181 Allison LnDavie Countv. NC • Tax Parcel Renort Wednesdav. October 12, 2016
Parcel Number:
NCPIN Number:
Account Number:
Listed Owner 1:
Mailing Address 1:
City:
State:
Zip Code:
Legal Description:
Assessed Acreage
Deed Date:
Deed Book / Page:
Plat Book:
Plat Page:
Building Value:
WAK1VllV(T: "1'tllS 1� 1VU'l� A aUKV�Y
Parcel Information
H30000003503 Township: Calahaln
5719718500 Municipality:
1365000 Census Tract: 37059-801
ALLISON MARGARET B Voting Precinct: NORTH CALAHALN
181 ALLISON LANE Planning Jurisdiction: Davie County
MOCKSVILLE Zoning Class: DAVIE COUNTY I-4,R-20
NC Zoning Overlay:
2702&8100 Voluntary Ag. District: No
2.25 AC OFF POWELL RD LIFE ESTATE Fire Response District: CENTER
. 2.02 Elementary School Zone: WILLIAM R DAVIE
Land Value:
Total Assessed Value:
9"�'A Davie County,
�o��,�� NC
7/2004 Middle School Zone: NORTH DAVIE
005600665 Soil Types: PaD,PcC2,CeB2
Flood Zone:
Watershed Overlay: DAVIE COUNTY
Outbuilding 8 Extra
0.00 Freatures Value: 0.00
8290.00 Total Market Value: 8290.00
8290.00
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` AUTH9RI�ATION NO '% ��,� J DAVIE COUNTY HEALTH DEPARTMENT
�� � '+ Environmental Health Section PROPERTY INFORMATION
Permittee's J /� .,,,) P.O. Box 848
Name: t'��7}ii �°� r'�t' ���"�j��''" . Mocksville, NC 27028 Subdivision Name:
i�:�l�Lt '1.. � � �ti;��t- �=� Phone #: 704-634-8760
Directions to property: . r Section: Lot:
�i t,r'�F,I Lc:.Fr �, AU �ORIEWATER �R
� �`��` � � SYSTEM CONSTRUC'TION Tax Office PIN:# •� �� �� �� - � �t-
fr-.� ,�f i.� i_ �=_ F'� /i•r �i Q 3�.. �t11�L- G C�F'i �/f�c;y �.� 7�� c�3 � v/- i' Road Name: ��-'�-�—`'�-'a3 �.►'J Zip; L%c::�2�'�
**NOTE** This Authorization for Wastewater System Construction MUST BE ISSUED by the Davie County Environmental Health Section prior
to issuance of any Building Pernuts. This Forrn/Authorization Number should be presented to the Davie County Building Inspections
Office when applying for Building Pernuts.
(In compliance with Article 11 of G.S.,Cfiapter 130A, Wastewater Systems, Section .1900 Sewage Treatment and Disposal Systems)
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�- �' � i� l'`,,."�� ,%-.�'�""�""""`� � j,� ***NOTICE*** THIS AUTHORIZATION FOR WASTEWATER CONSTRUCTION
�_.e� l` ---"�r`"j %7 ��7� IS VALID FOR A PERIOD OF FIVE YEARS.
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ENVIROI3NIEN7'A�L�-IEALTH SPECIALI DATE ISSUED
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`" � � -' ".� � "� DAVIE COUNTY HEALTH DEPARTMENT
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' '`''�� IMPROVEMENT AND OPERATION PERMITS PROPERTY INFORMATION
Pernuttee's : � �
N�me:�,; ; '�r , ' � _; �. `' '���€.� /'.� �'�, ��.�`.� Subdivision Name:
'Directions io property: '%'� p, ` 11, � ` '• : ` `� �"'~'�
, Section: Lot:
' IMPROVEMENT ,
. f,� � t. � » ;, ���. f .�rr �.: �.�-� PERMTI' Tax Office PIN:# "�, .�r � ~�'� _ ~'";� � �
{ F e '3 . �.. f a ��.. . l'. . �l S,�- /, ' -, s ..
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_, . � ;.- � �;"' ; ;. { � d. � �� Road Name: .t � ' .� � �� Zlp: � c._ �f <. .. f ;
**NOTE** This Improvement Pernut DOFS NOT authorize the construction or installation of a septic tank system or any wastewater system. An
AUTHORIZATION FOR WAST'EWATER SYSTEM CONSTRUCT'ION must be obtained frc�m this Department prior to the
construction/installarion of a system or the issuance of a building pernut.
(In compliance with Article 11 of G.S. Chapter 130A, Wastewater Systems, Section .1900 Sewage Treatment and Disposal Systems)
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ENVIRONMENTAIiHEALTH SPECIALIST-� �•. ' DATE ISSUED
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***NOTICE*** THIS PERMIT IS SUBJECT TO REVOCATION IF SITE
PLANS OR THE INT'ENDED USE CHANGE. YOUR WASTEWATER
SYSTEM CONTRACTOR MUST SEE THIS PERMIT BEFORE
INSTALLING T'f� SYSTEM.
