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292 Montclair Drive Lot 11Davie County, NC t Tax Parcel Report Thursday, October 20, 2016 WAR-NING':THIS 1S NOTA SURVEY T ]i 1• 1 "I%.\:1 irliui11 ULAiL. ParccI ;I;.Imbcr: F712000011 To -, ishir: Shady Grove NCPIN Number: 5870062282 Municipality: Account Number: 82531458 Census Tract: 37059-803 Listed O,•-nncr 1: t."ORRISON PAUL V Voting Prccinct: WEST SHADY GROVE Mailing Address 1: 292 MONTCLAIR DR 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 11 BALTIMORE HEIGHT S PHASE 2 Fire Response District: ADVANCE Assessed Acreage: 0.78 Elementary School Zone: SHADY GROVE Deed Date: 612005 Middle School Zone: WILLIAM ELLIS Deed Goon 1 Page: 006)11020.1 Soil Types: MrC2 Plat Book: 0008 Flood Zone: Plat Page: 016 Watershed Overlay: DAVIE COUNTY Building 4cIu^: 191010.00 Ou46i!dm- &. Extra turesFreaValue: 8100.00 Land VaIu:: 36000.00 Total r!,zr ct Valun-: 235110.00 Total Assessed Value: 235110.00 t,6) rt, F"- � G' E0 ...� t., i Davie County, I I All data is provided as Is without warranty or guarantee of any kind either expressed or Implied including but not limited to the implied warranties of merchantability or fitness for a particular use. All users of Davie County's GIS website shall hold harmless the County of Ca,,ie, North C1: CI: i:_, its dgen;.5, COI15liu.:S1t5, contractors or employees from aily and 3:: c1a m6 or C3u ez cf ac:iuli du_ to Pp� �4 NC or arising out of the use or inability to use the GIS data provided by this website. — .,.III a DAVIE COUNTY HEALTH DEPARTMENT ,3 Environmental Health Section • P. O. Boz 848/210 Hospital Street Mocksville, NC 27028 2.1 /0 (336)751-8760 / IMPROVEMENT/OPERATION PERMIT Account #: 990002736 Tax PIN/EH #: 5870-06-2282 Billed To: David Gordon Subdivision Info: Baltimore Heights Lot # 11 Reference Name: Location/Address: Montclair Drive -27006 Proposed Facility Residence Property Size: 100x 365 **NO"I E * ThIs�mprovement/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 _ #Baths Dishwasher: 25" Garbage Disposal: ❑ Washing Machine: e 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) Site: New En Repair ❑ System Specifications: Tank Siz GAL. Pump Tank GAL. Trench Width � Rock Depth "'r -""Linear A. -W Other: RPnmrPA Qita MnAiiirratinnc/rnnrlitinnc- IMPROVEMENT/OPERATION PERMIT LAYOUT - AP"V,FFLUENT FILTER RISER(S) IF 6 " BELOW FINISHED GRADE. ****NOTICE: Contact a representa Ke of a Wavie 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: p.m n ti/day of installation. Telephone # is (336)751-8760.