760 Duke Whitaker RdDavie County, NC Tax Parcel Report cD 0— Thursday, September 29, 2016
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All data Is provided as is without warranty or guarantee of any Idnd either expressed or Implied Including but not limited to the
Davie County, Impliedwamntlas of merchantability or fitness for a particular use. All users of Davie County's GIS website shall hold harmless the
N`' County of Davie, North Carolina, Its agents, consultants, contractors or employees from any and all claims or causes of action due to
1. or arising out of the use or Inability to use the GIS data provided by this website.
WARNING: THIS IS NOT A SURVEY
Parcel Information
Parcel Number
E200000047
Township:
Clarksville
NCPIN Number.
5801945563
Municipality:
Account Number:
82530962
Census Tract:
37059-801
Listed Owner 1:
GROCE MONICA P
Voting Precinct:
CLARKSVILLE
Mailing Address 1:
760 DUKE WHITAKER 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:
1.972 AC DUKE WHITAKER RD
Fire Response District:
SHEFFIELD - CALAHALN
Assessed Acreage:
2.02
Elementary School Zone:
WILLIAM R DAVIE
Deed Date:
7/2009
Middle School Zone:
NORTH DAME
Deed Book / Page:
008000740
Soil Types:
MnC2,MnB2,ChA
Plat Book:
Flood Zone:
Plat Page:
Watershed Overlay:
DAVIE COUNTY
Building Value:
134820.00
Outbuilding 8r Extra
Freatures Value:
0.00
Land Value:
22540.00
Total Market Value:
157360.00
Total Assessed Value:
157360.00
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All data Is provided as is without warranty or guarantee of any Idnd either expressed or Implied Including but not limited to the
Davie County, Impliedwamntlas of merchantability or fitness for a particular use. All users of Davie County's GIS website shall hold harmless the
N`' County of Davie, North Carolina, Its agents, consultants, contractors or employees from any and all claims or causes of action due to
1. or arising out of the use or Inability to use the GIS data provided by this website.
: - = e .yr„•i �,�, 1 r.y, '::.i n:.,,.t•• '.':.-w^"y-.I.:.�e r ,. - %-�n^�.-r.. Y'f�>..-.._ .,,
Pennittee's f % . DAVIE COUNTY HEALTH DEPARTMENT ey /711 C) S
Name: r'l. `AGI tf'- l ` - Environmental Health Section PROPERTY INFORMATION
r-, r t " P.O. Box 848;'
Directions to property: �J . t /` + �' �;' rp ocksville, NC 27028 Subdivision Name:
Phone #: 336-751-8760
Section: Lot:
AUTHORIZATION. FOR
WASTEWATER Tax Office PIN:#
SYSTEM CONSTRUCTION
AUTHORIZATION NO: 45- A _ /7&�N met K„'"
p
**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 l~orm/Authorization Number should be presented to the Davie County Building Inspections
Office when applying for Building Permits:
(In compliance with Article I 1 of G.S. Chapter 130A; Wastewater Systems, Section .1900 Sewage Treatment and Disposal Systems)
***NOTICE*** THIS AUTHORIZATION FOR
VALID FOR A PERIOD WASTEWATER CONSTRUCTION
OF.FIVE YEARS. ,
ENVIRONMENTAL HEAL H SPECIALIST. DATE ISSUED
RESIDENTIAL SPECIFICATION: BUILDING "TYPE, # BEDROOMS # BATHS Q # OCCUPANTS GARBAGE DISPOSAL: Yes or No
COMMERCIAL SPECIFICATION: FACILITY TYPE/ # PEOPLE # PEOPLE/SHIFT # SEATS INDUSTRIAL WASTE: Yes orNo
LOT SIZE TYPE WATER SUPPLY C DESIGN WASTEWATER FLOW (GPD) NEW SITE REPAIR SITE
SYSTEM SPECIFICATIONS: TANK SIZE GAL. PUMP TANK GAL. 'TRENCH WIDTH--J t7' ROCK DEPTH�� (r LINEAR FT./06
OTHER /f TCS PC' Z tJ' rL�
REQUIRED SITE MODIFICATIONS/CONDITIONS:
**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 (336)751-8760.
DAVIE COUNTY HEALTH DEPARTMENT
Environmental Health Section
PO Box 848/210 Hospital Street
Mocksville, NC 27028
Phone: (336)751-8760
ON-SITE WASTEWATER CERTIFICATION FOR DWELLING '
(Check One) REPLACEMENT ❑ REMODELING ❑ RECONNECTION ❑
Name: ~�cj c. Zit Phone Number: _L(Home)
Mailing Address: -� ; o �, ��_ r r '7 f.l 1��f< �i.6 low ' �O �s (Work)
FLe P f Do71oS
Detailed Directions To Site:
Property
Please Fill In The Following Information About The Existing Dwelling.
