164 Buckingham Ln Davie Couttty,NC Tax Parcel Report 3 La� Monday, September 26, 2016
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WARNING: THIS IS NOT A SURVEY
-. Parcel Information
Parcel Number: E20000001602 Township: Clarksville
NCPIN Number: 5801856573 Municipality:
Account Number: 8304561 Census Tract: 37059-801
Listed Owner 1: MEDLIN JEFFREY S Voting Precinct: CLARKSVILLE
Mailing Address 1: 164 BUCKINGHAM LANE Planning Jurisdiction: Davie County
City: MOCKSVILLE Zoning Class: DAVIE COUNTY R-A
State: NC Zoning Overlay:
Zip Code: 27028 Voluntary Ag.District: No
Legal Description: 2.934 AC OFF DUKE WHITAK Fire Response District: SHEFFIELD-CALAHALN
Assessed Acreage: 2.69 Elementary School Zone: WILLIAM R DAVIE
Deed Date: 12/2014 Middle School Zone: NORTH DAVIE
Deed Book/Page: 009760212 Soil Types: MnB2
Plat Book: Flood Zone:
Plat Page: Watershed Overlay: DAVIE COUNTY
Building Value: 63580.00 Outbuilding 8r Extra 5760.00
Freatures Value:
Land Value: 24640.00 Total Market Value: 93980.00
Total Assessed Value: 93980.00
161
NC AlldataIsprovided 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
1. 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
Environmental Health Section
P.O.Boz 848/210 Hospital Street
Mocksville,NC 27028
(336)751-8760
Account #: 990002992 Tax PIN/EH#: 5801-85-3039.LP
Billed To: Key Homes,lnc. Subdivision Info: 11041/
Reference Name: Leesa&William Parker Location/Address: Buckingham Lane-27028
Proposed Facility: Residence Property Size: 2.94 acres
ATC Number: 3628
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 WASTEWATER CONSTRUCTION IS VALID FOR A PERIOD OFFIVEYEARS.
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
given period of time.
10
to
Septic System Installed By: A4,0��q a--
Environmental Health Specialist's Signature: Date: /
'00,
DCHD 05/99(Revised)
'Appraisal Card / Page 1 of 1
W'11(a
DAVIE COUNTY NC 2/7/2013 1:24:48 PM
ARKER WILLIAM M ROBB-PARKER LEESA Retum/Appeal Notes: E2-000-00-016-02
164 BUCKINGHAM LN UNIQ ID 5805 -
2521712 ID NO:5801856573
COUNTY TAX(100),FIRE TAX(100) CARD NO.1 of 1
eval Year:2013 Tax Year:2013 2.934 AC OFF DUKE WHITAK 2.930 AC SRC-Estimated
raised by 02 on 05/31/2007 02001 BEAR CREEK CHURCH TW-02 C- EX-AT- LAST ACTION 20110722
CONSTRUCTION DETAIL MARKET VALUE DEPRECIATION CORRELATION OF VALUE >
oundation-3ER BASE Standard 0.1500
rM
ontinuous Footing 8.0 S 0 Area UA RATE RCN EYB AYB REDENCE TO MARKET z
ub Floor System-4
lywood 11.00 02 102 1,6041_107 46.01 480 200 00 %GOOD 85.0 )EPR.BUILDING VALUE-CARD 63,58Ca
xterior Walls-30 TYPE:Manufactured Home(Multi) Manufactured Home)EPR.OB/XF VALUE-CARD F
