171 Boxwood Circle Lot 165Davie County, NC Tax Parcel Report Thursday, October 27, 2016
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All data Is provided as Is without warranty or guarantee of any Idnd either expressed or implied Including but not limited to the 1
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
County of Davie, North Carolina, its agents, consultants, contractors or employees from any and all claims or causes of action due to i
r'p i NC or arising out of the use or Inability to use the GIS data provided by this website.
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WARNING: THIS IS NOT A SURVEY
Parcel Information
Parcel Number:
D803OA0010
Township:
Farmington
NCPIN Number:
5882056383
Municipality:
BERMUDA RUN
Account Number:
12898000
Census Tract:
37059-803
Listed Owner 1:
CARNEY CARL V
Voting Precinct:
HILLSDALE
Mailing Address 1:
PO BOX 1724
Planning Jurisdiction:
BERMUDA RUN
City: CLEMMONS
Zoning Class:
BERMUDA RUN CR
State:
NC
Zoning Overlay:
Zip Code:
27012-0000
Voluntary Ag. District:
No
Legal Description:
2.057AC BOXWOOD CIRCLE
Fire Response District:
CLEMMONS
Assessed Acreage:
2.05
Elementary School Zone:
SHADY GROVE
Deed Date:
4/1999
Middle School Zone:
WILLIAM ELLIS
Deed Book / Page:
002100827
Soil Types:
MrC2,GaD
Plat Book:
0004
Flood Zone:
Plat Page:
089
Watershed Overlay:
BERMUDA RUN
Building Value:
392850.00
Outbuilding & Extra
Freatures Value:
0.00
Land Value:
75000.00
Total Market Value:
467850.00
Total Assessed Value:
467850.00
All data Is provided as Is without warranty or guarantee of any Idnd either expressed or implied Including but not limited to the 1
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
County of Davie, North Carolina, its agents, consultants, contractors or employees from any and all claims or causes of action due to i
r'p i NC or arising out of the use or Inability to use the GIS data provided by this website.
I ;
DAVIE COUNTY HEALTH DEPARTMENT
Environmental Health Section 112 1 !
' P. O. Boa 848/210 hospital Street
Mocksville, NC 27028
(336)751-8760
IMPROVEMENT/OPERATION PERMIT
Account #:
990001063
Tax PIN/EH #:
5882-05-6383
Billed To:
Carl Camey
Subdivision Info:
Bermuda Run Sec.11 Lot # 165
Reference Name:
Carl Camey
Location/Address:
Boxwood Circle -27006
Proposed Facility:
Residence
Property Size:
See Map
932 1
**NOTlC * Thiblmprovent/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 /7 #People _ #Bedrooms #Baths
Dishwasher: 01*1' Garbage Disposal: ❑ Washing Machine: Basement w/Plumbing: ❑ Basement/No Plumbing;lz�
Commercial Specification: Facility Type #People #People/Shift #Seats Industrial Waste: ❑
Lot Size Type Water Supply_ Design Wastewater Flow (GPD) Site: New Repair ❑
System Specifications: Tank Size,/ GAL. Pump Tank GAL. Trench Width ' Depth Linear Ft.
Other:
Required Site Modifications/Conditions:
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.****
A&V&1 I/V
Environmental Health Specialist's Signature: d Date: VI/
DCHD 05/99 (Revised)
-
-t—t
A&V&1 I/V
Environmental Health Specialist's Signature: d Date: VI/
DCHD 05/99 (Revised)
ATC Number: 2932
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 System tion .1900 Sewage Treatment and Disposal Systems). THIS
AUTHORIZATION FOR WASTE WAfER NS N IS VAL O A PERIOD OF FIVE YEARS.
Environmental Health Specialist's Signature:Date: �` dor
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 I 1 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)
AllqsS ee i
Affl �
Date:'
DAVIE COUNTY HEALTH DEPARTMENT
Environmental Health Section
P. O. Boz 848/210 Hospital Street
Mocksville, NC 27028
(336)751-8760
Account #:
990001063
Tax PIN/EH M
5882-05-6383
Billed To:
Carl Carney
Subdivision Info:
Bermuda Run Sec.11 Lot # 165
Reference Name:
Carl Carney
Location/Address:
Boxwood Circle -27006
Proposed Facility:
Residence
Property Size:
See Map
ATC Number: 2932
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 System tion .1900 Sewage Treatment and Disposal Systems). THIS
AUTHORIZATION FOR WASTE WAfER NS N IS VAL O A PERIOD OF FIVE YEARS.
Environmental Health Specialist's Signature:Date: �` dor
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 I 1 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)
AllqsS ee i
Affl �
Date:'
e
J9 ow
�44 I APPLICA ON FOR SRE EVALUATION/IMPROVEMENT PERMIT & ATC D
Davie County Health Department 2 7 2000
Environmental Health Suction
P.O. Box 848/210 Hospital Street
Mocksville, NC 27028
`> (336) 751-8760
***I1�ORTANT*** THIS APPLICATION CANNOT BE PROCESSED UNLESS ALL THE REQUIRED
INFORMATION IS PROVIDED. Refer to the INFORMATION BULLETIN for instructions.
