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184 Montclair Drive Lot 12Davie Countv. NC Tax Parcel R ennrt Wednesday. October 19. 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 1S NU1' A SUKVLY Parcel Information F712OA0012 Township: Shady Grove 5860953388 Municipality: WILLIAM ELLIS 82523118 Census Tract: 37059-803 GARRETT ROBERT F Voting Precinct: WEST SHADY GROVE 184 MONTCLAIR DRIVE Planning Jurisdiction: Davie County ADVANCE Zoning Class: DAVIE COUNTY R -A NC Zoning Overlay: 27006-7096 Voluntary Ag. District: No LOT 12 BALTIMORE HEIGHTS Fire Response District: ADVANCE Land Value: Total Assessed Value: 1.00 4 Nv �F Elementary School Zone: SHADY GROVE 7/2004 Middle School Zone: WILLIAM ELLIS 005630472 Soil Types: MrC2,SeB,MrB2,GnB2 0006 Flood Zone: 076 Watershed Overlay: DAVIE COUNTY 209890.00 Outbuilding & Extra 4990.00 Freatures Value: 36000.00 Total Market Value: 250880.00 250880.00 All data is provided as is without warranty or guarantee of any Idnd 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 NC County of Davie, North Carolina, its agents, consultants, contractors or employees from any and all claims or causes of action due to NC rap or arising out of the use or inability to use the GIS data provided by this website. DAVIE COUNTY HEALTH DEPARTMENT ' 3� - I IMPROVEMENTS PERMIT AND CERTIFICATE OF COMPLETION *NOTE: Issued in Compliance With Article 11 of G.S. Chapter 130a aSanitary Sewage Systems <,,�` � ` Permit Number Name Date ��i=� C.. Date �` I N2 I 674 Location Subdivision Name �•� ` �� o �,`�"�"�Lot No. Sec. or Block No. Lot Size amu- House Mobile Home"— Business., Industry, No. Bedrooms No. Baths3---'No.-in Family _— Public Assembly Other Garbage Disposal YES Q NO Specifications for System: Auto Dish Washer YES NO Auto Wash Ma^hine YESjt ' NO ❑ '' B0 \ � Type Water Supply — "C C) — ------ O *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. �UuNg Improvements permit by *Contact a representative of the Davie County Healtl�,DepartmOnt for final inspection of this system between 8:30-9:30 A.M., 1:00-1:30 P.M. or 4:30-5:00 P.M. on day of completion. Telephone Number: 704-634-5985. Final Installation Diagram �Os�9s / VAI `'� Al W �)el j Of liePal IAJ System Installed by m � ) �>V'- /V.-.14ls -- 1�- 7.'A t6whAt^ �� � Certificate of Completion `-3 �`�` 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. t , APPLICATION FOR SITE EVALUATIOWIMPROVEMENTS PERMIT . Davie County Health Department Environmental Health Section P. O. Box 665 Mocksville, NC 27028 1. Application/Permit Requested By C, Mailing Address / ? �' i'??�1���1� C /Cl'�! %/�r/C�" A/CL Z,7e6 Home Phone ( .sBusiness Phone 2. Name on Permit if Different than Above 3. Application/Permit for: ❑ General Evaluation ❑ Septic Tank Installation 4. System to Serve: ❑ House ❑ Mobile Home ❑ Place of Public Assembly ❑ Business ❑ Industry ❑ Other ❑ Unknown 5. If house, mobile home: Subdivision CIZ0,6C% C Section Z 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 No. of People Served No. of Commodes No. of Lavatories No. of Sinks No. of Urinals No. of Water Coolers No. of Showers / Water Usage Figures 7. Type of water supply: 2 -Public ❑ Private 8. Property Dimensions Sewage Disposal Contractor 9. Do you anticipate additions/expansion of the facility this sytem is intended to serve? ❑ Yes If yes, what type? M ❑ Community '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: This is to certify that the information provided is correct to the est f my knowledge, anc incurred from this application. 