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469 Cedar Grove Church RdDavie Countv, NC Tax Parcel Report Tuesday, October 1 l, 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: W AKl�l11V l=: 1 I11� l� 1� V 1 L� .� Ult V� Y Parcel Information K70000004701 Township: Fulton 5767942290 Municipality: 82522420 Census Tract: 37059-804 SPEAKS JACK B Voting Precinct: FULTON 469 CEDAR GROVE CHURCH ROAD Planning Jurisdiction: Davie County MOCKSVILLE Zoning Class: DAVIE COUNTY R-A Land Value: Total Assessed Value: NC 27028-7115 2.410 AC CEDAR GROVE CHR 2.19 3/2004 005430357 60120.00 29800.00 90800.00 Zoning Overlay: Voluntary Ag. District: Fire Response District: Elementary School Zone: Middle School Zone: Soil Types: Flood Zone: Watershed Overlay: Outbuilding & Extra Freatures Value: Total Market Value: No FORK CORNATZER WILLIAM ELLIS Pc62,PcC2 DAVIE COUNTY 880.00 90800.00 �,vi All data is provided as is without warranry or guarantee of any kind either ezpressed or implied including but not Iimited to the 9�" e F D�vie County� Implied warranties of inerchantability or fitness for a particular use. All users of Davia County's GIS website shail hold harmless the N� County of Davie, North Carolina, its agonts, eonsultants, contractors or employees from any and all claims or causes of action tlue to np��N,�" or arising out of the use or inability to use the GIS data provlded by this website. _ _ :, q,+v:.,�rlC � �rr�`b. n,,�.yY..rs -•..�..,r:. (�.r9�9.M.- •• �-i�niy':Je... . � a.�-:. . ,�v...,:;�7 _ ,.,. .,�..i.... . ` ?. . . r 3 _ .+r�...i'" ,f.i r=r:^r . ... - l � �XD , ALJT[-�C�IZATION NO: �� DAVIE COUNTY HEALTH DEPARTMENT _. `�• r= . ! Environmenta! Health Section PROPERTY INFORMATION Permittee's„�,..•��" P.O. Box 848 Name:•=�t��'}a'9et �.(':.. Mocksville, NC 27028 Subdivision Name: /j --x ;/ Phone # 336-751-8760 Directions to property: r'/%;- �� i�.�: ��'' ..(, ~ • {' � . r Section: Lot: AUTHORIZATION FOR �;: ,� WASTEWATER F.* .�. ,/r* �, p ;� l ,f,,� SYSTF,M CONSTRUCTION Tax Office PIN:#_„�",� �i`- �?.� -� �� : /t /� � (�� u r�: �� - Road Name: L.��"' CTi'rl'�ip: c2 CJ: ig **NOTE** This Authorization for Wastewater System Conswction MUST BE ISSUED by the Davie Counry Environmental Health Section prior to issuance of any Building Permits. This Form/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) �/ / L--ti� �� . r` ***NOTICE*** THIS AUTHORIZATION FOR WASTEWATER CONSTRUCTION ,- �'` � j/.f;�,i' �:�f./�� . ��' �;� �<3 IS VALID FOR A PERIOD OF FIVE YEARS. ENVIRONMENTAL HEALTH SPECIALIST DATE ISSUED f�.1.;�� f��"i.