204 Deerfield Dr Davie County,NC Tax Parcel Report � W3 Monday, September 26, 2016
234
rf i�
204
IS
Iti ,2 3 9
�* 206
REDFIELD RD ,........
205
WARNING: THIS IS NOT A SURVEY
Parcel Information. ... ._a
Parcel Number: B60000001807 Township: Farmington
NCPIN Number: 5853574150 Municipality:
Account Number: 655500 Census Tract: 37059-802
Listed Owner 1: ALLEN ELMER G Voting Precinct: FARMINGTON
Mailing Address 1: 204 DEERFIELD DRIVE Planning Jurisdiction: Davie County
City: MOCKSVILLE Zoning Class: DAVIE COUNTY R-A
State: NC Zoning Overlay: DAVIE COUNTY QD
Zip Code: 27028-0000 Voluntary Ag.District: No
Legal Description: 4.723 AC OFF ARROWHEAD RD Fire Response District: FARMINGTON
Assessed Acreage: 4.72 Elementary School Zone: PINEBROOK
Deed Date: 10/1991 Middle School Zone: NORTH DAVIE
Deed Book/Page: 001610086 Soil Types: GnB2,GnC2,GaD,ChA
Plat Book: Flood Zone:
Plat Page: Watershed Overlay: DAVIE COUNTY
Building Value: 107520.00 Outbuilding&Extra 5260.00
Freatures Value:
Land Value: 63440.00 Total Market Value: 176220.00
Total Assessed Value: 176220.00
�v All data Is provided as Is without warranty or guarantee of any kind either expressed or Implied Including but not limited to the
� F Davie County, 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
NC or arising out of the use or Inability to use the GIS data provided by this website.
1
DAVIE COUNTY ENVIRONMENTAL HEALTH
P.O.Box 848/210 Hospital Street
Mocksville,NC 27028
(336)753-6780/Fax#(336)753-1680
OPERATION PERMIT
&,OwOoo 1ct0'a
Account #: 990005691 Tax PIN/EH : 5853-56-7868
Billed To: Jeff Vaughn Subdivision Info
Reference Name: Location/Address: Deerfield Drive-Drive
Proposed Facility: Residence Properly Size: 1 Acre
ATC Number: 5783
**NOTE**The issuance of this Operation Permit shall indicate the system described on the ATC 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.
l
System Type: S.T.Manufacturer AO Tank Date Ll Tank Size &)�?o
Pump Tank Size / (itN
rr �,t� '
System Installed By:6/ A 1jTM ro E.H.Specialist: Date: Xlz
GPS Coordinate:
l5,
2�
DCHD 11/06(Revised)
1
DAVIE COUNTY ENVIRONMENTAL HEALTH
$ P.O.Box 848/210 Hospital Street
Mocksville,NC 27028
(336)753-6780/Fax#(336)753-1680
AUTHORIZATION FOR WASTEWATER SYSTEM CONSTRUCTION
Account : 990005691 Tax P1Ni1=H 5853-56-7868
Bided To: Jeff Vaughn Subdivi iort;Info:
Reference Name: i Location/Address: Deerfield Drive-Drive!,, :.:
Proposed Facility: Residence F PfteiflytSize: 1 Acre
Site Type: flew ❑Repair ❑Expansion
ATC Number: 5783
**NOTE**This Authorization to Construct(ATC)MUST BE ISSUED by the Davie County Environmental
Health Section prior to issuance of any building permit(s),(in compliance with Article 11 of G.S.Chapter 130A
Wastewater Systems,Section.1900 Sewage Treatment and Disposal Systems). THIS AUTHORIZATION TO
CONSTRUCT IS VALID FOR A PERIOD OF FIVE YEARS. This ATC is subject to revocation if site plans,plat
on the intended use change.
Residential Specifications: #Bedrooms #Bathrooms#People Basement[A Basement plumbing❑
Non-Residential Specifications: Facility Type #People #Seats
Square Footage(or Dimensions of Facility)
Lot Size t`i�(. Type of Water Supply: ❑County/City )fWell ❑Community Well
System Specifications: Design Wastewater Flow(GPD) VQ-Tank Size&a GAL.Pump Tank GAL.
Il �c r
Trench Width Max.Trench Depth Rock Depth Linear Ft.�Gv��
Site Modifications/Conditions/Other: h
Contact the Davie County Environmental Health.Section for final inspection of this,system between
8:30—%30a.m.on the day of installation. Telephone#(336)751-8760.
