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381 Dalton RdDavie County, NC Tax Parcel Report l 41 Tuesday, September 27, 2016 60 �\ I id 4 • �O\ J\ I \ M \ N o N iJ �I a 0759 0 1769\\� lZ 00 Y \\ J�N t — 398 2574 'moo .__-- ___-l.230 -_ as 20 N 141 All data is provided as is without warranty or guarantee of any kind either expressed or implied including but not limited to the Davie County, NC implied 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 c - - Parer nformation Parcel Number: J60000002301 Township: Mocksville NCPIN Number. 5757070759 Municipality: Account Number: 82515524 Census Tract: 37059-807 Listed Owner 1: WILKES GLENN L Voting Precinct: SOUTH MOCKSVILLE Mailing Address 1: 365 DALTON ROAD Planning Jurisdiction: Davie County City: MOCKSVILLE Zoning Class: DAVIE COUNTY R -A State: NC Zoning Overlay: Zip Code: 27028-0000 Voluntary Ag. District: No Legal Description: 1.090 AC DALTON RD Fire Response District: FORK Assessed Acreage: 0.99 Elementary School Zone: CORNATZER Deed Date: 7/2000 Middle School Zone: WILLIAM ELLIS Deed Book/Page: 003400282 Soil Types: PaD,CeB2 Plat Book: Flood Zone: x Plat Page: Watershed Overlay: - Building Value: 110420.00 Outbuilding & Extra 0.00 Freatures Value: Land Value: 18150.00 Total Market Value: 128570.00 Total Assessed Value: 128570.00 141 All data is provided as is without warranty or guarantee of any kind either expressed or implied including but not limited to the Davie County, NC implied 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. PAID Date:� RECEIVED Received by' Testa Davie County Health Department 181� Environmental Health Section P.O. Box 848 210 Hospital Street Courier #: 09-40-06 Mocksville, NC 27028 Phone: (336) - 753 - 6780 Fax: (336) - 751-8786 ON-SITE WASTEWATER CERTIFICATION FOR DWELLING ala 11 beY� (Check One) Replacement Remodeling Reconnection �9y 9 g Name: ,� 1't 1Ll( pf Crp hS}Tl,L(5(_-y� Phone Number �-1 ! 61 t Mailing Address: 1-141 � 4 (p 9t, (Work) n Wih Skt n &s P� 11� G oZ�l� ? Email �o[ Ob ✓► { r i Ln l�" Q C(a Detailed Directions To Site: Property Address: 3� -Dal un 9 (A0 ;4 i NQ - Please Fill In The Following /I �n1formation.About The EXISTING Facility: Yt 1 Name System Installed Under: L�1 4 W I Type Of Facility: Q,51 d Py►CP . Date System Installed (Month/Date/Year): % - [' 06 Number Of Bedrooms:___q_Number Of People: Is The Facility Currently Vacant? Yes & If Yes, For How Long? Any -Known Problems? YesNo If Yes, Explain: Please Fill In The Following Information About The NEW Facility: Type Of Facility: to 1 X Is 1!1��_e L Number Of Bedrooms: Number of People Requested By: � T S� Date Requested: l.:20 ( 3 (Signature) For Environmental Health Office Use Only d X4b bu i I dm j WISP - Disapproved Comments: &a. -Al 5P?A 7a � 7 Environmental Health Specialist ���/�� _ Date: *The signing of this form by the Environmental Health Staff is in no wayintended, nor should be taken as a guarantee (extended or limited) that the