71Z 6- DATE Ir TURE Cr 121-sS 4 F t S �u I am responsible for all charges CONSENT FOR SITE EVALUATION TO BE16ONE ON ABOVE DESCRIBED PROPERTY MUST CHECK ONE: ❑ 1. 1 OWN the property. 0'2. 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 pf 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 toa ermine""said ite's suitability,for d absorption sewage treatment and disposal syst m. ATE _,_.eIGNATURE DCHD (12-90) DAVIE COUNTY HEALTH DEPARTMENT Environmental Health Section Soil/Site Evaluation NAME DATE EVALUATED ADDRESS ,� / PROPERTY SIZE PROPOSED FACIILTY ,ko, LOCATION OF SITE Water Supply: On -Site Well _ Community Public Evaluation By: Auger Boring Pit Cut FACTORS 1 2 3 4 Landscape position L L Sloe % HORIZON I DEPTH ell $'i Texture group IfG G Consistence Structure Mineralogy HORIZON II DEPTH Texture group Consistence ,- Structure / Mineralogy HORIZON III DEPTH Texture group Consistence 11711,11-1 ! Structure 1 010" Mineralogy / HORIZON IV DEPTH Texture group Consistence Structure Mineralogy SOIL WETNESS RESTRICTIVE HORIZON SAPROLITE CLASSIFICATION LONG-TERM ACCEPTANCE RATE , SITE CLASSIFICATION: P_K _ LDNG-TERM ACCEPTANCE RATE: REMARKS: DCHD(01-901 EVALUATED BY:��`� 7�TER(S) PRESENT: .�.4, 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- V1: -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 ■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■.■■■■■■■!■■..■.■.■�■■■!■■■■ MESS■!■ ■■■■■■■■■■■■�■!■■SSSS■N■■■.■■.■■■■/.■■■■■.■■■■■■ ■■■.■■■■.■■■■.■■ ■■.■■./■■■■■■■■■■■■..■..■.■/■■..■■■■...■■■■■ ■■■.■■/■/SSSS.■■/SSSS ■■.■..■.■��■■.■...■.■■■■■■■...■■ H■■..■■.!!!.■..E 'fiMMmMM■M■MM■■ ■■■■■■■!■■.!■■■■■■■■■■■■■■.■■■■■ ■■■■MMMMM■MEM■■�■■■G��Iti■■■■■■■■■■ MEMMMMMMMMMMENOMMMEMMMMMMEMMEMMMOMMMOSO�MEMM■MI�1■11�MMMMMMMmE■MEEM iiiiiiiiiiiiii= iiiiiiEOMMMMiiuiMMMMMMMENOmI�0 MEM EMMEMiM No ■■■■■■■■■■■■E■ MEN■■■■■■■■■■■■■■■■EE■■!■ ■■■ MM ■■■■■■■.■■■■■■■■■ES■■M■■■■■■■■■■■■■■■■■■■■■■■■■■■ ■■■■■■■■M■■■■■■■ ■■■■■■■■■■■■.■■■■■►M■■■■■■■■■■■■MM■■■■■■■■...■■■.■■.■■■■■ru■■■■■■ ■■■■■■■■■■■■■■!■■■■►■■■■■■■E■■■ ■■M■■■■NO■■■■■■■■■■■■�■■■■.■■!■ ■■■■■■■■■.■■■■■■■■.■►■■■■■■■■■■■■■■■■■■■■■■■.■■I==s=iiiiiiiiiiiME ■■■■■■■■■■■■■■■■■■■■■a■■M■■E■■■■■■■■■■■■E■■■■!■ MEE MMMMMMOMMMMMMMEEMEiiii niiiiiiiiiiMMMMMMEMMMEMEMMOOMMMEME&IMOMENOMMMM=m SM Eiii=iMMUMMOMMENEMiIMMME =I iiwiiii■iiiiiiiiiiiiiii■mommommmmoiiii■iim■iMMOVE iiiiiM =iii ■■om■■■■■■SSO■■S■■■■■mmomm...■■■/.N■!■!!■!■■ MUNUREMMMMM■■■O ■■■■.•.■■.■■■■■.MMMMMMHMMMEMEMMMM■MEMM■MMMMMME■ ■� EMMMIMMMM■MI ■■■MMONE"MMMEM■EMEE■E■■■■■■S■O■■■M■■■.!.■■■H■ ■ M■■! 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NOMSME■ H MIMMEMOMMMUMMUNI WE No iiiiiiiii■iii�iuii[�iii mom ■ �i��IMUSSEUM ■■..!■.■■EEE■■■NO.■EOM■■■MMEMEMMEMME NOON MEMMORM ONE ■■■E■M ■ ■ FRMS NOON ammom" so INONE ME No 0 �E■ ■u�■■pMME■■ ■ ■ .■ �.'� ONES ON 0 0 ME ON a ■.■■■■■.■■■■■■■..■S■■..■■■■■■E■!■■E■H l ■■RMEME ■■ ■■!EElElEEl..■■■SJN.O.SEEHOS■S EMO .VGG].NO�■/■ ■■■■■■SSSS■■■■M■■.EEEEE■E■E.■EEMIME ■MSM■■ME■M ■■ ■M■MMMEN. .MMEMMMEMEMEMEM■■ MIME N■■■■■H■■■ ■�MEMMEME ■■■■■■■■■■■u■■■!■Hon ■ 4MUMEMMO.