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240 Montclair Drive Lot 4Davie Countv. NC Tax Parcel Renort Wednesday. October 19. 2016 Parcel Number: NCP1N 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: WAK1V11NU: -lrilJ lb 1NU1 A bUKVhY Parcel Information F7120B0004 Township: Shady Grove 5870053473 Municipality: 82527504 Census Tract: 37059-803 LAPOINTE RONALD EDWARD Voting Precinct: WEST SHADY GROVE 240 MONTCLAIR DRIVE Planning Jurisdiction: Davie County ADVANCE Zoning Class: DAVIE COUNTY R -A NC Zoning Overlay: 27006-0000 Voluntary Ag. District: LOT 4 BALTIMORE HEIGHTS PHASE 2 Fire Response District: 0.97 Elementary School Zone. 1/2007 Middle School Zone: 006960267 Soil Types: 0008 Flood Zone: 016 Watershed Overlay: Outbuilding & Extra 215810.00 Freatures Value: 32400.00 Total Market Value: 275280.00 7 ADVANCE SHADY GROVE WILLIAM ELLIS MrC2,GnB2 DAVIE COUNTY 27070.00 275280.00 F-& Alldataisprovided 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 or arising out of the use or Inability to use the GIS data provided by this website • DAVIE COUNTY HEALTH DEPARTMENT Pd. Environmental Health Section P. O. Bog 848/210 Hospital Street Mocksville, NC 27028 (336)751-8760 Account #: 990002736 Billed To: David Gordon Reference Name: ATC Number: 4302 Tax PIN/EH #: 5870-05-3473 Subdivision Info: Baltimore Heights Section II Lot # 4 Location/Address: Montclair Drive -27006 AUTHORIZATION FOR WASTEWATER SYSTEM CONSTRUCTION **NOTE** This Authorization for Wastewater System Construction MUST BE ISSUED by the Davie County Environmental Health Section prior to issuance of any building permit(s). This Form/Authorization Number should be presented to the Davie County Building Inspections Office when applying for building permit(s) (in compliance with Article 11 of G.S. Chapter 130A, Wastewater Systems, Section .1900 Sewage Treatment and Disposal Systems). THIS AUTHORIZATION FOR WASTEWATER CONSSTR CTIOJN IS VALID FOR A PERIOD 1OF FIVE YEARS. Environmental Health Specialist's Signature: / " l Date: CERTIFICATE OF COMPLETION **NOTE** The issuance of this Certificate of -Completion shall indicate the system described on Improvement/Operation Permit has been installed in compliance with Article 11 of G.S. Chapter 130A, Section .1900 "Sewage Treatment and Disposal Systems," but shall in NO WA be tai�er� al a guarantee that the system will function satisfactorily for any given period of time. I I ` 6, l ka'? ID Septic System Installed By: 1'0 `�C Environmental Health Specialist's Signature :lo Date: 0 DCHD 05/99 (Revised) DAVIE COUNTY HEALTH DEPARTMENT + Environmental Health Section ` P. O. Box 848/210 Hospital Street �( Mocksville, NC 27028 �I (336)751-8760 �1 IMPROVEMENT/OPERATION PERMIT Account #: 990002736 Tax PIN/EH #: 5870-0573473 Billed To: David Gordon Subdivision Info: Baltimore Heights Section II Lot #4 Reference Name: Location/Address: Montclair Drive -27006 Proposed Facility: Residence Property Size: 120x **NOTE* Thi sl mpro4ement/Operation Permit DOES NOT authorize the construction 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 G.S. Chapter 130A, Wastewater Systems, Section .1900 Sewage Treatment and Disposal Systems). THIS PERMIT IS SUBJECT TO REVOCATION