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138 Lakeview RoadDavie County. NC Tnv PnrrPl RPnnrt Tuesday. January 17. 2017 WARNING: TH1h 15 N0T A SURVEY Parcel Information Parcel Number: 1614OA0052 Township: NCPIN Number: 5758649012 Municipality: Account Number: 72627250 Census Tract: Listed Owner 1: TAYLOR DAVID H Voting Precinct: Mailing Address 1: 138 LAKEVIEW DRIVE Planning Jurisdiction: City: MOCKSVILLE Zoning Class: State: NC Zoning Overlay: Zip Code: 27028-0000 Voluntary Ag. District: Legal Description: 1.49 AC LAKEVIEW DR Fire Response District: Assessed Acreage: 1.26 Elementary School Zone: Deed Date: 8/1998 Middle School Zone: Deed Book / Page: 002050341 Soil Types: Plat Book: Flood Zone: Plat Page: Watershed Overlay: Building Value: Outbuilding & Extra Freatures Value: Land Value: Total Market Value: Total Assessed Value: 9 tt� Shady Grove 37059-804 WEST SHADY GROVE Davie County DAVIE COUNTY R-20 CORNATZER - DULIN CORNATZER WILLIAM ELLIS Gn132,GnC2 DAVIE COUNTY No 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 1�T County of Davie, North Carolina, Its agents, consultants, contractors or employees from any and all claims or causes of action due to �o p S� 1� C or arising out of the use or inability to use the GIS data provided by this website. Y 7= DAVIE COUNTY HEALTH MARTMENT IMPROVEMENTS PERMIT AND CERTIFICATE OF COMPLETION *NOTE: Issued in Compliance With Article II of G.S. Chapter 130a ;Sanitary Sewage Systems y;. � „ Perm! � JJ rPer Name Date Location _ LP ke v�e c3 Subdivision Name Lot No. Sec. or Block No. 10 Lot Size House Mobile Home __ Business Speculation No. Bedrooms .No. Baths — '� No. in Family _ Garbage Disposal YES ❑ NO 'L7 Specifications ,,for',System:� Auto Dish Washer YES NO ❑ ,,�'. Auto Wash Ma shine YES g NO ❑ Type Water Supply *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. --"" r 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 i 0 C 1 vC�J Certificate of Completion Date "The signing of this certificate shall indicate that the system described above has been,in alled in compliance with the standards set forth in the above regulation, but shall in NO way be taken as a guarar fee that the system will function satisfactorily for any given period of time. ' APPLICATION FOR SITE EVALUATION/IMPROVEMENTS PERMIT Davie County Health Department Environmental Health Section P. O. Box 665 M/eAu Mocksville, NC 27028 1. Application/Permit Renested BCy,� L Iter' -5 �� ) t /�Vj Mailing Address�� �����'� � 70� Home Phone / �� �� Business Phone �� 3 If 2. Name on Permit if Different than Above 3. Application/Permit for: ❑ General Evaluation U,6eptic Tank Installation 4. System to Serve: House ❑ Mobile Home ❑ Place of Public Assembly ❑ Business ❑ Industry ❑ Other ❑ Unknown 5. If house, mobile home: Subdivision Section Lot # No. of People No. of Bedrooms i No. of Bathrooms 1 Dwelling Dimensions 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 04 7. Type of water supply: ublic ❑ Private 8. Property Dimensions t"} t q 1 L X 144 x Ell 9. wbl)Sewage Disposal Contractor 9. Do you anticipate additions/expansion of the facility this sytem is intended to serve? ❑ Yes If yes, what type? E�4asement/Plumbing ❑ Basement/No Plumbing Q4ashing Machine CD-*6ishwasher ❑ Garbage Disposal ❑ 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 a plication. -11q--D co, --- AT SIGNATURE CONSENT FOR SITE EVALUATION TO BE DONE ON ABOVE DESCRIBED PROPERTY MUST CHECK ONE: ❑ 1. 1 OWN the property. 'P� 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 f the Da ie CountyHealth Department to enter upon above described property located in Davie County and owned by I n e) - l _ C2 ��- to conduct all testing procedures as necessary to determine sai 'te's suitability for a ground absorption sewage treatment and disposal system. _ DATE SIGNATURE DCHD (12-90) f 1I DAVIE COUNTY HEALTH DEPARTMENT (iJ" IMPROVEMENTS PERMIT AND CERTIFICATE OF COMPLETION *NOTE: Issued in Compliance With Article I I of G.S. Chapter 130a Sanitary Sewage Systems Permit Number Name %',:� ��� <����,� Date 2 7- 22 NO 6 29 (, Location Subdivision Name h��ri'�r.