193 Dalton RdDavie County, NC Tax Parcel Report 6 0 R(,
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l data is provided as is without warranty or guarantee of any kind either expressed or implied including but not limited to the
Davie County, NCimplied warranties of merchantability or fitness for a particular use. All users of Davie County's GIS website shall hold
harmless the County of Davie, North Carolina, its agents, consultants, contractors or employees from any and all claims or
causes of action due to or arising out of the use or inability to use the GIS data provided by this website.
WARNING: THIS IS NOT A SURVEY
Parcel Number:
J600000014
Township:
Mocksville
NCPIN Number:
5757198393
Municipality:
Account Number:
82521024
Census Tract:
37059-807
Listed Owner 1:
DOULIN LILLIAN D
Voting Precinct:
SOUTH MOCKSVILLE
Mailing Address 1:
193 DALTON ROAD
Planning Jurisdiction:
Davie County
City:
MOCKSVILLE
Zoning Class:
DAVIE COUNTY R -A
State:
NC
Zoning Overlay:
Zip Code:
27020-5116
Voluntary Ag. District:
No
Legal Description:
1.87 AC DALTON RD
Fire Response District:
FORK
Assessed Acreage:
1.49
Elementary School Zone:
CORNATZER
Deed Date:
2/2003
Middle School Zone:
WILLIAM ELLIS
Deed Book f Page:
2002EO105
Soil Types:
WeB,MsD
Plat Book:
Flood Zone:
x
Plat Page:
Watershed Overlay:
-
Building Value:
103290.00
Outbuilding & Extra
1120.00
Freatures Value:
Land Value:
21890.00
Total Market Value:
126300.00
Total Assessed Value:
126300.00
[w]
l data is provided as is without warranty or guarantee of any kind either expressed or implied including but not limited to the
Davie County, NCimplied warranties of merchantability or fitness for a particular use. All users of Davie County's GIS website shall hold
harmless the County of Davie, North Carolina, its agents, consultants, contractors or employees from any and all claims or
causes of action due to or arising out of the use or inability to use the GIS data provided by this website.
Permittees DVI COUNTY HEALTH DEPARTMENT t
Namee:' '" V " .L7i} Environmental Health Section PROPERTY INFORMATION ----• -'
P.O. Box 848
Directions to property: Mocksville, NC 27028 Subdivision Name:
aL..... Phone #: 336-751-8760
I Section: Lot:
AUTHORIZATION FOR
WASTEWATER Tax Office PIN:#
SYSTEM CONSTRUCTION
AUTHORIZATION NO: 002643 A f Road Name: -JAip.
**NOTE** This Authorization for Wastewater System Construction MUST BE ISSUED by the Davie County 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 icl� 11 o G.S. fcZWtet`i, OA, Wastewater Systems, Section .1900 Sewage Treatment and Disposal Systems)
_ ***NOTICE*** THIS AUTHORIZATION FOR WASTEWATER CONSTRUCTION
_ q 'ti IS VALID FOR A PERIOD OF FIVE YEARS.
ENVIRONMEX A HEA_ H S ALIS \ DAT IS5 ED
RESIDENTIAL SPECIFICATION: BUILDING TYPE� ' Fes# BEDROOMS_ # BATHS # OCCUPANTS _(00—GARBAGE DISPOSAL: Yes or No
COMMERCiIAL SPEC^I,FIICCATTION: FACILITY TYPE # PEOPLE # PEOPLE/SHIFT # SEATS INDUSTRIAL WASTE: Yes or No
LOT SIZEPE WATER SUPPLY 0DESIGN WASTEWATER FLOW (GPD) NEW SITE REPAIR SITE
SYSTEM SPECIFICATIONS: TANK SIZE GAL. PUMP TANK GAL. TRENCH WIDTH _N_0�7 ROCK DEPTH R- LINEAR FT.
OTHER I tc-y)I u - I t ]k r ! of -i
REQUIRED SITE MODIFICATIONS/CONDITIONS: kr_� , L
IMPROVEMENT PERMIT LAYOUT
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FOR FINAL INSPECTION OF THIS SYSTEM PLEASE CALL BETWEEN 8:30 - 9:30 A.M. ON THE DAY OF INSTALLATION. TELEPHONE # IS (336) 751-8760.
OPERATION PERMIT 44A `y ` A t L�
SYSTEM INSTALLED BY: Jo*"�
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AUTHORIZATION NO..ZLR OPERATION PERMIT BY: DATE:
**THE ISSUANCE OF THIS OPERATION PERMIT SHALL INDICATE THAT TH SYSTE CRIBED ABOV AS BEEN INSTALLED IN CO PLIANCE
WITH ARTICLE I I 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.
