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118 Roxbury Court Lot 46Davie County, NC I Tax Parcel Report Wednesday, November 30, 2016 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: 125 �NaONCT 123 2 >3 112 128 C DR 120 WARNING: THIS IS NOT A SURVEY - Parcel Information H8060A0046 Township: Shady Grove 5789241290 Municipality: 8303410 Census Tract: 37059-804 SMITH TIMOTHY FLINN Voting Precinct: EAST SHADY GROVE 118 ROXBURY COURT Planning Jurisdiction: Davie County ADVANCE NC 27006 LOT 46 COVINGTON CREEK PHASE ONE 1.03 4/2014 009560349 0007 057 Zoning Class: DAVIE COUNTY R -A Zoning Overlay: Voluntary Ag. District: No Fire Response District: ADVANCE Elementary School Zone: SHADY GROVE Middle School Zone: WILLIAM ELLIS Soil Types: PaD,PcB2,PcC2 Flood Zone: Watershed Overlay: DAVIE COUNTY Outbuilding 8r Extra Freatures Value: Total Market Value: 10:1 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. Ali users of Davie Countys 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 NCor arising out of the use or Inability to use the GIS data provided by this website. DAVIE COUNTY HEALTH DEPARTMENT Environmental Health Section P. O. Boa 848/210 Hospital Street Mocksville, NC 27028 (336)751-8760 Account M 989900317 Tax PIN/EH #: 5789-24-1290 Billed To: Glory Home Builders Reference Name: Harvey Schneider Proposed Facility: Residence ATC Number: 2130 Subdivision Info: Covington Creek Sec. 1/1311k 1 Lot # 46- Location/Address: Roxbury Court -27006 Property Size: See map 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 Tr tment and Disposal Systems). THIS AUTHORIZATION FOR WASTEWATE CON ION IS ALID FOR A PERIOD OF /FIEARS. Environmental Health Specialist's Signatu e: Date:i 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. I/O /1,01 0 f � Septic System Installed Environmental Health Specialist's Signature: DCHD 05/99 (Revised) T,414 -75 -4e - ,!z' F; -/Ac __ Date:i .I , Account #: Billed To: Reference Name: Proposed Facility: DAVIE COUNTY HEALTH DEPARTMENT Environmental Health Section P. O. Boa 848/210 Hospital Street Mocksville, NC 27028 (336)751-8760 IMPROVEMENT/OPERATION PERMIT 989900317 Glory Home Builders Harvey Schneider Residence Tax PIN/EH #: 5789-24-1290 Subdivision Info: Covington Creek Sec. 1/Blk 1 Lot # 46 Location/Address: Roxbury Court27006 Property Size: See map ATC Number: 2130 **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�- e; #People #Bedrooms 3 #Baths 2.� Dishwasher: Garbage Disposal: ❑ Washing Machine: 121""' Basement w/Plumbing: ❑ Basement/No Plumbing: Commercial Specification: Facility Type #People #People/Shift #Seats Industrial Waste: ❑ Lot Size Type Water Supply Design Wastewater Flow (GPD) 7 Site: New i7ro."Repair ❑ ,1 System Specifications: Tank Size 1�AL. Pump Tank GAL. Trench Width Rock Depth I Z Linear Ft.� Other: �QjcjT�oasX� ,�T4t.1 _ L4Jme-'91a•C . Required Site Modifications/Conditions: � 1ST fl� {�t�L7-Sc, �, �p� 00P qvAP. L.,.3f- , IN)S;rQL L c».J C-P"Tp 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.**** \ F � UAum 10 E3P�`Q I(xo 1 �5 0 I ��3 4 J F2o� Environmental Health Specialist's Signature: DCHD 05/99 (Revised) A fa arJ d `�t � -s' ., s —_�. -y/ is-: i .� . r � v7�-; 'i :'ice ..�. r.. �, �.. .'f.y., '"`-. :. .. ...v ..- x.. . h '<- �•. .- � i / it Q � j Y w r ..:1 ~.;r• +r � w.L DAVIE COUNTY HEALTH DEPARTMENT IMPROVEMENT AND OPERATION PERMITS PROPERTY INFORMATION, Name' Subdivision Name: ��/i' ��• -�� Directions to property:j �`-� , y Section: Lot: Il�IPROVEMENT ✓ .