Name System Installed Under: L- )4. L_ L-,& °,.� Type Of Dwelling: S Cj
Date System Installed(Month/Day/Year): C� �' Number Of Bedrooms: � Number Of People:
Is The Dwelling Currently Vacant? Yes G-' No ❑ If Yes, For How Long?
Any Known Problems? Yes ❑ No V,-- If Yes, Explain:
Please Fill In The Following Information About The New Dwelling.
Type Of Dwelling: Number Of Bedrooms: L Number Of People. C/
Requested By: Date Requested:
(Signature)
For Environmental Health Office Use Only
Approved ❑ Disapproved ❑
Comments: � A f4 i:. j`�( i' T (; %..� , a /'�✓�y �:� ,�. �1
Environmental Health
.y
'"The signing of this form by the Environmental Health Staff is in no way intended, nor should be taken as a
euarantee(extended or limited) that the on-site wastewater system will function properly for any given period of time.
V
Payment: Cash B' Check ❑ Money Order ❑ # t $ U Date:
Paid By: �7 a S Received By: r�
L � q
Account #: -3'45-7 Invoice #:-4-1 7 � I
DAVIE COUNTY HEALTH DEPARTMENT
IMPROVEMENT PERMIT and OPERATION PERMIT
;'A
IMPROVEMENT PERMIT
**NOTE** This improvement permit DOES NOT authorize the construction or installation 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)
NAME PROPERTY ADDRESS h'W k(" 71011 . / lI' ZI � r�D�
/`'/` C_ DATE
LOCATION
SUBDIVISION NAME LOT NUMBER SEC./BLOCK NUMBER
RESIDENTAL SPECIFICATION: BUILDING TYPE eV t # BEDROOMS # BATHS _a7-# OCCVANTS GARBAGE DISPOSAL: Ye
COMMERCIAL SPECIFICATION: FACILITY TYPE # PEOPLE # PEOPLE/SHIFT # SEATS IN�DUSSTRI�AL WASTE: Yes/No
LOT SIZE TYPE WATER SUPPLY DESIGN WASTEWATER FLOW (GPD) %� NEW SITE �'' REPAIR SITE
SYSTEM SPECIFICATIONS: TANK SIZE
%1'� GAL. ,PUMP TRMI GAL. TRENCH WIDTH! ROCK DEPTH LINEAR FT.�
OTHER
REQUIRED SITE MODIFICATIONS/CONDITIONS:
***THIS PERMIT IS SUBJECT TO REVOCATION IF SITE PLANS OR THE INTENDED USE CHANGE. YOUR WASTERWATER SYSTEM CONTRACTOR MUST
SEE THIS PERMIT BEFORE INSTALLING THE SYSTEM.
ti.
IMPROVEMENT PERMIT BY/
**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 A ►J cel:: 1�.� Q
Gv�91 t12 rbT �"„sem Q
u
AUTHORIZATION NO. (q 1 G b OPERATION PERMIT BY �^-►`$ ”' DATE0-2:2ZU
**THE ISSUANCE OF THIS OPERATION PERMIT SHALL INDICATE THAT THE SYSTEM DESCRIBED ABOVE 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.
DCHD 10/95
APPLICATION FOR SITE EVALUATION/IMPROVEMt
Davie County Health Department
Environmental Health Section 1996
P. O. Box 665 FEB ' 6
,) Mocksville, NC 27028
1. Application/Permit Requested By G'AeDL /91 G ...�:-Al
jHome Phone �•• : . �O� .��
j Mailing Address
I iocksy i l l e- .A)O— a 7pa ? Business Phone:% -'103&-
2. Name on Permit if Different than Above e
3. Application for: a General Evaluation ZSeptic Tank Installation Permit
4. System to Serve: ❑ House EY obile Home ❑ Place of Public Assembly
❑ Business ❑ Industry ❑ Other ❑ Unknown
5. If house, mobile home: Subdivision Section Lot #
❑ Basement/Plumbing
No. of People ❑ Basement/No Plumbing
No. of Bedrooms 3
No. of Bathrooms
Dwelling Dimensions /-%z X �� ---- ----
6. If business, industry, place of public assembly, other: Specify type
'.� No. of People Served
No of Commodes
No. of Sinks
No. of Urinals
No. of Lavatories No. of Water Coolers
1 No. of Showers Water Usage Figures
7. Type of water supply: public ❑ Private ❑ Community
8. Property Dimensions jf'�PLI tfn Cjosed Sewage Disposal Contractor RAndLl' m i e-
9.
9. Do you anticipate additions/expansion of the facility this sytem is intended to serve? ❑ Yes S -No
If yes, what type?
