159 South Hemingway Court Lot 330
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Davie Countv. NC '
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Tuesday, November 29, 2016
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Parcel Information
Parcel Number:
H8060A0033
Township: Shady Grove
NCPIN Number:
5789145085
Municipality:
Account Number:
8306311
Census Tract: 37059-804
Listed Owner 1:
SECHRIST JAIMIE LYNN
Voting Precinct: EAST SHADY GROVE
Mailing Address 1:
159 S HEMINGWAY CT
Planning Jurisdiction: Davie County
City:
ADVANCE
Zoning Class: DAVIE COUNTY R -A
State:
NC
Zoning Overlay:
Zip Code:
27006
Voluntary Ag. District: No
Legal Description:
LOT 33 COVINGTON CREEK PHASE TWO
Fire Response District: ADVANCE
Assessed Acreage:
0.82
Elementary School Zone: SHADY GROVE
Deed Date:
5/2016
Middle School Zone: WILLIAM ELLIS
Deed Book I Page:
010180001
Soil Types: PaD,PcB2,PcC2
Plat Book:
0007
Flood Zone:
Plat Page:
139
Watershed Overlay: DAVIE COUNTY
Building Value:
Outbuilding & Extra
Freatures Value:
Land Value:
Total Market Value:
Total Assessed Value:
Davie County,
All data Is provided as Is wltlrout warranty or guarantee of any kind either expressed or Implied Including but not limited to the
Implied warranties of merchantability or fitness for a particular use. All users of Davie Counq/s GIS website shall hold harmless the
F-01
NC
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.
' DAVIE COUNTY HEALTH DEPARTMENT
Environmental Health Section
P. O. Boa 848/210 Hospital Street
Mocksville, NC 27028
(336)751-8760
Account #: 990001296 Tax PIN/EH #: 5789-1145085
Billed To: Michael Myers Subdivision Info: COVINGTON CK sec 2 Lot # 33
Reference Name: Location/Address: S. Hemingway -27006
Proposed Facility: Residence Property Size: see map
ATC Number: 2911
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 CON TRUCTION IS VALID FOR A PERIOD OF FIVE YEARS.
Environmental Health Specialist's Signature: ;��wDate: ;�*-r&.-/' -e� /
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.
70
'*-
'*- l(-- Is Por
ow --gbCm- of A
W I Lel.. -J�L OVL 400A%,�)
Septic System Installed By:
Environmental Health Specialist's Signaturf:
DCHD 05/99 (Revised)
0-
Date: 1
DAVIE COUNTY HEALTH DEPARTMENT
• Environmental Health Section
` P. O. Boa 848/210 Hospital Street
Mocksville, NC 27028
(336)751-8760
IMPROVEMENT/OPERATION PERMIT
Account #: 990001296 Tax PIN/EH #: 5789-145085
Billed To: Michael Myers Subdivision Info: COVINGTON CK sec 2 Lot # 33
Reference Name: Location/Address: S. Hemingway -27006
Proposed Facility: Residence Property Size: see map
ATC Numb r: 2911
**NOTE** This le mprovement/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 #People #Bedrooms 1,T #Baths
Dishwasher -Garbage Disposa� Washing Machin Basement w/Plumbing: ElBasement/No Plumbing: ❑
Commercial Specification: Facility Type #People #People/Shift #Seats Industrial Waste: ❑
Lot Size Type Water Supply Design Wastewater Flow (GPD) V 6U Site: News[Z""Repair ❑
/; �� N /i
System Specifications: Tank Size' GAL. Pump Tank GAL. Trench Width Rock Depth Linear FtcUr
Other:
Required Site Modifications/Conditions:
IMPROVEMENT/OPERATION PERMIT LAYOUT - APPROVED EFFLUENT FILTER RISER(S) W 6 G° 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.****
Environmental Health Specialist's Signature: Date:
DCHD 05/99 (Revised)
a VJ N ht,)PCATION FOR SITE EVALUATION/IMPROVEMENT PERMIT & ATC
Davie County Health Department
g �a�� Environmenta/Health Section
J� � 2 P.O. Box 848/210 Hospital Street
Mocksville, NC 27028
-. 'onninnFNTAL HEALTH (336) 751-8760
***IMPORTANT*** THIS APPLICATION CANNOT BE PROCESSED UNLESS ALL THE REQUIRED
INFORMATION IS PROVIDED. Refer to the INFORMATION BULLETIN for instructions.
