138-158 Hidden Passage Way Davie County,NC � Tax Parcel Report ��5� Tuesday, October 4, 2016
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WARNING: TffiS IS NOT A SURVEY
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; _.... _ . , ___ _ ._ .__. ... _ ...__. Parcel Information _ _. _
Parcel Number. E60000002703A Township: Farmington
NCPIN Number. 5851633719 Municipality:
Account Number. 62544800 Census Tract: 37059-802
Listed Owner 1: ROY MARK E Voting Precinct: SMITH GROVE
Mailing Address 1: 138 HIDDEN PASSAGE WAY Planning Jurisdiction: Davie County
City: MOCKSVILLE Zoning Class: DAVIE COUNN R-20,1-4-S
State: NC Zoning Overlay: DAVIE COUNTY QD
Zip Code: 27028-0000 Voluntary Ag.District: No
Legal Description: 6.661 AC HALF MOON LAKE Fire Response District: SMITH GROVE
Assessed Acreage: 6.56 Elementary School Zone: PINEBROOK
Deed Date: 5/1998 Middle School Zone: NORTH DAVIE
Deed Book/Page: 002020410 Soil Types: EnB,EnC,ChA,WATER
Plat Book: Flood Zone:
Plat Page: Watershed Overlay: DAVIE COUNTY
Buildtng Value: 207310.00 Outbuiiding&Extra 5010.00
Freatures Value:
Land Value: 79780.00 Total Market Value: 292100.00
Total Assessed Value: 292100.00
9��v�t�, Atl data is proNded as Is without wamMy or guanntee of any Idnd elthn expressed or Implled Indudtng but not UmRed to the
Davie County� implied wammlea ot merchaMabllky or fitness for a partladu usn All u:er:of Davle CouMya GIS websfte ahall hold humless tha
�o� �T� CouMy ot Davie,North Grdina,Its aye�Rs,eonwaaiNs,contractors or anployees Trom any and aM datms or uuses M aW on due to
y� or aAsing out M fhe use or Inab0lty to usa fhe dS data pmvided by thls vrcbslta
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�. AU�?�¢R�ZA�I'ION,NO: �
U'� � �'�� DAVIE COUNTY HEALTH DEPARTMENT
,��s �� � �'' �;`,�! Environmental Health Section PROPERTY INFORMATION
�Pernu�. =�` : P.O.Box 848. t� ,(�
�rName:-�+�{��'`� �a� Mocksville,NC 27028 Subdivision Name: .�T�i��4dP���J��"" �
; � �� Phone#:704-634-87b0 �� �
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Directions to property: �r1C�', .t'�,��.,+7 /.�/'1.lc�' , ' Section: Lot: �
,
. AUTHORIZATION FOR `,
� . WASTEWATER ��� _ �� :_ ���
� � +�^:�/ Tax Office PIN:# _�,�,
� � SYSTEM CONSTRUCTTON
Road Name• � Zip:. Ol��c��
**NOTE**This Authorization for Wastewater System Construction MUST BE ISSLJED by the Davie County Environmental Health SecGon prior
to issuance of any Building Pernuts.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,SecUon.1900 Sewage Treatment and Disposal Systems).
j� ***NOTTCE***TIIIS AUTHORIZATION FOR WASTEWATER CONSTRUCTION
.i'��CJ'. ��� IS VALID FOR A PERIOD OF FIVE YEARS. ,
ENVIRONMENTAL HEALTH SPECIALIST' DATE ISSUED . -
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` �'.: ��r� ��'°� �,� DAVIE-COUNTY HEALTH DEPAR_ �NT
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`� � �' }��� • '�`�' ' � TMPROVEMENT AND OPERATION PERI�'IITS PROPERTY INFORMATION
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Directions to propert}�- �"'�=r°� .�Y.�.��': - Section: � Lot: '"�s �"' �
= -�f IlVIPROVEMENT �#�
' `��"� �-`_���� PERMIT: Tax Office PIN:#���,� _ �'f"�- _��.,�
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**NOTE**'This Improvement Pemut DOFS NOT authorize the constcuction or installation of a septic tank system or any wastewater system:An '
ALTfHORI7.ATION FOR WASTEWATER SYSTEM CONSTRUCTION must be obtained from this Department prior to the
construc6on/'uistallation of a system or the issuance of a building pemut. :' :
(In compliance with Article 11 of G.S.Chapter 130A,Wastewater Systeins,Section.1900 Sewage Treatment and Disposal Systems)� , �
,r' ,r' a f�"'f; . ***NOTICE***THLS PERNIIT IS SUBJECT TO REVOCATION IF SITE
¢a;+�,�`�`..��,�'r�;,;� �� �'.'»''..;�,�.���' PLANS OR Tf�INTENDED USE CHANGE.YOUR WASTEWATER
ENVIRONMENTAL HEALTH SPE^� DATE ISSUED SYSTEM CONTRACTOR MUST SEE THIS PERNII'I'BEFORE:
INSTALLING Tf�SYSTEM.