Environmental Health Specialist Date:
DCHD 11/06(Revised)
Davie County Environmental Health
P.O.Box 848/210 Hospital Street
Mocksville,NC 27028
(336)753-6780/Fax(336)753-1680
IMPROVEMENT PERMIT
Account #: 990005691 Tax PIN/EH#: 5853-56-7868
Billed To: Jeff Vaughn Subdivision Info:
Address: 4837 Bent Tree Way Location/Address: Deerfield Drive-Drive
City: Yadkinville Property Size: 1 Acre
Reference Name:
Proposed Facility: Residence
**NOTE**This Improvement Permit DOES NOT authorize the construction of a wastewater system. An
Authorization To Construct a wastewater system must be obtained from this office prior to the
construction/installation of a wastewater system or the issuance of a building permit(in compliance with
Article 11 of G.S. Chapter 130A,Wastewater Systems). This Improvement Permit is subject to
revocation if site plans,plat or the intended use change.
Permit Type: ANew ❑Repair ❑Expansions Permit Valid for: 195Years ❑No Expiration .
Residential Specifications: #Bedrooms 7 #Bathrooms#People 7 Basement❑ Basement plumbing0'
Non-Residential Specifications: Facility Type #People #Seats
Square Footage(or Dimensions of Facility)
' Design Flow(GPD): Type of Water Supply: AkCounty/City XWell; ❑Community Well
Site Modifications/Permit Conditions:
System Type LTAR
Initial, •3
Repair s - -3
Site Plan
t .
Environmental Health.SpecialistDate
i.p.11-06
Ki
1 \ c-
GO
Y v9ib� v
• //111 � �..+.. ���s�r �.• � r f.t � 1 �y�,
Y
� 4 c.�,,,,`b n. 1,-•f V•r � }�
SE 'O �• ,,' i r irF::y
N75 12'22' E 205.00' i. PSE t
ltne otsement •0 `
189.78' To Center
ExtsnM
r� REBAR r ' c yr '' t e+e..t `"1e.'_. ♦A i A +Yy{ iS y yiq L
PGS 472 .
CflNTRI]L CORNER -
iay'
�t li• yM� Q$ i� � � -t >` .t,�_,� is � •a
S t r*
1t � ^•
N
N _
F
RIM SU/771
78 696 PG 992
Al 5853 56 1462 SURVEY FOR:
tR� SEF'
T �..
205.00
AND WIFE •1 "e A.
CI]NTRDL CQRNER REFERENCE:1
- EXISTING PIN NWREN
StEBAR
- W.�Eugene James FARMIIIGTON TOWI
��--++ TION FOR SITE EVALUATION/IMPROVEMENT PERMIT&ATC
RE C E I Davie County Environmental Health
P.O.Box 848/210 Hospital Street
MAY 4 2011 Mocksville,NC 27028
(336)753-6780/Fax(336)753-1680
BY• _ �.• ite Evaluation/Improvement Permit ❑Authorization To Construct(ATC) ❑Both
Type of Application: ❑New System ❑Repair to Existing System ❑Expansion/Modification of Existing System or Facility
***IMPORTAN7***THIS APPLICATION C4NNOTBE PROCESSED UNLESS ALL OF THE REQUIRED
INFORMATION IS PROVIDED. Refer to the INFORMATION BULLETIN for instructions.
APPLICANT INFORMATION
Name to be Billed TeA V6fL Contact Person •S13rhL
Billing Addressr Home Phone �3/,- 7N5- �S'7
City/State/ZIP Business Phone
Name on Permit/ATC if Different than Above
Mailing Address City/State/Zip
PROPERTY INFORMATION *Date House/Facility Comers Flagged
NOTE: A survey plat or site plan must accompany this application. Included:❑Site Plan ❑Plat(to scale)
(Permit is valid for 60 months with site plan,no expiration with complete plat.)
Owner's Name Phone Number
Owner's Address AWCity/State/Zip U v- 1 1. O.Z
Property Address n JZL.--4-1JtLCity_m, (G.
Lot Size ).b At„rL Tax PIN# Sf(S3S 7f14.9
Subdivision Name(if a plicable) Section/Lot#
Directions To Site: a) ; '-
A ,-tni
If the answer to any of the following questions is"yes",supporting documentation must be attached.
