155 James RdDavie County, NC
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Tax Parcel Report 135 � Thursday, September 29, 2016
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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 Davie, NorthCarolina, 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.
WARNING: THIS IS NOT A SURVEY
w
Parcel Iaformation
Parcel Number:
H70000006404
Township:
Shady Grove
NCPIN Number:
5779051969
Municipality:
Account Number:
82514832
Census Tract:
37059-804
Listed Owner 1: ROTHROCK LAWRENCE H
Voting Precinct:
WEST SHADY GROVE
Mailing Address 1:
155 JAMES ROAD
Planning Jurisdiction:
Davie County
City: ADVANCE
Zoning Class:
DAVIE COUNTY R-A,R-20
State:
NC
Zoning Overlay:
Zip Code:
27006-7.000
Voluntary Ag. District:
No
Legal Description:
2.420 AC JAMES RD
Fire Response District:
FORK,ADVANCE
Assessed Acreage:
2.16
Elementary School Zone:
SHADY GROVE,CORNATZER
Deed Date:
6/2000
Middle School Zone:
WILLIAM ELLIS
Deed Book / Page:
003360311
Soil Types:
GnB2
Plat Book:
Flood Zone:
Plat Page:
Watershed Overlay:
DAVIE COUNTY
Building Value:
0.00
Outbuilding & Extra
Freatures Value:
13220.00
Land Value:
34800.00
Total Market Value:
48020.00
Total Assessed Value:
48020.00
161
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 Davie, NorthCarolina, 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.
47 10
.gAuC?RIZATION NO: A 7 2 DAVIE COUNTY HEALTH DEPARTMENT
J J Environmental Health Section PROPERTY INFORMATION
Permittee's � P.O. Box 848
Name: Mocksville, NC 27028, Subdivision Name:
Phone #: 704-634-8760
Directions to property: i9 F S ' A Section: Lot:
AUTHORIZATION FOR �'
WASTEWATER Tax Office PIN:#�
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)
/ ***NOTICE*** THIS AUTHORIZATION FOR WASTEWATER CONSTRUCTION
IS VALID FOR A PERIOD OF FIVE YEARS.
ENVIRONMENTAL HEALTH SPE t�fALIST DATE ISSUED
fT.. T .,iy .,.. _ ..... ..ar -...f fw f'a.;,Yy--•4..-.r..'i -�H-v a . y, %;,�K r v-5. .. - .. r ._ _ r - i
jV41.,:
.�, DAVIE COUNTY HEALTH DEPARTMENT
4 IMPROVEMENT AND OPERATION fkRMIU PROPERTY INFORMATION
it 9s
IV�ame: Subdivision Name:
Directions to property: Section: Lot:
IMPROVEMENT
PERMIT Tax Office PIN:#'�
Road Name•_=J�/y% ip: 0 tl
**NOTE4* 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/mstallation 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 ALIST DATE ISSUED SYSTEM CONTRACTOR MUST SEE THUS PERMIT BEFORE
INSTALLING THE SYSTEM.
RESIDENTIAL SPECIFICATION: BUILDING TYPE At/ # BEDROOMS # BATHS ---I—# OCCUPANTS !Z GARBAGE DISPOSAL: Yes or No
COMMERCIAL SPECIFICATION: FACILITY TYPE # PEOPLE # PEOPLE/SHIFT` # SEATS
h INDUSTRIAL WASTE: Yes or No
LOT SIZE f J( TYPE WATER SUPPLY �_ DESIGN WASTEWATER FLOW (GPD) -:re L� NEW SITE li REPAIR SITE
SYSTEM SPECIFICATIONS: TANK SIZE :QO— GAL. PUMP TANK GAL. TRENCH WIDTH XC ROCK DEPTH LINEAR FT. 7o6
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 DAY OF INSTALLATION. TELEPHONE # IS (704) 634-8760.
