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160 Bentbrook Drive Lot 19 & P/O 18Davie County, NC .- ; Tax Parcel Report Thursday, October 20, 2016 183 195 - 1 f 204 1 �O I lI \. 102 f' 160 - 114 126 <0' OC) _--kD{� 182 f 180- ,f `4 163 r' -�� 1 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: WARNING: THIS IS NOT A SURVEY Parcel Information G8060A0019 Township: Shady Grove 5880009987 Municipality: 8302062 Census Tract: 37059-804 JONES CLYDE L & MARY NELL S Voting Precinct: EAST SHADY GROVE 889 Underpass Road Planning Jurisdiction: Davie County ADVANCE Zoning Class: DAVIE COUNTY R-A,R-20 NC Zoning Overlay: 27006 Voluntary Ag. District: No LOT 19 + P/O 18 BENTROOK Fire Response District: ADVANCE Building Value: Land Value: Total Assessed Value: 1.51 Elementary School Zone: SHADY GROVE 3/2013 Middle School Zone: WILLIAM ELLIS 009201046 Soil Types: WeC,WeB,PcB2 0006 Flood Zone: 112 Watershed Overlay: DAVIE COUNTY 178010.00 Outbuilding & Extra 4800.00 Freatures Value: 40000.00 Total Market Value: 222810.00 222810.00 9tt� All data Is provided as Is without warranty or guarantee of any Idnd either expressed or Implied Including but not limited to the s i Davie County, III Implied warranties of merchantability or fitness for a particular use. All users of Davie County's GIS website shall hold harmless the ; County of Davie, North Carolina, its agents, consultants, contractors or employees from any and all claims or causes of action due to j �DUNi'� I NC I or arising out of the use or inability to use the GIS data provided by this website. rao cr& 3 DAVIE COUNTY HEALTH DEPARTMENT Environmental Health Section Account #: 989900195 Billed To: Richard Poindexter Reference Name: Proposed Facility: RESIDENCE ATC Number: 2513 P. O. Boz 848/210 Hospital Street MocksAlle, NC 27028 (336)751-8760 Tax PIN/EH #: 5880-00-9987.19 Subdivision Info: Bentbrook 1 Lot # 19 Location/Address: Bentbrook Drive -27006 Property Size: 1.55 ACRES 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 CONS RUCTION IS VALID FOR A PERIOD OF FIVE YEARS. Environmental Health Specialist's Signature:Date:-ey��O— 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 guarantee that the system will function satisfactorily for any given period of time. ---� Septic System Installed By: Environmental Health Specialist's Signature : DCHD 05/99 (Revised) 70 Date: -,? "d.2 "4ep DAVIE COUNTY HEALTH DEPARTMENT od -�/- Environmental Health Section CK P. O. Boz 848/210 Hospital Street Mocksville, NC 27028 (336)751-8760 IMPROVEMENT/OPERATION PERMIT Account #: 989900195 Tax PIN/EH #: 5880-00-9987.19 Billed To: Richard Poindexter Subdivision Info: Bentbrook 1 Lot # 19 Reference Name: Location/Address: Bentbrook Drive -27006 Proposed Facility: RESIDENCE Property Size: 1.55 ACRES ATC Number: 2513 **NOTE** This Improvement/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: e Garbage Disposal: ❑ Washing Machine: Ir Basement w/Plumbing: ❑ Basement/No Plumbing: 0 Commercial Specification: Facility Type #People #People/Shift 1#Seats Industrial Waste: 0 Lot Size /4 6 Type Water Supply �� Design Wastewater Flow (GPD) 7 gd Site: New Repair El System Specifications: Tank Size/an GAL. Pump Tank Other: Required Site Modifications/Conditions: GAL. Trench Width i,?Z� "Rock Depth /g Linear Ft D� 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.