153 Bryant Ln Davie County, NC Tax Parcel Report 3 aaa- Monday, September 26, 2016
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WARNING: THIS IS NOT A SURVEY
Parcel Iriformation
Parcel Number: H30000005401 Township: Calahaln
NCPIN Number: 5719822919 Municipality:
Account Number: 82527480 Census Tract: 37059-801
Listed Owner 1: BRYANT SHIRLEY A Voting Precinct: NORTH CALAHALN
Mailing Address 1: 153 BRYANT LANE Planning Jurisdiction: Davie County
City: MOCKSVILLE Zoning Class: DAVIE COUNTY R-20
State: NC Zoning Overlay:
Zip Code: 27028-0000 Voluntary Ag.District: No
Legal Description: 1.08 AC OFF HWY 64 Fire Response District: CENTER
Assessed Acreage: 1.09 Elementary School Zone: WILLIAM R DAVIE
Deed Date: 8/2006 Middle School Zone: NORTH DAVIE
Deed Book/Page: 2006EO261 Soil Types: PcC2
Plat Book: Flood Zone:
Plat Page: Watershed Overlay: DAVIE COUNTY
Building Value: 101870.00 Outbuilding&Extra 0.00
Freatures Value:
Land Value: 25000.00 Total Market Value: 126870.00
Total Assessed Value: 126870.00
161 All data Is provided as is without warranty or guarantee of any kind either expressed or Implied including but not limited to the
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
NC or arising out of the use or Inability to use the GIS data provided by this website. ,
• •. DAME COUNTY HEALTH DEPARTMENT
Environmental Health Section 3 -�
P.O.Bog 848/210 Hospital Street
Mocksville,NC 27028
(336)751-8760
163 ,Bryce f Lr�Ne
Account #: 990001512 Tax PIN/EH#: 5719-82-2919
Billed To: Subdivision Info:
Reference N e: FPeDD►t W-V& t Location/Address: 7028
Pro osed Facility: Residence Property Size: see ma
ATC Number: 3222
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 Systems,Section.1900 Sewage Treatment and Disposal Systems). THIS
AUTHORIZATION FOR WASTE W T VALID F R A PERIOD OF FIVE ARS.
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Environmental Health Specialist's Signature. -Date:
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 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
even period of time.
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Septic System Installed By: r�nniS C-- r A4 V,
Environmental Health Specialist's Signature: D
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DCHD 05/99(Revised)
DAVIE COUNTY HEALTH DEPARTMENT
Environmental Health Section 3 — ° L
• P.O.Boa 848/210 Hospital Street
Mocksville,NC 27028
(336)751-8760
IMPROVEMENT/OPERATION PERMIT
/5313rolvl 10no
Account #: 990001512 Tax PIN/EH#: 5719-82-2919
Billed To: Special K Builders Subdivision Info:
Reference Name: far- gQqA^IT --7009 1 IS Wighway 64 VV-'U
Proposed Facility: Residence Property Size: see map
**NO+F-N�proW?ent/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 CO1 N�TRACTOR MUST SEE THIS PERMIT BEFORE INSTALLING SYSTEM.
Residential Specification: Building Type hoot-=- #People 3 #Bedrooms_ #Baths 2
Dishwasher: Garbage Disposal: ❑ Washing Machine: Basement w/Plumbing: ❑ Basement/No Plumbing: ❑
Commercial Specification: Facility Type #People #People/Shift #Seats Industrial Waste: ❑
Lot Size 0-9660205 �.Type Water Supply ( Design Wastewater Flow(GPD) Site: New E lWRepair❑
//tCi,-�/�, 22,, -- JP r�
System Specifications: Tank Size / AL. Pump Tank GAL. Trench Width Bio Rock Depth /Z Linear Ft.czLA---'
Other: , '' r6V r�o'� xe3 , INSTALL L",,s 9'o.c. M,,-j.
Required Site Modifications/Conditions: 61S'fgLL Qr�') C.yn?rOe e kR�P 10,orc Kor, LJA l<4=� S`Of-F AoOSZ
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.****
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Environmental Health Specialist's gnature: Date:
DCHD A/11(Revised)
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APPLICATION FOR SITE EVALUATION/IAIPROVFAIENT PERMIT&A
Davie County Health Department qu
Environmental Health Section 19 27)'9
P.O. Box 848/210 Hospital Street
Mocksville, NC 27028 ENVIRONMENTAL HEALTH
(3361)751-8760 DAVIE COUNTY
***IMPORTANT*** THIS APPLICATION CANNOT BE PROCESSED UNLESS ALL THE REQUIRED
INFORMATION IS PROVIDED. Refer to the INFORMATION BULLETIN for
instructions.