**** Environmental Health Specialist's Signature: DCHD 05/99 (Revised) 9� Date: Account #: 990002736 Billed To: David Gordon Reference Name: ATC Number: 3784 DAVIE COUNTY HEALTH DEPARTMENT Environmental Health Section P. O. Boz 848/210 Hospital Street Mocksville, NC 27028 (336)751-8760 Tax PIN/EH #: 5870-06-2282 Subdivision Info: Baltimore Heights Lot # 11 Location/Address: Montclair Drive -27006 AUTHORIZATION FOR WASTEWATER SYSTEM CONSTRUCTION 140.4- ATC ` **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 77� CTION IS VALID FOR A PERIOD OF FIVE YEARS. t Environmental Health Specialist's Signature: Date: � CERTIFICATE OF COMPLETION **NOTE** The issuance of this Certificate ofCompleti has been installed in compliance with Artic Disposal Systems," but shall in NO WAY b given period of time. Septic System Installed By: 7T on Improvement/Operation Permit 900 "Sewage Treatment and will function satisfactorily for any 1,� J Environmental Health Specialist's Signature: Date: DCHD 05/99 (Revised) CATION FOR SITE EVALUATION/IMPROVEMENT PERMIT & ATC Davie County Health Department Environmental Health Section ��111 �4�i='► P.O. Box 848/210 Hospital Street 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 Billed t Go rAoV---*) Contact Person Mailing Address -o- �y / Q ((( J e e r r' u t-) LU( ►ti `e Home Phone 3 �/� L K.L�1 -3 0 Z Vp City/State/ZIP Va (J` � � /�,% ✓[ "Ce W.C, Z 7 Q Business Phone 3 2. Name on Permit/ATC if Different than Above Mailing Address City/State/Zip 3. Application For: ❑ Site Evaluation LI Improvement Permit/ATC ❑ Both 4. System to Service: `QI House ❑ Mobile Home ❑ Business ❑ Industry ❑ Other 5. Type system requested: ❑ Conventional ❑ conventional modified ❑ innovative 6. If Residence: # People # Bedrooms # Bathrooms @Dishwasher ❑Garbage Disposal 11MWashing Machine ❑Basement/Plumbing ❑Basement/No Plumbing 7. If Business/Industry /Other: verify type # People # Sinks # Commodes # Showers # Urinals # Water Coolers IF FOODSERVICE: # Seats Estimated Water Usage (gallons per day) 8. Type of water supply: County/City ❑ Well ❑ Community 9. Do you anticipate additions or expansions of the facility this system is intended to serve? ❑ Yes ��o 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: 100 X 36 WRITE DIRECTIONS (from Nlo&sville) to PROPERTY: Tax Office PIN:.. tF :7 0 0 G 2 113 2— Property Address: Road Name u 0 o e cu y— City/Zip C-7 V a YJ C e If in a Subdivision provide information, as follows: Name: tcz I�� im d I� (Q S1 Section: Block: Lot: Date home corners flagged: S'' (�' 0,j 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 ani 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. A 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). c C 7 Sign given IVJ Revised DCI -ID (05/03 Site Revisit Charge Date(s): Client Notification Date: EHS: Account No. A-7 3 Invoice No. Zg O ***IMPORTANT*** THIS APPLICATION CANNOT BE PROCESSED UNLESS ALL THE REQUIRED INFORMATION IS Pt to the INFORMATION BULLETIN for instructions. 