145 Blackberry Ln Davie County,NC Tax Parcel Report -07 d 3'J Friday, September 23, 201E
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= WARNING: THIS IS NOT A SURVEY
Parcel Information 3
Parcel Number: G700000115 Township: Shady Grove
NCPIN Number: 5769997298 Municipality:
Account Number: 17828000 Census Tract: 37059-804
Listed Owner 1: CORNATZER TOMMY F Voting Precinct: WEST SHADY GROVE
Mailing Address 1: 145 BLACKBERRY LANE Planning Jurisdiction: Davie County
City: ADVANCE Zoning Class: DAVIE COUNTY R-A,R-20
State: NC Zoning Overlay:
Zip Code: 27006-0000 Voluntary Ag.District: No
Legal Description: 2 AC OFF FORK BIXBY RD Fire Response District: ADVANCE
Assessed Acreage: 2.00 Elementary School Zone: SHADY GROVE
Deed Date: 11/1957 Middle School Zone: WILLIAM ELLIS
Deed Book/Page: 000590352 Soil Types: GnB2,EnB
Plat Book: Flood Zone:
Plat Page: Watershed Overlay: DAVIE COUNTY
Building Value: 356110.00 Outbuilding&Extra 1920.00
Freatures Value:
Land Value: 26810.00 Total Market Value: 384840.00
Total Assessed Value: 384840.00
t v All data is provided as Is without warranty or guarantee of any kind either expressed or implied including but not limited to the
9 ieM Davie County, Implied warranties of merchantability or fitness for a particular use.All users of Davie County's GIS website shall hold harmless the
County of Davie,North Carolina,Its agents,consultants,contractors or employees from any and all claims or causes of action due to
�oUty c NC or arising out of the use or Inability to use the GIS data provided by this website.
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Davie County Health Department
'o
P"18361 Environmental Health Section
i P.O.Box 848
210 Hospital Street
Courier# : 09-40-06 1911
Mocksville, NC 27028
Phone:(336)-753-6780 ON-SITE WASTEWATER CERTIFICATION Fax:(336)-753-1680
(Check One) Replacement Remodeling Reconnection
Name: 7 E'! l'1 Phone Number vp Z yv ygo 6 (Home)
Mailing Address: 2 7 t/kkl llr Pr- -- (Work)
�1C�r+cla� nlC. 7 7 2 � Email Address: Oki Tl�lijU hcu l p w+
Detailed Directions To Site: w 4q <7 CW✓1 A 7 -Z r C Gv, (r/r
`1�r r .,Sly ch PA( t/r
Property Address: p 9760000115-0000
F -4:5Alelel JP C'o ,jA-Iz'"r
Please Fill In The Following Information About The EXISTING Facility:
Name System Installed Under: Odtatd �1)dedcb Type Of Facility:.- (/Se
Date System Installed(Month/Date/Year): Number Of Bedrooms: 3 - Number Of People: r
Is The Facility Currently Vacant? Yes /�1q� If Yes,For How Long?
Any Known Problems? Yes CO If Yes,Explain:
Please Fill In The Following Information About The NEW Facility:
Type Of Facility: `� j /j7 O(a Number Of Bedrooms: Number of People
Pool Size: Garage Size: Other:
Requested By: fa-��t.k `��/-?;7 A Date Requested: &)11h2
(Signature)
For Environmental Health Office Use Only
Approved Disapproved
Comments:
Environmental Health Specialist Date:
*The signing of this form by the Environmental Health Sta is in no way intended,nor should be taken as a guarantee
(extended or limited)that the on-site wastewater system will function properly for any given'penod f time.
Payment: CashCheck Money Order # Amount:$ ZOO, 0 U Date:
1,
Paid By: Received By:_
Account#: 9 7i Invoice#:
,AUTHORIZATION N0: 0837 DAVIE COUNTY HEALTH DEPARTMENT =1/x0
" Environmental Health Section PROPERTY INFORMATION
Permidee's �
kid
P.O.Box 848
'Name: J/�!''•[ &74/ tr Mocksville,NC 27028 Subdivision Name:
Phone#:704-634-8760 qGt-p
Directions to property: - /ft' (/fir; �� �9� ' Section: Lot:
AUTHORIZATION FOR rJ 6 C� q c� - i
WASTEWATER T� frPIN:#rJ, '�- 4 S �- Lvl
1
SYSTEM CONSTRUCTION TJ- r_
Roa Name: herr ip: 'w6
**NOTE**This Authorization for Wastewater System Construction MUST BE ISSUED by the Davie County Environmental Health Section prior
to issuance of any Building Permits.This Form/Authorization Number should be presented to the Davie County Building Inspections
Office when applying for Building Permits.
(In compliance with Article 11 of G.S.Chapter 130A,Wastewater Systems,Section.1900 Sewage Treatment and Disposal Systems)
***NOTICE***THIS AUTHORIZATION FOR WASTEWATER CONSTRUCTION
IS VALID FOR A PERIOD OF FIVE YEARS.