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R'"' �' "° i PROPERTY
Name '' +'
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Environmental Health Section
INFORMATION
Direction's ioProPerty:
P.O. Box 848
Mocksville, NC 27028
Subdivision Name:
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Phone #: 336-751-8760
Section: Lot:
AUTHORIZATION FOR
WASTEWATER
SYSTEM CONSTRUCTION
Tax Office PIN:# - -- -�---
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002643 NO:
Road Name:_ "'+ t�i !
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**NOTE** This Authorization for Wastewater System Construction MUST BE ISSUED by the Davie County 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 1 I of G.S. Ofrap er 130A, Wastewater Systems, Section .1900 Sewage Treatment and Disposal Systems)
***NOTICE*** THIS AUTHORIZATION FOR WASTEWATER CONSTRUCTION
IS VALID FOR A PERIOD OF FIVE YEARS.
ENVIRONMEjVTA HEAL H SPC ALIS DATf ISSUED
RESIDENTIAL SPECIFICATION: BUILDING TYPE BEDROOMS _.Z�# BATHS # OCCUPANTS (+_ GARBAGE DISPOSAL: Yes or No
COMMERCIAL SPECIFICAT
ION: FACILITY TYPE % # PEOPLE # PEOPLE/SHIFT # SEATS INDUSTRIAL WASTE: Yes or No
LOT SIZE 1' -�`�b WATER SUPPLY l DESIGN WASTEWATER FLOW (GPD) NEW SITE REPAIR SITE
SYSTEM SPECIFICATIONS: TANK SIZE GAL. PUMP TANK GAL. TRENCH WIDTH ROCK DEPTH L ' �l
�~ LINEAR FT.
REQUIRED SITE MODIFICATIONS/CONDITIONS:
IMPROVEMENT PERMIT LAYOUT
3L 1
�srrnlG�
FOR FINAL INSPECTION OF THIS SYSTEM PLEASE CALL BETWEEN 8:30 - 9:30 A.M. ON THE DAY OF INSTALLATION. TELEPHONE # IS (336) 751-8760.
OPERATION PERMIT
SYSTEM INSTALLED BY: 44 "A N— L—T( J
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AUTHORIZATION NO. Zfoq5k OPERATION PERMIT BY: 1YNDATE:
**THE ISSUANCE OF THIS OPERATION PERMIT SHALL INDICATE THAT THII SYSTE ESCRIBED ABOV AS BEEN INSTALLED IN CO PLIANCE
WITH ARTICLE 11 OF G.S. CHAPTER 130A, SECTION .1900 "SEWAGE TREATMENT AND DISPOSAL SYSTEMS", BUT SHALL IN NOWAY BETAKEN, ASA
GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORILY FOR ANY GIVEN PERIOD OF TIME.
DCHDMM(eevisea) .'. f1�t?7 413973 --r-vvo ice,
DAVIE COUNTY HEALTH DEPARTMENT
Environmental Health Section
Soil/Site Evaluation
APPLICANT INFORMATION PROPERTY INFORMATION
Account #: Tax PIN/EH #:
Billed To: j IAJ bVOL114 Subdivision Info:
Reference Name: Location/Address:
Proposed Facility: Property Size: Date Evaluated: -� LO
Water Supply: On -Site Well Community Public
Evaluation By: Auger Boring Pit Cut
FACTORS •
1 2 3 4 5 6 7
Landscape position
Slope %
HORIZON I DEPTH
-- 1
Texture group
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Consistence
Structure
Mineralogy
HORIZON 1I DEPTH
Texture group
Consistence
r.
Structure
Mineralogy
HORIZON III DEPTH
Texture groupG
Consistence
Structure
Mineralogy
HORIZON IV DEPTH
Texture group
Consistence
Structure
Mineralogy
SOIL WETNESS .
RESTRICTIVE HORIZON
SAPROLITE
CLASSIFICATION
LONG-TERM ACCEPTANCE RATE
SITE CLASSIFICATION: EVALUATION BY:
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
Structure
'SC -Single grain M - Massive CR - Crumb GR Granular ABK - Angular blocky
SBK - Subangular blocky PL - Platy PR - Prismatic
Mineralogy
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 - gal/day/ft2 ,
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DAVIE COUNTY ENVIRONMENTAL HEALTH SECTION
APPLICATION FOR IMPROVEMENT PERMIT (REPAIR)
NAME �-- I LLQ 11�n1 -i�DO L I N PHONE NUMBER
ADDRESS >L—TD/J 7P -b SUBDIVISION NAME
LOT #
DIRECTIONS TO SITE
DATE SYSTEM INSTALLENAME SYSTEM INSTALLED UNDER
TYPE FACILITY NUMBER BEDROOMS 3 NUMBER PEOPLE SERVED c�
TYPE WATER SUPPLY l ,& , —A SPECIFY PROBLEM OCCURRING
DATE REQUESTED INFORMATION TAKEN BY
This is to certify that the information provided is correct to the best of my knowledge. and that I understand I am responsible for all charges incurred from this application.
SIGNATURE OF OWNER OR AUTHORIZED AGENT
Rev.1193
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