1. Rei—Rei—me to be Zilla d _ �� Z,\ V. ��a;z Contact Person (n (Z t V_—
Mailing Address t ( Home Phone 3"
r
City/state/ZIP Business Phone Q (� �74
2. Name on Permit/ATC if Different than Above <40V1F—
Mailing Address
3. Application For: (Site Evaluation
4. System to Service: Hous
city/state/Zip
,.Improvement Permit/ATC ❑ Both
House
❑ Mobile Home ❑ Business ❑ Industry ❑ Other
5. If Residence: # People # Bedrooms
dishwasher fl Garbage Disposal asking Machine 11 Basement/Plumbing
6. If Business/Industry/Other: Specify type # People _
# Commodes # Showers # Urinals
# Bathrooms
` a-sement/No Plumbing
# Sinks
# Water Coolers
IF FOODSERVICE: # Seats Estimated Water Usage (gallons per day)
7. Type of water supply: A-eounty/City ❑ Well ❑ Community
e. Do you anticipate additions or expansions of the facility this system is intended to serve? ❑ Yes "6;90 -
If yes; what tyre? ki 0
***IMPORTANT*** CLIENTS MUST COMPLETE THE REQUIRED PROPERTY INFORMATION REQUESTED
BELOW. Either a PLAT or SITE PLAN MUST BESUBMITTED by the client with THIS APPLICATION.
`O � h f.w 1J V O I� i•, T R�lvn�/\l..C� ���..� Ri_..•.... ... _� nA VAyn Ta/_
Property Dimensions: V l�f � IG VY�1.Gl. i 1Vl\J �u ow mv�n:+�■uc, :v .� �. . •. a .
Tax Office PIN: #%01%Nor
Property Address: Road Name ( ,okt , 4n o aJ err-C]Q - PT-
City/Zip s r r~ 15 dC .,l,y o.►
If in a Subdivision provide information, as follows:
A
Name:
• - I - - -
Section: Block: 4 Lot: (0. 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 1, also, understand that 1 am responsible for all charges incurred from
this application. I, hereby, give consent to the Authorized Representative of the D vie County alth Department
to enter upon above described property located in Davie County and owned by . A (L R.'--
to conduct all testing procedures as necessary to determine the site suitabili
THIS AREA MAY BE USED FOR DRAWING YOUR SITE PE
property lines and dimensions, structures, setbacks, and septic
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DAVIE COUNTY HEALTH DEPARTMENT
Environmental Health Section
FACTORS
1 2 3 4 5 6 7
Soil/Site Evaluation
APPLICANT INFORMATION
PROPERTY INFORMATION
Account #:
990001063
Tax PIN/EH #:
5882-05-6383
Billed To:
Carl Camey
Subdivision Info:
Bermuda Run Sec.11 Lot # 165
Reference Name:
Carl Camey
Location/Address:
Boxwood Circle -270
Proposed Facility:
Residence
Property Size: See Map Date
Evaluated:
Water Supply:
On -Site Well
Community
Public
Evaluation By:
Auger Boring
Pit I __�
Cut
Structure
Mineralogy
FACTORS
1 2 3 4 5 6 7
Landscape position
Slope %
HORIZON I DEPTH
Texture group
Consistence
Structure
Mineralogy
HORIZON Il DEPTH
t ��
Texture rou
ConsistenceStructureMineralo
W//
-
/, `'
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. - Z
LONG-TERM ACCEPTANCE RATE: J 'tel
REMARKS: ! lC? jl f'/` or J
LEGEND
i
EVALUATION BY:
OTHER(S) PRESENT:
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 05/99 (Revised)
DAVIE COUNTY HEALTH DEPARTMENT
ENVIRONMENTAL HEALTH SECTION
P. 0. Box 848/210 Hospital Street
Courier #09-40-06
Mocksville, NC 27028
Phone #:. (336)751.8760
May 16, 2000
Mr. Carl V. Carney
P.O. Box 1670
Mocksville, NC 27028
RE: Site Evaluation/Lot 165 Bermuda Run
Dear Mr. Carney:
On May 12, 2000 this office did a soil/site evaluation on Lot 165 in Bermuda Run, N.C.
The soil conditions on this Lot are provisionally suitable for the installation of a septic
tank system however, topography and available space are limiting factors.
It is imperative that the Builder work closely with this office to ensure space is reserved for
the proposed installation of 400 linear feet.
If you have any questions please feel free to call our office between the hours of 8:30 a.m.
and 5:00 p.m. at (336) 751-8760.
Sincerely,
A14444
Robert B. Hall, Jr., R.S.
Environmental Health Specialist
RBH/mp
Enclosure(s)