130 Annie Ln Davie County,NC i Tax Parcel Report Wednesday, October 12, 2016
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WARNING: THIS IS NOT A SURVEY
Parcel Information
Parcel Number: H800000037 A Township: Shady Grove
NCPIN Number: 5789319412 Municipality:
Account Number: 8300223 Census Tract: 37059-804
Listed Owner 1: BODENHAMER JANE H Voting Precinct: EAST SHADY GROVE
Mailing Address 1: 1207 HOPPER RD Planning Jurisdiction: Davie County
City: SALISBURY Zoning Class: DAVIE COUNTY R-A,R-20
State: NC Zoning Overlay:
Zip Code: 28146 Voluntary Ag.District: No
Legal Description: 78.25 AC HWY 801 Fire Response District: ADVANCE
Assessed Acreage: 78.18 Elementary School Zone: SHADY GROVE
Deed Date: 11/2010 Middle School Zone: WILLIAM ELLIS
Deed Book/Page: 2010E0187 Soil Types: PaD,PcB2,PcC2,ChA
Plat Book: Flood Zone:
Plat Page: Watershed Overlay: DAVIE COUNTY
Building Value: 99020.00 Outbuilding&Extra 1240.00
Freatures Value:
Land Value: 623830.00 Total Market Value: 724090.00
Total Assessed Value: 284510.00
C ILLVwI� All 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 Countys 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
r'o N�4 NC or arising out of the use or Inability to use the GIS data provided by this website.
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DAVIE COUNTY HEALTH DEPARTMENT
. IMPROVEMENT PERMIT and OPERATION PERMIT
IMPROVEMENT PERMIT
13D �N
**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 6.5. Chapter 138A, Wastewater Systems, Section .1900 Sewage Treatment and Disposal Systems)
NAME PROPERTY ADDRESS DATE Jj
LOCATION iL- A I> -� Jl Yz'r� :/ ,� / / /,�y
SUBDIVISION NAME LOT NUMBER SEC./BLOCK NUMBER
RESIDENTAL SPECIFICATION: BUILDING TYPE f# BEDROOMS # BATHS o2 # OCCUPANTS �Z GARBAGE DISPOSAL: Ye
COMMERCIALSPECIFICATION: FACILITY TYPE # PEOPLE # PEOPLE/SHIFT # SEATS INDUSTRIAL WASTE: Yes/No
LOT SIZE Al TYPE WATER SUPPLY ��_ DESI6N WASTEWATER FLOW (GPD) —. 0 NEW SITE t---- REPAIR SITE
SYSTEM SPECIFICATIONS: TANK SIIE 0P GAL. PUMP TANK GAL. TRENCH WIDTH ��� ROCK DEPTH /�� LINEAR FT. �dG
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.
V;
r
IMPROVEMENT PERMIT BY ��
**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 SYSTEM INSTALLED BY
�W eo C/N
AUTHORIZATION NO. OPE TI PE IT BY �C_ 1f C�G(� ✓ DATE
**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 136A, SECTION .1900 'SEWAGE TREATMENT AND DISPOSAL. SYSTEMS', BUT SHALL IN NO WAY BE TAKEN AS A
GUARANTEE THAT THE SYSTEM WILL FICTION SATISFACTORILY FOR ANY GIVEN PERIOD OF TIME.
DCHD 10/95 '
rfN 14-
'7-
Davie
ta'7Davie County Health Department
ENVIRONMENTAL HEALTH SECTION P.O. Box 6b5
/3D Alvo�
Mocksville, N.C. 27028
AUTHORIZATION FOR WASTEWATER SYSTEM CONSTRUCTION
(Issued in compliance with Article it of
G.S. Chapter 130A, 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,Fore/Authorization Number should be presented to the Davie County Building Inspections
Office when applying for`Building Permits.***
_. NRME �/II�' l •lC��� DATE AUT}ORIZATION NUMBER '
N2 J 1 4 2
NAME ON IMPROVEMENT PERMIT (If different than above)
� I
SITE LOCATION
COMENTS/CONDITIONS ON AUTHORIZATION TO CONSTRUCT WASTEWATER SYSTEM
j **00TICE*** THIS AUTHORIZATION FM WASTEWATER SYSTEM CONSTRUCTION IS VALID FOR A PERIOD OF FIVE (5) YEARS.
