1948 Angell RdDavie County, NC, , Tax Parcel Report Wednesday, October 12, 2016
WAKNllV(T: '1'H1515 iVU"1' A �UKVr:Y
Parcel Information
Parcel Number: E30000008005 Township:
NCPIN Number: 5821529863 Municipality:
Account Number: 16940000 Census Tract:
Listed Owner 1: COOK WILLIAM RICHARD Voting Precinct:
Mailing Address 1: 1948 ANGELL ROAD Planning Jurisdiction:
City: MOCKSVILLE
State:
Zoning Class:
NC Zoning Overlay:
Zip Code: 27028-4605 Voluntary Ag. District:
Legal Description: 5.086 AC ANGELL RD Fire Response District:
Assessed Acreage:
Deed Date:
Deed Book / Page:
Plat Book:
Plat Page:
Building Value:
Land Value:
Total Assessed Value:
°"�'�' Davie County,
�o��,��' NC
4.83 Elementary School Zone:
5/2004 Middle School Zone:
005530740 Soil Types:
Flood Zone:
Watershed Overlay:
232370.00 Outbuilding & Extra
Freatures Value:
43400.00 Total Market Value:
297240.00
Clarksville
37059-801
CLARKSVILLE
Davie County
DAVIE COUNTY R-20
WILLIAM R. DAVIE
WILLIAM R DAVIE
NORTH DAVIE
PcC2,Ce62,MsD
DAVIE COUNTY
2147p.00
297240.00
No
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AUTHnRI.�ATION NO: �� Q� DAVIE COUNTY HEALTH DEPARTMENT
�' � Environmental Health Section
Perrriittee`ti � � P.O. Box 848
,. , ,
� i��(d
PROPERTY INFORMATION
Name: - ��-������ '. Mocksville, NC 27028 Subdivision Name:
Phone # 336-751-8760 -� f �" ��"' ��" � �'�; �'
Directions to property: �✓-� �%� :%`�- �`�''�� Section: L-vt''
AUTHORIZATION FOR ,�-� �,,, � � � / � f �
WASTEWA'I'ER Tax Office PIN:# �6 � - ��
SYSTF.M CONSTRUCTION
Road Name: ./7 t'l L�� ���p: � �vSC1
**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 Forni/Authorization Number should be presented to the Davie County Building Inspections
Office when applying for Building Permits.
(ln compliance with Article I 1 of G.S. Chapter 130A, Wastewater Systems, Section .1900 Sewage Treatment and Disposal Systems)
af ' �`; -•--'"> �/' ;'' r ,,�., *NOTICE*** THIS AUTHORIZATION FOR WASTEWATER CONSTRUCTION
�` '� ';l�J'� .,i''�'r �{��✓•' p7, f ,%'�`.G� '� � IS VALID FOR A PERIOD OF FIVE YEARS.
'1 ,•.� �;
ENVIRONMENTAL HE LTH SPEC IST DATE ISSUED
. , ._ r „- .-��._ ; .. .., �Y _
. r . . _ � � . . _
_ �'` • ` . � � � • � , � I�XO'
_ ' � �;� � - -. _.� - � � � � DAVIE � OUNTY HEALTH DEPARTMENT •
...,�..---- f,�, �' •' ' " TMPRO EMENT AND OPERATION PERMITS PROPERTY INFORMATION
_ � Pe;�fiifte�'�'"° .
�
" �Name =�; •�^',��1� ���diiCr�/��.. Subdivision Name: �, .
Y. ,..� � i�� v. '�_-_,. „�=-� �.,
,. DiFections to'property: r"�` � . � �" �'r'� Section: -�ot'
_ _ .�,, IMPROVEMENT .`�� :�i� t.' •:) % ..,r ( f
" : PERMTT Tax Of�ce PIN:# �_ �' ' �
�`�,,C'"_ Y � ��
Road Name: -�`��) "I � �.: �f� �`T`Zip; �'�-'�
**NOTE** Tkis Improvement Pernut DOES NOT authorize the conshuction or installation of a septic tank system or any wastewater system. An
AUTHORIZATION FOR WASTEWATER SYSTEM CONSTRUCT'ION must be obtained frc�m this Department prior to the
constniction/installation of a system or the issuance of a building pemut
(In compliance with Article 11 of G.S. Chapter 130A, Wastewater Systems, Section .1900 Sewage Treatment and Disposal Systems)
, ;; � � �,� ;._;,,, 1, , ***NOTICE*** TIIIS PERNIIT IS SUBJECT TO REVOCATION IF SITE
�;'; ; y �.... � j., � : . - ,: � w: f . ,- � + ,;J ;,�, i � %! PLANS OR TIIE INTENDED USE CHANGE. YOUR WASTEWATER
ENVIRONMENTAL HEALTH SPE IdLIST DATE ISSUED SYSTEM CONTRACTOR MUST SEE THLS PERMIT BEFORE
INSTALLING THE SYSTEM.
RESIDENTIAL SPECIFICATION: BUILDING TYPE �# BEDROOMS # BATHS _�_ # OCCUPANTS GARBAGE DISPOSALi Yes or No
COMMERCIAL SPECIFICATION: FACILII'Y TYPE # PEOPLE # PEOPLFJSHIFI' # SEATS INDUSTRIAL WASTE: Yes or No
LOT SIZE 'L !J� TYPE WATER SUPPLY ���// DESIGN WASTEWATER FLOW (GPD) �D NEW SITET_ REPAIR SITE
SYSTEM SPECIFICATIONS: TANK SIZE l,n� GAL. PUMP TANK GAL. TRENCH WIDTH ��3G . ROCK DEPTH � LINEAR Ff. �L'rr
REQUIRED SITE MODIFICATIONS/CONDITIONS:
� IMPROVEMENT PERMIT LAYOUT
i
•*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 (336)751-8760.
