1819 Hwy 64W Davie County, NC Tax Parcel Report 4,1 Tuesday, September 27, 201 E
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CODBEY RD- GODBEY RD
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- WARNING: THIS IS NOT A SURVEY
Parcel Information
Parcel Number: 130000001101 Township: Calahaln
NCPIN Number: 5729003433 Municipality:
Account Number: 63824000 Census Tract: 37059-801
Listed Owner 1: SEAFORD JEFFREY DEAN Voting Precinct: NORTH CALAHALN
Mailing Address 1: PO BOX 998 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: 3.415 AC HWY 64 Fire Response District: CENTER
Assessed Acreage: 2.89 Elementary School Zone: WILLIAM R DAVIE
Deed Date: 4/2015 Middle School Zone: NORTH DAVIE
Deed Book/Page: 009840951 Soil Types: PcC2,CeB2
Plat Book: Flood Zone:
Plat Page: Watershed Overlay: DAVIE COUNTY
Building Value: 125090.00 Outbuilding&Extra 0.00
Freatures Value:
Land Value: 276950.00 Total Market Value: 402040.00
Total Assessed Value: 402040.00
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
NC
County of Davie,North Carolina,Its agents,consultants,contractors or employees from any and all claims or causes of action due to
NC or arising out of the use or Inability to use the GIS data provided by this website.
• DAVIE COUNTY HEALTH DEPARTMENT
1 Environmental Health Section
P.O.Boa 848/210 Hospital Street
Mocksville,NC 27028
(336)751-8760
Account #: 990000708 Tax PIN/EH#: 5729-00-3433
Billed To: F1111PXa01ANeFks Subdivision Info:
Reference Name: f4wA-Falter Location/Address: 1819 N.C. Hwy.64 K-27028
Proposed Facility: Business Property Size: 3.498 Acres
ATC Number. 2137
AUTHORIZATION FOR WASTEWATER SYSTEM CONSTRUCTION
**NOTE** This Authorization for Wastewater System Construction MUST BE ISSUED by the Davie County Environmental
Health Section prior to issuance of any building permit(s). This Form/Authorization Number should be presented to
the Davie County Building Inspections Office when applying for building permit(s)(in compliance with Article 11 of
G.S.Chapter 130A,Wastewater Systems, Section.1900 Sewage Treatment and Disposal Systems). THIS
AUTHORIZATION FOR WASTEWATER CONSTRUCTION IS VALID FOR A PERIOD OF/FIVE/YEARS.
Environmental Health Specialist's Signature: a Date:
1004 qW. l�All(, /00 R l;ti0
CERTIFICATE OF COMPLETION
**NOTE**The issuance of this Certificate of Completion shall indicate the system described on hn ement/Operati n P mit
has been installed in compliance with Article 11 of G.S.Chapter 130A,Sectio 0"Sewage tment d
Disposal Systems,"but shall in NO WAY be taken as a guarantee that the system will satis or y
given period of time.
d
e
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Septic System Installed By:
Environmental Health Specialist's Signature:. d&-Date:
DCHD 05/99(Revised)
DAVIE COUNTY HEALTH DEPARTMENT
- Environmental Health Section
' P.O.Boa 848/210 Hospital Street
• Mocksville,NC 27028
• (336)751-8760
IMPROVEMENT/OPERATION PERMIT
Account #: 990000708 Tax PIN/EH#: 5729-00-3433
Billed To: Fuller Earthworks Subdivision Info:
Reference Name: Chad Fuller Location/Address: 1819 N.C. Hwy.64W.-27028
Proposed Facility: Business Property Size: 3.498 Acres
ATC Number: 2137
**NOTE**This Improvement/Operation Permit DOES NOT authorize the construction 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). THIS
PERMIT IS SUBJECT TO REVOCATION IF SITE PLANS OR THE INTENDED USE CHANGE. YOUR
WASTEWATER SYSTEM CONTRACTOR MUST SEE THIS PERMIT BEFORE INSTALLING SYSTEM.
Residential Specification: Building Type f #People #Bedrooms #Baths
Dishwasher: ❑ Garbage Disposal: ❑ Washing Machine: ❑ Basement w/Plumbing: ❑ Basement/No Plumbing: ❑
Commercial Specification: Facility Type's #People_� #People/Shift_� #Seats Industrial Waste: ❑
Lot Size Type Water Supply Design Wastewater Flow(GPD) lb?b Site: New;Repair❑
System Specifications: Tank Size 12M,0 GAL. Pump Tank GAL. Trench Width��� Rock Depth _,2 Linear Ft./,�90J
Other:
Required Site Modifications/Conditions:
IMPROVEMENT/OPERATION PERMIT LAYOUT- APPROVED EFFLUENT FILTER RISER(S)IF 6"BELOW
FINISHED GRADE. ****NOTICE: Contact a representative of the Davie County Health Department for final inspection of this
system between 8:30 a.m.to 9:30 a.m.or 1:00 p.m.to 1:30 p.m.on the day of installation. Telephone#is(336)751-8760.****
1�
Environmental Health Specialist's Signature: � /J , Date: J
DCHD 05/99(Revised)
r �n
APPLICATION FOR SITE EVALUATION/IMPROVEMENT PERMIT&ATC @ a v
Davie County Health Department
Environmental Heath SecUon �'�L� AUG 4 !
