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187 Country Circle Lot 15Davie County, NC Tax Parcel Report Wednesday, November 23, 2016 Building Value: 273300.00 Outbuilding & Extra 25810.00 Freatures Value: Land Value: 125710.00 Total Market Value: 424820.00 Total Assessed Value: 424820.00 E01 WARNING: THIS IS NOT A SURVEY All data Is provided as Is without warranty or guarantee of any Idnd either expressed or Implied Including but not limited to the Impliedwainu. es of merchantability or fitness for a particular use. AN 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 or arising out of the use or Inability to use the GIS data provided by this websIte. Parcel Information Parcel Number: 208 Shady Grove NCPIN Number: 05 12 138 Account Number: Census Tract: 37059-803 Y 15 444_. Voting Precinct: EAST SHADY GROVE 187 GOA Davie County City: Zoning Class: 13 7 37 State: Zoning Overlay: Zip Code: Voluntary Ag. District: No Legal Description: 163- ADVANCE Assessed Acreage: 8.75 Elementary School Zone: SHADY GROVE Deed Date: 4/1997 Middle School Zone: WILLIAM ELLIS Deed Book I Page: 001940309 Soil Types: MrC2,GnB2,EnC,ChA,RwAWATER ------ ----------- 0005 Flood Zone: Building Value: 273300.00 Outbuilding & Extra 25810.00 Freatures Value: Land Value: 125710.00 Total Market Value: 424820.00 Total Assessed Value: 424820.00 E01 WARNING: THIS IS NOT A SURVEY All data Is provided as Is without warranty or guarantee of any Idnd either expressed or Implied Including but not limited to the Impliedwainu. es of merchantability or fitness for a particular use. AN 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 or arising out of the use or Inability to use the GIS data provided by this websIte. Parcel Information Parcel Number: E8140A0015 Township: Shady Grove NCPIN Number: 5881018857 Municipality: Account Number: Census Tract: 37059-803 Listed Owner 1: Voting Precinct: EAST SHADY GROVE Mailing Address 1: Planning Jurisdiction: Davie County City: Zoning Class: DAVIE COUNTY R -A State: Zoning Overlay: Zip Code: Voluntary Ag. District: No Legal Description: LOT 15 8.76 AC COUNTRYSIDE Fire Response District: ADVANCE Assessed Acreage: 8.75 Elementary School Zone: SHADY GROVE Deed Date: 4/1997 Middle School Zone: WILLIAM ELLIS Deed Book I Page: 001940309 Soil Types: MrC2,GnB2,EnC,ChA,RwAWATER Plat Book: 0005 Flood Zone: Plat Page: 210 Watershed Overlay: DAVIE COUNTY Building Value: 273300.00 Outbuilding & Extra 25810.00 Freatures Value: Land Value: 125710.00 Total Market Value: 424820.00 Total Assessed Value: 424820.00 E01 Davie County, NC All data Is provided as Is without warranty or guarantee of any Idnd either expressed or Implied Including but not limited to the Impliedwainu. es of merchantability or fitness for a particular use. AN 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 or arising out of the use or Inability to use the GIS data provided by this websIte. L ,-n�.'�r yt fF*k - a w; 1 5,'« �`, vdw.d# i ryas },qr;: r.7ri:,µ1�%y�.P.�x•�f.W-brTe.:;1 i� 4t ;..+a4 '.n - � o r4-#"�4Y. itl�.:';��r V.Yf�� ;,yi'.�y".r �., � ` �Y'f6 7.y,,/" is � t �.i ' .r* 15`=, . P.ti�:k'( �. ./'�b'n +'�` i •;!"'-d' �.`.` a :v4' .."t"wF � uTH .