179 Hickory StDavie County. NC
Tax Parcel Report bvi l D
Thursday. September 29. 2016
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9Duvx�BAll data is provided as Is without warranty or guarantee of any Idnd either expressed or Implied Including but not limited to the
Davie County, Implied warranties of merchantability or fitness for a particular use. All users of Davie County's GIS website shall hold harmless the
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County of Davie, North Carolina, its agents, consultants, contractors or employees from any and all claims or causes of action due to
�o N C NC or arising out of the use or Inability to use the GIS data provided by this website.
WARNING: THIS IS NOT A SURVEY
Parcel Information
Parcel Number:
M50000000702
Township:
Jerusalem
NCPIN Number:
5735962335
Municipality:
COOLEEMEE
Account Number:
82519941
Census Tract:
37059-807
Listed Owner 1:
SAWS LP
Voting Precinct:
COOLEEMEE
Mailing Address 1:
PO BOX 738
Planning Jurisdiction:
COOLEEMEE
City: COOLEEMEE
Zoning Class: DAVIE COUNTY,COOLEEMEE
RS,0I,R-20
State:
NC
Zoning Overlay:
DAVIE COUNTY CZOD
Zip Code:
27014-0000
Voluntary Ag. District:
Legal Description:
5.200 AC HICKORY ST
Fire Response District:
COOLEEMEE
Assessed Acreage:
5.19
Elementary School Zone:
COOLEEMEE
Deed Date:
12/2002
Middle School Zone:
SOUTH DAVIE
Deed Book / Page:
004570195
Soil Types:
GnB2,GnC2,MsC
Plat Book:
Flood Zone:
Plat Page:
Watershed Overlay:
DAME COUNTY,COOLEEMEE
Building Value:
0.00
Outbuilding & Extra
Freatures Value:
4500.00
Land Value:
21120.00
Total Market Value:
25620.00
Total Assessed Value:
25620.00
No
9Duvx�BAll data is provided as Is without warranty or guarantee of any Idnd either expressed or Implied Including but not limited to the
Davie County, 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
�o N C NC or arising out of the use or Inability to use the GIS data provided by this website.
J
IMPROVEMENT PERMIT
DAVIE COUNTY HEALTH DEPARTMENT
IMPROVEMENT PERMIT and OPERATION 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.
(In compliance with Article 11 of G.S. Chapter 130A, Wastewater Systems, Section .1900 Sewage Treatment and Disposal Systems)
NAME t GEf"�'✓" r �% ,, ; >,.%' PROPERTY ADDRESS N, GV. �! S�
P 'I n 1 q
DATE
.0v
LOCATION
SUBDIVISION NAME
LOT NUMBER
SEC./BLOCK
NUMBER
RESIDENTAL SPECIFICATION: BUILDING TYPE
# BEDROOMS .T # BATHS 2
# OCCUPANTS
GARBAGE DISPOSAL: Yes/No
COMMERCIAL SPECIFICATION: FACILITY TYPE
# PEOPLE # PEOPLE/SHIFT
# SEATS
INDUSTRIAL WASTE: Yes/No
LOT SIZE .�'%<' TYPE WATER SUPPLY
DESIGN WASTEWATER FLOW (GRD) ` �� NEW SITE 1-' REPAIR SITE
SYSTEM SPECIFICATIONS: TANK SIZE/, GAL. GAL. PUMP TANK GAL. TRENCH WIDTH
/ ROCK DEPTH
/ ; LINEAR FT. - LG
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.
