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281 Houston RdDavie County, NC ` Tax Parcel Report " Tuesday, September 27, 2016 .\ 02 �1 (300) X275 9652 \ 60� 1 1365 - 363 ! I v 2630 N O O 3410 A Al data is provided as Is without warranty or guarantee of any kind either expressed or implied including but not limited to the 101 implied warranties of merchantability or fitness for a particular use. All users of Davie County's GIS website shall hold Davie County, NC 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. WARNING: THIS IS NOTA SURVEY — — �- arcet Information Parcel Number: M600000029 Township: i Jerusalem NCPIN Number: 5755549652 Municipality: Account Number: 50692000 Census Tract: 37059-807 Listed Owner 1: MILLER CLETUS Voting Precinct: JERUSALEM Mailing Address 1: 258 FAIRFIELD ROAD Planning Jurisdiction: Davie County City: MOCKSVILLE Zoning Class: ! DAVIE COUNTY R -A State: NC Zoning Overlay: Zip Code: 27028-0000 Voluntary Ag. District: No Legal Description: .97 AC HOUSTON RD Fire Response District: JERUSALEM Assessed Acreage: 0.78 Elementary School Zone: COOLEEMEE Deed Date: 8/1987 Middle School Zone: SOUTH DAVIE Deed Book/Page: 001390519 Soil Types: PaD,PcB2 Plat Book: Flood Zone: x Plat Page: Watershed Overlay: WS -IV -P . Building Value: 64800.00 Outbuilding & Extra 6560.00 Freatures Value: Land Value: 14740.00 Total Market Value: 86100.00 Total Assessed Value: 86100.00 Al data is provided as Is without warranty or guarantee of any kind either expressed or implied including but not limited to the 101 implied warranties of merchantability or fitness for a particular use. All users of Davie County's GIS website shall hold Davie County, NC 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. 11 �a o _ DAVIE COUNTY HEALTH DEPARTMENT�O�.Ud IMPROVEMENTS PERMIT AND CERTIFICATE OF COMPLETION j0., J,q.,5 *NOTE: Issued in Compliance With Article II of G.S. Chapter 130a Z 2aLP' Sa nary Sewage Sy tems \ Name_y a``2 _—_Date Location,_' _ Permit Number N2 818 Subdivision Name Lot No. Sec. or Block No. Lot Size' -.House _ Mobile Home _ _ Business Industry No. Bedrooms D-1 -. No:` Baths ,— ` — No. in Family �_ Public Assembly Other Garbage Disposal YES NO g p � - Specifications` for System: Auto Dish Washer' YESp .,NO Q� Auto Wash Ma^hine YES NO ❑ 1,�. S t Type Water Supply _� 'This 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 INSTALLING THIS 1 STEM. Improvements\ C\� permit by --__-- 'Contact a representative of the Davie County Health Department for final inspection of this system between 8:30-9:30 A.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 Iva ioa c -- Certificate of Completion Date v 'The signing of this certificate shall indicate that the system described 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. U DAVIE COUNTY HEALTH=bEPARTMENT 00.0 t� N e -r'�- IMPROVEMENTS PERMIT AND CERTIFICATE OF COMPLETION `NOTE:.fssued in Compliance With Article II of G.S. Chapter 130a Z $` _. Sarrlitary Sewage Systems - Permit Number ` Name - rti '� 1 \' �a \ --- Date ` ._- j`� N2 8187 -Location l..)l.._� i .r^" � t...'i;. �•1 � \. F.--"._�� !•.(.� ( ��,, l''J � ` :r.. x�,,,:�i'.i �!•'C`•- �?. "'�' •. "r —� r..',d�� -' r J `' �J. SC•�``.s.,�9,., �: ..> .��5,-., '� i _ ,};,.�+ -•�. ,Jt, Subdivision Name Lot No. Sec. or Block No. c,, 4 Lot Size = r_` _ House — Mobile Home ! Business Industry —_ No. Bedrooms -_No. Baths _ j _ No. in Family — Public Assembly Other Garbage'�Disposal YES ❑ NO Ell ' Auto Dish"Washer YES NO Specifications for System: _ ❑ Auto Wash Mahine YES NO ❑ <`: ~, ! Type. Water Supply ,_�*._�`• ---- -_t-7 c�t� �i ��y`i�, *This 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 i ATTENTION: ',,YOUR SEPTIC SYSTEM CONTRACTOR MUST SEE THIS PERMIT/LAYOUT BEFORE INSTALLING THIS 'SYSTEM. I ' pub ImprLments permit by 1.1 �,.._,_r *Contact a representative of the Davie County Health Department for final inspection of this system between 8:30-9:30 A.