1. Name to be Billed / t� y / d e N.? --1 Z -e 2. J!2, Contact Person 6 I y Mailing Address APPLI(,AT1UN f()it SITE IAALUA-JiGN/iliiN10VEitiENI PER&II :f is I • �`' City/State/ZIP Davie County Health Department Environmental Health Section All L. 2,7 UG'y Business Phone P.O. Box 848/210 Hospital Street'' AM -8 Mocksville, NC 27028 (336) 751-8760 EfdVIFQi::':01' _ - DAME C191IPl411.kLTii ***IMPORTANT*** THIS APPLICATION CANNOT BE PROCESSED UNLESS ALL THE REQUIRED INFORMATION IS PROVIDEDD. Refer to the INFORMATION BULLETIN for instructions. 1. Name to be Billed / t� y / d e N.? --1 Z -e 2. J!2, Contact Person 6 I y Mailing Address 0 93 /I'1 o ,v -,L . a A -z Home Phone City/State/ZIP All L. 2,7 UG'y Business Phone 2. Name on Permit/ATC if Different than Above Mailing Address City/State/Zip 3. Application For: a Site Evaluation ❑ Improvement Permit/ATC Il Both 4. System to Service: "ouse ❑ Mobile Home ❑ Business f.] Industry IJ Other 5. If sidence: # People a Bedrooms _ # Bathrooms Dishwasher LI Garbage Disposal UZhimg Machine LI Basement/Plumbing II Basement/No Plumbing 6. If Business/Industry/Other: Specify type # Commodes # Showers # Urinals # People # Sinks D Water Coolers IF FOODSERVICE: # Seats Estimated Water Usage (gallons per day) 7. Type of water supply: e-County/City U Well I Community 8. Do you anticipate additions or expansions of the facility this system is intended to serve? ❑ Yes )�No If yes, what type? ***IMPORTANT*** CLIENTS MUST COMPLETE THE REQUIRED PROPERTY INFORMATION REQUESTED BELOW. Eitber a PLAT or SITE PLAN MUST BESUB3,UTTED by tike client with THIS APPLICATION. Property Dimensions: Tax OfficeIN: # Property Address: Road NameDYzrJc-(ut-- Dr,✓� City/Zip A41, 2,7,,06 If in a Subdivision provide information, as follows: Name: �. l 0, e --el Section: Block: Lot: WRITE DIRECTIONS (from Mocksville) to PROPERTI': Date Property Flagged: w t i { l"� �� Q (,.C. 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 aur responsible for all charges incurred from this application. 1, hereby, give consent to the Authorized Representative of the Davie County Hcalth 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). Revised DCHD (07/99) 1 Site Revisit Charge Date(s): Client Notification Date: EHS: Account No. �" -3 Invoice No. 6 O DAVIE COUNTY HEALTH DEPARTMENT Environmental Health Section Soil/Site Evaluation APPLICANT INFORMATION PROPERTY INFORMATION Account #: 990002232 Tax PIN/EH #: 5860-95-1543.11 Billed To: Guy Comatzer Subdivision Info: Baltimore Heights Lot # 11 Reference Name: Location/Address: Montclair Drive -27006 Proposed Facility: Residence Property Size: see map Date Evaluated: Water Supply: On -Site Well Community Evaluation By: Auger Boring Pit 1/ Public !