106 Covington Drive Lot 1T
Davie Countv. NC
Tax Parcel R Pnnrt
Wednesday. November 30. 2016
WAKNINU: '1'tllJ IS 1VU"1' A NUKVEY
Parcel Information
Parcel Number:
H806OA0001
Township:
Shady Grove
NCPIN Number:
5789343790
Municipality:
Account Number:
8301650
Census Tract:
37059-804
Listed Owner 1:
SCHUH KEVIN D
Voting Precinct:
EAST SHADY GROVE
Mailing Address 1:
106 COVINGTON DRIVE
Planning Jurisdiction:
Davie County
City:
ADVANCE
Zoning Class: DAVIE COUNTY R-20
State:
NC
Zoning Overlay:
Zip Code:
27006
Voluntary Ag. District:
No
Legal Description:
LOT 1 COVINGTON CREEK PHASE ONE
Fire Response District:
ADVANCE
Assessed Acreage:
0.71
Elementary School Zone: SHADY GROVE
Deed Date:
12/2012
Middle School Zone:
WILLIAM ELLIS
Deed Book I Page:
009100118
Soil Types:
PcI32,PcC2
Plat Book:
0007
Flood Zone:
Plat Page:
057
Watershed Overlay:
DAVIE COUNTY
uildin& Extra
Building Value:
FO eatures Value:
Land Value:
Total Market Value:
Total Assessed Value:
Es
All data Is provided as Is without warranty or guarantee of any idnd either expressed or implied Including but not limited to the
Davie County, Implied warranties of merchantability or fitness for a particular use. All 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 ail claims or causes of action due to
NC or arlsing out of the use or Inability to use the GIS data provided by this website.
Account #:
989900035
Billed To:
Richard Short
Reference Name:
Richard Short
Proposed Facility:
Residence
ATC Number: 2182
DAME COUNTY HEALTH DEPARTMENT
Environmental Health Section
P. O. Boa 848/210 Hospital Street
Mocksville, NC 27028
(336)751-8760
Tax PIN/EH #: 5789-34-3790
Subdivision Info: Covington Creek Sec.1 Lot # 1
Location/Address: Hwy. 801 S.-27006
Property Size: 250 x 100
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 Trrent and Disposal Systems). THIS
AUTHORIZATION FOR WASTE N IS ALID FOR A PERIOD OF FIVE YEARS.
Environmental Health Specialist's Signature: Date: /b 41
CERTIFICATE OF COMPLETION
**NOTE** The issuance of this Certificate of Completion shall indicate the system described on Improvement/Operation Permit
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.
0
Septic System Installed By:
Environmental Health Specialist's Signature:
DCHD 05/99 (Revised)
. is -o x3 X•.2
/-5by3X/2
Date: O -F'-'0 2-06
DAVIE COUNTY HEALTH DEPARTMENT
' Environmental Health Section
' P. O. Boz 848/210 Hospital Street
Mocksville, NC 27028
(336)751-8760
IMPROVEMENT/OPERATION PERMIT
Account M 989900035 Tax PIN/EH #: 5789-34-3790
Billed To: Richard Short Subdivision Info: Covington Creek Sec.1 Lot # 1
Reference Name: Richard Short Location/Address: Hwy. 801 S.-27006
Proposed Facility: Residence Property Size: 250 x 100
ATC Number. 2182
**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.
Residential Specification: Building Type 40jsc- #People #Bedrooms 3 #Baths 2 .S
Dishwasher: O"' --Garbage Disposal: a Washing Machine: Basement w/Plumbing: ❑ Basement/No Plumbing: ❑
Commercial Specification: Facility Type 13/s #People #People/Shift #Seats Industrial Waste:
Lot Size Type Water Supply C Design Wastewater Flow (GPD) :Ey Site: New ❑-�-R—epair ❑
System Specifications: Tank SizeIbODGAL. Pump Tank GAL. Trench Width Z ' Rock Depth
IZ ' Linear Ft. SDd
Other: Z -D ISTb oo rio-J-86iazS , I �JSi3LL la "S 1,0 .e-.
Required Site Modifications/Conditions:
,j c: b rJTWe—, "L-,� CF 4 a os 2. V- e r --P
fl�
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.****
40+1
r/ L LQ
l
/10Y
Environmental Health Specialist's Si
DCHD 05/99 (Revised)
Date: 10 /
DAVIE COUNTY HEALTH DEPARTMENT /
Environmental Health Section SECTION X- LOT
Soil/Site Evaluation
APPLICANT'S NAME DATE EVALUATED
PROPOSED FACILITY %�� PROPERTY SIZE-�2IAe�
SUBDIVISION
Water Supply:
On -Site Well Community
Evaluation By: Auger Boring Pit L�
ROAD NAME 23ILZ
Public L�
Cut
FACTORS
1
2 3 4 5 6 7
Landscape position
J,
Sloe %
HORIZON I DEPTH
Texture group
Consistence
Structure
Mineralogy
HORIZON II DEPTH
Texture group
Consistence
- r
Structure
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 I,
SITE CLASSIFICATION: d5
LONG-TERM ACCEPTANCE RATE: '
REMARKS
DCHD (01.90)
EVALUATION BY: Tlt
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
T x ure
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
maid
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
SC - Single grain M - Massive CR - Crumb GR - Granular ABK - Angular blocky
SBK - Subangular blocky PL - Platy PR - Prismatic
Mineraloav
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
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 UNI
1
THE RE UIRED INFORMATION IS PROVIDED.
