930 Cana RdDavie Countv. NC Tax Parcel Renort Wednesdav. October 12. 2016
Parcel Number: F41
NCPIN Number: 58
Account Number:
Listed Owner 1: TAYLOR MARY
Mailing Address 1: 930 C
City: MOCKSVILLE
State:
Zip Code: 27028-00(
Legal Description: 20.25 A�
Assessed Acreage:
Deed Date:
Deed Book I Page:
Plat Book:
Plat Page:
Building Value:
WAKNIN(i: '1'1i15 151VU'1' A �UKVLY
Parcel Information
)0000015 Township:
31204851 Municipality:
72748500 Census Tract:
FRANCINE Voting Precinct:
ANA ROAD Planning Jurisdiction:
Zoning Class:
NC Zoning Overlay:
i0 Voluntary Ag. District:
� CANA RD Fire Response District:
19.63 Elementary School Zone:
5/1988 Middle School Zone:
001430277 Soil Types:
4 Flood Zone:
16 Watershed Overlay:
53480.00 Outbuilding & Extra
Freatures Value:
Land Value: 141150.00 Total Market Value:
Total Assessed Value: 103170.00
9P1°�F Davie County,
�o�,N�� NC
Mocksville
37059-806
CLARKSVILLE
Davie County
DAVIE COUNTY R-A
WILLIAM R. DAVIE
WILLIAM R DAVIE
NORTH DAVIE
Mr62, EnB,ChA
DAVIE COUNTY
24620.00
219250.00
No
� � . . . . ,� ! � 66.� X�
. 1�U'Y'rIORI2�`ATION NO: �� 9� DAVIE G�OUNTY HEALTH DEPARTMENT ����
';, -�----�' � ° Environmental Health Section PROPERTY INFORMATION
PermitteP's !� � P.O. Box 848
_.Name`. �'"f���4"'� �� . Mocksville, NC 27028 Subdivision Name:
�� �i C fl=: J�j �� (� Phone # 336-751-8760
Directions to property: Section: Lot:
AUTHORIZATION FOR
WASTEWATER Tax Office PIN:# '��%� - ��1
SYSTF.M CONSTRUCTION
: _ Road Name: �/+%� �v Zip: ��`Q��
**NOT'E** This Authorization for Wastewater System Construction MUST BE ISSCIED by the Davie County Environmental Health Section prior
to issuance of any BuildingPermits. This Form/Authorization Number should be presented to the Davie Counry Building Inspections
Office when applying for BuildingPermits.
(ln c� pliance with Article 11 of G.S. Chapter I30A; Wastewater Systems, Section .1900 Sewage Treatment and Disposal Systems)
����. f`���'.��,;�f�'� ,,�' ���r;� ***NOTICE*** THIS AUTHORIZATION FOR WASTEWATER CONSTRUCTION
�� �� �r ��� IS VALID FOR A PERIOD OF FIVE YEARS. �
ENVIRONMENTAL HEALTH SPECIALIST DATE ISSUED
��.� � ,; .� .. �. � o � "� r� „ f // � /. 6Q ��',X l�
..�;'" �. �,�.,;..�. � � - '� � � � DAVIE �OUNTY HEALTH DEPARTMENT ~ �
::.�-- - " IMPRO, EMENT AND OPERATION PERMITS PROPERTY INFORMATION
. �
;:l�rrriii�'ee s • _ _ , �
_ _,
. Name:" r�l��Ii E,� ��f�f ' Subdivision Name:
.o...��+�" .9 . . � w 4' • �,,,,� _ a � } . . t . . . � . � . �- - .. . . _ . . .