Name to be Billed .ee(2 1I V ��+� ICIGYS Contact Person`17K aoecnYSQ
Mailing Address Y� /� 10 Flame Phone '� g t/
City/State/ZIP #,Jc a���y Business Phone _ 336 We-o Y7
2. llama on Permit/ATC if Different than Above y� /,
Mailing Address _.23 3 44,I Y c?2cA � City/State/zip Yporc� d l r /UC -;t 2
3. Application For: /Site Evaluation trt�mprovement Permit/ATC fl Both
A. System to service: VHouse 0 Mobile Home ❑ Business 0 Industry ❑ Other
S. If Residence: # People _73 # Bedrooms # Bathrooms
LL-Kishwasher 11 Garbage Disposal LLWashing Machine H Basement/Plumbing 1-1 Basement/llo Plumbing
, r
'G. If Business/Industry/Other: Specify type # People # Sinks
I Commodes # Showers # Urinals # water Coolers
IF FOODSERVICE: 9 Seats Estimated Water Usage (gallons per day)
7. Typo of water supply: PCounty/City 0 Well ❑ Community
n. Do you anticipate additions or expansions of the facility this system is intended to serve? 0 Yes
f yes,what type?
***IAIP0R7AN7'*** CLIEN'T'S 1lIUSTCOAIPLETETHE RE=QUIRED PROPERTY INFORMATION REQUESTED
IIELOW. Either n PLAT or SITE,PLAN AIUST BESUDA=ED by the client with THIS APPLICATION.
Property Dimensions: ' •6 — WRITE DIRECTIONS(front Mocksville)to PROPERTY: 1t
Tax Office PIN: {l5—� I I b a 9L9 19
Properly Address: Road Name a 0 9 U S 14,4/(p yy
City/Zip mo ckwi l l f
If in a Subdivision provide information,as follows:
Name:
t.�t tl Gq�t�
Section: Block: Lot: Date Property Flagged: 2 2
This is to certify that the information provided is correct to the best of my knowledge. I understand that any pernli((s)
issued hereafter are subject to suspension or revocation, if the site plans or intended use change,or if the information
submitted in Misapplication is falsified or changed. I, also,understand that I am responsible for all charges incurred front
this application. I, hereby,give consent to the Authorized Representative of the Davie County Ilealth Department
to enter upon above described properly located in Davie County and owned by _
to conduct all testing procedures as necessary to determine the site suitability.
DATE; �' l S� O Z� SIGNATURE—�^ U �
TIIIS AREA MAY BE USED FOR DRAWING YOUR SITE PLAN(Include all of the following: Existing and proposed
property lines and dimensions, structures, setbacks, and septic locations).
Site Revisit Charge
Datc(s):
Client Notification Date:
EIiS:
G � Account No. �� 2
Revised DCIiD(07/99) �_ Invoice No. d
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DAVIE COUNTY HEALTH DEPARTMENT
1 IMPROVEMENTS PERMIT AND CERTIFICATE OF COMPLETION
*NOTE:Issued in Compliance With Article 11 of G.S.Chapter 130a
Sanitary Sewa e Syste s �N// 1 Permit Number.
Name _ Date �1 N2 1 5�F
Locat' n zf
Subdivision Name Lot No. Sec. or Block No.
Lot Size y�( House — Mobile Home Business Industry
No. Bedrooms 15!–/ —.No. Baths 'No. in Family _ Public Assembly Other
Garbage Disposal YES NO ❑ Specifications for System:
Auto Dish Washer YES NO ❑ /QOD ally X!
Auto Wash Ma thine YES �NJO ❑ C F t/
Type Water Supply C a
*This permit Void if sewage system described below is not installed within 5 years from date of issue.
This permit is subject to revocation if site plans or the intended use change.
a
F
Improvements permit by
*Contact a representative of the Davie County Health Department for final inspection of this system between 8:30-9:30 A.M.,
1:00-1:30 P.M.or 4:30-5:00 P.M.on day of completion.Telephone Number:704-634-5985.
Final Installation Diagram: System Installed by —
Certificate of Completion Date
"The signing of this certificate shall indicate that the system described above has been installed in compliance with
the standards set forth in the above regulation, but shall in NO way be taken as a guarantee that the system will function
satisfactorily for any given period of time. _
lb
DAVIE COUNTY HEALTH DEPARTMENTS...
