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190 Cable LnDavie Countv, NC Tax Parcel Report Tuesday, October 11, 2016 Parcel Number: NCPIN Number: Account Number: Listed Owner 1: Mailing Address 1: City: State: Zip Code: Legal Description: Assessed Acreage; Deed Date: Deed Book / Page: Plat Book: Plat Page: Building Value: WAK1VliVli: ll�l� 1J 1VU1 A JUKVI�:Y Parcel Information L4130A0033 Township: 5736638319 Municipality: Jerusalem 11466000 Census Tract: 37059-807 BUMGARNER CAROLYN MCDANIEL Voting Precinct: COOLEEMEE 177 CABLE LANE Planning Jurisdiction: Davie County MOCKSVILLE Zoning Class: DAVIE COUNTY R-A NC Zoning Overlay: DAVIE COUNTY CZOD 27028-5105 Voluntary Ag. District: .48 AC OFF GLADSTONE RD Fire Response District: Land Value: Total Assessed Value: °"��°'F Davie County, �ot;N�i NC 0.49 Elementary School Zone: 12/1994 Middle School Zone: 001770520 Soil Types: Flood Zone: Watershed Overlay: 52670.00 Outbuilding & Extra Freatures Value: 9450.00 Total Market Value: 66620.00 No JERUSALEM COOLEEMEE SOUTH DAVIE Ce62 DAVIE COUNTY 4500.00 66620.00 .� . . _ . : _, .-:.- ., ... ,;;., �:r•.� . �:t .. 6 __ � . .:�;�� .. � Au�oRi�aTiorr rro: O S 2 4 DAVIE COUNTY HEALTH DEPARTMENT i I• 3 ` � ' Environmental Health Section PROPERTY INFORMATION Permittee's �-'— ,�'�,/ / P.O. Box 848 Name: •_�'�'��/�:' �'/i./��.a.,f Mocksville, NC 27028 Subdivision Name: , � � �` Phone #:704-634-8760 � L„ Directions to property: _.�/`:.G' � "`ci"�+;',� Section: �� I • AUTHORIZATION FOR / (� . WASTEWATER Tax Office PIN:# ��t`�`t U' � -/�� SYSTEM CONSTRUCTION _ Road Name: �� t�� 1 • Zip: � l��' ci I**NOTE** This Authorization for Wastewater System Construction MUST BE ISSUED by the Davie County Environmental Health Section prior to issuance of any Building Pernuts. This Form/Authorization Number should be presented to the Davie County Building Inspections Office when applying for Building Pernuts. " (In compliance with Article 11 of G.S. Chapter 130A, Wastewater Systems, Section .1900 Sewage Treatment and Disposal Systems) �/�''� � � r ***NOTICE*** THIS AUTHORIZATION FOR WASTEWATER CONSTRUCTION _.�"'�'""L�� %�J�. �;:�'-t' �� j'� � �-� / - �% � IS VALID FOR A PERIOD OF FIVE YEARS. ENVIRONMENTAL HEALTH SPECIALIST DATE ISSUED __ _ .; ,. ., . ., ,, ._ . _. , .. � . .--- , ,. . . ; ; ., . ., ,,:� ..��,�,; :�� s1��: ., DAVIE COUNTY HEALTH DEPARTMENT � I�,3� " �-.\'� 4`; IMPROVEMENT AND OPERATION PERMITS PROPERTY INFORMATION r Perinitt�e's "� j ' . , • �--� ; � � Name:�_r��'' �- �%': i;f S Subdivision Name: i A; e D�ections to property: �`%�r =' -'�`' � : � �%�' Section: l.,otf-- � `� f -" � IMPROVEMENT . -� �, PERMIT Tax Office PIN:# ��/ F`�!�- L� -{'�� `., ' Road Name: �'_� �� r i� .1w.