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1173 Farmington RdDavie County. NC Tax Parcel Report '04d Friday, September 30, 201E WARNING: THIS IS NOT A SURVEY I Parcel Information Parcel Number: E50000001407 Township: Farmington NCPIN Number: 5841681752 Municipality: No Account Number: 25983000 Census Tract: 37059-802 Listed Owner 1: FORTNER RHONDA LEIGH Voting Precinct: FARMINGTON Mailing Address 1: C/O RHONDA LEIGH WARNER Planning Jurisdiction: Davie County City: MOCKSVILLE Zoning Class: DAVIE COUNTY R-20 State: NC Zoning Overlay: DAVIE COUNTY QD Zip Code: 27028-0000 Voluntary Ag. District: No Legal Description: 1.62 AC PUDDING RIDGE RD Fire Response District: FARMINGTON Assessed Acreage: 1.39 Elementary School Zone: PINEBROOK Deed Date: 7/1991 Middle School Zone: NORTH DAVIE Deed Book / Page: 001600242 Soil Types: EnB Plat Book: Flood Zone: Plat Page: Watershed Overlay: DAVIE COUNTY Building Value: 0.00 Outbuilding & Extra 7710.00 Freatures Value: Land Value: 31240.00 Total Market Value: 38950.00 Total Assessed Value: 38950.00 O MIS Davie County, 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 �OUryC� NC 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. **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) NAMEi fO%t(J`rZ /iii %s��'!' PROPERTY ADDRESS- LOCATION DDDDRESS-LOCATION SUBDIVISION NAME LOT NUMBER I iq DATE SEC./BLOCK NUMBER RESIDENTAL SPECIFICATION: BUILDING TYPE # BEDROOMS S # BATHS -.Q # OCCUPANTS I GARBAGE DISPOSAL: Yes/No COMMERCIAL SPECIFICATION: FACILITY TYPE # PEOPLE # PEOPLE/SHIFT # SEATS INDUSTRIAL WASTE: Yes/No LOT SIZE F> TYPE WATER SUPPLY F d DESIGN WASTEWATER FLOW (GPD) NEW SITE L.,,;* REPAIR SITE SYSTEM SPECIFICATIONS: TANK SIZE ri3A)6k. PUMP TANK GAL. TRENCH WIDTH !K ROCK DEPTH /9 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. F dW r / IMPROVEMENT PERMIT BY�'� **CONTACT A REPRESENTATIVE OF THE DAVIE COUNTY HEALTH DEPARTMENT FOR FILL 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 j qb to �p SY NSTALLED 4� � � �w L �J AUTHORIZATION N0. 6 cV OPERATION PERMIT BY Za" % DATE 4/3 14 **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 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) ***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 pplying for Building Permits.*** AUTHORIZATION Ntlf9ER NAME DATE NATE ON IMPROVEMENT PERMIT (If different than above) SITE LOCATION C0061TS/C111DITIONS ON AUTHORIZATION TO CONSTRUCT WASTEWATER SYSTEM APPLICATION FOR SITE EVALUATIONAMPROVEMENT PERMIT & ATC 013 Davie County Health Department rt �0-Jc- ��' Environmental Health Section P.O. Box 848 o{ �p Mocksville, NC 27028 /1 rc (704) 634-8760 ****IMPORTANT**** THIS APPLICATION CANNOT BE PROCESSED UNLESS ALL THE REQUIRED INFORMATION IS PROVIDED. 1. Name to be Billed' iR 6Y\\da L, 'Fo d- l e K _ Contact Person "hO r� Mailing Address 11 �P 7 D -d K i n V0J1 e qab� Home Phone L! City/State/Zip �dv�C-E . if G oZ � � b to Business Phone C9 I b 9 [ Ll 18 2. Name on Permit/ATC if Different than Above Mailing Address 3. Application For: [ ] Site Evaluation City/State/Zip ] Improvement Permit & ATC M/Both 4. System to Serve: [ ] House [Mobile Home [ ] Business [ ] Industry [ ] Other 5. If Residence: # People I # Bedrooms 3 # Bathrooms [ ] Dishwasher [ ] Garbage Disposal [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 [ ] No If yes, what type? br %U%W,,O\ (k. \oAe r PROPERTY INFORMATION REQUIRD: *** IMPORTANT *** A PLAT OF THE PROPERTY MUST BE a53.Y�ee�-a10 �o�rr„SUBMITTED WITH THIS APPLICATION. )-t PD Dxx s ;?rq ,rts fee4- cl r�xld� "�j► Q bad Property Dimensions: a93.9 fef-M- WRITE DIRECTIONS (from Mocksville) TO PROPERTY: 'R69 creel- Wk FO�rti+1 ►^ oc� Tax Office PIN: # - -r{} a ;ACLF, 17— LA E"4- +b Property Address: Road Name Coirnl%r Nb-� tAp City/Zip `k 1Pi,�(1l�lcnA t��t��12 ��QI�S nv� QPef� 1MLt1P�tJ If in Subdivision provide information, as follows: C�(� i Name: e Section: Lot #: ;�1 u d Cly it�AP� 0.ri 6 . 