409 Brier Creek Road Lot 61-63 + 72-73U
Davie Countv, I`nC
Tax PnrrP) Ri-nnrt
Tuesday. January 3. 2017
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:
Building Value:
Land Value:
Total Assessed Value:
WA" INki: 'l'Mb lb PIV l A bUKV.LY
Parcel Information
H702OA0005 Township: Shady Grove
5769865143 Municipality:
82518409 Census Tract: 37059-804
VERMEULEN JOANN Voting Precinct: WEST SHADY GROVE
409 BRIER CREEK ROAD Planning Jurisdiction: Davie County
ADVANCE Zoning Class: DAVIE COUNTY R -A
NC Zoning Overlay:
27006-0000 Voluntary Ag. District:
LOTS 61-63 + 72-73 GREEN BRIER Fire Response District:
2.72 Elementary School Zone:
3/2002 Middle School Zone:
004130771 Soil Types:
0005 Flood Zone:
099 Watershed Overlay:
Outbuilding & Extra
Freatures Value:
Total Market Value:
No
ADVANCE
SHADY GROVE
WILLIAM ELLIS
GnB2,EnB
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
f Davie County, implied wanantles of merchantability or fitness for a particular use. All users of Davie County s GIS website shall hold harmless the
a'County of Davie, North Carolina, its agents, consultants, contractors or employees from any and all claims or causes of action due to
NC
or arising out of the use or Inability to use the GIS data provided by this website.
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` ,$. �•`�r. , DAVIE COUNTY HEALTH DEPARTMENT
IMPROVEMENTS PERMIT AND, CERTIFICATE OF COMPLETION
*NOTE: Issued in Compliance With Article II of G.S. Chapter 130a
Sanitary Sewage Systems Permit Number
Name�"��,�%%�� .�. , �1/0f ;Date��� NO
Location Z,
Subdivision Name. Lot No. IJZa,4m"ec. or Block No.
Lot Size- House `�' Mobile Home —T Business Speculation
No. Bedrooms^.No. Baths D No. in Family_
Garbage Disposal YES, p NO p'
Specifications for System:
Auto Dish Washer YES 4 NO ❑ . l
Auto Wash Ma^hine YES 4] NO ❑ 17
Type Water Supply�-
R
*This permit Void if sewage system described below is not installed within 5 years from date of issue.
This.permit is subject to, revocation if site plans or the intended use change.
I'
1;
f•
4
Improvements permit by��
'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 day of completion. Telephone Number 704-634-5985.
p `t,
Final Installation Diagram:
j ep'
30> t 1:f
.,P
Sv�"�• Al
i'
�L i
b
System Installed by � C a R N a't Q R
b L(
Certificate of Completion Date /0-/9 " 9a
'The signing,of thisrcertificate shall indicate that the system described above has been installed -in compliance with
the standards set forth`in the above regulation, but shall in NO way be taken as a guarantee that the system will function
satisfactorily for any, given period of .time.
i
APPLICATION FOR SITE EVALUATION/IMPROVEMENTS PERMIT
Davie County Health Department
Environmental Health Section
P. O. Box 665 J
Mocksville, NC 27028
1. Application/Permit Requested By p /i /. � r Cr /,
Mailing Address/ &/�/iT� /�D�; AK ��� �� � ,9210�Z �7�,
Home Phone �q��) 7'(Zh.?p Business Phone n1q� !�- 9/1�
2. Name on Permit if Different than Above
3. Application/Permit for: ❑ General Evaluation Er -Septic Tank Installation
4. System to Serve: "Ouse ❑ Mobile Home ❑ Place of Public Assembly
❑ Business ❑ Industry El Other El Unknown
/
5. If house, mobile home: Subdivision l`� refAhr r Section Lot #
01"Basement/Plumbing
No. of People` ❑ Basement/No Plumbing
No. of Bedrooms z' O'Washing Machine
No. of Bathrooms [a -Dishwasher
Dwelling Dimensions P'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: l Public ❑ Private
8. Property Dimensions Sewage Disposal Contractoi
9. Do you anticipate additions/expansion of the facility this sytem is intended to serve?
If line whnf fvnn0
❑ Yes XNo
❑ 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:
X 7
✓
tea/
L FT7Z
7 3
This is to certify that the information provided is correct to the best of
incurred from this application.
DATE
and I understand I am responsible for all charges
SIGNATURE
FtaonCONSENT FOR SITE EVALUATION TO BE DONE ON ABOVE DESCRIBED PROPERTY
d
ECK ONE: ❑ 1. I OWN the property. ❑ 2. I DO NOT OWN the property.
ked Box #2, the rest of this form MUST be completed by the owner or a person authorized by the owner:
ve consent to the authorized representative of the Davie County Health Department to enter upon above described
cated in Davie County and owned by
all testing procedures as necessary to determine said site's suitability for a ground absorption sewage treatment
al system.
