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215 Buck Seaford Rd �avie County, NC Tax Parcel Report �}�a7L Monday, October 3, 201 t '`�� —�"—'-`�,� _, ��L 1�9 i �--�,�� t�� '`"---,�._..��' �`;, ''"'—�,II •�`"t �� _�� I ~�. �t.��.1 '.�"~`_ � r �-r`"��'k r``�176 ` i `titi1 � ��'i —�---�-- - -- _�f �'� � t� _ �1�, � ;�. _ ___��.r ' _ � � `�_ �` � r�� . `�J'�j� f♦ � ,15�,x � 4��— �`,�"�^_`— LJ 1 ( � ,� k � � i. � lJ� � � � "----- M1 � � � �4 +L S r �� ,�� `,.4.. -- ...---.....................................--- --............ ........_...............1......._... ....................._..................:.:`..`.�..�-.�.._.............._._._...__..._..._................._. WARNING: THIS IS NOT A SURVEY . .�._ � ,�� _. _ - _ , �. . . .,.�, _ r , r� , �.r..,.. �,__� _ ,_a._ �_.��n� _._. _ �., __�� , , _.,_� ,__--- _ __,�_ _� __,_. ` n ,�, Parcel Informatione ' Parcel Number: K400000034 Township: Mocksville NCPIN Number: 5737035557 Municipality: Account Number: 82524104 Census Tract: 37059-801 Listed Owner 1: MILLER BRANDI S Voting Precinct: SOUTH MOCKSVILLE Mailing Address 1: 215 BUCK SEAFORD ROAD Planning Jurisdiction: Davie County City: MOCKSVILLE Zoning Class: DAVIE COUNTY R-A State: NC Zoning Overlay: Zip Code: 27028-0000 Voluntary Ag.District: No Legal Description: 5.681 AC BUCK SEAFORD RD Fire Response District: MOCKSVILLE Assessed Acreage: 5.03 Elementary School Zone: MOCKSVILLE Deed Date: 5/2004 Middle School Zone: SOUTH DAVIE Deed Book/Page: 2004E0181 Soil Types: PaD,PcC2,RnD,ChA Plat Book: Flood Zone: Plat Page: Watershed Overlay: DAVIE COUNTY Building Value: 162110.00 Outbuilding&Extra 0.00 Freatures Value: Land Value: 42890.00 Total Market Value: 205000.00 Total Assessed Value: 205000.00 9t,�l�, Atl data is provided as Is without warranty or guarantee of any kind elther expressed or Implied Including but not Iimited to the Davie County� Implied warrandes oi merchantability or fitness for a parttcular use.All users oT Davle County'a GIS website ahall hold harmless the 7�7 County of Davie,North Carolina,its agents,consultants,contractors or employees irom any and all claims or causes of action due to �oU��S� 1\C or arising out of the use or Inability to use the GIS data provided by this website. , Davie County Health Department ��is f�ct' Environmental Health Section ' F;_ _, , ., 4 �,:�� P.O. Box 848 � � 210 Hospital Street � fj C� '�,► �.��_,_.I'. p� ��. Courier# : 09-40-06 •, 1�i 1 . Mocksville, NC 27028 Phone:(336)-753-6780 Fax:(336)-753-1680 ON-SITE WASTEWATER CERTIFICATION (Check One) Replacement Remodeling Reconnection ` " �/I,�/� 4 M�� Name: /v � 1 1�_�'(/ Phone Number (Home) Mailing Addres�: (Work) Email Address: Detailed Directions To Site: .t� (,C,.C.K � Q�%L�7 U'"�-1 r�V I S� O t�.S �,� 1,-C �-�- �°As�- G-,.v�.w� b �n �1,�-��— Property Address:�/ l c�� QC f� Please Fill In The Following Information About The EXISTING Facility: Name System Installed Under: Type Of Facility: Date System Installed(Montt�/Date/Year): Number Of Bedrooms: Number Of People: Is The Facility Currently Vacant? Yes No If Yes,For How Long? Any Known Problems? Yes No If Yes,Explain: Please Fill In The F owing Information