1. Name to be Billed �f �"ct Person
Mailing Address % Home Phone �!)�0��
City/State/ZIP %v Business Phone y��/%�
2. Name on Permit/ATC if Different than Above
Mailing Address C:ittyy/State/Zip
3. Application For: ❑ Site Evaluation 'ti' provement Permit/ATC ❑ Both
4. System to Service: & House ❑ Mobile Home ❑ Business ❑ Industry ❑ Other
5. If Residence: # People # Bedrooms J # Bathrooms
KJ Dishwasher ❑.Garbage Disposal ''[- Washing Machine U Basement/Plumbing LVBasement/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 mater supply: IT/County/City ❑ Well ❑ Community
8. Do you anticipate additions or expansions of the facility this system is intended to serve? ❑ Yes 41 No
If yes, what type?
***IMPORTANT*** CLIENTS MUST COMPLETETHE REQUIRED PROPERTY INFORMATION REQUESTED
BELOW. Either a PLAT or SITE PLAN MUST BESUBMITTED by the client with THIS APPLICATION.
Property Dimensions: S'WRITE DIRECTIONS (from Mocksville) to PROPERTY:
Tax Office PIN: #.V1 Art
Property Address: Road Name
City/Zip
If in a Subdivision provide information, as follows:
Name: e,o1/4�T0 / Zlf
IA
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 that I 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 pr edures as necessary to determine the site suitability.
DATE SIGNATURE
.�
+THIS A MAY B USED FOR DRAWING YOUR SITE PLAN (Include all o�efollowing: Existing and proposed
pro erty 'nes and dimensions, structures, setbacks, and septic locations).
�r�IAK pgjvr'AY
Client Notification Date:
EHS:
Revised DCHD (07/99)
Account No.
Invoice No. 2yo 7 c-1�
APPLICATION FOR SITE EVALUATIONAMPROVEMENT PERMI
Davie County Health Department
Environmental Health Section
P.O. Box 848
Mocksville, NC 27028
(704) 634-8760 t
****IMPORTANT**** THIS APPLICATION CANNOT BE PROCESSED UNLESS ALL
THE REQUIRED INFORMATION IS PROVIDED.
ZC. �Gr!— (' ks� 6 Y,.-% �� I
1. Name to be Billed "A ^-A E C Contact Person � �1 e-
Mailing Address ?1) ) >! Home Phone
City/State/Zip kj4pj Ce- N( 2704)(3 Business Phone
2. Name on Permit/ATC if Different than Above
Mailing Address City/State/Zip
3. Application For: ite Evaluation
Imlrovement Permit &ATC � [ l Both
4. System to Serve: [ j House [ ] Mobile Home [ ] Business [ l Industry [ ] Other 10+ ut�l u�.Sio�J
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 [ 1q0 -
If yes, what type?
I r r rrr ►; .'. I'l. l 1 ! `r, :lir i t t:;
PROPERTY INFORMATION REQUIRED: *** IMPORTANT ***'A FLAT OF THE PRCPERTY MUST B'3
SUBMITTED WITH TPxS APPLICATION.
Property Dimensions: A)3 04 A.0 , 04 f Ce WRITE DIRECTIONS (from Mocksville) TO PROPERTY:
Tax Office PIN: # 78`3 - '9-4/— - ]= 1S QST iti 0� �G�y4 M: [-e
Property Address: Road lame g01 _Dr o / in ► — w`S -� S'Ide- a_f R
City/Zip f �d • 2?00 [ (�Q1;�5�-fpm �2 �� i� u�'t'S i
If in Subdivision provide information, as follows:
Name z '
r
Section: ! Lot #•
This is to certify that the information provided is correct to the best of my knowledge. I understand that any permit(s) issued hereafter ar
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 Authorize
of the Davie County Health Department to enter upon above described property located in Davie County and owne
all testing procefiuFs as necessary to determine the site suitability.
DATE Ly—�'3 81,
Revised DCHD (06-96)
1111: :ll;l7.1 ,1111 L;F 11 F.b j'l1h I)PAII'IN6 !0111? : 1 11 MAN:
0
DAVIE COUNTY HEALTH DEPARTMENT
Environmental Health Section SECTION,/ LOT.
Soil/Site Evaluation
APPLICANT'S NAME
PROPOSED FACILITYY
SUBDIVISION C A?/i/14 'ex) t C BA
Water Supply: On -Site Well
Community,
Evaluation By: Auger Boring Pit
4.�
DATE EVALUATEDi6 P
PROPERTY SIZE "aej
ROAD NAME '1J % �
Public !�
Cut
FACTORS 1 2 3 4 5 6 7
Landscape position
Slope %
HORIZON I DEPTH
Texture group
Consistence
Structure
Mineralogy
HORIZON II DEPTH
Texture group 1*7G
Consistence —
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 RAMJ FEE]
SITE CLASSIFICATION: .62
LONG-TERM ACCEPTANCE RATE:
REMARKS:
DCHD (01-90)
EVALUATION BY:
OTHER(S) PRESENT:
V " 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
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
Mineralo`Uv
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