1110 Williams Road Lot 3DaN
M311
[all
All data Is provided as Is Wkioutwam�dy or guarantee of any kind eitherespromed or Implied Including but netIlmked to the
Davie County, Implied wamamles of menchantabllky orliltneaa for a parthadaruse. All users of Davie County's GIS nebske shall hold harmless the
county of Davie, North Carolina, Id agent% consultand, contractor oremployeeafrom anyend all claims or causes of ackon due to
NC or arising out of the use or Inability fo use the GIS dad provided by this saindta, '
WARNING: THIS IS NOT A SURVEY
Parcel Information
Parcel Number:
170000004312
Township:
Fulton
NCPIN Number:
5778161791
Municipality:
Account Number.
.. 82532342
Census Tract:
37059-604 "
Listed Owner 1:
STROUD JENNIFER D
Voting Precinct:
FULTON
Mailing Address 1:
154 SHANNON 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 Descrlption
LOT 3 CARTERS COURT
Fire Response District:
FORK
Assessed Acreage:
0.75
Elementary School Zone:
CORNATZER
Deed Date:
10/2010
Middle School Zone:
WILLIAM ELLIS
Deed Book / Page:
008400274
Soil Types:
WeC,PcB2
Plat Book:
0007
Flood Zone:
Plat Page:
086
Watershed Overlay:
DAME COUNTY
Building Value:
30470.00
Free ores Vldina &extra
0.00
Land Value:
15050.00
Total Market Value:
45520.00
Total Assessed Value:
45520.00
[all
All data Is provided as Is Wkioutwam�dy or guarantee of any kind eitherespromed or Implied Including but netIlmked to the
Davie County, Implied wamamles of menchantabllky orliltneaa for a parthadaruse. All users of Davie County's GIS nebske shall hold harmless the
county of Davie, North Carolina, Id agent% consultand, contractor oremployeeafrom anyend all claims or causes of ackon due to
NC or arising out of the use or Inability fo use the GIS dad provided by this saindta, '
DAVIE COUNTY HEALTH DEPARTMENT
Environmental Health Section
P. O. Boa 848/210 Hospital Street
Mocksville, NC 27028
(336)751-8760
IMPROVEMENT/OPERATION PERMIT
Account #: 990000827
Billed To: Donald & Jennifer Stroud
Reference Name: Donald Stroud
Proposed Facility: Residence
Tax PIN/EH #: 5778-06-7187.03
Subdivision Info: Carters Court Lot#3
Location/Address: Williams Road -27028
Property Size: 100x300x150x
ATC Number: 2743
**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 M. IaOMC #People 4 #Bedrooms _� #Baths :2 -
Dishwasher:
Dishwasher: M' Garbage Disposal: ❑ Washing Machine: 0� Basement w/Plumbing: ❑ Basement/No Plumbing: ❑
Commercial Specification: Facility Type #People #People/Shift #Seats Industrial Waste: ❑
Lot Size Type Water Supplyc_Dk � Design Wastewater Flow (GPD) 3tc+tp Site: New E;K Repair ❑
System Specifications: Tank Size ICOOGAL. Pump Tank GAL. Trench Width a6 Rock Depth Z4 1 Linear Ft.ZEep'
Other: 1 SSL i I.-ssTQu-- u.SeS
Required Site Modifications/Conditions: V,-r4P 2'- M• No titEi VL --=P I& t7( -F PPoP ti aC
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.****
yr IOE�'v�'S�'x2ti" 120
27' 30 E:FF
Environmental Health Specialist's Signa e: Date:
L
DCHD 05/99 (Revised) *—F4I.5 A -e t >
11llplqA
DAVIE COUNTY HEALTH DEPARTMENT
Environmental Health Section
P. O: Boz 848/210 Hospital Street
Mocksville, NC 27028
(336)751-8760
IMPROVEMENT/OPERATION PERMIT
