143 Baity Rd.
�avie County, NC
Tax Parcel Report Wednesday, October 12, 201 E
WARNING: THIS IS NOT A SURVEY
� � ��,� � ,�� Parcel Information � � ���� ��� ��,���„���
Parcel Number: C30000006801 Township: Clarksville
NCPIN Number: 5823211244 Municipality:
Account Number: 82513278 Census Tract: 37059-801
Listed Owner 1: BAITY JONATHAN LUKE Voting Precinct: CLARKSVILLE
Mailing Address 1: PO BOX 1311 Planning Jurisdiction: Davie County
City: MOCKSVILLE Zoning Class: DAVIE COUNTY R-A,R-20
State: NC Zoning Overlay:
Zip Code: 27028-1311 Voluntary Ag. District: No
Legal Description: 3.81 AC BAITY RD Fire Response District: WILLIAM R. DAVIE
Assessed Acreage: 3.48 Elementary School Zone: WILLIAM R DAVIE
Deed Date: 11/1999 Middle School Zone: NORTH DAVIE
Deed Book / Page: 003190373 Soil Types: MrC2,MnC2,MdD,MsC
Plat Book: Flood Zone:
Plat Page: Watershed Overlay: DAVIE COUNTY
Building Value: 77260.00 Outbuilding & Extra 31320.00
Freatures Value:
Land Value: 35300.00 Total Market Value: 143880.00
Total Assessed Value: 143880.00
°`18'F Davie County,
`'�UN�'' NC
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IPIPROVEP�NT PERMIT
DAVIE COUNTY F�flLTH DEPARTMENT
IMPROVEMENT PEAMIT and �ERATIDN PERMIT
*�NDTE*+� This i�prove�ent per�it D�5 NOT authorize the �onstru�tion or installation of a septic tank syste� or any NasteNater
syste�. AN RUTHORIZATION FOR IJRSTEWATER SYSTEM CDN5TRUCTION �ust be obtained fro� this Depart�ent prior to the
construction/installation of a syste� or the issuance of a building per�it.
(In co�pliance with Article il of 6.5. Chapter 13@R, NasteNater Syste�s, 5ection .1900 5ewage Treat�ent and Disposal 5yste�s)
Mt�ME �1 �7��rx 1'�,�lJ �� � f�, PRDRERTY RDDRE55 �/ /� l�� ,� G� �d� g DATE �
_... `S�
LOCATION ��Cg: �.� ��(�
5UBDIUI5IDN NAME LDT MkIBER SEC. /BLDCK MJ�iBER
RESIDENTAL SPECIFICATION: BUILDING :TYPE _1���!!rP � BEDROOMS ...t� # BATHS �% t OCCUF�ANTS �,,,,�J 6ARB{�E DISPOSAL: Yes(t�
COMMERCIRL SPECIFICRTION: FACILITY TYPE � PEDRLE # pEOGLE/5HIFT # SERTS IFIDUSTRIRL NASTE: Yes/No
LOT SIZE ��G?`(_'_ TYPE WATER SI�PLY �.�I DE5I6N {�STEWATER FLOW iGPD),�� � ri NEH SITE � REPAIR SITE
5Y5TEM 5PECIFICATI�IS: TANK SIZE�J�Y%Q 6AL. PUMR 7Rr6� 6AL. TRENCH NIDTH ��,� ��ROCK DEPTH �'1 �� LINEAR FT. '��d �
OTHER
REQUIRED 5ITE MODIFICATIDN5/CONDITIONS:
*�+�TNI5 PERMIT IS SUBJECT TO REVOCATION IF 5ITE PlAN5 OR TF� INTENDED USE CHANSE. VDUR WASTERWATER SY5TEM CONTRACTOR hAIST
SEE THIS PERMIT BffORE INSTALLING THE SYSTEM.
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IM�'RDVEMENT PERMIT BY ��� / /
�*CONTACT A REPRESENTRTIVE � THE DAVIE C�JTY HEAITH DEPARTMENT FOR FIt�L INSPECTIDN DF THIS SYSTEM BETWEEN
B:30-9:30 A.M. OR 1:�-1:30 P.M. ON THE DAY OF INSTALLATION. TELEPHONE # IS 17041 634-87E0.
�ERATION PERMIT
SYSTEM INSTALLED BY � ^��� LA ��G''�
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AUTHORIZATION N0. O33j TI `� (�1 E� 1� � u
�*THE ISSURNCE � THI5 QPERATION PERPIIT SHALL INDICATE THAT THE SYSTEM DESCRIBED ABOVE HAS BEEN INSTALI.ED IN COb�LIFWCE NITH
I ARTICLE 11 � G.S. CHAPTER 130A, SECTIOrI .19� "SE4IAGE TREATMENT AND �ISPOSAL SYSTEMS°, BUT SHALL IN NO WAY BE TAKEN AS A
I (�.IARAMTEE THAT TF1E 5Y5TEM WILL FlINCTION SRTISFACTORILY FDR AFIY 6IVEN PEAIDD � TIM�. ,
DCHD 10/95
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Davie County Nealth �epartient
ENVIADNPIENTRL HEALTH 5ECTIDN
P.O. Aox 665
Mocksville, N.C. 27028
AUT}IDRIZATION FOR WASTEHRTER SYSTD� CON5Ti�lCTI�1
tIssued in co�pliance with Articie 11 of
G.S, Ghapter 13►dA, Wastewater Systeis)
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+�+�+�This Ruthorization For Wastewater �ysta� Construction �ust be issued by the Davie County Environ�ental Health 5ection prior to
issuance of any Building Per�its. This For�/Authorizatian Nu�ber should be presented to the Davie County Building Inspections
Dffice when applying for Building Per�its.+�+�
� �/ AllTF�RIZATION FI1t9ER
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NAIE ��l? /� ✓,��i � i T l.� DATE <'i � � �� � � _ � � v �:
NRME ON IMPRDUEMENT PERMIT (If different than above)
� ` /�CN
SITE LOCATION _ Q,"��.r
COMEENT5/(XINDITIaV5 ON fll1T}IORITATION TO CONSTRIICT NRSTEWATER SYSTEM
�ft�'TICE� THIS AUTHDRIZRTID R WflSTEWflTER 5Y5TEM CONSTRIICTIDN IS VALID FD A GERIOD OF FIUE 15) YEARS.
