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1134 Yadkin Valley RdDavie Countv. NC 0 u Tax Parr.Pl RPnnrt Wednesdav, 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: Building Value: Land Value: Total Assessed Value: WAKNiNG: TlilS 1S NOT A SUKVEY Parcel Information B70000007201 Township: Farmington 5863740649 Municipality: 47248000 Census Tract: 37059-802 MARSHALL ANGELA D Voting Precinct: FARMINGTON 1134 YADKIN VALLEY ROAD Planning Jurisdiction: Davie County ADVANCE Zoning Class: DAVIE COUNN R-A NC Zoning Overlay: DAVIE COUNTY QD 27006-0000 Voluntary Ag. District: 2.07 AC YADKIN VALLEY RD Fire Response District: ,�°"�'�' Davie County, �o— �'� NC 1.95 Elementary School Zone: 1/1992 Middle School Zone: 001620403 Soil Types: Flood Zone: Watershed Overlay: 231240.00 Outbuilding 8� Extra Freatures Value: 45760.00 Total Market Value: 277000.00 � FARMINGTON PINEBROOK NORTH DAVIE ApB,WeC DAVIE COUNTY � �� 277000.00 � _,; • - ..._•�.,..�.+�.......y,.`- ,�T•,.o�--�-..,......,, �,.v-� ....r-+nr..we.:...�„r�� ..- - - `/�.e.//�'_,.�../�"/i. ����• T � - ' DAVIE �COUNTY �HE/1L'TX DEPAR7MENT ��� 'V C� y �_�� �,e.t' "' r �IIiAPROYEMENTS' PERMIT AND�CERTIF7CATE: OF COMPL'ETION �, .... �'NQTE:IadueAlnC.ompllance.Wlfh'6rtICIeII�of.G:S.Gfiapter�190e� ' � �I . �8enitery; . 9eSY.stema! . :P.�i1111t ;NU111bM' . // � �r.o:0 eQ�/..��./.CA �/i.�. iu/ �� Neme•,Fr�� oete� /- J�?•.rJ.�7 '.NG 6, <<. . �_.. n T . .... / 633 � L.cCe�lon /rT�'-/i'�'✓.6f:v�/a.i�- �Il/ .'S.�/Y�- . //�N b l�., ^ ' ' ' / �� . f; �..�_�n �,�'. f�— n,. �i.✓�7" ✓fa�. U�,L.� �..�r ��, ..� _�rl�iN 'Qi(/ .: � l' ' 1 Gai .BubdivleibnlMeme .. . . .. �Lot'No:. .Sec: or�BlockiNo:.� � `I iw si:a_ _9n� HWae . �� MODile!Home ,Bu$inese Spaculqtbn� �I ��No: Bedioorris � ?�� ;No:�Belhs a ���No;�in:Famlly� � ' � � 6erti�ege Disposal. `YESi p• N0. p! � Specificdtions.�lor. tem: ' � AuWiDieFi Waehei• YES ' �� NO. O: ����� � � I� Auto WaM Me:hlne •YES'Q NO: p ���v,%^" /� n 11 Type. Weter,SuDP�Y. . f�. _ ��X�.Y�'� X/��� � I -• _ , �r 'Thle�peimit�VOIE!If�sewdge'systam!Geseii6ed'be,lowjis;iwt'.inatellediwittiin;5'.y.earai�romtlale:of�isaue: . ' Tliis permiti�aubje6t:to?FeJocetiori�if.site:plana or thejintended�use;change. I,� II �I � �� �� � r , � � �i �� . �� ��� �I �` ' ` ��� i! ,� � • � . ' , ' . �� • ,; � � . i; . �-,;. •� �� �� �j� Improyemants permit 6y _ / � � � _ _ �� ;Coritdot a�epreeent5ti"ve;6f the':Devie Gounty.�HedltK?Depeilment;for-final inapeclion ol�ithis sy6tem �betweero:8:30- , I�� 9:30 �A:M:�or a:00`-1:30 P.M.�on�tlay ofSboinplelion Teleplione Numtier 709-834-5985: �Finai�InelelletionDiagrem: �� � I,� . .. .�...Inets�letl._tiy ��^+�,^ �m+�r� . li .._ . . _... _ ' �� P ' v r, � � �, , � � 9 �� �,��C� ��E" �i'�� � � - � ' i P� � -��` , ' - , � " � � '�� , ��,, , . . �� ,, I�'� c D � : P � �h,, 9° ;' �v�` � � . ; /I,14, 1 �(u _ 1� /�u� � _ i � � . �'� � �' h �lR � l � � ' �Certificateidf:Gbmpletion. ,Dare� � � 'TM slgni�•otathfs�cehiflbete.=ahall inAloele thelSlhesyatein tleacribetlKeDove has tieen inslalled��ln�complience?�witFi. •the standards�eet:fonli In�tfie�ati�ovelreguletion,itiut�sFie'll'in'NO way,�6e;isken�es;e!yueruiteeitheGtRe.syebm,will,funotion aetiefactorily.ki<any giveniperiod'of��lme,. � 6 `� � ��� /a�9-�C�.��- •'+, �` APPLICATION FOR SITE EVALUATION/IMPROVEMENTS PERMIT � Davie County Heaith Department /�, l�r�� Environmental Health Section l � � P. O. Box 665 Mocksville, NC 27028 � ���M � r 1. Application/Permit Requested By Mailing Address ; _ ,C"� c;�.... `��-;t .,. , �-� ,•,, Home Phone � r� " � f ; ��i 3 F *`� Business Phone `� � �'�� ' � ��-�� t" 2. Name on Permit if Different than Above f}i <.