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 j j io0 Certificate of Completion _ Date .1i/27/g2 ,'The signing of this certificate shall indicate that the 'system described above has been installed in compliance with the standards setforth 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. j APPLICATION FOR SITE EVALUATION/IMPROVEMEN oDavie County Health Department ' Environmental Health Section P. O. Box 665 7SEP `7Mocksville, NCi p 27028 1. Application/Permit Requested By 01G.rV 02., T-( L I Mailing Address 7. ( ko "S' o IV Home Phone Business Phone P ffo 3 2. Name on Permit if Different than Above 3. Application for: ❑ General Evaluation 134eptic Tank Installation Permit 4. System to Serve: ❑ House E ' Mobile Home ❑ Place of Public Assembly ❑ Business ❑ Industry ❑, Other ❑ Unknown 5. If house, mobile home: Subdivision Section Lot # I t ❑ Basement/Plumbing No. of People ❑ Basement/No Plumbing No. of Bedrooms ErWashing Machine No. of Bathrooms ❑ Dishwasher Dwelling Dimensions ❑ Garbage Disposal 6. If business, industry, place of public assembly, other: Specify type; No. of People Served i No. of Sinks No. of Commodes No. of Urinals No. of Lavatories No. of Water Coolers No. of Showers :Water Usage Figures 7. Type of water supply: ❑ Public ; 21"Private 8. Property Dimensions Sewage Disposal Contractor 9. Do you anticipate additions/expansion of the facility this sytem is intended to serve? ❑ Yes If ves_ what tvne? CSKNo ❑ 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:_ L — 6 NIZ, S e gym% lVr /)-y` "Iletl-,el 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 appli atio bATt SIGNATURE CONSENT FOR SITE EVALUATION TO BE DONE ON ABOVE DESCRIBED PROPERTY MUST CHECK ONE: ❑ 1. I OWN the property. ❑ 2. I 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 absorption sewage treatment and disposal system. DATE SIGNATURE DCHD '(1 X93) j • ` r DAVIE COUNTY HEALTH DEPARTMENT Environmental Health Section ` Soil/Site Evaluation NAME C DATE EVALUATED ADDRESS v v jvt, Q PROPERTY SIZE PROPOSED FACIILTY LOCATION OF SITE Water Supply: On -Site Well _ Community Public Evaluation Byt'q L Auger Boring Pit L/ Cut . FACTORS 1 2 3 4 Landscape position Slope % " I- S 6 HORIZON -I DEPTH ' Texture group C L Q_L_ Consistence 1 Structure Q - 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 SS' RESTRICTIVE HORIZON SAPROLITE -- -- CLASSIFICATION LONG-TERM ACCEPTANCE RATE y SITE CLASSIFICATION: 'S EVALUATED BY: Q04 LONG-TERM ACCEPTANCE RATE: \ OTHER(S) PRESENT: � y REMARKS: Z�����-� LEGEND Landscape Position R -Ridge S -Shoulder L -Linear slope FS -Foot slope N -Nose slope CC -Concave slope CV -Convex slope IT -Terrace FP -Flood plain H -Head slope E 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 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 ■..■/..■■■.■■■..■.■a■s■.■■■■.■■■■■■■■■M■e■■..M■.■.MMMENNEN ■■efi'i■■ ■■.■..NOON■■■Ms.■■■...■/.■■■e... ■.■■■■.■■■�■■■■■.■■■■■■■■■■■■■■■ ■■...■.■/■M■■■■Me/.//.■../..M...■.■.■■.■■.■Mer,■■/if//.H ■.■■■..e■■ ■■■■■■■■■■■■e..M■■■■■■■MMee■■e■■eM■■■.Me■ ■■■/s�\ ■ �rM■ :NOON■ ■■ ■■■■■■■■■■■■■■■■■■■■■■■■.■■■■■■■■■.■■■eee:■■c�_rsk �■■■:■■■":_e■'�i■e ■■.■■M■■■■■■■..■■■■■■■.■■■M■■■■■■.■■■■eee■■M�'�1_4%�I�m.M.M■■.���MI►�%%N■ ■■.■■■■M■■■■■.■■MM■M■■■■■■■.■■■e�■■■■EE�N�e�v.AM.■M■■■eM..eMM►rice■■ Kai Nil No ONO ■■■■■■■EO■■■■■■■.■■■■■■■■■■.■■■e■■■C�■n.■■ .1■ell.:■■M■■ ■�re.l;la. ■.■.■..■..■■■.■■.■...■■■■.■■■■■tl OMMERM/■e:.11 A1■■■e■■e■■■■■.■■■■ SEEM ■■■■■■■.eee■■eeEMM■■e■H■■M■.■■e■ner!\■■■.■■■erl■■ � e.■m...l■e■.■■�m NOON■.■MME■■■■■■■■M■MeMM.■ME.■o■■uMr.�■■EM e■M11■ ■■.■■■■■■■■.■■MMM■M■.NMMMM.■M..�/v�nMMM►a�11M ■r_Me■MEM ■■■■■■■■ ■::::i■ ■ ■ ■ ~p111.1111111mlu:' ■eM■■■■MMM■MMe■e■■■■■■.■MMM■eeM►/. ■ INNe■I ■ ■ ■.■ M■■■■■: ppppp""p"""MMMMMM �k nu::�111MI M :: : HIM l:: ::lump ::::::::::::::m'M::::::M\�■■M.MMI�■■■. no un n■■ ■.■■■e■■■: :::: upr1 'p ■ ::ppi',iMmuenvom ■■■.■■M..MEHH■Me■OMM■e■.e■■EOM:■:E■ -i� �OR/■■MOR No MENNEN ..■......�... uM MEN MHMMM■ OWN ME No OMMEMIN ■■■■■■Me■■■■■■.■EH.■■■■■■■\NOON■\. 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