on-site wastewater system will function properly for any given period of time. Payment: Cash heck Money Order. # 5,q:5 S Amount:$ ) 00 -CSO Date: �7 3 Paid By:Ll{aC66V CQ�,�� Received By: Account #: Invoice #: 1I �6 �� �Yiy� ? ; - -- DAVIE COUNTY HEALTH DEPARTMENT �r 7 Environmental Health Section P. O. Boz 848/210 Hospital Street Mocksville, NC 27028 (336)751-8760 IMPROVEMENT/OPERATION PERMIT Account #: 989900073 Tak PIN/EH #: 5757-07-1769 Billed To: Homemax Subdivision Info: Reference Name: <Glenn Wilkes::. Location/Address: Dalton Road -27028 Proposed Facility: Residence Property Size: 1.090 Acre (NEC 14 b r. 2455 **NOTE* This �mprovement/Operation Permit DOES NOT authorize the construction of a septic tank system or any wastewater system. An AUTHORIZATION 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 (in compliance with Article 11 of G.S. Chapter 130A, Wastewater Systems, Section .1900 Sewage Treatment and Disposal Systems). THIS PERMIT IS SUBJECT TO REVOCATION IF SITE PLANS OR THE INTENDED USE CHANGE. YOUR WASTEWATER SYSTEM CONTRACTOR MUST SEE THIS PERMIT BEFORE INSTALLING SYSTEM. Residential Specification: Building Type J7 #People #Bedrooms_ #Baths Dishwasher: l2f Garbage Disposal: ❑ Commercial Specification: Facility Type Lot Size Washing Machine: d Basement w/Plumbing: ❑ Basement/No Plumbing: ❑ Type Water Supply ei& #People #People/Shift #Seats Industrial Waste: ❑ Design Wastewater Flow (GPD) 'il90 Site: New lid Repair ❑ 3, System Specifications: Tank Size,%,L} GAL. Pump Tank GAL. Trench Widt � Rock Depth Af . Linear Ft��b Other: Required Site Modifications/Conditions: IMPROVEMENT/OPERATION PERMIT LAYOUT - APPROVED EFFLUENT FILTER. RISER(S) IF 6 " BELOW FINISHED GRADE. ****NOTICE: Contact a representative of the Davie County Health Department forfinal inspection of this system between 8:30 a.m. to 9:30 a.m. or 1:00 p.m. to 1:30 p.m. on the day of installation. Telephone # is (336)751-8760.**** Environmental Health Specialist's Signature: i� Date: DCHD 05/99 (Revised) . •. • • . Y DAVIE COUNTY HEALTH DEPARTMENT (�4L g-7- U v Environmental Health Section P. O. Boz 848/210 Hospital Street Mocksville, NC 27028 (336)751-8760 Account #: 989900073 Billed To: Homemax Reference Name: Glen W Proposed Facility: Residence IMPROVEMENT/OPERATION PERMIT Tax PIN/EH #: 5757-07-1769 Subdivision Info: Location/Address: '�Dalton Road -27028 Property Size: 1.090 Acre d4TC Number: 2455 **NOTE** E is mprovement/Operation Permit DOES NOT authorize the construction of aseptic tank system or any wastewater system. An AUTHORIZATION 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 (in compliance with Article 11 of G.S. Chapter 130A, Wastewater Systems, Section .1900 Sewage Treatment and Disposal Systems). THIS PERMIT IS SUBJECT TO REVOCATION IF SITE PLANS OR THE INTENDED USE CHANGE. YOUR WASTEWATER SYSTEM CONTRACTOR MUST SEE THIS PERMIT BEFORE INSTALLING SYSTEM. Residential Specification: Building Type #People , -;�— #Bedrooms #Baths 3 3I.CZ Dishwasher: Z Garbage Disposal: ❑ Washing Machine: d Basement w/Plumbing: ❑ Basement/No Plumbing: ❑ Commercial Specification: Facility Type #People #People/Shift #Seats Industrial Waste: ❑ Lot Size Type Water Supply eS Design Wastewater Flow (GPD) -1"X0 Site: New Er Repair ❑ 1, j. Ir System Specifications: Tank SizG%� GAL. Pump Tank GAL. Trench Width Rock Depth /g Linear Fts�,�b Other: .2 (a' A/& Required Site Modifications/Conditions: IMPROVEMENT/OPERATION PERMIT LAYOUT - APPROVED EFFLUENT FILTER, RISER(S) IF 6 K BELOW FINISHED GRADE. ****NOTICE: Contact a representative of the Davie County Health Department for final inspection of this system between 8:30 a.m. to 9:30 a.m. or 1:00 p.m. to 1:30 p.m. on the day of installation. Telephone # is (336)751-8760.**** e5kll tleallx Aep -/ Zoe �alrc me flk ev al 45, Environmental Health Specialist's Signature: Date: Z, DCHD 05/99 (Revised) ' DAVIE COUNTY HEALTH DEPARTMENT Environmental Health Section P. O. Boz 848/210 Hospital Street Mocksville, NC 27028 (336)751-8760 Account #: 989900073 Billed To: Homemax Reference Name: Glenn Wilkes Proposed Facility: Residence ATC Number: 2455 Tax PIN/EH #: 5757-07-1769 Subdivision Info: Location/Address: Dalton Road -27028 Property Size: 1.090 Acre AUTHORIZATION FOR WASTEWATER SYSTEM CONSTRUCTION **NOTE** This Authorization for Wastewater System Construction MUST BE ISSUED by the Davie County Environmental Health Section prior to issuance of any building permit(s). This Form/Authorization Number should be presented to the Davie County Building Inspections Office when applying for building permit(s) (in compliance with Article 11 of G.S. Chapter 130A, Wastewater Systems, Section .1900 Sewage Treatment and Disposal Systems). THIS AUTHORIZATION FOR WASTEWATER CONSTRUCTION IS VALID FOR A PERIOD OF FIVE YEARS. Environmental Health Specialist's Signature: Date: CERTIFICATE OF COMPLETION **NOTE** The issuance of this Certificate of Completion shall indicate the system described on Improvement/Operation Permit 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. 12z© &Nt, 34.3 >c _ to U�RSS �s� i u a.G'-rt72 ! sr C Septic System Installed By: Environmental Health Specialist's Signature: DCHD 05/99 (Revised) t ego 10 Ibl,3 KA -4 q 4_TlW5- Ll,-zr APPUCATION FOR SITE EVAUTATION/IMPROVEMENT PERMIT & Davie County Health Department Environment/ Heath S;eWon P.O. Box 848/210 Hospital Street Mocksville, NC 27028 (336) 751-8760 ***Ii4P0RTANT*** THIS APPLICATION CANNOT BE PROCESSED UNLESS ALL THE REQUIRED INFORMATION IS PROVIDED. Refer to the INFORMATION BULLETIN for instructions. 