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208 Bentbrook Drive Lot 15I)avic Countv. NC P Tax Parcel Rennrt Thursday. October 20, 2016 Parcel Number: NICPlry Number: Account Number: Listed Owner 1: Mailing Address 1: City: State: Zip Cod,: Legal Description: Assessed Acreage: Dc -^d Date: Deed Book / Page: Plat Book: Plat Page. Building Value: arr1 In fon i-intion G806OA0015 Township: 5860111510 r0unicipality: 82532303 Census Tract: ROMINGER DENNA H Voting Precinct: 2013 BENTBROOK DRIVE Punning Jurisdiction: ADVANCE Zonina Class: Land Value: Total Assessed Value: NC Zoning Overlay: 27005-0000 Voluntary Ag. District: LOT 15 BENTBROOK Fire Response District: 0.98 Elementary School Zone: 10,2010 r iddl: School Z onc: 008390104 Soil Types: 0006 Flood Zone: 112 VvIatershed Overlay: 180420.00 Outbuil-ding & Extra Freatures Value: 40000.00 Total Market Value: 229260.00 Shady Grove 37059-804 EAST SHADY GROVE Davie County DAVIE COUNTY R-20 ADVANCE SHADY GROVE %MLLIA'14 ELLIS WeB DAVIE COUNTY 8840.00 229260.00 PY y w i Me All data is provided as is without warranty or guarantee of any kind either expressed or implied including but not limited to the DT Ci avie County, ty� implied warranties of rn-rhantabi{ity or fitness for a particular use. All users of Davie County's GIS wehs0 shall hold harmless the rY.L T?T r County of Davie, North Carolina, its agents, consultants, contractors or employees from any and all claims or causes of action due to OUN1 ; I �' ' or arising out of the use or inebiiity to use the GIS data provided by this website. I V/ DAVIE COUNTY ENVIRONMENTAL HEALTH SECTION WORKSHEET FOR SEPTIC SYSTEM REPAIR PERMIT NAME effi c-� < �•`n��4G/`� PHONE NUMBER ADDRESS �Un�� pl'<y c SUBDIVISION NAME SUBDIVISION LOT # /15— DIRECTIONS TO SITE DATE SYSTEM INSTALLED ,p NAME SYSTEM INSTALLED UNDER /� �Gh SPECIFY PRO Cl/e PROBLEMS OCCURRING� / DATE REQUESTED y' %tiy ItS O/'' NFORMATION TAKEN BY /�Y'/ x' 4 -,4i. DAME COUNTY HEALTH DEPARTMENT IMPROVEMENT AND OPERATION PERMITS PROPERTY INFORMATION Permlttee's Name �J�=` /.�l � Y Subdivision Name: --49& fe Directions to property: f� _'-7.rr r, Section: F'� Lot: s IMPROVEMENT ° l + � ' I ; #: _ 1` r"`. /;' r , i PERMIT Tax Office PIN:# Road Name. -) � e., t t _ `,'..Zi ✓� ,� t •, . **NOTE** This Improvement Permit DOES NOT authorize the construction or installation 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) r - '""`"`IVU11UE** -1'ti1JYr:HM11 0bU1$JhU1'lU1ir:VUUA11U1N1k bilk PLANS OR THE INTENDED USE CHANGE. YOUR WASTEWATER ENVIRONMENTAL HEALTH -SPECIALIST DATE ISSUED SYSTEM CONTRACTOR MUST SEE THIS PERMIT BEFORE INSTALLING THE SYSTEM. RESIDENTIAL SPECIFICATION: BUILDING TYPE; f r # BEDROOMS � # BATHS.,* # OCCUPANTS GARBAGE DISPOSAL: Yes or No COMMERCIAL SPECIFICATION: FACILITY TYPE # PEOPLE # PEOPLE/SHIFT # SEATS INDUSTRIAL WASTE: Yes or No LOT SIZE .f�;'C TYPE WATER SUPPLY DESIGN WASTEWATER FLOW (GPD) Fel-d NEW SITE REPAIR srm SYSTEM SPECIFICATIONS: TANK SIZE / GAL. PUMP TANK GAL. TRENCH WIDTH —.Lf� ROCK DEPTH �7 • LINEAR FT, 5n:, L OTHER REQUIRED SITE MODIFICATIONS/CONDITIONS: IMPROVEMENT PERMIT LAYOUT "CONTACT A REPRESENTATIVE OF THE DAVIE COUNTY HEALTH DEPARTMENT FOR FINAL INSPECTION OF THIS SYSTEM BETWEEN 8:30 - 9:30 A.M. OR 1:00 - 1:30 P.M. ON THE DAY OF INSTALLATION. TELEPHONE # IS (704) 634-8760. OPERATION PERMIT SYSTEM INSTALLED BY: AUTHORIZATION NO. OPERATION PERMIT BY: /_ DATE: "THE ISSUANCE OF THIS OPERATION PERMIT SHALL INDICATE THAT THE SYSTEM DESCRIBED ABOVE 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. DCHD 05/96 (Revised) AUTHORIZATION NO: "0 5,10 DAVIE COUNTY HEALTH DEPARTMENT Environmental Health Section PROPERTYffiFORMATION Permittee �. Cd1F�• !�� ::.