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204 Pine Valley Road Section 1 Lot 6r r Davie County, NC Tax Parcel Report Tuesday, January 24, 2017 2 3 0 226 ! I ,�..���� ✓r 218 212 ._ 204 1 7 194 .� 1 18 2 / 205 WARNING: THIS IS NOT A SURVEY Parcel Information Parcel Number: J605OA000402 Township: Fulton NCPIN Number: 5758913049 Municipality: Account Number: 20557900 Census Tract: 37059-804 Listed Owner 1: DAMS MICHAEL SCOTT Voting Precinct: FULTON Mailing Address 1: 204 PINE VALLEY ROAD Planning Jurisdiction: Davie County City: MOCKSVILLE Zoning Class: DAME COUNTY R-12-S,R-20 State: NC Zoning Overlay: Zip Code: 27028-0000 Voluntary Ag. District: No Legal Description: LOT 6 HICKORY HILL SECTION 1 Fire Response District: FORK Assessed Acreage: 0.45 Elementary School Zone: CORNATZER Deed Date: 911991 Middle School Zone: WILLIAM ELLIS Deed Book / Page: 001600638 Soil Types: Gn132 Plat Book: 0004 Flood Zone: Plat Page: 105 Watershed Overlay: DAVIE COUNTY Outbuilding & Extra Building Value: Freatures Value: Land Value: Total Market Value: Total Assessed Value: 1-W-1 l 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 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. No. Bedrooms No. Baths — R No. in Family `,-( _DAVIE COUNTY HEALTH DEPARTMENT til O" Specifications for System: Auto Dish Washer YES p" NO ) oo. U 0 - IMPROVEMENTS PERMIT AND CERTIFICATE OF COMPLETION YES g, NO *NOTE: Issued in Compliance With Article 11 of G.S. Chapter 130a Permit; Sanitary Sewage Systems f' Number Name V Date t ' 1 / NO Location Subdivision Name Vt ` �' �' ` l ` `' 1 Lot No. Sec. or Block No. �– G IC�o , Lot Size ' -", p° House '�Mobile Home — Business Speculation No. Bedrooms No. Baths — R No. in Family L _ - Garbage Disposal YES ❑ NO O" Specifications for System: Auto Dish Washer YES p" NO ❑ f Do Auto Wash Ma^hine YES g, NO ❑ , �' , . T W L c� ^ I ype ater Supply r _ *This permit Void if sewage system described below is not installed within 5 years from date of issue. This permit is subject to revocation if site plans or the intended use change. c. J= �N Improvements permit bY-'' --'' — *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 day of completion. Telephone Number 704-634-5985. Final Installation Diagram: System Installed by�� cc oc E� Certificate of Completion �� Date *The signing of this certificate shall indicate that the system described above has been installed in compliance with the standards set forth in the above regulation, but shall in NO way be taken as a guarantee that the system will function satisfactorily for any given period of time. V ,,( APPLICATION FOR SITE EVALUATION/IMPROVEMENTS PERMIT Davie County Health Department �g(� ►�1 ,,ll' / ?41 '4,/Environmental Health Section/ P. O. Box 665 u� 1 Mocksville, NC 27028 U6 2 a '199 1. Application/Permit Requested By. ) L DAM 5 Mailing Address Ri- 23' BOX (Jr q3�— Home Phone 7D ' q Jrrr,� 2 g 2 Z Business Phone %O%6 ."i (D — 60 Oa 2. Name on Permit if Different than Above 3. Application/Permit for: ❑ General Evaluation peptic Tank Installation 4. System to Serve: P House ❑ Mobile Home ❑ Place of Public Assembly ❑ Business ❑ Industry ❑ Other ❑ Unknown 5. If house, mobile home: Subdivision acv,(, FL `� Section Lot # i Oc"IZ ❑ Basement/Plumbing No. of People ` 7' No. of Bedrooms 3 No. of Bathrooms Z Dwelling Dimensions 2 © OO 5971-- T 6. If business, industry, place of public assembly, other: Specify type No. of People Served No. of Commodes No. of Lavatories No. of Sinks No. of Urinals No. of Water Coolers No. of Showers Water Usage Figures _ 7. Type of water supply: Public ❑ Private 8. Property Dimensions )00 J. --)- oo Sewage Disposal Contractor ❑ Basement/No Plumbing "ashing Machine 2 Dishwasher ❑ Garbage Disposal 9. Do you anticipate additions/expansion of the facility this sytem is intended to serve? ❑ Yes ❑ No If yes, what type? ❑ Community 'NOTE: Improvements Permits shall be valid for a period of 5 years from date issued. Improvements Permits are subject to revocation, if site plans or the intended use change. Effective October 1, 1989. Directions to Property: This is to certify that the information provided is correct to the best of my knowledge, and I understand I am responsible for all charges incurred from this application. a DATE SIGNATURE CONSENT FOR SITE EVALUATION TO BE DONE ON ABOVE DESCRIBED PROPERTY MUST CHECK ONE: OX 1. 1 OWN the property. ❑ 2. 1 DO NOT OWN the property. If you checked Box #2, the rest of this form MUST be completed by the owner or a person authorized by the owner: I hereby give consent to the authorized representative of the Davie County H ,alth DA,qpartment to enter upon above described property located in Davie County and owned by �'. �� 7 to conduct all testing procedures as necessary to determine said site's suitability for a ground absorption sewage treatment and disposal system. DATE SIGNATURE DCHD (12-90) DAVIE COUNTY HEALTH DEPARTMENT Environmental Health Section Soil/Site Evaluation NAME \`\ \C�WWA AV %—c ADDRESS Ah"4 PROPOSED FACIILTY DATE EVALUATED b - D-9 - 011 PROPERTY SIZE �p0- a 00 LOCATION OF SITE Water Supply: On -Site Well Community PublicV Evaluation By,.t•-�,L Auger Boring 1% Pit Cut FACTORS 1 2 3 4 Landscape position S S 0 13 HORIZON I DEPTH b' " h $ " Texture group C, L Consistence \Y,�= Structure R Mineralogy VA '• HORIZON II DEPTH tA O' - Texture group Consistence F F 1Z)` Structure S iz Ap R)<$ Mineralogy HORIZON III DEPTH Texture group Consistence Structure Mineralogy HORIZON IV DEPTH Texture group Consistence Structure Mineralogy SOIL WETNESS '5's s 5 S RESTRICTIVE HORIZON -� -- - SAPROLITE -- CLASSIFICATION ,S S S LONG-TERM ACCEPTANCE RATE y ,u\ SITE CLASSIFICATION: —T.5. • S- EVALUATED BY: LONG-TERM ACCEPTANCE RATE: I OTHER(S) PRESENT: N Opp REMARKS: CL _�.`;S3A S__ A_ . 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 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 DCHD(01-901