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351 Ivy Circle Lot 22Davie County, NC. ITax Parcel Report Wednesday, October 26, 2016 1 N J. — 325 Z`� 337 f'�J \1z' 01( 347351 361" 375 ` 1 ' 385 WARNING: THIS IS NOT A SURVEY All data Is provided as Is without warranty or guarantee of any Idnd either expressed or Implied Including but not limited to the implied warranties of merchantability or fitness for a particular use. All users of Davie Countys GIS website &hall hold harmless the F—& Parcel Information County of Davie, North Carolina, Its agents, consultants, contractors or employees from any and all claims or causes of action due to arising of the use or Inability to the GIS data by this website. Parcel Number: D807000015 Township: Farmington NCPIN Number: 5872649114 Municipality: BERMUDA RUN Account Number: 60527500 Census Tract: 37059-803 Listed Owner 1: REVELLE WILLIAM D Voting Precinct: HILLSDALE Mailing Address 1: 351 IVY CIRCLE Planning Jurisdiction: BERMUDA RUN City: BERMUDA RUN Zoning Class: BERMUDA RUN CR State: NC Zoning Overlay: Zip Code: 27006-0000 Voluntary Ag. District: No Legal Description: LOT 22 BERMUDA RUN GOLF&COUNTRY Fire Response District: CLEMMONS Assessed Acreage: 0.77 Elementary School Zone: SHADY GROVE Deed Date: 3/1998 Middle School Zone: WILLIAM ELLIS Deed Book / Page: 002000813 Soil Types: MrB2,GnB2 Plat Book: 0004 Flood Zone: Plat Page: 082 Watershed Overlay: BERMUDA RUN Building Value: 203580.00 Outbuilding 8r Extra Freatures Value: 480.00 Land Value: 75000.00 Total Market Value: 279060.00 Total Assessed Value: 279060.00 Davie County, All data Is provided as Is without warranty or guarantee of any Idnd either expressed or Implied Including but not limited to the implied warranties of merchantability or fitness for a particular use. All users of Davie Countys GIS website &hall hold harmless the F—& NCor County of Davie, North Carolina, Its agents, consultants, contractors or employees from any and all claims or causes of action due to arising of the use or Inability to the GIS data by this website. out use provided . . DAVIE COUNTY HEALTH DEPARTMENT ' . � ` UMPROVEMENTS PERMIT AND CERTIFICATE OF COMPLETION ~~ -*NOTE: Issued in Compliance with G.S. of North Carolina Chapter 130 Article 18o Sewage Treatment and Disposal Rules (10 NCAC 10A .1Q3Permit1S08) ����� Number/ -'-- Name �Location Subdivision Name Pn� Lot No. J^2 Sec. orBlock No. Lot Size House Mobile Home ___-- Business --- Speculation No. Bedrooms No. Baths ' � ' No. in Family Garbage Disposal YES NO [] Specifications for System: Auto Dish Washer YES NO E] Auto Wash Machine YES NO E] Type Water Supply --' *This permit Void if sewage system described below is not installed within 36 months from date of issue. y Improvements permit bv *Contact a representative of the Davie County Health Department for final inspection of this system between 8:30- 9:30 A.M. :3O'S:30A.K8. or 1:00'1:30 P.M. on day of completion. Telephone Number: 704'G34'5Q85. ` ` \ Final Installation Diagram: System Installed by ` ^ /-_ \. __- Certificate of Co mpetion `` Date 'The signing of this certificate ohnU indicate that the system described obnvo 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 DAVIE COUNTY HEALTH DEPARTMENT IMPROVEMENTS PERMIT AND CERTIFICATE OF COMPLETION *NOTE: Issued in Compliance with G.S. of North Carolina Chapter 130 Article 13c Sewage Treatment and Disposal Rules (10 NCAC 10A .1934-.1968) Permit Number Name _ '�_ �' Date Location' Subdivision Name A Lot No. - _ Sec. or Block No. Lot Size ^f Ll—j 4%''1House Mobile Home _ Business Speculation No. Bedrooms % _ No. Baths No. in Family T Garbage Disposal YES [T] NO Specifications for System: Auto Dish Washer YES �NO Auto Wash Machine YES NO ,0 Type Water Supply 'This permit Void if sewage system described below is noLinstalled within 36 months from date of issue. I , 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 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. APPLICATION FOR SITE EVALUATION/ IMPROVEMENTS PERMIT % Davie County Health Department Environmental Health Section P. O. Box 665 I I� Mocksville, N.C. 27028 CONSTRUCTION SHALL NOT BEGIN UNTIL IMPROVEMENTS PERMIT HAS BEEN ISSUED. Home Phone 1. Permit Requested By A(Z I/ Business Phone 2. Address _ 4[,!3 &tr_K 3. Property Owner if Different than Above G, `�� �`k 7/2, Address `60:� 7 Gl Q ,1 n-oPs rJ .0 _ Z1 U l Z- P( to �J � `7 g -3 11 7 4. Permit To: a) Install Alter Repair b) Privy Conventional Other Type Ground Absorption c) Sub -Division am� Ruda N Sec. Lot No. 12- 5. System used to serve what type facility: House—' Mobile Home Business Industry Other b) Number of people! - 3 6. a) If house or mobile home, state size of home and number of rooms. House Dimensions 3 ° X (o 5 Bed Rooms 4 Bath Rooms � z Den w/Closet b) If Business, Industry or Other, State: Number of persons served tj What type business, eta Estimate amount of waste daily (24 hours) 7. Number and type of water -using fixtures: commodes 'I lavatory -4 urinals showers 3 garbage disposal ' washing machine dishwasher I sinks 8. a) Type water supply: Public Private Community b) Has the water supply system been approved? Yes ✓ No 9. a) Property Dimensions 119.50 63 zc 1 `�q. i X -2 C 9 b) Land area designated to building site 36 A0 c) Sewage Disposal Contractor 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 iscor ect to the best of my knowledge. ly6-T . (, / S �� - �_ - A ci,� -, '4-1— Date ner Sign ure OWNER IS SOLELY RESPONSIBLE FOR COMPLIANCE WITH ALL STATE AND LOCAL LAWS Allow 5 days for processing Directions to property: v.N ' ray Eur (-4wyr5$ 2e e 5 (4-5 10Y Ci 2c(e DCHD (6-82) TL��o Name— Address FA r.Tr) RC DAVIE COUNTY HEALTH DEPARTMENT Environmental Health Section P. O. Box 665 Mocksville, N.C. 27028 SOIL/SITE EVALUATION Date —Ai Lot Size ARFA 1 APPA 7 AREA .q ARFA A ) Topography/ Landscape Position 2) 3) 4) 5) 6) 7) 8) 9) S S S PS PS PS U U U U Soil Texture (12-36 in.) Sandy, �� S S S Loamy, Clayey, (note 2:1 Clay) (/PSS PS PS PS U U U Soil Structure (12-36 in.) S S S Clayey Soils S PS PS PS U U U Soil Depth (inches) S S S PS PS PS U U U U U Soil Drainage: Internal S S S PS PS PS U U U External S S PS S PS S PS U U U U Restrictive Horizons Available Space PS S PS S PS S PS U U U U Other (Specify) S PS S PS S PS S PS U U U U Site Classification U—UNSUITABLE Recommendations/Comments: Described by SITE DIAGRAM DCHD (6-82) S—SUITABLE PS—Provisionally Suitable Date APPLICATION FOR SITE EVALUATION/ IMPROVEMENTS PERMIT Davie County Health Department Environmental Health Section R O. Box 665 y Mocksville, N.C. 27028 4 CONSTRUCTION SHALL NOT BEGIN UNTIL IMPROVEMENTS PERMIT HAS BEEN ISSUED. cs° ( II Home Phone 9.1�� 1. Permit Requested By �-4 I c ��' I �� Business Phone 2. Add ress ? / rXs o-0 d )�.—� 3. Property Owner if Different than Above Address 4. Permit To: a) Install Alter Repair b) Privy Conventional Other Type Ground Absorption fV-0-111r, c) Sub -Division Sec Lot No. 5. System used to serve what type facility: House Mobile Business Industry Other b) Number of people 6. a) If house or mobile home, state size of home and number of rooms. House Dimensions 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 urinals garbage disposal lavatory showers washing machine_ dishwasher sinks 8. a) Type water supply: Public Private Community b) Has the water supply system been approved? Yes No 9. a) Property Dimensions b) Land area designated to building site c) Sewage Disposal Contractor 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 cor t the best of my knowl dge. Date Owner Signature OWNER IS SOLELY RESPONSIBLE FOR COMPLIANCE WITH ALL STATE AND LOCAL LAWS Allow 5 days for processing Directions to property: ��� as�w ,�, �y3 . �,!!