749 Fork Bixby Rd (2)Davie County, NC r Tax Parcel Report Wednesday, September 28, 2016
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Davie County, NC
WARNING: THIS IS NOTA SURVEY
Parcef Information
causes of action due to or arising out of the use or inability to use the GIS data provided by this website.
Parcel Number:
170000009401
Township:
Fulton
NCPIN Number:
5778265687
Municipality:
Account Number:
8304396
Census Tract:
37059-804
Listed Owner 1:
RCC ASSETS LLC
Voting Precinct:
FULTON
Mailing Address 1:
765 FORK BIXBY ROAD
Planning Jurisdiction:
Davie County
City:
ADVANCE
Zoning Class:
DAVIE COUNTY R-20
State:
NC
Zoning Overlay:
Zip Code:
27006
Voluntary Ag. District:
No
Legal Description:
0.858 AC FORK BIXBY RD
Fire Response District:
FORK
Assessed Acreage:
0.78
Elementary School Zone:
CORNATZER
Deed Date:
512001
Middle School Zone:
WILLIAM ELLIS
Deed Book I Page:
370950037
Soil Types:
WeC,PcB2
Plat Book:
Flood Zone:
X
Plat Page:
Watershed Overlay:
Building Value:
113030.00
Outbuilding & Extra
0.00
Freatures Value:
Land Value:
17150.00
Total Market Value:
130180.00
Total Assessed Value:
130180.00
141
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.
AUTHORIZATION NO:
196, 1 DAVIE COUNTY HEALTH DEPARTMENT � Xo
.rEnvironmental Health Section PROPERTY INFORMATION
Permittees- M' C P.O. Box 848
Name: 1' ► C2P—A M Mocksville, NC 27028 Subdivision Name:
f
Directions to property: l ID�I� Phone # 336-751-8760 Section: Lot:
AUTHORIZATION FOR O Q3
WASTEWATER Tax Office
SYSTEM CONSTRUCTION
q
Road Nam
e:o�L -�
**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. ,?r� �p
(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.
~ENVIRONYEN EAL SPE(ilALI DAT ISS D
DAVIE C UNTY HEALTH DEPARTISILNT k) 6/961 X o
IMPROVEMENT AND OPERATION PERMITS PROPERTY INFORMATION
Permittees-)�+
Name - 1)+ / . Subdivision Name:
Directions to property: �'� , ` a 1=! Section: Lot:
4 IMPROVEMENT
T2 PERMIT � X71
� •`3v/, t(W� , '�' � ;,,�,} (� / �. � ._ i`.c. PERMIT Tax Office PIN•
.) l l t i /e.� rs 1 • t_)Q < Utz i,l`
Road Name:
**NOTE** This Improvement Permit DOES NOT authorize the construction or installation of a septic tank system or any wastewater system.
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
PLANS OR THE INTENDED USE CHANGE. YOUR WASTEWATER
ENVIRONMEN AL HEALTH SPECIALIST DA, ISSUED SYSTEM CONTRACTOR MUST SEE THIS PERMIT BEFORE
INSTALLING THE SYSTEM.
RESIDENTIAL SPECIFICATION: BUILDING TYPE # BEDROOMS # BATHS _�_ # OCCUPANTS GARBAGE DISPOSAL: Yes or No
COMMERCIAL SPECIFICATION: FACILITY TYPE # PEOPLE # PEOPLE/SHIFT # SEATS INDUSTRIAL WASTE: Yes or No
LOT SIZE TYPE WATER SUPPL4� DESIGN WASTEWATER FLOW (GPD) NEW SITE REPAIR SITE V
SYSTEM SPECIFICATIONS: TANK SIZE GAL. PUMP TANK GAL. TRENCH WIDTH _ n ROCK DEPTH 1$ LINEAR FT.
