112 Dinks Way Lot 2 Davie County,NC ` I Tax Parcel Report Monday, December 19, 2016
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WARNING: THIS IS NOT A SURVEY
Parcel Information
Parcel Number: K510OA003001 Township: Jerusalem
NCPIN Number: 5747110295 Municipality:
Account Number: 8302330 Census Tract: 37059-807
Listed Owner 1: JAMES SHARON THOMPSON TRSTEE Voting Precinct: JERUSALEM
Mailing Address 1: 169 TURRENTINE CHURCH ROAD Planning Jurisdiction: Davie County
City: MOCKSVILLE Zoning Class: DAVIE COUNTY H-B,R-20
State: NC Zoning Overlay:
Zip Code: 27028 Voluntary Ag.District: No
Legal Description: LOT 2 DINKS WAY Fire Response District: JERUSALEM
Assessed Acreage: 0.70 Elementary School Zone: COOLEEMEE
Deed Date: 6/2013 Middle School Zone: SOUTH DAVIE
Deed Book/Page: 009290897 Soil Types: Gn132
Plat Book: 0007 Flood Zone:
Plat Page: 025 Watershed Overlay: DAVIE COUNTY
Building Value: Outbuilding&Extra
Freatures Value:
Land Value: Total Market Value:
Total Assessed Value:
91 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
N County of Davie,North Carolina,its agents,consultants,contractors or employees from any and all claims or causes of action due to
��U N•�� `C or arising out of the use or Inability to use the GIS data provided by this webstte.
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,4"�UTHOidZATI9N NO: '12.43' DAVIE COUNTY HEALTH DEPARTMENT
Environmental Health Section PROPERTY INFORMATION '¢
Permittees P.O.Box 848
Name: Mocksville,NC 27028 Subdivision Name: let
Phone#:704-634-8760
Directions to property: �.>C/,� Section: _Lot: ..ems
AUTHORIZATION FOR
WASTEWATER Tax Office PIN� J
SYSTEM CONSTRUCTION
Road Name
**NOTE**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.
(In compliance with Article 11 of G.S.Chapter 130A,Wastewater Systems,Section.1900 Sewage Treatment and Disposal Systems)
r ***NOTICE***THIS AUTHORIZATION FOR WASTEWATER CONSTRUCTION
l� r IS VALID FOR A PERIOD OF FIVE YEARS.
ENVI ONMENTAL HEALTH SPECIALIST DATE ISSUED
x ;»r,Yrr+f; b"'� �A3 .« a •,�` ' :.''i-Y ^`•a`: --. s,. ,.r mss= _ /
124
3 DAVIE COUNTY HEALTH DEPARTMENT
�`' • ' � IMPROVEMENT AND OPERATION PERMITS. PROPERTY INFORMATION "'�'� �
»; t ;
Penn Ace's
Name: Subdivision Name:
Directions to property: r f Section: Lot:, »
M]PROVEMENT
PERMIT Tax Office PIN:# r
Road Name: 1,61-5. 44
**NOTE**.This Improvement Permit DOES NOT authorize the construction or installation of 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)
w ***NOTICE***THIS PERMIT IS SUBJECT TO REVOCATION IF SITE.
A4 PLANS OR THE INTENDED USE CHANGE.YOUR WASTEWATER
ENVIRONMENTAL HEALTH SPECIALIST DATE ISSUED SYSTEM CONTRACTOR MUST SEE THIS PERMIT BEFORE
INSTALLING THE SYSTEM.
RESIDENTIAL SPECIFICATION:BUILDING TYPE #BEDROOMS #BATHS #OCCUPANTS GARBAGE DISPOSAL:Yes or No,'-
COMMERCIAL
o, ,COMMERCIAL SPECIFICATION: FACILITY TYPE #PEOPLE #
PEOPLE/SHIFT #SEATS INDUSTRIAL WASTE:Yes or No
LOT SIZE '� " C TYPE WATER SUPPLY f�e_ DESIGN WASTEWATER FLOW(GPD) NEW SITE—L,----
REPAIR SITE "
SYSTEM SPECIFICATIONS: TANK SIZEe!� �Y GAL. PUMP TANK" GAL. TRENCH WIDTH _'ROCK DEPTH LINEAR FT.LL�'
OTHER
REQUIRED SITE MODIFICATIONS/CONDITIONS:
IMPROVEMENT PERMIT LAYOUT
F
**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 INSTALLATION.TELEPHONE#IS(704)634-8760.
OPERATION PERMIT C
SYS NSTALLED BY: �--�7�
i
AUTHORIZATION NO. OPERATION PERMIT BY: Gam[( DATE:
**THE ISSUANCE OF THIS OPERATION PERMIT SHALL INDICATETHAT.THE SYSTEM DESCRIBED ABOVE HAS BEEN INSTALLED IN COMPLIANCE
WITH ARTICLE I 1 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 WELL FUNCTION SATISFACTORILY FOR ANY GIVEN PERIOD OF TIME.
DCHD 05/96(Revised) .
DAVIE COUNTY HEALTH DEPARTMENT
..
- ` IMPROVEMENT AND OPERATION PERMITS PROPERTY INFORMATION
.Permit"t�e's
Name: r { may', r7 Subdivision Name. .. •' - �
Directions to property: r_=t Section: „+' Lot: '„
IMPROVEMENT
PERMIT Tax Office PIN
:#., ��
3, #.
