE. YOUR WASTEWATER SYSTEM CONTRACTOR MUST SEE THIS PERMIT BEFORE INSTALLING THE SYSTEM. RESIDENTIAL SPECIFICATION: BUILDING TYPE /%I/i # BEDROOMS '�� # BATHS ✓�-- # OCCUPANTS �- GARBAGE DISPOSAL: Yes or No COMMERCIAL SPECIFTCATION: FACILITY T'YPE # PEOPLE # PEOPLFJSHIFT # SEATS __ _ INDUSTRIAL WASTE: Yes or No � .t c-� � % LOT SIZE f��� TYPE WATER SUPPLY /� DESIGN WASTEWATER FLOW (GPD) �'% � NEW SITE �✓ REPAIR STfE SYSTEM SPECIFICATIONS: TANK SIZE,� �a GAL. PUMP TANK GAL. TRENCH WIDTH �-ryG �/ ROCK DEPTH �%�� LINEAR FT. t�'��G� / REQUIRED SITE MODIFICATIONS/CONDITIONS: IMPROVEMENT PERMIT LAYOUT � Y "*CONTACT A REPRESENTATIVE OF THE DAVIE COUNTY HEALTH DEPARTMENT FOR FINAL INSPECTION OF THIS SYSTEM I BETWEEN 830 - 9:30 A.M. OR 1:00 - 1:30 P.M. ON THE DAY OF INSTALLATION. TELEPHONE # IS (704) 634-8760. OPERATION PERMIT SYSTEM INSTALLED BY: _ W �ti�ie.-c���cT' F �i . � � nr, R s' 4 -- �o � � o _ � , � p t� �9 'O v z z � � ry w > > > > i,� � t� �, AUTHORIZATION NO. b � � � OPERATION PE IT . �-����?-x 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 OSN6 (Revised) � w•, ,, APPLICATION FOR SITE EVALUATION/IMPROVEMENT PERMIT & ATC � i � �� � � Davie County Health Department � 2 � � a � n � , � �,� ' �� � Environmental Health Section ' � l5 V �f9 , }� v l' Q� � � �� �-� J� r� P 'J' � U' � � �- � ****IMPORTAN ***�` P O. Box 848 Mocksville, NC 27028 (704) 634-8760 THIS APPLICATION CANNOT BE PROCESSED'I THE REQUIRED INFORMATION IS PROVIDED. � S�P ` 51996 1. Name to be Billed �A�� �a--s o� .e � ��v � Contact Person JC� /� .a �f� ,�. ��/'' ��`%/ ��� Mailing Address /% � /�,rJde ,ea� s s �� Home Phone �g g - � �{ � � City/State/Zip �aL -�� .�J ��,. Gl% G ,� 7d o 6 Business Phone 26 �— %��� l��i�'�' 2. Name on PermidATC if Different than Above I[9/7A�� Ah � // �/�I�' f �/i Mailing Address ��'-n'� c_ City/State/Zip 3. Application For: �Site Evaluation [ Improvement Permit & ATC [�Both 4. System to Serve: [] House [�j Mobile Home [] Business [] Industry [] Other 5. If Residence: # People �- # Bedrooms�_ # Bathrooms z [t�'Dishwasher [] Garbage Disposal (�] Washing Machine [] Basement/Plumbing [] Basement/No Plumbing 6. If Business/Other: Specify type # People #Sinks # Commodes # Showers # Urinals # Water Coolers If Foodservice: # Seats Estimated Water Usage (gallons per day) 7. Type of water supply: [�ounty/City [ j Well [] Community 8. Do you anticipate additions or expansions of the facility this system is intended to serve? [] Yes �o If yes, what type? . PROPERTY INFORMATION REQUIRED: *** IMPORTANT *** A PLAT OF THE PROPERTY MUST BE SUBMITTED WITH THIS APPLICATION. . ,r Property Dimensions: J��� � / � WRITE DIRECTIONS (from Mocksville) TO PROPERTY: Tax Office PIN: # ��5� �. - _��� ; g D � — �l n �o �i e� � �+t • �,, o SC �-'� �'r a�i Property Address: Road Name 1�.1'Z�an.� aSs S� � T• �t" � c� S�.�k-�� �`"T. R �1" vY•. City/Zip �V Qn-t� Z Z o o(s ; Ul'�l�..pu�S — �1 � h Nt t.