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193 Deacon Way Lot 16 Davie County,NC Tax Parcel Report Monday, December 19, 2016 - 206 247-= 239 .` 1 217 78 193 tk 162 1-161 WARNING: THIS IS NOT A SURVEY Parcel Information Parcel Number: K503OA0016 Township: Mocksville NCPIN Number: 5747650751 Municipality: Account Number: 82523133 Census Tract: 37059-805 Listed Owner 1: BISHOP ALFRED E Voting Precinct: SOUTH MOCKSVILLE Mailing Address 1: 193 DEACON 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 16 DEACONS RIDGE Fire Response District: JERUSALEM Assessed Acreage: 2.62 Elementary School Zone: CORNATZER Deed Date: 7/2004 Middle School Zone: WILLIAM ELLIS Deed Book I Page: 005630846 Soil Types: 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: 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 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 NCor arising out of the use or Inability to use the GIS data provided by this webstte. AUTHORIZATION NO: Q 5 Q 8 DAVIE COUNTY'HEALTH DEPARTMENT Environmental Health Section PROPERTY INFORMATION Permittee's -�-� P.O.Box 848 , .Name: �! JW, l5 Mocksville,NC 27028 Subdivision Name: 'Phone#:704-634-8760 Directions to property: Section: Lot: ell AUTHORIZATION FOR WASTEWATER Tax Office PIN:# SYSTEM CONSTRUCTION Road Name: Zip: **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 bepresented 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) ***NOTICE***THIS AUTHORIZATION FOR WASTEWATER CONSTRUCTION IS VALID FOR A PERIOD OF FIVE YEARS. ENVIRONMENTAL H ALTH SPE ALIST DATE ISSUED "��i�i!sit�sYn*i`t:'rtw�rr '' t�,',," ^ow.:s.,�.�' '>,n��Irt:��Pw1�^wn'W'i53_A'S`fly*°'�w•.•+i' ,h,,� , ,.t. . ate,., _ . =- DAVIE COUNTY HEALTH DEPARTMENT ' 7 IMPROVEMENT AND OPERATION PERMITS PROPERTY INFORMATION Permit4 e's _-�-� Name: AW46 Tbr2*- , Subdivision Name: Directions to property: Section: Lot: .•. -� IMPROVEMENT ,c PERMIT Tax Office PIN:# 1 P � . Road Name:, **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 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 SPE IALIST DATE ISSUED SYSTEM CONTRACTOR MUST SEE THIS PERMIT BEFORE INSTALLING THE SYSTEM. RESIDENTIAL SPECIFICATION:BUILDING TYPE 00V #BEDROOMS -5' #BATHS 3' #OCCUPANTS GARBAGE DISPOSAL:Yes or No COMMERCIAL SPECIFICATION: FACILITY TYPE,p #PEOPLE #PEOPLE/SHIFT #SEATS INDUSTRIAL WASTE:Yes or No LOT SaZF %(' TYPE WATER SUPPLY C '!1 DESIGN WASTEWATER FLOW(GPD) NEW SITEy REPAIR SITE SYSTEM SPECIFICATIONS: TANK SIZE GAL. PUMP TANK - GAL. TRENCH WIDTH ROCK DEPTH _ LINEAR FT.S'D 6 OTHER REQUIRED SITE MODIFICATIONS/CONDITIONS: IMPROVEMENT PERMIT LAYOUT r- x **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: �o�ray.,. Z � F ,c L a AUTHORIZATION NO.O D OPERATION PERMIT BY: 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 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) APPLICATION FOR SITE EVALUATIONAMPROVEMENT PERMIT&ATC •p��p� �� Davie County Health Department Environmental Health Section R O.Box 848 CY Mocksville,NC 27028 (704)634-8760 0 ****IMPORTANT**** THIS APPLICATION CANNOT BE PROCESSED UNLESS ALL THE REQUIRED INFORMATION IS PROVIDED. 1. Name to be Billed Contact Person UGt#+e s V. cSlae A Mailing Address _1,31 -len/✓ t° IJa W ►vQ Home Phone 20`-F Cn`f 6 56 7 City/State/Zip Mos.: ( - f/�P. /V.. c-. Business Phone 2. Name on Permit/ATC if Different than Above Mailing Address 13 f eAzV e w ba we- City/State/Zip /K0 c h5'i1d 12.N C , 3. Application For: Site Evaluation ❑ Improvement Permit&ATC ❑ Both 4. System to Serve: 14—House ❑ Mobile Home ❑ Business ❑ Industry ❑ Other 5. If Residence: # People j # Bedrooms _ # Bathrooms 1_ P'bishwasher ❑ Garbage Disposal J*YWashing Machine ❑ Basement/Plumbing ❑ Basement/No Plumbing 6. If Business/Other: Specify type # People # Sinks # Commodes # Showers # Urinals # Water Coolers If Foodservice: # Seats Estimated Water Usage(gallons per day) 7. Type of water supply: County/City ❑ Well ❑ Community 8. Do you anticipate additions or expansions of the facility this system is intended to serve? ❑ Yes -4—No If yes,what type? PROPERTY INFORMATION REQUIRED: ***IMPORTANT***A PLAT OF THE PROPERTY MUST BE SUBMITTED WITH THIS APPLICATION. Property Dimensions: F ` (?1=�.�`r'1`� R��Sf S c� 14c'-e7 WRITE DIRECTIONS(from 1 Mocksville)TO PROPERTY: Tax Office PIN: # {� --c 1 p c NS U Property Address: Road Name Q Q m S kL" 1 1 City/Zip /11 a,kr✓t i f gly-e— 97 o D$ 1 1 1 If in Subdivision provide information,as follows: 1 np 1 Name: .QQCQAZ5 Q; l p 1 1 1 Section: Lot #:�� 1 . 1 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 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 a "I eniP b tnc ." GNI' to conduct all testing procedures as necessary to determine the site suitability. to 0a DATE q-17-Fb SIGNATURE V, 2wa-66 Revised DCHD(06-96) S • DAVIE COUNTY HEALTH DEPARTMENT 16 Environmental Health Section '= Soil/Site Evaluation NAME 019 DATE EVALUATED ADDRESS PROPERTY SIZE LC 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 Sloe % HORIZON I DEPTH Texture group Consistence Structure Mineralogy HORIZON II DEPTH ,� r Texture groupG Consistence Structure 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 • c/ 77- SITE CLASSIFICATION: �� EVALUATED BY: J l/ LONG-TERM ACCEPTANCE RATE: OTHER(S) PRESENT: REMARKS: Z- / d"V" r , o z� /� eodlZe�/l� 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 ■■■..■■■■....0........■■■■■..■■...■..■■■..■...■.■.■■■■■.■■....MMM■ ■■■■a■..■M■M...■■■M■.■■MEM.■..■�..■■■■.■.■■■■■■.■■■■■■■■■■■■■■■■ iiiiiiiiiiiiiiiiiiii■��i�■iiiii�iiiiiiii� �iiiiiiiiiiiiiiiiii=iii ■.■.M.M..E.■■...■O...N■■..■■■....■....■■f�.■■■■■.■■.■�■■....■.■■■l ■■■..........■■..■■....■.■.■........■........■■...... 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