250 Dutchmanview Ln3avie Countv, NC
Tax Parcel Report 6 X) 9 Thursdav, September 29, 201 E
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WARNING: THIS IS NOT A SURVEY
All data Is provided as is without warranty or guarantee of any kind either expressed or Implied Including but not limited to the
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
or arising out of the use or Inability to use the GIS data provided by this website.
�ParcelInformation��
Parcel Number:
C30000010802
Township:
Clarksville
NCPIN Number::
5813503360
Municipality:
Account Number:
82522635
Census Tract:
37059-801
Listed Owner 1:
SMITH BENNIE D
Voting Precinct:
CLARKSVILLE
Mailing Address 1:
250 DUTCHMANVIEW LANE
Planning Jurisdiction:
Davie County
City: MOCKSVILLE
Zoning Class:
DAVIE COUNTY R -A
State:
NC
Zoning Overlay:
Zip Code:
27028-4834
Voluntary Ag. District:
No
Legal Description:
23.956 AC JACK BOOE RD
Fire Response District:
WILLIAM R. DAVIE
Assessed Acreage:
21.98
Elementary School Zone:
WILLIAM R DAVIE
Deed Date: -
3/2006
Middle School Zone:
NORTH DAVIE
Deed Book / Page:
006540442
Soil Types: MnC2,MnB2,MdB,ChA,WATER,MdE
Plat Book:
Flood Zone:
Plat Page:
Watershed Overlay:
DAVIE COUNTY
Building Value:
75340.00
Outbuilding & Extra
Freatures Value:
12380.00
Land Value:
120600.00
Total Market Value:
208320.00
Total Assessed Value:
208320.00
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Davie County,
NC
All data Is provided as is without warranty or guarantee of any kind either expressed or Implied Including but not limited to the
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
or arising out of the use or Inability to use the GIS data provided by this website.
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DAVIE COUNTY HEALTH DEPARTMENT
IMPROVEMENT PERMIT and OPERATION PERMIT
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.
(Incompliance with Article 11 of B.S. Chapter 130A, Wastewater Systems, Section .1900 Sewage Treatment and Disposal Systems)
PROPERTY ADDRESS / d crib DATEP�
LOCATIONC
SUBDIVISION NAME LOT NUMBER SEC./BLOCK NUMBER
RESIDENTAL SPECIFICATION: BUILDING TYPE # BEDROOMS �,T # BATHS # OCCUPANTS - / GARBAGE DISPOSAL.: Ye�
COMMERCIAL SPECIFICATION: FACILITY TYPE # PEOPLE # PEOPLE/SHIFT # SEATS T INDUSTRIAL WASTE: Yes/No
LOT SIZE TYPE WATER SUPPLY &e,&.,. DESIGN WASTEWATER FLOW (GPD) -'?60 NEW SITE "IR SITE
SYSTEM SPECIFICATIONS: TANK SIZE ,Z& GAL. PUMP TANK GAL. TRENCH WIDTH -�lN 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.
IMPROVEMENT PERMIT BY 14
**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
AUTHORIZATION NO. 0 ?iss OPERATION PERMIT BY
DCHD 10/95
DATE
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Davie County Health Department
ENVIRONMENTFL HEALTH 5ECTION
P.O. Box 665
Mocksville, N.C. 27028
AUTHORIZATION FOR WASTWATER SYSTEM CONSTRUCTION
Ussued-# cyrpliance+with Article 11 of
G.S. Chapter 130A, Wastewater Systems)
***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.***
AUTHORIZATION MLMBER -
NAME AL./ c' /—Z DATE sRO&?g �� Na 3
NAME ON IMPROVEMENT PERMIT (If different than above)
SITE LOCATION
COMMENTS/CONDITIONS ON AUTHORIZATION TO CONSTRUCT WASTEWATER SYSTEM
• " APPLICATION FOR SITE EVALUATION/IMPROVEMEN11
TS
Davie County Health Department v
Environmental Health Section D
P. O. Box 665 MAR . 2 6 1996
Mocksville, NC 27028
1. Application/Permit AAA!!!ggquested By C5 1'n c -Jt 1� , I r v
Mailing Address , % Home Phone
U y A �- ce Business Phone 91q
2. Name on Permit if Different than Above i
3. Application for: ❑ General Evaluation UMeptic Tank Installation Permit
4. System to Serve: ouse ❑ Mobile Home ❑ Place of Public Assembly
❑ Business" ❑ Industry, �— ❑�/O,thheer ❑ Unknown
5. If house, mobile home: Subdivision J ' '� (�'�^-�+ 1�1 < Section 3 Lot #
❑ Basement/Plumbing
No. of People �❑ BaasementlNo Plumbing
No. of Bedrooms E?14shing Machine
No. of Bathrooms ishwasher
Dwelling Dimensions Od ❑ Garbage Disposal
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.
No. of Showers Water Usage Figures.
7. Type of water supply: ff Pub 'c ❑ Private
8. Property Dimensions Sewage, Disposal Contractoi
9. Do you anticipate additions/expansion of the facility this sytem is intended to serve?
If yes, what type?
