119 Janice Ln (2)Davie County, NC
Tax Parcel Report 6`51 Thursday, September 29, 201(
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WARNING: THIS IS NOT A SURVEY
All data Is provided as Is without warranty or guarantee of any kind either expressed or Implied Including but not limited to the
Implled warranties of merchantability or fitness for a particular use. All users of Davie County's GIS website shall hold harmless the
.. ����II�Y
Parcel Information ��
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Parcel Number:
L5100B001705
Township:
Jerusalem
NCPIN Number:
5746330809
Municipality:
Account Number:
82523388
Census Tract:
37059-807
Listed Owner 1:.
BLALOCK JEFFREY L .
Voting Precinct:
JERUSALEM
Mailing Address 1:
PO BOX 773
Planning Jurisdiction:
Davie County
City: COOLEEMEE
Zoning Class:
DAVIE COUNTY R-20
State:
NC
Zoning Overlay:
DAVIE COUNTY CZOD
Zip Code:
27014-0773
Voluntary Ag. District:
No
Legal Description:
1.258 AC HWY 601
Fire Response District:
JERUSALEM
Assessed Acreage:
1.25 Elementary School Zone:
COOLEEMEE
Deed Date:
9/2004
Middle School Zone:
SOUTH DAVIE
Deed Book / Page:
005740072
Soil Types:
PcC2,CeB2
Plat Book:
Flood Zone:
Plat Page:
Watershed Overlay:
DAVIE COUNTY
Building Value:
74150.00
Outbuilding 8r Extra
Freatures Value:
9460.00
Land Value:
27500.00
Total Market Value:
111110.00
Total Assessed Value:
111110.00
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Davie County,
All data Is provided as Is without warranty or guarantee of any kind either expressed or Implied Including but not limited to the
Implled 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
NC
or arising out of the use or Inability to use the GIS data provided by this website.
DAVIE COUNTY HEALTH DEPARTMENT 9�
IMPROVEMENT PERMIT and OPERATION PERMIT IBA
IMPROVEMENT PERMIT
0 �
**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)
NAME PROPERTY ADDRESS .Tangy c_t La..t2 712 r DATE "� • G
LOCATION
SUBDIVISION NAME LOT NUMBER SEC./BLDG( NUMBER
RESIDENTAL SPECIFICATION: BUILDING TYPE M # BEDROOMS # BATHS a # OCCUPANTS (I GARBAGE DISPOSAL: Ye No
COMMERCIAL SPECIFICATION: �fA(JLITY TYPE # PEOPLE # PEOPLE/SHIFT # SEATS INDUSTRIAL WASTE: YeAllNo
LOT SIZE cs css TYPE -,WATER SUPPLY l; DESIGN'WASTEWATER FLOW (GPD) p ..NEW SI /(lam' REPAIR,,,SITE
SYSTEM SPECIFICATIONS: TANK SIZE, 00 D GAL. Ptd TANK GAL. TRENCH WIDTH 3� ROCK DEPTH LINEAR FT'.
x
OTHER
REQUIRED SITE MODIFICATIONS/CONDITIONS:
***THIS PERMIT IS SUBJECTJO REVOCATION IF SITE PL.ANSQOR THE INTENDED USE R WASTERWATER SYSTEM CONTRACTOR MUST
SEE THIS PERMIT BEFORE INSTALLING THE; SYSTEM. a .
k. a a
IV
11
IMPROVEMENT PERMIT BY
**CONTACT A REPREPTATIVE`OF`THE DAV19-CMkTTY HEALTH DEPARTMENT FOR FINAL INSPECTION OF THIS SYSTEM BETWEEN
8:30-9:30 A.M.,,OR 1:N-1:30 P.M. ON THE DAY OF INSTALLATION. TELEPHONE # IS (704) 634-8760.
OPERATION PERMIT . ` SYSTEM INSTALLED BY '
AUTHORIZATION NO. 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 10/95
Davie County Health Department�`I'��
ENVIRONMENTAL HEALTH SECTION
P.O. Box 665
ti J Mocksville, N.C. 27028 1 0U. ®Q
.w AUTHORIZATION FOR WASTEWATER SYSTEM CONSTRUCTION
(Issued in compliance with Article 11 of
G.S. Chapter 130A, Wastewater Systems)
***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 Couf►ty,Building Inspections
Off' wh 1• f B 'ld' P t *** VC,
ic99 \en OFF
�y.�ng or uiQing ern s. q {
NAME x„10 xp Q ' \ V 4 �' t� DATE � " 6' I b
NAME ON IMPROVEMENT PERMIT (If different than above)
SITE LOCATION y c cz �+AN Q
COMMENTS/CONDITIONS ON AUTHORIZATION TO CONSTRUCT WASTEWATER SYSTEM
NAUTHORIZATI NUP%R t
,.'
