109 Elk LnParcel #: M509OA0015 A
Davie County, NC - Basic Estate Search
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Parcel #: M509OA0015 A Account #: 82521668
Owner Information Tax Codes
OGUE MERRELL OTIS& HOGUE SHAWNA S W ADVLTAX - COUNTY T
O BOX 953 READVLTAX - FIRE TAX
OOLEEMEE NC 27014
Building:
60f23
Property Information
Township
Land (Units/Type): 1.000 LT
[Address: 109 ELK LN
JERUSALEM
Market:
72 73
ssessed:
Deed Information
Local Zoning
Date: 02/2003 Book: 00519 Page: 0250
Plat Book: 0001 Page: 096
Unqualified
Vacant
3,000
>_
Le al Description
PIN
LOTS 108-109 O C WALL
5735967840
Property Values
Building:
60f23
BXF•
Year Instrument
Land:
12,50
Market:
72 73
ssessed:
72f73
Deferred
1998 WD
Sales Information
No.
Book
Page
Month
Year Instrument
Qual/UnQuai
Improved
Price
L
00203
0209
06
1998 WD
Unqualified
Vacant
3,000
>_
00204
0448
07
1998 WD
Unqualified
Vacant
5,500
3
00457
0192
12
2002 WD
Unqualified
Vacant
0
I
00519
0250
02
2003 WD
Unqualified
Vacant
0
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Davie County Web Site
All information on this site is prepared for the inventory of real property found within Davie County. All data is compiled from recorded deeds,
plats, and other public records and data. Users of this data are hereby notified that the aforementioned public information sources should be
consulted for verification of the information. All information contained herein was created for the Davie County's internal use. Davie County,
its employees and agents make no warranty as to the correctness or accuracy of the information set forth on this site whether express or
implied, in fact or in law, including without limitation the implied warranties of merchantability and fitness for a particular use.
If you have any questions about the data displayed on this website please contact the Davie County Tax Office at (336) 753-6120.
1.5.9
http://maps.daviecountync.gov/itsnet/View.aspx?prid=1463239 10/5/2016
AUTHORIZATION NO: 1521 DAVIE COUNTY HEALTH DEPARTMENT
Environmental Health Section PROPERTY INFORMATION
Permittee's P.O. Box 848
Name: " -4 rL Mocksville, NC 27028 Subdivision Name:
Zile G Phone # 336-751-8760
Zil
Directions to property: 'T� Section: Lot:
AUTHORIZATION FOR
WASTEWATER Tax Office PIN:#,:r% 'y // �
SYSTEM CONSTRUCTION
Road Name:
**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 I I of G.S. Chapter 130A, Wastewater Systems, Section .1900 Sewage Treatment and Disposal Systems)
/,•'' / ,.' �.
***NOTICE***. THIS AUTHORIZATION FOR WASTEWATER CONSTRUCTION
IS VALID FOR A PERIOD OF FIVE YEARS.
ENVIRONMENTAL HEALT rSkCIALIST DATE ISSUED
.'DAVIE CPUNTY HEALTH DEPARTMENT
`± IMPROVEMENT AND OPERATION PERMITS
Permittee's
Name:J
4j,A
Directions to property:
T_ ✓moo
PROPERTY INFORMATION
' subdivision Name:
Section: Lot:
IMPROVEMENT /
PERMIT Tax Office PIN: '�'/-
Road Name: ip: Vol q
**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)
r. �.? ***NOTICE*** THIS PERMIT IS SUBJECT TO REVOCATION IF SITE
l f PLANS OR THE INTENDED USE CHANGE. YOUR WASTEWATER
ENVIRONMENTAL HEAL'I'H'SPECIALIST DATE ISSUED SYSTEM CONTRACTOR MUST SEE THIS PERMIT BEFORE
INSTALLING THE SYSTEM.
