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295 Daniel Rd
�avie Countv, NC Tax Parcel Report Wednesdav, October 12, 201E WARNING: THIS IS NOT A SURVEY � �.�. _ .,.� � �w� a� �� �wR. �� � �� : � � Parcel Information .�.�� s_�..=. _� ���F,�� �� � �,�,.���� Parcel Number: L500000004 Township: Jerusalem NCPIN Number: 5736971178 Municipality: Account Number: 82514496 Census Tract: 37059-807 Listed Owner 1: MICHAEL JAMES P Voting Precinct: COOLEEMEE Mailing Address 1: 295 DANIEL ROAD Planning Jurisdiction: Davie County City: MOCKSVILLE Zoning Class: DAVIE COUNTY R-A,R-20,1-3-S,H-B-S,I-2 State: NC Zoning Overlay: DAVIE COUNTY CZOD Zip Code: 27028-0000 Voluntary Ag. District: No Legal Description: 107.470 AC DANIEL RD Fire Response District: JERUSALEM Assessed Acreage: 106.20 Elementary School Zone: COOLEEMEE Deed Date: 2/2004 Middle School Zone: SOUTH DAVIE Deed Book / Page: 2004E0054 Soil Types: WeB,GnB2,RnC,PcC2,MsC,ChA,Ce62,WATER Plat Book: Flood Zone: Plat Page: Watershed Overlay: DAVIE COUNTY Building Value: 0.00 Outbuilding 8 Extra 9750.00 Freatures Value: Land Value: 383470.00 Total Market Value: 393220.00 Total Assessed Value: 147160.00 9" �'�' Davie County, �'o�N�'� NC , , . ;, . , , , . . . _ _ . , . . . __ . ._ . . _ :,. . : , . _ . _ s✓� �� ;., �; ti''AUTHOFcIZATION NO. O 9% � DAVIE COUNTY HEALTH DEPARTMENT 2 N �' ' '" Environmental Health Section PROPERTY INFORMATION A � Permittee's P.O. Box 848 0� ��� ' Name: �1,� �'� � Mocksville, NC 27028 Subdivision Name: ��A Phone #: 704-634-8760 Directions to property: �,�n., ��� :�,-t' � Section: Lot: AUTHORIZATION FOR 7 / r WASTEWATER Tax Offce PIN:#� l�ln -�- ( C)r SYSTEM CONSTRUCTION R�ac�Name� !.:/fl��'�G. (++[�.7in• �rJ�r�i� **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 Forn�/Authorization Number should be presented to the Davie County Building Inspections O�ce when applying for Building Pernuts. ' (In compliance with Article 11 of G.S. Chapter 130A, Wastewater Systems, Section .1900 Sewage Treatment and Disposal Systems) ,� r ' r ��r } �,,.,'�.` � �,,.; � r� � � � ` ` � ! � ENVIRONMENTAL HEAL'�H"SPECIALIST DATE ISSUED ***NOTICE*** THIS AUTHORIZATION FOR WASTEWATER CONSTRUCTION IS VALID FOR A PERIOD OF FIVE YEARS. .--+.: ,�� "� - �._ ..�..,. � . ��,.:.,. ..,.,..-� , , �-� . , . � ., ,r -.- , , . . , . . . , • . .•�� . . ., ,. _ . „ . , . .. ..� - , �: ..:,.. . . ... � - � n,. . . .� . . _ . � Y . . . . _, 9 . . . . � . . . ., . . '. .. _ � . . _ � _ :.. , ,., ���`� . . � �': .� . 1` , ,, j ` . . .. . � .. . ��., f.' ` s-� DAVIE COUNTY HEALTH DEPARTMENT ,..,�--�' =� `'- . �� � _ ���� � IMPROVEMENT AND OPERATION PERMITS PROPERTY INFORMATION � � W Perc�itteeKs ` ' � . " Name; ' ,'���'}�7 �,�'�� "�,!q �l� �. , Subdivision Name: (��p r• �Directions to property: � �. �. r� ��°t : - _"'� "Section: Lot: � s. . • �. IlVIPROVEMENT , , - . "'" PERMIT Tax Office PIN:# �/� � - �' f ✓ - ` � � �� ' Road Name: �.ir"d:-�1 °� �f : t�."