luminum n Sidi 32-00ARKET LAND VALUE-CARD 24,64
oofing Structure-03 STORIES:1-1.0 Story DIAL MARKET VALUE-CARD 88,22
able 9.0
Doting Cover-03
ksphalt or Composition Shingle 5.0 TOTAL APPRAISED VALUE-CARD 88,22
nterior Wall Construction-5 TOTAL APPRAISED VALUE-PARCEL 88,22
)rywall/Sheetrock 28.0
nterior Floor Cover-08 TOTAL PRESENT USE VALUE-PARCEL
heet Vinyl/Laminate 7.00 TOTAL VALUE DEFERRED-PARCEL
nterior Floor Cover-14 TOTAL TAXABLE VALUE-PARCEL 88,22
0.00
eating Fuel-04 PRIOR
lectric 1.00 WILDING VALUE 73,43
eating Type-10 BXF VALUE
eat Pump 5. ------ ND VALUE 23,90
r Conditioning Type-03 I W D D I RESENT USE VALUE
entral 5.0c I I EFERRED VALUE
3edrooms,(Bathrooms/Half-Bathroonis _ = rOTAL VALUE 97,330
2 0 0.0 I I
rooms I I
S-3FUS-OLL-0 +---""26-"'--..+-----18--"'+--12---+
throoms I S A S I a
S-2 FUS-0LL-0 I I PERMIT
OTAL POINT VALUE 111.00 I I CODE DATE NOTE NUMBER AMOUNT
BUILDING ADJUSTMENTS I I m
uali 3 AVG 1.000 I I OUT:WTRSHD:
a Desi 4 FACTOR 4 1.05 2 2 c
SALES DATA
ize 3 Size 0.910 1 7 o
FF.
OTAL ADJUSTMENT FACTOR 0.9 = = RECORD ATE DEED INSALES o
DI
OTAL QUALITY INDEX 10 1 I OOK AGE R TYPE / PRICE
c
I I 0520 918 30 00 WD V IB00 0
I I
+---"'-24""---+--12--'+""'20......+
IFOP I
I I
B 8 HEATED AREA 1,512
I I
+•-1 2..-+ NOTES
SUBAREA UNIT ORIG% SIZE ANN DEP % OB/XF DEPR.
t04174
D UA DESCRIPTIO T NIT PRICE COND LDG FACT Y RATE V GOND VALUE
TYPE S AREA TOTAL OB XF VALUE
S 151
OP 9 DD 21
LREPLACEE Fabricated 1,0 .
1,8274,8G DIMENSIONS BAS-W12 WDD-N12W18S12E18 W44S27E24 FOP-S8E72N8W12 E32N27 .
ORMATION
THERADJUSTMENTS LAND TOTAL
T USE LOCAL FROM DEPTH/ LND COND ND NOTESAUNIT LAND UNT TOTAL ADJUSTED LAND LAND
CODE ZONING TAGE EPT SIZE MOD FAR RF AC LC TO OT TYPE PRICE UNITS TYP ADJST UNIT PRICE VALUE NOTES
0120 70 0 1.5120 4 0.8300 02-15+00+00+00 PD 6700.0 2.93 AC 1.25 8 408.5 2463
ARKET LAND DATA 2.93 24,64
ESENT USE DATA
http://maps.co.davie.nc.us/ITSNet/AppraisalCard.aspx?parcel=E20000001602 2/7/2013
DAVIE COUNTY HEALTH DEPARTMENT 171 Abe--
Environmental
beiEnvironmental Health Section `/
` P.O.Boa 848/210 Hospital Street ! [
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' Mocicsville,NC 27028 .� --� se ca -(
(336)751-8760
IMPROVEMENT/OPERATION PERMIT ..
Account #: 990002992 Tax PIN/EH#: 5801-85-30391P
Billed To: Key Homes,lnc. Subdivision Info:
Reference Name: Leesa&William Parker Location/Address: Buckingham Lane-27028
Proposed Facility: Residence Property Size: 2.94 acres
ATC Number: 3628
**NOTE** This Improvement/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 CONTRACTOR MUST SEE THIS PERMIT BEFORE INSTALLING SYSTEM.