About The NEW Facility: Type Of Facility: �� Number Of Bedrooms: Number of People Pool Size: ��'J Garage Size: Other: Requested By: Date Requested: �� I s� ( ignature)_ For Environmental Health Office Use Only Appro ed isapproved , Comm Environmental Health Specialist ate: r� ��'� *The signing of this form by the Environmental Health Staff 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 period of time. Payment: Cash Check Money Order # Amount:$ Date: Paid By: Received By: Account#: Invoice#: � DAVIE COUNTY HEALTH DEPARTMENT �� Environmental Health Section P.O.Boz 848/Z10 Hospital Street Mocksville,NC 27028 (33G)751-8760 Account #: 990003527 Tax PIN/EH#: 5737-03-5557 Billed To: Brandi Miller Subdivision Info: Reference Name: Location/Address: Buck Seaford Rd-27028 Proposed Facility Residence Property Size: 5.681 acres ATC Number: 4022 AUTHORIzATION FOR WAST�WATER SYSTEM CONSTRUCTION **NOTE** This Authorization for Wastewater System Construction MiJST BE ISSLJED 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 WASTEWATER CONSTRUCTION IS VALID FOR A PERIOD OF FIVE YEARS. / 1 Environmental Health SpecialisYs Signature: �(. Date: -.5��- �'S . CERTIFICATF OF COMPLET�J�V � �,�cC s e�.�'�,-�r **NOTE** The issuance of this Certificate of Completion shall indicate the system described on ImprovemendOperation Permit has been installed.in compliance with Article 11 of G.S.Chapter 130A,Section .1900"Sewage Treatment and Disposal Systems,"but shall� I r,� AY be taken as a guarantee that the system will function satisfactorily for any _ given period of time. �v; �� — � ; �G. � (�1 �.�a�' � `��'�� \ g� �C � �� , �,, � �� .�i' �5 N � �� f� ` C'-2fi�-��^ � �6` c �6 ( 1\ 34� 7 3%cb i , �� t�ti � J �� ..-� � . � � /y cti a�' � � �I��°°� Septic System Installed By: Environmental Health Specialist's Signature: Date: � — � � � 6� DCHD OS/99(Revised) � � � . DAVIE COUNTY HEALTH DEPARTMENT • + , Environmental Health Section ` • P.O.Boz 848/210 Hospital Street Mocksville,NC 27028 (33G)751-87G0 Account #: 990003527 Tax PIN/EH#: 5737-03-5557 Billed To: Brandi Miller Subdivision Info: Reference Name: Location/Address: Buck Seaford Rd-27028 Proposed Facility Residence Property Size: 5.681 acres ATC Number: 4022 AUTHORIZATION FOR WASTEWATER SYSTEM CONSTRUCTION **NOTE** T'his Authorization for Wastewater System Construction MUST BE ISSLJED 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 WASTEWATER CONSTRUCTION IS VALID FOR A PERIOD OF FIVE YEARS. // l � Environmental Health Specialist's Signature: /( Date: 3/��Z �S CERTIFICAT� OF COMPLETJ�J�T u c(c f'r 4�'c,�-d **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 given period of time. � � , �G. ( y S6 M � � .��G� l.��-� � ��P g�� ' , , �5 ` C.eC�.