467 Buck Seaford Rd 3avie County,NC Tax Parcel Report 144. Monday, September 26, 201 E
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WARNING: THIS IS NOT A SURVEY
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Parcel Information
-
Parcel Number: K40000004308 Township: Mocksville
NCPIN Number: 5737002351 Municipality:
Account Number: 82524926 Census Tract: 37059-801
Listed Owner 1: .. HAMPTON JENNIFER ELLEN_' Voting Precinct: SOUTH MOCKSVILLE
Mailing Address 1: 1722 BUDDY STREET Planning Jurisdiction: Davie County
City: WINSTON SALEM Zoning Class: DAVIE COUNTY R-A
State: NC Zoning Overlay:
Zip Code: 27103-5914 Voluntary Ag.District: No
Legal Description: 0.928 AC BUCK SEAFORD RD Fire Response District: MOCKSVILLE
Assessed Acreage: 0.75 Elementary School Zone: MOCKSVILLE
Deed Date: 1/2016 Middle School Zone: SOUTH DAVIE
Deed Book/Page: 010090059 Soil Types: PcC2,ChA
Plat Book: Flood Zone:
Plat Page: Watershed Overlay: DAVIE COUNTY
Building Value: 0.00 Outbuilding&Extra 0.00
Freatures Value:
Land Value: 18270.00 Total Market Value: 18270.00
Total Assessed Value: 18270.00
9 t !E 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.
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DAVIE COUNTY HEALTH DEPARTMENT
IMPROVEMENTS PERMIT AND CERTIFICATE OF COMPLETION G
'NOTE:Issued in Compliance With Article 11 of G.S.Chapter 130a g "
Sanitary Sewage Systems ” (t0" e17111t Number
Name �c•'� - Date �i - 9 N2 7 4 2 9 x
Locations-�
\-R1 _ _ p
Subdivision Name Sec. or Block No.
Lot Size °House U Mobile Home —T Business -- Industry
No. Bedrooms 3_—.No. Baths _ —"Na,^fin Family * 2 — Public Assembly Other
Garbage Dis osal`, _ YES NO *�'''
9 P Q d, Specrfications for System: s �
Auto Dish Washer YESd"f`IO`❑i -
Auto Wash Ma^hive YES NO ❑
Type Water Supply
*This permit Void if sewage s'ystem'describ d ba6w is not installed-with r`'S years from date..of issue.
This permit is subject to revocation if site`-plans mor the intended use change:,.
.:
;L r
1
ra`l c
'7 Improvements permit by
*Contact a re esentative of'the.Davie County Health Department for final inspection of this system between 8:30-9:30 A.M.,
1:00-1:30 P or 4:30-5:00 P.M.on'day of completion.Telephone Number:704-634-5985.
Fin stallation Diagram: System Installed by D
C
Certificate of Completion `- — Date, D 9
*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.
+� -�* —'� DAVIE COUNTY HEALTH DEPARTMENT ;. v
IMPROVEMENTS PERMIT AND CERTIFICATE OF COMPLETION y
�I tE' :Issued in Compliance With Article I I of G.S.Chapter 130a q&q S�c�o��
:Sanitary Sewage Systems Permit Number
Name , ~ . — Date .j �l N2 7429
, "�'
Locations
Subdivision Name `- `LofNo -_..__ Sec. or Block No.
Lot Size_1 Ob Vis'° House `vim Mobile Home _� Business -- Industry
No. Bedrooms 3 .No. Baths —lam`No. in Family �-- — Public Assembly Other
Garbage.Disposal YES ❑ NO ER( Specifications for System: .5,%N
,
Auto Dish Washer YES NO
Auto Wash Ma^hine YES NO ❑ t�
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:
. /
Improvements permit by — —
*Contact a reesentative of the Davie County Health Department for final'inspection of this system between 8:30-9:30 A.M.,
1:00-1:30 P or 4:30-5:00 P.M. on day of completion.Telephone Number::7,04-634-5985.