�� --TQl
REQUIRED SITE MODIFICATIONS/CONDITIONS:
IMPROVEMENT PERMIT LAYOUT
R�
v� 3
oJ2-
1/'lJt✓`2T' _<
�-IL L5" r�
c.�
"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 <Z
SYSTEM INSTALLED BY:
s S14A"J
171
AUTHORIZATION NO. ` 1 OPERATION PERMIT BY: DATE:
"THE ISSUANCE OF THIS OPERATION PERMIT SHALL INDICATE THAT THE SYSTEM DESCRIBED ABOVE 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)
l
F]
Z .r.. 1�4'�Ju.taU�
,a AUTHORIZ•,,-i ION NO: 0 5 7 5 DAVIE COUNTY HEALTH DEPARTMENT
•' t Environmental Health Section PROPERTYFORMATION
Z1s
Permittee's C 1 P.O. Box 848 Q
Name: ���pV a �> Mocksville, NC 27028 Subdivision Name: �a
Phone #: 704-634-8760
Directions to property: �;�`� 1� ��� Section: Lot:
AUTHORIZATION FOR
WASTEWATER Tax Office PIN:#r' 7 �. _ r. �' �� 73
SYSTEM CONSTRUCTION
i y..:.. ).� .3 s; J �.i• .s ,�.+ ► a. R.Q VC, 1 : Zip: l- h �"1h ~
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 11 of G.S. Chapter 130A, Wastewater Systems, Section .1900 Sewage Treatment and Disposal Systems)
J e� ***NOTICE*** THIS AUTHORIZATION FOR WASTEWATER CONSTRUCTION
_ . '�,s� s ��Y-_5-•�v�°�,�,.. IS VALID FOR A PERIOD OF FIVE YEARS.
ENVIRONMENTAL HEALTH SPECIALIST DATE ISSUED
I� RESIDENTIAL SPECIFICATION: BUILDING TYPE SQ. #BEDROOMS =# BATHS = # OCCUPANTS GARBAGE DISPOSAL Yes r No
I
COMMERCIAL SPECIFICATION: FACILITY TYPE # PEOPLE - # PEOPLEISHIFr # SEATS INDUSTRIAL WASTE: Yes or No
LOT SIZE TYPE WATER SUPPLY DESIGN WASTEWATER FLOW (GPD)b_ NEW SITE REPAIR SITE
j SYSTEM SPECIFICATIONS: TANK SIZE Ooa GAL. PUMP TANK GAL. TRENCH WIDTH 3 ROCK DEPTH '1 11 � LINEAR Fr 0 c)
OTHER .
i REQUIRED SITE MODIFICATIONS/CONDITIONS:
if .,
IMPROVEMENT PERMIT LAYOUT
41
- � __.• � 0.a
"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.
AUTHORIZATION NO. OPERATION PERMIT BY: DATE:
**THE ISSUANCE OF THIS OPERATION PERMIT SHALL INDICATE THAT THESYSTEM DESCRIBED ABOVE HAS BEEN INSTALLED IN COMPLIANCE
WITH AR'T'ICLE I 1 OF G.S. CHAPTER 130A, SECTION .1900 "SEWAGE TREATMENT AND DISPOSAL SYSTEMS", BUT SHALL W NO WAY BE TAKEN AS,A ',
GUARANTEE TIiAT THE SYSTEM WILL FUNCTION SATISFACTORILY FOR ANY GIVEN PERIOD OF TIME. ri: `•'•
DCHD 05/96 (Revj") ,
• CLC - �1 c Gr-a'�-��1..//`..';
t AUTHORIZ! 'i ION'NO: Q 5 % 5 DAVIE COUNTY HEALTH DEPARTMENT
ERTYEnvironmental Health Section PROPORMATION
`j
Per'inittee s t % 1 P.O. Box 848 ��`� °'1l - �IJBA TV
•,'
Name: � pV Mocksville, NC 27028 Subdivision Name: W
Directions to property:l`to t Phone #: 704-634-8760
Section: Lot:
AUTHORIZATION FOR
C,j WASTEWATER Tax Office PIN:41 T1
SYSTEM CONSTRUCTION
Road Name:c,
��x��'l;� Zip:h^ ���
**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 1 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 HEALTH SPECIALIST DATE ISSUED
RESIDENTIAL SPECIFICATION: BUILDING TYPE SQ # BEDROOMS #BATHS #OCCUPANTS GARBAGE DISPOSAL Yes r No
COMMERCIAL SPECIFICATION: FACILITY TYPE # PEOPLE # PEOPLE/SHIFT # SEATS INDUSTRIAL WASTE: Yes or No
LOT SIZE TYPE WATER SUPPLY DESIGN WASTEWATER FLOW (GPD) NEW SITE REPAIR SITE
SYSTEM SPECIFICATIONS: TANK SIZE Ot)a GAL. PUMP TANK GAL. TRENCH WIDTH 3 ROCK DEPTH L LINEAR FT Q 0
OTHER
i REQUIRED SITE MODIFICATIONS/CONDITIONS:
r
IMPROVEMENT PERMIT LAYOUT A
A f��ro-
tyl 0,
1
0.0
�o �o VO
,d
**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.
"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 ASAw
GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORILY FOR ANY GIVEN PERIOD OF TIME.
DCIiD 05ro6 (Reviva) e
�. n .:�+i. L•.•.:...5 _( .. -47 "1' . - r 1. .y.: tY♦ '.i; -.. .`t. . wtj' ♦ :I ...... '^ ....,, 'I
.a' AUTHORIZATION NO: 0 5 7 5 DAVIE CO LINTY HEALTH DEPARTMENT +
�; ' • 3 Environmental Health Section PROPERTY I, I ORMATION J&
Periilitee's� P.O. Box 848 ��� 3
Name: �� aV a- N `�t;� Mocksville, NC 27028 Subdivision Name:
Phone #: 704-634-8760
Directions to property: �`� 1� l.� tss� Section: Lot:
AUTHORIZATION FOR
Tax Office ffice PIN:#�'� �' -�7 31
SYSTEM CONSTRUCTION
'��=���•C�3w� ac�3rr;. � Road Name: VC., :A7 Zip:h47 0,.A
**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)
+ ' `•,J ;�{� 1' ***NOTICE*** THIS AUTHORIZATION FOR WASTEWATER CONSTRUCTION
_%� ,mss ""�� ��]�,`9i• 1�� ��*
� �..y. IS VALID FOR A PERIOD OF FIVE YEARS.
ENVIRONMENTAL HEALTH SPECIALIST DATE ISSUED
RESIDENTIAL SPECIFICATION: BUILDING TYPE 2 # BEDROOMS - # BATHS # OCCUPANTS GARBAGE DISPOSAL Yes r No
COMMERCIAL SPECIFICATION: FACILITY TYPE # PEOPLE # PEOPLEISHIFT # SEATS INDUSTRIAL WASTE: Yes or No
,1v 1r��'•
LAT SIZE J TYPE WATER SUPPLY DESIGN WASTEWATER FLOW (GPD) NEW SITE � REPAIR SITE
SYSTEM SPECIFICATIONS: TANK SIZE OOa GAL. PUMP TANK GAL. TRENCH WIDTH ` ROCK DEPTH L LINEAR FT 0 0
OTHER
c
REQUIRED SITE MODIFICATIONS/CONDITIONS:
IMPROVEMENT PERMIT LAYOUT •Cj
�10,-5�► rn�`
41
1 0 ..TP
I
CLO
---- \cc) y0
�o
**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.
DCHD 05N6 (Revised) C !' l- a4k
APPLICATION FOR SITE EVALUATIONAMPROVEMENT PERMIT
r Davie County Health Department (�
Environmental Health Section u
P. O. Box 848
Mocksville, NC 27028
(704) 634-8760
@ IE Ov R
****IMPORTANT**** THIS APPLICATION CANNOT BE PROCESSEDLUNI6ESS------ —
ALL THE REQUIRED INFORMATION IS PROVIDED.
1. Name to be Billed I 'b " /' Contact Person Pa"
Mailing Address S ALIS Home Phone109
City/State/Zip le, 7,,, Business Phone
2. Name on Permit/ATC if Different than Above
Mailing Address .
3. Application For:
4. System to Serve:
5. If Residence:
la'Dishwasher
6. If Business/Other:
# Commodes _
If Foodservice:
7. Type of water supply:
❑ Site Evaluation
City/State/Zip
Ei07Improvement Permit & ATC -
•O—House ❑ Mobile Home ❑ Business ❑ Industry ❑ Other
# People
EMarbage Disposal
Specify type
®Both
# Bedrooms _ # Bathrooms D
G—Washing Machine ❑ Basement/Plumbing ❑ Basement/No Plumbing
# People # Sinks
# Showers # Urinals
# Seats Estimated Water Usage (gallons per day)
CYCounty/City
❑ Well
# Water Coolers
❑ Community
8. Do you anticipate additions or expansions of the facility this system is intended to serve? ❑ Yes -9—No
If yes, what type?