**** Environmental Health Specialist's DCHD 05/99 (Revised) Date: N 406 + R M APPLICATION FOR SITE EVALUATION/IMPROVEMENT PERMIT & ATC d Davie County Health Department Envlmnmental Healtfi Section a 2 5 2000 J P.O. Box 848/210 Hospital Street I Mocksville NC 27028 / E"'IRRWNTA1 H, m ee� 1io�i-S-� (336) 751-8760 DAVIE COUNTY ***51P00RTANT*** THIS APPLICATION CANNOT BE PROCESSED UNLESS ALL THE REQUIRED INFORMATION IS PROVIDED. Refer to theINFORMATIONBULLETIN for instructions. 1. Name to be Billed Contact Person Mailing Address City/state/ZIP /6z '7006 Bone Phone Business Phone 9119� -4;?4915�a 2. Name on Permit/ATC it Different than Above Mailing Address City/state/Zip 3. Application For: 0 Site Evaluation Improvement Permit/ATC ❑ Both 4. System to service: 0 House ❑ Mobile Home 0 Business 0 Industry ❑ Other S. If Residence: # People # Bedrooms � # Bathrooms —72 %S Dishwasher n Garbage Disposal .01 washing Machine S. If Business/industry/Other: specify type ❑ Basement/Plumbing icr Basament/No Plumbing # People # sinks # Cosmodes # $homers # Urinals # Rater Coolers IF FOODSERVICE: g Seats Estimated Nater Usage (gallons per day) 7. Type of water supply: 'County/City ❑ well 0 Community e. Do you anticipate additions or expansions of the facility this system Is intended to serve? ❑ Yes )[rNo 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. C� Property Dimensions: J -J er t. -e-3" WRITE DIRECTIONS (from Mocksville) to PROPERTY: Tax Office PIN: # > 5�0-06J? % 0- 7 e Property Address: Road Nam 606 , he d �— City/Zip n71?,i7�d�f �r O �.'%% 16 0,q Y,�+ -A), If in a Subdivision provide ini"ormation as toll Name:�P✓r�1—y�/� Section: Block: l Lot:�gT �� Date Property Flagged: .ii 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 1, also, understand that I am 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 suitpb DATE �-' o�.> �� SIGNATURE `� THIS AREA MAY BE USED FOR DRAWING YOUR SITE PLAN (Inc a all of the following: Existing and proposed property lines and dimensions, structures, setbacks, and septic locations). Site Revisit Charge Date(s): I Client Notification Date: EHS: Revised DCHD (07/99) Account No. Invoice No. b ��L 1. APPLICATION FOR SITE EVALUATION/IMPROVEMENTS PERMIT Davie County Health Department Z; Environmental Health Section P. 0. Box 665 Mocksville, NC 27028 2. Name on Permit if Different than Above Business Phone 3. Application for.General Evaluation ❑ Septic Tank Installation Permit 4. System to Serve: Z Houses ❑ Mobile Home ❑ Place of Public Assembly ❑ Business ❑ dustry O Other ❑ Unknown 1p 5. If house, mobile home: Subdivision 4--o Section Lot # No. of People No. of Bedrooms No. of Bathrooms Dwelling Dimensions 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 ❑ Basement/Plumbing ❑ Basement/No Plumbing O Washing Machine O Dishwasher ❑ Garbage Disposal No. of Showers Water Usage Figures 7. Type of water supply: ❑ Publlc ❑ Private ❑ Community 8. Property Dimensions __,% ~e2�� Sewage Disposal Contractor 9. Do you anticipate additions/expansion of the facility this sytem is intended to serve? O 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. Directions to Property: This is to certify that the information provided is correct to the best of my knowledge, and I understand I am responsible for all charges Incurred from this application. DATE MUST CHECK ONE: ❑ 1. 