��. Zip: �� `'_ ,!J� ; �,� **NOT'E** This Improvement Pernut DOFS NOT authorize the construction or installation of a septic tank system or any wastewater system. An AUTHORIZATION FOR WASTEWATER SYSTEM CONSTRUGTION must be obtained from this Deparlrnent prior to the conshuction/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 PERMIT IS SUBJECT TO REVOCATION IF SITE �; '�;;; ,; {� .� ,1 PLANS OR TI� INTENDED USE CHANGE. YOUR WASTEWATER ENVIRONMENTAL HEAL'I'H SPECIALIST DATE ISSUED SYSTEM CONTRACTOR MUST SEE THIS PERNIIT BEFORE INSTALLING THE SYSTEM. RESIDENTIAL SPECIFICATION: BUILDING TYPE "7 -� # BEDROOMS r� # BATHS �# OCCUPANTS � GARBAGE DISPOSAL: Yes or No COMMERCIAL SPECIFICATION: FACILTfY TYPE # PEOPLE # PEOPLFJSHIFT # SEATS INDUSTRIAL WASTE: Yes or No LOT SIZE %� r TYPE WATER SUPPLY �� DESIGN WASTEWATER FLOW (GPD) �� �l� NEW SITE� '� REPAIR SITE SYSTEM SPECIFICATIONS: TANK SIZE%_ // �GAL. PUMP TANK GAL. TRENCH WIDTH �� �� ROCK DEPTH ./. � LINEAR FT. I'� �G� OTHER REQUIRED STTE MODIFICATIONS/CONDiTIONS: IMPROVEMENT PERMIT LAYOUT ��. **CONTACT A REPRESENTATIVE OF THE DAVIE COUNTY HEALTH DEPARTMENT FOR FINAL INSPECTION OF THIS SYSTEM BETWEEN 8:30 - 930 A.M. OR 1:00 - 1:30 P.M. ON THE DAY OF INSTALLATION. TELEPHONE # IS (704) 634-8760. OPERATION PERMIT ���� �t ��� SYSTEM INSTALLED BY: � �� � pb`� ,D �'T� ' " � . H(�/�'��,, �l � �4 ^ AUTHORIZATION NO. � L I OPERATION PERMIT BY: DATE: 7 (• / **THE ISSUANCE OF THIS OPERATION PERMIT SHALL INDICATE THAT THE SYSTEM DES ED 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 FUNCTION SATISFACTORILY FOR ANY GNEN PERIOD OF TIME. DCHD OS/96 (Revised) .. ; , , . . .. _. .. t . , _ . : , . r 4�. . ' � 1 . , . � . . .. . . _ . . . . . � ���` �� . � ' � ;,as;`. _.� � DAVIE COUNTY HEALTH DEPARTMENT ,,,,, ,��-�'' • � IMPROVEMENT AND OPERATION PERMITS PROPERTY INFORMATION -'' � w Perinittee: sr._,,. � �' �� i "��r� Name,: ` ..�::��"�� +.�'"�� ��:�l�fi t"-`� -?� Subdivision Name: l��-��`� .�. • . .:, ' Directions to property: _"" �=r�►`µ . '� Section: Lot: " ' :: M IlIZPROVEMENT �.., ,,.;, , . � r _ ; " PERNIIT Tax Office PIN:#�^ �=�'� _`� a _ j�� f , :; ""' rA Road Name: �'��it•�`l !" t .,�, g�,, Zlp; ! %' �.