PROPERTY INFORMATION REQUIRED: *** IMPORTANT *** A PLAT OF THE PROPERTY MUST BE
SUBMITTED WITH THIS APPLICATION.
eqq
Property Dimensions: 3 s 1 WRITE DIRECTIONS (from
L� M gcksville) TO PROPERTY:
Tax Office PIN: # �S % %Sf - - �% J/
Property Address: Road Name /C 1- L - / W t -e /i I p Lr
R VK
City/Zip l lJA �2 7l
1
If in Subdivision provide information, as follows:
Name: i
1
T�--
Section: Lot #:� _ L
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 Dopar
and owned by / 1 il/i4 g4tJ r /� 1 P i /rte•
as necessary to determine the site suitability.
DATE /C� "-�-?�' �/ _ SIGNATURE
Revised DCHD (06-96)
to enter upon above described property located in Davie County
conduct all testing procedures
1
fou"o
IRON Rp0 i
1610 60 ,—• '
WILLIAMS S RD FORK RD.
SR. 1611
60' R/ W
•��- -� ` FRANKLIN EDWARD WILLIAMS -ALMA
(
DEEDBOOK 45, PACE 298
o ( N 89° 30' 43" E --,,- 950.41' 143.74 '
Oti IRON PIPE IRON PIPE 010PKNAIL IN C/L
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a -i-- S 89 ° 02'43" W 1069.20' Io.9r
1 ;
I LONNIE BONCE JONES - MARY LOUISE
DEED BOOK a0, PACE 117
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SEAL 3
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"1. CERTIFY THAT ON
Af- . WE SURVEYED THE PROPERTY SHOWN ON
1114 PLATt
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0 200 400 600
FOR POTTS REAL ESTATE, INC
• SCALE •
-TOWNSHIP- • COUNTY -
• STATE •
•OAT[
1" +200'
FULTON DAVIE
N. C.
8 -IS -85
BEING THE TRACT OF LAND RECORDED IN DEED BOOK 126, PG515
SURVEYCD
FRANCIS B. GREENE on NO.
SURVEYING AND MAPPING CO.
P.O. SOX S01 MOCKSVILLE. N.C. 27020
MAPPEOI
— 'J.A. .. .- � .._._;ter.. ..�i4.:... _•_•___••'�-rx..-. •-•- - —' ci'+ •• �. ..... ...
.�.' tDAV E COUNTY HEALTH DEPARTMENT , \
ffrivironmental Health Section 1a�
Soil/Site
Evaluationn La CUiAUAT, EVALUATED
ADDRESS S A ri^ e �,IO PROPERTY SIZE
PROPOSED FACIILTY 1-i ().Q sty LOCATION OF SITE 0 k
Water Supply: On -Site Well _ Community Public
Evaluation By: C £L. Auger Boring V Pit Cut
FACTORS
1
2
3 4
Landscape position
S
—S
Sloe %
HORIZON I DEPTH
410
"4,11
Texture groupL
1..
Consistence
Z
Structure
Mineralogyt
t
t
HORIZON II DEPTH
2 •
LIZ.
-
Texture group
Consistence
FT
FT
Fz
Structure
ro Q
Mineralogy
HORIZON III DEPTH
Texture group
Consistence
Structure
Mineralogy
HORIZON IV DEPTH
Texture group
Consistence
Structure
Mineralogy
SOIL WETNESS
SS
5
RESTRICTIVE HORIZON
SAPROLITE--
CLASSIFICATION
• S
LONG-TERM ACCEPTANCE RATEI
M
SITE CLASSIFICATION: S EVALUATED BY: `iq"
LONG-TERM ACCEPTANCE RATE: -A OTHE (S)PRESENT:
01N'Q_
REMARKS: ,V,,%,. -
LEGE
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- 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
Mineralo¢y
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
MEMEMMEME
WEEMOMMEN