RESIDENITAI:SPECIFTCAT'ION:BUII.DING 1'YPE� #BEDROOMS�#BATHS_5�#OCCUPANTS�GARBAGE DISPOSAL:Yes or No
COMMERCIAL SPECIFICATION: FACILITY T'YPE " #PEOPLE �' #PEOPLFJSHIFT #SEATS INDUSTRIAL WASTE:Yes or No
• LOT SIZE_�„ TYPE WATER SUPPLY�_ DESIGN WASTEWATER FLOW(GPD) NEW SITE �" '�REPAIR SITE
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SYSTEM SPECIFICA S: TANK S��GAL. PUMP TANK GAL. TRENCH WIDTH�_ ROCK DEPTH,�;� LINEAR Ff.�Q
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OTHER ,c,t. � .i �' � � �:�!1�raf
REQUIRED SITE MODIFICATIONS/CONDITIONS: .
IMPROVEMENT PERMIT LAYOUT �.
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**CONTACT A REPRESENTATIVE OF THE DAVIE COUNTY TH DB�,�RTMENT FOR FINAL.INSPECTION OF THIS SYSTEM
BEI'WEEN 8:30-930 A.M.OR 1:00-1:30 P.M.ON I�AY C1F INSTALLAT'ION.TELEPHONE#IS(704)634-8760. .
OPERATION PERMTf D
SYSTEM � .
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AUTHORIZATION NO. ` /l� OPERATION PERMIT BY: C�'�'�-� DATE: � � �
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**THE ISSUANCE OF THIS OPERATION PERMIT SHALL INDICATE THAT THE SYSTEM DESCRIBED ABOVE HAS BEEN INSTALLED IN COMPLIANCE
WIT'H ARTICLE I 1 OF G.S.CHAP'TER 130A,SECI'ION.1900"SEWAGE TREATMENT AND DISPOSAL SYSTEMS",BUT SHALL IN NO WAY BE TAKEN AS A
GUARANTEE THAT THE SYSTEM WII.L FUNCTION SATISFACTORILY FOR ANY GIVEN PERIOD OF TIME." '
DCHD OS/96(Revised)
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, " t�_�ri ` APPLICATION FOR SITE EVALUATION/IMPROVEMENT PERMIT C � a a
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� `�._. � ' Davie County Health Department D �
' ' Environmental Health Section
�`� P o.BoX sas APR — 7 �
�V"�� s�� Mocksville,NC 27028
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( (33�8 60 ENVI DA lEECOUNn�TH
****IMPORTANT**** THIS APPLICATION CANNOT BE PROCESSED U �
ALL THE REQUIRED INFORMATION IS PROVIDED.
1. Name to be Billed _,��� C� ��.A�L1 flt.1 Contact Person ��-
, MailingAddress �73 ���W NAM(�SNI�� C� HomePhone33G �5 �' ��9�
- " . City/State/Zip �1C��I LL.C= N� ��� O BusinessPhone j75� aaot� Sl1JIC��oop
� 2. Name on PermidATC if Different than Above
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"r� . Mailing Address C' y tat i . . `.
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3.?'Application For: O� Site Evaluation � Im rov ment Pemut&ATC ❑ Both
4. System to Serve: L� House C� Mobile Home ❑ Business ❑ Industry ❑ Other - .
5. If Residence: # People �_ # Bedrooms �,_ # Bathrooms �_
I�Dishwasher . Ca Garbage Disposal G� Washing Machine ❑ Basement/Plumbing ❑ Basement/No Plumbing
6. 'If'Businessl0ther: . 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? 0 Yes �No
If yes,what type?
E Z THER
PROPERTY INFORMATION REQUIRED: ***IMPORTANT***A F�',�THE PROPERTY MUST BE
SUBMITTED WITH THIS APPLICATION.
