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521 Cedar Grove Church RdDavie Countv, NC Tax Parcel Report Tuesday, October 11, 2016 WA1t1V11V1i: 1111�J 1� 1rV 1 H�UICV L' Y Parcel Information Township: Fulton Municipality: Census Tract: 37059-804 Voting Precinct: FULTON Planning Jurisdiction: Davie County Zoning Class: DAVIE COUNTY R-A Zoning Overlay: Voluntary Ag. District: No Fire Response District: FORK Elementary School Zone: CORNATZER Middle School Zone: WILLIAM ELLIS Soil Types: PaD,Pc62,PcC2 Flood Zone: Watershed Overlay: DAVIE COUNTY Outbuilding & Extra 0.00 Freatures Value: Total Market Value: 124490.00 Parcel Number: NCPIN Number: Account Number: Listed Owner 1: Mailing Address 1: City: State: Zip Code: Legal Description: Assessed Acreage: Deed Date: Deed Book I Page: Plat Book: Plat Page: Building Value: K700000043 A 5767847102 10836000 BROWN JESSIE J III 521 CEDAR GROVE CHURCH ROAD MOCKSVILLE Land Value: Total Assessed Value: NC 27028-0000 1.025AC CEDAR GROVE CH RD 0.85 6/1965 000720385 108920.00 15570.00 124490.00 9"��^'F Davie County, �o�,p�c" NC .. .�..'.,. �. ,�... „s:' ;.. F•�.. ... r ... �. , . ,... . -. ... r� � . . .. . � . . ... . . .. . ... � ... ... . _ . , �i ' . .. �..;'lv � � . .. . .�s�.' . .l..:r a... - . ... �.. c . _ . . . ( AUTHORi7ATION NO: � O O O DAVIE COUNTY HEALTH DEPARTMENT JY �� X v� � �%�` =� Environmental Health Section PROPERTY INFORMATION Perttri��ee's • � P.O. Box 848 Name: _�� ' f'D Mocksville, NC 27028 Subdivision Name: � � ' � Phone #: 704-634-8760 ,�,�_.-, . Directions toproperty: �y,%✓ ' �%J��q'<` Section: �-,- ,�� Lo[: � AUTHORIZATION FOR WASTEWATER Tax Office PIN:# =-� � � '�% - .� % SYSTEM CONSTRUCTION �1 � • ��„�,,; _ _ Road Name: t..o..f'�-c►�L . iP: ��Ck--�u **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 O�ce when applying for Building Permits. ' (In compliance with Article 11 of G.S. Chapter 130A, Wastewater Systems, Section .1900 Sewage Treatment and Disposal Systems) �� ,, � � �.- : �,�� ,, �, ***NOTICE*** THIS AUTHORIZATION FOR WASTEWATER CONSTRUCTTON � i; �,+`� �-f ,.^�-r<; N'�lr� f•� /, e�" l IS VALID FOR A PERIOD OF FIVE YEARS. ENVIRONMENTAL HEALTH SPECIALIST DATE ISSUED ,� .�:.� .,'.; .i..r .,...�..� _ � �� ..q , � .. .'" . . �'i.,. .--- -y . ' .. .... -' ' _ .'-_ _ , . ' ' �4"�':i ,// w:.,�� ,-~ � . . � � D��/ I ,fi' �/V �,,�� . � � — ,,, � - = s — DAVIE COUNTY HEALTH DEPARTMENT � ` ��- �=° f}�' IMPROVEMENT AND OPERATION PERMITS PROPERTY INFORMATION �� - - � P`erntitfee S, � `r � �1 - Naine:`+ �.�'' ��? a ��,'''�!� ,i . - . _ . � t�� e�"' � � � p}, Directions to propeity: ! r:' �'' �� '" f�'`� Il14PROVEMENT PERMIT Subdivision Name: Section: --� --=�� Lot: Tax Office PIN:#.'`'� ,�' � '�' - �' r- �" 'i J. i�: '. '2 1t r',.[�*,,. ...y�.�.-� � Y Road Name: � C• j•� .-+ St. �= '? r�"'��p: `�� **NOTE** This Improvement Pemut DOFS NOT authorize the construction or installation of a septic tank system or any wastewater system. An ALJTHORIZATION FOR WASTEWATER SYSTEM CONSTRUC'TION must be obtained from this Department priox to the "` . construction/nistallation 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) � f r' � ***NOTICE*** THI.S PERNIIT IS SUBJECT TO REVOCATION IF SITE �" f� `~' � PLANS OR Tf� IlVTENDED USE CHANGE. YOUR WASTEWATER �" , r' a��. � � ,;. ,. �: �. ! �, �' , �„ "' Y,f''�; � Yi''./� ENVIRONMENTAL HEALTH SPECIALIST DATE ISSUED SYSTEM CONTRACTOR MUST SEE THLS PERMIT BEFORE INSTALLING TI� SYSTEM. RESIDENTIAL SPECIFICAT'fON: BUII..DING T'YPE?;`'� +� # BEDROOMS �_ r # BAT'HS �# OCCUPANTS '� GARBAGE DISPOSAL: Yes or No f?