� ..mom M MEME mom■■.! . M■NONE mom M WOMEN mom�MNM■MEMEMM■M■EM MMEMMEMMUNMEMEME No mom _. ■...._.un.... MIME SSSS■SE.■■O.M■.O.■■/.■.■■.■ ■■■■■■■■■M.S■■.00O■■■■■■■■■O■.■■■■■■■■ SSSS ■■SSSS■!S■S■■■■■■.■■■l�MEMMOMME■■ ■�\EEE■EEEE■■■■■■EE.■■..S ■ APPLICATION FOR SITE EVALUATION/IMPROVEMENTS PERMIT Davie County Health Department Environmental Health Section P. O. Box 665 Mocksville, NC 27028 1. Application/Permit Requested By J`�l G �.� lZe% GLA-jE- Mailing Address Home Phone Business Phone } �r`a - ,2lO O 2. Name on Permit if Different than Above 3. Application/Permit for: 4. System to Serve: ER- ouse ❑ General Evaluation ❑ Mobile Home Septic Tank Installation ❑ Place of Public Assembly ❑ Business ❑ Industry ❑ Other ❑ Unknown 5. If house, mobile home: Subdivision ZFA L //m&,O� /O G A-ZI Section Lot # No. of People 3 No. of Bedrooms No. of Bathrooms 3 Z Dwelling Dimensions 22 fz0 5.,57 6. If business, industry, place of public assembly, other: Specify type No. of People Served No. of Commodes No. of Lavatories No. of Showers No. of Sinks No. of Urinals No. of Water Coolers Water Usage Figures ❑ Basement/Plumbing 2-15a'sement/No Plumbing 21ashing Machine ishwasher ❑ Garbage Disposal 7. Type of water supply: E-fu'blic ❑ Private ❑ Community 8. Property Dimensions / G � Sewage Disposal Contractor ZA- 9. Do you anticipate additions/expansion of the facility this sytem is intended to serve? ❑ Yes O'1g0 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. Directions to Property: This is to certify that the information provided is correct to incurred from this application. ze�-a DA -(E G 7 .nom of my knowledge, and I understand I am responsible for all charges c SIGNATURE CONSENT FOR SITE EVALUATION TO BE DONE ON ABOVE DESCRIBED PROPERTY MUST CHECK ONE: ❑ 1. 1 OWN the property. 2 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 Counjy Health Dqppartment to enter upon above described property located in Davie County and owned by A," to conduct all testing procedures as necessary to determin ite's suitability for a grou sorption sewage treatment and disposal system. f f Z7 S� DAT SIGNATURE DCHD (12-90) ' � 1 Davie Caanty ,71eali Department and Mame NealtI Ayeaq, 210 HOSPITAL STREET i P.O. BOX 665 MocKSVILLE. N.C. 27028 PHONE: (704) 634.5985 April 3, 1995 Glenda Vaughn 184 Montclair Dr. Advance, HC 27006 Re: Baltimore Heights -Lot 12 Dear Ms. Vaughn: This letter is to confirm our conversations on March 29, 1995, regarding the location of your septic system and landscape positioning on your lot in Baltimore Heights. The area where the septic tank system was installed has settled since its installation, and it appears to be picking up surface water from the rear and left side of your lot. The surface water that drains from the back and left side of the lot needs to be diverted by a burm or terrace that will prevent it from draining across the septic system. Also, the area over the nitrification lines needs to be filled to the original grade to prevent surface water from infiltrating the lines. When this landscaping is completed, grass should be sown immediately. Please find enclosed a copy of the original site evaluation. If I can be of further assistance, feel free to call. Sincerely, 44a. x�4A4�— Robert B. Hall, Jr., R.S. Environmental Health Section RH/wd Enclosures cc: Rick Bailey