r'r
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n %L
IMPROVEMENT PERMIT BYell-
1
**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 J!%Q.�YSTEM INSTALLED BY t l I, n �13-•��+�-:,�
AUTHORIZATION NO. 0 OPERATION PmIT BY i �``?�e�� ` � � - DATE ?1- 94
**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 FINCTIONI SATISFACTORILY FOR ANY GIVEN PERIOD OF TIME.
DCHD 10/95 ..__,
E' APPLICATION FOR SITE EVALUATION/IMPROVEMENTS PER
Davie County Health Department
Environmental Health Section
P. O. Box 665
Mocksville, NC 27028
1. Application/Permit Requested By
JU 1 0 1995
�
Mailing Address - . Q. U r%-30 p �//n n Home Phone `�%Qq'
h� ��/c�9 7
-0 Business Phone
2. Name on Permit if Different than Above
3. Application for: IJ General Evaluation dSeptic Tank Installation Permit
4. System to Serve: ❑ House Mobile Home
❑ Business ❑ Industry.. II El Other
5. If house, mobile home: Subdivision O ZA
No. of People
No. of Bedrooms ,3
No. of Bathrooms
Dwelling Dimensions N yoo
6. If business, industry, place of public assembly, other: Specify type
No. of People Served No. of Sinks
No. of Commodes No. of Urinals
No. of Lavatories No. of Water Coolers
❑ Place of Public Assembly
❑ Unknown
Section Lot #
❑ Basement/Plumbing
❑ Basement/No Plumbing
❑ Washing Machine
❑ Dishwasher'
❑ Garbage Disposal
No. of Showers Water Usage Figures
7. Type of water supply: Public ❑ Private ❑ Community
8. Property Dimensions Sewage Disposal Contractor
9. Do you anticipate additions/expansion of the facility this sytem is intended to serve? ❑ Yes 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.
Directions to Property: � L
This is to certify that the information provided is correct to the st of my
incurreM71 this application.
����
DATE
PROPERTY INFORMATION REQUIRED:
Tax Office PINI PDX A)
Road Name r
Box # (if available)
City �aP�
; and pderstand I am responsible for all charges
GNATURE
CONSENT FOR SITE EVALUATION TO BE DONE ON ABOVE DESCRIBED PROPERTY
MUST CHECK ONE: El 1. 1 OWN the property. EI -12. 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 representativ f the Dav' o ty Heal h Depa ent to enter on abov de cri d
property located in Davie County and owned by
to conduct all testing procedures as necessary to determin s ' site's suitability for ground rotibol sewage tredtment
and disposal system.
DATE I
DCHD'(1193)
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DAVIE COUNTY HEALTH DEPARTMENT
r Environmental Health Section
Soil/Site Evaluation
NAME .%
ADDRESS yy>
PROPOSED FACIILTY
DATE EVALUATED
PROPERTY SIZE
LOCATION OF SITE
Water Supply: On -Site Well _ Community Public
Evaluation By: Auger Boring Pit Cut
FACTORS 1
2 3 4
Landscape position L
Slope %
HORIZON I DEPTH
Texture group
Consistence
Structure
Mineralogy
HORIZON II DEPTH
Texture group
Consistence
Structure
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 RATE ,
SITE CLASSIFICATION: Z'5
LONG-TERM ACCEPTANCE RATE: ,
REMARKS:
DCHD (01-901
EVALUATED BY:
OTHER(S) PRESENT:
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- V--ry 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 Health Department
• ENVIRONMENTAL HEALTH SECTION
P.O. Box 665
Mocksville, N.C. 27028
AUTHORIZATION FOR WASTEWATER SYSTEM CONSTRUCTION
o
(Issued in compliance with Article 11 of
G.S. Chapter I30A, 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 whe a plying for Building Permits.***
7✓ �MRIIAT NUV'YBER
NAME DATE
-T
1011,
NAME ON IMPROVEMENT PERMIT (If different than above)
SITE LOCATION
C@IEMITS/CONDITIONS ON AUTHORIZATION TO CONSTRUCT WASTEWATER SYSTEM
*HNOTICE*** THIS AUTHORIZATION FOR A5 WATER SYSTEM CONSTRUCTION IS VALID FOR A PERIOD OF FIVE (5) YEARS.
i
EN ROMIENTAL WATHQkCIALIST DATE
DCHD 10/95