162 Deacon Way Lot 3 � 1
Davie County,NC Tax Parcel Report Monday,December 19, 2016
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WARNING: THIS IS NOT A SURVEY
Parcel Information
Parcel Number: K5030A0003 Township: Mocksville
NCPIN Number: 5747655546 Municipality:
Account Number: 82515566 Census Tract: 37059-805
Listed Owner 1: STAKELY GERALD D SR Voting Precinct: SOUTH MOCKSVILLE
Mailing Address 1: 162 DEACONS WAY Planning Jurisdiction: Davie County
City: MOCKSVILLE Zoning Class: DAVIE COUNTY R-A
State: NC Zoning Overlay:
Zip Code: 27028-5183 Voluntary Ag.District: No
Legal Description: LOT 3 DEACONS RIDGE Fire Response District: JERUSALEM
Assessed Acreage: 2.03 Elementary School Zone: CORNATZER
Deed Date: 9/2000 Middle School Zone: WILLIAM ELLIS
Deed Book/Page: 003460030 Soil Types: PaD,PcC2,CeB2
Plat Book: 0006 Flood Zone:
Plat Page: 060 Watershed Overlay: DAVIE COUNTY
Building Value: Outbuilding&Extra
Freatures Value:
Land Value: Total Market Value:
Total Assessed Value:
9 tl� 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 webaite 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
�o U N Ca NC or arising out of the use or Inability to use the GIS data provided by this website.
DAVIE COUNT' HEALTH DEPARTMENT y oU
IMPROVEMENTS PERMIT AND CERTIFICATE OF COMPLETION , l� :`30
*NOTE:Issued in Compliance With Article II of G.S.Chapter 130a
Sanitary Sewage System' Permit Number
Name Date �� ''� G 7412
Location Mx, �P � /IrZr y /� �*"Y ✓� /�fi'�:_.r., �r'�-
Subdivision Name , �1211-lr Lot No. `.� Sec,-0 Block No.
Lot Size ��f House Mobile Home Business'_.._— Industry
No. Bedrooms _ !
— Baths _� No. in Family Public Assembly Other /
Garbage Disposal YES ❑ NO
2' Specifications for System:
Auto Dish Washer YESNO ❑
Auto Wash Ma thine YES W NO p`
Type Water Supply
'This permit Void if sewage system described below is not installed within 5'years from date of issue.
Thi§ permit is subject to revocation if site plans or the intended use change.
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Improveme is permit b �t Ila–�Y
*Contact a representative of the Davie County Health Department for final inspection of t Is 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 704-634-598 .
Final Installation Diagram: EV SystemInst lied by
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Certificate of Completion' . _ Date
'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 waybe taken as a guarantee that the system will function
satisfactorily for any given period of time.
APPLICATION FOR SITE EVALUATION/IMPROVEMENTS PERMIT
Davie County Health Department
Environmental Health Section
P. O. Box 665 r F C E 0 V�
Mocksville, NC 27028
JAN 1 81994
1. Application/Permit Requested By r --/ _--
Mailing Address e �sX _ Home Phone-116�-
/%D Business Phone 9yD - '72 z12,
2. Name on Permit if Different than Above
3. Application for: ❑General Evaluation MCeptic Tank Installation Permit
4. System to Serve: 0,-House ❑ Mobile Home ❑ Place of Public Assembly
❑ Business ❑ Industry 0 Other ❑ Unknown
5. If house, mobile home: Subdivision 5' Section Lot# 3
❑ Basement/Plumbing
No.of People ❑ Basement/No Plumbing
No. of Bedrooms -3 [B"Washing Machine
No. of Bathrooms CEJ Dishwasher
Dwelling Dimensions x ❑ 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: 03"Public ❑ Private ❑ Community
8. Property Dimensions A, g /�'G� Sewage Disposal Contractor /
9. Do you anticipate additions/expansion of the facility this sytem is intended to serve? El Yes ETNo
If yes, what type?
'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:
This is to certify that the information provided is correct to the b t o_f my knowledge, and I un erstan m responsible for all charges
incurred from this application.
DATE SIGNATURE
FtaonCONSENT Q SITE EVA UATI N TO BED NE ON ABOVE DESCRIBED PROPERTY
d
ECK ONE: 1. I OWN the property. ❑ 2. I DO NOT OWN the property.
ked Box #2, the rest of this form MUST be completed by the owner or a person authorized by the owner:
ve consent to the authorized representative of the Davie County Health Department to enter upon above described
cated in Davie County and owned by
all testing procedures as necessary to determine said site's suitability for a ground absorption sewage treatment
al system.
DATE SIGNATURE
DCHD(1193)
` DAVIE COUNTY HEALTH DEPARTMENT
y Environmental Health Section
f Soil/Site Evaluation
NAME SGt/j`l'N GIr90 n DATE EVALUATED
ADDRESS PROPERTY SIZE f�C
PROPOSED FACIILTY LOCATION OF SITE
Water Supply: On-Site Well Community Public
Evaluation By: Auger Boring Pit �/ Cut
FACTORS 1 2 3 4
Landscape position L, L
Sloe %
HORIZON I DEPTH
Texture group
Consistence
Structure
Mineralogy
HORIZON II DEPTH
Texture group
Consistence
Structure /l
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 RATFJ
SITE CLASSIFICATION: EVALUATED BY:
LONG-TERM ACCEPTANCE RA R! OTHER(S) PRESENT:
REMARKS: eP42 �'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
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(01-901
'., DAVIE COUNTY HEALTH DEPARTMENT o`er f 1
Environmental Health Section
Soil/Site Evaluation
NAME u' �r' DATE EVALUATED
ADDRESS PROPERTY SIZE
PROPOSED FACIILTY �"�' LOCATION OF SITEurlr� r
Water Supply: On-Site Well Community Public
Evaluation By: Auger Boring j/ Pit Cut
FACTORS 1 2 3 4
Landscape position -4:,
Sloe %
HORIZON I DEPTH
Texture group
Consistence
Structure
Mineralogy
HORIZON II DEPTH f r
Texture group
Consistence
Structure K f ll
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: O
LONG-TERM ACCEPTANCE RATE: - �j 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(01-90)
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