RESIDENTIAL SPECIFICATION: BUILDING TYPE 11VH # BEDROOMS �,? # BATHS ' �_ # OCCUPANTS GARBAGE DISPOSAL: Yes or No
COMMERCIAL SPECIFICATION: FACILITY TYPE # PEOPLE # PEOPLE/SHIFT # SEATS INDUSTRIAL WASTE: Yes or No
LOT SIZF/--2y0 TYPE WATER SUPPLY DESIGN WASTEWATER FLOW (GPD) NEW SITE REPAIR SITE
SYSTEM SPECIFICATIONS: TANK SIZE &0,6 GAL. PUMP TANK GAL. TRENCH WIDTH ROCK DEPTH LINEAR FF. 04::N
OTHER
REQUIRED SITE MODIFICATIONS/CONDITIONS: _
IMPROVEMENT PERMIT LAYOUT
F
A 4
L-
"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.
OPERATION PERMIT
SYSTEM INSTALLED BY:
/0
YO g�
AUTHORIZATION NO. OPERATION PERMIT BY: DATE:
r�
**THE ISSUANCE OF THIS OPERATION PERMIT SHALL INDICATE THAT THE SYSTEM DESCRIBED ABOVE HAS BEEN INSTALLED IN COMPLIANCE
WITH ARTICLE I 1 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 05196 (Revised)
- APPLICATION FOR SITE EVALUATIONAMPROVEMENT PERMIT
Davie County Health Department
Environmental Health Section
t P. O. Box 848
dy
Mocksville, NC 27028
e (704) 634-8760
****IMPORTANT**** THIS APPLICATION CANNOT BE PROCESSED UNLESS
j� ALL THE REQUIRED INFORMATION IS PROVIDED.
1. Name to be Billed 1 /� p 6 Contact Person oy ��
Mailing Address I O �� X �, ) u'' Home Phone
City/State/Zip �ioa Il.`�� 1�/ `1 Business Phone
2. Name on Permit/ATC if Different than Above
Mailing Address
City/State/Zip
SUBMITTED
WITH THIS APPLICATION.
I /� 1
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b
3. Application For:
C$V Site Evaluation
❑ Improvement Permit & ATC
❑ Both
4. System to Serve:
❑ House M Mobile Home ❑ Business ❑ Industry
❑ Other
5. If Residence:
# People
# Bedrooms
# Bathrooms z—
U Dishwasher
❑ Garbage Disposal
Washing Machine ❑ Basement/Plumbing
❑ Basement/No Plumbing
6. If Business/Other:
Specify type
# People
# Sinks
# Commodes
If Foodservice:
7. Type of water supply:
# Showers
# Seats /
❑ County/City
# Urinals
Estimated Water Usage (gallons per day)
❑ Well
# Water Coolers
❑ Community
8. Do you anticipate additions or expansions of the facility this system is intended to serve? ❑ Yes ❑ No
If yes, what type?
PROPERTY INFORMATION REQUIRED: *** IMPORTANT *** A PLAT OF THE PROPERTY MUST BE
SUBMITTED
WITH THIS APPLICATION.
I /� 1
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b
Property Dimensions: / LJ
1
WRITE DIRECTIONS (from
# �7 2�
G
�D p�
Mocksville) TO PROPERTY:
(
Tax Office PIN: � -
-
1
0 / �� � O'
I -j� J
Property Address: Road Name 0 � C
44
4 A `�� n l� a
L lam(
r n
City/Zip �alC�m`C�
/�
/'
��04 1
1
pa
If in Subdivision provide information, as follows:
1
1
Name:
1
1
I `r
(,
Section:
Lot #:
1
1
I
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
0
as necessary to determine the site suitability.
DATE (9 — ;)a -01 b S
conduct all testing procedures
Revised DCHD (06-96)
"O�v l6
64
i
t-
0
0
DAVIE COUNTY HEALTH DEPARTMENT
Environmental Health Section SECTION LOT
Soil/Site Evaluation
APPLICANT'S NAME DATE EVALUATED Z
PROPOSED FACILITY 1% f PROPERTY SIZE
SUBDIVISION
Water Supply: On -Site Well
Community
ROAD NAME
Evaluation By: Auger Boring Pit
Public
Cut
FACTORS
1
2 3 4 5 6 7
Landscape position
Sloe %
HORIZON I DEPTH
Texture group
Consistence
Structure
Mineralogy
HORIZON II DEPTH
Texture group
Consistence
AA
Structure
Mineralo
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:
LONG-TERM ACCEPTANCE RATE:
REMARKS:
LEGEND
DCHD (0I-90)
Landscape Position
EVALUATION BY: Aw /
OTHER(S) PRESENT:
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
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