`..Y��/'- �� P.O. Box 848 Name: Mocksville, NC 27028 Subdivision Name: Phone #: 704-634-8760 Di ections to property: Section: Lot: p'h�`j_ �' U b K„ J �J Y'. •, b 1 "�- AUTHORIZATION FOR WASTEWATER f el SY TEM CONSTRUCTION Tax Office PII�:# - - I Road Name: Zip: **NOTE** This Authorization for Wastewater System Construction MUST BE ISSUED by the Davie County Environmental Health Section prior to issuance of any Building Permits. This Form/Authorization Number should be presented to the Davie County Building Inspections Office when applying for Building Permits. (In compliance with Article 11 of G.S. Chapter 130A, Wastewater Systems, Section .1900 Sewage Treatment and Disposal Systems) 6"'e 1 ,..,, ENVIRONMENTAL HEALTH SPECIALIST DATE ISSUED ***NOTICE*** THIS AUTHORIZATION FOR WASTEWATER CONSTRUCTION IS VALID FOR A PERIOD OF FIVE YEARS. ' APPLICATION FOR SITE EVALUATIONAMPROVEMENT PERMIT Davie County Health Department Environmental Health Section P. O. Box 848 Mocksville, NC 27028 (704) 634-8760 ****IMPORTANT**** THIS APPLICATION CANNOT BE PROCESSED UNLESS ALL HE RE UIRED INFORMATION IS PROVIDED. - 1. Name to be Billed / - Contact Person Mailing Address Home Phone Re-- City/StatefZip ��/ /L/_ �_ / V ��/�_ Business Phone 2. Name on PermitIATC if Different than Above Mailing Address 3. Application For: 4. System to Serve: 5. If Residence: ,' Dishwasher 6. If Business/Other: # Commodes If Foodservice: 0 Site Evaluation 4 House # People ❑ Garbage Disposal Specify type City/State/Zip Improvement Permit & ATC ❑ Mobile Home ❑ Business ❑ Industry # Bedrooms Washing Machine ❑ Basement/Plumbing # Showers # Seats # Urinals 0 Both ❑ Other i # Bathrooms 0 Basement/No Plumbing # People # Sinks Estimated Water Usage (gallons per day) # Water Coolers 7. Type of water supply: County/City ❑ Well ❑ Community 8. Do you anticipate additions or expansions of the facility this system is intended to serve? ❑ Yes IU No If yes, what type? PROPERTY INFORMATION REQUIRED: *** IMPORTANT *** A PLAT OF THE PROPERTY MUST BE SUBMITTED WITH THIS APPLICATION. Property Dimensions: / . d '0 / f ' &')-� Tax Office PIN: # Property Address: Road Name �Yl] �� cwL.�€YG•�/ City/Zip 1 , t/ r C. If in Subdivision provide information, as follows: Name: Section: Lot #: WRITE DIRECTIONS (from Mocksville) TO PROPERTY: 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 am responsible for all charges incurred from this application. I, hereby, give consent to the Authorized Representative of the Da �County/H�ealth Department to enter upon above described property located in Davie County and owned by as necessary to determine the site suitability. DATE 1716 SIGNATI Revised DCHD (06-96) to conduct all testingr� met L11, -7K Ida 04- / ock 1. APPLICATION FOR SITE EVALUATIONAMPROVEMENTS PERMIT Davie County Health Department Environmental Health Section P. O. Box 665 Mocksville, NC 27028 Mailing Address Home Phone / / `/ 7'X Business Phone 2. Name on Permit if Different than Above 3. Application for. General Evaluation O Septic Tank Installation Permit 4. System to Serve: Houses ❑ Mobile Home ❑ Place of Public Assembly ❑ Business ❑ dustry ❑ Other ❑ Unknown 5. If house, mobile home: Subdivision �Ph/'o0�` Section Z Lot # �S ❑ 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 Sinks No. of Commodes No. of Urinals No. of Lavatories No. of Water Coolers No. of Showers Water Usage Figures 7. Type of water supply: ❑' Public ❑ Private ❑ Community 8. Property Dimensions— I �� Sewage Disposal Contractor 9. Do you anticipate additions/expansion of the facility this sytem is intended to serve? ❑ 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. DAVIE COUNTY HEALTH DEPARTMENT Environmental Health Section j Soil/Site Evaluation /a,,, NAME "l L /,,-,/ "— ADDRESS PROPOSED FACIILTY ,,`/91� DATE EVALUATED '//- /- 0� PROPERTY SIZE /X_111 / LOCATION OF SITE )S-21/%�/� , Water Supply: On -Site Well Community Public Evaluation By: Auger Boring Pit I,--- Cut FACTORS 1 2 3 4 Landscape position L .0 Sloe % 2 HORIZON I DEPTH Texture group Consistence Structure Mineralogy HORIZON II DEPTH Texture groupC' C Consistence Structure SZ 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 -7 1 SITE CLASSIFICATION: /�� EVALUATED BY: LONG-TERM ACCEPTANCE RATE: REMARKS: SPS a&/;� 0� �l 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 �C-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