� ���:'t ��� �� 4''?` � � "_'"_�,° 3. Application/Permit for: {,�General Evaluation C�eptic Tank Installation 4. System to Serve: �House ❑ Mobile Home ❑ Business ❑ Industry ❑ Other 5. If house, mobile home: Subdivision �i.� � l`� No. of People f��' No. of Bedrooms ���� No. of Bathrooms � ` "�.� Dwelling Dimensions o� � � a n.�b ,�J �;�, �i`� X 3� ❑ Place of Public Assembly ❑ Unknown � 4 Section �� } Lot # �`:. � �', ❑ BasemenVPlumbing (�'�BasemenUNo Plumbing [�IVashing Machine � ishwasher ❑ Garbage Disposal � S�,q 6. If business, industry, place of public assembly, other: Specify type ��= t` No. of People Served No. of Commodes _ No. of Lavatories _ No. of Showers �- No. of Sinks `�� r• No. of Urinals No. of Water Coolers _ Water Usage Figures .�--- 7. Type of water supply: �°"Public p Private ❑ Community 8. Property Dimensions � -'��!„t".� F.-�''� Sewage Disposal Contractor �{ F e� ��'� a : : �._'"R G:�t ��. �j:� � � •='.,� �rv � - 9. Do you anticipate additions/expansion of the facility this sytem 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 plans or the intended use change. Effective October 1, 1989. e t � Directions to Property: � i� �, ���.t j`�:,,(� r"� ���� t°� � }-�f..�i� �� °" �' ;� (� 1 L�,���G''�' � ,�.� �'' .s'i� �Y7 �� �E�C,��.: � ` � tiC (� ��- !�-'�'�J/ �-�}-� �-�:�e� c,�� � �� �..i� V 4 �' /� �� ,� ,/ f �..,d'�-�^"'�/ ������ ol��f / e�'� � � ���� �� �-i�� e � This is to certify that the information provided is correct to the best of my knowledge, and I understand t am responsible for all charges incurred from this application. � � � ?J % ,� �. \ 'i'�,C,,R.e df� _ DATE GNATURE CONSENT FOR SITE EVALUATION TO BE DONE ON ABOVE DESCRIBED PROPERTY MUST CHECK ONE: �1. I OWN the property. ❑ 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 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 disposal system. DCHD (12-90) DATE SIGNATURE � �._ t '' '�_� � DAVIE COUNTY HEALTH DEPARTMENT ' Environmental Health Section Soil/Site Evaluation ' NAME �� DATE EVALUATED �`�L.�°�, ADDRESS PROPERTY SIZE �r� G PROPOSED FACIILTY ,������ LOCATION OF SITE _)i� !/. G� �'�r Water Supply: On-Site Well Community Public �� Evaluation By: AugerBoring ,/ Pit Cut FACTORS 1 2 3 4 Landsca e osition L �- L � Slo e 7. — � HORIZON I DEPTH � � � � < �' � �� Texture rou � �'L s'.� r Consistence Structure Mineralo HORIZON II DEPTH L/�r �r d,yr- /�- Texture rou i / Consistence ,1- -� � � Structure _�' ,c� h �� Mineralo /,• • / -/ �, - / HORIZON III DEPTH Texture rou Consistence Structure Mineralostv HORIZON IV DEPTH Texture qroup Consistence Structure Mineralo SOIL WETNESS RESTRICTIVE HORIZON SAPROLITE CLASS.LFICATION LONG-TERM ACCEPTANCE RATE , SITE CLASSIFICATION: EVALUATED BY: /7l= � LONG-TERM ACCEPTANCE RATE: � z/ OTHER(S) PRESENT: REMARKS• 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 Textnre 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-AnBular blocky SBK-Subangular blocky PL-Platy PR-Prismatic MineraloltY 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) 5oi1 wetness - Inches from land surface to free watef 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 ■��■■■����������������■■��■���������■���■■���■�■������■��■ ■■■��■ ■■�������������������■■\������■���■/���������■����■���■������■���■ ■�■�■������������■����������■��■ ■��������������������������5���■ ■�■��■������■�■■������■�■�■■■�����■■������������������■��■����■�■ ■■■��■■i■��5��■■■��■����■�■���■�■�����������������������■�■����■�■ ■�������■��������■����■���■■�������������■�����������������������■ ■�������■�■���■��■����■���■���������������■���■�■����������������■ ■������������■����■������������■������■������■�■■���■�■■������■��■ 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'i-- - -�- i.