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282 Covington Drive Lot 16Davie Countv, NC - ITax Parcel Report Tuesdav, November 29, 2016 WAKN1LNki: '1'1Hb IS 1VV'1" A SURVEY Parcel Information Parcel Number. H806OA0016 Township: Shady Grove NCPIN Number: 5789149912 Municipality: Account Number. 8301848 Census Tract: 37059-804 Listed Owner 1: WYATT JASON K Voting Precinct: EAST SHADY GROVE Mailing Address 1: 282 COVINGTON DRIVE 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 16 COVINGTON CREEK PHASE TWO Fir Response District: ADVANCE Assessed Acreage: 0.77 Elementary School Zone: SHADY GROVE Deed Date: 1/2013 Middle School Zone: WILLIAM ELLIS Deed Book / Page: 009150818 Soil Types: Pc62 Plat Book: 0007 Flood Zone: Plat Page: 139 Watershed Overlay: DAVIE COUNTY & Extra Building Value: Freatures Va ue: Land Value: Total Market Value: Total Assessed Value: 101 M 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. An users of Davie County's GIS website shall hold harmless the County of Davie. North Carolina, Its agents, consultants, contractors or employees fromany and all claims or causes of action due to NC 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 #: 989900141 Billed To: Michael Wayne Myers, Inc. Reference Name: Mike Myers Proposed Facility: Residence ATC Number: 2179 Tax PIN/EH #: 5789-14-9555.16 Subdivision Info: Covington Creek Sec.3 Lot # 16 Location/Address: Hwy. 801 S.-27006 Property Size: 203x111x94 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 eatment and Disposal Systems). THIS AUTHORIZATION FOR WASTE C IO S VALID FOR A PERIOD OF FIVE YEARS. Environmental Health Specialist's Signa e: Date: 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 1 I 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 Oe f c r� S s T Septic System Installed By: Environmental Health Specialist's Signatur Date: �n DCHD 05/99 (Revised) DAVIE COUNTY HEALTH DEPARTMENT (J�J Environmental Health Section P. O. Boa 848/210 Hospital Street I GAJ Mocksville, NC 27028 (336)751-8760 IMPROVEMENT/OPERATION PERMIT Account #: 989900141 Tax PIN/EH #: 5789-14-9555.16 9 Billed To: Michael Wayne Myers, Inc. Subdivision Info: Covington Creek Sect Lot # 16 Reference Name: Mike Myers Location/Address: Hwy. 801 S.-27006 Proposed Facility: Residence Property Size: 203x111x94 ATC Number: 2179 **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 oose #People #Bedrooms 3 #Baths Z , Dishwasher: Er"'— Garbage Disposal: Er Washing Machine: 2 - Basement w/Plumbing: ❑ Basement/No Plumbing: Commercial Specification: Facility Type #People #People/Shift #Seats Industrial Waste: 13Lot Size* 774 h�' me Water Supply Design Wastewater Flow (GPD) �JtGO Site: New La' Repair ❑ System Specifications: Tank Size ICOOGAL. Pump Tank ICMGAL. Trench Width--"ip it Rock Depth iz Linear Ft.30c> Other: J� !%TPS 131)Ttc,J �. In1�`1"9Lt� Gl�✓eS /.,9 Required Site Modifications/Conditions: 1r4SgN — ©r) C -43-10,9e tlit' Id pFr--220 • U-- 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.**** Iv tesr �y �V s Environmental Health Specialist's DCHD 05/99 (Revised) Date: r L5���1J L5 APPLIt3A1lON FOO SITE t1lAWAt10N/I111PROVEIAFM PERUIR 1t ATC D Davie County Health Department SEP 2 DIM Entftnntenbe/ HMO Sacblon 1.0. Hoar 949/210 Hospital. Street Nooksville, VC 27026 (336)751-6760 * e MeM23 <ti'le e • THIS APPLICllTMA Cato= ffi PROG'UMM =use am MM RZQUIRZD Iti110PZ UIOU IS WROVIDZD. Rates to the Itili'olil 2ZON DUUZ21H for instructions. 1. Sum to be slued�G /��t�./1 f�G / ����1! /TT Contact lesson wMaq Address &�l! ,t 1% same amse �V4 CLty/stab/sss A 1/, AGF /iii .. �o o ( suaLnees Phone a. st.me an sermit/A!c is OLst;ereat tbsn Above Mailing Addesse 71sptoweaslut tab/sip s. application tore a site evaluation Tornit/112C $doth e. system to sarviase evause 0 Mobile Hone 0 Business 0 Industry D Other a. It Residences i people s Bedrooms 3 I Batthroom$ e-vre'um"z tr'aaaba" DLeposel A-Ra•buw usa m D lla••mant/aimbiaQ tl"sa•wntllio sin bing 6. Zt awiae88/Matey/Ctber8 speoily two a VMV14 t sLnks I Commodes i ebowere i VcL ahs ! Vabs C001•ss IT ItOt1QSxMCst d seats .r_. =stinated Nater Usage (4a11ona Wr day) 