Name to be Billed 171b rv% e- q Contact Person e! e-
Mailing Address �d/� / 1 X -,-,,3 d 6 Home Phone
City/State/Zip V,11J C -e- A2C. 2706(3 Business Phone
2. Name on Permit/ATC if Different than Above
Mailing Address City/State/Zip
3. Application For: ite Evaluation (] Improvement Permit & ATC [ ] Both
+� hot
.
4. System to Serve: [ ] House [ •] Mobile Home [ ] Business [ ] Industry [ ] Other cC -2,16+ SUho[ 1 V /S /04
5. If Residence: # People # Bedrooms # Bathrooms [ ] Dishwasher [ ] Garbage Disposal
[ ] Washing Machine [ ] Basement/Plumbing [ ] Basement/No Plumbing
6. If Business/Other: Specify type # People #Sinks # Commodes
# Showers # Urinals # Water Coolers
If Foodservice: # Seats Estimated Water Usage (gallons per day)
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 Hf qo
If yes, what type?
177!IL1% ,t IIIA I OR `;LII; III- k:4
PROPERTY INFORMATION REQUIRED: *** IMPORTANT ***�A FLAT OF THE PROPERTY MUST BE
SUBMITTED WITH THIS APPLICATION.
Property Dimensions: qtr+ V� 1>8 4'c, WRITE DIRECTIONS (from Mocksvillle) TO PROPERTY:
Tax Office PIN: # 789 - O -q_ - �3 u� ; Lt,� i 126 1 tsh IJ n::c lgdy` Pu ce
Property Address: Road Dame 9O1
Dir 6 A % m
City/Zip =Or rrl iw u e r5 -. -
If in Subdivision provide information, as follows:
Name: �bl in'0�1 ree-k. �rcoSzc(
� r
Section: Lot #: to -
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
of the Davie County Health Department to enter upon above described property located in Davie County and owned
cam. 7=-�AXW4
all testing proce. u s as necessary to determine the site suitability.
Revised DCHD (06-96)
71118 ,11?FA ,11.11/ BE, 115EI) r0P 1JIMIVIN6 /0111? SIZF: 1'1-.1N:
LOT 20, MAP H-8
LEWIS M. CARTER &
WIFE DOROTHY P. CARTER
DB 59, PC 393
FUTURE PHASE 1
-- 1" EIP
mx.-R. P�-
Notary Puolic
,o
153.27' 10T L 3 J. 7' S 7' 44' 23" \ 6 Z��i_
240.00' b P
RICHARD C. SHORT e - __ - - - - - - T-E*RZCAP
>.
COVINGTON CREEK 8 s" �•
FUTURE PHASE 2 32, 3
I O
CONTROL o I 3• \ ,� 9��
CORNER N 1 S g9; \ O
R/W � Ir 9. c, `/ , s� 'PIP 0-
o
` 03 / 4 i 3 s
I ��
v 1 '• O
a,• , 64 >
"ES CONTROL I � I `o. N I�
CORNER 1 ^ N °c�n
(\ m I r+ J a," I_ N 7a
83.21' 44.79'` ® ib b a3 0 I ao
128.00' S_ 887. 55' 27"Q ' a
_
V
lid I
n I �� 94tr• � �/ �I
N I FUTURE FJ U. jj, I Oi
TENNISg
V)I COURTS Q S8 v //r\\\�N69J*19'KJ
_ -
4 5
—/ 62 2�
4 5 _ Off I �
_ 168.79'
4 9.19 N 7' 31 31
4,S6 \ I u7
7ti-_ 4
C: 5 A
100.00 98 - • — K .- A
.00'CD
50.00' -\ \ \ \ \ G \ \
I I I I I I #
aD
CA
o
Iz 10
1z I
Iz I I>A I \y \
I, I 1_ I
ap�
'1
ADVANCE
UNINCORPORATED
JIM
i.
DA OE COUNTY, NORTH CAROLINA.
• ��
I, q Notary of the County and State aforesaid,
certify that John C. Grgy and G. Ropert Stone
Registfred Land Surveyors, personally appeared
before me this day and acknowledged the 9,ecution
i
of the foregoing instrument. Witness my hand and
official stomp or seal,
�...
this day of November, 1998.