�9. .�.. na..::_✓�. :. ....�� ..:v��:s„-N-.�.a.� __" �§i: '- ��.. •. . ,.. � �.�. � .. _.'. , . ..... . .-.. ...... . . '1. . . ' � r �s.- - ' _ A c�XO . , � �� f�� DAVIE OUNTY HEALTH DEPARTMENT M 'a � +�. . �. �.,�r;�~ , TMPR , VEMENT,.�AND,OPERATION PERMITS PROPERTY INFORMATION Pernvttee's�,.:�. ^�" _ _ -Name"�""� „ �� ,� :'r`r �,�=� � Subdivision Name: , �� , , Direct�ons to property: t- •' Section: Lot: IMPROVEMENT �'`��r r . PERMTI' Tax Office PIN:#..�`"'ws f:' �� —��' r:' - � � �� p. _i i+.. �, � i(; ..� l f ti,-� � ` '"" [.T"� j ��` *-.- + ", ,.. � Road Name �..t;:-� t t .� 2ip; -�: �,:.,, ti �*NOT'E** This Improvement Pemut DOES NOT authorize the consWction or installation of a septic tanic system or any wastewater system. An AUTHORIZA'fION 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. ' Tn compliance with Article 11 of G.S. Chapter 130A, Wastewa[er Systems, Section .1900 Sewage Treatment and Disposal Systems) ,, �. �, � ..�Nviit;�,.•• ir� r�xmii � �u�sJ�i:i iv x�vu�wii�iv ir �ilr. ; . �` �;, , `�'�� , ;; { � ;' �'� ` PLANS OR TIiE INTENDED USE CHANGE. YOUR WASTEWATER � y�� f � SYSTEM CONTRACTOR MUST SEE THIS PERMIT BEFORE ENVIRONMENTAL HEALTH SPECIALIST DATE ISSUED INSTALLING T'I� SYSTEM. . ; _ . . •_�. .. RESIDENTIAL SPECIFICATION: BUILDING TYPE �� # BEDROOMS _� # 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 �_ DESIGN WASTEWATER FLOW (GPD) �. �v NEW SITE %� REPAIR SITE SYSTEM SPECIFICATIONS: TANK SIZE '% GAL. PUMP TANK GAL. TRENCH WIDTH l�, ROCK DEPTH��.i�_ LINEAR FF� n+� OTHER REQUIRED SITE MODIFICATIONS/CONDITIONS: 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 - 1:30P.M. ON THE DAY OF INSTALLATION. TELEPHONE # IS (336)751-8760. OPERATION PERMIT � SY M INSTALLED BY: _( � � p�a�k3 � �' �� AUTHORIZATION NO. � OPERATION PERMIT BY: DATE: /� "'+THE ISSUANCE OF THIS OPERATION PERMIT SHALL INDICATE THAT THE SYSTEM DESCRIBED ABOVE HAS BEEN INSTALLED IN COMPLIANCE W1TH ARTICLE 11 OF G.S. CHAP'TER 130A, SECTION .1900 "SEWAGE TREATMENT AND DISPUSAL SYSTEMS", BUT SHALL IN NO WAY BE TAKEN AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORILY FOR ANY GIVEN PERIOD OF TIME. DCHD OS/96 (Revised) .,.,�. . APPLICA710N FOR SITE EVALUA710N/IMPROVEMENT PERMIT & � Davie County Health Department � - Environmenta/HealdrSecdon P.O. Box 848/210 Hospital 3treet Mocksville, NC 27028 �336)751-8760 1 � • �,: ***.T.1►�ORTANZ'�** THI3 APPLICATION CANNOT 8E PROC'.LSSED L1NLE33 ALI, THE REQUIRED INFORMATION IS PROVIDED. Refer to the INFORMATION BULLETIN for instructions. i. Name to be Hilied � /iJi � f� Contact person / 6�m/l7i ��' Nailinq Addresa ��„( Q �f�,��l�'/,�'JS � So�ee Fhone City/State/Zip ��/%C� �f ,c.