143 Carters Ridge Road Lot 4Dav
!016
phv�AAll data Is provided as Is wIthout%varranty, or guarantee of any Idnd eftherexpressed or Implied Including but not Ifinhed to the
Davie County, Implied mmanties, of merchantability ornmoss for a particularuse. Ali users 0 Davie County's 013 websth, shall hold harmless the
Courtly M a, North Carolina, Ib agent,
NC r arising out of the uw orinahghytouae the GIS data provided by this vvebsfte.
WARNING: THIS IS NOT A SURVEY
..-Parcel Infortnation
Parcel Number:
K809OA0004
Township:
Fulton
NCPIN Number;
5776399841
Municipality:
Account Number:
82517651
Census Tract:
37059-804
Listed Owner 1:
ASHBY ANDY
Voting Precinct:
FULTON
Mailing Address 1:
143 CARTERS RIDGE ROAD
Planning Jurisdiction:
Davie County
City:
ADVANCE
Zoning Class: DAME COUNTY R -A
State:
NC
Zoning Overlay:
Zip Code:
27006-0000
Voluntary Ag. District:
No
Legal Description:
LOT 4 CARTERS RIDGE PHASE I
Fire Response District:
FORK
Assessed Acreage:
0.92
Elementary School Zone:
CORNATZER
Deed Date:
10/2001
Middle School Zone:
WILLIAM ELLIS
Deed Book I Page:
003890973
Soil Types:
PaD,ChA
Plat Book:
0007
Flood Zone:
Plat Page:
065
Watershed Overlay:
DAVIE COUNTY
Building Value:
156030.00
OuretbuildinVgalue' & Extra
Fatures
3180.00
Land Value:
14400.00
Total Market Value:
173610.00
Total Assessed Value:
173610.00
phv�AAll data Is provided as Is wIthout%varranty, or guarantee of any Idnd eftherexpressed or Implied Including but not Ifinhed to the
Davie County, Implied mmanties, of merchantability ornmoss for a particularuse. Ali users 0 Davie County's 013 websth, shall hold harmless the
Courtly M a, North Carolina, Ib agent,
NC r arising out of the uw orinahghytouae the GIS data provided by this vvebsfte.
'AUT O IZATION NO ,r 9� DAVIE COUNTY HEALTH DEPARTMENT
t1ol �[ RGmodd(�[Environmental Health Section PROPERTY INFORMATION
6AQ
Directions to propert
i
L;t 1;,1i
t �
[o Issumce U1 Guj',DUUWUb'".rCIUUL\. 1IIIb PV1111fMULIZVUGaIUVu. PIL
Office when applying for,Bdilding Permits
(ln,compliane6With Article II ofa.S.`Chapter 130A Wastewater Systems;
***NOTICE'
iENVIRONMENTALHEALTH SPECIALIST i. ' DATE ISSUED
iUCL) by Me Davie County tnvironmental Healm Jection pnor
should be presanted.to the Davie county Buit'ding Inspections''.''
1900Sewage, Treatment and Disposal Systems) ,'
d.7-19prq.
IEC OUNTY HEALTH DEPARTMENT
fi e ilulcDn n r dMItiROVEMENT AND OPERATION PE I S_ PROPERTY INFORMATION
Name a 'ir)•:. ����' .:Ni „ F .(r;.
Subdivision
Directions to'property :' r l Section: O Lot:
IMPROVEMENT
PERMIT - ' + Taxflffice PIN 42_
Road Name:' ` /[/f "� ip:
**NOTE**This Improvement permit DOES NOT authorize the construction or installation of a septic tank system or any wastewater system. An
AUTHORIZATION FOR WASTEWATER SYS'T'EM CONSTRUCTION must be obtained from this Department prior to the
constructionlinstallation of a system or the issuance of a building permit.
(Incompliance with Article 11 of G'S. Chapter 130A, Wastewater Systems, Section :1900 Sewage Treatment and Disposal Systems)