1 OWN the property. ❑ 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 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. DATE WHO (IBM SIGNATURE DAVIE COUNTY HEALTH DEPARTMENT Environmental Health Section q� Soil/Site Evaluation NAME //�>/�7c �� , 4�Y��� DATE EVALUATED ADDRESS PROPERTY SIZE %/�� PROPOSED FACIILTY 40111 LOCATION OF SITE Water Supply: On -Site Well Community Public L--'*' Evaluation By: Auger Boring Pit Cut FACTORS 1 2 3 4 Landscape position L L Slope % -.511-� HORIZON I DEPTH Texture group Consistence Structure Mineralogy HORIZON II DEPTH l r 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 3 SITE CLASSIFICATION: '��r EVALUATED BY:::��� LONG-TERM ACCEPTANCE RAXE REMARKS: �t r DCHD(01-901 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 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 ' ff DAVIE COUNTY HEALTH DEPARTMENT Environmental Health Section Soil/Site Evaluation NAME .))/v�,,�" i✓"✓ ADDRESS PROPOSED FACIILTY ,/�`l // _< 1 DATE EVALUATED //- �f 2 3 4 PROPERTY SIZE %G LOCATION OF SITE Sloe Z Water Supply: On -Site Well Community Public L-.-' Evaluation By: Auger Boring Pit Cut FACTORS 1 2 3 4 Landscape position L Sloe Z G> HORIZON I DEPTH Texture group Consistence Structure Mineralogy HORIZON II DEPTH f �� Texture group Consistence i Structure ,c_ -5-;41( Mineralogy HORIZON III DEPTH Texture group Consistence Structure Mineralogy HORIZON IV DEPTH Texture group Consistence Structure MineraloEy SOIL WETNESS RESTRICTIVE HORIZON SAPROLITE CLASSIFICATION LONG-TERM ACCEPTANCE RATE SITE CLASSIFICATION: /1Y EVALUATED BY: LONG-TERM ACCEPTANCE RATE: i- OTHER(S) PRESENT: REMARKS: ��7 / t rn-r-5- KI �li �r��� ^/-5 cc/7/JGi �N S' LEGEND Landscape Position �111�✓il�r'` R -Ridge S -Shoulder L -Linear slope FS-Footslope 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 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 DCHD (01-901 v•ti vV • „ 80 3v.. 470.00' 230.16! 4' N / C4 s 239.8, R?e / ^� • w 1.0 0 ' U, .. 1.0241 ACRES . o h s sR 1.8296 ACRES c21/ �,•_ cs C2 �cj�o a ,y,�y•XJ! l.7 f ���� /OQ� C20' �^V +• . `• . .. eco✓ /.C24 1.6120 AC R ES e •�` ,C2507 1 c > �� �� Z Nry / h •,y� 1.6125 ACRES �-3 1:0108 `ACRES:` �; `:,; ": •� / �� 5 / .� 20'j' DRAINAGE EASEMENT 10''EACIj SIDE OF .CREEK 1.13533. ACRES �C2 .c� r.a,��•{ 0� obi ,ocp -'-'Sro �o, 1.0100 ACRES 4 cb 100, 70. \ �yre0(20• 6 .09;,. \�o 1.0001 ACRES 0 Pi /C8 C10\ C9 C15 Cie cb aid" y �. ta Ln 1e �' o smN ry J 1.6723 ACRES 1.2525 ACRES 1.0001 ACRES . N ---40.21196.68' 193.04' 30.59 r N'87-21'51 "W 88 .6T 147.62'' , EASEMENT oft .,U"t,," PtADIUS TANGENT DELTA CHORD C BH ERRING -' N 86025'09 11 , P. , C 1ar.; `"60.00' 21.54' 39°29'56" 40.55' N 74°23'28"E CURVE RADIUS TANGENT DELTA`.' CHORD- i ,30.00' 13.42' 48011'23" 24.49' N 70002'44"E :.• lC"14�� CQ 5 2,' '20.00' 9.61' 51°19'04" 17.32' S 18°36'35"W C-24 60.00 34.84 •` +1' 60 .16 56.. 60. 1 R +^:330.00' CC 7Ap'l.ti270.00' "`., 15.39' 10.31' 5020'25" 4°22'20" 30.75' 20.60' S 04"22'45"E N 04°51'47"W . C-25 30.00' 13.42' 48'11'2.3" 21'32'15" 24, 14 �t., C-26 381.36' 72.53' 20.00' 9.61' 51019'04" 17.32' N 32042'29"W C-27 20.00' 20.00• ..;: :'90°00'00": 28 321.36' 61.12' 21032'15" 120.09' N 35°10'55"E C-28 470.00. 83.89 +;.;' o_ " X20 14 24. 165. C-=20.1 t.',": 30.00' 13.42' 48011'23" 24.49' N 00°19'06"E C-29 330.00 ' 73.86' . ' 25.13'55" 1'44, 60.00' 98.30' 117°12'04" 102.43' N 34°49'26E C-30 20.00' 18.37 85.08'46" 27.G C-22:`' •. ,. 