167 Dusty Hill RdDavie County, NC
III
541
583
634
Tax Parcel Report Q b y Thursday, September 29, 2016
163
09 gUSjY.HILL R
164
179 t 180
161
N^ M data is provided as Is witlrout warranty or guarantee of any Idnd either expressedor 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 theCounty of Davie, North Carolina, Ifs agents, consultants, contractors or employees from any and all claims or causes of aWon due to
Cor 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:
F500000010
Township:
Mocksviile
NCPIN Number.
5840385784
Municipality:
Account Number.
48524000
Census Tract:
37059-806
Listed Owner 1:
MCCLAMROCK GLENAS M
Voting Precinct: NORTH MOCKSVILLE COUNTY
Mailing Address 1:
179 DUSTY HILL ROAD
Planning Jurisdiction:
Davie County
City: MOCKSVILLE
Zoning Class:
DAVIE COUNTY R -A
State:
NC
Zoning Overlay:
Zip Code:
27028-5751
Voluntary Ag. District:
No
Legal Description: 13.719AC DUSTY HILL RD LIFE ESTATE
Fire Response District:
WILLIAM R. DAVIE
Assessed Acreage:
13.72
Elementary School Zone:
WILLIAM R DAVIE,PINEBROOK
Deed Date:
12/1993
Middle School Zone:
NORTH DAVIE
Deed Book / Page:
1993EO236
Soil Types: MrB2,EnB,MsC,MsB
Plat Book:
Flood Zone:
Plat Page:
Watershed Overlay:
DAVIE COUNTY
Building Value:
58040.00
Outbuilding & Extra
Freatures Value:
440.00
Land Value:
83630.00
Total Market Value:
142110.00
Total Assessed Value:
81000.00
161
N^ M data is provided as Is witlrout warranty or guarantee of any Idnd either expressedor 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 theCounty of Davie, North Carolina, Ifs agents, consultants, contractors or employees from any and all claims or causes of aWon due to
Cor arising out of the use or inability to use the GIs data provided by this website.
r Ts' i �''"q r { S,•. r � s ~w 6'fi ont. .t +' 1 ...r. t ".A;j
A(J, *ORIZATION NO: 0584 DAME COUNTY HEALTH DEPARTMENT �' ' / bO • D 0
Environmental Health Section PROPERTY INFORMATION
Permitt e's P.O. Box 848
Name! �`� �'`a� \xi Mocksville, NC 27028 Subdivision Name:
Phone #: 704-634-8760
Directions to property: Section: Lot:
�`` AUTHORIZATION FOR
`G�+ xS" ?s:� •: ' ?...j 5r� WASTEWATER Ta Office PIN:# 7+ V)� �y
SYSTEM CONSTRUCTION
Al .w" }.7�r �t `'s+i3." ~ ,1� �s ` . Road Name: t..> u ... � ��� Zip:.
**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 Form/Authorization Number should be presented to the Davie,County Building Inspections
Office when applying for Building Permits.'
(In compliance with Article 11 of G.S. Chapter 130A, Wastewater Systems, Section .1900 Sewage Treatment and Disposal Systems)
***NOTICE*** NOTICE THIS AUTHORIZATION FOR WASTEWATER CONSTRUCTION
, ` y 1 ' 1Ip IS VALID FOR A PERIOD OF FIVE YEARS.
ENVIRONMENTAL HEALTH SPECIALIST' DATE ISSUED
jt
f�
DAVIE COUNTY HEALTH DEPAIh!V NT
•�, IMPROVEMENT AND OPERATION PERMITS PROPERTY INFORMATION
Permit
,. Name1 e "�- �b"'� '' ' �, �`�"a Subdivision Name: r
Directions to property: 'V4 `� 3' Section: Lot:
t ''� - 1 °x �. • ��. •
IMPROVEMENTPERMIT Tax Office PIN•# S`i- t z5r Rolad 7ame: L �VA Z i p: 152 �0-,
**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)
` ***NOTICE*** THIS PERMIT IS SUBJECT TO REVOCATION IF SITE
t ' » ! ~% ' PLANS OR THE INTENDED USE CHANGE. YOUR WASTEWATER
ENVIRONMENTAL HEALTH SPECIALIST DATE ISSUED SYSTEM CONTRACTOR MUST SEE THIS PERMIT BEFORE
INSTALLING THE SYSTEM.