DATE SIGNATURE
DCHD (12-90)
• DAVIE COUNTY HEALTH DEPARTMENT
• Environmental Health Section
Soil/Site Evaluation
NAME — ';�4
ADDRESS
PROPOSED FACIILTY
DATE EVALUATED
PROPERTY SIZE
LOCATION OF SITE
Water Supply: On -Site Well Community Public
Evaluation By: Auger Boring Pit Cut
FACTORS 1 2
3
4
Landscape position
Slope %
HORIZON I DEPTH
Texture group
Consistence
Structure
Mineralogy
HORIZON II DEPTH C
Texture group AG
Consistence
Structure A4,11 h /
el
&4
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 ,Z
SITE CLASSIFICATION: ` EVALUATED BY: Ah
LONG-TERM ACCEPTANCE RATE: G/ OTHER(S) PRESENT:
REMARKS:
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-Firrn 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
■E■
■E■
■E■
■E■
■N■
■E■
DAVI1; COUi?TY HEALTH DEPART1IEi?T
ENVIROBI ITAL HEALTH SECTION
SOIL/SITE EVALUATIOU
PTAME JIdPC '?t?��.lt/!I DATE 3 - /D -� 2
ADDRESS
LOCATIO:P
LOT SIZE
TOPOGRAPHY: �S Sy6.r• � ! - %���tla7�/oi.•.-
SOIL TE�,TUREa ?5'6i/- 9j- ;S :S s/s,►t.� 6elrw
SOIL STRUCTURE: ?S
DEPTH. o
RESTRICTME HORIZOI?Sa ?'/t'
PERCOLATION FATE:
1.
2.
3.
Presoak i Bark & time Drop Time Pate/riin. Inch
* CLASSIFICATIOP?s
SuitableProvisionally Suitable Unsuitable
COI 11,1EUTS e Vrpr p" - "./-j � L:/._ - r .,.r_ s is
/ 2 o
SAP?ITARIAN
SITE DIAGRAM
DAVIL COU -IM HEALTH DEPART.IEdT
ENVI71,0ITIM1TAL HEALTH SECTION
SOIL/SITE EVALUATIOI?
IIAI4E /-,��, Pc_ ,���,� DATE to - Z-
ADDRESS
LCCATI01i
LOT SIZE /001(20 0 2 .44,1 c4 4 A - �tec�%Pfe:!- 2.�, �
-
TOPOGRAPHY: v�5 - S.00R•l:/� f /d' - a ZOO
SOIL TEZTURE: u
W • a "°� �ap8ess..CJ acs. - utr� �Fe�: ��,,-1- }�-e
SOIL STRUCTURE: k!.
DEPTH: 4$ \e� wa- -4`e �to.s - 1s �brnat- �w•►�--
"�aQa . + �` I let a ►Q Q cnc g $
RESTRICTIVE HORIZOVS:
PERCOLATION FATE: Presoak
1.
Z.
3.
Bark & time
Drop
Time
Pate/iin. Inch
***CLASSIFICATIOIT:Suitable Provisionally Suitable Unsuitable
COiig3EI?TS: Pe-P—X P,,j..//J - S4d- 617 -/Qv7
SAVITARIAP 4/� /,.,w %ND 1
SITE DIAGFA.v'i
DAVIE COUi?TY HEALTH DEPART1IE ?T
EIM1,10i1iMi1TAL HEALTH SECTION
SOIL/SITE EVALUATIO17
%IAT' _ Zd DATE 3 - 2 ? - 2 -
ADDRESS
LOT SIZE /!ll► �1' �ir�
TOPOGR•APT?Y o p,S ('J "'4 /g) 4,3-I-'
SOIL TEZTURE a uS
1
SOIL STRUCTURE:(/5
DEPTH: /Z-/4 w
RESTRICTIVE HOFIZOFS a
PERCOLATION RATE:
1.
2.
3.
LOCATEIOi?
Sudr.: �• u r�7 s�4I�'.w. - g " lo��. f /�c�d7
Presoak Hark & tirze Drop Time Fate/iii%. Inch
***CLASSIFICATIOT?:Suitable Provisionally SuitableUnsuitable
COMHEITTS o ,eA"ka&//1
SAP?ITARIAN Z"— *W'D d
SITE DIACP,A,i 62
DAVI^ COITITTY HEALTH DEPART IMIT
ENVIROYMEUTAL HEALTH SECTION
SOIL/SITE EVALUATIOT?
T?AFS %%vP�..._.1 10 �iit.Cl DATE 3 " 2 3 - 9'2.
ADDRESS
LOT SIZE /00 rp-0 D
TOPOGRAPHY: it
SOIL TE:iTURE: NJ
SOIL STRUCTURE: H3
DEPTH: pS
RESTRICTIVE HORIZOUS:
PERCOLATION FATE:
1.
2.
3.
LOCATION
S/a6se:C- limy Sha.,/.w heu.y
ilay . IVAS1ivG olecew
S�pe•L:fe a4' /Z-'/f/'i
Presoak Hark & time Drop Time Fate/i r.. Inch
***CLASSIFICATIOTT:Suitable Provisionally Suitable Unsuitable
COUTIEI?TS: IV�,Q,C /19«uI-IJ 77
SAP?ITARIAF?
SITE DIAD AM
DAVIu COU'i?TY HEALTH DEPARTIMIT
EIIVIi,0I1i-T 1TAL HEALTH SECTION
SOIL/SITE EVALUATIOU
I?AIS //,J"p e ,8J1 Luj DATE 3 -23 -92 --
ADDRESS
-23 -82 -ADDRESS
LOCATIO14
LOT SIZE �"ez ad o
TOPOGRAPHY: ?S"
SOIL TEZTURE a kf
e.
SOIL STRUCTURE, :05
DEPTH: 6 .,P"
RESTRICTIVE HORIZOi?So 8-2 ie"— SAOAI./-
PERCOLATION PATE:
1.
2.
3.
073
y L ��ILM Q p
Cluj
SAP/1•L`.Je- a -f f _/e„ C�c�, A�� SBO�,�:�
Presoak Bark & time I Drop Time Pate/iiia. Inch
**CLASSIFICATIOI?°Suitable Provisionally Suitable Unsuitable
CO£Z1EI?TS: .GRnee &,, 11,f pn, r—,4 - A-1 7 - /_971
SITE DIAGUM
SANITARIAN �Id/f