166 Green Grass RdQ'
Davie County, NC Tax Parcel Report 0 6 ( Wednesday, September 28, 2016
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vivre All data is provided as is without warranty or guarantee of any kind either expressed or implied including but not limited to the
Davie County, NC 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
°net causes of action due to or arising out of the use or inability to use the GIS data provided by this website.
WARNING: THIS IS NOT A SURVEY
Me -
Parcel Number.
N50000007001
Township:
Jerusalem
NCPIN Number.
5744897595
Municipality:
Account Number.
45616500
Census Tract:
37059-807
Listed Owner 1:
LEWIS MICHAEL E
Voting Precinct:
JERUSALEM
Mailing Address 1:
166 GREEN GRASS ROAD
Planning Jurisdiction:
Davie County
City:
MOCKSVILLE
Zoning Class:
DAVIE COUNTY R -20,H -B
State:
NC
Zoning Overlay:
DAVIE COUNTY CZOD
Zip Code:
27028-6647
Voluntary Ag. District:
No
Legal Description:
3.984 AC OFF PINE RIDGE
Fire Response District:
JERUSALEM
Assessed Acreage:
4.08
Elementary School Zone:
COOLEEMEE
Deed Date:
6/2007
Middle School Zone:
SOUTH DAVIE
Deed Book f Page:
007171110
Soil Types:
PaD,WeC,WeB,PcB2
Plat Book:
Flood Zone:
x
Plat Page:
Watershed Overlay:
-
Building Value:
120550.00
Outbuilding & Extra
28800.00
Freatures Value:
Land Value:
21750.00
Total Market Value:
171100.00
Total Assessed Value:
171100.00
vivre All data is provided as is without warranty or guarantee of any kind either expressed or implied including but not limited to the
Davie County, NC 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
°net causes of action due to or arising out of the use or inability to use the GIS data provided by this website.
DAVIE COUNTY HEALTH DEPARTMENT
IMPROVEMENTS PERMIT AND CERTIFICATE --OF COMPLETION
,t
*NOTE: Issued in Compliance With Article II of G.S. Chapter 130a
Sa ' itary Sewage ystems Permit Number
f. r;
fj. ,y �,..r�>"x'�r ", d"fir Date '' � N28016
Name — —
Location
Subdivision Name Lot No. Sec. or Block No.
Lot Size -__.— House _�� Mobile Home ---_ Business __ Industry
dY
No. Bedrooms _No. Baths- No. in Family_— Public Assembly Other
Garbage Disposal ` YES p NO p1
Specifications for System:
Auto Dish Washer YES 0 NO
Auto Wash Ma^hine YES [Q NO O
,Type Water Supply --- '� r ---- --- ,�✓ f
'Thi$ -permit Void if sewage system described below is not installed within 5 years from date of issue.
This permit is subject to revocation if site plans or the intended use change
ATTENTION: YOUR SEPTIC SYSTEM CONTRACTOR MUST SEE THIS PERMIT/LAYOUT BEFORE INSTALUNG THIS
SYSTEM. t
a
1"
l f
Improvements permit by _IL�/Z
-uoniaci a represemauve or ine uavie Vouniy maim wuptuunum wi nnni nwNouuun ui uuo oyatv11 vvL►+avii v.vv-a.. V n.m.,
1:00-1:30 P.M. or 4:30-5:00 P.M. on day of completion. Telephone Number: 704-634.5985.
Final Installation Diagram: System Installed by _ _c 1)
I
Certificate of Com letionI Date Vl
'The signing of this certificate shall indicate that the system describ above has been installed in compliance with
the standards set forth in the above regulation, but shall in NO way be taken as a guarantee that the system will function
satisfactorily for any given period of time.
APPLICATION FOR SITE EVALUATION/IMPROVEMENTS PERMI
Davie County Health Department !. l�{{cc
Y Environmental Health Section ,L
P. O. Box 665 OCT % 6 lql7
Mocksville, NC 27028
1. Application/Permit Requested By �///0,,���
Mailing Address i-�D� r'le �� J�� Home Phone a�y-yy� 7
� Ic��S✓�'//t, /j/G �,? %U a Business Phone 9/6 - 71 .k- 7.31.2
2. Name on Permit if Different than Above
3. Application for:
4. System to Serve:
General Evaluation
❑ House
❑ Business ❑ Industry
5. If house, mobile home: Subdivision
No. of People 7
No. of Bedrooms -3
No. of Bathrooms
❑ Septic Tank Installation Permit
❑ Mobile Home ❑ Place of Public Assembly
❑ Other * Unknown
Dwelling Dimensions �2Z D DO 2244.
4.
6. If business, industry, place of public assembly, other: Specify type
No. of People Served
No. of Commodes
No. of Lavatories
No. of Showers
7. Type of water supply: Public
No. of Sinks
No. of Urinals
No. of Water Coolers
Water Usage Figures
❑ Private
8. Property Dimensions yaer ens Sewage Disposal Contractor
Section Lot #
ABasement/Plumbing
❑ Basement/No Plumbing
Washing Machine
Dishwasher
❑ Garbage Disposal
9. Do you anticipate additions/expansion of the facility this sytem is intended to serve? ❑ Yes * No
If yes, what type?
❑ Community
'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.
Directions to Property: n e i�E'n �e-P4 on o �� 6�mSS Pd. X , -le claw,. on
'tJ 6-0c{.Q C Lg-c'-- .
This is to certify that the information provided is correct to the best of my knowledge, and I understand I am responsible for all charges
incurred from this application.
1457-,2115;- :�y' _
DATE SIGNATURE
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 determine said site's suitability for a ground ab orpti n sewage treatment
and disposal system.
DATE SIGNATURE'
DCHD (1193)
DAVIE COUNTY HEALTH DEPARTMENT
Environmental Health Section
Soil/Site Evaluation
NAME A/l/l/i')
ADDRESS
PROPOSED FACIILTY
DATE EVALUATED 11'-' 2
PROPERTY SIZE �'�I 6
LOCATION OF SITE Cg�!2
Water Supply: On -Site Well Community
Evaluation By: Auger Boring � Pit
FACTORS 1 2 3 4
Landscape position G
Slope %
HORIZON I DEPTH
Texture group
Consistence
Structure
Mineralogy
HORIZON II DEPTH �-
Texture group
Consistence ��-
Structure _r4 /r,
Mineralogy
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 RATEI
SITE CLASSIFICATION: - % 1 EVALUATED BY: ,/Y� `z
LONG-TERM ACCEPTANCE RATE: OTHER(S) PRESENT:
REMARKS:
DCHD(01-901
LEGEND
Public C/
Cut
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-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
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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Davie County ealt1 De artment
4 ♦ '
and Aoine Nealtlf Mgerrcy
210 HOSPITAL STREET/ P.O. BOX 665
MOCKSVILLE. N.C. 27028
PHONE: (704) 634.5985
November 4, 1994
Norman Gray Allen, Jr.
508 pineridge Rd.
Mocksville, NC 27028
Re: Site Evaluation
Green Grass Road
Dear Mr. Allen:
As requested, a representative from this office visited the aforementioned
site on November 2, 1994. Based upon the information provided on the
application for a site evaluation and after the evaluation was completed, the
site was found to be provisionally suitable for the installation of an on—site
sewage disposal system.
If you have any questions, please feel free to contact this office.
Sincerely,
A4't ��•
Robert B. Hall, Jr., R.S.
Environmental Health Section
RH/wd
Enclosure