� tn� le F+ — l.e '�' If in Subdivision p ovide information, as follows: ��6z ��-�- �� S ��-�- Name: � � � Section: Lot #: ; This is to certify that the information provided is correct to the best of my knowledge. I understand that any permit(s) issued hereafter are subject to suspension or revocation, if the site plans or intended use change, or if the information submitted in this application is falsified or changed. I, also, understand that I am responsible for all charges incurred from this application. 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��ic c.c/P, itJ� ��, � ��c ,� � i N� to conduct all testing procedures DATE y � SIGNATURE� � _� i Revised DCHD (06-96) � to dete�mine the site suitability. � � . - _ ��?irn 5.f i�. 25 _ __ _ �.t�pAc.) � - _— _ 7 , i � — -- --J 6 5 ' � � � i 5 8 s z �'o ' ° � � ��� o �- � __ . ' � — — - - � 9 0 � �� �, �� � � � . ( . 4i a �. ) .� . - -�% --� � : � � ; � � �� � � � � � x � �9 �9 ' ` � . : � . _ --' � � � . �. .� � � � �'�� � � "'`� � .74Q �� 94 � 176 � —� � { A c. ) 94 . t�, 37g. 5 0 � �� . 33 Ac . ) �r � � . 5 f Q � � -d� � ��� � � �'� � �� p _'�' � �� o �, °� i `��� � _____ � � (. �O,ac.J ,��.� , � � . �, ; --_ ` 80 ° ' ° � � � - v :a� � :�. 4 , � �` _ f-�..... �,. �: � �— �_Z � � � � 8 � ° ' � � � ' , k � N � OIR � � � � i .60 q c. � � o . : :. � � '� � � 7 .c�+ � . ` � `�n � .,=---- . 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DAVIE COUNTY HEALTH DEPARTMENT ` • � • ' Environmental Health Section Soil/Site Evaluation NAME � � ✓�%1, DATE EYALUATED %���� ADDRESS PROPERTY SIZE � G PROPOSED FACIILTY � LOCATION OF SITE �L,'�,:,;�p�� � Water Supply: On-Site Well _ Community Public � Evaluation By: AugerBoring v Pit Cut FACTORS Landscape position Slope R HORIZON I DEPTH Texture group Consistence Structure Mineralogy HORIZON II DEPTH Texture group Consistence Structure Mineralogy HORIZON III DEPTH Texture group Consistence Structure Mineralogy HORIZON IV DEPTH Texture ¢rouv �onsis�en Structure Mineraloe RESTRICTIVE HORIZON SAPROLITE CLASSIFICATION LO�IG-TERM ACCEPTANC SITE CLASSIFICATION: LDNG-TERM REMARKS: _ RATE CE RATE: �00� ���� ���_ �'����� ������ 1_--_ ��--� �--� ����� _���� -�s�r�� EVALUATED BY: �/ , 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 Texture � S-Sand LS-Loamy sand SL-Sandy loam L-Loam SI-Silt , SICL-Silt,y �: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 5tructure ,iC--Sin�le grain M-Massive CR-Crumb GR-Granular ABK-MQular blocky SBK-Subangular blocky PL-Platy PR-Prismatic Mineralc►ity 1:1, 2:1, Mixed Notes tiorizon depth - 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BOX 848I 2� O HOSPITAL STREET COURIER tfO9-4O-06 MocKsviue, N.C. 27028 PHONe: (704) 634-8760 September lE, 1996 Jane Gasparrini 178 Underpass Rd. Advance, NC ?7k�6 Re: Site Evaluation/Underpass Rd. Tax ��IN: #5880-31-139� Aear Client: As req��eated, a r�epresentative fr,om this office visited the aforementioned site on September• 13; 1996. Based upon the infor�tation pravided on the application for site evaluation and aftet, the evaluation was completed, the site aias found to be provisionally suitable on the t�pper side of the site for the installation of an on—site sewage disposal system. If you h�ve any questions, please feel free to contact this office. Since�^ely, l�l�i '�"�`� �" i✓� Robert P. Hal l, Jr. , R. S. Environmental Health Section RH/wd Enrlos«re(s)