RESIDENTIAL SPECIFICATION: BUILDING TYPElA SSL # BEDROOMS 5 # BATHS # OCCUPANTS GARBAGE DISPOSAL: Yes o
COMMERCIAL SPECIFICATION: FACILITY TYPE # PEOPLE # PEOPLE/SHIFT # SEATS INDUSTRIAL WASTE: Yes or No
LOT SIZES TYPE WATER SUPPLY �� DESIGN WASTEWATER FLOW (GPD) 0 NEW SITE V REPAIR SITE
2 )� �► J
SYSTEM SPECIFICATIONS: TANK SIZE SOU GAL. PUMP TANK GAL. TRENCH WIDTH 5 ROCK DEPTH —'W LINEAR FT. 3oa
OTHER
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 (704) 634-8760.
OPERATION PERMIT '
SYSTEM INSTALLED BY:
A C 43
Z
a p 7
w a
---,.DATE:
^ q
AUTHORIZATION NO. v o l OPERATION PERMIT BY: `��• DATE:
"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 05/96 (Revised)
APPLICATION FOR SITE EVALUATIONAMPROVEMENT
Davie County Health Department
Environmental Health Section
P.O. Box 848
Mocksville, NC 27028
(704) 634-8760
' & ATC
NOV 1 3 1199�97'653
****IMPORTANT**** THIS APPLICATION CANNOT BE PROCESSED UNLESS ALL
THE REQUIRED INFORMATION IS PROVIDED.1I�, 1 j�
1. Name to be Billed �' � u V`L' 0����� ''rodc Contact Person
Mailing Address 7 �j 1AS-�n 1�'c it ad Home Phone C1 01 S - 3 S c3
City/State/Zip MUNG 91 UJ -g Business Phone
2. Name on Permit/ATC if Different than Abo``ve m ' ko" S. 13 '0-0'V"'0-0'V"Mailing Address 163 n US6 4J U Q& —City/State/Zip
3. Application For: [-T'S-ite Evaluation [ ] Improvement Permit & ATC
Ate—. N C—
[ ] Both
4. System to Serve: [ ] House [Mobile Home [ ] Business [ ] Industry [ ] Other
5. If Residence: # People a # Bedrooms 3 # Bathrooms -"I-- [w,15'i'shwasher [ ] Garbage Disposal
[ ashing 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 f Well [ ] Community
8. Do you anticipate additions or expansions of the facility this system is intended to serve? [ ] Yes [1-140
If yes, what type?
PROPERTY INFORMATION REQUIRED: *** IMPORTANT *** A PLAT OF THE PROPERTY MUST BE
SUBMITTED WITH THIS APPLICATION.
Property Dimensions: A4 WRITE DIRECTIONS (from Mocksville) TO
Tax Office PIN: #SSV 0 - 39 - -�8' � / � � � Xty� Val -L2
Property Address: Road Names tl2L- C 1t
City/Zip /10 Lk' /VC. a?0;)..0-
If
;)-.0'If in Subdivision provide information, as follows:
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 7� t /Ci1GC� / .SCO �iJ%�'� c,,,�,to cond ct all testing rocedure as nece ary to determine the site suitability.
DATE-//-/-;- �'I SIGNATURE_ &�1 a
Revised DCHD (06-96)
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DAVIE COUNTY HEALTH DEPARTMENT
Environmental Health Section
Soil/Site Evaluation
NAME •�• `'`o �"�-�t ��� ��Q�- DATE EVALUATED
ADDRESS S Atr.o PROPERTY SIZE os_yy
PROPOSED FACIILTY b ft\o LOCATION OF SITE
Water Supply: On -Site Well V _ Community Public
Evaluation ByQk LAugerBoring ✓ Pit Cut
FACTORS
1
2 3 4
Landscape position
Sloe Z4
-
HORIZON I DEPTH
"
Texture groupL
Consistence
Structure
L�2.
Mineralogy1'•
\
\'•1
HORIZON II DEPTH
ETA
2%
Texture groupC
Consistence
Structure
AF3�c
Mineralogy
HORIZON III DEPTH
Texture group
Consistence
Structure
Mineralogy
HORIZON IV DEPTH
Texture group
Consistence
Structure
Mineralogy
SOIL WETNESS
S
SS
RESTRICTIVE HORIZON
--
—
SAPROLITE
--
CLASSIFICATION
.5.
•S
LONG-TERM ACCEPTANCE RATE
1�{
SITE CLASSIFICATION: V '-:>
LONG-TERM CCpEP ANCE RATE:
REMARKS: 16�
DCHD(01-901
EVALUATED 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- V, ---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 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
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