k
... -Directions to property: ~ ,r� " � f ,� ,� ,•� Section: � Lot:
, . � IMPROVEMENT � i.,� �,a
, . PERMTT Tax Office PIN:#��1 ,� ` - '�ai -�,��"'�
Road Name: � ,�'�)/-� � �a� Zip: .� � ��'.��
**NOTE** This Improvement Pernut DOES NOT authorize the consWction or installation of a septic tanlc system or any wastewater system. An
AIJTHORIZATION FOR WASTEWATER SYSTEM CONSTRUCTION must be obtained from this Department prior to the
cpnstruction/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 SIT'E
r- �� �<i ; e,{' �� , >'',� � _.i�% � , `r - .. ;'' �; ' PLANS OR TI� INTENDED USE CHANGE. YOUR.WASTEWATER
�;�
�ENVIRONMENTAL HEALTH SPECIALIST DATE ISSUED SYSTEM CONT'RACTOR MUST SEE TEIIS PERNIIT BEFORE
, INSTALLING TI� SYSTEM. ,
RESIDENTIAL SPECIFICATION: BUILDING TYPE ��rn # BEDROOMS, # BATHS _� # OCCUPANTS GARBAGE DISPOSAL: Yes or No
COMMERCIAL SPECIFICATION: FACILITY TYPE # PEOPLE # PEOPLFJSHIFT # SEATS INDUSTRIAL WASTE: Yes or No
LOT SIZE ��fl C TYpE WATER SUPPLY DESIGN WASTEWATER FLOW (GPD) NEW SITE REPAIR SITE
SYSTEM SPECIFICATIONS: TANK SIZE /a00 GAL. PUMP TANK GAL. TRENCH WIDTH �„�� ROCK DEPTH �-� � LINEAR FT. �GF'� �
� � � ` i / � ' _ . _ / , i�, / / i _ .
REQUIRED SITE MODIFICA1,vn�i�v,vu► i iviv�:
IMPROVEMENT PERMIT LAYOUT
**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 - 130 P.M. ON THE DAY OF INSTALLATION. TELEPHONE # IS (336)751-8760.
� OPERATION PERMIT
SYSTEM INSTALLED BY:
V �
�
P/ " � ' E�
� �� � �9� � ��
�� �/? � _
� � �� ���
��
�e� ,�����' -
C � � �s
,�
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, (a �
$a �.,� ,��,9
� / �� �
s
AUTHORIZATION NO. � OPERATION PERMIT BY: DATE:
�
**Ti� ISSUANCE OF THIS OPERATION PERMIT SHALL INDICATE THAT THE S TEM DESCRIBED ABOVE HAS BEEN INSTALLED IN COMPLIANCE
WITH ARTICLE 11 OF G.S. CHAP'TER 130A, SECTION .1900 "SEWAGE TREATMENT AND DISPOSAL SYSTEMS", BUT SHALL IN NO WAY BE TAKEN AS A
GUARANTEE THAT THE SYSTEM WII.L FUNCfION SATISFACTORILY FOR ANY GIVEN PERIOD OF TIME.
DCHD OS/96 (Revised)
. APPIJCAl10N FUR SITE EVAUlAl1UN/IMPROVEMEM PEflMIT & A
! ` , Davie County Health Oepartrnent [� � � Q �] [�
'� � - Environmenta/Nea/lfi Se+cifon a
�+'� �' P.O. Box 84B/210 Hospital Street �� 9�
• Mocksville, NC 27028
�336�751-8760
EtaVIRONP,IEPJTAL NEALTH
***ZMPORTANT*** THI3 APPLICATION CANNOT BE PROC�ESSED UNLE33 ALL I
INFORMATION IS PROVIDED. Refer to the INFORMATION BULLETIN for instructions.