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'h,nr,A0,- Le►Gh YbK'1hP r to conduct ail testing procedures as necessary to determine the site suitability. DATE �) I3 lv J SIGNATURE'�—%i A&.0— O�P- -G Revised DCHD (06-96) APPLICATION FOR SITE EVALUATION/IMPROVEMENTS PERMIT Davie County Health Department Environmental Health Section P. 0. Box 665 it uL ` Y ; E, Mockoville, NC 27028 1. Application/Permit Requested By :11'L 0 9 �G.'1 h � ,�Iner �G Mailing Address (f/11C7,� 1 UL.-.,V Home Phone 6210,9 �g' 1� �//-r(-►VCAP l � r Business Phone00) l `� n�I q" CPO J 2. Name on Permit if Different than Above 3. Property Owner if Different than Above 4. Application/Permit For: General Evaluation 0 S/Tank Installation 5. System to Serve: 0 House 3 Mobile Home Q Business Industry u Other [Unknown 6. If house, mobile home: Subdivision Sec. Lot# No. of People Dwelling Dimensions No. of Bedrooms Basement/Plumbing No. of Bathrooms ` Basement/No Plumbing 0 Washing Machine J Dishwasher []'Garbage Disposal 7. If business, industry, other: Specify type No. of People Served No. of Sinks No. of Commodes No. of Urinals No. of Lavatories No. of Water Coolers No. of Showers 8. Type of water supply: Public 0 Private Community 9. Property Dimensions Aca5 _ 10. Sewage Disposal Contractor 11. Do you anticipate add tions/expansions of the facility this system is intended to serve? add No If yes, what type? *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. This is to certify that the information provided is correct to tllF= best of my knowledge, and I understand I am responsible for all charges incurred from this application. 1---)-01/ /P 61,u� h , 'y" I Date S•gnature Directions to roperty: C> DCHD (10-89) -p-c ri (n -t Yl DAVIE COUNTY HEALTH DEPARTMENT ENVIRONMENTAL HEALTH SECTION SITE EVALUATION CONSENT FORM 1. Complete the form below and return to the Davie County Health 2. Carefully follow the procedures as outlined in the enclosed "Information Bulletin." NOTE: THE ABOVE MUST BE COMPLETED BEFORE A SANITARIAN WILL BE ABLE TO BEGIN THE REQUESTED EVALUATION. DETACH HERE AND RETURN TO: Davie County Health Department, Environmental Health Section, P. O. Box 665, Mocksville, N.C. 27028 Davie County Health Department Environmental Health Section Site Evaluation Consent Form LOCATION OF PROPERTY: DATE RECEIVED 1?�rni rl � �U�t�� h� (office use only) yes no 1. I am the owner of the above described property. yes no 2. 1 am not the owner of the above described property, however, I certify that I have consent from 1 �rtPTS �. rby. p,� -�,P_ (�l� owner to obtain a owner's name site evaluation by the Davie County Health Department for the purpose of determining the suitability for a ground absorption sewage treatment and disposal system. yes no 3. 1 hereby give consent to the authorized representative of the Davie County Health Department to enter upon the above described property and conduct all testing procedures as necessary to determine its suitability for a ground absorption sewage treatment and disposal system. DATE SIGNATU 4. 