7. Type at seater supplirs I116--itnty/City 0 will 0 Community a. Do you anticipate addition or espauslons of the facility tbb system Is Intended to serve? By" "a Myer, what type? �4"IMPORTANP" CMM 1E MC7OM UNTll1i REQUMEDPROPEM INFORMATION REQUESTED BELOW. Either a PLAT or SIT1I PLAN MI ST BE SIIBMITTBD by the tHeM with THIS APPUCATION. Property Dimesslont Tax OificePINI Property Addrent Road Name cltyalp U In a SubdIvblon provide isformation, a follows: WRITE DIRECTIONS (from Mot1wills) to PROPER'l'Ye Name: lc�L/U�l��L—sLCf1� n Sections �.. Blocks a �". Date Property Maedt 'Ibb Is to certify that the Isfbrmstioa provided d correct to the bat of my knowledge. I understand that any permit(s) Issued hereafter are subject to suspension or revocation, It the site plan or Intended as change, or It the Information submitted in this application Is fabiried or changed. 1, aba, understand that I an responsible for all charges Incurred jtom this appOcadots. 16 hereby, give consent to the Anthe&W Represented" of the WAS County Health Department to enter upon above described property located to Davie County and awned by to conduct ad testing procedures as necessary to determine the site suitability. DATE 4— i -7 7 81aNATURZ 4offA M-1/ THIS ARBA MAY SSE USED ICOR WAVING YOUR 86-6 PL UI (Inst a alt of the folloM ao'" . F-Shong and proposed property bines and dimensions, structures, setbacks, and septic locationA Revised DCUD (07!99) site Revisit Charge IMU0,11 Client Notification Dates EHSt Account No. 4Zz- - -- Invoice No, d9-2- •APPLICATION FOR SITE EVALUATIONAMPROVEMENT PERMIT Davie County Health Department Environmental Health Section P.O. Box 848 Mocksville, NC 27028 (704) 634-8760 1 ****IMPORTANT**** THIS APPLICATION CANNOT BE PROCESSED UNLESS ALL '\ THE REQUIRED INFORMATION IS PROVIDED. 1. Name to be Billed- H6 r'A S Contact Person % �1 �- t►r Mailing Address ?A / R (1 >! � 6 � s Home Phone City/State/Zip ,./'f/i Uaij ce— A21(. Q loo b Business Phone ��'—`�77.2. 9/3,39/9- 6 AI -d - 2. Name on Permit/ATC if Different than Above Mailing Address City/State/Zip 3. Application For: M4ite Evaluation [ ] Improvement Permit & ATC [ ] Both 4. System to Serve: [ ] House [ •] Mobile Home [ ] Business [ ] Industry [ ] Other % 0+ utrV41 V/S A0,4 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 H'No If yes, what type? V 11111 Ik' -1 PLA I ('h S I I L I'L UN PROPERTY INFORMATION REQUIRED: *** IMPORTANT ***`A'FI;AT OF THE PROPERTY MUST BE SUBMITTED WITH THIS APPLICATION. Property Dimensions: A)ar+ Gt.0 , Lwrc-e- WRITE DIRECTIONS (from Mocksville) TO PROPERTY: Tax Office PIN: # - _�� 1 cT_�f� 5a IJ �. �'� /gacV4 P Property Address: Road Dame 9191 Dir A A%n m [A.� ► — City/Zip ^A�U• Z?vo ('e-[��, •+ rzsm ade �' 4er-5 If in Subdivision provide information, as follows: Name: All/nOAiree-IC �1 w6,zed ; / r Section: 1 Lot #: 0— 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 ve of the Davie County Health Department to enter upon above described property located in Davie County and owned IS 1% all testing procefiur�s as nepessary to determine the site suitability. Revised DCHD (06-96) 11118 >kRrA %f,1I/ L;E 11SE•.b 1-01t L)Lt> IUNI(I /0111? SITE PL,IN: r ' DAVIE COUNTY HEALTH DEPARTMENT l,( Environmental Health Section SECTION LOT -4 Soil/Site Evaluation APPLICANT'S NAME PROPOSED FACILITY SUBDIVISION Water Supply: On -Site Well Community, Evaluation By: Auger Boring Pit L DATE EVALUATED PROPERTY SIZE ROAD NAME 2s (a Z Public L� 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 Consistence 411 Structure Mineralogy HORIZON III DEPTH Texture group Consistence Structure Anieralogy HORIZON IV DEPTH Texture group Consistence Structure Mineralogy SOIL WETNESS RESTRICTIVE HORIZON SAPROLITE CLASSIFICATION LONG-TERM ACCEPTANCE RATE c SITE CLASSIFICATION: ,- LONG-TERM ACCEPTANCE RATE: REMARKS: DCHD (01 A0) EVALUATION BY: vr1'lit// 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 CONSISTENCE .I 1st V"FR - Very friable FR - Friable FI - Firm VFI - Very firm EFI - Extremely firm w Ct 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 dotes 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