***NOTICE*** THIS PERMIT IS SUBJECT TO REVOCATION IF SITE .
/' {'' ✓ • j f /J;;f . PLANS OR THE INTENDED USE CHANGE. YOUR WASTEWATER
ENVIRONMENTAL HEALTH SPECIALIST; DATE ISSUEDSYSTEM CONTRACTOR MUST SEE THIS PERMIT BEFORE
INSTALLING THESYSTEM. ->
RESIDENTIAL SPECIFICATION: BUILDING TYPE # BEDROOMS %_ # BATHS # OCCUPANTS _ GARBAGE DISPOSAL: Yes or No
COMMERCIAL SPECIFICATION: TYPE # PEOPLE # PEOPLEISHIFI'x' #SEATS INDUSTRIAL WASTE: Yes or No
LOT SIZE f0 I ,TYPE WATER SUPPLY `�/.�% DESIGN WASTEWATER FLOW (GPD) NEW SITE - �/ REPAI SITE _-
�'•'"- SYSTEM SPECNS:TANK SIZE �AL. PUMP TANK GAL. TRENCH WIDTH � ROCK DEPTH LINEAR /
OTHER — /•. ✓�' ��/i' ��/,.�Fi//� •% '.9 /.. .P /' ili.!% �"� %%) P
REQUIRED SITE MODIFICATIONS/CONDITIONS: -
",.ea- - ..1�•.
IMPROVEMENT PERMIT LAYOUT
**CONTACT A REPRESENTATIVE OF THE DAVIE COUNTY HEALTH DEPART ENT-FOR�INA•i"II SYECTION OF THIS SYSTEM
BETWEEN 8:30 - 9:30 A.M. OR 1:00 - L30 P:M. ON THE DAY OF INSTAL. ATION. TELEPHONE # IS (336)751-8760. "
)
7 SYSTEM INSTALLED BY:
r
t
AUTHORIZATION NO.� OPERATION PERMIT BY: _���`^"7 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 WELL FUNCTION SATISFACTORILY FOR ANY GIVEN PERIOD OF TIME. -
I)CHD 05/96 (Revised)
r ..
( , APPLICATION FOR Davie CountyAHealth DepartmentPERMIT tFrn
90
Envfronmenla/Hea/tnSeCUGHL5P.O. Box 848/230 Hospital Street2 9 1999
Mocksville, NC 27028
(336)751-8760MENTAL HEALTH
***IMPORTANT*** THIS APPLICATION CANNOT BE PROCESSED UNLESS ALL QUIRED
INFORMATION IS PROVIDED. Refer to the INFORMATION BULLETIN for i/nstruc/t'ions.
1. name to be Billed 7T�7 A,0,411 J/. /Y /_'/1%%T^� Contact Person
nailing Address S e7 14- 2�- Some Phone 9 4�O ^a:'l I�,I
City/state/LIP a,0-/,qh CF .liLF .1-42!�Z,1-4 Business Phone
2. name on Permit/ATC Sr Different than Above
nailing Address C
�it
Jy/state/zip
3. Application For:❑ Site Evaluation id Improvement Permit/ATC ❑ Both
4. System to service: U -House ❑ Mobile Home ❑ Business ❑ Industry ❑ Other
s. If Residence: # People 0 Bedrooms 4 Bathrooms
Di
B'Re�shxasher 0 Garbage Disposal 41-Wa-s'hing machine 0 Basement/Plumbing D Basement/no Plumbing
S. If Business/Industry/Other: Specify type 4 People / sinks
f Commodes 4 Showers 4 Urinals 4 nater Coolers
IF rOODSERVICE: i Seats ' Estimated Water Usage (gallons per day) �
7. Type of water supply: ❑ County/City ell ❑ Community
e. Do you anticipate additions or expansions of the facility this system is Intended to serve! ❑ Yes Jdiqe�
If yes, wtiat type!
I***IMPORTANT*** CLIENTS MUST COAIPLETE THE REQUIRED PROPERTY INFORMATION REQUESTED
BELOW. Either a PLAT or SITE PLAN MUST RESUBMITTED by the client with THIS APPLICATION.
Property
Tax Office PIN:
Property Address: Road Name
City/Zip
If in a Subdivision pprrovide Information, as follows'/:
Name:/C �P./� (1 �t1 UC1IF—
Section: Block: Lot:
DIRECTIONS (from Mocluville) to PROPERTY:
Date Property Flagged: I�9�
This is to certify that the information provided is correct to the best of my knowledge. i understand that any permits)
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 responiMlefor all charges 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 owoed by 4tiSCP4A/� -�� Z'tQ2 l eP
to conduct all testing procedures as necessary to determine the site suitabif
DATE ! 9 SIGNATURE
THIS AREA MAY BE USED FOR DRAWING YOUR SITE PLAN (Include ail of the following: Existing and proposed
property lines and dimensions, structures, setbacks, and septic locations).
Revised DCHD (07/98)
Account No.
Invoice No.
•aar,bel comer"
I
Parcel 56
Tax Map K-7
George T. Grubb
D.B. 58 - 004
ff„
N 16658'05"E 1
P
N 05.35120"W 67.74'
PI
N 08652.50"W 171.91'1
2207.43' 7.45'
2
36.22'00"W
40.6' -
F
�v 70.00
7x58.08'10"E 66.
