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254 Montclair Drive Lot 6Davie County, NC Tax Parcel Report Wednesdav, October 19. 2016 WA"IIN T: THIS 1S NUT A SURVEY Parcel Information Parcel Number: F7120B0006 Township: Shady Grove NCPIN Number: 5870052763 Municipality: Account Number: 82532345 Census Tract: 37059-803 Listed Owner 1: WASHBURN EDWARD R Voting Precinct: WEST SHADY GROVE Mailing Address 1: 254 MONTCLAIR DRIVE Planning Jurisdiction: Davie County City: ADVANCE Zoning Class: DAVIE COUNTY R -A State: NC Zoning Overlay: Zip Code: 27006-0000 Voluntary Ag. District: No Legal Description: LOT 6 BALTIMORE HEIGHTS PHASE 2 Fire Response District: ADVANCE Assessed Acreage: 0.78 Elementary School Zone: SHADY GROVE Deed Date: 10/2010 Middle School Zone: WILLIAM ELLIS Deed Book / Page: 008400302 Soil Types: MrC2,GnB2,PcB2 Plat Book: 0008 Flood Zone: Plat Page: 016 Watershed Overlay: DAVIE COUNTY Building Value: 180920.00 Outbuilding & Extra 14510.00 Freatures Value: Land Value: 36000.00 Total Market Value: 231430.00 Total Assessed Value: 231430.00 Davie County, All data is provided as Is without warranty or guarantee of any Idnd either expressed or implied Including but not limited to the implied warranties of merchantability or fitness for s particular use. All users of Davie County's GIS website shall hold harmless the �o UNC 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. Account #: 990002736 Billed To: David Gordon Reference Name: Proposed Facility: Residence DAVIE COUNTY HEALTH DEPARTMENT Environmental Health Section P. O. Boz 848/210 Hospital Street Mocksville, NC 27028 C (336)751-8760 IMPROVEMENT/OPERATION PERMIT �, i -v 3 Tax PIN/EH #: 5860-95-1543.06DG Subdivision Info: Baltimore Heights Lot # 06 Location/Address: Montclair Drive -27006 Property Size: see map ATC Number: 3587 **NOTE** This Improvement/Operation Permit DOES NOT authorize the construction of 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 141 #People #Bedrooms If -I #Baths cx-?/iZ Dishwasher: X"" Garbage Disposal: ❑ Washing Machine Basement w/Plumbing: ❑ Basement/No Plumbing: ❑ Commercial Specification: Facility Type #People #People/Shift #Seats Industrial Waste: ❑ Lot Size Type Water Supply Design Wastewater Flow (GPD) -'1'4 Site: New' Repair ❑ System Specifications: Tank Sizer GAL. Pump Tank GAL. Trench Width s Rock Depth i�� Linear Ft. yAd or Other: Required Site Modifications/Conditions: IMPROVEMENT/OPERATION PERMIT LAYOUT - APPROVED EFFLUENT FILTER. RISER(S) IF 6 " BELOW FINISHED GRADE. ****NOTICE: Contact a representative of the Davie 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.m. on the day of installation. Telephone # is (336)751-8760.**** Ll 0 /I Environmental Health Specialist's Signature: o/ `ZDate: 1-11il DCHD 05/99 (Revised) ' DAME COUNTY HEALTH DEPARTMENT Environmental Health Section P. O. Boz 848/210 Hospital Street Mocksville, NC 27028 (336)751-8760 Account #: 990002736 Tax PIN/EH #: 5860-95-1543.06DG Billed To: David Gordon Subdivision Info: Baltimore Heights Lot # 06 Reference Name: Location/Address: Montclair Drive -27006 Proposed Facility: Residence Property Size: see map ATC Number: 3587 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 CONSTRU TION IS VALID FOR A PERIOD OF FIVE YEARS. Environmental Health Specialist's Signature: 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 WAY be taken as a gua that the system will function satisfactorily for any given period of time. 7S �0 7t' io s' �DDIi3 ?C/ Y r Septic System Installed By: Environmental Health Specialist's Signature: 64( Date: DCHD 05/99 (Revised) n i Al) TION FOR SITE EVALUATION/IMPROVEMENT PERMIT & ATC L JO3 Davie County Health Department r Environmenta/Hea/th Section EtMRONMENTAL HEALTH P.O. Box 848/210 Hospital Street DAVIECOUNTY Mocksville, NC 27028 (336)751-8760 ***IMPORTANT*** THIS APPLICATION CANNOT BE PROCESSED UNLESS ALL THE REQUIRED INFORMATION IS PROVIDED. Refer to the INFORMATION BULLETIN for instructions. 