**WICE*ff THIS AUTHORIZA
N FOR WASTEWATER SYSTEM CONSTRUCTION IS VALID FOR A PERIOD
OF FIVE (5) YEARS.
--9�
ENVIN ENTAL HEALTH SPECIALIST .
DATE
DCHD,10/95
.', _..._ _ . ...,. ... .'1.-.. ¢ ..
..,. .. .., s ..,•d �.,.z`7
APPLICATION FOR SITE EVALUATIONAMPROVEMENT,
' Davie County Health Department Q �%
Environmental Health Section D
P.O. Box 848
Mocksville, NC 27028
(704) 634-8760
****IMPORTANT****. THIS APPLICATION CANNOT BE PROCESSED UNLESS ALL
THE REQUIRED INFORMATION IS PROVIDED.
1. Name to be Billed er 0W Contact Person 0 �� D r Pi A/
Mailing Address 2 33 Home Phone *27 / 2 2 / ig
City/State/Zip rn,c—ffSV,0Z.t� AJC, 170 Business Phone
2. Name on Permit/ATC if Different than Above
Mailing Address City/State/Zip
3. Application For: [ Site Evaluation bolimprovement Permit & ATC [Both
4. System to Serve: [ ] House [ *10"Obile Home [ ] Business [ ] Industry [ ] Other
5. If Residence: #PeopleZ # Bedrooms # Bathrooms 2 [AlDishwasher[ ]Garbage Disposal
W-'ashing 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 [,]-No
If yes, what type?
PROPERTY INFORMATION REQUIRED: *** IMPORTANT *** A PLAT OF THE PROPERTY MUST BE
SUBMITTED WITH THIS APPLICATION.
Property Dimensions: MC4-e— WRITE DIRECTIONS (from Mocksville) TO P/ROPI
Tax Office PIN: # -7 yL - 33 - D -3 6ol -5. F A
Property Address: Road Name 'tce,L /`` • O O f) A !� t�
city/zip M o C6y ; I (e , /y<- 2 76 22 L A/.
If in Subdivision provide information, as follows:
Name:
Section: Lot #: '
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
Represe of the Da {County Health Department to enter upon above described property located in Davie County and owned
by,TiZe, �3 i ' O W Ifto coVyct aptest ng procedures as neqdgto determine the site suitability.
DATE
Revised DCHD (06-96)
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DAVIE COUNTY HEALTH DEPARTMENT
• ' Environmental Health Section
R- Soil/Site Evaluation
NAME ° `�� `� , �o W DATE EVALUATED
ADDRESS M f PROPERTY SIZE 1
PROPOSED FACIILTY
. o (`cro LOCATION OF SITE0
Water Supply: On -Site Well _ Community Publicy
Evaluation By: Auger Boring —� Pit Cut
FACTORS
1
2 3 4
Landscape position
Sloe %
HORIZON I DEPTH
Texture groupL
I�
Consistence
Structure
Mineralogy
HORIZON II DEPTH
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Texture group
Consistence
Structure
Mineralogy
HORIZON III DEPTH
Texture group
Consistence
Structure
Mineralogy
HORIZON IV DEPTH
Texture group
Consistence
Structure
Mineralogy
SOIL WETNESS
5S
RESTRICTIVE HORIZON
—
—'
SAPROLITE
—
--
CLASSIFICATION
,S
LONG-TERM ACCEPTANCE RATE
SITE CLASSIFICATION: ��' EVALUATED BY:
LONG-TERM ACCEPTANCE RATE: �� OTHER(S) PRESENT: N R
REMARKS: —e
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 :lay loam, SIL -Silty loam CL -Clay loam SCL-Sandy clay loam
SC -Sandy clay SIC -Silty clay C -Clay
CONSISTENCE
Moist
VFR- V? --.-y 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
3C --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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