IF SITE PLANS OR THE INTENDED USE CHANGE. YOUR WASTEWATER SYSTEM CONTRACTOR MUST SEE THIS PERMIT BEFORE INSTALLING SYSTEM. Residential Specification: Building Type #People #Bedrooms #Bath G<s� Dishwasher: Garbage Disposal: ❑ Washing Machine: Basement w/Plumbing: ❑ Basement/No Plumbing: ❑ Commercial Specification: Facility Type #People #People/Shift #Seeats Industrial Waste: El Lot Size Type Water Supply Design Wastewater Flow (GPD) ' I� Site: New Repair ❑ 1/ System Specifications: Tank Size%GAL. Pump Tank GAL. Trench Width Rock DepthIQ _ Linear Ft -W Other: fis stated in 15A NCAC . Required Site Modifications/Conditions: accepted Systems may also be use IMPROVEMENT/OPERATION PERMIT LAYOUT - APPROVED EFFLUENT FILTER. RISERS) IF 6 " BELOW FINISHED GRADE. ****NOTICE: Contact a representat've of the Davi County Health Department for final inspection of this system between 8:30 a.m. to 9:30 a.m. or 1:00 p.m. to 1:30 p.V. o4 thef day otinstallation. Telephone # is (336)751-8760.**** 0 Environmental Health Specialist's Signature: / Date: DCHD 05/99 (Revised) TION FOR SITE EVALUATION/Ml PROVENIENT PERMIT & ATC Davie County Health Department Environmental Healt/i Section P.O. Box 848/210 Hospital Street Mocksville, NC 27028 (336) 751-8760 .PORTANT*** INFORIiATION IS THIS APPLICATION CANNOT BE PROCESSED UNLESS ALL PROVIDED. Refer to the INFORMATION BULLETIN for THE REQUIRED instructions. ❑ 130th (G_ Home ❑ Business ❑ Industry ❑ 1. Name to be Billed tJ��X (? n t �� Contact Person /�/ Mailing Address 1�G `� (�� V� 25/� (�C) ��`! %� , home Phone City/State/ZIP Vcj K l AUL 6 �� `- Z� 04! 1 Business Phone _ �� '7 c;--2 R� 2. Name on Permit/ATC if Different than Above Mailing Address City/State/Zip 3. Application For: ❑ Site Evaluation EY'Improvement Permit/ATC ❑ 130th 4. System to Service: & House ❑ Mobile Home ❑ Business ❑ Industry ❑ Other 5. Type system requested: M Conventional ❑ conventional modified _ ❑ innovative paccepted 6. If Residence: it People # Bedrooms_ # Bathrooms 2 , VIDisliwasher ❑Garbage Disposal Washing Machine ❑Basement/Plumbing 'Basement/No Plumbing 7. If Business/Industry /Other: verify type # People # Sinks # Commodos # Showers # Urinals # Water Coolers IF FOODSERVICE: It Seats Estimated Water Usage (gallons per day) 8. Type of water supply: 1I" CQunty/City ❑ Well ❑ Community 9. Do you anticipate additions or expansions of the facility this systein is intended to serve? ❑ Yes ®No If yes, what type? ***L,1J10RT4N7-** CLIENTSMUSTCOAIPLETETHE REQUIRED PROPERTY INFORA4ATION REQUESTED BELOW. Either a PLAT or SITE PLAN A1UST BE SUBMITTED by the client witli THIS APPLICATION. Properly Dimensions: L2Y—�0 � Tax Office PIN: it a: ( ] Q 0 '� C ) Properly Address: Road Name Lo1`Il city/zip If in a Subdivision provide information, as follows: i / Nainc: �u 1�"l rnQ re 4,`sVj� Section: Block: Lot:_ WRITE DIRECTIONS (from Nlocksville) to PROPERTY.' F l(ow N,( t ( IM 0 cr e UP C. Date home corners flagged: I ` (5-- U This is to certify that the information provided is correct to the best of my knowledge. I understand that any permits) 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 ant responsible for all charges incurred front this application. I, hereby, give