P.O. Box 848/210 Hospital Street
Mocksville, NC 27028
(336)751-8760 t ;,� L .:. wr- •. �.
***IMPORTANT*** THIS APPLICATION CANNOT BE PROCESSED UNLESS ALL THE REQUIRED
INFORMATION IS PROVIDED. Refer to the INFORMATION BULLETIN for instructions.
1. Name to be Billed Fuller Earthworks Contact person Chad Fuller
mailing address 855 Salisbury Rd. Some Phone 751-3712
city/statenip Mocksville, NC 27028 Business Phon&751-3712
2. Name on Permit/ATC if Different than Above
Mailing address City/ t•/Zip
3. Application For: Site Evaluation Improvement Permit/ATC X/Both
4. System to Service: ❑ House ❑ Mobile Home Business ❑ Industry ❑ Other
5. If Residence: # People # Bedrooms # Bathrooms
❑ Dishwasher ❑ CarbaQo Disposal ❑ Washing Machine ❑ Basement/Plumbing ❑ Bassment/No Plumbing
6. If Business/Industry/Other: Specify type # People # Sinks
# Commodes # Showers # Urinals # Water Coolers
IF FOODSERVICE: # Seats Estimated Water Usage (gallons per day)
7. Type of water supply: 1 County/City ❑ Well ❑ Community
S. Do you anticipate additions or expansions of the facility this system is intended to serve? ❑Yes ❑No
If yes,what type?
***IMPORTANT***CLIENTS MUST COMPLETE THE REQUIRED PROPERTY INFORMATION REQUESTED
BELOW. Either a PLAT or SITE PL/AN MUSST BE SUBMITTED by the client with THIS APPLICATION.
Property Dimensions: 2,� '7 n�/7c1'(f WRITE DIRECTIONS(from MockrAlle)to PROPERTY:
Tax Office PIN: # 5q2,9-Q0 -,9q3'-?) '�forne r 07r
Property Address: Road Name 18191,�NC HWY. 64Wy p
City/Zip Mocksville, NC 27028
If In a Subdivision provide Information,as follows:
Name:
Section: Block: Lot: Date Property Flagged:
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
to conduct all testing procedures as necessary to determine the site suitab
DATE T SIGNATURE
THIS AREA MAY BE USED FOR DRAWING YOUR SITE PLAN(Include all of the following: Existing and proposed
property lines and dimensions, structures, setbacks, and septic locations).
Site Revisit Charge
Date(s):
Client Notification Date:
EHS•
Account No.
Revised DCHD(07/99) Invoice No. �'
Now or Formerly
Center Methodist Church
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No � or Form erlp ��J� �y ,
Ophelia Ferebee ►1, <y
Deed Book: 53 Pege: 609 '�,��
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No �r or Form erly
Ophelia Ferebee
Deed Book: 53 Page: 609
NOTES:
1) Property Zoned HB
2) Minimum Building Setback Lines: 30' Front yard,
10' Side yard and 20' Rear yard.
3) lmpervious Limits: Tofa/ Building Areo: 6,000 Sq.Ff.
Area in new Grave/ Porking 12,040 Sq.Ft.
Total lmpervious A�eo: 18,040 Sq. Ft.
(Toto/ Site A�ea: 3.498 Acres = 152,372.88 Sq. Ft.)
Percen t o f Co verage = 0.118 9'
SO
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Pork ng Area dt Orive
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3.498 Acres
(A�eo by Coo�diote Method)
S88"02'21 "i� 122.21 � Ll N89"09':�7"iY 97.37
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Map Book: 1 Pa�-s: 2 �
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IC SCALE
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= 50 ft.
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334. 06
No ir or Form erly
Williem R. Clement
Deed Book: 119 Page: 373
PRELIMINARY PLAN
NOT FOR �'��^?DATION,
CONVEYA��i�_S OR SALES
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LlNE TABLE
LINE LENGTH BEARING
L 1 15.12 S84 44'41 'E
JOB NAME: Si t e Pl an for
zoo "����e1� �E �9
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PA TTERSON, BREWE �c ASSDCIA TE,�', P.A.
ENGlNEERING * SUR EYING * PLANNING
P.O. BOX 1387, Mo esville, N.C. 28115
(�04) ss2-o�o0 # F X (�04) ss2-o�o�
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LOCATION: CALAHALN TOWNSHIP, DAVIE COUNTY, NC
OWNER/DEVELOPER:
rULLER cAP.THWORKS
DRAWN BY: PAF
SCALE: 1 " = 50'
DATE OF FIELD SURVEY:
CHECKED BY: JHP
DATE OF MAP: AUGUST 3, 1999
JOB NUMBER: IBOOK N0:
99171
• DAVIE COUNTY HEALTH DEPARTMENT
Environmental Health Section
Soil/Site Evaluation
• APPLICANT INFORMATION PROPERTY INFORMATION
Account #: 990000708 Tax PIN/EH#: 5729-00-3433
Billed To: Fuller Earthworks Subdivision Info:
Reference Name: Chad Fuller Location/Address: 1819 N.C. Hwy. 64 K-27028
Proposed Facility: Business Property Size: 3.498 Acnes Date Evaluated:
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 II DEPTH 241t
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 RATE
SITE CLASSIFICATION: EVALUATION BY:
i
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 05/99(Revised)
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