Fina stallation Diagram: System"Tnstalled by DaN"c�a
Certificate of Completion;., Date U 9 Ll
'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. � '
�.. DAVIE COUNTY ENVIRONMENTAL HEALTH SECTION
APPLICATION FOR IMPROVEMENT PERMIT(REPAIR)
NAME ' PHONE NUMBER
ADDRESS R'� c1 o .�3 SUBDIVISION NAME
o c�sy LOT#
DIRECTIONS TO SITE
DATE SYSTEM INSTALLED 9(cam NAME SYSTEM INSTALLED UNDER "
TYPE FACILITY \ko tj$° NUMBER BEDROOMS 3 NUMBER PEOPLE SERVED
TYPE WATER SUPPLY C v v SPECIFY PROBLEM OCCURRING
DATE REQUESTED_ �' °�` °\ INFORMATION TAKEN BY
This is to certify that the information provided is correct to the best of my knowledge,and that I understand I am responsible for all charges Incurred from this application.
SIGNATURE OF OWNER OR AUTHORIZED AGENT-
Rev,1/93
< APPLICATION FOR SITE EVALUATION/IMPROVEMENTS PE � ����®
fir,
'• �' Davie County Health Department
CEnvironmental Health Section JUL Z 7 1994
P. O. Box 665
V-1 �,. .
Mocksville, NC 27028
1. Application/Permit Requested By
Mailing Address Ul .-cn dC �C) Home Phone 1,3 ' 3
• O 10 d' Business Phone
2. Name on Permit if Different than Above
3. Application for: Il General Evaluation eptic Tank Installation Permit
4. System to Serve: 12- use ❑ 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 l� ❑ Washing Machine
No. of Bathrooms �` ❑ Dishwasher
Dwelling Dimensions ❑ Garbage Disposal
6. If business, industry, place of public assembly, other: Specify type
No. of People Served No. of Sinks
No. of Commodes No. of Urinals
No. of Lavatories No.of Water Coolers
No. of Showers Water Usage Figures
7. Type of water supply: ❑ 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 er o
If yes,what type?
'NOTE: Improvements Permits shall be valid for a period of 5 years from date.rissued. Improvements Permits are subject to
revocation, if site plans or the intended use change. Effective October 1, 1989.
Directions to Property:
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.
�56ATE SIGNATURE
CONSENT FOR SITE EVALUATION TO BE DONE ON ABOVE DESCRIBED PROPERTY
MUST CHECK ONE: 59-T. I 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 SI ATU E
DCHD(1/93)
DAVIE COUNTY HEALTH DEPARTMENT
Environmental Health Section
Soil/Site Evaluation.
NAME _) IAI DATE EVALUATED
ADDRESS PROPERTY SIZE A0
PROPOSED FACIILTY /���f� LOCATION OF SITE B/
Water Supply: On-Site Well / Community Public
Evaluation By: Auger Boring (/ Pit Cut
FACTORS 1 2 3 4
Landscape position I-- L L
Sloe %
HORIZON I DEPTH
Texture group
Consistence
Structure
MineralogX
HORIZON II DEPTH f
Texture groupG
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 S
SITE CLASSIFICATION: EVALUATED BY:
LANG-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(01-901
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DAVIE COUNTY ENVIRONMENTAL HEALTH SECTION
APPLICATION FOR IMPROVEMENT PERMIT(REPAIR) _
NAME o hne S�J�C��xpo.� y'
� PHONE NUMBER
ADDRESS 3c'`-�� LQ M/' SUBDIVISION NAME
LOT#
DIRECTIONS TO SITE
DATE SYSTEM INSTALLED NAME SYSTEM INSTALLED UNDER
TYPE FACILITY NUMBER BEDROOMS NUMBER PEOPLE SERVED M
TYPE WATER SUPPLY SPECIFY PROBLEM OCCURRING
DATE REQUESTED 6k) Do INFORMATION TAKEN BY v�
This is to certify that the information provided is correct to the best of my knowledge,and that I understand I am responsible for all charges incurred from this application.