Road Name: �aC.t1...�Zip:
**NOTE**This Improvement Permit DOES NOT authorize the construction or installation of aseptic 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)
***NOTICE***THIS PERMIT IS SUBJECT TO REVOCATION IF SITE
PLANS OR THE INTENDED USE CHANGE.YOUR WASTEWATER
ENVIRONMENTAL HEALTH SPECIALIST DATE ISSUED SYSTEM CONTRACTOR MUST SEE THIS PERMIT BEFORE
INSTALLING THE SYSTEM.
RESIDENTIAL SPECIFICATION:BUILDING TYPE /0' #BEDROOMS ctP #BATHS 4 S_#OCCUPANTS GARBAGE DISPOSAL:Yes or No
COMMERCIAL SPECIFICATION: FACILITY TYPE #PEOPLE #PEOPLE/SHIFT #SEATS INDUSTRIAL WASTE:Yes or No
LOT SIZE. TYPE WATER SUPPLY _ DESIGN WASTEWATER FLOW(GPD) d NEW SITE• f REPAIR SITE
SYSTEM SPECIFICATIONS: TANK SIZE =sed GAL. PUMP TANK GAL. TRENCH WIDTH f ROCK DEPTH J LINEAR FT.-tW
OTHER
REQUIRED SITE MODIFICATIONS/CONDITIONS:
IMPROVEMENT PERMIT LAYOUT
"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 DA 7 INSTALLATION.TELEPHONE#IS(704)634-8760.
OPERATION PERMIT /J
SYS M NSTALLED BY: � G���t
AUTHORIZATION NO. OPERATION PERMIT BY: DATE:
"THE ISSUANCE OF THIS OPERATION PERMIT SHALL INDICATE THAT THE SYSTEM DESCRIBED ABOVE HAS BEEN INSTALLED IN COMPLIANCE
WITH ARTICLE I 1 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 FUNCTION SATISFACTORILY FOR ANY GIVEN PERIOD OF TIME.
DCHD 05/96(Revised)
a°'
APPLICATION FOR SITE EVALUATION/IMPROVEMENT PEI MILT-&14T:C
Davie County Health Department v
r
Environmental Health Section D
4
P.O. Box 848 NOV f 9
Mocksville,NC 27028
(704) 634-8760
****IMPORTANT**** THIS APPLICATION CANNOT BE PROCESSED UNLESS ALL
THE REQUIRED INFORMATION IS PROVIDED.
1. Name to be Billed ���� J1�'Y11r ContactPerson
Mailing Address 601 ��L( ll�'i I N?/ (tet'l Od - Home Phone
City/State/Zip (�,kt f / Business Phone —70 CL— 7 S�
2. Name on Permit/ATC if Different than Above _
:i Mailing Address City/State/Zip
3. Application For: [ ]Site Evaluation [ ]Improvement Permit&ATC [q-Toth
4. System to Serve: [ ]House [,}'Mobile Homed [ ]Business [ ]Industry [ ] Other
5. If Residence: #People_' #Bedrooms L #Bathrooms [ ]Dishwasher[ ]Garbage Disposal
[elVashing Machine [ ]Basement/Plumbing [ ]Basement/No Plumbing
6. If Business/Other:Specify type #People #Sinks #Commodes
I` #Showers #Urinals #Water Coolers
j If Foodservice:#Seats Estimated Water Usage(gallons per day)
7. Type of water supply: [4"C—ounty/City [ ]Well [ ]Community,.,
8. Do yoi anticipate additions or expansions of the facility this system is intended to serve?[ ]Yes K-90
If yes,,Nk hat type? _
+ EITHER A PLAT OR SITE PLAN
PROPERTY INFORMATION REQUIRED:***IMPORTANT OF THE PROPERTY MUST BE.,,.,,"
SUBMITTED WITH THIS APPLICATION
Property Dimensions: 4�?o$� `� ?�� y WRITE DIRECTIONS(fro Mocksville)TO PROPERTY
ax Office PIN: # 7 _�-
1
Property Address: Road 1�ame �i/1!lC.S W 14-V � ;G�Y/rE 6,141
City/Zip oFr (F'o t -5dt, �-
If in Subdivision provide inform tion,as follows: F /'70 3 —a 5 b o/ 5 . _
Name:
Section: Lot#: ;
' This is to certify that the information provided is correct to the best of my knowledge. I understand that any permit(s)issued hereafter are
1 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 charges 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 and owned
by C` GL�'15 to���uZffr ;!�ras necessary to determine the site suitability.
k DATE SIGNATURE
Revised DC''.D(06-96)
A
THIS Alk EA MAY BE USED FOR DRAIVINC JOU SITE PLAN:
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•'.* DAVIE COUNTY HEALTH DEPARTMENT
Environmental Health Section SECTION--/
Soil/Site Evaluation
APPLICANT'S NAMEDATE EVALUATED
PROPOSED FACILITYTY PROPERTY SIZE l ��
SUBDIVISION ROAD NAME x7491_5'
Water Supply: On-Site Well Community Public
Evaluation By: Auger Boring ✓ Pit Cut
FACTORS 1 2 3 4 5 6 7
Landscape position
Slope%
HORIZON I DEPTH
Texture group
Consistence
Structure
Mineralogy
HORIZON Il DEPTH f H
Texture group
Consistence /
Structure iC
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 e
SITE CLASSIFICATION: EVALUATION BY:
LONG-TERM ACCEPTANCE RATE: f 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-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
Structure
SC-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(OI.90)
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