❑ Yes e-Ao '
❑ Community
'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: nb PROPERTY INFORMATION REQUIM:
Tax Office PIN: #
PROPERTY AbbRES , as of ows:
Road Name:
City:
SUBMIT A PLAT WITH THIS APPLICATION.
Revisions effective October 1, 1995.
This is to certify that the information provided is correct to the of my
incurred from this application
D E
I understand I am responsible for all charges
NATURE
CONSENT FOR SITE EVALUATION TO BE DONE ON ABOVE DESCRIBED PROPERTY
MUST CHECK ONE: ❑ 1. 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 determin sai site's sui ' i y or round absorption sewage treatment
and disposal system.
DATE SIGNATURE
DCHD"(1/93)
10 )+ APPLICATION FOR SITE EVALUATION/IMPROVEMENTS 7 (�
U' l Davie County Health Department �-�►
Environmental Health Section Nov Z 9
P. O. Box 665
Mocksville, NC 27028
1. Application/Permit Re uested By J
Mailing Address o y �,, / Home Phone �i
w 7� Business Phone 52n O
-2. Name on Permit if Different than Above
3; Application for: ®'General Evaluation a Septic Tank Installation Permit
4.., System to Serve: House ❑ Mobile Home ❑ Place of Public Assembly,
❑ Indust❑Otp)f Unknown Business
5. If house, mobile home: Subdivision ! �`- e r� -�' Section 3 Lot # /d
Q—Basement/Plumbing `
No. of People B4asement/No Plumbing
No. of Bedrooms 21 ashing Machine
No. of Bathrooms ❑ Dishwasher
Dwelling Dimensions
6. If business, industry, place of public assembly, other:
No. of People Served
No. of Commodes
Specify type
No. of Sinks
No. of Urinals
❑ Garbage Disposal
No. of Lavatories No. of Water Coolers
No. of Showers Water Usage Figures
7 Type of water supply: Public ❑ Private ❑ Community
8. Property Dimensions �-u- 41610 Sewage Disposal Contractor
f:
9 Do you anticipate additions/expansion of the facility this sytem is intended to serve? ❑ Yes o F.
If yes, what type?
i
t
'NOTE: Improvements Permits shall be valid for a period of 5 years from date issued. Improvements Permits are subject to
revocation, if site plans or the intended use change. Effective October 1, 1989.
PROPERTY INFORNIWEION REQUIRED:
�3 AE:, /
� rr6�
j -p
This is to certify that the information provided is correct to
incurred from this application.
DATE
Tax Office PIN /#
Road ria e-.. Cocro -Q-
Box # (if available)
cityC/ v/'</-2
6a/
I understand I am responsible for all charges I
SIGNATURE
CONSENT FOR SITE EVALUATION TO BE DONE ON ABOVE DESCRIBED PROPERTY
MUST CHECK ONE: 1. I 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 deter ' e said site' suitability for a ground absorption sewage treatment
and disposal system. G .
DATE SIGNATURE
DCHD (1193)
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• DAVIE COUNTY HEALTH DEPARTMENT
Environmental Health Section
Soil/Site Evaluation
NAME fi / DATE EVALUATED
ADDRESS PROPERTY SIZE �� C
PROPOSED FACIILTY l� �i'/t�OU/7✓ LOCATION OF SITE�%���4_1
Water Supply: On -Site Well - Community Public
Evaluation By: Auger Boring Pit Cut
FACTORS 1
1 2 3 4
Landscape position
Sloe Z
-�
HORIZON I DEPTH
Texture group
Consistence
Structure
Mineralogy
HORIZON II DEPTH`
TI
Texture groupC
Consistence
Structure Ilk/(
-
Mineralogy ,`
`
HORIZON III DEPTH -
Texture group
Consistence
Structure
Mineralogy
HORIZON IV DEPTH
Texture group
Consistence
Structure
Mineralogy
SOIL WETNESS
RESTRICTIVE HORIZON
SAPROLITE
CLASSIFICATION IT
LONG-TERM ACCEPTANCE RATE 1
SITE CLASSIFICATION: - EVALUATED BY:
LONG-TERM ACCEPTANCE RATE: y 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 ;lay loam, SIL -Silty loam CL -Clay loam SCL-Sandy clay loam
SC -Sandy clay SIC -Silty clay C -Clay
CONSISTENCE
Moist
VFR- Ve.-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
Mineraloey
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
DCHD(01-901
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Tdvie County Xedltfr De drhrrent
a and Nake -Nedltlf Ayency
210 HOSPITAL STREET/ P.O. Box 665
MOCKSVILLE. N.C. 27028
PHONE: (704) 634-5985
December- 12, 1995
Roy Potts
P. D. Pox 11
Advance, IVC 27006
Re: 2 Site Evaluations
Jack Booe Road
Dear Mr. Potts:
As requested, a representative from this office visited the aforementioned
sites on December 6, 1995. Rased upon the information provided on the
application(s) for site evaluation(s) and after the evaluations were completed,
the sites were found to be provisionally suitable for the installation of an
on—site sewage disposal system on each lot.
If you have any questions, please feel free to contact this office.
Sincerely,
Robert B. Hall, Jr., R. S.
Environmental Health Section
RH/wd
Enclosure(s)