1. Name to be Billed wome / Q.0e Contact Person - �/Cryn idi lkeS Mailing Address / /53 6 -A, -Se Churc� �L� Home Phone 60 H 1,y7-96 13 City/State/ZIP /, c/SUi / be UC Business Phone%jai %/ 000 2. Name . on Permit/ATC if Differentthan Mailing Address �%-2��%��AAME/1, rl�+ •`K City/state/Zip � /iS�kV[. AL `a�S/� 7 3. Application For: V'Siit'e Evaluation ❑ Improvement Permit/ATC /�'' Goth 4. system to service: 2 --House ❑ Mobile Home ❑ Business ❑ Industry ❑ Other 5. if Residence: # People �_ # Bedrooms # Bathrooms 3 P Dishwasher ❑ Garbage Disposal CCK ashing Machine ❑ Basement/Plumbing ❑ Basement/No Plumbing 6. If Business/Industry/Other: Specify type # People # sinks # Commodes # shovers # Urinals # Water Coolers IF FOODSERVICE: # Seats 7. Type of Water supply: Estimated Water Usage (gallons per day) CSC unty/City e. Do you anticipate additions or expansions of the facility this system is intended to serve? If yes, what type? ❑ Community ❑ Yes &-N;- ***IMPORTANT*** CLIENTS MUST COMPLETE THE REQUIRED PROPERTY INFORMATION REQUESTED BELOW. Either a PLAT or SITE PLAN MUST BE SUBMITTED by the client with THIS APPLICATION. Property Dimensions: 1, e2 90 A'4es Tax Office PIN: # 57S-7-07-176? Property Address: Road Name City/Zip 1,%O' e .-& .2-7162g_ If in a Subdivision provide information, as follows: Name: WRITE DIRECTIONS (from Mocksville) to PROPERTY: AW1 GZ E a04jd GA%'bYiartc lS. It /ni e-3 - /um 4 612me- 1fxa as Zhy,e- L'dd- ad )aa ul- Section: Block: Lot: Date Property Flagged: �'' �`-� O 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 Davin/ 9unty Health Department to enter upon above described property located in Davie County and owned by % a Jl�a to conduct all testing procedures as necessary to determine the site suitability. r DATE -/'Ob SIGNATURE G� THIS AREA MAY BE USED FOR DRAWING YOUR SITE PLAN (Include all of the following: Existing and proposed property lines and dimensions, structures, setbacks, and septic locations). Site Revisit Charge Date(s): Client Notification Date: I EHS: Revised DCHD (07/99) Account No. &7 Invoice No. Isz-3 DFESS1 ' 2Q .SEP1Lc y% L-2527 9,yO3URV�yOQ.'O �pY �Q;.• 1, GRADY L TUTTEROV, CERTIFY THAT UNDER NY DDR WN FROM AND SI+�PERV1S10N, TNIS NAP WAS DRAWN FROM ACTUAL FIELD SURYEY MADE Y T TERD URVEY G EDMPANY. PROEESSi L LAND SURVEY �J 1-252 TUTTEROW SURVEYING COMPANY 124 SOUTH SALISBURY ST, MOCKSVILLE, N.C. 27028 (336) 751-5616 50 25 0 an _ ? 165 9 } AREA= 1.090 } an INCLUDES S.R. 1605 R in tob CA AtZJQ bEn n cl 3a Do N 81^11'18• �... _...._.---:_..- __... _ 209.06 _ w -- - M 81.11'18• y V�^.,:.,,-..-...,. �"PJ P I NILDA D. SCOTT ' D.B. I 154, PC. 211 z u� I I i . c DFESS1 ' 2Q .SEP1Lc y% L-2527 9,yO3URV�yOQ.'O �pY �Q;.• 1, GRADY L TUTTEROV, CERTIFY THAT UNDER NY DDR WN FROM AND SI+�PERV1S10N, TNIS NAP WAS DRAWN FROM ACTUAL FIELD SURYEY MADE Y T TERD URVEY G EDMPANY. PROEESSi L LAND SURVEY �J 1-252 TUTTEROW SURVEYING COMPANY 124 SOUTH SALISBURY ST, MOCKSVILLE, N.C. 27028 (336) 751-5616 50 25 0 an _ a APPLICANT INFORMATION Account #: 989900073 Billed To: Homemax Reference Name:. Glenn Wilkes Proposed Facility: Residence DAVIE COUNTY HEALTH DEPARTMENT Environmental Health Section Soil/Site Evaluation PROPERTY INFORMATION Tax PIN/EH #: 5757-07-1769 Subdivision Info: Location/Address: Dalton Road -27028 Property Size: 1.090 Acre Date