00.25'45"W
32.7 7
�20
9647.50'25"E 26, ,
7.2
0.54'45"W
.
79.7T
14,
,
7050'45'W
E050
49.51
' 3.35'25"E
38.32 _-
221
Found
Vk ,T
114.45.
F
�v 70.00
DEGREE
CHORD
CH.BEARING
�20
Its
7 QIX 20,
j! Puax
0.
t
14,
j�
/
6 ^4
w 'UWAY Ir >veaER rACTe T47 rr K o+�
35.18'
t i O
•y�b
DRA++Aac GiwDff !
U
D. PEF
a U D.
41.. t
1a•xro'
r��...� &D.L
9
25
77
/a"�dT � c� �
d
�y
24
148.49' 1
vv VJ"W 659. i 1'
Parcel 19.01
Judy P. Broadway
D.B. 107 - 300
N 86.57'05'W 667.
�R
Seaford Road
(
30' R/W See Deed Book 139-630) S.R. yR
• 1g13
JGENT
I
F
�v 70.00
DEGREE
CHORD
CH.BEARING
�20
90.07'
176.14'
29'28'48"
16.44'10"
174.20'
70.00'
z�
to 2110
w 'UWAY Ir >veaER rACTe T47 rr K o+�
35.18'
c
22
16.44'10"
165.90'
n_
Ago AGUAATE TITLE RAA61. ear Fw IberD TO W Ae ,
85.24'
50.39'
s
28'36'30"
15'55'00"
15'53'40"
15'53'40"
99.82'
N 10'48'30"E.o
aAixa TAL oam[Tic COMM wencrm ME LOCM
11.18'
21.03'
48611'25"
229.11'00"
20.41'
S 69.01'40'W
vv VJ"W 659. i 1'
Parcel 19.01
Judy P. Broadway
D.B. 107 - 300
N 86.57'05'W 667.
�R
Seaford Road
(
30' R/W See Deed Book 139-630) S.R. yR
• 1g13
JGENT
LENGTH
DELTA
DEGREE
CHORD
CH.BEARING
R°aKtI of AATF OF T 19 n ECMDeIECT rn II *TTO T DAKY ATE refart
90.07'
176.14'
29'28'48"
16.44'10"
174.20'
70.00'
N 1853'56"E
N 39 30'25"E
w 'UWAY Ir >veaER rACTe T47 rr K o+�
35.18'
70.12'
11.44'10"
16.44'10"
165.90'
N 32'04'15"E
Ago AGUAATE TITLE RAA61. ear Fw IberD TO W Ae ,
85.24'
50.39'
167.40'
100.14'
28'36'30"
15'55'00"
15'53'40"
15'53'40"
99.82'
N 10'48'30"E.o
aAixa TAL oam[Tic COMM wencrm ME LOCM
11.18'
21.03'
48611'25"
229.11'00"
20.41'
S 69.01'40'W
Ecoo FEET OF THII "OPIRT7.
55.90'
84.11'
96.22'45"
114.35130"
74.54'
N 86.52'44'W
28.87'
52.38'
80000'00"
114.35'30"
50.00'
N 08'41'20'W
LEGEND
28.87'
52.36'
60.00'00"
114.35'30"
50.00'
N 51618'40"E
68.41'20"E
rtnv _ Rghl-of-way - �•
28.87'
32.38'
60'00'00"
114.35'30"
229'11'00"
50.00'
20.41'
S
S 62'47'00"E
Imm Pt _
pP - Exivor'g Iron Rebar
11.18'
11.18'
21.03'
21.03'
48'11'25"
48'11'25"
229.11'00"
20.41'
N 69'01'40'E
N 74.22'20'E
Pahl M
�P °°� ew In
28.22'
S1.3D'
55'52'50"
114.35'30"
49.15'
60.00'
S 39.19'05"E
POlooed
P/L - Property Lin.
37.50'
64.33'
48.68'
73.44'25'
53'29'15"
114033'30"
114.35'30"
45.00'
S 24.17'45"W
a A - Corrtmned Ao p}ip _ P°
25.20'
"
229'11'00"
20.41'
S 26.56'40"W
rt s�E - so
11.18'
21.03'
48'11'25
19.35'20"
13.57'30"
139.68'
S 12'38'40"W
CMP= crrqot* Mew
CTS
70,88'
140.34'
100.25'
13659'33"
13057'30"
100.00'
S 29626'10"W
-F- too yWWr Rood DU
50.38'
8.56'35"
13857'30"
64.00'
S 40'54'15"W
_�--txuu.e -s-
a.