+RIZATION NO. DAVIE COUNTY HEALTH DEPARTMENT d ' ( 7 4A PROPERTY INORM TION Environmental Health Section Permittee's `- P.O. Box 848 Name: i%' Mocksville, NC 27028 Subdivision Name:���--" / Phone # 336-751-8760 �r Directions to property: Section: ♦ Lot: AUTHORIZATION FOR WASTEWATER Tax Office PIN:# �} ,,� SYSTEM CONSTRUCTION - fl f - Road NameZ j ` r Zip: 7lrr **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) ***NOTICE***, THIS AUTHORIZATION FOR WASTEWATER CONSTRUCTION IS VALID FOR A PERIOD OF FIVE YEARS. ENVIRONMENTALHEALT PECIALIST DATE ISSUED } r•a �e a•``tt— w;..y3 kr �..•. e.,.h�t.liar."'e.-+..;r,r'r+FN,.%+vior»�,f'"rj. r-. ^a ..i y;., a•. fe .1 e•.. 1 . r ^' .. .':# ...t•it r.`y .. r..�`'.Y r�DAVIE COUNTY HEALTH DEPARTMENT �� L ' /� / . •,;. ,,,,� IMPROVEMENT AND OPERATION PERMITS PR ,PE INFORMATION Perim ee'.s` Name: '�,. `r ) .' rJ' ;;. Subdivision Name. r ,' Directions to property: `` j +?`' Section: Lot:�- 'q IMPROVEMENT ,.. PERMIT Tax Office PIN:# ,E Road Name: <,r Zip:, **NOTE** Thi 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 f ra this Departmentprior 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 anan d Disposal Systems) r ***NOTICE*** THIS PERMIT IS SUBJECT TO REVOCATION IF SITS PLANS OR THE INTENDED USE CHANGE. YOUR WASTEWATER" ENVIRONMENTAL HEALT SPECIALIST DATE ISSUED SYSTEM CONTRACTOR MUST SEE THIS PERMIT BEFORE INSTALLING THE SYSTEM. RESIDENTIAL SPECIFICATION: BUILDING TYPE _�`'� # BEDROOMS , # BATHS # OCCUPANTS GARBAGE DISPOSAL: Yes or No COMMERCIAL SPECIFICATION: FACILITY TYPE # PEOPLE # PEOPLE/SHIFT # SEATS INDUSTRIAL WASTE: Yes or No LOT SIZE TYPE WATER SUPPLY e4b DESIGN WASTEWATER FLOW (GPD) l/ NEW SITE REPAIR SITE SYSTEM SPECIFICATIONS: TANK SIZE -M-0—GAL. PUMP TANK /!!A" GAL. TRENCH WIDTH C r ROCK DEPTH L LINEAR FT. OTHER REQUIRED SITE MODIFICATIONS/CON ITIOI�jS: IMPROVEMENT PERML VEA EFFLUENT FILTER* *RISER(S) IF 691, BELOW FINISHED GRADE* �a **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 # ISI (336)751-8760 DCHD 05/96 (Revised) . 1. Z. tiPP""CAIION FOR SITE EVAII AMON/IMPROVEMEN : PERMIT & ATC . , Davie County Heal°,h 3epartmejit Entritnnmental Health Seco.! P.O. Hcx 8961210 Hospital S?=wt Mooksville, NSC 27028 (336) 751-8760 ***IMPORTAt?f*** TaNXS�_roPPL'SCATION.,isRNRU • MW PPAOMSSE°D UNLESS ALL THE REQUIRED IN-10RMATIOri IS PROVIDED. iEefer to the INFORMATION BUMATIN Z: z =-st-==tions. / Ham to be Billed / Jw ✓ r. 4 Contact person Mailing Address / % 2 S city/state/zip _ % c.-- - < <,/ .2? C7 / '.Z Business Phoma C3 3C, 3 V S— Z o u to Mame on Pewit/ASC if Different than Above Nailing Address 3. Application For: Il-irite Evaluation City/state/Lip .,/ 0 Improvement Permit/ATC 11Both +. system to service: Z XbUse 0 Mobile Home 0 Business 0 Industry 0 Other s. If Residence: # People Z # Bedroom �_ # Bathrooms Z 9-61'shwasher 8'darbage Disposal O-ashing Machine 6. If Business/Industry/other: specify type # Commodes # shavers 0 Basement/Plumbing dement/No Plumbing # people # sinks # Urinals # Nater Coolers IF FOODSERVICE: 11 Seats Estimated Water Usage (gallons per day) 7. Type of water supply: 9-6u ❑ Well 0 Community 8. Do you anticipate additions or expansions of the facility this system is intended to serve! 0 Yes Z64-0- If -No If yes, what type' ***IMPORTANT***CLIENTS AIUSTCOAIPLETETHE REQUIRED PROPERTY INFORMATION REQUESTED BELOW. Either a PLAT or SITE PLAN MUST BESUBMITTED by the client with THIS APPLICATION. Property Dimensions: k, S L --7 /1 WRITE DIRECTIONS (from MockrAlle) to PROPERTY: Tax Office PIN: # S' is 2:� 1 — b 1 ff X S 7 .00/`s� = �' o �� / S T✓, _ /,� ¢ Property Address: Road Name City/Zip 4,,1,. , < < Z -7 os, If in a Subdivision provide information, as follows: Name: r .