Evaluated: Water Supply: On -Site Well Community Public Evaluation By: Auger Boring L" Pit Cut FACTORS 1 2 3 4 5 6 7 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 71, LONG-TERM ACCEPTANCE RATE ti ' SITE CLASSIFICATION: os EVALUATION BY%�l�i// LONG-TERM ACCEPTANCE RATE: >J OTHER(S) PRESENT: REMARKS: 46aggt� )`J, in u �Q/ �/�,�% Zo `� �� C/ 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 DCHD 05/99 (Revised) ME ■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■ ■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■ SSSS■■■■ecce■■■■■■■■■■■■■■■■■■ ■■■■e■■c■eeS■■ ■■■■e■■■■■■■■■■■■■■■■■■■■■■■■See■■■■■■■■■■■■■■ ■■■■■e■■■es■se■■■■■■e■■sa■■S■eeee■e■■■■■■■■See SSSS■sec■■■■■■e■■eR■sR■■Ecce■■■e■■e■■■s■■■■■■■ ■■■■■e■■■■■e■■■■■■e■■■■■■■■■■■ SSSS■■■■eee■■■ ■■■■■■■■■■■■e■■SSSS■■■■■■■■■■■■e■■■■■■■■■■■■■■ ■■■S■■■■■■■■■■■■■■■■■■■■■■i�►�■■ SSSS■■■See■■■■ ■■■■■ SOMME ■■■e■ ■EMM■ ■E■■■ ■■M■■ ■M■■■ ROME■ ■■■R■ MENS■ ■■■■■ ■■■OWN ■■■■■■■■ MEN ■■■■■■■S■RMEM■■■■■■NONE ■■■■■■■■■■■■■■■■■■■ ■■■■■■■■■■■■■e■■■■■■■e■■■■■■■■■■■SSSS■■e■■■■■■■■■■■■e■eeee■Re■■■ ■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■See■■■■■■■■■■■■■■■■■■■■■■■■■■■ SSSS■■■■s■■■■■■■■■■■■e■s■e■■■■ ■■■R■■ee■■■■■■■■■EMs■■■■■■■■■■■■ ■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■See■■ SSSS■■ecce■■■■■■■■■■e■■■■e■e■■■e■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■ ■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■ ■■See■■■■■■■■■■■■■■■■c■■■■■■■■■■■■S■■■■■■■■■■■■■■■■■■■■■■■■■■■ ■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■SSSS■■■■s■■■■■■■■■■■■■■■■■■■■■■ ■■SSS■■■■■s■■■■■■■■■■■■■■■■■■■■e■■■■�_:���■■■■■■e■■■■■■■■Oce■■■■■ ■■■■■■■■■■■■■■■■■■■e■■■■■�._==c::SSSS■■■u■■■■■■■■■■■■■■■■■■■■■■■ MEMEMEMEMNONEMMEMIN MEMEME ROEMER "MENEMMENNENMEMNON ■■■e■■SSS■■■■■■■SS■■s■■■■■■e■SSS■■■■■■■e■i�e■■■■■Re■■■■■Ra■e■■■■■ ■e■■■■■■■■■■■■■■■■■■e■■■■■■■■■ ■■Oce■■■■■■c■■e■e■■■e■■■■■■■■■■■ ■■■■■■■■■■■■■■■See■■■■SS■■SSSS■■■■■e■■Oce■■■■■■■■■■■■■■■■■SSS■■■ ■■■■■■■■■■■■■e■■■■■■■■■■e■■■■■■■■■■■■■■■■■e■■■■■■See■■■S■■■■e■■■ ■SSSS■■■e■SS■■■■■■■■■■■■e■■■■■■e■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■ ■■■■■■■■e■■■■■■■S■■■S■■■■■S■■■e■■■M■■■■■■■■M■■■■■■S■■■O■■■■■■■■■ ONE mom ■■■■■■■M■■■■■■■■ ■■■■■■■■■■■■■■■■ ■■■■■M■■■■■■■■■■ ■■■■■■■■■■■■■■■■ ■■■■■■■■■■■E■■■■ ■■MESE■■M■■■■■■■ ■■■■■■■■■■■■■■■■ ■■■■■■See■■■■■■■ ■■■■■M■■■■M■■■e■ ■■■■■■■■■■■e■■■■ ■■■■■■eee■■■■M■■ ■■■■■■■■■■■■■■■■ ■■■■■■■■■■■■■■■■ ■■■■■■■■■■■■■■■■ MEMS ■MEMS■■■■i Ess■ ■■■O■■■■■i ■■■■EEE■■MNE■■■i ■■■■■■■■■■%e■■■i ■■■■■■■■■IUMMMM■i ue■■■ MORE SSSS ■■■■ ■■■■■■ ■■■■■eR■■■■■See■■■■■■■ ■es■See■■sM■■eee■■■■e■ ■eSS■■■■■■R■■■■■S■■■e■ ■e■■■■■■■eee■■■■■■■■■■ ■■■■■■cM■■■e■■See■Oce■ ■e■■■■■e■e■■■■■■Sae■■■ ■■■■■■■■■■■■■■■■■■■■■■ ■■■■■■■■■■M■■■■■■ ■■e■■■■■■■■■■■■■■ M■■■e■■■■■■■■■e■■ ■■■■■■■■■■■■■■■■■ ■■■■■M■■■■■■■■■■■ ■■■■■■■■■■■■■■■■■ ■■■■■■■■■■■■■■■■■ ■■■■e■■■■■■■■■■■■ ■■■■M■■■■■■■■■■■■ ■■eee■■■■■■■■■■■■ ■■■■■■■■■■■■■■■■■ ■■■■■■■■■■■■■■■■■ ■■■■■■■■■■■■■■■■■ ■■■■■■■■■■■■■■■■■ ■■■■■■■■■■■■■■■■■ ■■■E■■■■■■■■■■■■■