1. Name to be BilledQ� (j (a L . ( 7 Q'r'C%� Contact Person(ay Mailing Address a (�?j e s r rU� t. C�We Home Phone J^d+� City/State/ZIP �+, U'\ (/V t% t � Business Phone 3 3C, -�J 2. Name on Permit/ATC if Different than Above Mailing Address �( City/State/Zip 3. Application For: ite Evaluation Improvement Permit/ATC ❑ Both 4. System to Service: /////y House ❑ Mobile Home ❑ Business ❑ Industry ❑ Other 5. Type system requested: Mt Conventional ❑ conventional modified ❑ innovative (/ 6. If Residence: # People # Bedrooms_ # Bathrooms 2-/ 2— dishwasher ❑Garbage Disposal 19Washing Machine ❑Basement/Plumbing ❑Basement/No Plumbing 7. If Business/Industry /Other: verify type # People 11 Sinks # Commodes # Showers # Urinals b # Water Coolers IF FOODSERVICE:. ## Seats Estimated Water Usage (gallons per day) 8. Type of water supply: 0 County/City ❑ Well ❑ Community i . 9. Do you anticipate aditions or expansioIls of the facility this system is intended to serve? ❑ Yes MNo it T' If yes, what type? - F ***IMPORTANT#** CLIENTS MUST COMPLETE THE REQUIRED PROPERTY INFORMATION REQUESTED BELOW. Either a PLAT or SITE PLAN MUST BE SU6MITTED by the client with THIS APPLICATION. Property Dimensions: ` (10 X WRITE DIRECTIONS (froin Mo&sville) to PRO41:RTY: Tax Office PIN: # g -le a - i s l 5 L/ 3, . 60���_ (T -c V' �7 Property Address: RoadName IerC (i10 LL-Ld c-aLt city/zip A Auct N c -e o O u If in a Subdivision provide information{, as follows Name: GL it �"1'LC� � � l4 E -C! L-ts Section: .rte Block: Lot:_ Date home corners flagged: 25-- (D This is to certify that the information provided is correct to the best of my knowledge. I understand that any pernlit(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 1 ain responsiblefor all charges incurred from this application. I, hereby, give consent to the Authorized Representative of the Davie County IIealth Deparlmen( 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 _ ( — 2 -Li - ()' ) - SIGNATURE � ) , J �/ ( rN'n 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). tv • Sign given Revised DCHD (05/03 Site Revisit Charge Date(s): Client Notification Date: EHS: Account No. 2z� Invoice No. a F-` APPLICANT INFORMATION Account #: 990002736 Billed To: David Gordon Reference Name: Proposed Facility: Residence Water Supply: On -Site Well DAVIE COUNTY HEALTH DEPARTMENT Environmental Health Section Soil/Site Evaluation Property Size: PROPERTY INFORMATION Tax PIN/EH #: 5860-95-1543.06DG Subdivision Info: Baltimore Heights Lot # 06 Location/Address: Montclair Drive -27006 see map Date Evaluated: Community Evaluation By: Auger Boring Pit Public Cut FACTORS 1 2 3 4 5 6 7 Landscape position Sloe % 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 group Consistence Structure Mineralogy SOIL WETNESS RESTRICTIVE HORIZON SAPROLITE CLASSIFICATION LONG-TERM ACCEPTANCE RATE SITE CLASSIFICATION: LONG-TERM ACCEPTANCE RATE: REMARKS: LEGEND Landscane Position EVALUATION BY: OTHER(S) PRESENT: 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) �ce�- �. APPLICATION FOR SITE EVALUA7IGN/IR 111011BIENI :ERith a /', i Davie County Health Department Environmental Health Section f ff f AM!I P.O. Box 848/210 Hospital Street ` $- ' Mocksville, NC 27028 (336)751-8760 MIVIR0?