��"%' «i **NOTE** This Improvement Pernut DOFS NOT authorize the construction or installation of a septic tanlc system or any wastewater system. An AUTHORIZATION FOR WASTEWATER SYSTEM CONSTRUCTION must be obtained from this Departrnent prior to the construction/installation of a system or the issuance of a building pemut. (In compliance with Article 11 of G.S. Chapter 130A, Wastewater Systems, Section .1900 Sewage Treatment and Disposal Systems) �' _ ***NOTICE*** THIS PERMIT IS SUBJECT TO REVOCATION IF STTE -'' +: � 'J PLANS OR Tf� INTENDED USE CHANGE. YOUR WASTEWATER ENVIRONMENTAL HEALTH SPECIALIST DATE ISSUED` SYSTEM CONT'RACTOR MUST SEE TfIIS PERMTI' BEFORE INSTALLING THE SYSTEM. RFSIDENTIAL SPECIFICATION: BUILDING TYPE ��L� # BEDROOMS "`'� # BATHS �# OCCUPANfS � GARBAGE DISPOSAL: Yes or No COMMERCIAL SPECIFICATION: FACILITY TYPE # PEOPLE # PEOPLFJSHIFT # SEATS INDUSTRIAL WAST'E: Yes or No LOT SIZE 'r�% r TYPE WATER SUPPLY < n DESIGN WASTEWATER FLOW (GPD) �?� S�r`-� NEW SITE� REPAIR S1TE i; SYSTEM SPECIFICATIONS: TANK SIZE GrG�GAL. PUMP TANK GAL. TRENCH WIDTH -. `� %� �� ROCK DEP'fH .� % LINEAR Ff. ��`�'� � REQUIRED SITE MODIFICATIONS/CONDTI'IONS: 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 - 1:30 P.M. ON THE DAY OF INSTALLATION. TELEPHONE # IS (704) 634-8760. I OPERATION PERMIT SYSTEM INSTALLED BY: ���''��� F"'� �'�`"�' � l.,o I �--, � _.�;;,,,�� , . �Y���� l -{/Zu^:,'T ..-----•.��.. p:l U� Gi J"`^ j"'j � 1'� .1-It�r�L ` "� � C� '� �,`�..;;r (��>�}�,~.,.. ; �-�—^—�, � AUTHORIZATION NO. `� ' � � OPERATION PERMIT BY: �--�-- f(=� � � �-� /'f � DATE: / ~ � �� � **THE ISSUANCE OF THIS OPERATION PERMIT SHALL INDICATE THAT Tf� SYSTEM DES BED 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 WILL FUNCTION SATISFACTORII,Y FOR ANY GIVEN PERIOD OF TIME. DCHD OS/96 (Revised) ;, .. � ' APPLICATION FOR SITE EVALUATION/IMPROVEMENT j Davie County Health Department Environmental Health Section P.O. Box 848 Mocksville, NC 27028 (704)634-8760 r ��UV� D JUL I 419�7 � . M �► i ****IMPORTANT**�* THIS APPLICATION CANNOT BE PROCESSED UNLESS ALL THE REQUIRED INFORMATION IS PROVIDED. Name to be Billed � M � � �h � 'e-' Contact Person �1 � ^^ M',C-�'`�'�'�' � Mailing Address �� s ��� F- � 2�' Home Phone �� a"' � ZQ� City/State/Zip �0(.kS u�� �� (� C_ a702g Business Phone 6� Li "�% 7�S 2. Name on PermiUATC if Different than Above Mailing Address 3. Application For: [] Site Evaluation City/State/Zip [ ] Improvement Permit & ATC [�'�oth 4. System to Serve: [] House E`C] Mobile Home [] Business [] Industry [) Other 5. If Residence: # People 2- # Bedrooms � # Bathrooms 'L [X] Dishwasher [] Garbage Disposal [x] 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: [k] County/City [] Well [] Community 8. Do you anticipate additions or expansions of the facility this system is intended to serve? [] Yes [JCJ No If yes, what type? E Z THER A PL�IT OR S Z TE PLAN PROPERTY INFORMATION REQUIRED: *** IMPORTANT *** A.7ILY��OF THE PROPERTY MUST BE y SUBMITTED WITH ��.5 APPLICATION. � .