3140 Hwy 64E (2) Davie County,NC Tax Parcel Report Friday, December 16, 2016
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WARNING: THIS IS NOT A SURVEY
r Parcel Informationr� � q _.
Parcel Number: J712OA0026 Township: Fulton
NCPIN Number:. 5777186197 Municipality:
Account Number: `_•82517795 Census Tract: 37059-804
Listed Owner 1 c-. FORK BAPTIST CHURCH` Voting Precinct: FULTON
Mailing"Address 1: 3140 US HIGHWAY 64 EAST Planning Jurisdiction: Davie County
City: - MOCKSVILLE Zoning Class: DAVIE COUNTY R-A,R-20,H-B
:State:..-- NC Zoning Overlay:
Zip Code: 27028-0000 Voluntary Ag.District: No
Legal Description: 8.347AC HWY 64 Fire Response District: FORK
Assessed Acreage: 8.97 Elementary School Zone: CORNATZER
-Deed Date:: 11/2001 Middle School Zone: WILLIAM ELLIS
Deed Book/Page: 003930892 Soil Types: PaD,PcB2
Plat Book: Flood Zone:
Plat Page: Watershed Overlay: DAVIE COUNTY
Building Value: Outbuilding&Extra
Freatures Value:
Land Value: Total Market Value:
Total Assessed Value:
9 A Ml� 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 Davis.North Carolina,Its agents,consultants,contractors or employees from any and all claims or causes of action due to
cOUN t NC or arising out of the use or Inability to use the GIS data provided by this website.
DAVIE- COUNTY HEALTH DEPARTMENT
IMPROVEMENTS PERMIT-AND .CERTIFICATE OF COMPLETION
*NOTE:Issued in Compliance With Article.II of G.S.Chapter 130a __
,. Sanitary Sewage Systems Permit Number
Name i o �! �'�r. ��� ,i� Date — J� , N2 7
Location —
—�� o its
U ile
SubdivisionNameLot No. Sec. or Block No.
Lot Size House Mobile Home ___ Business —L--''� Speculation
No. Bedrooms Baths No. in Family
Garbage Disposal YES ❑ NO p Specifications for System:
Auto Dish Washer YES NO 0
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Auto Wash Ma.hine YES p NO ❑ �G�Di <' �! G� / `
Type Water Supply --- a. � ,a`'St•-f
VThis-permit Void if sewage system described below is not installed within 5 years from date of issue.
This permit is subje t`to•rev_ocation if site plans or the intended use change.
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Improvements 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 day of completion. Telephone Number 704-634-5985.
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Final Installation Diagram: Rt��KI �'� System Installed by
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Certificate of Completion Date- 7 '2'
*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 way be taken as a guarantee that the system will function
satisfactorily for any given period of time.
r '(lP , , DAVIE COUNTY HEALTH DEPARTMENT
( G,�;r�c" '`'`` IMPROVEMENTS PERMIT AND CERTIFICATE OF COMPLETION
�f..NOTE:Issued in Compliance With Article II of G.S.Chapter 130a
Sanitary Sewage Systems/ _ Permit Number
Name_ to r.�l yr«<if f . ;���.� �� Date r2& _ N2
� 656
Location
Subdivision Name Lot No. Sec. or Block No.
Lot Size , �� House Mobile Home -- Business � 1� Speculation
No. Bedrooms .No. Baths No. in Family'
Garbage Disposal YES ❑ NO Specifications for System:
Auto Dish Washer YES ❑ NO
Auto Wash Ma,hine YES ❑ NO
G
Type Water Supply
'This permit Void f sewage system described below is not installed within 5 years from date of issue.
This permit is subject to revocation if site plans or the intended use change. 17�
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._---/�,L/ Im ovements permit by —
'Contact a representative of a Davie C unty Health Department for final inspection of this system between 8:30-
9:30 A.M. or 1:00-1:30 P.M. day of ompletion. Telephone Number 704-634-5985.
Final Installation Diagram: System Installed by
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 way be taken as a guarantee that the system will function
satisfactorily for any given period of time.