� 1 Zip: �'`.:�� °,/�(; ,;> � **NOTE** This Improvement Pemut DOFS NOT authorize the construction or installation of a septic tanlc system or any wastewater system. An AUTHORIZATION FOR WASTEWATER SYSTEM CONSTRUCTION must be obtained from this Department prior to the constcuction/installation of a system or the issuance of a building pernut. (In compliance with Article 11 of G.S. Chapter 130A, Wastewater Systems, Section .1900 Sewage Treatment and Disposal Systems) �- ;�,�' ***NOTICE*** THIS PERNIIT IS SUBJECT TO REVOCATION IF S1TE , ;.� � , : .;�; ,,,-` , : �;� d-,; . ; ;f' ;r' PLANS OR THE INTENDED USE CHANGE. YOUR WASTEWATER ENVIRONMENTAL HEALTH SPECIALIST DATE ISSUED SYSTEM CONTRACTOR MUST SEE THIS PERMIT BEFORE INSTALLING TIiE SYSTEM. RESIDENTfAL SPECIFICATION: BUILDING TYPE �� # BEDROOMS �� # BATHS � # OCCUPANfS �" GARBAGE DISPOSAL: Yes or No COMMERCIAL SPECIFICATION: FACILITY TYPE # PEOPLE # PEOPLE/SHIFI' # SEATS INDUSTRIAL WASTE: Yes or No LOT SIZE TYPE WATER SUPPLY � DESIGN WASTEWATER FLOW (GPD7`--f�'��J NEW SITE L/ REPAIR SITE .-+ / � � � , SYSTEM SPECIFICATIONS: TANK SIZE %Jl.� GAL. PUMP TANK GAL. TRENCH WIDTH S�� ROCK DEPTH � LINEAR FI'. S�d � REQUIRED SITE MODIFICATIONS/CONDITIONS: IIuI�:i��1u1�1►YM3� 7ulYli4:l'(�IIyY **CONTAGT 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 T'HE DAY OF INSTALLATION. TELEPHONE # IS (704) 634-8760. OPERATION PERMIT EV �� E� SYSTEM INSTALLED BY: � � \1.Al�S« AUTHORIZATION NO.�� OPERATION PERMIT BY: �• DATE: � V� U��? **THE ISSUANCE OF THIS OPERATION PERMIT SHALL INDICATE THAT THE SYSTEM DESCRIBED ABOVE HAS BEEN INSTALLED IN COMPLIANCE WITH ARTICLE 11 OF G.S. CHAPT'ER 130A, SECTION .1900 "SEWAGE TREATMENT AND DISPOSAL SYSTEMS", BUT SHALL IN NO WAY BE TAKEN AS A GUARANTEE THAT THE SYSTEM WII.L FUNCTION SATISFACTORILY FOR ANY GIVEN PERIOD OF TIME. DCHD OS/96 (Revised) ._..�. •' •_ APPLICATION FOR SITE EVALUATION/IMPROVEMENT PERMIT & ATC ' . ' Davie County Health Department � Environmental Health Section � � � � � � • ' P.O. Box 848 D Mocksville, NC 27028 �P� � 7 �997 � (704) 634-8760 ****IMPORTANT**** THIS APPLICATION CANNOT BE PROC ' THE REQUIRED INFORMATION IS PROVIDED. 1. Name to be Billed �� U� �� 1 1 l)� S Contact Person 5}C'v� �h'w (1 1 P S Mailing Address %%�p C��/ � l� 11/ `� Home Phone �v s� - a� y- l�c � y City/State/Zip /� OC �C S V j ��-2 �i� (�• � iDo1 � Business Phone �o y- G 3� -�Do �.Ex f f� y�/ 2. Name on PermidATC if Different than Above Mailing Address City/State/Zip 3. Application For: �Site Evaluation [�]'rmprovement Permit & ATC �'} Both 4. System to Serve: [] House �Mobile Home [] Business [) Industry [] Other 5. If Residence: # People_,� # Bedrooms�_ # Bathrooms � �Dishwasher [] Garbage Disposal �Washing 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: � County/City [] Well [] Community 8. Do you anticipate additions or expansions of the facility this system is intended to serve? [] Yes J�No If yes, what type? EITHER tt PLttZ OR SZTE F'LttN PROPERTY INFORMATION REQUIRED: **'� IMPORTANT *** �A�'OF THE PROPERTY MUST BE SUBMITTED WITH T APPLICATION. Property Dimensions: �//� �/ D U � WRITE DIRECTIONS (from Iocksville) TO PROPERTY: � � ) Tax O�ce PIN: #� - �— - _�� ; l,0 �/ _�%�� /l'!C t/l�0 ✓;� � �t1 %�t�t� k Property Address: Road Name C/9 6%'�L ��`}N "� � � M � �� ' d � f) n�� ( f�l�. p�v �`�'. I O c�cyiz�P Nlocksv� ll e ��o� �;�'Ab��. 