SIGNATURE OF OWNER OR AUTHORIZED AGENT
Rev.1193
1-y4.!A? u 'a
. AUTHORIZATION NO8 0 id .DAVIE COUNTY HEALTH DEPARTMENT"
Environmental Health Section PROPERTY INFORMATION
Permittee' P.O.Box 848
Name: Mocksville;NC 27028 Subdivision Name:
-' / -' /' Phone# 336-751-8760
Directions to propertyk fl el��''Tllr Section: Lot:
AUTHORIZATION FOR
.A'!lG` �f/• lr .��'f/� WASTEWATER
SYSTEM CONSTRUCTION Tax Office PIN:# -
Road NamtK &etFcnc( Zip:L70Zp'
**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 CountyBuilding Inspections`
'Office when applying for Building Permits. ,
(In compliance with Article 1 I'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 �»-
or
gDAVIE COUNTY HEALTH DEPARTMENT
IMPROVEMENTAND OPERATION PERMITS PROPERTY INFORMATION
i
Permittee'
Name: Subdivision Name: f
Directions to property Section: Lot:
_T IMPROVEMENT
PERMIT Tax Office PIN:# -
Road Name?U c K S er#FcPd, Zip•Z?o Z.V,
**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
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 #.00CUPANTS–,/—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
E REPAIR SITE
SYSTEM SPECIFICATIONS:.TANK SIZE GAL. PUMP TANK GAL. .TRENCH WIDTH ROCK DEPTH/(J LINEAR FT.'�!
OTHER
r _
' REQUIRED SITE MODIFICATIONS/CONDITIONS:
IMPROVEMENT PERMIT LAYOUT
*APPROVED EFFLUENT FILTER* *RISER(S) IF 6" BELOW FINISti,ED GRADE*
f.
{ 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(704)634-8760.
xxxxxxxxW
A4 b) IZIL—Ulbk
OPERATION PERMIT
SYSTEM INSTALLED BY:
ti
;r
7D
(�N ,
.�► aid
- Y
AUTHORIZATION NO. l PERATION PERMIT BY: DATE: r
, r
r.
.*THE ISSUANCE OF THIS OPERATION PERMIT SHALL INDICATE THAT THE SYSTEM DESCRIBED ABOVE HAS BEEN INSTALLED IN COMPLIANCE
/, ,14x,
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)
DAVIE COUNTY HEALTH DEPARTMENT-
IMPROVEMENT AND OPERATION PERMITS PROPERTY INFORMATION
Permittee'Name: d of'
Subdivision Name:
Directions to property:. Section: Lot:
IMPROVEMENT
PERMIT Tax Office PIN:#
Road Nam3i I(.K Se,-#rld Zip:Z 71
**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
PLANS OR THE INTENDED USE CHANGE.YOUR WASTEWATER
SYSTEM CONTRACTOR MUST SEE THIS PERMIT BEFORE
ENVIRONMENTAL HEALTH SPECIALIST DATE ISSUED INSTALLING THE SYSTEM.
RESIDENTIAL SPECIFICATION:BUILDING TYPE� #BEDROOMS__�Z2_#BATHS_/ #OCCUPANTS GARBAGE DISPOSAL:Yes or No
COMMERCIAL SPECIFICATION: FACILITY TYPE #PEOPLE #PEOPLE/SHIFT- #SEATS INDUSTRIAL WASTE:Yes or No
'
LOT SIZE TYPE WATER SUPPLY f DESIGN WASTEWATER FLOW(GPD)NZ/O)NEW SITE REPAIR SITE
SYSTEM SPECIFICATIONS: TANK SIZE GAL. PUMP TANK____---GAL. TRENCH WIDTH ROCK DEPTH 16p, LINEAR Fr. 1,r
OTHER
REQUIRED SITE MODIFICATIONS/CONDITIONS:
IMPROVEMENT. ,PERMIT LAYOUT
iAPPROVED EFFLUe4T FILTER* *RISER(S) IF Gil BEIDW FINISHED GRADE*
k 4.,
**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.
XXXXXXXXX
OPERATION PERMIT
SYSTEM INSTALLED BY:
k
a
AUTHORIZATION NO. PERATIONPERMIT BY: I)A/TE:
"THE ISSUANCE.,OF THIS OPERATION PERMIT SHALL INDICATE THAT THE SYSTEM DESCRIBED ABOVE HAS BEEIC INSTALLED IN COMPLIANCE
WITH ARTICLE 11 OF G.S.CHAPTER 130A,SECTION.1900"SEWAGE TREATMENT AND DISPOSAL SYSTEMS",BUT SHALL IN NOWAY BETAKEN ASA
GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORILY FOR ANY GIVEN PERIOD OF TIME.
z DCHD 05/96(Revised)