�'J�J ,. t.. ��' 1� � � \\�,� Tk`� .../ � ' � � � � _ , . , DAV�IE COUNTY HEALTH DEPARTMENT IMPROVEMENTS' PERMIT AND CERTIFICATE OF COMPLETION *NOTE: Issued in Compliance With Article I I of G.S. Chapte 130a Sanitary Sewage S ste sn �� Permit Number Name �i//i/ /G /%%/�/..r'�`��/�'f������ � Date �/� �� NO 1 G 7 0 �ocation /9��-�:., �i% c y G2�— - j� �G� • �✓%✓.�i�r� �Jr' -��'� ,��r' ��f� � l%� � Gri'��� F�%/�.�'.r - -- �-��� Subdivision Name Lot Na Sec. or Block No. �� Lot Size No. Bedrooms � Garbage Disposal Auto Dish Washer Auto Wash Ma^hine Type Water Supply House Mobile Home _T Business _— Speculation _.No. Baths � �� No. in Family � _ YES ❑ NO [� Specifications for System: YES NO p p�.rX 6 X�' � YES � NO ❑ � �' ` --- '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. �, { � I - y� � W,�� s .1--�---'_.._..----- /� �'v � ^ Improvements permit by _ �/r �/ 'Contact 2 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 Certificate of Completion Date •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. �.,, , � , . .. .. .' .. �� . .. � .� n � _. � . � . . , .. .... ; � � ,. t _ �. .. ... - r , � _ N+ `�:.._. . . . �« ,- , . . 'r ` .' .. �."" _ ' ...�....� "- . � -�= - �� DA1�IE COUNTY HEALTH DEPARTMENT - :. _ �' -� IMPROVEMENTS PERMIT AND CERTIFICATE OF COMPLETION �'NOTE:�Issued in Compliance With Article I I of G.S. Chapter 130a F_ � � � Sanitary Sewage S�ystems;� � , �%�'��'` ,.y� _ Permit�JV� � �b�e� . . . .� jr/��/Lf !/����. �*` r f �f / �`�-%�.. d�,V t�- .��•/�,,' �. ...�. . .�;�''_.� � O � - Name � — Date N� � . J' , ., ..� / � � r" ..- r� . ���,� .i ' ; ) `. !. ,�','/i ,. � � ,'./i ,!' , . �"! '' l,;. '/� <� ,.f'. ./i'�/�/��::�..�..+l�.. ,.� � .;r,�. / �.,�r �'✓ tr, C: Locatio,n �' — ��, (i`- ; , ,� �': /` t:"- :; ,%: . � Subdivision Name Lot No. Sec. or Block No. �� Lot Size House � Mobile Home _�_ Business _— Speculation „ , �.,�_' ; % �? �-�- No. Bedrooms No. Baths = No. in Family _ e Garbage Disposal YES [� NO p S ecifications for, S stem: R , . , ;- . Y Auto Dish Washer YES [i]r NO ❑ ,_ . ->+; � -�� :�: �?" Auto Wash Ma^hine YES p NO ❑ , Type Water Suppty � ` ___ '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. -y I�1 F / � � _ M1 � , ` f � r /: � _. rF ��. / L` I ` . � \��•.. /,'' ' l�..i : /lIi � �A �'7.�. %l/ l. �„��,,,,,,,,.,,.w�-�+�'- / Improvements permit by , �" ! i�s`, � � � 'Contact 2 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 Certificate of Completion Date '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. �.* �"� DAVIE COUNTY ENVIRONMENTAL HEALTH SECTION .. • ` ' APPLICATION FOR IMPROVEMENT PERMIT (REPAIR) NAME �S%� �M� /�1��3'�l i PHONE NUMBER ADDRESS !G� G� lG� /g� • Z7� °�' SUBDIVISION NAME LOT # DIRECTIONS TO SITE 1/,�1r1/l�► v�/�s., /%� •y^`' ,P'�! - �i�s T ��P• i�'d� /� ' .ti• leO� �iFrcL 1faLiW �d� DATE SYSTEM INSTALLED ��'� Q'1 L NAME SYSTEM INSTALLED UNDER /7ngic aiy*,�, TYPE FACILITY �� NUMBER BEDROOMS .3 NUMBER PEOPLE SERVED TYPE WATER SUPPLY �"�'� SPECIFY PROBLEM OCCURRING1� '.�.� �� Q- �-- s� 6� �/.�1�,.. ��c�, G�- �H G�� ,,����► z�- -�. w��►�/ y� ��,�.... DATE RE�UESTED P�'�7"9Z- INFORMATION TAKEN BY This is to certify that the informatlon provided is corcect to the best of my knowledge, and that I understand I am responsible for all charges incurred from this appiication. SIGNATURE OF OWNER OR AUTHORIZED AGENT Rev. 1/93