--4, ., S J ' / Section: Block: Lot: s� Date Property Flagged: 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 respondblefor all charges lncurred 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-- P.o conduct all testing procedures as necessary to determine the site suitability. D A,TE �/S 9 SIGNATURE C THfM , AREA MAY BE USED FOR DRAWING YOUR SITE PLAN (Include all of the following: Existing and proposed property linea and dimensions, structures, setbacks, and septic locations). Revised DCHD (07/98) Account No. Invoice No.©fir APPLICATION FOR SITE EVALUATIONAMPROVEMENTS P "' Davie County Health Department s 0 V 9 Environmental Health Section P. O.. Box 665 Mocksville, NC 27028 3 0 1. Application/Permit Requested By �°Q ¢ r d ing M1IUT HEALT H 'VIE Malting Address S°Zy rl-- ^4 -fo , S -t /zv, /�% �- .<t /� / o Y, Home Phone -2 (0 0 G StE Business Phone to Y' 1' 2. Name on Permit if Different than Above 3. Application/Permit for: Id General Evaluation ❑ Septic Tank Installation � 4. System to Serve: 2 House ❑ Mobile Home ❑ Place of Public Assembly ❑ Business ❑ Industry O Other ❑ Unknown 5. If house, mobile home: Subdivision C --d Section Lot # �S ❑ Basement/Plumbing No. of People O Basement/No Plumbing No. of Bedrooms O 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 Commodes No. of Sinks No. of Urinals No. of Lavatories No. of Water Coolers No. of Showers Water Usage Figures 7. Type of water supply: [3 -Public ❑ Private ❑ Community 8. Property Dimensions • .S! Sewage Disposal Contractor 9. Do you anticipate additions/expansion of the facility this sytem is Intended to serve? ❑ Yes ❑ No If yes, whist 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 incurred from this application. ,�—j —75— —q DATE of my knowledge, and I understand 1 am 4 E I e 9 #J:N-- -14-;� SIGNATURE for all charges CQNSEN EM aM EVALUATION IQ BE QDNE QN ABOVE DESCRIBED PROPERTY MUST CHECK ONE: ❑ 1. 1 QWN the property. 9-2-11 DO NOT OWN the property. If you checked Box #2, the rest of this form h4M 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 a c # V-- G.1 A Y P e f't� to conduct all testing procedures as necessary to d e said site's suitability for a ground absorption sewage treatment and disposal system. OJA — DATE SIGNATURE DCHD (12.00) DAVIE COUNTY HEALTH DEPARTMENT Environmental Health Section Soil/Site Evaluation NAME < Z!S7'� ADDRESS PROPOSED FACIILTY DATE EVALUATED PROPERTY SIZE LOCATION OF SITE _ Water Supply: On -Site Well _ Commuln, Public V Evaluation By: Auger Boring Pit !� Cut FACTORS 1 2 3 4 Landscape Rosition S' s Sloe 7.. O" S -3a 30 C. - 3d HORIZON I DEPTH ' \1 2�� " 2 Texture group CL C L, CL C Consistence Structure Mineralogy HORIZON II DEPTH =3 to 6' 3 b Texture group L° Consistence Structure d',i- Mineralogy Mineralo 1', 1 HORIZON III DEPTH Texture group Consistence Structure Mineralogy HORIZON IV DEPTH Texture group Consistence Structure Mineralogy SOIL WETNESS S S RESTRICTIVE HORIZON --' -- SAPROLITE CLASSIFICATION LONG-TERM ACCEPTANCE RATE .� 17 SITE CLASSIFICATION: EVALUATED BY: `31'1� LONG-TERM ACCEPTANCE RATE: e� STHER(S) PRESENT:�� REMARKS: Zp LE EN 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 ;lay loam, SIL -Silty loam CL -Clay loam SCL-Sandy clay loam SC -Sandy clay SIC -Silty clay C -Clay CONSISTENCE Moist VFR- Vl_--y 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 S 27°50' 21" E S 330 27' 21' E C 16561 S 380 04; 16' E��� S 19° 4 7' 1 S R' ROAD' C� - UN 471.59 TOTAL 72.07+ 9 919 8'}r' 50 RAW. 41` 17' -64 E �'12893 / 0.3q +��-S N 611.99 TOTAL S 342.66 A -7 38.32 9� �� + r.. } � �, LOT 27'� o z 90` S 41° 17 � 34 E 403.13 I �o A 1.509 AC. . o )1. 