,
'DAVIE COUNTY HEALTH DEPARTMENT f Yl
r - r • '` IMPROVEMENTS PERMIT AND .CERTIFICATE ,.OF COMPLETION
\ *NOTE:Issued in Compliance With Article I I of G.S.Chapter 130a -
Sanitary Sewage Systems
Permit ,Number
Name, ��.N ;/ ._;/,i. f I , �.._,:, Date —L/- f `�1� N2
6 P5 6 41
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Location
--> -Subdivision Name Lot No. Sec. or Block No.
Lot Size House Mobile Home —T Business 4LZ � Speculation
No. Bedrooms 4 No. Baths No. in Family;
Garbage Disposal YES ❑ NO [ � Specifications for System:
Auto Dish Washer. YES ❑ NO
Auto Wash Ma.hine YES ❑ NO
Type Water Supply
*This,permit Void if sewage system described below is not installed within 5 years from date of issue.
This permit is subject to revocation if site plans or the intended use change.
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_�__---------y^� \ Improvements permit by —1
l� --- ---t —. —..—
*Contact a representative of a Davie County Health Department for final inspection of'.this system between 8:30-
9:30 A.M. or 1:00-1:30 P.M, n day of mpletion. Telephone Number 704-634-5985.
Final Installation Diagram: �CtT� r� System Installed by
c
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i
"_ Certificate of Completion ''` Date ' r
r-: _
'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 way be 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 Healt!'i Section
P.O. Box 665
Mocksville, NC 27028
1. Application/Permit Requested By. J)JT�O6A ZCAC-E-L-
Mailing
Address t5• Onc, k 1 -712 ��nr10 QT-U-I" N3 ..�
Home Phone Business Phone C'
2. Name on Permit if Different than Above �ra/� �A�j i�1 C 11'j"ec-d
3. Application/Permit for: ❑ General Evaluation E2 Septic Tank Installation
4. System to Serve: JX House ❑ Mobile Home IIS Place of Public Assembly
❑ Business ❑ Industry ❑ Other ❑ Unknown
5. If house, mobile home: Subdivision Section Lot #
❑ Basement/Plumbing
No. of People ❑ Basement/No Plumbing
No. of Bedrooms ❑ Washing Machine
No. of Bathrooms ❑ Dishwasher
Dwelling Dimensions ❑ Garbage Disposal
6. If business, industry, place of public assembly, other: Specify type C lay
No. of People ServedJ t'>"V) -� 0 No. of Sinks
t
No. of Commodes / No. of Urinals
No. of Lavatories No. of Water Coolers
No. of Showers Water Usage Figures
7. Type of water supply: KI Public ❑ Private ❑ Community
8. Property Dimensions Sewage Disposal Contractor
9. Do you anticipate additions/expansion of the facility this sytem is intended to serve? ❑ Yes El No
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: (J '
b
� 16D
This is to certify that the information provided is correct to the best o my knowledge, and fun rstand I am responsible for all charges
incurred from this application.
/o- -/ - �/
DATE SIGNATURE
CONSENT FOR SITE EVALUATION TO BE DONE ON ABOVE DESCRIBED PROPERTY
MUST CHECK ONE: ❑ 1. 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.
DATE SIGNATURE
DCHD(12.90)
A
. .= DAVIE COUNTY HEALTH DEPARTMENT
Environmental Health Section
Soil/Site Evaluation /
NAME_, ��`/`S DATE EVALUATED
ADDRESS
PROPERTY SIZE
PROPOSED FACIILTY , >'l�i�s�l ��� LOCATION OF SITE [� ��—
Water Supply: On-Site Well Community Public c,-"
Evaluation By: Auger Boring k,,< Pit Cut
FACTORS 1 1 2 3 4
Landsca e position
Sloe Z —
HORIZON I DEPTH
Texture group
Consistence
Structure
MineralogX
HORIZON II DEPTH
Texture group
Consistence r r
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 RATEI I
����
SITE CLASSIFICATION: ' EVALUATED BY: /*z
LONG-TERM ACCEPTANCE RATE: 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(01-901
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