IMPROVEMENTS PERMIT AND CERTIFICATE OF COMPLETION/
NOTE in Compliance With Article I I of G.S.Chapter 130a
Sanitary Sewa a Systems j,/% Permit Number
/t'�
Name• /' �� . '� Date t c�.� �'t/ ' ';� NO
7 CZ 45
Locat' n 5'� !, r /E� L�" / ✓E'e `
Subdivision Name Lot No: Sec. or Block No
Lot Size_ House &-! Mobile Home _ Business Industry
No. Bedrooms !k No. Baths _ - No. in Family _ Public Assembly Other
Garbage Disposal YES NO ❑ Specifications for System:
Auto Dish Washer YES NO ❑ ,,�- -i ;t/
Auto Wash Ma thine YES NO ❑
Type Water Supply
*This permit Void if sewage system described below is not installed within 5 years from date of issue.
This permit is subject to revocation if site plans or the intended use change.
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bo
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4 tmprovements permit by
~t*Contact a representative of the Davie County Health Department for final inspection of this system between 8:30-9:30 A.M.,
`1:00-;1130 P.M.'o(4:30-5:00 P.M.on day of completion.Telephone Number:704-634-5985. _
1 17
Findl Installation Diagram: i-System Installed by _ fi
"-;-�"7�c
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Certificate of Completion Date
The signing of this certificate shall indicate that the system described,above has been installed in compliance with
the standards set forth in the above regulation, but shall'in NO way betaken as a guarantee that the system will function
satisfactorily for any given period of time.
APPLICATION FOR SITE EVALUATION/IMPROVEMENTS PE IT
s• ,�_; .f a �,r. �lis.`
` – Davie County Health Department .'.=. (;
Environmental Health Section
P.O. Box 665 ON 25 1994
Mocksville, NC 27028
1. Application/Permit R uested By
Mailing Address o S— Home Phone
Business Phone
2. Name on Permit if Different than Above
3. Application for. ❑General Evaluation Septic Tank Installation Permit
4. System to Serve: House ❑ Mobile Home ❑ Place of Public Assembly
❑ Business ❑ Industry ❑ Other ❑ Unknown
5. If house, mobile home:Subdivision Section Lot #
—�� Basement/Plumbing
No.of People / ❑ Basement/No Plumbing
No. of Bedrooms Washing Machine
No. of Bathrooms � �❑ Dishwasher
Dwelling Dimensions O X Garbage Disposal
6. If business, industry, place of public assembly, other: Specify type
No. of People Served No. of Sinks S
No. of Commodes No.of Urinals
No. of Lavatories 2- No. of Water Coolers
No.of Showers 2--\ _ Water Usage Figures
7. Type of water supply: �6/� Public ❑ Private ❑ Community
8. Property Dimensions Sewage Disposal Contractor
9. Do you anticipate additions/expansion of the facility this sytem is intended to serve? ❑ Yes No
If yes, what type?
'NOTE: Improvements Permits shall be valid for a period of 5 years from date issued. Improvements Permits are subject to
revocation, if site plans or the intended use change. Effective October 1, 1989.
00
Directions to Property: Lti�✓ /� t��?S� A''°"� vP�oa G✓:, D � f /�
��s1,74
/ 7 4— /c/)
This is to certify that the information provided is correct to the est of my knowledge, nd I der nd I am responsible for all charges
incurred from this application.
-S --0
y- �5 �y
DATE SIGNATU
CONSENT FOR SITE EVALUATION TO BE DONE ON ABOVE DESCRIBED PROPERTY
MUST CHECK ONE: �IrJJ 1. 1 OWN the property. ❑ 2. 1 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 representative of the Davie County Health Department to enter upon above described
property located in Davie County and owned by
to conduct all testing procedures as necessary to determine said site's suitability for a ground absorption sewage treatment
and disposal system.
DATE SIGNATURE
DCHD'(1/93)
r
DAVIE COUNTY HEALTH DEPARTMENT
r` Environmental Health Section
r Soil/Site Evaluation /
NAME l' `�` DATE EVALUATED
ADDRESS PROPERTY SIZE
PROPOSED FACIILTY LOCATION OF SITE Gl/
Water Supply: On-Site Well Community Public-
Evaluation
ublicEvaluation By: Auger Boring Pit Cut
FACTORS 1 2 3 4
Landscape position ,L
Slope % vZ-
HORIZON I DEPTH
Texture group
Consistence
Structure
Mineralogy
HORIZON II DEPTH t _e_
Texture group
Consistence
Structure / ie S'
Mineralogy
HORIZON III DEPTH
Texture group
Consistence
Structure
Mineralogy
HORIZON IV DEPTH
Texture group
Consistence
Structure
Mineralogy
SOIL WETNESS
RESTRICTIVE HORIZON
SAPROLITE
CLASSIFICATION y1S
LONG-TERM ACCEPTANCE RATE
SITE CLASSIFICATION: l� EVALUATED 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
3C-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
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