_V
Y —;.2- AM
My commission e>+plres
LOT 20, MAP H-8
LEWIS M. CARTER &
WIFE DOROTHY P. CARTER
DB 59, PC 393
FUTURE PHASE 1
-- 1" EIP
mx.-R. P�-
Notary Puolic
,o
153.27' 10T L 3 J. 7' S 7' 44' 23" \ 6 Z��i_
240.00' b P
RICHARD C. SHORT e - __ - - - - - - T-E*RZCAP
>.
COVINGTON CREEK 8 s" �•
FUTURE PHASE 2 32, 3
I O
CONTROL o I 3• \ ,� 9��
CORNER N 1 S g9; \ O
R/W � Ir 9. c, `/ , s� 'PIP 0-
o
` 03 / 4 i 3 s
I ��
v 1 '• O
a,• , 64 >
"ES CONTROL I � I `o. N I�
CORNER 1 ^ N °c�n
(\ m I r+ J a," I_ N 7a
83.21' 44.79'` ® ib b a3 0 I ao
128.00' S_ 887. 55' 27"Q ' a
_
V
lid I
n I �� 94tr• � �/ �I
N I FUTURE FJ U. jj, I Oi
TENNISg
V)I COURTS Q S8 v //r\\\�N69J*19'KJ
_ -
4 5
—/ 62 2�
4 5 _ Off I �
_ 168.79'
4 9.19 N 7' 31 31
4,S6 \ I u7
7ti-_ 4
C: 5 A
100.00 98 - • — K .- A
.00'CD
50.00' -\ \ \ \ \ G \ \
I I I I I I #
aD
CA
o
Iz 10
1z I
Iz I I>A I \y \
I, I 1_ I
ap�
'1
ADVANCE
UNINCORPORATED
JIM
i.
APP"CATION FOR SITE EVALUATION/IMPROVEMEM PERMR & ATC Q
Davie County Health Department D
Env/ronmenfyl Health AkWon
P.O. Box 848/210 Hospital Street SEP 2 71999
Mocksville, NC 27026
(336)751-8760
***XMPORTANTk** THIS ANPLICATION CANNOT BB BROClSZV UNLESS ALL TSE REQUIRED -T
INFORMATION IS PROVIDED. Refer to the INFORMATION BULLETIN for instructions.
1. Mane to be billed
Contact person _ 1 _ c !_v/tot i,
)tailing Address �(} �� c� 3dy nose phone �+�ftb•%-c
city/state/asp 4-2710 -✓G� a id d Business when. 918- S/77 ii - 80(f
2. hams on pewit/ATC it Different than Above
Nailing Address City/state/sip
3. Application For: a Site Evaluation 4�mprovement Permit/ATC
4. System to serdost ia'&onse O Mobile Home O Business 13 Industry O Other
a. If Residence: t people f Bedrooms Is i Bathrooms 02-�
ishnasher Disposal 04" • Machine 0 sages nt/pinabinq O sasearntAto Plumbing
S. If business/Industry/other: specify type # people i sinks
# Commodes i showers s Urinals 4 water Coolers
IF FOODSERVICE: # Seats Eatimated Yater Osage (gallons per day)
7. Type of water supply:CB' ounty/City a Well. 0 Comatuaity
a. Do you anticipate additions or expansions of the facility this system is intended to serve? 11 Yes W co
If yes, what type?
***IMPORTANT*** CLIENTS MUSTCOMPLETETHE REQUIRED PROPERTY INFORMATION REQUESTED
BELOW. Either a PLAT or SITE PLAN MUST BESUBMITTED by the client with THIS APPLICATION.
Property Dimensions: A±Z o;2,�/dd
VV
Tax Office PIN: # 9 7.Y -31- 3 6
Property Address: Road Name
City/ZIp
If in a Subdivision provide information, as follows:
Name: CdViedr1 Creek
Section: Block: Lot:
WRITE DIRECTIONS (from Mockn9le) to PROPERTY:
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 ase change, or if the Information
submitted in this application Is falslited or changed 1, also, understand that 1 ant responsible for aU charges Incurred from
this application. I, hereby, give consent to the Authorized Representative of the Davie Conn H Ith rtment
to enter upon above described property located in Davie County and owned by
to conductt all testing procedures as necessary to determine the site sal .
el -
DATE % - c?' -� - 47 9 SIGNATURE
THIS AREA MAY BE USED FOR DRAWING YOUR SITE PLAN (Include all of the following. Existing and proposed
property Hues and dimensions, structures, setbacks, and septic locations).
Site Revisit Charge
Date(s):
Client Notification Date:
f EAS:
Revised DCIED (07/99)
Account No. y&—
Invoice No. x9r,