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Property Dimensions: ��v' � WRITE DIRECTIONS(from
/ rL � Mocksville)TO PROPERTY:
Ta�c O�ce PIN: # 5g 5 I . - l�7�i - ��,_� 1 S� +' p
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Property Address: Road Name �oX �u•� � l ,
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If in Subdivision provide information,as follows: �
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Name: ,bt� ' :�'�'` ' 1 � Gt.�-
� /� C� � a� '
9ection: Lot #: � � ! _ / � �'�/ -
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This is to certify that the information provided is correct to the best of my knowledge.I understand that any permit(s)issued hereafter�C�
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 chazges 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 v��
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; and owned by 4-.eflNA� � • ��.J�akJ�1;�1i(3� to conduct all testing procedures �'" �
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as necessary to deternune the site suitability. �N
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DATE �'�'7' 7 SIGNATURE � � ��—`
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Revised DCHD(06-96) � ��;m Q��J'd� Z
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y0U Mt11J USE THE $ACK O� THZS �OIZM �OR bR�IWID�G yOUR SITE PL�tN. � r �^'+�
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, • � ' � DAVIE COUNTY HEALTH DEPARTMENT
.:.
� �:�r - Environmental Health Section sECTTON LOT�
� SoiUSite Evaluation '��
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APPLICANT'S NAME d DATE EVALUATED v <
PROPOSED FACILITY PROPERTY SIZE
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SUBDIVISION ��-l�/�'��"�- �a� ROAD NAME
Water Supply: On-Site Well Community Public
Evaluation By: Auger Boring ''� Pit Cut
FACTORS 1 2 3 4 5 6 7
Landsca e osition
Slo e%
HORIZON I DEPT'H (��' /Q �'
Texture rou �.
Consistence
Structure
Mineralo
HORIZON II DEPTH �` 'Y r"
Texture rou �_
Consistence � /-
Structure �" ,�
Mineralo - / /.
HORIZON III DEPTH
Texture rou ,
Consistence
Structure
Mineralo
HORIZON IV DEPTH
Texture rou
Consistence
Structure -
Mineralo
SOIL WETNESS
RESTRICTIVE HORIZON
SAPROLITE
CLASSIFICATION
LONG-TERM ACCEPTANCE RATE
SITE CLASSIFICATION: EVALUATION BY:
LONG-TERM ACCEPTANCE RATE: .� OTHER(S)PRESENT:
REMARKS: ��� d�d/p� `'
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
truct re
SC-Single grain M-Massive CR-Crumb GR-Granular ABK-Angular blocky
SBK-Subangulaz blocky PL-Platy PR-Prismatic
Mineraloav
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-gaUday/ft2
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'� � . -. � �'' � Davie County.�CeaCth 2�epa�nt
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• �w p�oM���:��2, ,�ga and.�-fome�Cealth�.�encr�
�fF�G�'33�75-a76° �nvironmentaf.�eaCtFi Section
P.O.BOX B4E/ Z�O HOSPRAL STREET
COURIER#09-40-06
MOCKSVILLE,N.C.27028
PHONE:(704)634-8760
• Kay 14, 1998
I{ark Edward Roy
173 NeW Hampshire Ct.
Mocksville, NC 27028
Re: 2 Site Evaluations
Half Moon Lake/Lot 4 ,
Tax PIH: �5851-64-3332
Dear Client(s):
As requested, a representative from this office visited the aforementioned
sites on May 13, 1998. Based upon the information provided on the
application(s) for site evaluationfs) and after the evaluations rere completed,
site 1 was found to be provisionally suitable for the installation of an on-
site sevage disposal system, and site 2 was found to be provisionally suitable
for the installation of a modified, oversized on-site seKage disposal system.
SFECIAL NOTE: •Before any permit can be issued on any specific lot in the
abovementioned subdivision, a map (one that xill be or has been recorded rith
the Register of Deeds) must be provided to this office. *
� Bef ore any permitis) can be issued the appropriate applicationts) must be
filled out and the house/mobile home location(s) staked off.
If you have any questions, please feel free to contact this office.
Sincerely.
/�
����'�'��, '
�. �.
Robert B. Hall, Jr., R.S.
Environmental Health Specialist
RH/vd
Enclosure(s}
cc: Zoning Office