consent to the Authorized Representative of the Davie County IIealth Department to enter upon above described property located in Davie County and owned by to conduct all testing procedures as necessary to determine the site suitability. J DATE ` I ' C) SIGNATURE Q) 4 "-� TIIIS AREA fvIAY BE USED FOR DRAWING YOUR SPIE PLAN (Include all of the following: Existing and proposed property lines and dimensions, structures, setbacks, and septic locations). Sign given. Revised DC1lD (05/03 Site Revisit Charge Date(s):_ Client Notification Date: EES: Account No. Invoice No. �_ 1. Name to be Billed(Ayry�N4--1 2:C e J2, Contact Person Mailing Address Eat ?j M o N •f - Home Phone —V 2 City/State/ZIP ��r? ti C.2 /VI L. 2- ;7 Business Phone G �/ i "�-u .3 2. Name on Permit/ATC if Different than Above Mailing Address City/State/Zip 3. Application For: Er"Site Evaluation ❑ Improvement Permit/ATC I1 Both 4. System to Service: "Ouse ❑ Mobile Home ❑ Business 1-1 Industry I -.I Other 5. If 'd e: # People a Bedrooms # Bathrooms t.Y_1 Dishwasher CI Garbage Disposal asking Machine LI Basement/Plumbing II Basement/No Plumbing 6. If Business/Industry/Other: Specify type # Commodes # Showers # Urinals # People # Sinks # Water Coolers IF FOODSERVICE: # Seats Estimated Water Usage (gallons per day) 7. Type of water supply: to County/City ❑ Well ❑ Community e. Do you anticipate additions or expansions of the facility this system is intended to serve? ❑ Yes )i No If yes, what type? ***IMPORTANT*** CLIENTS MUST COMPLETE THE REQUIRED PROPERTY INFORMATION REQUESTED BELOW. Either a PLAT or SITE PLAN MUST BE SUBMITTED by the client with THIS APPLICATION. Property Dimensions: Tax OfficeIN: # IF, ' ` S "` f Property Address: Road Namen u� pr ✓ c City/'Lip 4a6- 276,04 If in a Subdivision provide information, as follows: Name: 12>f .`�' ► "`�' � e ��T Section: Block: Lot: T WRITE DIRECTIONS (from Mocksville) to 11110PER'fl': Date Property Flagged: L-� (i This is to certify that the information provided is correct to the best of my knowledge. 1 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. 1, also, understand that I am responsible for all charges incurred from this application. 1, 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 the site suitability. DATE — G Z SIGNATURE THIS AREA MAY BE USED FOR DRAWING YOUR SITE PLAN (Include all of the following: Existing and proposed property lines and dimensions, structures, setbacks, and septic locations). Site Revisit Charge Datc(s): Client Notification Date: EHS: Account No. c3 Revised DCHD (07/99) Invoice No. [ ktV VA ri DAVIE COUNTY HEALTH DEPARTMENT Environmental Health Section • Soil/Site Evaluation APPLICANT INFORMATION Account #: 990002232 Billed To: Gary Comatzer Reference Name: Proposed Facility: Residence Property Size: PROPERTY INFORMATION Tax PIN/EH #: 5860-95-1543.04 Subdivision Info: Baltimore Heights Lot # 04 Location/Address: Montclair Drive -27000 �� SEE MAP Date Evaluated: e Water Supply: On -Site Well Community Evaluation By: Auger Boring Pit Public Cut FACTORS 1 2 3 4 5 6 7 Landscape position Slope % HORIZON I DEPTH Texture groupl� Consistence Structure Mineralogy HORIZON II DEPTH c3 r Texture groupC Consistence r i Structure