'ENVIRONMENTAL HEALTH SPECIALIST DATE ISSUED
RESIDENTIAL SPF.C]FICATION:BUILDING TYPE #BEDROOMS,,_?-#BATHS cWZ1.#OCCUPANTS GARBAGE DISPOSAL:.Yes or No
COMMERCIAL.SPECIFICATION:FACILITY TYPE If PEOPLE #PEOPLEISHIFT #SEATS INDUSTRIAL WASTE:Yes or No
LAT SIZE Irl- TYPE WATER SUPPLY DESIGN WASTEWATER FLAW(GPD) NEW SITE y� REPAIR SITE
SYSTEM SPECIFICATIONS:TANK SIZE/[ GAL.. PUMP TANK GAL. TRENCH WIDTH _ROCK DEPTH _LINEAR Fr.
- OTHER
REQUIRED SITE MODIFICATIONS/CONDMONS:
IMPROVEMENT PERMIT LAYOUT
F
**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)6348760.
OPERATION PERMIT
SYSTEM INSTALLED BY: LDiLNiJ
" la IT.13A-1-efL 1 I
/00� O�NPQ SI��D NG�tl,C.
INr#r C� tv10V% CtuSe2 1D�QtJ�
-Pr 1AAST tol (7&VA
s
III X91 5r'9T%r_ OIJ=,�)
AUTHORIZATION NO.yu3� OPERATION PERMIT BY: r DATE: t O
**THE ISSUANCE OF THIS OPERATION PERMIT SHALL INDICATE THAT THE SYSTEM DEsCJM3tD ABOVE HAS 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 05/96(Revised)
GoMAPS - Davie County NC Public Access
WATERSHED STRUCTURES
WATER-BODIES
I , r' / COUNTY_BOUNDARY
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—'s"`-- aa_- •.} '.,' ' ADDRESS
DRIVES
STREETS
• , _�,•:•'
RAILROAD-CENTERLINE
PARCELS
2010AarIal_Photos
CITY_LIMITS
BERIdUDA RUN
COOLEEMEE
f ;� �. . i OAVIE COUNTY
i,M rF ^ fl li' MOCKSVILLE
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0 34z Wednesday, August 1 2012
***WARNING: THIS IS NOT A SURVEYI***
This map is prepared for the inventory of real property found within this jurisdiction, and is compiled from recorded
deeds, plats, and other public records and data. Users of this map are hereby notified that the aforementioned public
primary information sources should be consulted for verification of the information contained on this map. The
County and mapping company assume no legal responsibility for the information contained on this map.
wrrti..;,�s1 `i �'�..=v r'"',�:kff' .Y..'�f`s'+!'.%F+'.l� �'`..'-�fi 't lr,wr`.�,i..#,-r �t 'fi rr>i.`'r,+� ;,`: '•,«. � - h�- .r.,i ` r-:,i:tS ....Ui:c�-t ."1i.<.ti ..-4..__ j.-t-.1_;;,�",v
.AUTHORIZATION NO: O 8 3 7 DAVIE COUNTY HEALTH DEPARTMENT
:rt/X0
Environmental Health Section PROPERTY INFORMATION
Cze.
P.O.Box 848
/(� /�/� ®�i1llrc✓Gf Mocksville,NC 27028 : Subdivision Name:
Phone#::704-634-8760
Directions to property: r , - "Section: 'f Lot:
AUTHORIZATION FOR c,.. c� .. 7
WASTEWATER O q,
r SYSTEM CONSTRUCTION Tax ffi PIN:# _-dR
t �t
Roa Name:&9k600'& ip •r Q d
**NOTE**This Authorization for Wastewater System Construction MUST BE ISSUED by the Davie County Environmental Health Section prior
to issuance of any Building Permits.This Form/Authorization Number should be presented to the Davie County Building Inspections
Office when applying for Building Permits.
(In compliance with Article 11 of G.S.Chapter.130A,Wastewater Systems,Section.1900 Sewage Treatment and Disposal Systems)
} ***NOTICE***THIS AUTHORIZATION FOR WASTEWATER CONSTRUCTION
IS VALID FOR A PERIOD OF FIVE YEARS. _
ENVIRONMENTAL HEALTH SPECIALIST'' DATE ISSUED
DAVMCOUNTY HEALTH DEPARTMENT
IMPROVEMENT AND OPERATION PERMITS PROPERTY INFORMATION 2�X
Subdivision Name.
Directions to property: Section: "'' �- Lot: l
IMPROVEMENT r 'II " 7A
PERMIT Taxffifie'PIN:#~ r c- /21
,
oa Name- k)-
x Rp:
**NOTE**This Improvement Permit DOES NOT authorize the construction or installation 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)
+ ***NOTICE***THIS PERMIT IS SUBJECT TO REVOCATION IF SITE
`3 j'✓ `tI PLANS OR THE INTENDED USE CHANGE.YOUR WASTEWATER
ENVIRONMENTAL HEALTH SPECIALIST DATE ISSUED SYSTEM CONTRACTOR MUST SEE THIS PERMIT BEFORE
INSTALLING THE SYSTEM.