� � d(o +4C. Property Dimensions: � WRITE DIRECTION5 (from ocksville) TO PROPERTY: Ta�c Office PIN: #� 3� - "l - 1 I 7 8 ; l���'��I :��� C-�1 � o u� Z• `l� a_ .' �C,_5_ � Property Address: Road Name n� l rc � . � H 1'� �EL C�- .� p City/Zip ��k511� � ��_ c� �0� � � 1 ` ' i'"?1 � % If in Subdivision provide information, as follows: �_ ---� � bt ��L�l'�-- Name: � � � Section: Lot #: � This is to certify that the information provided is correct to the best of my knowledge. I understand that any permit(s) �ssued 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 by 3� 6 R. ���^�,.-C to conduct all testing procedures as necessary to determine the site suitability. DATE ! ' � � "c � SIGNATURE � /L• t Revised DCHD (06-96) THIS AIZEA �11t1� $E USE�b �OR btZrt�VINC� JOUII SZTE YLftN: �. �b;��� �,ll �. �11 � �� ���. ��D � (� , `-�-� e-�, . � ,. � _ ;}; y� i,,�..� r� � s= _.��, r �,s: - �,y,! •� �.��� �' � '�. c�` `K,�'�� � c9 a:'�-: ��" s,.-- � . � - . � . � ;' %=M'�� . ��: ry �• �,r . . 0j ' � ; .:.w. .,� f r �� `, ; ". . rc` , . " .. ""....YY . „�s� � .. -- _ . � . . . a;� . 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('a ii _ , 4 � � ,_ �_ 4 t i d :Y._ r -'F. . . _ . _. :� i>,. — _ ,}-�� _ _ f '� ` ,. _ ,,` _.. _, . .,._: , :... �.�_�.�_ a __, _.s. _ _ . ... ..... . _ .. -. ,� . . � . � ' DAVIE COUNTY HEALTH DEPARTMENT � Environmental Health Section SECTION LOT Soil/Site Evaluation APPLICANT'S NAME i�r(���d!/ DATE EVALUATED ��'� �L �% PROPOSED FACILITY %/�7 /� PROPERTY SIZE �S�7�G' —� n SUBDIVISION ROAD NAME dl��I✓��S" Water Supply: Evaluation By SOIL WETNESS On-Site Well Community Auger Boring Pit SITE CLASSIFICATION: � LONG-TERM ACCEPTANCE RATE: , REMARKS: DCHD (01-90) Public Y 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 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 Mineralogv 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 - gallday/ft2 ■ ■ ■ ■■■s■■■■■■■ ■�������■■■ ■�■���■■■■■ ■■■■■■■■�t■ ■■■t�����■■ ■■■�■■■■��■ ■■��������■ ■■��■�■�■■■ ■■■■■�■■■■■ ■���■�■���■ ■��■�■����■ ■�����■�■■■ ■����■�■■�■ ■����■�■■�■ ■�■��■■■■�■ ■■■��■�■■�■ ■■■■■��■��■ ■■■■■■■■��■ ■■�������■■ ■���■�■��■■ ■■������■■■ ■��■■■■�■■■ ■��■■�����■ ■■■■■■■■�■■ ■��■�■��■■■ ■■�■■■�■■�■ ■■■����■■■■ ■�����■ ■■■�■�■ ■���■�■ ■■����■ ■■�■��■ ■��■��■ ■�■■��■ ■�■���■ ■■ ■�■��■ ■���■■ ■■■■■■ ■■���■ ■■��■■ ■■■■■■ ■�■��■ ■�■��■ ■�■��■ ■■�■��■�■�■�■ ■■■■■■■�■■��■ ■�����������■ ■■■�■■■■■■■�■ ■■■���������■ ■■■�■�������■ ■■��■�������■ ■��■■■�■■■■�■ ■■�����■���■■ ■�■■■■■■■■■�■ ■■■■���■���■■ ■�s■■�■ ■�:����■ ■iiY■■�■ ■���■�■ ■�■�■ ■■■■■ ■�■��■■ ■■■���■ �■■����■ ■■����■ ■�■�■��■ ■■�■■■�■ ■■��■��■ ■����■■■ ■������■ ■■������■ ■■■■�■■■■ ■■������■ ■��■■�■■■ :�■�■■■■■ ■i■■■■■■■■ ■�������■■ ■'�■■�■■�■ ■�������■ ■��■■�■■■■ ■■ ■■ �� ■■ ■���■ ■■�■ ■■■■ ■��■ ■��■ ■�■■ ■��■ ■■■■ ■��■ ■�■■ ■■�■ ■■�■ ■��■ ■■�■ ■��■ ■■�■ ■■�■ ■■■■ ■�■■ ■■■■