� ri , PERMIT Tax Office PIN:#� - -1 - Road Name: Zip: **NOTE** This 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 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) . - ***NOTICE*** THIS PERMIT IS SUBJECT TO REVOCATION IF SITE PLANS OR THE INTENDED USE CHANGE. YOUR WASTEWATER ENVIRONMENTAL HEALTH SPECIALIST DATE ISSUED SYSTEM CONTRACTOR MUST SEE THIS PERMIT BEFORE INSTALLING THE SYSTEM. - RESIDENTIAL SPECIFICATION: BUILDING TYPE 17` #BEDROOMS '3 # 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 �' DESIGN WASTEWATER FLOW (GPD) -"79 % NEW SITE REPAIR SITE SYSTEM SPECIFICATIONS: TANK SIZE GAL. PUMP TANK GAL. TRENCH WIDTH ROCK DEPTH LINEAR FT. OTHER d 12F� REQUIRED SITE MODIFICATIONS/CONDITIONS: IMPROVEMENT PERMITLAYouT*APPROVED EFFLUENT FILTER* *RISER(S) IF b'.'' BELOW FINISHED GRADE*: , ,veletl C `t� �lsd � 4 i j ra �e "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 # IS j�6 OO (335)751-8760 427 �. OPERATION PERMIT _SXSTEMI�STALLED BY: ,: . �:- - . Yrtr V �. n_.{ +v .:•. "...iY :'.. ,,,.>:a:.::ii /'--4r:+:-` .ti.^ -y..; ..� �r'sa,., :'if'i,..-.w��..°.+ir'.^'HO'.{{`tr"Pci...3T .in .. .e•3iL ..L'N•-Yfi(1. ±,f.i�'.i }•5'. �.-1" .. ray -6 N NO: � " 6 Z r T c32ATI r , ,... 2dbAVIE COUNTY HEALTH DEPARTMENT f'Environmental Health Section PRr0PE0RCT'Y?I AiFORMATION P.O. Box 848 Name: X.— Mocksville, NC; 27028 Subdivision Name: wi /t rt4� Phone # 336-751-8760 J Directions to I � .;„ roperty: ,,��+? . � � ,� tff �Y Section: Lot: AUTHORIZATION FOR WASTEWATER Tax Office PIN: �- SYSTEM CONSTRUCTION Road Name: Zip **NOTE* This Authorization for Wastewater System Construction MUST BE ISSUED by the Davie County Environmental Health Section prior to issuance of any Building -Pen -nits. This Fonn/Authorization Number should be presented to the Davie County Building Inspections t Office when applying for Building Permits. (In comp dance with Article 1 I of G.S. Chapter 130A, Wastewater Systems, Section .1900 Sewage Treatment and Disposal Systems) ***NOTICE*** THIS AUTHORIZATION FOR.WASTEWATER CONSTRUCTION IS VALID FORA PERIODOF FIVE YEARS. ENVInk )NMENTAL HEALTH SPECIA IST ' DATE ISSUED S 34"49'08"E 340.00' W-0 N u 32.00 U e.001 \ � r ` AB �'OC IA L "s G f- l•2G9C 4t SITE PLAN ONLY THIS WAS MAPPED FROM . A DEED OR RECORD PLAT AND NOT FROM A SURVEY BY ME. yc 47 COVINCfON DR SITE —� os 010 LOCATION MAP 30 0 30 60 HHHHHi Gj GRAPHIC SCALE — FEET OL MAP FOR GLORY BUILDERS SCALE TOWNSHIP COUNTY STATE r = 30' SHADY GROVE DAME N. C. 7 LOT 46 COVINGTON CREEK PHASE ONE P.B. 7 PG. 57 HOWARD SURVEYING JOHN RICHARD HOWARD PLS P.O. BOX 276 ADVANCE. N.C. (336) 998-5396 Mm W 32.00• ` ' - � 39.5_>•_ � O � �o O C T \ _ t U PROPOSED h HOUSE jp N I d N N u 32.00 U e.001 \ � r ` AB �'OC IA L "s G f- l•2G9C 4t SITE PLAN ONLY THIS WAS MAPPED FROM . A DEED OR RECORD PLAT AND NOT FROM A SURVEY BY ME. yc 47 COVINCfON DR SITE —� os 010 LOCATION MAP 30 0 30 60 HHHHHi Gj GRAPHIC SCALE — FEET OL MAP FOR GLORY BUILDERS SCALE TOWNSHIP COUNTY STATE r = 30' SHADY GROVE DAME N. C. 7 LOT 46 COVINGTON CREEK PHASE ONE P.B. 7 PG. 57 HOWARD SURVEYING JOHN RICHARD HOWARD PLS P.O. BOX 276 ADVANCE. N.C. (336) 998-5396 • ,_ ` • : . , ' . DAVIE COUNTY HEALTH DEPARTMENT Environmental Health Section SECTION_ LOT Soil/Site Evaluation APPLICANT'S NAME �l/%� PROPOSED FACILITYY� / �! SUBDIVISION e R h /I4 / rid% / C eA Water Supply: On -Site Well Community Evaluation By: Auger Boring Pit c� DATEEVALUATED dr PROPERTY SIZE ROAD NAME �6 % Public 11---*- Cut FACTORS 1 2 3 4 5 6 7 Landscape position Slope % HORIZON I DEPTH Texture group Consistence Structure _ Mineralogy HORIZON II :DEPTH f -Ir r Texture group Consistence Structure ✓ Mineralogy I HORIZON III DEPTH 'iexture 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: OJ LONS-TERM ACCEPTANCE RATE: REMARKS: UCHD (0i-90) EVALUATION BY: 2 42 / 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 Moist 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 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 APP1,11A ION FOR SITE EVALUATIONAMPRWIMENT PERMIT Davie County Health Departrne!!t Environmental Health Section P.O. Box 848 Mocksville, NC 27028 (704) 634-8760 ****IMPORTANT**** THIS APPLICATION CANNOT BE PROCESSED UNLESS ALL THERqUIRED INFORMATION IS PROVIDED. 