/ Cut FACTORS 12 3 4 5 6 7 Landscape position �— Slope % 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 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 - S(suitable), PS (provisionally suitable), U(unsuitable) LTAR - Long-term acceptance rate - gal/day/ft2 DCHD 05/99 (Revised) ■ ■ on .0 ■■ mom ■M■ ■E■ ■E■■■■■■■■■■■E■■■ ■■■■s■■■■■■MCE■E■ ■M■OWMEME■■REAME■ ■E■E■ ■SE■IGMUNM■E■ ■MEMO■EMEAIUMME■■■ ■■■■O■7f111l1■■■MEM■ ■■■mmumoz-A■■■■■E■ ■■EMIIIL' ■■II■/M ■■lloo■ ■■NAM■ ■■■■■■ ■■■■E■ ■■O■■■ ■■■■■■ ■■■■■■ ■■■■■■ ■■■■■EE■M■MME■M■■ ■■■■■■EM■■E■■■■■■ ■M■■■EM■■■ESE■■■■ ■■M■■ME■■■■ME■E■■ ■■SMO■■■■■■■■■■■■ ■■t■■■■MMMMEMMEM■ ■■E■■E■■ME■■E■■■■ Ott■■Et■■■■■■■■■■ ■■■■■E■■■■■■■■■■■ ■tM■■E■ME■Et■■M■■ ■■■■■M■■t■■M■EEM■ ■■E■■■■■E■ME■■■M■ ■t■■■■■■E■■■■■■■■ U\■■■■■■E■■■■E■■■ ■\\■■■■■M■M■■■M■■ ■M\1■■■■■■■■■■■■M■ ■■O■■■■■■■SSS■■M■ ■UMEMEM■U■■E■E■ ■■■■■■ ■■■■■1■■■■■o\■■■■ ■■■■■■■■■■■■1\■■■ ■■■MESE■■■■OMENOM ■■tttt■■■■■■■■Ma■ ■■■■■■■■MM■■■■t■a ■■■■■■E■E■■EE■■■■ ■■■■■■■■EE■EM■■■■ ■■■■EEE■■■■■E■t■■ ■■t■■E■■■■■■■■E■■ ■■■■■Et■■■■EM■E■■ ■■E■■■■■■■E■E■■■■ ■■M■■■■■M■■ME■■t■ ■■■■■MM■■■M■■EEM■ ■■■■■E■■E■Et■M■M■ ■■M■■■E■E■E■■M■E■ ■M■■M■■M■■■■■■■■■ ■M■■M■MM■■E■OM■■■ ■tete■■■■■■■■■■■■ ■OMM■■E■■OMM■■M■■ ■E■M■■M■ME■EME■■■ ■■■MEMS■E■■■M■M■■ ■■E■■M■■ME■EME■■■ ■■■■■M■■M■■■■■MM■ ■MEM■■■ME■■■■MO■■ ■■E■■■■M■■E■■EMM■ ■■■■■■MME■■■■■■■■■■��■■■■■■■■■ ■Fart■■■■E■■EEt■E�M■EE■Ee■■E■ ■■■■■■Ott/�■■■■■■■■■■■■■■■■■■ ■■■■■■■IIS■■Ott■■■■t■■■■■■■■■ Ott■��■■■E■■eEEMEE■■EEtt■■■■■ ■E■E��■EE■■■■■■■■■■Ott■■tet■■■ ■E■■1�■tE■tE■ttt■EttttEEttE■t■ ■E■tE►�Et■■tE■t■■Ott■■Ett■■■■■ Ott■■■�lE■tE■t■■■■■■■E■■t■t■■■ ■■■■■■�■■■■■■■■Ott■■EEEE■■■t■ ■■■■Ori■■■■■■■■■t■■■■■■■■■■■■■ ■t■■i■t■■tt■tE■E■■■■Eta■■■et■ ■■i■■eM■■■■■■■■■E■■t■■■■■Ott■ ��tt■E■E■■M■■■■Ott■■Etttt■■EM■ ■■■■■■■■■■■Ott■■■■■■■■■■■■■■■ ■■■■■■■■■■■■■■■■■■■■■Ott■■■■■ %NOOSE iMENNENMEMNONMENEM ■■■■■■■■■■E■■Ott■■■■■■■■■tet■ ■■■■■■■■■■■■■■■■■■■■■■■■■■■■■ ■■■■■■■■■Ott■■t■■■■e■■■E■■■■■ ■Ettt■■■Ott■■■■■■■■■■■■■■■■■■ ■■■■■■■■■■■■■■■■■■■■■■■■■■■■■ ■■■■■■■■■■Enema■■■■■■■■■■■■■■■ ■■EE■■■■■■■■r■Et■■Ott■■■■■■■■ ■■■■■■■■■■■■■■■■■■■■■■■■■■■■■ ■■■■■■■■■■■■■■■■■■■■■■■■■■■■■ Ott■■■■■■■■■■■■■■■■■■■■■■■■■■ ■■■■■■■■■■■■■■■■■■■■■■■■■■■■■ ■■■■■■■■■■■■■■■■■■■■■■■■■■■■■ ■■■■■■■■■■■■■■■■■■■■■■■■■■■■■ ■■■■■■■■■■■■■■■■■■tet■■■■■■■■ ■■■■■ ■■ ■■ ■■■■■■■■■■■■■ ■■■■ ■■■■ ■■■■■■■■■■■■ ■■■■■■■■■ ■ ■■■■■■■■■ ■■■■■■■■■■ ■■ ■■■■ ■■■■■■■■■■■■■■■■■■■■■■■■■■■ ■■■■■■■■■■■■■■■■■■■■ ■■■■ ■■■■■ ■■■■■■■■■■■■■■■■■■ ■■■■ ■ ■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■ ■■■■ ■ ■■■■■■■■■■■■■■■■■■■■ ■■ ■■■■ ■■■■■■■■■■■■■■■■■■■ ■■■■■