1. Name to be Hilled Contact Person
!lailing Address Hame Bhone _�����/�/
City/State/zIp _��[Y1� f///�(� �t �//,7��f Businesa Fhone ��i - 7��' ���U
2. tiame on Ye�it/ATC if Diflerent than Above '"`
Nailiag Addres� �'— City/9tate/Zip —"-
3. Application Sor: Od' 3ite Evaluation .C! Improv�em�ent Pe=mit/ATC ,t7 Both
�. Bystem to Service: 0 House ❑ Mobile Home � Business ❑ Industry �Other
s. i� Resideace: # People � Bedrootns � Bathrooms
0 Dishxasher O Garbaqe Diapoaai 0 ifashing 1lachine U Hasement/plumbinq 0 Buemeat/No Piumbinq
� 6.1 I! Suaineas/InQuatry/other: Specity type ���/1i # Feopie � Sinks _�
��
# Co�odes �_ # Showera �_ � Urinals • Nater Coolers
IF FOOD3ERVICE: � 3eats Estimated i+Tater Osaqe (galions per day>
7. �pe of water supplp: U Conaty/City ri i%11 0 Comua�nity
s. Do you anticipate addition� or e:pansions ot the facility thi� eystem is intended to aervei 0 Yes 9'No
lf ye�, wbat type'
""*IMP�ORTANT"• CLIENTS MUST COrtPLETE THE REQUIRED PROPERTY INFORMATION REQUESTED
BELOW. Eit6et a PI.AT or StTE PI.AN AtUST BESUBMITTED by the cllent wit6 TIiIS APPI,iCATION.
o, a.sY
Property Dimenaiona• ��' WRITE DIRECI'IONS (trom Mocksville) to PROPERTY:
Ta:Ofiice PIN: # .� 83i- �o -- ��s/ .1�400�� �o/ �I/� �z-���r1A � . /��.�.v
Property Addre�a: Ruad N �D�.,%�/j%�
—
City/Zip �j//� �' �
a�GaB
If in a Subdivision prnvide informatio�, as followa: � ��
Name:
Section: Block: � Lot: Date Property Flagged: ��- ' a�� q�
Thi� is to certify that t6e ioformation provided is correct to the best of my knowledge. I underatand ihat any permit(s)
issued hereafter are subject to suspeasion or revceation, if the aite plans or intended use cbange, or if the intormation
submitted in this applieation ia talsiGed or c6anged I, also, understand that I am responsible jor all eharges i�rer�rred from
this application. I, hereby, give consent to the Aut6orized Representative ot t6e Da� �' jCounty Heal�epartment
to enter upon above described property located in Davie County and owned b�- / i I� `� /r�}'� LD /�
to conduct all teatiug procedurea as necesaary to determine the site suitabilih�.
DATE ,L� -� 9- 7� SIGNATURE L
Tfl[S AREA MAY BE USED FOR DRAWINC YOUR SITE PI.AN (Iaciude all of t6e toliowing: E�sting and proposed
property lines and dimensions, atructures, aetbacks, and acptic Iceations).
Revised DCHD (07/98)
�
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p� ��- )C° _ Q.
�ARn1 � ��>o.r'� `Q�',�
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5�� ��
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Pf �,
Account No. �� _
lavoice No. � �
�
� • " DAVIE COUNTY HEALTH DEPARTMENT
'` �' Environmental Health Section SECTION r.oT
� SoiUSite Evaluation
APPLICANT'S NAME l a DATE EVALUATED ,�/��
PROPOSED FACILITY �,� ('�,� PROPERTY SIZE __ �l'i�
SUBDIVISION ROAD NAME �,%�
Water Supply:
Evaluation By
On-Site Well Community
Auger Boring � Pit
I��J►[e�I��:�u/:�K�1�IJ1/:�►`[y�.711Y�1
SITE CLASSIFICATION: �' /
�
LONG-TERM ACCEPTANCE RATE: -
REMARKS:
DCHD (O1-90)
Public ��
Cut
EVALUATION BY:
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
Wet
NS - Non sticky
NP - Non plastic
FR - Friable FI - Firm VFT - Very firm EFI - Extremely firm
SS - Slightly sticky S- Sticky VS - Very Sticky
SP - Slightly plastic P- Plastic VP - Very plastic
tructure
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
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