Account A 990000827 Tax PIN/EH #: 5778406-7187.03
Billed To: Donald & Jennifer Stroud Subdivision Info: Carter's Court Lot # 3
Reference Name: Donald Stroud Location/Address: Williams Road -27028
Proposed Facility: Residence Property Size: 100x300x150x
ATC Number: 2243
**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. H
Residential Specification: Building Type M • , Me; #People 4J #Bedrooms 3 #Baths 2
Dishwasher: R'�- Garbage Disposal: ❑ Washing Machine: 2'� Basement w/Plumbing: ❑ Basement/No Plumbing: ❑
Commercial Specification: FacilityType #People #People/Shift #Seats Industrial Waste: ❑
Lot Size Type Water Supply C09-J'rYDesign Wastewater Flow (GPD) Site: New 0 Repair El
System Specifications: Tank SizebDOGAL. Pump Tank GAL. Trench Width �t Rock Depth 12L Linear FtZcc�
Other: (�1S-rQ tR�J no-� 34?v. -1 O .c-,
Required Site Modifications/Conditions: O -N 1-g5o,1TpJ2. Y-k-ezP -S: BF1=
IMPROVEMENT/OPERATION PERMIT LAYOUT - APPROVED EFFLUENT FILTER. RISER(S) IF 6 4° 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 d,3y of installation. Telephone # is (336751-8760.****
—9r- APazoti.ln
Environmental Health Specialist's Signature:
DCHD 05/99 (Revised)
PM
Date: I/%/o�-
DAVIE COUNTY HEALTH DEPARTMENT
Environmental Health Section
P. O. Boz 84SCIO Hospital Street
Mocksville, NC 27028
(336)751-8760
Account #: 990000827
Billed To: Donald $ Jennifer Stroud
Reference Name: Donald Stroud
Proposed Facility: Residence
ATC Number: 2243
Tax PIN/EH #: 5778-08-7187.03
Subdivision Info: Carter's Court Lot # 3
Location/Address: 'Williams Road -27028
Property Size: 100x300x150x
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 CONSIRLCTION ISI9ALID FOR A PERIOD OF FIVE YEARS.
Environmental Health Specialist's Signature:
CERTIFICATE OF COMPLETION
Date:
**NOTE** The issuance of this Certificate of Completion shall indicate the system described on Improvement/Operation Permit
has been installed in compliance with Article 1 I 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.
r
eta pyo ter""
b tom' !G aro ��24"
Septic System Installed By: Vex- I m e '&t -c
Environmental Health Specialist's Signature
DCHD 05/99 (Revised)
Date: /`P
1
APPLICATION FOR SITE EVALUATION/IMpROVEMMF PERMIT & ATC
Davie County Health Department
Env1P.C. ox 8� Z� Realift o
ospital Street
Mccketriller NC 27028
(336)751-8760
•*•I!>QORTaHTete
OCT 2 11999
BVI DAVIE COUNTH`/�LTH
TRIG appt.ICaTION ta1Rw0T ER pRCCcggrp URLE11 Ba a7.f. , RL()UIRtED
INyORlATICR 28 BRCVID1tD. Reser to tha �'MMIOR BM=TIR for instructions.
1- Rime to be slued �flnt2 i d k1 nni` t� �trW&rr
Contact "Coon �'k inn
uuisos ate1R some shone 4 C7 Z = 7 � 9 2-
tiro/et.ta/sly /a:v C LJ% �. adsineee prone _7 <l fY = QO — &
2. Item- an *.salt/a7A Lt DSleerant thin above
ka►ltoe address .
t:Ltr/:lata/pip
e. application Tor: D Bite llvalUat:ioa b[Y>cprovamaat parsit/]1TC
e � 0 Roth
e- Mtem to se=vloe: 0 Rouse X"ile Roma 0 Business 0 Indus
✓ � ��// try 0 other
s. I! Ratidanoet L i people `i a Bedrooms �_
I Bathrooms
•r}4lebwaehar O se naebaMopoeal Rasbing Madliae 0 aaaemant/pl:mbing 0 Daeeamt/ao pim.biag
t. It Mewissen/xo&Wt=r/other: speolft type/`
e people a eldca
I comGe a shower. a Urinal.