60.00' 34.26' 59026'46" 59.50' S 56°51'09"E C-23 ;" 60.00' 21.51 39°27'00" 40.50' S 07°24'16"E Davie C onnty_ NC: Tax Pnrnel R Pnnrt Thnrcrlav (lrtnhar 7n 11111A Parcel Information Parcel Number: G8060A0019 Township: Shady Grove NCPIN Number: 5880009987 Municipality: Account Number: 8302062 Census Tract: 37059-804 Listed Owner 1: JONES CLYDE L & MARY NELL S Voting Precinct: EAST SHADY GROVE Mailing Address 1: 889 Underpass Road Planning Jurisdiction: Davie County City: ADVANCE Zoning Class: DAVIE COUNTY R -A R-20 State: NC Zoning Overlay: Zip Code: 27006 Voluntary Ag. District: No Legal Description: LOT 19 + P/O 18 BENTROOK Fire Response District: ADVANCE Assessed Acreage: 1.51 Elementary School Zone: SHADY GROVE Deed Date: 3/2013 Middle School Zone: WILLIAM ELLIS Deed Book / Page: 009201046 Soil Types: WeC,WeB,PcB2 Plat Book: 0006 Flood Zone: Plat Page: 112 Watershed Overlay: DAVIE COUNTY Building Value: 178010.00 Outbuilding & Extra Freatures Value: 4800.00 Land Value: 40000.00 Total Market Value: 222810.00 Total Assessed Value: 222810.00 9 Pw rl�, All data Is provided as Is without warranty or guarantee of any Mnd 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 County of Davie, North Carolina, Its agents, consultants, contractors or employees from any and all claims or causes of action due to r'Op tyS'ti NC or arising out of the use or Inability to use the GIS data provided by this website. 1. r APPLICATION FOR SITE EVALUATION/IMPROVEMENTS PERMIT Davie County Health Department Environmental Health Section P. O. Box 665 Mocksville, NC 27028 Mailing Address 2. Name on Permit If Different than Above Business Phone 3. Application for. General Evaluation O Septic Tank Installation Permit 4. System to Serve: j Houses ❑ Mobile Home ❑ Place of Public Assembly ❑ Business ❑J(�dustryy / ❑ Other El Unknown 5. If house, mobile home: Subdivision``- �h / ,100 Section Lot # No. of People No. of Bedrooms No. of Bathrooms ❑ BasemenUPlumbing ❑ Basement/No Plumbing ❑ Washing Machine ❑ 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 Showers 7. Type of water supply: 0 Public No. of Sinks No. of Urinals No. of Water Coolers Water Usage Figures ❑ Private 8. Property Dimensions _ -z2a� Sewage Disposal Contractor 9. Do you anticipate additions/expansion of the facility this sytem is intended to serve? ❑ Yes ❑ No If yes, what type? ❑ 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 best of my knowledge, and I understand I am responsible for all charges Incurred from this application. DATE MUST CHECK ONE: ❑ 1. 1 OWN the property. ❑ 2. 1 DQ_ 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. DATE SIGNATURE DCHD (11P DAVIE COUNTY HEALTH DEPARTMENT Environmental Health Section ' Soil/Site Evaluation NAME 4 , .�7 t�,V l'C✓ ADDRESS PROPOSED FACIILTY A4 &_� 1, Lo� /y DATE EVALUATED ��` Community PROPERTY SIZE zliG LOCATION OF SITE Pit Z__� Water Supply: On -Site Well Community Public L ---- Evaluation By: Auger Boring Pit Z__� Cut FACTORS 1 2 3 4 Landscape position L Slope % HORIZON I DEPTH Texture group Consistence Structure Mineralogy HORIZON II DEPTH Texture group Consistence 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: A— EVALUATED BY: 14 /// LONG-TERM A�CnCEETANCE RATE: i OTHER(S) PRESENT: REMARKS: /G�7 /It^lilS 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(01-901