1. Name to be Billed Hb ^4 e— S Contact Person el e• -V r'f Mailing Address ?A t) >l L3 d 1) Home Phone City/State/Zip_, Unto CE .2 706 Business Phone 1913-391P' 2. Name on Permit/ATC if Different than Above Mailing Address City/State/Zip i 3. Application For:ite Evaluation [ ] Improvement Permit & ATC Both 4. System to Serve: [ ] House [ •] Mobile Home [ ] Business [ ] Industry [ ] Other /0+ utr ► >f �.S �On1 5. If Residence: # People # Bedrooms # Bathrooms [ ] Dishwasher [ 1 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 [`]'1Qo If yes, what type? 1 I ►err ►; ,� lY. (1 .(Ir; ;.1 I I' I'! l;; PROPERTY INFORMATION REQUIRED: *** IMPORTANT ***`A FLAT OF THE PROPERTY MUST BE SUBMITTED WITH THIS APPLICATION. Property Dimensions: _fit"+' of 66 A.0 . JM« -e —,'WRITE DIRECTIONS (from Mocksville) TO PROPERTY: Tax Office PIN: # _ �wwcTzbid L p:� AVaPuce Property Address: Road lame City/Zip ,Q�U• 217004 CQ'1`=Cc7%m ade11 comers L If in Subdivision provide information, as follows: Name: o t•p Section: f Lot #: dM - This is to certify that the information provided is correct to the best of my knowledge. I understand that any permit(s) issued hereafter sr subject to suspension or revocation, if the site plans or intended use change, or if the information submitted in this application is falsified o changed. I, also, understand that I am responsible for all charges incurred from this application. I, hereby, give consent to the Authoriz of the Davie County Health Department to enter upon above described property located in Davie County and owne Revised DCHD (06-96) all testing procoures as necessary to determine the site suitability. 1111: :tl;I".l Af k1l tir I1""Fb 1-01; WMIHN(i 1f(.)Ill? "I IT PLAN: "' APPLICATION FOR SFFE EVALUATION/iMPROvEMFM PERMIT & ATC Davie County Health Department En vitonmenf a/ Hea/Ifi Section P.O. Box 848/210 Hospital Street Mocksville, NC 27028 (336) 751-8760 ENYIRO VIE COUNTY Al1H ***ZMPORTANT*** THIS APPLICATION CANNOT BE PROMSSED UNLESS ALL THE REQUIRED INFORMATION IS PROVIDED. Refer to theINFORMATIONBULLETIN for instructions. 1. Nass to be Milled �� i K i� Contact Person Pay'i't—�Z Mailing Address jS�y33 1�a yf�Al��'ii�/ Ross Phone City/State/ZIP //✓, Ir SI�Dn' �� /Ym NG ���%� Business 2. Name on Permit/ATC if Different than Above Mailing Address City/state/Zip 3. Application For: ❑ Site Evaluation 8'fmprovement Permit/ATC ❑ Both 4. system to service: 4420u9e ❑ Mobile Home ❑ Business ❑ Industry ❑ Other s. If Residence: # People # Bedrooms # Bathrooms 02 >s _ tt11ishwasher ❑ Garbage Disposal J,�,W hing Machine ❑ Basement/Plumbing P-gZsemant/No Plumbing 6. If Business/Industry/Other: Specify type # People # Sinks # Commodes # showers # Urinals # Water Coolers IF FOODSERVICE: # Seats Estimated Water Usage (gallons per day) 7. Type of water supply: V"County/City ❑ Well ❑ Community e. Do you anticipate additions or expansions of the facility this system is intended to serve? ❑ Yes %49 -No If yes, what type? ***IMPORTANT*** CLIENTS MUST COMPLETE THE REQUIRED PROPERTY INFORMATION REQUESTED BELOW. Either a PLAT or SITE PLAN MUST BE SUBMITTED by the client with THIS APPLICATION. Property Dimensions: �--1 Tax Office PIN: # -7 _� I Property Address: Road Namego)(40 0I City/Zip ��Q r/o v, c �P WRITE DIRECTIONS (from Mocksville) to PROPERTY: �I 7' o � � � di�A�ay► �-� If in a Subdivision provide information, as follows: Name: i ` d n Cf PE' Section: �_ Block: �_ Lot: 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 I, also, understand shat 1 am responsible for all charges incurred 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 to conduct all testing procedures as necessary to determine the site suitability. A 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). Site Revisit Charge Date(s): Client Notification Date: EHS: Revised DCHD (07/99) Account No.1' U Invoice No. 7&