� p -03oID DCHD (6-82) 'Z�7 clkc— _ DAVIE COUNTY HEALTH DEPAPMMENT SITE EVALUATION CONSE14T FORM INSTRUCTIONS/PREREOUISTES 1. Complete the form below and return it to the Davie Co. Health Department. 2. Along with the form, remit the amount due as shown on enclosed statement. 3. Carefully follow the procedures as outlined in the enclosed "Information Bulletin". 4. Notify Health Department upon completion of item number 3. NOTE: ALL THE ABOVE MUST BE DONE BEFORE A SANITARIAN WILL BE ABLE TO BEGIN THE REQUESTED EVALUATION. DETACH HERE AND RETURN TO THE(DAVIE COUNTY HEALTH DEPARTMENT,P.O. BOX 57) (MOCKSVILLE, N.C. 27028) LOCATIUN OF PROPERTY: J /Y-3 DAVIE COUNTY HEALTH DEPARTMENT SITE EVALUATION CONSENT FORM �'iE3�'•r. trsd�� 7''�s p DATE RECEIVED (office use only) yes no-, (1.) I am the owner of the above described property. yes no (2.) I am not the owner of the above described property, however, I ti certify that I have consent from ,owner to owner's Hama obtain a site evaluation by the Health Department for the purpose of determining the suitability for a ground absorption sewage disposal system:,. yes no (3.) I hereby give consent to the authorized representative of the �t Davie County Health Department to enter upon the above described property and conduct all testing procedures necessary to determine its suitability for a ground absorption sewage disposal system. DA E SIGNATURE (4.) I hereby authorize the Davie County Health Department to release site evaluation results from the above described property to the following: � �Z � E SIGNATURE Owner Only M Owner's designated representative ,Anyone requesting results 0 Only those listed below Name— Address ame Address DAVIE COUNTY HEALTH DEPARTMENT Environmental Health Section P. O. Box 665 Mocksville, N.C. 27028 SOIL/SITE EVALUATION Date Zl„�c� Lot Size 4P FACTORS ARFA 1 ARFA 9 ARFA .q APPA n 1) Topography/ Landscape Position 3) 4) 5) 6) 7) 8) 9) S S 51 PS S PS U S PS U 2) Soil Texture (12-36 in.) Sandy, Loamy, Clayey, (note 2:1 Clay)PS S U' S PS U S PS U Soil Structure (12-36 in.) Clayey Soils S &5) S P S PS S PS U U U U Soil Depth (inches) C� S P S PS S PS U" U U Soil Drainage: Internal S PS P , S PS U S PS U External S pS S PS S PS S PS U U Uj Restrictive Horizons �_ Y Available Space PS U S PS U S PS U S PS U Other (Specify) S PS U S PS U S PS U S PS U Site Classification , U 5- U—UNSUITABLE S—SUITABLEPS—Provisionally Suitable Recommendations /Comments: Described by SITE DIAGRAM DCHD (6-82) Title ��L� Datell , 111f,"ll �e 114s I'l V, pu i/ �tti�iP noun#� �Pti�#� � P;J2Yr#mPn# Mnii �vmE �PiI�#� ��Ent� P. O. BOX 665 Auchsbille, North Carolina 271iZ8 OFFICE OF THE DIRECTOR TELEPHONE July 16, 1986 (704) 634.5985 Mr. Donald B. Polley, dr. Lambe Young Realty 3400 Healey Drive Winston Salem, NC 27103 Mr. Polley: On July 15, 1986 this office evaluated lot 22 in Bermuda Run. Soil borings on this lot reveal a red clay soil in the front portion of the lot and is classified provisionally suitable. The back portion of the lot contains a heavy red clay with moderate to severe shrink/swell poten- tial thus the back is classified unsuitable. Before any permit can be issued the prospective buyer must fill out the appropriate application and the house staked off. If you have any questions, feel free to call. Sincerely, 1 C� Robert B. Hall, Jr. R. S.