OPERATION PERMIT � � � ^lam IS
SYSTEM INSTALLED BY:
X3r,X,Z��
C13
CA
110
2�Z
AUTHORIZATION NO. I ✓. ! OPERATION PERMIT BY: DATE: 9
**THE ISSUANCE OF THIS OPERATION PERMIT SHALL INDICATE THAT THE SYS M 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 PERMA x
Davie County Health Departments ►, r
Environmental Health Section
P O. Box 848 APR - 6 19%
Mocksville, NC 27028
(336)751-8760 ENVIRONMENTAL HEALTH
****IMPORTANT**** THIS APPLICATION CANNOT BE PROCESS L-C4VIE COUNTY
ALL THE REQUIRED INFORMATION IS PROVIDED.
n
1. Name to be Billed S v (le—,kPA25Jy2(Q1C' Contact Person ��✓� ��-/�
Mailing Address Tf L24 47 //114 aR . Home Phone 29"Lla
City/State/Zip �G�' (i �(/C' i /�� �e Business Phone ��✓ ��Q�7`
_
2. Name on Permit/ATC if Different than Above
PROPERTY INFORMATION REQUIRED: *** IMPORTANT *** A P,y� THE PROPERTY MUST BE
SUBMITTED WITH THIS APPLICATION.
Property Dimensions: 5�1�d 1 WRITE DIRECTIONS (from
r/ 9 Mocksville) TO PROPERTY:
Tax Office PIN: # / - - �/
Property Address: Road Name 1
CJ
City/zip '
1'�., f a,y Fmk BiX
If in Subdivision provide information, as follows:
Name: '
' /SS �LIiL1PS Ad,
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 by0[��%i �� �� to conduct all testing procedures
as necessary to determine the site suitability.
DATE 6 11 p — !ff SIGNATURE
Revised DCHD (06-96)
YOU MAY USE THE BACK Of THIS FORM fOR DRAWINCG YOUR SITE PLAN.
Mailing Address
City/State/Zip
3.
Application For:
❑ Site Evaluation❑ Improvement Permit & ATC
Both
4.
System to Serve:
❑ House Mobile Home ❑ Business ❑ Industry ❑ Other
qI'
5.
If Residence:
# PeopleSIP _ # Bedrooms #
Bathrooms
❑ Dishwasher ❑ Garbage Disposal fid' Washing 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
VIN
8.
Do you anticipate additions or expansions of the facility this system is intended to serve?
❑ Yes
If yes, what type?
PROPERTY INFORMATION REQUIRED: *** IMPORTANT *** A P,y� THE PROPERTY MUST BE
SUBMITTED WITH THIS APPLICATION.
Property Dimensions: 5�1�d 1 WRITE DIRECTIONS (from
r/ 9 Mocksville) TO PROPERTY:
Tax Office PIN: # / - - �/
Property Address: Road Name 1
CJ
City/zip '
1'�., f a,y Fmk BiX
If in Subdivision provide information, as follows:
Name: '
' /SS �LIiL1PS Ad,
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 by0[��%i �� �� to conduct all testing procedures
as necessary to determine the site suitability.
DATE 6 11 p — !ff SIGNATURE
Revised DCHD (06-96)
YOU MAY USE THE BACK Of THIS FORM fOR DRAWINCG YOUR SITE PLAN.
q�
M.
... ... ..... .....
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14
0 Vq
DAVIE COUNTY HEALTH DEPARTMENT
Environmental Health Section SECTION LOT
Soil/Site Evaluation
APPLICANT'S NAME 5 r i O /
PROPOSED FACILITY a GT
SUBDIVISION
Water Supply: On -Site Well
Community
Evaluation By: Auger Boring Pit
DATE EVALUATED � �Z /QC
PROPERTY SIZE oC i �/ fic '
ROAD NAME
Public
Cut
FACTORS
1 2 3 4 5 6 7
Landscape position
Slope %
JIV .2
HORIZON I DEPTH
Texture group
Consistence
Structure
Mineralogy
HORIZON II DEPTH
Texture groupG
Consistence
1�
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
, 4-1 "J
SITE CLASSIFICATION:
LONG-TERM ACCEPTANCE RATE:
REMARKS:
DCHD (01-90)
EVALUATION BY: A �//
OTHER(S) PRESENT:
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
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