5"Washing Machine
ET -Dishwasher
❑ Garbage Disposal
'NOTE: Improvements Permits shall be valid from date issued. Improvements Permits are subject to
revocation, if site plans or the intended use change. Effective October 1, 1989.
Directions to Property:
loD i/I/
wI Pops R 44 --
Tax Office PIN: # A7 ODA06O
PROPERTY ADDRESS, as.follows:
Road Name: pu,41. bi.I bi %t19 k'Pf
1
city: mocksu; 11�. lN(
SUBMIT A PLAT WITH THIS APPLICATION.
Revisions effective October 1, 1995.
This is to certify that the information provided is correct to the best of my knowledge, and I understand I am responsible for all charges
incurredfro this application.
Z& &
DATE SIGNATURE
CONSENT FOR SITE EVALUATION TO BE DONE ON ABOVE DESCRIBED PROPERTY
MUST CHECK ONE: �. 1 OWN the property. ❑ 2. 1 DO NOT OWN the property.
If you checked Box #2, the rest of this form MUST be completed by the owner or a person authorized by the owner:
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
to conduct all testing procedures as necessary to determine said site's suitability for a ground absorption sewage treatment
and disposal system.
DATE SIGNATURE
DCHD (1/93)
311'
•••I,C:RAY C AT ES certify that on JUNE 2 8 , 19 94 • I surveyed the property shown on this plat; s
thdt the property lines and location of all structures are accurately shown hereon; that no structure located on this property
encroaches on any adjacent street or property; and that no structure on adjacent property encroaches on the premises z
surveyed."
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PARCEL 15.01 rco
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D.B. 113-653 0.
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T AK R r E�
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_---- PROPERTY OF
. CAROL L. ALLEN 'e
15.02 DAVIE COUNTY TAX MAP E-2 }
LOT NO. MAP OF BLOCK NO.
CLARKSVI LLE TOWNSHIP, 1,
DEED BOOK 133 PAGE 169 - DAV I E COUNTY, N. C.
SCALE: 1 INCH= 100 FEET
Joe rlo 3270 r f
I1IOYTH9IIN PHOTO PRINT • SUPPLY CO.—WINYTOM•YALIIM N50"9 .. ,• 4! rl t �`_ �`y{
- i
' DAVIE COUNTY HEALTH DEPARTMENT f
Environmental Health Section
Soil/Site Evaluation
NAME '" f
ADDRESS
PROPOSED FACIILTY
DATE EVALUATED
PROPERTY SIZE
LOCATION OF SITE
Water Supply:
On -Site Well _
Community
Public f
Evaluation By:
Auger Boring jam_
Pit
Cut
FACTORS 1 2 3 4
Landscape position
Sloe Z -L
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 / G
SITE CLASSIFICATION: -(
LDNG-TERM ACCEPTANCE RATE: l
REMARKS:
DCHD(01-901
EVALUATED BY: i �
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 :lay loam- SIL -Silty loam CL -Clay loam SCL-Sandy clay loam
SC -Sandy clay SIC -Silty clay C -Clay
Moist
VFR- Vc.-y 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
3C --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 watet' 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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r,,.. ?bane . C oarzly �ealK Department
and .dome AealtFl Aenvy
210 HosPITAL STREET/ P.O. BOX 665
MOCKsvILLE. N.C. 27028
M
PHONE. (704) 634 5985 �I
June 27, 1994
Carol Allen
F'. 0. Box 524
Mocksville, IVC 27028
Re:� 2 Site Evaluations
Dike Whitaker Road/Sites 1 & 2
Dear Ms. Allen:
As requested, a representative from this office visited the aforementioned
sites on June 24, 1994. Based upon the information provided on the application
for a site evaluation and after the evaluations were completed, two sites were
found to be provisionally suitable for the installation of an on—site sewage
disposal system on each site.
If you have any questions, please feel free to contact this office.
s Sincerely,
Robert B. Hall, Jr., R.S.
Environmental Health Section
RH/wd
Enclosure
cc: Jesse Boyce
Davie County Health Department
ENVIRONMENTAL HEALTH SECTION
P.O. Box 665
Mocksville, N.C. 27028
AUTHORIZATION FOR WASTEWATER SYSTEM CONSTRUCTION
(Issued in compliance with Article 11 of
G.S. Chapter 130A, Wastewater Systems)
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***This Authorization For Wastewater System Construction must be issued by the Davie County Environmental Health Section prior to
issuance of any Building Permits. This Fore/Authorization Number should be presented to the Davie County Building Inspections
Office when applying for Building Permits.***
AUTHORIZATION NUMBER
NAME / />f�t'7'//f'i'i/ DATE C7� (� N2 phi 15 5
NAME ON IMPROVEMENT PERMIT (If different than above)
SITE LOCATION
COMMFMS/CUNDITIONS ON AUTHORIZATION TO CONSTRUCT WASTEWATER SYSTEM