✓: �"� Lot No. Sec. or Block No. Lot Size House �� Mobile Home Business _— Speculation No. Bedrooms �� No. Baths _a2yo No. in Family Garbage Disposal YES ❑ NO ©- Specifications for System: Auto Dish Washer YES , NO ❑ /D��; `��r� � �� Auto Wash Ma^hine YES LTJ NO ❑ (((UJJJ�' Type Water Supply *This permit Void if sewage system described below is not installed within 5 ye s fror�ia of issue. This permit is subject to revocation if site plans or the intended use c ange. 1 \\ *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 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. DAVIE COUNTY HEALTH DEPARTMENT k"IMPROVEMENTS PERMIT AND . CERTIFICATE OF COMPLETION * NOTE: Issued in Compliance With Article 11 of G.S. Chapter 130a Sanitary Sewage Systems Permit Number Name /� _, .�s` Date 'a�""l�f N2; 2 Location l`i.f r j, r . Subdivision Name Lot No. _ Sec. or Block No. Lot Size House ��� Mobile Home _ Business Speculation No. Bedrooms No. Baths crNo. in Family Garbage Disposal YES ❑ NO p' Specifications for System: Auto Dish Washer YES p NO ❑ Auto Wash Ma.hine YES p NO ❑ v ,,r Type Water Supply *This, permit Void if sewage system described below is not installed within 5 yeas fro d.at of issue. This,permit is subject to revocation if site plans or the intended use c ange. \ y *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 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. t 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. , al .e. . 1�41g" _P P PYAPLICATION FOR SITE EVALUATION/IMPROVEMENTS PERMIT t Davie County Health Department Environmental Health Section I RECEIVED Fr P. 0. Box 665 o Mocksville, N.C. 27028 �` J � CONSTRUCTION SHALL NOT BEGIN UNTIL IMPROVEMENTS PERMIT HAS BEEN ISSUED. Home Phone 1. Permit Requested ByBusiness Phone g d 2. Address 3. Property Owner if Different than Above Address 4. Permit To: a) Install Alter Repair b) Privy Conventional Other Type Ground Absorption c) Sub -Division Sec. Lot No. 5. System used to serve what type facility: House M�ome Business 4 ,.01� Industry Other b) Number of people 6. ay If house or mobile home, state size o home and number of rooms. House Dimensions o Bed Rooms Bath Rooms Den w/Closet b) If Business, Industry or Other, State: Number of persons served What type business, etc. Estimate amount of waste daily (24 hours) 7. Number and type of water -using fixtures: commodes 3 urinals lavatory 3 showers —13 garbage disposal washing machine dishwasher % sinks 8. a) Type water supply: PublicPrivate Co unity b) Has the water supply systems bp9n approved? Yes r No 9. a) Property Dimensions / 'y '4 'L b) Land area designated to building site 7 c) Sewage Disposal Contractor GLS'0 - 10. Do you anticipate any additions or expansions of the facility this sewage system is intended to serve? What type? (/This is to certify that the information is co h ct to thlest of my knowledge. _ i — f/ Date Owner Signature OWNER IS SOLELY RESPONSIBLE FOR COMPLIANCE WITH ALL STATE AND LOCAL LAWS Allow 5 days for processing Directions to property: DCHD (6-82) P /"—� ("'L_ 6."'j'— - . DAVIE COUNTY HEALTH DEPARTMENT _ Environmental Health Section Soil/Site Evaluation NAME Y-42'XI) ADDRESS PROPOSED FACIILTY 2f2w DATE EVALUATED PROPERTY SIZE LOCATION OF SITE Water Supply: On -Site Well Community Public Evaluation By: Auger Boring Pit Cut FACTORS 1 2 3 4 Landscape position A. Z�- SloeZ HORIZON I DEPTH Texture groupL S'L f< SL Consistence Structure Mineralogy r /,• l 1, / HORIZON II DEPTH A o /-IV r— Texture group Consistence l' Structure le Mineralo J 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 a SITE CLASSIFICATION: _ 0�9 ,, EVALUATED BY: �// LANG -TERM ACCEPTANCE RATE: REMARKS: DCHD(01-901 OTHER(S) PRESENT: LEG 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 -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 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 rDavie County Xealtfr 7ye arbnent nandXOifle Xealb cy 210 HOSPITAL STREET I P.O. BOX 665 MOCKSVILLE. N.C. 27028 PHONE: (704) 634-5985 February 19, 1991 Potts Realty P. 0. Box 11 Advance, HC 27006 Re: Site Evaluation Cindy Beane— Cornatzer Rd. Dear Realtor: As requested, a representative from this office visited the aforementioned site on February 11, 1991. The site was found provisionally suitable for the installation of a ground absorption sewage system. The property was low in the middle, which may require pumping. The house must be staked before a permit can be issued. If you have any questions, please feel free to contact this office. Sincerely, Robert B. Hall, Jr., R.S. Environmental Health Section RH/wd Enclosure