32.10'
109.93'
84.OT
210.29'
41613'00"
19.36'00"
205.79'
S 24.48'00'
«
S.D.E. - Sight Distance Easement
DAVIE COUNTY HEALTH DEPARTMENT
., Environmental Health Section SECTION " a LOT
Soil/Site Evaluation
APPLICANT'S NAME DATE EVALUATED
PROPOSED FACILITY, PROPERTY SIZE lye C
SUBDIVISION ROAD NAME
Water Supply:
On -Site Well
"Community
Public
,Evaluation By:
Auger Boring
Pit
Cut
Consistence
SITE CLASSIFICATION: EVALUATION BY: /cy
LONG-TERM ACCEPTANCE RATE:/'�j ,OTHER(S) PRESENT:
REMARKS: 45 -e -P /J%/� 6-D Ale
-PLEGEND
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 - Finn 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 ARK - Angular blocky
SBK - Subangular blocky PL - Platy PR - Prismatic
Mineraloev
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)
LIAR - Long-term acceptance rate - gal/day/ft2
DCHD (01-90)
• 7,917L • •
Consistence
I • . • •
��►��ri®®®tea
1'1019 MINI LTA •
• .
®-oma®o®
•qw.9
SITE CLASSIFICATION: EVALUATION BY: /cy
LONG-TERM ACCEPTANCE RATE:/'�j ,OTHER(S) PRESENT:
REMARKS: 45 -e -P /J%/� 6-D Ale
-PLEGEND
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 - Finn 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 ARK - Angular blocky
SBK - Subangular blocky PL - Platy PR - Prismatic
Mineraloev
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)
LIAR - Long-term acceptance rate - gal/day/ft2
DCHD (01-90)
JUN 2 Ft!w"o IR SITE EVALUATION/IMPROVEMENT PERMIT & ATC
av(e County Health Department
Environmental Health Section
ENVIRCNMENTALHEALTH P.O Bos 848/210 Hospital Street ! /
DAVIE COUNTY Mocksville, NC 27028 ' 7� n
(336)751-8760 (( (J�
***XMPORTANT*** THIS APPLICATION CANNOT BE PROCESSED UNLESS ALL THE REQUIRED
INFORMATION IS PROVIDED. Refer to the INFORMATION BULLETIN for instructions.
1. Name to be Billed Contact Person �J/PPiYKhg3�71�( yU.5'7J7-r
fl
T�%/Mailing Address , //9— Bon- Phone
City/State/ZIP Vvr� A/, q 1163 Business Phone 1D0 r3 Rd
J
2. Name on Permit/ATC if Different than Above
Mailing Address City/ to/Zip
3. Application For: !Site Evaluation R"imprcvement Permit/ATC ❑ Both
4. system to Service. &Icuse ❑ Mobile Home ❑ Business rte❑ Industry ❑ Other
s. If Residence: # People # Bedrooms 3 # Bathrooms o2
-Er—Dishwasher.@Garbage Disposal 2 -Washing Machine ❑ Basement/Plumbing-ErBasement/No Plumbing
6. If Business/Industry/Other: Specify type # People # Sinks
�—
# Commodes # Showers ,Q2 _ # Urinate #water Coolers
IF FOODSERVICE: # Seats Estimated Water Usage (gallons per day)
7. Type of water supply: ❑ County/City ❑ Well ❑ community
e. Do you anticipate additions or expansions of the facility this system is intended to serve? ❑ Yes ❑ No
If yes, what type?
***IMPORTANT*** CLIENTS MUST COMPLETETHE REQUIRED PROPERTY INFORMATION REQUESTED
BELOW. Either a PLAT or SITE PLAN MUSTBESUBMITMbythe client with THIS APPLICATION.
Property Dimensions: / ,!
Tax Office PIN: # -5-77&�// 7�
Property Address: Road Name�i^4,'SdyG
City/Zip cc-
WRITE DIRECTIONS (from Mocksville) to PROPERTY:
If in a Subdivision provide inform/a�tion, as follows: / Jr /COY O r` c
Name: t'� Cc /y7l!) S / L' 66) �i
Section: Block: V Lot: Date Property Flagged 6uJG le=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 am responsible for all charges incurred from
this application. I, hereby, give consent to the Authorized Representative of the Dgqe Conn Healf4 Depa ent
to enter upon above described property located in Davie County and owned by _'Q,/1id���i �¢ar o j)
to conduct all testingCprrocedures as necessary to determine the site suitability. —�
DATE (Q ,-- ' Q r aSIGNA
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)
Site Revisit Charge
Date(s):
Client Notification Date:
EHS:
d4 Account No.
Invoice No.
Ply.