-'!i:i;:iilhl !f!hCii) Dl1V1[: LIUfd?'�' J T.1 ***IMPORTANT*** THIS APPLICATION CANNOT BE PROCESSED UNLESS ALL THE REQUIRED INFORMATION IS PROVIDED. Refer to the INFORMATION BULLETIN for instructions. 1. Name to be Billed C / 1A• (j�NJA 71` 2� 2 J!,21. Contact Person Mailing Address 3 M o /y •i -c /u •,t Piz Home Phone City/State/ZIP �� � /� N C- � /y, C. 2;7 oD t! Business Phone y C/ � _ T- u 3 1 2. Name on Permit/ATC if Different than Above Mailing Address City/State/Zip 3. Application For: mite Evaluation ❑ Improvement Permit/ATC 1-1 Both 4. System to Service: W,"House U Mobile Home f_I Business fl Industry 1-1 Other 5. If sidence: 41 People # Bedrooms # Bathrooms Dishwasher LI Garbage Disposal ashing Machine LI Basement/Plumbing II Basement/No Plumbing 6. If Business/Industry/Other: Specify type # Commodes # Showers # Urinals # People # Sinks it Water Coolers IF FOODSERVICE: # Seats Estimated Water Usage (gallons per day) 7. Type of water supply: 'er County/City U Well 1.1 Community a. Do you anticipate additions or expansions of the facility this system is intended to serve? ❑ Yes )hNo If yes, what type? 'IMPORTANT*** CLIENTS MUST COMPLETE -THE REQUIRED PROPERTY INFORMATION REQUESTED BELOW. Eithcr a PLAT or SITE PLAN MUST BESUBMITTED by the client with THIS APPLICATION. Property Dimensions: WRITE DIRECI'IONS (from Mocksville) to PROPERTY: Tax Office IN: # " S V3 Property Address: Road Name IKOr�k- Ur ✓ I City/Zip _ 4dd• 2 loo L If in a Subdivision provide information, as follows: Name: I12 -A i>` Section: Block: Lot: Date Property Flagged: 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 ant 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 to conduct all testing procedures as necessary to determine the site suitability. DATE G 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). r Revised DCHD (07/99) Site Revisit Charge Datc(s Client Notification Date: EHS: Account No. 2�� �— Invoice No. DAVIE COUNTY HEALTH DEPARTMENT Environmental Health Section Soil/Site Evaluation APPLICANT INFORMATION Account M 990002232 Billed To: Guy Comatzer Reference Name: Proposed Facility: Residence Water Supply: Evaluation By: PROPERTY INFORMATION Tax PIN/EH #: 5860-95-1543.06 Subdivision Info: Baltimore Heights Lot # 06 Location/Address: Montclair Drive -27006 Property Size: see map Date Evaluated: 7' ;_ On -Site Well Community Auger Boring Pit L/ Public LI -11 Cut FACTORS 1 2 3 4 5 6 7 Landscape position ,L Slope % HORIZON I DEPTH Texture group Consistence Structure Mineralogy HORIZON II DEPTH Texture groupG Consistence Structure , Mineralogyl 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: fIV LONG-TERM ACCEPTANCE RATE: REMARKS: LEGEND Landscape Position EVALUATION BY: OTHER(S) PRESENT: 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 - 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GIS/Mapping System Page 1 of 1 Zoom To Scale: GO Click Here To Start Over '--•, Quick Search:(County ID or Owner Name) Ci0 f ` .� Active Layer. r Use f+fap Tips 01119`` Map Layers I Tools I Help I Links• ; ' F, ----Select Layer- ---------] ZI Address/Name/Parcel Search I Results http://maps.co.davie.nc.us/GoMaps/map/mapframe.cfm?CFID=50956&CFTOKEN=94315220 5/29/2009