Are there any existing wastewater systems on the site? ❑Yes o
Does the site contain jurisdictional wetlands? ❑Yes o
Are there any easements or right-of-ways on the site? ❑Yes Eo
Is the site subject to approval by another public agency? Dyes Will wastewater other than domestic sewage be generated? ❑Yes
IF RESIDENCE FILL OUT THE BO W
#People #Bedrooms #Bathrooms Garden Tub/Whirlpool�s ❑No
Basement: ❑No Basement ng: 2-�re-s ❑No
IF NON-RESIDENCE FILL OUT THE BOX BELOW
Type of Facility/Business Total Square Footage of Building #People
#Sinks #Commodes #Showers #Urinals
Estimated Water Usage(gallons per day) (Attach documentation of similar facility water consumption)
FOODSERVICE ONLY: #Seats
Type system requested: 26onventional ❑Accepted ❑Innovative ❑Alternative ❑Other
Water Supply Type:❑County/City Water C ew Well ❑Existing Well ❑Community Well
Do you anticipate additions or expansions of the facility this system is intended to serve?❑Yes
Ifyes,what type?
This is to certify that the information provided on this application is true and correct to the best of my knowledge. I understand
that any permits)or ATC(s)issued hereafter are subject to suspension or revocation if the site is altered,the intended use
changes,or if the information submitted in this application is falsified or changed I hereby grant right of entry to the Authorized
Representative of the Davie County Health Department to conduct necessary inspections to determine compliance with applicable
laws and rules. I understand that I am responsible for the proper identification and labeling of property lines and comers and
I ating and flaggin r stak'n the hous f i'ty location,proposed well location and the location of any other amenities.
.rNP/L
roperty owner's or owner's legal representative signature Site Revisit Charge
Date(s):
Client Notification Date:
Date EHS:
Sign given ❑Yes❑No r �� Account#
Revised 11/06 '`�V Invoice#
07
ooh
t
ko -4,J
_4"aA.4, QY-7
4
loor
n-
r-n
GoMaps GIS Page 1 of 6
rn �
22B rn
m
f ,
'ir 1
f I 1
_•.+. , ! 204
2Y4 !
r 1
R[DFICLD RD y,
1
2J5� O
rn
y � 1
x
t � 1
1
1;33— 2� 1r
00185ft f
http://maps.co.davie.nc.us/GoMaps/map/map.cfm?CFID=4129&CFTOKEN=61640881 5/24/2011
V APPLICATION FOR SITE EVALUATIONAMPROVEMENT
{ L� •e' Davie County Health Department E
Environmental Health Section P.O. Box 848 W .219%
Mocksville, NC 27028
(704) 634-8760ElIVIRONh1ENTAtK ILI
DAR COUI
****IMPORTANT**** THIS APPLICATION CANNOT BE PROCESSED UNLESS ALL
THE REQUIRED INFORMATION IS PROVIDED.
1. Name to be Billed 4 /lm A A Ile h. / Contact Person ,
Mailing Address -1 d %C �ee,e-�'ie/!..-1// P/-, Home Phone 11 �k>• 6A,
City/State/Zip hO6�SJ/iWe /Y.G. .774 ,� Business Phone
2. Name on Permit/ATC if Different than Above
Mailing Address City/State/Zip
3. Application For:,Site Evaluation [ ]Improvement Permit&ATC e�V, d
4. System to Serve: [&,I House [ ]Mobile Home usiness [ ]Industry [ ]Other por MSS
5. If Residence: #People _ #BedroomsL3J #Bathrooms _ [✓]'Dishwasher[ ]Garbage Disposal
J]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 [--rNo
If yes,what type?
EITHER A PLAT OR SITE PLAN
PROPERTY INFORMATION REQUIRED:***IMPORTANT**SAT OF THE PROPERTY MUST BE
SUBMITTED WITH THIS APPLICATION.
Property Dimensions: ';2D!!g Z6 WRITE DIRECTIONS(from Mocksville)TO PROPERTY:
Tax Office PIN: # 5-
Property Address: Road Name' ADA— —
City/Zip &dr-, .79G 170
If in Subdivision provide information,as follows: _, 7f.Uz(d.� �'" KtVOZe4 �.
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)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
by Pl^-g ' A L2'e'!fi" to conduct all testing procedures as necessary to determine the site suitability.