IROplENIAL SPECIALIST .DATE
DCHD 10/95
.r. _ _.. _ • a ... _ _ .:.. ., x � .... .. - __-7' .,_ . . ..; .... .__.• i t . . .ivy.
APPLICATION FOR SITE EVALUATION/IMPROVEMENTS PERMI a
Davie County Health Department JAN —5 19% j
Environmental Health Section t
P. O. Box 665 '
4
Mocksville, NC 27028 :.
o/ DAVIE Colif iTYY' +�
1. Application/Permit Requested By
Mailing Address P &OA 3/00 Home Phone&/-(:22 292?-2-#
Vance NG 704 Business Phon �//D 7-le-%x.5`.3
2. Name on Permit if Different toan Above 9/D S S -5,V-5 o
3. Application for: ❑General Evaluation iCl Septic Tank Installation Permit
4. System to Serve: ❑ House 2 Mobile Home ❑ Place of Public Assembly
❑ Business ❑ Industry ❑ Other ❑ Unknown `
5. If house, mobile home: Subdivision Section Lot #
❑ Basement/Plumbing
No..of People !!Z ❑ Basement/No Plumbing
No. of Bedrooms 3 D-Washing Machine
No. of Bathrooms C-Dishwasher
Dwelling Dimensions 5a x 2 F ❑ Garbage Disposal
6. If business, industry, place of public assembly, other: Specify type t
No. of People Served 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 ❑ Private ❑ CommunityIs
r,
8. Property Dimensions Sewage Disposal Contractor '
j
9. Do you anticipate additions/expansion of the facility this sytem is intended to serve? ❑ Yes R—No
• i
If yes, what type?
't
`NOTE: . . Improvements Permits are subject to
revocation, if site plans or the intended use change. Effective October 1, 1989. 1
PROPERTY INFORMATION REQUIRED: t.
Directions to Property: y
Tax Office PIN 1157�9-3►-9�1�
U / G✓jtil 7Ci��/ f v Road Name 011050,4
Box # (if available)
city
Qef�;,,cl 6 a7S/ Fol eAll 7, - 110ne
Y11
k
This is to certify that the information provided is correct to the st of my know edge, and I understand I am responsible for all charges
incurred from this application.
DATE SIGNATURE
CONSENT FOR SITE EVALUATION TO BE DONE ON ABOVE DESCRIBED PROPERTY
MUST CHECK ONE: ❑ 1. 1 OWN the property. 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 scene &tev jam&
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(1193)
m o 9.51 Aa.� '� o
2575
117
560A �:
_ 712. 04 w , ,•
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34 .
2135.93
SC
EOp Es f }
115.14 Ac c, o N p o EK R� a
A ; 117.6 Q' ;
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^ i. n ttl rt r a ,Q_37.01 s '4
6.48Ac . " .. ' 1.99Ac SS
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5�i !�+� • 7`' m h46.7
�. F,� r R: . . ;,fit��. +c 5�' � .• ,: 1 , :'��.
r � 66
4 � ' j. ,..' ..i i
,u
621. 80
52 — — --
' ' 37.02 < Y'
41.05 :„ a
7 B 25 Acjx
k 11
40 t0
16 Ac . xow
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3 �6 80JA j,..l c ,039
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.50 Ac. / N
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DAVIE COUNTY HEALTH DEPARTMENT
•- = Environmental Health Section
Soil/Site Evaluation
NAME J`)'!�' DATE EVALUATED
ADDRESS PROPERTY SIZE /���
PROPOSED FACIILTY LOCATION OF SITE —2&_Slouy
tJ
Water Supply: On-Site Well _ Community Public
Evaluation By: Auger Boring ,/ Pit Cut
FACTORS 1 2 3 4
Landscape position Slope %
HORIZON I DEPTH
Texture group
Consistence
Structure
Mineralogy
HORIZON II DEPTH
Texture group
Consistence
Structure 122-
Mineralogy
CMineralo
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 �c /
SITE CLASSIFICATION: EVALUATED BY:
LONG-TERM ACCEPTANCE RATE: > 7 OTHER(S) PRESENT:
REMARKS:
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-Ve.-y friable FR-Friable FI-Finn 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
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