�. Z�o a � Businesa Phone /,5�� /�/,j 2. Name on Pe�oit/ATC if Differet�t than Above )failing Address City/8tate/21p 3. Application For: �ite Evaluation �mprov�ement Peaait/ATC �th 4. system to service: 0 House �Mobile Homa 0 Busiaess ❑ Industry ❑ Other 5. If Residence: # People �_ # Bedrooms �_ • Hathrooms ! �Dishxasher D Qarbaqe Diapoaal tl�ashing Machine O Basement/Plumbing 0 Basement/No Blumbinq 6. If Bnainess/InQuatry/Other: Specify type # peaple � Coaomodes � 8hrn+ers � Urinala / Sinks � ftater Coolers IF FOOD3ERViCF: � 3eats Estimated Nater Usage (qailons per day) 7. Type of Nater supplp: ❑ Couaty/City �ell ❑ Co�tunity s. Do you anticipate additions or e:pansions of tde facility t6is ayatem is intended to serve? 0 Yes (�No U yes, w6at type' *"IMFIDRTANT"! CLIENTS MUST CD�1iPLETE THE REQUIRED PROPERTY INFORMATION REQUESTED BELOW. Eit6er a PI.AT or SITE PLAN �fUST BESUB�1tITTED by the client wit6 THIS APPI.ICATION. Property Dimensions: ,�� y� G% l'/�/.S WRITE DIRECfIONS (from Mocicsville) to PROPERTY: Tai Office PIN: # .5�6 x 9 � � �o?�O �, Ob0 � P�� y� �o ��rk ; /�� a � �'P�� /r'�� v�q � Prnperty Address: Road Name CP�u� 6i��e L��iu��,� �tiU�� /�� ,%� �n.% �n�r 7v /1�ui �.�/�° c�t�iz�p /nac .s�.//e ,l�zT� �n l��'7`. lf in a Subdivision provide information, a� follows: NAme: Section: Block: Lot: Date Property Flagged: // //- 9� This is to certify t6at tbe ioformation provided is cor��cct to the best of my knowledge. I understand that any permit(s) issued hereafter are subject to auspension or revocation, if the site plans or intended uae change, or if t6e informatioa submitted in t6is applicatioa is falsified or c6anged. I, also, anderstand that I am responsiblejor all clbarges incr�rred from this application. I, hec+eby, give conaent to the Authorized Repr�sentative of t6e Davie County Health Department to eoter upon above described property located in Davie County and owned b�- to conduct all teating procedurea as necessary to determine the aite suitabilit;��. DATE !/ '%� � / O SIGNATIIRE/� � THIS AREA MAY BE USED FOR DRAWING YOUR SITE PLAN (Include all of the tollowing: Eiisting and prnposed property lines and dimensiona, atrnctures, setbacka, and septic locations). Revised DCHD (07/98) Account Na v� lo � Invoice No. 3� � M; ti; r �/D' o �-� �''°i�O�f� ��e H - � ''='�� ' � � . DAVIE COUNTY HEALTH DEPARTMENT .