1 hereby authorize the Davie County Health Department to release site evaluation results from the above described property to the following: — Owner only Owners designated representative Anyone requesting results Only those listed below q -,)-9 ( DATE DCHD (11 /84) DAVIE COUNTY HEALTH DEPARTMENT Environmental Health Sectionv Soil/Site Evaluation NAME ADDRESS PROPOSED FACIILTY 9 DATE EVALUATED 9Z PROPERTY SIZE LOCATION OF SITE Water Supply: On -Site Well Community Public Evaluation By: Auger Boring L/ Pit Cut FACTORS 1 2 3 4 Landscape position ,L 44— LSlo Slope e % HORIZON I DEPTH Texture group Consistence Structure MineralogX HORIZON II DEPTH < g' Texture groupf� Consistence,— Structure Mineralo /�- HORIZON III DEPTH Texture group Consistence Structure Mineralogy HORIZON IV DEPTH Texture group Consistence Structure Mineralogy SOIL WETNESS RESTRICTIVE HORIZON SAPROLITE CLASSIFICATION J J LONG-TERM ACCEPTANCE RATEI Id G SITE CLASSIFICATION:J✓ EVALUATED BY: ZZ LDNG-TERM ACCEPTANCE RATE: �� 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 DCHD(01-901 ■■■■�■��■■■■��■■■■��■��■■��■■�■��■■��■�■�■ ■0■�!!�■ ■��■��■��■■■��e��■o��■■��■��■��■�■■��■o■ ■��■■�■��■■��■��■��■��■��■��■■�■��■■ ■■�■��■��■■��■�■��■ ■■��■■�■�■■��■��■■ ■■��■■■■■�■■��■��■■��■�■■��■��■��■��■ ■��■��■��■■��■�■��■��■■��a��■■��■ ■��■��■��■��■■��■■■■��■�■■��■■ ■��■��■��■��■�■�■■■��■■■��■■��■��■��■��■ ■�■■��■��■��■��■��■��■��■��■■■ ■��■��■��■��■■■��■��■��■ ■��■��■��■ ■��■■��■�■��■ ■�■��■��■��■��■��■��■��■��t��■��■��■■ ...........................�...................................... ........................... ...................................... .............................................. ................... 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BOX 665 MOCKSVILLE, N.C. 27028 PHONE: (704) 634-5985 July 9, 1991 Rhonda Leigh Fortner Rt. 6, Box 7 Advance, HC .27006 Re: Site Evaluation/Corner 1.66 Acres Farmington b Pudding Ridge Roads Dear Ms. Fortner: As requested, a representative from this office visited the aforementioned site on July 9, 1991. The site was found provisionally suitable for the installation of a ground absorption sewage system. If you have any questions, please feel free to contact this office. RH/wd Enclosure Sincerely, Robert B. Hall, Jr., R.S. Environmental Health Section D. REV BENNE— D.B. 60 PG existing �. Iron S 15. 0000- w J. T. CONNER 150.16 D.B. 72 PG. 162 S 83• Co. 00" 128100 1010f; 259.00 AREA = 1 .622 ACRES 2C' pa.b oacsa f S 12. 07' 37- W 88.54 111 r' o i r.ai 284.95 - n ra. -- - ---- N 82. 45' 00-- Yy ' PUDDING RIDGEROAD S.R. 1435 " r . O r v --1ALL'S LAND SURVEYING CO- P.O. BOX 294 IMOCKSVILLE . NC. 27028 1 704 1 634 - :155 1 �-i C ® am r «.-.. s. q SURVEY FOR : �Ns•s.su..•.s . Si Rt r4L 19.1 �� • W i� U � �U•�� w STATE OF NORTH CAROiINA. )AkIE____ COUNTY I, SAM P. HALL CERTIFY THAT !H'S M:P WS$ DRAWN UNDER MY SUPERV;S:611 FnOM AN ACPVAL FIELD SURVEY MADE UNDER MY SUPER715+^N. WITNESS MY HAhO AND SEA: THIS ZZ �t DAY OF _�Gr'1L�+4Ct- it REGISTERED LAND SURVEYOR L 29 i3 ELLA A. FURCHES ESTATE •C'ALE: r . 50` APPROVED BY ORAWN BY DATE: 9/23/88 1 SPH RHD DEED REFERENCE: D9. 23 PG. 265 ; D.B. 72 PG. 157 TAX MAP REFERENCE: E - 5 . PARCEL 14 FARUNGTON TWSP.. DAVIE CO.. N.C. DRAWING NUMBER E514 88-2 Q 0 t 72' DOr4y � t � rl I Asn 2260 --- s �•Sr33"w r , e7.95 ;N vow MC•l ♦ I r 4 • 9' A i T? 40 i 2C' pa.b oacsa f S 12. 07' 37- W 88.54 111 r' o i r.ai 284.95 - n ra. -- - ---- N 82. 45' 00-- Yy ' PUDDING RIDGEROAD S.R. 1435 " r . O r v --1ALL'S LAND SURVEYING CO- P.O. BOX 294 IMOCKSVILLE . NC. 27028 1 704 1 634 - :155 1 �-i C ® am r «.-.. s. q SURVEY FOR : �Ns•s.su..•.s . Si Rt r4L 19.1 �� • W i� U � �U•�� w STATE OF NORTH CAROiINA. )AkIE____ COUNTY I, SAM P. HALL CERTIFY THAT !H'S M:P WS$ DRAWN UNDER MY SUPERV;S:611 FnOM AN ACPVAL FIELD SURVEY MADE UNDER MY SUPER715+^N. WITNESS MY HAhO AND SEA: THIS ZZ �t DAY OF _�Gr'1L�+4Ct- it REGISTERED LAND SURVEYOR L 29 i3 ELLA A. FURCHES ESTATE •C'ALE: r . 50` APPROVED BY ORAWN BY DATE: 9/23/88 1 SPH RHD DEED REFERENCE: D9. 23 PG. 265 ; D.B. 72 PG. 157 TAX MAP REFERENCE: E - 5 . PARCEL 14 FARUNGTON TWSP.. DAVIE CO.. N.C. DRAWING NUMBER E514 88-2