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ENVI AL �f.Al. CIALIST DATE
DCHD 10/95 '
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w .
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� r APPLICATION FOR SITE EVALUATION/IMPROVEMENTS
' Davie County Heaith Department
Environmental Health Section
P. O. Box 665
Mocksville, NC 27028
� 41
App�ication/Permi2 Requested B -..� /� Cx C.t, r r
Mailing Address
%S (� � � Cv- ome Phone ��� ^7 �S- � � �d
pC�S (�� i�, !'l� � e� c�?b �[� Business Phoneq��'�%33-"s�� �
2. Name on Permit if Different than Above
3. Application for: �General Evaluation
4. System to Serve: [� House
❑ Business
❑ Indus4ry
5. If houso, mobole home: Subdivisian
No. of People a
Ne. of Bedrooms 3
f�Septic Tank Installation Permit ,
❑ Mobile Home ❑ Place of Public Assembly
❑ Other
No. of Bathrooms �
Dwelling Dimensions �0 � ��
6. If business, industry, p�ace of public assembly, other: Specify type
No. of People Served
No. of Commodes
No. of Lavatories
No. of Showers
7. Type of water supply: ❑ Public
No. of Sinks
No. of Urinals
No. of Water Coolers
Water Usage Figures
l�Private
❑ Unknown
Section Lot #
B sement/Plumbing
f� Ba menUNo Plumbing
ashing Machine
ishwasher
❑ Garbage Disposal
8. Property Dimensions e� R �p-� Sewage Disposal Contractor
9. Do you anticipate additions/expansion of the facility this sytem is intended to serve? ❑ Yes o
If yes, what type?
❑ Community
`NOTE: Improvements Permits shall be valid from date issued. Improvements Permits are subject to
revocation, if site pfans or the intended use change. Effective October 1, 1989.
Directions to Property:
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Tax Of,fice PIN: # S8a3-ai��c���
PnOPE1tTJ Abb1ZESS, as follows:
noad Name: � _� �� (L
cit�: %y�,� c�s�� 1Je,rv�C
SU$MZT A PL,0.T WZTH THZS tIPPLICATZON.
$evisions effective October 1� 1995.
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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 application.
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DATE SIGNATURE
CONSENT FOR SITE EVALUATION TO BE DONE ON ABOVE DESCRIBED PROPERTY
MUST CHECK ONE: ❑ 1. I OWN the property. � I 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 representativ of th avie Count Health epartment to enter upon above described
property located in Davie County and owned by e t N S o%�
to conduct all testing procedures as necessary to determine s id site's suitability for a ground absorption sewage treatment
and disposal system. '
�1-aa-9� �'
DATE � SIGNATURE
DCHD (7/93)
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DATE� ��,2���9qo SURVEYED BY� N�1 F/ELD�. BOO
SCALE• � u= I oo� ORAWN BY� N W ` :
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CHECKED � CL OSURE BY ��I W
� ' • DAVIE COUNTY HEALTH DEPARTMENT
' . ' ' Environmental Health Section
� Soil/Site Evaluation
NAME '� � DATE EVALUATED �'��8',�¢,�
ADDRESS PROPERTY SIZE � ���
PROPOSED FACIILTY LOCATION OF SITE ��� 7`�f •f'id
Water Supply: On-Site Well t/� _ Community Public
Evaluation By: Auger Boring i/ Pit Cut
FACTORS 1
Landsca e osition �
Slo e �
HORIZON I DEPTH
Texture rou
Consistence
Structure
Mineralo
HORIZON II DEPTH
Texture rou
Consistence �
Structure � /� -
Mineralo
HORIZON III DEPTH
Texture rou
Consistence
Structure
Mineraloav
HORIZON IV DEPTH
Texture group
Consistence
Structure
Mineralogy
SOIL WETNESS
RESTRICTIVE HORIZO
f!�lS�1�1
;1G-TERM ACCEPTANCE RATE
SITE CLASSIFICATION:
C
EVALUATED BY: ��li
LDNG-TERM ACCEPTANCE RATE: � OTHER(S) PRESENT:
REMARKS:
LEGEND
Landscape Position
R-Ridge 5-Shoulder L-Linearslope FS-Footslope 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 �;lay loam• SIL-Silty loam CL-Clay loam SCL-Sandy clay loam
SC-Sandy clay SIC-Silty clay C-Clay
CONSISTENCE
Moist
VFR-V��.-y friable FR-Friable FI-Firm VFI-Very firrn EFI-Extremely firm
Wet
NS-Non sticky SS-5lightly sticky S-Sticky VS-Very Sticky
NP-Non plastic SP-Slightly plastic P-Plastic VP-Very plastic
Structure
,iC--Sin�le grain M-Massive CR-Crumb GR-Granular ABK-MQular blocky
SBK-Subangular blocky PL-Platy PR-Prismatic
Mi neralo�y
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 w etness - Inches from land surface to free watef or inches from land surface to soil cotors
with chroma 2 or less
Classification - S(suitable), PS(provisionally suitable), U(unsuitable)
LTAR - Long-term acceptance rate - gal/day/ft2
DCHD (01-901
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