426 Deadmon Rd Davie County,NC Tax Parcel Report Thursday, December 15, 2016
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WARNING: THIS IS NOT A SURVEY
Parcel Tnformahon
Parcel Number: -- -K500000089 Township: Jerusalem
NCPIN Number: : 5747429625 Municipality:
Account Number:: ?,'46800690 Census Tract: 37059-807
Listed Owner 1: MACE GLENN F JR: Voting Precinct: JERUSALEM
Mailing Address 1:- 426 DEADMON 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: - 3.270 AC DEADMON RD Fire Response District: JERUSALEM
Assessed Acreage: 3.27 Elementary School Zone: CORNATZER
Deed Date: - 12/1996 Middle School Zone: WILLIAM ELLIS
Deed Book/Page: 001910669 Soil Types: PcC2,CeB2
Plat Book: Flood Zone:
Plat Page: Watershed Overlay: DAVIE COUNTY
Building Value: Outbuilding&Extra
Freatures Value:
Land Value: Total Market Value:
Total Assessed Value:
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, 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
�OUN� NC or arising out of the use or Inability to use the GIS data provided by this website.
DAVIE COUNTY HEALTH DEPARTMENT
-- - IMPROVEMENT PERMIT and OPERATION PERMIT
IMPROVEMENT PERMIT
**NOTE** This iiprovement 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 I1 of 6.S. Chapter 130A, Wastewater Systems, Section .1900 Sewage Treatment and Disposal Systems)
NAME ��G(l ` ���/1A��1 PR�ERTY ADOREfZ&H�J YYl d YL fQ1 . — a g DATE
LOCATION
SUBDIVISION NAME LOT NUMBER SEC./BLOCK NUMBER
RESIDENTAL SPECIFICATION: BUILDING TYPE # BEDROOMS # BATHS # OCCUPANTS GARBAGE DISPOSAL: Yes/No
COMMERCIAL SPECIFICATION: FACILITY TYPE # PEOPLE # PEOPLE/SHIFT # SEATS INDUSTRIAL WASTE: Yes/No
LOT SIZE _ TYPE WATER SUPPLY _ DESI6N WASTEWATER FLOW (GPD) s NEW SITE _REPAIR SITE
SYSTEM SPECIFICATIONS: TANK SIZE &2,GAL. PUMP TANK GAL. TRENCH WIDTH z" ROCK DEPTH /9 'LINEAR FT. � Q
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
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
/bD FIK14
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OPERATION PERMIT BY it DATE
IT SHALL INDICATE THAT THE SYSTEM DESCRIBED ABOVE HAS BEEN INSTALLED IN COMPLIANCE WITH
TION .1900 "SEWAGE TREATMENT AND DISPOSAL SYSTEMS , BUT SHALL IN NO WAY BE TAKEN AS A
SATISFACTORILY FOR ANY 6IVEN PERIOD OF TIME.
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— 4 J - 5 J — 6 °RT" DAV I E COUNTY N. C.
K - 4 F K K - 6 TAX MAPS (�
L — 4 L — 5 L — 6 SCALE' 1"= 400'
i
Davie County Health Department
ENVIRONMENTAL HEALTH SECTION
P.O. Box 665
Mocksville, N.C. 27028
AUTHORIZATION FOR WASTEWATER SYSTEM CONSTRUCTION
a;
(Issued in compliance with Article 11 of
G.S. Chapter 13OA, 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,when applying for Building Permits.*-**
/ AUTHORIZATION NMER
NAME �Gf�/ /l /t� j egazL DATE "'S�-- �'J '�'� N2 0255
NAME Ok„IIPROVEMENT PERMIT (If different than above)
SITE LOCATIW
COMMENTS/CONDITIONS ON AUTHORIZATION TO CONSTRl1CT WASTEWATER SYSTEM
• - tr" - rt}. fit✓ { ray.,
*HNOTICE*H THIS AUTHORIZATION;FOR TEWATER SYSTEM CONSTRUCTION IS VALID FOR A PERIOD OF FIVE (5) YEARS.
-:�,ENVIWNMENTAL A011kCIALIST DATE .
DCH1); 10/95
APPLICATION FOR SITE EVALUATION/IMPROVEMENTS P
' Davie County Health Department D v
l of,tp Environmental Health Section
d P. O. Box 665
n h
(� MAR 2 51996
Mocksville, NC 27028
1. Application/Per it Requested By 14
Mailing Address P - 3 o X 3 Home Phone 9,OV- 631/- SSSS
40 C S v('J F 1`J C ? 7 0 2 43 Business Phone
2. Name on Permit if Different than Above
3. Application for: ❑General Evaluation arSeptic Tank Installation Permit
4. System to Serve: P house ❑ Mobile Home ❑ Place of Public Assembly
❑ Business ❑ Industry ❑ Other ❑ Unknown
5. If house, mobile home: Subdivision Section Lot #
❑ Basement/Plumbing
No. of People 2 CBsement/NO Plumbing
No. of Bedrooms I"Washing Machine
No. of Bathrooms Z Dishwasher
Dwelling Dimensions Oki o��- ❑ Garbage Disposal
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
No. of Showers Water Usage Figures
7. Type of water supply: Public ❑ Private ❑ Community
8. Property Dimensions 2/l 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 from date issued. Improvements Permits are subject to
revocation, if site plans or the intended use change. Effective October 1, 1989.
Directions to Property: PROPERTY INFORMATION REQUIRED:
17E1FDr++u•v 1Qef - oZ /7��vf way °A-' Tax Office PIN: #_��'i�7'�, To--
f
g3f io4s 7 Go M'n T, PROPERTY ADDRESS, as follows:
Road Name: (�FyfDsr►6N /Y
City: 171c,"k ✓/116
SUBMIT A PLAT WITH THIS APPLICATION.
Revisions effective October 1 , 1995.
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.
DATE SIGNAT E
CONSENT FOR SITE EVALUATION TO BE DONE ON ABOVE DESCRIBED PROPERTY
MUST CHECK ONE: M-1-.7-1 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 absorption sewage treatment
and disposal system.
3 ^ ZS ^ g � .
DATE SIGN RE
DCHD(1193)
• • DAVIE COUNTY HEALTH DEPARTMENT
Environmental Health Section
Soil/Site Evaluation
NAME ///�j DATE EVALUATED `�ll/W
ADDRESS
PROPERTY SIZE �i9e
�/
PROPOSED FACIILTY " �4ex- C- LOCATION OF SITE
Water Supply: On-Site Well Community Public !/
Evaluation By: Auger Boring i / Pit Cut
-v
FACTORS 1 2 3 4
Landscapeposition_______ L
Sloe Z
HORIZON I DEPTH
Texture group
Consistence
Structure
Mineralogy
HORIZON II DEPTH
Texture groupC' C'
Consistence
Structure S
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: EVALUATED BY: �f�
LONG-TERM ACCEPTANCE RATE: / Y 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 <.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-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
Mineraloffy
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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