�Cr �'�� .9�� .ri �Q` c 34' ��''� r `\ �/ �G' 3 f t� � ��' �--1 y� Q � . �y G�' �' � �I,G�°` Septic System Installed By: Environmental Health Specialist's Signature: Date: � — � � � 6� DCHD OS/99(Revised) � DAVIE COUNTY HEALTH DEPARTMENT � �_ �,. �--o.! Environmental Health Section � ; P.O.Boz 848/210 Hospital Street " • , _ Mocksville,NC 27028 � (33G)75]-8760 IMPROVEMENT/OPERATION PERMIT Account #: 990003527 Tax PIN/EH#: 5737-03-5557 Billed To: Brandi Miller Subdivision Info: Reference Name: Location/Address: Buck Seaford Rd-27028 Proposed Facility Residence Property Size: 5.681 acres ATC Number: 4022 **NOTE** This ImprovemendOperation Permit DOES NOT authorize the construction ofa septic tank system or any wastewater system. An AUTHORIZATTON 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 CONTRACTOR MUST SEE THIS PERMIT BEFORE INSTALLING SYSTEM. _ �y � Residential Specification: Building Type #People�_ #Bedrooms v #Baths �.S Dishwasher:,� Garbage Disposal: ❑ Washing Machine:� Basement w/Plumbing:� Basement/No Plumbing: ❑ Commercial Specification: Facility Type #People #People/Shift #Seats Industrial Waste: ❑ Lot Size Type Water Supply �D Design Wastewater Flow(GPD)==_� Site: New Y Repair❑ // � System Specifications: Tank Size ��GAL. Pump Tank GAL. Trench Widt�_��Rock Depth� Linear Ft� Other: Required Site Modifications/Conditions: - IMPROVEMENT/OPERATION PERMIT LAYOUT- APPROVED EFFLUENT FILTER. RISER(S) IF 6 " BELOW FINISHED GRADE. ****NOTICE: Contact a representative ofthe Davie County Health Department for final inspection ofthis system between 8:30 a.m,to 930 a.m.or 1:00 p.m.to 130 p.m.on the day of installation. Telephone#is(33C►)751-87G0.**** �M w�/��P �� - �I . � . � �1��r� "h ��d i� � �'� � �B` �� Environmental Health Specialist's Signature: - Date: DCHD OS/99(Revised) • , • e, APPLICATION FOR SITE EVALUATION/IMPROVEh1ENT PERMIT A�' � � /� ' • Davie County Health Department � �l � � Environmenta/Hea/th Section P.O. Box 848/210 Hospital Street �✓fAR � Mocksville, NC 27028 8 Z�QS (336)751-8760 ��h��iSi ***IMPORTANT*** THIS APPLICATION CANNOT BE PROCESSED UNLESS ALL TH / INFORMATION IS PROVIDED. Refer to the INFORMATION BULLETIN for instructio . 1. Name to be Billed ��1� ��11e� Contact Perso I��u`h� ��1'I f.'� Mailing Address ��( �0.l Y� F�� el d j1(1(,1 Home Phon�� I 0 c� �—i F-'�L/ Y, , m�c��v�j �►e N� ��7U�'�S �� I � �- '�a`7��`� � �`X-- Cit State ZIP Huainess P ne i � � � 2. Nama on Permit/ATC if Different than Above Mailing Addresa City/State/Zip 3. Application For: ❑ Site Evaluation ❑ Improvement Permit/ATC -�Both 4. syatem to service: [�iouse ❑ Mobile Home ❑ Business ❑ Industry ❑ Other 5. Type ayatem requested:j� Conventional ❑ conventional modified ❑ innovative � 5. =f Residence: # People � # Bedrooms �� # Bathrooms �\/ �" �ishwasher ❑Qarbage Disposal �7ashing Machine �asement/Plumbing ❑Basement/No Plumbing 7. If Business/Industry /Other: verify type # People # Sinks # Commodes # Showara # Urinals # Water Coolera IF FOODSERVICE: # Seats Estimated Water Usage (gaiiona per day) s. xy�e of water supply:�County/City ❑ Well � Community 9. no you anticipate additions or expansions of the facility tl�is system is intended to serve? ❑Yes �No If yes,what type? ***IMPORTANI"'**CLIENTS MUST COMPLETE THE REQUIRED PROPERTY INFORMATION REQUESTED BELOW. Eithcr a PLAT or SITE PLAN MUST BE SUBdlITTLD by tl�e clicnt �vitl�TFIiS APPLICATION. Property Dimensions: �� VRITE DIRECTIONS(from Modcsvillc)to PROP�RTY: �- Tax Office PIN: # ,r��1 �� 5�5�7 �u 1 L) p� I�' ' �-u,l ; � � Y-e� Property Address: Road Namc IJ��Il �-l'(l��C� I CU � L �� 1 f J� 6� � ��tY,Z�P ma��c��►� a�oa� ��h� C i�. � �� If in a Subdivision providc information,as follows: C)� �U�� i rCl � � 7�'�C'(�' Namc: LU YYI�� Lb� ,1 S � (-O � 1��'a�QL� � rc�s Scction: Block: Lot: Date homc corners flagged: J �S � — � Tl�is is to certify that tlie information provided is correct to the best of my kno�vledge. I understand tliat any permit(s) issued I�ereafter are subject to suspension or revocation,if the site plans or intended use cl�ange,or if tlie information suUmitted in tl�is application is falsiGed or cl�anged. I,also, «�rderstancl thnt I nni respo�isible for nll c1��rges iiicurred front tliis applicatio�r. I,liereby,give consent to the Authorized Representative of the Davie County Healtli Department to enter upon above described property located in Davie County and o�vncd by�1 Ci.rl�� "� i1 1��-P� to conduct all testing procedures as necessary to determine tl�e site suitability. � DAT� �'� 0� b� SIGNATURE L �/(,/�'t'1��' „/� �—/ /(�/�'l.�"1 � , TIiIS AREA MAY BE USED FOR DRAWING YOUR SIT�PLAN(Include all of tlic following: Existing and proposcd property lines and dimensions, structures, setbacks, and septic locations). . Sitc Rcvisit Ci�argc � �� S Datc(s): "' � a Clicnt Notification Date: ��.� � ��- � 3 o b EHS: Sign given �-' �� y�. Account No. �� f ��'` �' Revised DCH (OS/03 � , Q„ _ � Invoicc No. � W"!�� , A l� '' � DAVI� COUNTY H�ALTH D�I'ARTMLNT � � . Environmental Health Section � ' Soil/Site Evaluation APPI.iCANT iNFORMATION I'ROPERTY INFORMATION ccoun . 27 Tax PINLEH#: 5737-03-5557 ' ��` Billed To: Brandi Miller Subdivision Info: Reference Name: Location/Address: Buck Seaford Rd-27028 Proposed Facility: Residence Property Size: 5.681 acres Date Evaluated: __��QS� Water Supply: On-Site Well Community Public Evaluation By: Auger Boring Pit Cut FACTORS ! 2 3 4 5 6 7 Landsca e osition Slo e% HORIZON I DEPTH S Texture rou • � '� Consistence � Structure Mineralo : HORIZON II DEPTH �� Texture rou Consistence - - Structure - Mineralo HORIZON III DEPTH K 1 p-c Texture rou � . Consistence Structure Mineralo HORIZON IV DEPTH Texture rou Consistence Structurc Mineralo SOIL WETNESS RESTRICTIVE HOKIZON SAPROI.ITE CLASSIFICATION LONG-TERM ACCEPTANCE RATE � , S1TE CLASSIFICATION:�� EVALUATION BY: LONG-TERM ACCEPTANCE RATE: `� OTHER(S)PRESENT: REMARKS: LEGEND � L�ndscape 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 cx ur S-Sand LS-Loamy sand SL-Sandy loam L- Loam SI-Silt S1CL-Silty clay loam SIL-Silty loam CL-Clay loam SCL-Sandy clay loam SC-Sandy clay SIC-Silty clay C-Clay CONSISTENCE is VFR-Very friable FR-Friable FI-Firm VFI-Very firm EFI-Extremely firm � � NS-Non sticky SS-Slightly sticky S-Sticky VS-Very Sticky � NP-Non plastic SP-Slightly plastic P-Plastic VI'-Very plastic r ture 'SC-Single grain M-Massive CR-Cromb GR-Granular ABK-Angular blocky SBK-Subangular blocky PL-Platy PR-Prisrpatic �,Vlineralo�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 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 � �iii�i��iiiiiiiii�iiiiiii��=iiiiiiiiiii�iiiiiiiii�ini�� ..C..........C....... ..........................�... . 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