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373 Deadmon Rd f -Davie County, NC Tax Parcel Report Monday, September 26, 2016 I i 373 F 374 WARNING: THIS IS NOT A SURVEY t , Parcel'Informafion Parcel Number: K50000001701 Township: Mocksvilie NCPIN Number: 5747423718 Municipality: Account Number: 8301841 Census Tract: 37059-805 Listed Owner 1: DALTON BETH W Voting Precinct: SOUTH MOCKSVILLE Mailing Address 1: 373 DEADMON ROAD Planning Jurisdiction: Davie County City: MOCKSVILLE Zoning Class: DAVIE COUNTY R-A State: NC Zoning Overlay: Zip Code: 27028 Voluntary Ag.District: No Legal Description: .725 AC DEADMON RD Fire Response District: JERUSALEM Assessed Acreage: 0.73 Elementary School Zone: CORNATZER Deed Date: 5/2013 Middle School Zone: WILLIAM ELLIS• Deed Book/Page: 009261162 Soil Types: Ce62 Plat Book: 11 Flood Zone: Plat Page: 295 Watershed Overlay: DAVIE COUNTY Building Value: 117840.00 Outbuilding 8r Extra 0.00 Freatures Value: Land Value: 14280.00 Total Market Value: 132120.00 Total Assessed Value: 132120.00 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, Implied warranties of merchantability or fitness for a particular use.All users of Davie County's GIS website shall hold harmless the NC County of Davie,No Rh Carolina,Its agents,consultants,contractors or employees from any and all claims or causes of action due to npU N� or arising out of the use or Inability to use the GIS data provided by this website. - . DAME COUNTY HEALTH DEPARTMENT ' Environmental Health Section P.O.Boa 848/210 Hospital Street Mocksville,NC 27028 (336)751-8760 Account #: 990003518 Tax PIN/EH#: 5747-42-3718 Billed To: Beth Waller Subdivision Info: c3`J3 Reference Name: Location/Address: Deadmon Road-27028 Proposed Facility Residence Property Size: 0.725 acres ATC Number: 4016 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 Treatm t and Disposal Systems). THIS AUTHORIZATION FOR WASTEWATER CONST IS V ID F A PERIOD OF FIVE YEARS. Environmental Health Specialist's Signature: ate: V e57 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. lE T"vis-^ �Q�1T y J2, Septic System Installed By: I 'by t L Environmental Health Specialist's Signature: Date: DCHD 05/99(Revised) \ DAVIE COUNTY HEALTH DEPARTMENT Environmental Health Section P.O.Boz 848/210 Hospital Street po� Mocksville,NC 27028 (336)751-8760 IMPROVEMENT/OPERATION PERMIT Account #: 990003518 Tax PIN/EH#: 5747-42-3718 Billed To: Beth Waller Subdivision Info: Reference Name: Location/Address: Deadmon Road-27028 Proposed Facility Residence Property Size: 0.725 acres ATC Number: 4016 **NOTE**This Improvement/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 �D0 #People #Bedrooms #Baths ' Dishwasher: © Garbage Disposal: ❑ Washing Machine: e Basement w/Plumbing: ❑ Basement/No Plumbing: C1 Commercial Specification: Facility Type #People #People/Shift #Seats Industrial Waste: ❑ Lot Size Type Water Supplyc'ZoNW Design Wastewater Flow(GPD) 2qo Site: New Repair❑ System Specifications: Tank Size 1X0 GAL. Pump Tank GAL. Trench Width Rock Depth t` & Linear Ft. Other: 10 i�ST�t�V'ro•J �`� L-:�TL1� a /O �'1�t,�,I"io.� 5����sw`� 'p r Required Site Modifications/Conditions: (;�151'/aL� (7�J Gc��JTCt�2, ?t�T Ys ep* Lkt,5, ki�R ic; :F P f�niti: IMPROVEMENT/OPERATION PERMIT LAYOUT- APPROVED EFFLUENT FILTER RISER(S)IF 6"BELOW FINISHED GRADE. ****NOTICE: Contact a representative of the Davie County Health Department for final inspection ofthis 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.