DATE 3' /a'98 SIGNATURE
Revised DCHD(06-96)
THIS AREA AIAJ BE USED FOR DRAWING YOUR SITE PLAN:
R IJ14
i
coq
J
• DAVIE COUNTY HEALTH DEPARTMENT
• '�' Environmental Health Section SECTION LOT
Soil/Site Evaluation
APPLICANTS NAME A/�//�/✓ DATE EVALUATED /ate
PROPOSED FACILITY �YU5-"f PROPERTY SIZE
SUBDIVISION ROAD NAME
Water Supply: On-Site Welly Community Public
Evaluation By: Auger Boring t/ 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
LONG-TERM ACCEPTANCE RATE
SITE CLASSIFICATION: A EVALUATION BY:
LONG-TERM ACCEPTANCE RATE: t 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
DCRD(01.90)
■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■
■■■■■■■■■■■■■■■■■e■■■\�//■■■■■eee■■■ee■e■■■e■■■e■■■////■■■■■■■■■■e■
■■■■■■■■■■■■■■■■■■■■■11■■■■■■■■■■�■■■■■,■■■■■■■■■■■■■■■■■eee■■■■■■■
■■//■■e/■eeee■■■ee■■ell■■■■ue■■epee■■■■■■ie■■■■■■■■■■■■e■■■■■■■■■■e■
■■e■■■■■e■■eee■■■■■■■11■■■■nnii�e■■■■■■■■■u■■■■■■■■■■■■■■■e■■■■■■e■■
■■■■■■■■■■■■■/■/■/■/■1�■■■■eve■■■■■■■■■■■/11■■■/■■/e■■■■■■e■■■■■/e■■■
ieiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiii:��1■■■■■■■■■■■■■epi■■■/■■■■■■
■■/■■■/■■■//■■■■■■■■■Ise■■■■/■■�■•��:�/■//■■■e■■ee■■e/■■■i■■■■■/■■■■
■■■■■■■■■■■e■■■■■■■■■Ile■■�_c::ir■ii■■■s■■■■■■■■■■s■■■■■■ei■■■■■■■■■■
MEMNON.' liiiiiiMENNENmammmii"iiiiiii
■■ea■■■e■■e■■■■e■■■eee■■■■■■■■■■■�■■■■■e■■ee■■■■■■■■■■■1�■eei■ee■■■■
swoon
■■■■■■e/////■eee■■■■■■■■■■■■/■■■//■I,�e■e■■■■■■■■■///■■■■li■■■ue■■rr■■
■/////■e■■■■■■■■■■ee■_-■►�/■■■■■■■■■■eee■■■■■■e■■■■■■■■■■■11■Il�t���r�u■els■
■/////■■■■■■■■■■11■■■■//i�//■■■■■■■■■eee/ecce■■�-�■■■/■/■11■■e■is■�e/■
■//■■■■■■//■/■■■11■e►rl7r�■►�e/■■/■e■■■ee■►■/■///■�■■■■■e■■■elle■e■■e■■■■
■//■■■■■■e/■e//■il■�•��cr:■■i�e■■■/■e■ ■■■i�■■■■■■■�r■■�wnar/■■■Ile■■■■■■■■■
■■■■■■■■■e■■■■■■►■era■■a■■■■■■e■I�i■■■�t■■e■■■■►�■�uee■■■■11■■■■■■■■■■
■■■ee////////■■■ae■■■■■tie■■/■■■■■■e■■s�■//e■■■u■e■e/e//■Ile■■■i■■///■
■e■eee/■■e■■■■■gee■■■■■re■■■■■■■■■■■■■■�■ee■■■�e�e�-.:ee■Ile■■■�■■■■■■
■e■eee■■■■■■■■■e:��:::::�■■■■■■■■//■■■■■�■■■■■/■■e■■■■e�.l■e■■■■■■■■
■■■■/■/■■/■■■■■■■■/■■■■■■■■e■■■■■e■■■■■//■■ee■/e/■■■■■■■■■■eee■■■■
Davie County Health Department
N�M8Eag88 andHome-Come Health agency
NEW pN°MAaG"C 22' Environmenta( ealth Section
EFFEG�t33 75�'876� P.O.Box
COURIER#09 40-06 srREET
MOCKSVILLE,N.C.27028
PHONE:(704)634-8760
March 27, 1998
Elmer Allen
204 Deerfield Dr.
Mocksville, NC 27028
Re: Site Evaluation
Deerfield Drive
Tax PIN: #5853-56-7868
Dear Client(s) :
As requested, a representative from this office visited the
aforementioned site on March 25, 1998. Based upon the information
provided on the application for site evaluation and after the evaluation
vas completed, the site Was found to be provisionally suitable for installation
of an on-site sevage disposal system.
If you have any questions, please feel free to contact this office.
Sincerely,
Robert B. Hall, Jr., R.S.
Environmental Health Specialist .
RH/vd
Enclosure(s)