�' �� COMMERCIAL SPECIFICATION: FACILITY TYPE # PEOPLE __ # PEOPLFJSHIFT # SEATS INDUSTRIAL WASTE: Yes or No LOT SIZE ,�� `� r TYpE WATER SUPPLY _l' i:� DESIGN WASTEWATER FLOW (GPD) �_. Sl/; /.1 NEW SITE �.1^' REPAIR SITE � ,/ � ,. SYSTEM SPECIFICATIONS: TANK SIZE ✓C' ? I GAL. PUMP TANK GAL. TRENCH WIDTH �-1 r� ROCK DEPTH %r LINEAR FT. �-� J''� **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 INSTALLAT'ION. TELEPHONE # IS (704) 634-8760. OPERATION PERMIT SYSTEM INSTALLED BY: ✓ ./l�,,�, ��= AUTHORIZATION NO. ��r OPERATION PERMIT BY: DATE: '' �✓ **THE ISSUANCE OF THIS OPERATION PERMIT SHALL INDICATE THAT THE SYSTEM DESCRIBED 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 OS/96 (Revised) � ..,... � t APPLICATION FOR SITE EVALUATION/IMPROVEMENT PERMIT & ATC ' Davie County Health Department ��7 �-- Environmental Health Section � � � v � P.O. Box 848 D Mocksville, NC 27028 AUG — 6 19�7 M (704) 634-8760 '�***IMPORTANT**** THIS APPLICATION CANNOT BE PROCESSE� THE REQUIRED INFORMATION IS PROVIDED. 1. Name to be Billed i'� �� J ��OC,'�%� �- Contact Person l 4e-Q�'\�\� �� ''�� Mailing Address � o l � ��Y' �v'c, i ��C'� � Home Phone C% � Qq � � Co �� City/State/Zip lI�,�C�__C�S L�� .�.0 . 7G�� Business Phone 2. Name on PermibATC if Different than Above �l' \��1 S�� ' � �� , �1�� '-' Mailing Address City/State/Zip �"i �`X' ��S U�� .�� ' . 7C�� SS 3. Application For: [] Site Evaluatio " provement Permit & ATC �i]'goth 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 [�No If yes, what type? PROPERTY INFORMATION REQUIRED: *** IMPORTANT *** bY.�'tiT.�1'�COF THE PROPERTY MUST BE y � SUBMITTED WITH T�II�S APPLICATION. Property Dimensions: 1 � k� a�� ; WRITE DIRECTIONS (from ��Iocksville) TO PROPERTY: Tax Office PIN: # � 7 - O - 7l02 ;`��i 11� �./-� C►�si -�c� C�c��r C-yrt? 4�� PropertyAddress: Roa a� � �� `Jli.� �/1 i��I �"�cr"�"1 l�,cirf' CGc:• I �� City/Zip If in Subdivision provide information, as follows: Name: Section: Lot #: C r��.. v� ny r — t?��h�t �� hausc u.�.'� 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 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 n, t n bY�,��5'��r `(�,Cc�i9�/�� DATE SIGNA' Revised DCHD (06-96) THIS �i1tEA �1flJ $E � �3�� all testing procedures as �OIZ �LZrIWINC JOULZ SZTE PL.tIN: a p to determine the site suitability. v- :M �y� o''ti R �� i F .�"�9 ' � �,. �� ix,' 't� �S7' � `�'t. �. .%!� �S ,'3. .� �� 1 ..i�i � ' a. .s.. �', } � k '�:.Y]�; f�0ir � r ;�'; `7�: .Yvlr sr,,; . 95 K r ' ' � �j Y,t ,. � . ,,. � �I ` �� .. /� � rr l �' T � ��( +^��' • �� '° i�" 0'� '�k r, � - �'F fi��.? �iSi� �\.1'��.: �f�� , .t ._ ty �v - d ,j: ��z A ..I.. �� ^� �. ' . ti �, , v �� yx � fi�+' s ��" `✓�, t/ h �� F � �;< t,�� NL�3� � 'v � ! 