OPERATION PERMIT
SYSTEM INSTALLED BY: ��� (,C[�
�
AUTHORIZATION NO. /S�� OPERATION PERMIT BY: �f'YV/ r1LJ�0 DATE: �� �" T�
0
•'THE ISSUANCE OF THIS OPERATION PERMIT SHALL INDICATE THAT THE SYSTEM DESCRIBED ABOVE HAS BEEN INSTALLED IN COMPLIANCE
WITH ARTICLE 11 OF G.S. CHAP'TER 130A, SECTION .1900 "SEWAGE TREATMENT AND DISPUSAL SYSTEMS", BUT SHALL IN NO WAY BE TAKEN AS A
GUARANTEE THAT THE SYSTEM WII.L FUNCTION SATISFACTORILY FOR ANY GIVEN PERIOD OF TIME. �
DCHD OS/'96 (Reviud)
•, '' APPLICATION FOR SITE EVALUATION/IMPROVEMENT PERMIT &
Davie County Heaith Department
Environmenia/ Hea/th Section
P.O. Box 848/210 Hospital Street
Mocksville, NC 27028
(336) 751-8760
***Il►�ORTANT*** THIS APPLICATION CANNOT BE PROC,ESSED UNLESS ALL Ti� REQUIRED
INFORMATION IS PROVIDED. Refer to the INFORMATION BULLETIN for instructions.
. %�
1. Name to be Billed �� Q►1 ►�Jr�t.11 S 1/1 G Q� Contact Person � �Gy�, ,�cp�,� S r n c.^
Mailing Acidress � � � p /t�L:�,e ( ( /.C� Home Phone -1 � 0 ^ %'t � �
City/state/2IP __ � B � �5�1 � ��.� , N � a7�� � Business Phone 7J l — � �g l
2. Name on Permit/ATC if Different than Above
Tiailing Address
City/State/Zip
3. Application For: 0 Site Evaluation ❑ Improvement Permit/ATC 0 Both
4. system to sesvice: � House ❑ Mobile Home ❑ Business 0 Industry i�l" Other .��
5. If Ftestaence: # People � Bedrooms # Bathrooms _L_
0 Dishwasher ❑ Garbage Disposal ❑ Washing Machine ❑ Base�►ent/Plumbing ❑ Basement/No Plumbing
6. If Business/Industry/Other: Specify type
# Com�odes �_ i! Showers �_ � Urinals
� Peaple � Sinks
# Water Coolers
IF FOODSERVICE: # Seats Estimated Water Usage (gaiions per aay)
�. zype of .+ater supply: ❑ County/City �Well 0 Cosa�aunity
a. Do vou anticipate additions or eapansions of t6e facility t6is system is intended to serve? 0 Yes ❑ No
�jc.. 1 a i n��� f e.,5 ,
*'*IMFORTANT't** CLIENTS DfUST CO�1iPLETE THE REQUIRED PROPERTY WFORMATION REQUESTED
BELOW. Eit6er a PLAT or SITE PLAN �tlUST BE SUB�1iITTED by the client with THIS APPLICATION.
Propert�• Diroensions: 1�A��-
Taa Office PIN: # S"$".�f � � .� ' f.3 � �
Property Address: Road Name � �
City/Zip
If in a Subdivision pro��de intormation, as follows:
Namc:
Section: Block: Lot:
R'RITE DIRECTIONS (from Mocks�111e) to PROPERTY:
G o/,�1 J,-�h ,-�-u.r n� r i �al�-�-
� r�. A-��a � I 1 R�i �, 2 Nt�s
O�'t �-�, .� ! :2..� �
This is to certif�� that the information provided is correct to t6e best of my knowledge. I understand that any permit(s)
issued hcreafter are subject to suspension or re�•ocation, if the site pians or intended use change, or if the information
submitted in this application is falsified or changed. I, also, under�7and that I am responsible jor all charges incurred jrom
thu application. I, hereby, give consent to the Authorized Representative of the Da��e County Health Department
to enter upon abo��e described propert3• Iceated in Da�•ie County and o���ned b�-
to conduct all testing procedures as necessary to determine t6e site suitabitity.
DATE 7 I�I � SIGNATURE �Q Q..� �,�,,,�cl.�u /J 1.2,, c��--
THIS AREA MAY BE USED FOR DRAWING YOUR SITE PLAN:
ac ��: ��
.���lication No.
Invoice No. �'
Re�-ised DCHD (07/98)
� ,; , ; , . , DAVIE COUNTY HEALTH DEPARTMENT
• • Environmental Health Section SECTION LOT
SoiUSite Evaluation
APPLICANT'S NAME G %/Jl f''� DATE EVALUATED ��% /�d
PROPOSED FACILITY �` • PROPERTY SIZE �/�L'
SUBDIVISION ROAD NAME���� .�
Water Supply:
Evaluation By:
On-Site Well ��
Auger Boring t�
Community
Pit
Public
Cut
SITE CLASSIFICATION: 1� EVALUATION BY: �� %
�---�
LONG-TERM ACCEPTANCE RATE: � 7 OTHER(S) PRESENT:
REMARKS:
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 frm
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 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 - gaUday/ft2
DCHD (O1-90)
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