290 Covington Drive Lot 17Davie County, NC TTax Parcel Report Tuesday, November 29, 2016
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COVINGTON DR )I- COVINGTON DR
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WARNING: THIS IS NOT A SURVEY
Parcel Information -
Parcel Number:
H806OA0017
Township: Shady Grove
NCPIN Number:
5789148914
Municipality:
Account Number:
82526272
Census Tract:
37059-804
Listed Owner 1:
HARPER WENDELL J JR
Voting Precinct: EAST SHADY GROVE
Mailing Address 1:
290 COVINGTON DRIVE
Planning Jurisdiction:
Davie County
City:
ADVANCE
Zoning Class: DAVIE COUNTY R -A
State:
NC
Zoning Overlay:
Zip Code:
27006-0000
Voluntary Ag. District:
No
Legal Description:
LOT 17 COVINGTON CREEK PHASE TWO
Fire Response District:
ADVANCE
Assessed Acreage:
0.75
Elementary School Zone:
SHADY GROVE
Deed Date:
4/2006
Middle School Zone:
WILLIAM ELLIS
Deed Book I Page:
006580035
Soil Types:
PcB2
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:
1:01
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
j� County of Davie, North Carolina, its agents, consultants, contractors or employees from any and oilclaims or causes of action due to
� ` C 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
IMPROVEMENT/OPERATION PERMIT
Account M 989900093
Billed To: Shelton Construction Services
Reference Name:
Proposed Facility: Residence
Tax PIN/EH #: 5789-14-8914
Subdivision Info: COVINGTON CK two Lot # 17
Location/Address: Covington Creek Drive -27006
Property Size: see map
** �T *�l ffb&r: 2921
N is 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
i
#People #Bedrooms #Baths v�• S
Dishwasher; Garbage Disposal: ❑ Washing Machine 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) 0/6 Site: New Repair ❑
System Specifications: Tank Size"GAL. Pump Tank
Other:
Required Site Modifications/Conditions:
GAL. Trench Width Rock Depth Linear F
IMPROVEMENT/OPERATION PERMIT LAYOUT - APPROVED EFFLUENT FILTER RISER(S) H+ 6 " BELOW
FINISHED GRADE. ****NOTICE: Contact a representative ofthe�e 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. a otostallation. Telephone # is (336)751-8760.****
Environmental Health Specialist's Signature. Date:
DCHD 05/99 (Revised)
Account #: 989900093
DAVIE COUNTY HEALTH DEPARTMENT
Environmental Health Section
P. O. Boz 848/210 Hospital Street
Mocksville, NC 27028
(336)751-8760
Billed To: Shelton Construction Services
Reference Name:
Proposed Facility: Residence
ATC Number: 2921
Tax PIN/EH #: 5789-14-8914
Subdivision Info: COVINGTON CKtwo Lot# 17
Location/Address: Covington Creek Drive -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 Treatment and Disposal Systems). THIS
AUTHORIZATION FOR WASTEWATER C ST CTI(T IS VALID FOR PERIOD OF FIVE YEARS.
Environmental Health Specialist's Signature:
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.
Septic System Installed By:
Environmental Health Specialist's Signature:
DCHD 05/99 (Revised)
Date: /—to
I
• �' �' 71ON FOR SITE EVALUATION/IMPROVEMENT PERMIT & ATC
Davie County Health Department
Eavironmenta/Health Section
JUL 9 2001 P.O. Box 848/210 Hospital Street
Mocksville, NC 27028
(336)751-8760
ENVIRONMENTAL HEALTH
PLICATION CANNOT BE PROCESSED UNLESS ALL THE REQUIRED
INFORMATION IS PROVIDED. Refer to,, the INFORMATION BULLETIN for instructions.
1. Name to be Billed� Contact Person •
Mailing Address 12- j 7 [l S 14 �o Y t.J Home Phone
City/State/ZIP -n- ` 4% •,;) c . L . 2 i rAI-Ir Business Phone 3 2 c v 1.
2. Name.on Permit/ATC if Different than Above
Mailing Address City/State/Zip
3. Application For: ite Evaluation ❑ Improvement Permit/ATC ❑ Both
4. System to Se rvice:ouse ❑ Mobile Home ❑ Business ❑ Industry ❑ Other
5. If Residence: # People # Bedrooms �_ # Bathrooms
A -Dishwasher 9-137arbage Disposal ft'Va—shing Machine ❑ Basement/Plumbing ❑ Basement/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: (-Ceunty/City ❑ Well ❑ Community
8. Do you anticipate additions or expansions of the facility this system is intended to serve? ❑ Yes &NO
If yes, what type?