_ - 1 Rats Cooler.
I! 100D810tVICM: ti -tate sstimat:ed water Osage (gallon@ per day)
7. Type of Rater acpplps .Wrounty/City 0 Well 0 Community
a. Do YOU anticipate additions or expans/loner of the facility this system is Intended to serve? 0 yea
0
If yes, what type?
a�eIMPO(FAMOtCLENTSM157COMPLEWTHEttLcQt)JpPINESfEp
BELOW, Either aPLWerSITE Pt.ANM►tcrnv.ctmtnR-E n.RE__... ROPERTY.._ ___FORMATIONREQU_
Property Dimensions: 7/7n X , l� X Sy x 6 WRITE DMEMONS (from Mocheville) to PROPERTY:
Tax Office PDts q LI
577 dd RonPNg!�I�li
�� nProperly Addreps Ra u L a UA S ` fZ lU Qj �(�• �j i k
CIty21p v
It to a Subdivision provide information, as follows: _{l./!)� P v,4-cA fed
Name: _ 1 _O rffV D
1S ocsy-{ r 1
SeeHoes Blocks
Let: � _ Date Property Flagged= of o
This is to certify that the InforataHou provided is correct to the bat of my knowledge. I understand that any permit(-)
seemed hereafter are licsti t to suspension o c revues Met
if the site plane or Intended we change, or If the Information
submitted la Ihb appllutiou is GisIRed or changed I, GISO, Understand that! am responsible for all charger Incurred froas
this appllcadon. I, hereby, glue consent to the Authorized Representative of the vie County lth De But
to enter upon above described properly located lu Davie County and by v
to conduct all telling procedures As necessary to determine the site ems Mly. Q P
DATE( SIG
TNATURE
HIS AREA MAY B USED FOR DRAWING YOUR SITE LAN
property Ban and dimensions, structures, settee clad- of the tollawingt Existing and proposed
lu, and zea c Hoe■
Site Revisit Charge
Date(:):
i11 lent Notification bate:
G4� soEHS:
'L
Account No.
Revised DCHD (07/99) UsO
Invoice Na.
If yes, what type?
***IMPORTANT***CLIENTS MUSTCOMPLETETHE REQUIRED PROPERTY INFORMATION REQUESTED
BELOW. Either a PLAT or SITE PLAN MUSTRESR!YnE
R by the client with THIS APPLICATION.
ItaO 3�oKi �,(a>tS
Property Dimensions: %f '�C� WRITE DIRECTIONS (from Moclwllle) to PROPERTY:
Tax Office PIN: # 5 7 7 5�- Q 6 - 7 / 8' 7.0 3 k14 Ca, -,4 Zs,, /,.,,,, , .rZy
Property Address: Road Name t�/ .�P�� �p
n d/�
City/Zip (� M . �. Yr. C _ 2 7 o6 % " u 'g-, /,d o f
If in a Subdivision" provide Information, as follows:
Name: CFiM*y Coun-F
Section -Block: Lot: 3 Date Property Flagged: 1 /02
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 is tris application I.- :abilled ar chr;b_d. I, also, understand that I am respsns23Ft jar cK caxrges Incurred from
this application. 1, 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 conductt all testing procedures as necessary to determine the site sui bifity.
DATE ///.� ::' • �- 3 — II n 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).
I Date(s)-
EHS:
Revised DCHD (07/99)
Site Revisit Charge
Notification Date:
Account No. "Z 'tea -2
Invoice No. 0�45�—
APPLICATION FOR SITE EVALUATION/IMPROVEMENT PERMIT &ATC
Davie County Health Department
Environmental Heath Seef ion
P.O. Box 848/210 Hospital Street
JUN 2 3 1999
+
Mockeville, NC 27028
�!