RESIDENTIAL SPECIFICATION:BUILDING TYPE _ #BEDROOMS,-? #BATHS�,�2 #OCCUPANTS _GARBAGE DISPOSAL:Yes or No
COMMERCIAL SPECIFICATION: FACILITY TYPE #PEOPLE #PEOPLE/SHIFT #SEATS INDUSTRIAL WASTE:Yes or No
LOT SIZE TYPE WATER SUPPLY DESIGN WASTEWATER FLOW(GPD) / NEW SITE REPAIR SITE
SYSTEM SPECIFICATIONS: TANK SIZE/JPZLGAL. PUMP TANK GAL. TRENCH WIDTH ��r ROCK DEPTH �� LINEAR FT. PM/
OTHER
REQUIRED SITE MODIFICATIONS/CONDITIONS:
IMPROVEMENT PERMIT LAYOUT
1
1_
**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 - co" Zl.
SYSTEM INSTALLED BY:
1•��T'WAi''�..SYL L 1�
/�� (��n1E2 Sb►mD ' NG vJ11,L
_�o�'ki2 ,. (^AP1k� rd►OVti CwSc���JQ,tJ�
'A'r L 0%5T lol Feow�
s
AUTHORIZATION NO.yV3� OPERATION PERMIT BY: �1T DATE:
**THE ISSUANCE OF THIS OPERATION PERMIT SHALL INDICATE THAT THE SYSTEM DESCMED ABOVE HAS EN INSTALLED IN COMPLIANCE
WITH ARTICLE 11 OF G.S.CHAPTER 130A,SECTION.1900"SEWAGE TREATMENT AND DISPOSAL SYSTEMS",BUT SHALL IN NO WAY BETAKEN ASA
GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORILY FOR ANY GIVEN PERIOD OF TIME.
DCHD 05/96(Revised)
APPLICATION FOR SITE EVALUATIONAMPROVEMENT PERT
4 - ' Davie County Health Department D _
Environmental Health Section
P.O. Box 848 APR 2 41997
Mocksville,NC 27028
M (704) 634-8760
****IMPORTANT**** THIS APPLICATION CANNOT BE PROCESSED UNLESS ALL
THE REQUIRED INFORMATION IS PROVIDED.
1. Name to be Billed U•� ll Contact Person
Mailing Address / Home Phone
City/State/Zip c� /I/
/Y /V• G - 0�7�1� Business Phone
'.
' 2. Name on Permit/ATC if Different than Above
j Mailing Address City/State/Zip
3. Application For: [ ]Site Evaluation [ ]Improvement Permit&ATC Both
4. System to Serve: House [ ]Mobile Home [ ]Business [ ]Industry [ ]Other
5. If Residence: #People� #Bedroom #Bathrooms_ f}1J Dishwasher[ ]Garbage Disposal
A]Washing Machine [ ]Basement/Plumbing pd Basement/No Plumbing
6. If Business/Other:Specify type #People #Sinks #Commodes
#Showers #Urinals #Water Coolers
If Foodservice:#Seats Estimated Water Usage(gallons per day)
7. Type of water supply:,W County/City [ ]Well [ ]Community
8. Do you anticipate additions or expansions of the facility this system is intended to serve?[ ]Yes k]No
If yes,what type?
EITHER A PLAT OR SITE PLAN
PROPERTY INFORMATION REQUIRED:***IMPORTANT***AUMOF THE PROPERTY MUST BE
y // �7l 9-q f— 7�q 8 SUBMITTED WITH APPLICATION.
Property Dimensions: /d lam/' WRITE DIRECTIONS(fromksville)TO PROPERTY:
Tax Office PIN: # -- /iy� S� 1 d/or�'lJi
Property Address: Road Name.D�dc.K e 114-nI:" 7a 6 Le
,/n n
City/Zip d��r A16 :`DD ��lLse / Ar,�Ce O, �° Oa P�'f'
If in Subdivision provide information,as follows:
Name: ;
Section: Lot#:
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 rr, J ofe-? t duct t ng ocedu as necessary to determine the site suitability.
DATE SIGNATURE i
Revised DCHD(06-96)
THIS AREA litAty 13E USEI) FOR DRAWING YOUR SITE PLAN:
DAVIE COUNTY HEALTH DEPARTMENT
Environmental Health Section SECTION LOT
Soil/Site Evaluation
APPLICANT'S NAME v/"Gr DATE EVALUATED
PROPOSED FACILITY / _ PROPERTY SIZE
SUBDIVISION ROAD NAME ,,d1ackbeY✓4
Water Supply: On-Site Well Community Public
Evaluation By: Auger Boring Pit Cut
FACTORS 1 2 3 4 5 6 7
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
SITE CLASSIFICATION: EVALUATION BY:
LONG-TERM ACCEPTANCE RATE: / 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 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(01-90)
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