3 U� �"'a�"� '^, � �'1 ,� �=F , -� �� r --, - - � � . �� y � } C \ . � tk �: a �{ '� F a ✓ 'h 3� 1 `^�� . � � � � '� i .. �. .' � a: :.Vr �`t �:'�,? € � z �",� t r � "t�� . � -i' � � •>, ,r :s tr y �'. � ti `. ' , r ,� " ;: � 9 . y � 3 � � i� � 4� 1 � ,q S m y ,� � � „_ f ry i� f _ f� i � .:� yl t . y{ � ,r L 1 W S ��yT �� p? ` A �y. : i ;'� 7 , �j ,� � ' r,.� ; � `' � i � , rY M�d� �i` ��,��y�xi@t��.Fd��4� �� (Z� Y � i �` �'h ;4 � �Y � f !�� .9�� f� sF e .��k .� '��}r,` �' � � � m" ��f� ••��N j� H �"kYy';'��y �� !;£ � * R �w/ ,. .E 4 �:� Y �sd i��`� I �'� i'� � �� f R, A. �� y��, ,�j '�� ; �� ' t 4 i'. Y�'� �4 `L , "� � �A '�p ,.: «3 � h�'� _ 3�'1 f �o. . � � � �� i � t`.�3 �: :" � .yat ,y r ��x`�'�, ,z, r y �� i'bs'Mr �.�•' .. f 1 �� ,� �� j- � � .i�- r��, 1- =�`, r`� „t, �' �` ` ° l ZQ ��',,.� ,9 ' �' ; � �y � ..� � } "}� �� ' � y 4 '3�'�� £ ;k �1 L"�} ��'Y� `. �� 'v �YI � � � '- �� .. � . �"'�'! ��2f3 . � � 2.fi7 ' ,^_' �/ �v �.� . ` e � ��'r� 3 � ;�, _ & . <'c^ s��xt?�i°'.. . �..._ . . �, ,7 P ` ( C T �� t � �. r .,.� � . . . .a � .- .. • � ' DAVIE COUNTY HEALTH DEPARTMENT .• Environmental Health Section SECTION LOT 5oi1/Site Evaluation , APPLICANT'S NAME ��LtJI'�/ DATE EVALUATED �// ! "G� PROPOSED FACILITY T%�I �y` PROPERTY SIZE �i'�e SUBDNISION ROAD NAME 1� �Jl_t.a✓� � -�� • Water Supply: Evaluation By: 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 S[ructure Mineralogy HORIZON IV DEPTH Texture group Consistence On-Site Well Community Auger Boring Pit SOIL WETNESS RESTRICTIVE HORIZON SAPROLITE 1 I 2 LONG-TERM ACCEPTANCE RATE I . �/ I. SITE CLASSIFICATION: �� LONG-TERM ACCEPTANCE RATE: REMARKS: DCHD (O1-90) Public 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 - 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 VFI - Very firm EFI - Extremely frm SS - Slightly sticky S- Sticky VS - Very Sticky SP - Slightly plastic P- Plastic VP - Very plastic Structure SC - Single grain M- Massive CR - Cnzmb GR - Granular ABK - Angular blocky SBK - Subangulaz blocky PL - Platy PR - Prismatic Mineralogv 1:1, 2:1, Mixed No es 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 ■■■■ ■��■ ■��■ ■■�■ ■■■■ ■■�■ ■�■■ ■��■ ■■�■ ■■■■ ■■�■ ■■�■ ■■■■ ■■■��■��■■�■■■■�■ ■■■�■■■■■■■��■■ ■�■��■■�■■■■�■ ■��■■■■■■■■■��■ ■�■�■■�■■��■■■■■■ ■■■��■��■ ■��■��■■■■■�■�■ ■��■■■■■■��■�■ ■■■��■�■■■■■■ ■��■�■■■■��■�■��■�■ ■��■�■■■■■■■�■ ■��■�■■■■��■■■�■■�■ ■��■■■■■■��■■��■■ ■��■■��■�■■■■■��■■ ��■■��+�� ■��■■��■■■■��■�■■ ■�■■■■■■■■■��■■ ■�■■��■��■�■�■■■■�■ ■■■■��■�■■■■��■■��■ ■■■■■■��\��l1�1■■■■ ■��■■��■��■■��■�:�■■■■ ■�■�■��■■■■��Llrl��■■ ■�■��■��■■■■■■■��■�■ ■�■■■■■■■��■■■ ■�■■��■��■■■■■■■�■■�■ ■■■■��■��■■�■■■■ ■�■�■■■■■■■■■■��■�■ ■■■■■��■■�■■��■�■ ■■■■��■��■�■ ■�■■■�■�■�■■��■■��■■■ ■��■■■■■■��■�■ ■�■■��■�■■�■■■��■ ■��■�■■■■ ■��■�■■■■�■■��■�■ ■■■■��■��■■■■■■��■�■ ■■■■■■�■��■��■■■■��■�■ ■�■■��■��■��■■�■■■■ ■■■■■■■��■■�■��■■��■ ■�■�■■■■■■■��■■■■■■��■ ■■��■■��■��■�■�■ ■�■■■��■�■■��■�■��■�■ ■■■■��■��■■■ ■�■�■■■■■■■■■■■■■��■ ■�■��■��■■ ■■■■■■■■■■■■■■�■��■■ ■�■�■��■��■■■■■■■ ■��■■■ ■■��■ ■��■■■ ■��■ ■��■■■ ■��■■■ ■��■■ ■■��0■ ■�■�■■ ■■■■■■ ■��■■ ■■■�■■ ■�■��■ ■�■■�■ ■�■��■ ■■■�■■ ■■■��■ ■�■■■■ ■■�■■■ ■�■��■ ■��■■ ■■■��■ ■�■■�■ ■■■■■■ ■�■■■■ ■��■ ■■��■ ■�■■■■ ■�■��■ ■��■ ■��■ ■��■ ■��■ ■�■■■■ ■��■ ■■■■■■ ■��■ ■■■■■■ ■��■ ■�■■�■ ■��■ ■\��■ ■■■■■■ ■■�■�■ ■■��■■ ■■■■■■ ■■■��■ ■■■■■■