**** Pei ON _1 I / i Environmental Health Specialist's Signature: Date: DCHD 05/99(Revised) DAVIE COUNTY HEALTH DEPARTMENT Environmental Health Section n • P.O.Boz 848/210 Hospital Street • Mocksville,NC 27028 (336)751-8760 J IMPROVEMENT/OPERATION PERMIT : Account #: 990003518 Tax PIN/EH#: 5747-42-3718 Billed To: Beth Waller Subdivision Info: Reference Name: Location/Address: Deadmon Road-27028 Proposed Facility Residence Property Size: 0.725 acres ATC Number: 4016 **NOTE** This Improvement/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 �0%_T G #People #Bedrooms ( #Baths 1 �� Dishwasher: u Garbage Disposal: ❑ Washing Machine: d Basement w/Plumbing: ❑ Basement/No Plumbing: Commercial Specification: Facility Type #People #People/Shift #Seats Industrial Waste: ❑ Lot Size ©- -S itm� Type Water Supply Design Wastewater Flow(GPD) 21'F0 Site: New Repair❑ -- System Specifications: Tank Size 10co GAL. Pump Tank GAL. Trench Width ti Rock Depth I Z' Linear Ft.2ZC� Other: 2 D STPA&VTIQJ T�Ox Required Site Modifications/Conditions: tosT6- J-- �-p ','S bW 11-00Y—at 1 tom( ua� IMPROVEMENT/OPERATION PERMIT LAYOUT- APPROVED EFFLUENT FILTER RISER(S)IF 6"BELOW FINISHED GRADE. ****NOTICE: Contact a representative of the Davie County Health Department for final inspection of this Ustem 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.**** �1 g_ 4 Zco 3Lt N V Environmental Health Specialist's Signature: Date: I 106 DCHD 05/99(Revised) APPLICATION FOR SITE EVALUATION/IMPROVEMENT PERMI CE C E Davie County Health Department Environmental Health Section P.O. Box 848/210 Hospital Street AIAR _ Mocksville, NC 27028 4 2005 (336)751-8760 ENVIRO .An- ***IMPORTANT*** THIS APPLICATION CANNOT BE PROCESSED UNLESS AL INFORMATION IS PROVIDED. Reefer to the INFORMATION BULLETIN for 'i�n_srtructI 1. Name to be Billed �j��;���Ll1�P✓ Contact Person Mailing Address �1 D674i ry" N. Home Phone 31&- 277 9q City/State/ZIP OCKSMI'-f bl C 27022 Business Phone 42&5 2. Name on Permit/ATC if Different than Above Mailing Address City/State/Zip 3. Application For: Site Evaluation Improvement Permit/ATC ❑ Both 4. System to Service: House ❑ Mobile Home /❑ Business ❑ Industry ❑ Other S. Type system.requested: K Conventional ❑ conventional modified ❑ innovative 6. If Residence: # People # Bedrooms # Bathrooms RDishwasher ❑aarbage Disposal Fwashing Machine 5��$asement/Plumbing XBasement/No Plumbing 7. If Business/Industry /Other: verify type # People # Sinks # Commodes # Showers # Urinals # Water Coolers IF FOODSERVICE: # Seats Estimated Water Usage (gallons per day) S. Type of water supply: lCounty/City 13 well 11 Community 9. Do you anticipate addi/tions or expansions of the facility this system is intended to serve? ❑Yes gNo 'If yes,what type? ***IMPORTANT'CLIENTS MUST COMPLETE THE REQUIRED PROPERTY INFORMATION REQUESTED BELOW. Either a PLAT or SITE PLAN MUST BE SUBMITTED by the client witli THIS APPLICATION. Property Dimensions: �d 41-52 ,00 WRITE DIRECTIONS(from Mocksville)to PROPERTY: a Tax Office PIN: # Z - e mgr% I Ap 'DPn mov-N U- TA Y-o PropertyAddress: Road Na Ica on Packf1-y-,, SS 9 DAA ern