� Environmental Health Section SECTION LOT Soil/Site Evaluation APPLICANT'S NAME �,.,(Z[� DATE EVALUATED �� `7 � ��: PROPOSED FACILITY .!%%/� , PROPERTY SIZE _ �I'i �' SUBDIVISION ROAD NAME �/_�G��'��o�-c � �`r Water Supply: On-Site Well Community Public Evaluation By: Auger Boring Pit Cut HORIZON III DEPTH Texture group ('nncietrnrP 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 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 tructure SC - Single grain M- Massive CR - Crumb GR - Granular ABK - Angular blocky SBK - Subangular 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 DCHD (OI •9Q) ■■■�■■■ ■�■��■■ ■�■■�■■ ■■■��■■ ■��■�■ ■■��■�■ ■�■■��■ ■��■■ ■��■��■ ■■��■�■ ■■■�■�■ ■�■��■■ ■�■■ ■�■■ ■��■ ■��■ ■�■■ ■�■■ ■��■��■ ■��■��■■�■ ■��■�■■�■ ■■�■��■ ■■��■�■■■�■ ■■■�■■■��■ ■■�■�■�■■■ ■�■■��■�■■ ■�■��■■■■ ■��■■��■ ■�■��■■�■ ■■■�■�■■�■ ■��■��■■■ �■�■■�■ �■�■■■ ■��■■��■ ■�■�■�■■�■ ■��■��■■■ ■�■■■��■�■ ■■■e�■�■■■ ■■■��■■�■■ ■■■��■�■■ ■■■��■�■■ ■�■��■■ ■�■■■��■�■ ■■■��■�■■■ ■��■■��■■ ■■��■�■■ ■■�■��■■■■ ■ ■■ ■ ■�■��■ ■■�■ ■■■■ ■■��■■ ■■��■■ ■■■■■■ ■�■■�■ ■�■�■�■��■■■■■ ■■■�■�■■ ■�■�■■ ■�■■��■��■■��■■■ ■��■■■��■■ ■��■��■■�■■�■�■ ■■■�■�■�■��■■��■ ■�■��■■��■��■■■■ ■�■■��■■�■■��■■■ ■��■�■��■■ ■■�■■■�■ ■■�■�■ ■��■��■��■ ■■■�■�■��■■��■ ■�■�■�■■��■■■■ ■■■��■��■■�■■■■ ■■�■�■�■■�■��■■ ■■��■■��■��■ ■■��■■■��■■��■ ■■■�■�■■ ■■■■�■ ■�■■t'��■■■�■■�■■ ■��■�r��■■■�■�■■ ■■�■■■�■■�■■��■ ■��■■■�■�■��■ ■�■�■■■�■��■■■�% ■■��■N ■■■��■■ ■■■■�■■ ■■■■�■■ ■■�■��■ 1ii��■ ■�■�■�■ ■■��■ � ■■■■■ ■■■■�■■ ■��■��■ ■��■��■ ■��.� ■■■■■��■ ■■■�■��■ ■�■��■�■ ■�■��■■■ ■■�■�■�■ ■��■��■ ■��■■ ■■��■�■■ ■�■�■�■■ ■�■�■■�■ ■■■��■■■ ■��■■■ ■��■�■ ■■�■��■■ ■■■■■��■ ■■■��■�■■■■��■■ ■�■■�■■�■�■��■ ■�■��■�■�■■■�■ ■■��■�■�■��■■■ ■��■�■��■■ ■■�■��■■■■ ■■■■��■�■��■■ ■��■�■�■�■�■■ ■��■■■■■��■■ ■�■■■��■■■�■ ■��■�■�■��■■t■ ■■�■��■■■�■ ■■��■■■■��■■ ■��■■�■�■�■�■■ ■■■■�■��■�■■ ■■■■��■�■■ ii ii ■■ ■■ ■■ ■� ■■ ■■ ■■ ■■�■ ■�■■ ■�■■ ■■■■ ■�■■ ■t■■ ■�■�■■■■ ■�■��■�■ ■�■��■■■ ■��■��■■ ■■�■■��■ ■■��■��■ ■■■�■��■ ■�■�■■■■ ■�■■■■■■ ■�■■�■■■ ■��■��■ ■■�■��■ ■■■�■�■■ ■�■�■�■■ ■��■�■■ ■��■ ■�■■■ ■��■ ■■��■ ■��■ ■�■�■ ■�■�■ ■■��■■ ■■��■��■�■■ ■��■■■�■■■ ■�■■�■■��■■ ■��■■��■ ■�■■■�■■■�■ ■�■■■��■■■■ ■��■■��■■ ■■��■ ■■■■■ ■■�■ ■■■■■��■■�■ ■�■��■■�■ ■��■■�■■ ■■��■��■■�■ ■■��■■■�■ ■�■�■■��■■■ ■�■��■■■��■ ■�■■��■ ■��■■��■ ■��■�■��■ ■■��■��■■■ ■�■�■■■■��■■ ■�■■■��■��■ ■��■■■■■��■ ■��■■■��■ ■��■■��■■�■ ■■�■��■■■■ ■■��■�■��■�■ ■��■■��■■■■ ■■■�■��■■ ■��■■�■��■■ ■�■■�■�■��■■ ii ■■ ■■