119 Buena Vista LnDavie County, NC Tax Parcel Report Tuesday, October 11, 2016
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WARNING: TIIIS IS NOT A SURVEY
Parcel Information
Parcel Number: E30000000203 Township: Clarksville
NCPIN Number: 5811692420 Municipality:
Account Number: 42334000 Census Tract: 37059-801
Listed Owner 1: KELLER BOBBY JAMES Voting Precinct: CLARKSVILLE
Mailing Address 1: 1336 COUNTY LINE RD Planning Jurisdiction: Davie County
City: HARMONY Zoning Class: DAVIE COUNTY R-20
State:
Zip Code:
Legal Description:
Assessed Acreage:
Deed Date:
Deed Book / Page:
Plat Book:
Plat Page:
Building Value:
Land Value:
Total Assessed Value:
NC Zoning Overlay:
28634 Voluntary Ag. District: No
17.640 AC LIBERTY CHURCH Fire Response District: WILLIAM R. DAVIE
17.08 Elementary School Zone: WILLIAM R DAVIE
9/1987 Middle School Zone: NORTH DAVIE
001400007 Soil Types: MnC2,MnB2,MdD,WATER
0007 Flood Zone:
024 Watershed Overlay: DAVIE COUNTY
68170.00 Outbuilding & Extra 16170.00
Freatures Value:
142060.00 Total Market Value: 226400.00
226400.00
0�,^�i�, A�I data is provided as is without warranry or guarantee of any klnd either ezpressed or implied including but not limited to the
Davie County� Implied warranties of inerchantability or fitness for a particutar use. AII users of Uavie County's GIS website shall hold harmless the
County of Davie, North Carolina, fts agents, consultants, controetors or employeas from any and all claims or causea of action due to
�'o�,N,�"' NC or arising out of the use or inability to use the GIS data provldod by this website,
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UTHORIZATION NO: '����`' DAVIE COUNTY HEALTH,DEPARTMENT ��%'�O
� • Environmental Health Section PROPERTY INFORMATION
Per��ttee's ^� P.O. Box 848
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N�me: t-� t-� �%'�!'� �lCe..�ts�.- Mocksville, NC 27028 Subdivision Name:
Phone #: 704-634-8760
Directions to property: j�'(..%� !� "'T[` � t�iz��'�Y Section: Lot:
AUTHORIZATION FOR
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�T— — SYSTEM CONSTRUCTION
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`�11 �� la �..: tt� Road Name: i�'t> t-_ raA ��1`�'ilt �� Zip: 2'ii.`� �i
**NOTE** This Authorization for Wastewater System Construcdon MUST BE ISSLTED by the Davie County Environmental Health Section prior
to issuance of any Building Pernuts. T'his Forn�/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)
� ' f ' ' ,.�..y �.�.--"""`~, � � „ ***NOTICE*** THIS AUTHORIZATION FOR WASTEWATER CONSTRUCTION
�T ��� � ���/' � -� IS VALID FOR A PERIOD OF FNE YEARS.
ENVIRONMENTAL H�ALTH SPECIAL�CST'� DATE SS ED
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��� �;.�`:• ,�,,,. -�— IMPROVEMENT AND OPERATION PERMITS PROPERTY INFORMATION
Pen4fittee's rt=; � •
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Name:' � - � s ' '� � �= 4 � � """ Subdivision Name:
Directions to property: ��' � f �`� � 1� �.�'� �- f?�� Section: 1 Lot:
-.,,, �` Il1�PROVEMENT
! � `�- � % 1 ^ � E i.' 6.' r� ; . n� � ~�:, � i. r.,` t� PERNIIT Tax Office PIN:# � � i _ t ' ; _ � - !.� .� e';�
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�� t.� Road Name: �^�.. ��.�t,1{��i'aC� nJ ZIP; � f r:: ���
,**NOTE** This Improvement Pemut DOFS NOT authorize the construction or installation of a septic tanlc system or any wastewater system. An
i AUTHORIZATION FOR WASTEWATER SYSTEM CONSTRUCTION must be obtained fn�m this Department prior to the
construction/installation of a system or the issuance of a building pernut.
,(In compliance with Artide 11 of G.S. Chapter 130A, Wastewater Systems, Section .1900 Sewage Treatment and Disposal Systems)
' _. .. ., ,,�-�- '" ***NOTICE*** THIS PERMIT IS SUBJECT TO REVOCATION IF SIT'E
? :: : ,� ; , . `..� '�� '� ��� PLANS OR TI� INTENDED USE CHANGE. YOUR WASTEWATER
ENVIRONMENTAL HEALTH SPECIALIST DATE SSUED SYSTEM CONTRACTOR MUST SEE TFQS PERNIIT BEFORE
,.. INSTALLING THE SYSTEM.
RESIDENTIAL SPECIFICATION: BUILDING TYPE M N # BEDROOMS � # BATHS 2# OCCUPANTS '�`� GARBAGE DISPOSAL: Yes or No .