RESIDENTIAL SPECIFICATION: BUILDING TYPE �!•� # BEDROOMS -� # BATHS 7�, # OCCUPANTS _L GARBAGE DISPOSAL: Yes or�oJ
COMMERCIAL SPECIFICATION: FACILITY TYPE
7 L �,�">">
LOT SIZE L•��' �YPE WATER SUPPL��k= Z-�
# PEOPLE # PEOPLFJSHIFf # SEATS INDUSTRIAL WASTE: Yes or No
DESIGN WASTEWATER FLOW (GPD) -~-�-�� NEW SITE �REPAIR SITE
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SYSTEM SPECIFICATIONS: TANK SIZE GAL. PUMP TANK GAL. TRENCH WIDTH �=-''��=' ROCK DEPTH ��` LINEAR FT. -�' /'�'
. OTHER I ��`7 � t�'L�"�T f� o.J r"Y>;�
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REQUIREDSITEMODIFICATIONS/CONDITIONS: �'*�c�>7'��-�- C�`°a Ct'��CU``" �'���-±5 � C�F �-,Gif":�c- j��'-�'4:1 (,�T' �F j`�.c:C(� ,
'../',,. �_
**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 THE DAY OF INSTALLATION. TELEPHONE # IS (704) 634-8760.
OPERATION PERMIT
SYSTEM INSTALLED BY: _S
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' AUTHORIZATION NO. " V � OPERATION PERMIT BY: DATE: �,o�� �/ ✓
**THE ISSUANCE OF THIS OPERATION PERMIT SHALL INDICATE THAT THE SYSTEM DESCRIBED ABOVE 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.
DCHD OS/96 (Revised)
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y � � APPLICATION FOR SITE EVALUATION/IMPROVEMENT PERM � �A �� `� �`�
Davie County Health Department � �'' � `' � �� � " `i
� Environmental Health Section 1
P. O. Box 848 �R 2 � ��
Mocksville, NC 27028
� (336 751-8760 ENYIRONP�IENTAL HF1`il.IFI '
4AVIE COl1fJTY
****IMPORTANT**** THIS APPLICATION CANNOT BE PROCESS
ALL THE REQUIRED INFORMATION IS PROVIDED.
1. Name to be Billed .a / /� � � Contact Person � �
Mailing Address %�/ ,���. G �.r� � y. - Home Phone �`!2- h 7�'"7
City/State/Zip 1�%� n �S' 1/ � � ��-P /�, �. �-7 �' � � Business Phone
2. Name on PermiUATC if Different than Above �'�_� I� �' r� ti�,[g- _ /� I�� S�'r�
Mailing Address ����� .'r ,..._ 1. �. City/State/Zip /1�4C �'� C ��� %/. 19C: 2 7 G'��
3. Application For: ❑ Site Evaluation
0 Improvement Permit & ATC
� Both
4. System to Serve: ❑ House 0� Mobile Home ❑ Business ❑ Industry ❑ Other
5. If Residence: # People _� # Bedrooms � # Bathrooms �
❑ Dishwasher ❑ Garbage Disposal � Washing Machine ❑ Basement/Plumbing ❑ Basement/No Plumbing
6. If Business/Other:
# Commodes
If Foodservice:
7. Type of water supply:
Specify type
# Showers _
# Seats
❑ County/City
# People # Sinks
# Urinals
Estimated Water Usage (gallons per day)
pd' Well
# Water Coolers
❑ Community
8. Do you anticipate additions or expansions of the facility this system is intended to serve? ❑ Yes �' No
If yes, what type?
E Z THER tt PLttT OR SI IE PLrIN
PROPERTY INFORMATION REQUIRED: *** IMPORTANT *** A P.�' THE PROPERTY MUST BE
SUBMITTED WITH THIS APPLICATION.
Property Dimensions: � • .Z � �i ,C ,C��
Tax Ofiice PIN: # S %� � - " �% � - D �Q �
Property Address: Road Name ����'s �,.-� j�
City/Zip '� �l'� � �
� If in Subdivision provide information, as follows:
Name:
Section:
Lot #:
WRITE DIRECTIONS (from
Mocksville) TO PROPERTY:
G C� r.�� � �- %�a
��'
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
as necessary to determine the site suitability.
DATE ���_ SIGNATURE
Revised DCHD (06-96)
.;
l�JOU MAI,J USE THE $ttCK O� THIS �OIZM �'OR blZttWING l�/OUR SITE PLtIN.
conduct all testing procedures
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Scale:l"= 616 April 21,1998 9:26 AM
, • ' ' , .
� , �` •� • � ' DAVIE COUNTY HEALTH DEPARTMENT
Environmental Health Section SECTION LOT
Soil/Site Evaluation
APPLICANT'S NAME �.`�i� �LLI_ F�� l`� DATE EVALUATED �� I hg 1 q�
PROPOSED FACILITY '`� �� �% PROPERTY SIZE 2-.�LCca QC.�L;z�
SUBDIVISION ROAD NAME %-bLLtS�On) ��
Water Supply: On-Site Well � Community
Evaluation By: Auger Boring '� Pit
FACTORS
Landscape position
Slope %
HORIZON I DEPTH
Texture group
Consistence
Structure
Mineralogy
HORIZON II DEPTH
Texture group
Consistence
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
C�
l' 1 ).
SITE CLASSIFICATION: i -� �
LONG-TERM ACCEPTANCE RATE: � � ��
REMARKS:
DCHD (OI-90)
Public
Cut
3 4 5 6 7
EVALUATION BY: �I�F � �
�
OTHER(S) PRESENT: ��^1`�"/1o�t1�"� �
TT��-�.vs�—
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
MineraloEv
1:1, 2:1, Mixed
Notes
Horizon depth - In inches
Depth of fll - 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 - gaUday/ft2
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