1�9n�� '" /e�'�- -if1�- DrAd If in Subdivision provide information, as follows: � e'NCI �D� ) S .S'� �'A +'S �+� ��,P�� Name: � r � � Section: .i�at#'-s� � � This is to certify that the information provided is correct to the best of my knowledge. I understand that any permit(s) issued hereafter aze 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 by ��E'(/C ��i9 f0� jN �� 1� � P� to conduct all testing rocedures as necessary to determine the site suitability. DATE Y — I %" %7 SIGNATURE , �I Revised DCHD (06-96) THIS AlzE�l MA� $E USEb �OI� �I�iWINC� �OU1z SZTE YLttN: G3�-3�i� ' � . � � � - DAVIE COUNTY HEALTH DEPARTMENT . Environmental Health Section SECTION LOT • ' ' SoiUSite Evaluation APPLICANT'S NAME �/� �,Pl DATE EVALUATED S�/ ''9 % 0 PROPOSED FACILITY PROPERTY SIZE /2� �' SUBDIVISION ROAD NAME �i�r b ��/ Water Supply: On-Site Well Community Evaluation By: Auger Boring � Pit FACTORS Landscape position 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 Structure Mineralogy SOIL WETNESS RESTRICTIVE HORIZON SAPROLITE CLASSIFICATION LONG-TERM ACCEPTANCE RATE 1 � 0 SITE CLASSIFICATION: LONG-TERM ACCEPTANCE RATE: � REMARKS: DCHD (01-90) � 0 t 0 Public l'/ Cut 3 4 5 6 7 EVALUATION BY: OTHER(S) PRESENT: LEGEND Landscape Position R- Ridge S- Shoulder L- Lineaz slope FS - Foot slope N- Nose slope CC - Concave slope CV - Convex slope T- Terrace FP - F1ood 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 - Subangulaz blocky PL - Platy PR - Prismatic Mineraloev 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 - gaUday/ft2 ■■■■■�■■■��■��■�■■■■ ■��■�■■■�■■■■■■■■■�■ ■��■ ■■■■■■■■��■��■■■■■■■■■■ ■��■■■■■■■■■■■■��■ ■�■■�■■��■�■��■■��■��■■■��■■■■ ■■�■�■■��■■�■■��■��■■��■■��■■�■■ ■��■■�■�■■■■■■■■■■��■��■■��■■ ■��■■�■■��■■■■■■�■�■■�■ ■■�■�■■��■■�■■�■■■��■�■ ■��■�■■ ■■■■�■■■�■■��■■��■ ■�■��■■ ■��■■■■��■■■■■■�■■��■■ ■��■�■■�■■■�■■�■■��■■��■■�■■ ■��■�■■��■■■�■■■■��■��■■��■■��■■ ■■■■■■■�■■��■��■■�■■■��■■ ■��■��■■■■■■■■■��■��■■ ■■�■�■■�■■■�■��■■��■�■■��■��■■ ■�■■�■��■■■■■■■■■��■�■■��■■�■■■ ■�■■■■��■��■■��■��■ ■■■�■■■ ■��■■■■�■■■■�■■■��■��■��■■ ■��■��■■■■��■■■�■■�■■��■■�■■■ ■��■��■�■��■■��■■■■■��■■■■■■ ■■■■■■�■■■■■■■■��■■��■■ ■��■�■■��■■�■��■■■��■■■�■■�■■■ ■■■■■■■■■■��■■■■■■��■■■■■■ ■��■■■�■�■■■��■��■■��■■ ■■■■■■■■�■■�■■��■��■ ■�■■■■■ ■■��■��■■■■■■■■■■■■��■��■■ ■�■■■■■�■■■■■�■■��■�■■■��■■■■■■ ■��■��■��■�■■■■■■■�■�■■��/!Cii7■ ■�■■■■■■■■■�■��■��i��■■■■11■ ■�■■■■■��tIC�■■■■ ■��■�■��■��■��■��I■■■�■■ ��■��■�■■■■HI■�■�■■ �� ■�■ ■�■ ■�■ ■�■ ■■■ ■�■ ■■■ ■■■ ■■■ ■■■ ■■■ ■■■ ■�■ ■�■ ■�■ ■�■ ■�■ ■O■ ■■■ ■■■ ■ ■�■ ■0■■■■ ■��■ ■■■■■■ ■��■ ■�■��■ ■■��■ ■■■■�■ ■■�■�■ ■��■ ■■■■■■ ■��■■ ■■■■■■ ■��■ ■■■■■■ ■■■��■ ■■��■ ■■��■ ■■■■■■ ■■��■■ ■��■ ■�■��■ ■��■ ■■■■■■�■■ ■��■ ■■�■�■■■■ ■��■��■ ■■■■■■■■■�■■