***IMPORTANT*** CLIENTS MUST COMPLETETHE REQUIRED PROPERTY INFORMATION REQUESTED
BELOW. Either a PLAT or SITE PLAN MUST BE SUBMITTED by the client with THIS APPLICATION.
Property Dimensions: . 1 4 L .- L WRITE DIRECTIONS (from Mocksville) to PROPERTY:
Tax Office PIN: # Y5 ! y 5 ! y o' :.- t 4 _ 1l!
Property Address: Road Name ef" 17 L. ._,4-,_ p,:,.. . f 1-7
City/Zip 'Q -1 u + - % < 02-70 oto
If in a Subdivision provide information, as follows:
Name: C, o ., : ! 4-. C . , 4
Section: Block:
Lot: Z
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 S 4 a / A. _ G • _ , �� _�-: .
to conduct all testing procedures as necessary to determine the site suitability.
DATE D / 5 y ! SIGNATURE
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).
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Client Notification Date:
Account No. �3-
Revised DCHD (07/99) Invoice No.
APPLICATION FOR SITE EVALUATIONAMPROVEMENT PERMIT
Davie County Health Department D C� Q n
Environmental Health Section V
P.O. Box 848
Mocksville, NC 27028
(704) 634-8760
****IMPORTANT**** THIS APPLICATION CANNOT BE PROCESSED UNLESS ALL
THE REUIRED INFORMATION IS PROVIDED.
Il-SA6ri— � IA -5- f. 6 Y" �7
1. Name to be Billed 4514PRITa. Hb r+% a q Contact Person
Mailing Address ?,8/ R 1 X 3 d 1) Home Phone
City/State/Zip „0'f/[ 0,11d %e— A2( . Q 766 Business Phone_ M4/77.:L �8/3-X 51/8' CIVAAd
2. Name on Permit/ATC if Different than Above
Mailing Address City/State/Zip
3. Application For: ite Evaluation [ ] Improvement Permit & ATC [ ] Both
4. System to Serve: [) House [ •] Mobile Home [ ] Business [ l Industry [ ] Other c2 -Z 10+ &L&4 J d/•S 1104
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
If yes, what type?
T 111ILR A I'L t OR SI'IL PLAN
PROPERTY INFORMATION REQUIRED: *** IMPORTANT ***`A FLAT OF THE PROPERTY MUST BE
SUBMITTED WITH THIS APPLICATION.
Property Dimensions: fir+ &C, aa,r(-e WRITE DIRECTIONS (from Mocksville) TO PROPERTY:
Tax Office PIN: # S'789 — - ; �%f�y a �Cb Z61A L 94 Ami vel ru r.e
Property Address: Road lame 801 Dr A A m �t — [aL5 4 5'de ,4
City/Zip rr&,gs:Ccz)m 6 d e I J lel 4e rs T
If in Subdivision provide information, as follows:
Name: b l7 / n.'OAl Or—eek
Section: 1 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 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
Revised DCHD (06-96)
SIGN
all testing procS�luFs as necessary to determine the site suitability.
THIS ,tlMil ,11;111 13E 11SEb rUfi bIG1111INC I10111t SITE PL,IN:
DAVIE COUNTY HEALTH DEPARTMENT /7
Environmental Health Section SECTION— LOT
Soil/Site Evaluation
APPLICANT'S NAME , �' E� DATE EVALUATED 0"
PROPOSED FACILITY PROPERTY SIZE T
Zli9L
SUBDIVISION
Water Supply:
On -Site Well Community,
Evaluation By: Auger Boring Pit i
ROAD NAME 2!ffd Z
Public
Cut
FACTORS 1 2 3 4 5 6 7
Landscape position A— ell
Slope %
HORIZON I DEPTH
Texture group
Consistence
Structure
Mineralogy
HORIZON II DEPTH
Texture group
Consistence T
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
SITE CLASSIFICATION: /V
LONG-TERM ACCEPTANCE RATE: ScZ /
REMARKS: , �id,C al,470 c '4/t
DCHD (01-90)
LEGEND
Landscaae Position
EVALUATION BY: .&t/9-//
OTHER(S) PRESENT:
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 - Finn 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
Mineraloev
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 - Lor_g-term acceptance rate - gal/day/ft2