city/zip oaslf�llPT c :2)Q?2 U U�Y%8 kende Of wk%4-e If in a Subdivision provide information,as follows: LX4 SP Cfr'\ IP-Q, Name: Section: Block: Lot: Date home corners flagged: 0 1 -OS 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 Da ie Coun y Halth Department to enter upon above described property located in Davie County and owned by to conduct all testing procedures as necessary to determine the site suitability. DATE ©3 --n 4-O(�, SIGNATURE 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 Client Notification Date: EHS: Sign given -6 Account No. Revised DCH (05/03 Invoice No. r DAVIE COUNTY HEALTH DEPARTMENT ' Environmental Health Section Soil/Site Evaluation APPLICANT INFORMATION PROPERTY INFORMATION 18 Tax PIN/.EH#: 5747-42-3718 ' Billed To:' Beth Waller Subdivision Info: Reference Name: Location/Address: Deadmon Road-'27028 Proposed Facility: Residence Property Size: 0.725 acres Date Evaluated: - Water Supply: On-Site Well Community Public Evaluation By: Auger Boring Pit Cut FACTORS 1 2 3 4 5 6 7 Landscape position l_ (s L_ Slope% A 7-0 HORIZON I DEPTH 1 _ —Co a Texture group VCL- SC-L- Consistence ss cxe Structure Mineralo HORIZON II DEPTH to- 1 20 Texture group C_ Consistence , Structure v Mineralogy HORIZON III DEPTH 'Zo - - Texture group I<r_k Sit S Consistence Ik S"o : Structure $ Mineralogy HORIZON IV DEPTH L44 t-k t Texture group CC;. �S Consistence f r Structure G (2— Mineralogy SOIL WETNESS l RESTRICTIVE HORIZON SAPROLITE CLASSIFICATION LONG-TERM ACCEPTANCE RATE ©.Lj SITE CLASSIFICATION: fs EVALUATION BY: � �,,P LONG-TERM ACCEPTANCE RATE: ©•q OTHER(S)PRESENT: ' �CREMARKS: 5 - --y I J %400- 2 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. 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■■ee■■ee■eeeetlle■■■■■e■■cell/■t■eeeeeee/_,.:ice■■■■■eeeeeeeee■■eeeeeee■ s 0 ,9501 2� 426 35 m� 8 usa\ aN O I �S BS'SBl 0: OItC N 30. GOLDN a<< 2.0 m 329 m � V 333 � c (2DB2 B9f (199) (570) CIO , 0 _ e—° 312 • 9 _ 313 s ., OWL STREET ^M 2m 5 a x 227 $ 0 96Z a 2 7 2T6 297 - - o 00 ,99 - ,� qo �J q \fib �I 4t I � z � I -N RpAU N `, ► cE,��M. c I F 7 CALLER No- �� � r:. Wt E N osc 2 A A pG- 3 KERM 112 D.B• 1 new VICINITY MAP S Iron 1 jEED NORTH D8. 112 PG. 23 H �•A6 09. E `111 13 � 1 1 new 1iron ,1 1l` ,1 1 1 - t I w � I N � AREA = 0.725 ACRE 1 TS SU JECT TO S.R. 1801 R if r E L AREA B / 1 �*Z 86 . I Z �EITx 63 '1�pG. I � ro 1 CALLER '� N LSCA pG 23 D• 95 / new 25 00 �1 iron S 09 .A609. S .� s•R �801 - Rp A \ a``a � AR'BMON d1 ii ` • .EADo�: P®F�sS,o;� PEA ) ,.� \ -� o SEAL ¢)09• E L-2527 I GRADr L TUTTEROW, CERTIFY THAT UNDER Ml' DIRECTION AND SUPERVISION, THIS MAP WAS N 25663 ��••���<� � .®o MADE DRAWN UTROMOANSUP ACTEA FIELD SURVEY p° SUFN X Q. LOUIS �2 P \ - --- - --- ------ 1 PROFESSION L LA URVEYOR L-2527 D•D' \ existing iron PLAT OF SURVEY FOR HERMAN OSCAR WALLER I tae,, N 11�A63 REVISIaJS SCALE 1 30 APPROVED BY- DRAVN Bn rILE NAME, WALL—HER A19' DATE, 1/13/05 G L T RHD COORD, NAME WALLER 72 ,I. 15 0 30 f,o 90 TUTTEROW SURVEYING COMPANY BEING 0.725 ACRE TAKEN FROM 107 NORTH SALISBURY U THE HERMAN OSCAR WALLER PROPERTY (DB 112 , PG. 23) MOCKSVILLE, N.C. 27028 L71NG IN THE MOCKSVILLE TOWNSHIP , DAVIE COUNT! NORTH CAROLINA eeGor9 'SCALE IN FEET X336) 751 -5616 TAX MAP REFERENCE. K-5 , P/C PARCEL 1 7 DRAWING NUMBER, 505-3 J 3 b