9 cn y� 6 N w ^ LOT 21 -1 i-, v 8 � o :0 m 1,718 AC o S 34° 09' 00 E -+ c Ln =' N o LOT II owLn "� cn 329.89 cA o- LOT 20 L O T 10 w L bD +- N 340 09' 00' W 74 o: 2.560 AC. No 0 o rn 2.402 AC '.545 A C. o 0 0. 340.00 z iw o LOT 26 0 S G'� C- , 7 �. o, * o o �, 0 >l 3G 6c -� rn Control Corner o 0 8 w 1.515 AC 8 1 4° 09 00" W -•-- N Be 09' 06'W o LOT 22 v_� '� -'-' N 34° 09 C' 285.00 400.00 3 1.717 AC. 0 n "-' N 34° 09' �„ W Z 379.96 z S 55° 51' COP W = r � 329.89 Ln v, LOT 12 87.42 a 8 m N v' -d o-�- N 34° 09 00" W S o w L O T 19 LOT 9 ° 2.031 AG Q to S. 46° 41' S0" W 339.44 LOT 25 ^' p v'. 0 2.035 A 1.439 AC. o ARC = 132.59 o o •F CHORD = 13203 ? 1.515 AC. 8 o 0 o: LOT 23% z N 340 09' 00' W f m 14° 09 OO' W m -•- N 34° 27' IC W cs ,p 1.994 AC N w g z N 340 09 285.00 421.01 J, %y9,Q0P90 S ° N 329.89 0 390 -BE 'A O o m p m m° p0 U N 55 51' 04' I ° v! 56.94 y0 ���\\�° `� `�'3 `S�Q �`SS `° o o cin. F-5 �T A� �1 h� pro �'� � _LOT 4 w �G�.�Q.'3. OFi38,0P o:2 ti w� O �0�n LN 72025' 24„ 1. 53 8 AC. o L 0 T 13 °`moo '�; °0 0 * 0. �P O ti' O ARC 133.0E 0 z� i� O /p� F OAC, o `L� CHORD: 131,^c O N 3.4 6 5 A C. Q'o$ 1 1 O� P� 1� y0 ° 00 Wy� ,'L N 25 29 :i4° 0v 00" W o gA03°S.,• Cot//V % PO 445.17 285.00• �? o o v� C"14 ' 2` 28" RY CIRCLE , ,2�5 29oq o�� 0 01 O PS �. /9 .9OF /�'- , ,�(Po CNORC _ 93C E / L O T 7 L\) m 62 9c�6 O P, c 80� ,0, 0- 89. 0 o �- O 1.370 AC. 0 f,u p~ 00 q3 o O � ,ti G O o [s3. 0. W) o 0° °- 26 Droinoge 33° 54 41" W ti 2� is c _to „" p Easement 284.99. ��a oiQ o o En N 32°33' 58"E LOT 14 vet N ARC : 20.32v' °^ cn , 10rn --r CHORD 19,76 m 7. 59 6 ASC. . J o R:25.00 c LOT 6 0 - U 3 ^>"� �% 00 V. a o 2.300 AC. r f/ A NOD v M 0) 5 Qr CPO"_ _� �0 8.569LOT 1 AC. �. �N LOT 16 L, z \ 7.922 AC. a 10. M � r ZONE A FLOOD LI AKEN o o° -40.87 0 39.61 FROM U.S. DEP . 0 HOUSING & \ + URBAId DEV. MAP i �+rte +� rn /, /9 CL Z OOO dg? a 15' 59' W 50.00 Q ' . 29" w CARTERS CREEK 8211 9 N 67°1I' 06' W 0. N 42°54' 53" W} �+ 9410 + m 72.44 N 56° 31' 02" E ---�'� �+ -� cD 5C8 '• N 14 E 60.4810TOTAL+� 49° 01.30 + e9/� �� \ 7028 50.00 +.�,_+ 114.00 N 250 5 6' 5 5"- + n` N 37°2$ 17"W 184.2 T8 07ALW p + 50.00+ 00 1 090 56' 51" E v a N 500 37' 43" E \� �� • ' •+ POTTS INVESTMENTS + 10 +1 Davie County Neall Department and dome .wealth-���y�ency 210 HOSPITAL STREET/ P.O. BOX 665 MOCKSVILLE. N.C. 27028 PHONE: (704) 634.5985 April 18, 1995 Mr. Paul Pelton 520 Knobview Winston-Salem, NC 27104 Re: 2 Site Evaluations Countryside/Lots 14-15 Dear Mr. Pelton: On April 12, 1995, I did site evaluations on lots 14 and 15 in Countryside off Underpass Road. Both lots are provisionally suitable on the very front of each lot. You will have to pump to these areas. Also, each lot will need a modified system with extra line. The back portion of each of these lots is unsuitable and also is in a flood area. Sand filter systems could empty in the Carter's Creek, which is behind lots 14 and 15. The permits for these systems are issued by Environmental Management out of Winston-Salem at 910/896-7007. If you have any questions, please feel free to contact me at 704/634-8760. Sincerely, Charles E. Little, R.S. Environmental Health Section CEL Enclosure