COMMERCIAL SPECIFICATION: FACILIT'Y T'YPE # PEOPLE # PEOPLFJSHIFT # SEATS INDUSTRIAL WASTE: Yes or No
LOT SIZE -7D, i� `j"fYPE WATER SUPPLY ��c3�T� DESIGN WASTEWATER FLOW (GPD) -�`�v NEW SITE �-�' REPAIR SITE
.� ' � ' � �
SYSTEM SPECIFICATIONS: TANK SIZE ��AL. PUMP TANK GAL. TRENCH WIDTH -''L ROCK DEPTH � 2 LINEAR FT. -���
OTHER I �-% h ���� �',' ��I�� T�n�
REQUIRED SITE MODIFICATIONS/CONDITIONS: i`v%'T'e` �-�- 71� C�..O �±�I V(�„
IMPROVEMENT PERMIT LAYOUT �� �.� • � � U � *' '�( �' ��
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**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 PERMTT
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SYSTEM INSTALLED BY:
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AUTHORIZATION NO. `2�� OPERATION PERMIT BY: DATE: �� `�
**THE ISSUANCE OF THIS OPERATION PERMIT SHALL INDICATE THAT THE SYSTEM DESC BED ABOVE 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.
DCHD OSN6 (Revised)
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APPLICATION FOR SITE EVALUATION/IMPROVEMENT PERMIT & ATC
Davie County Health Department
Environmental Health Section
P.O. Box 848
Mocksville, NC 27028
(704) 634-8760
'�***IMPORTANT****
THIS APPLICATION CANNOT BE PROCESSEI�„]
THE REQUIRED INFORMATION IS PROVIDED.
1. Name to be Billed ' 7� � �
Mailing Address � -�� � �
City/State/Zip �bC-/�S 1/l /T, �, � %���
2. Name on PermidATC if Different than Above
Mailing Address
Contact Person
Home Phone �li � - y/ -z ':.53 y/
Business Phone
City/State/Zip
3. Application For: [] Site Evaluation [� ] Improvement Permit & ATC {a'Both
4. System to Serve: [] House � Mobile Home [] Business [] Industry [] Other
5. If Residence: # People.� # Bedrooms�_ # Bathrooms�_ ��jbishwasher [] Garbage Disposal
�ashing Machine [ ] Basement/Plumbing [ ] 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:➢'j�County/City [] Well [] Community
8. Do you anticipate additions or expansions of the facility this system is intended to serve? [] Yes [�No
If yes, what type?
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EZTHER A PLttT On SZTE PLAN
PROPERTY INFORMATION REQUIRED: *** IMPORTANT **��T OF THE PROPERTY MUST BE
SUBMITTED WITH THIS APPLICATION.
Property Dimensions: 02 � ��� � WRITE DIRECTIONS (from Mocksville) TO PROPERTY:
�'aX o�ce Puv: # ��! I _ ��1 - �Ly � o ; � d % N � a Lia-e�� C�i� � _
Property Address: Road IhTame �., c3 �i"� L �,�j � � �d ,6-Gi9/f//f ���9- �/� �� tv ij���_
�Bt ✓rt /f Y s'7►'A� L�¢.aiL. i ' / I
City/Zip ,�YJcc,�ct�i /(� ,iV�' .� 7b`2�2; �S /� �lie1�� e��i
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If in Subdivision provide information, as follows: �
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Name: �
�
�
Section: Lot #: ;
This is to certify that the infortnation 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
,��b 7�i�u . kc%e�
by to conduct all testing procedures as necessary to determine the site suitability.
DATE %—.� Q- 9 S SIGNATURE�'�'j� //r'i�Z-t� y�,��r.--�
Revised DCHD (06-96) `
THIS AREA MAJ 23E USEb �OR btZttWINC� JOUR SZTE 1'L�i1V:
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DAVIE COUNTY HEALTH DEPARTMENT
Environmental Health Section SECTION LOT
Soil/Site Evaluation
APPLICANT' S NAME � � `i� C�LI��
PROPOSED FACILITY i1i�,, ��MC
SUBDIVISION
Wa[er Supply:
Evaluation By:
FACTORS
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
On-Site Well Community
Auger Boring '�^ Pit
SOIL WETNESS
RESTRICTIVE HORIZON
SAPROLITE
CLASSIFICATION
LONG-TERM ACCEPTANCE RATE �
SITE CLASSIFICATION: PS
LONG-TERM ACCEPTANCE RATE: �•-3�
REMARKS:
DCHD (01-90)
DATE EVALUATED 3 I�� �
PROPERTY SIZE 2_D. l� L��Q-�-S
ROAD NAME �J� Q � � ST� L-�
Public �
___ Cut
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EVALUATION BY: � 4�-�
OTHER(S) PRESENT:
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
Mineraloav
1:1, 2:1, Mixed
Notes
Horizon depth - In inches
Depth of fll - In inches
Restrictive horizon - Thickness and inches from land surface
Saprolite - S(sui[able), 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 - gaUday/ft2
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