(336)751-8760 EWVIItOi::iFlJll,lNE.!dlil--
V
U
DAVIE
CU14TY
***ZWCRTANT***
THIS APPLICATION CANNOT BE PROCESSED UNLESS ALL THE REQUIRED
INFORMATION IS PROVIDED. Refer to the INFORMATION BULLETIN for instructions.
1.
-Bass, to be Billed
contact Parson l/. -&e --
Mailing Address
f ,0 Ute. L) ,.7'none Phons, O " y/" -7O
City/state/zIP
�. :.-r,C. f Pi. L V ? ol e> Business none
2.
Bane on Pezmit/ATC if Different than Above
Mailing Address
City/statenip ••
3.
Application For:
❑ Site Evaluation ❑ Improvement Permit/ATC fr�th
e.
Systen to Service&
P�House ❑ Mobile Home ❑ Business ❑ Industry ❑ Other
5.
If Residence:
# People # Bedrooms �3 # Bathrooms 2....
❑ Dishwasher ❑ aarbage Disposal O Washing Machine O. Basement/Plumbing O Basement/Bo Plumbing
6.
I! Business/Industry/others Specify type # People # sinks
# Commodes
# Showers # Urinals # water Coolers
IF FOODSERVICE:
# Seats Estimated Seater Usage (gallons per day)
7.
Type of water supply: ❑ County/City ❑ Well ❑ Community
S.
Do you anticipate additions or expansions of the facility this system Is Intended to serve? ❑ Yes ❑ No
If yes, what type?
***IMPORTANT***CLIENTS MUSTCOMPLETETHE REQUIRED PROPERTY INFORMATION REQUESTED
BELOW. Either a PLAT or SITE PLAN MUSTRESR!YnE
R by the client with THIS APPLICATION.
ItaO 3�oKi �,(a>tS
Property Dimensions: %f '�C� WRITE DIRECTIONS (from Moclwllle) to PROPERTY:
Tax Office PIN: # 5 7 7 5�- Q 6 - 7 / 8' 7.0 3 k14 Ca, -,4 Zs,, /,.,,,, , .rZy
Property Address: Road Name t�/ .�P�� �p
n d/�
City/Zip (� M . �. Yr. C _ 2 7 o6 % " u 'g-, /,d o f
If in a Subdivision" provide Information, as follows:
Name: CFiM*y Coun-F
Section -Block: Lot: 3 Date Property Flagged: 1 /02
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 is tris application I.- :abilled ar chr;b_d. I, also, understand that I am respsns23Ft jar cK caxrges Incurred from
this application. 1, 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 conductt all testing procedures as necessary to determine the site sui bifity.
DATE ///.� ::' • �- 3 — II n 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).
I Date(s)-
EHS:
Revised DCHD (07/99)
Site Revisit Charge
Notification Date:
Account No. "Z 'tea -2
Invoice No. 0�45�—
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A DAVIE COUNTY HEALTH DEPARTMENT
Environmental Health Section
Soil/Site Evaluation
APPLICANT INFORMATION" PROPERTY INFORMATION
Account #: 989900562Tax PIN/EH M 5778-06-7187.03
Billed To: Gray Carter Subdivision Info: Carters Court Lot # 3
Reference Name: Gray Carter Location/Address: Williams Road -27006
Proposed Facility: Residence Property Size: 320x100x300x Date Evaluated: Z1�
Water Supply:
Evaluation BY:.
On -Site Well
Auger Bonn
gg..
Community,
-Pit ..
Public 2,>':
Cut.:
FACTORS
1 ' _ 2."": 3 q
5 (,. 7.
Landscape position ....
_ ._.., -
Slope %
G
HORIZON I DEPTH
Texture group
Consistence
Structure'
EVALUATION BY: ' l�Y o✓(�/
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 ...
m
VFR - Very friable FR -
Friable FI - Firm VFI - Very firm EFI - Extremely firm
i1'et'
NS -Non sticky ', SS - Slightly stickyS - 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)