i
Residential Specification: Building Type /7)// #People .� _ #Bedrooms #Baths
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 L / Design Wastewater Flow(GPD) 3Vv 4� Site: New)2T Repair❑
System Specifications: Tank Size GAL. Pump Tank GAL. Trench Width JY 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 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.****
Q Z
Environmental Health Specialist's Signature: / I Date:
DCHD 05/99(Revised)
P ION FOR SITE EVALUATION/IMPROVEMENT PERMIT&ATC
l5 �Vf Davie County Health Department
DEnYirOnmentaiHeaitIl SectiOn
P.O. Box 848/210 Hospital Street
NOV g 20 3 Mocksville, NC 27028
(336)751-8760
S
IS AP ICATION CANNOT BE PROCESSED UNLESS ALL THE REQUIRED
INFO D. Refer to the INFORMATION BULLETIN for instructions.
1. Name to be Billed /A16• Contact Person -JaG/ G
Mailing Address �� / M / .t/ 4L) Home Phone
City/State/ZIP Business Phone /
2. Name on Permit/ATC if Different than 9, �Above 4ez
Mailing Address �3.3y 934.1/5-W64 . City/State/Zip 0'V/,.`y 2-710-7
3. Application For: ❑ Site Evaluation 9( Improvement Permit/ATC ❑ Both
4. System to Service: ❑ House ldkMobile Home ❑ Business ❑ Industry ❑ Other
5. Type system requested: a Conventional ❑ conventional modified ❑ innovative
6. If Residence: # People 102— # Bedrooms �?> t # Bathrooms Z %
PlUishwasher ❑Garbage Disposal Owashing Machine ❑Basement/Plumbing ❑Basement/No Plumbing
7. If Business/Industry /Other: verify type # People # Sinks
# Commodes # Showers # Urinals # Water Coolers
IF FOODSERVICE: # Seats Estimated Water Usage (gallons per day)
S. Type of water supply: ❑ County/City R Well ❑ Community
9. Do you anticipate additions or expansions of the facility this system is intended to serve? ❑Yes ❑No
If yes,what type?
***IMPORTANT***CLIENTS MUST COMPLETE THE REQUIRED PROPERTY INFORMATION REQUESTED
BELOW. Either a PLAT or SITTE PLAN MUST BE SUBMITTED by the client with THIS APPLICATION.
Property Dimensions: O`_ / WRITE DIRECTIONS(from Mocksville)to PROPERTY:
Tax Office PIN: # �� /-�S- o 3 , �-1P 6� t tJ 4 Ll a C- - 4-L L-
Property Address: Road Namel?wr✓�c L-,-1 ,,ti- Jle, C e- C4. 42,C
City/zip
If in a Subdivision provide information,as follows: ° r` �S'1'~ ��c ��••,
Name:
Section: Block: Lot: Date home corners flagged:
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 ant 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
to conduct all testing procedures as necessary to determine the site suitability.
DATE SIGNATURE '
THIS 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).
[ (—/ ? — J 3 Site Revisit Charge
Q Date(s):?
JO k1
Client Notification Date:
3/ L / a EHS:
Sign given Va r) Account No.
Revised DCHD(05/03 I( '' '1( �`r ► Invoice No,
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APPLICATION FOR SITE EVALUATION/IMPROVEMENT PEI D Arg
Davie County Health Department U v 15
EnyizoninentaiHeaith Section
P.O. Box 848/210 Hospital Street J p 1
U.d 17 !