Mineralogy-/ 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:C" LONG-TERM ACCEPTANCE RATE: REMARKS: EVALUATION BY: A/a4z 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 - 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 05/99 (Revised) ME ■EE■■E■EME■■E■■M■■ ■EMME■■MM■■M■■M■■■ ■■■ME■O■■U■■■■M■■ ■■E■EMM■■ ■■M■MM■ ■■EME■M■MMEM■■EME■ ■■E■EMM■MEMM■MEMM■ ■EMEMEM■M■MMM■MEM■ ■E■MEM■MEM■■MMEM■■ ■E■■MEMEMOMMEMME■■ ■■■EM■■■M■■■M■■M■■ ■■■■M■■■■UMM■■■■■ ■MMM■M■O■ ■■M■MM■ ■■■E■■■■■■■■■M■■■■ ■■■M■M■M■MMM■M■M■■ ■■■M■MM■M■ME■■■■■■ ■M■MM■■■■MM■MM■MM■ ■■■■■■■■■■MM■M■MM■ ■M■■■■■M■■MM■■■MM■ ■E■■■■■■■U■■■■■■■ ■■■■■MM■■ ■■M■MM■ ■■■■■■MM■■■M■■■■■■ ■OE■■■■M■■■■E■■■■■ ■■■■■M■■■■■■M■M■■■ ■■■■■■EM■E■■■MMMM■ ■NMN■■■■M■■E■■■M■■ ■■MM■■M■MM■M■■M■■■ ■■NMN■■■MU■■■■■M■ ■■MM■nMMM ■■■■M■■ ■■MMWm%M■MM■■■M■M■ ■■■E■M■E■■E■■■E■E■ ■E■■EME■■■■E■■■■E■ ■E■■MME■■■EM■■EM■■ ■EMMEM■■■MME■■■■E■ ■E■■■OMM■■■E■■E■M■ ■E■M■M■M■ ■EMEM■■ ■ME■■M■M■ ■EMEM■■ ■E■■■E■E■■MM■■■■■■ ■■■■■■■■■■■■■■■■■■■■ ■■■■■■■■■■■■■■■■■■■■ ■■■■■■■■■■■■■■■■■■■■ ■■■■■■■■■■■■■■■■■■■■ ■■■■■■■■■■■■■■■■■■■■ ■■■■■■■■■■■■■■■■■■■■ ■■■■■■■■■■■■■■■■■■■■ ■■■■■■■■■■■■■■■■■■■■ ■■ ■ moon NEON moon ■■M■ ■EM■ MEMO ■■M■ ■E■■ ■■■■E■■WEEE ■EMMEMME■■■ ■EMMMEMEM■■ ■■■■■M■MME■ ■M■MMEMEME■ ■■■E■MO■MO■ ■■MEMO■■■■■ ■MEMM■■M■M■ ■MMEMMEM■M■ ■E■■■M■■E■■ ■E■EO■E■■o■ ■■■■■MEMO■■ ■MMM■■■■M■■ ■E■■■M■■MM■ ■■■MEMO■EO■ ■■■■E■ ■■M■O■ ■■E■E■ ■■■■E■ ■ME■■■ ■ENN■■ ■M■M■■ ■■MEM■ ■■■N■■ ■■M■■■ ■E■■E■M■ ■E■■M■■■ ■EME■■■■ ■■MEMOM■ ■■■OMEM■ ■■EMEME■ ■EMM■■M■ ■■■■M■■■ ■E■■M■E■ ■■■■■■M■ ■E■■MME■ ■E■■■■■■ ■EMEME■■ Jan 29'07 10:50a DANE LAMPLEY 3365956148 p,1 YI X11 /4J V f • V• LMo • Vpr aC Vvy•�� v„�•,�V � V11, 595 • vim v • vv r err D ' TIE COUNTY HEALTH DE?AR7?AE T `� ) t7 � `3) Btvbmnmeatal Hralth &&*ion v� PO Boot "61=0 Hoepiiat Street MockrAHe, NC VW �� JAN 2� 200 Phoar. C.ua7�sx.a�o W TEWATER MTMCAInON FOR DWELLING 0 REMODELING 0 RECONNECTION D LA i0o id rg r :N+mter_33_4_ �'f Mail* Addra• � t�g?_.j'Y10_ NT C 4 A ( R- 0 R L As 7- 1406.4: 0 N (Iz-) Property Address: Z- 44 0 m o AJ r L fti it D (t. R j0VAMC T y 6Z.S,. Z.,7 CSO b Pease Fill in The Following informati m About The $xisting DweUlm Now Says Inatslled Under h' Type Of Ar -,Y D&4 Syst= ItxtsllW(pa cnIh f Dsy/Year);, Number Of Bedr*=w - -3'1- _Number Of People, 3- is Uu DweilingCuna* Vacant? Yrs 0 NO)L If Yom• For How Long? Any Kno” Problems? Yes 0 No K If Yeif &pbdat_— n 1 'Zav 5F 45 OA) Rcc'p n.,04,Vi,vs S17X P? -AA Please Fall in The Following iuibamation About The New Dwelling* 'tjrpa Oi DweWng: _ r ._..�Iwmbt+r of sedroamns;_.._,_ _- Nu=%b..- 0f P p&w Requeated srU, V n4o N"tum) CEI. 33f, 413 For Environmentltl Huth Office Use Oltly Approved)3"'Disapgroved O f he elpdr,g of this form by the EnvirocwwnW I iealth Staff is in no way cmbend4 twr should be W= an a �wuantse(extemded or Rafted) that the wkiftewatnnter MCea: wM: y j2= i+er'Uad ci tt3= Payment Cash 0 chwk 0 Money ( :der 0 p — Ar,wAt: S / — Paid By: _ ed By: Jan,29-07 10:51a D . ANE LAMPLEY,. 3365956I48 P.2 4§9 Roq LAPOLtirS P9 6 3-EcT' Z40' MON-rct-AM'bf- AaVA-r4,cf-..lN-C- 27000 SCALE I' - �* T 14 E, A -Fl P, 0. Boy- I z WALK E (ZT'OtJ-'04f -7 0 S"( DANC LAMPLIFY OFFICE! So' ?MoTe AccE.ss, eA$fr%ejr MorJTCLAI(L D9. iar FAp\i,- . Y 7- ti id i MSK z