Mocksville, NC 27028
(336)751-8760
***IMPORTANT*** THIS APPLICATION CANNOT BE PROCESSED ,UIIL '
INFORMATION IS PROVIDED. Refer to the INFORMATION BULLETIN for instructio
t •
1. Name to be Billed Contact Person _ __
Mailing Address l Home Phone
City/State/ZIP l Business Phone
2. Name on Permit/ATC if Different than Above
Mailing Address 7T City/State/Zip
3. Application For: brIslite Evaluation ❑ Improvement Permit/ATC ❑ Both
4. system to service: House ❑ Mobile Home ❑ Business ❑ Industry &Other
S. Type system requested: Conventional ❑ conventional modified ❑ innovative
Z
6. If Residence: # People # Bedrooms # Bathrooms
12bishwasher ❑ li�i
Garbage Disposal 9ashing Machine ❑Basement/Plumbing ❑Basement/No Plumbing
7. If Business/Industry /Other: verify type # People # Sinks
# Commodes # Showers # Urinals 11 Water Coolers
IF FOODSERVICE: # Seats Estimated Water Usage (gallons per day)
S. Type of water supply: County/City ❑ Well ❑ Community
9. Do you anticipate additions or expansions of the facility this system is intended to serve? ❑Yes ZI-Mo
If yes,what type?
***IMPORTANT***CLIENTS MUST COMPLETE THE REQUIRED PROPERTY INI:ORMATION REQUES'T'ED
BELOW. Either a PLAT or SITE PLAN MUSTBESUBMITTED by the client with THIS APPLICATION.
Property Dimensions: aI 1'VIZITE DIRECTIONS(from locicsville)to PROPERTY:
Tax Office PIN: it �g a ! - �' 5 3 3 �j< 16l
Property Address: Road Name KQ �AA au
�
City/Zip l)I y0'
�CZ
If in a Subdivision provide information,as follows:j-:7 -
Name: , /
Section: Block: Lot: Date home corners flagged: +! 2 d v 3
This is to-certify that the information provided is correct to the best of my knowledge. I understand that any permits)
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. 1,also,understand that I am responsible fur all charges incurred from
this application. I,hereby,give consent to the Authorized Representative of the Davie County IIealth Department
to enter upon above described property located in Davie County and owned by
to conduct all testing procedures as necessary to determine the site suitability.
DATE --I —co SIGNATURE �' C-'
THIS AREA MAY BE USED FOR DRAWING YOUR SITE PLAN(Include all of the following: Existing and roposed
property lines and dimensions, structures, setbacks, and septic locations).
Site Revisit Charge
Datc(s):
Client Notification Date:
EHS:
Sign givenAccount No,
O C�
Revised DCH (05/03 Invoice No.
• DAVIE COUNTY HEALTH DEPARTMENT
Environmental Health Section
SoiVSite Evaluation
APPLICANT INFORMATION PROPERTY INFORMATION
Account #: 990002808 Tax PIN/EH#: 5801-85-3039.A
Billed To: William Barneycastle Subdivision Info:
Reference Name: Location/Address: Buckingham Lane-27028
Proposed Facility: Residence Property Size: 2.94 acres Date Evaluated:
Water Supply: On-Site Well. Community Public
Evaluation By: Auger Boring 1'-' Pit i 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 A
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 I Q
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
ois
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 05/99(Revised)
M Z4 I
IIIf � I
I NEW !RON tiXISTC�;:
ON UNE
+ (CAR ,lAt,u.)
250.00
SCALE
a VI CINI' l P
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Li BILLY B. SHOFFNER Jr.
D.B. 337, PC. 337
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ENVIRONMENTAL HEALTH SECTION
P. 0. Box 848/210 Hospital Street
Courier #09-40-06
Mocksville, NC 27028
June 25,2003
William S.Bameycastle
1421 Main Church Road
Mocksville,NC 27028
Re: Site Evaluations/3 sites on Buckingham Lane
Tax Office Pin : #5801-85-3039
Dear Client(s):
As requested, a representative from this office visited the aforementioned site on June 25,
2003. Based upon the information provided on the Application for Site Evaluation and
after an evaluation was completed on the site,the site was found to be provisionally
suitable for the installation of an on-site sewage system.
Before an Improvement Permit/Authorization to Construct can be issued the appropriate
application must be filled out and the house/mobile home location staked off.
If you have any questions,please feel free to contact this office.
Sincerely,
Robert B. Hall,Jr.,R.S.
Environmental Health Specialist
RH/df