1903 Jericho Church RdDavie county. NC
Tax Parcel Report
() � 31 Monday, October 10, 2016
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Building Value:
Land Value:
Total Assessed Value:
109570.00 Outbuilding & Extra
Freatures Value:
108950.00 Total Market Value:
221360.00
i'18110 79
E
E18213 Is -
1823; 1813 t`
Mocksville
37059-801
SOUTH MOCKSVILLE
Davie County
DAVIE COUNTY R -A
I
177E
i
We
CENTER, MOCKSVILLE
COOLEEMEE,MOCKSVILLE
SOUTH DAVIE
SeB,EnB,IrB,EnC
DAVIE COUNTY
2840.00
221360.00
WARNING: THIS IS NOT A SURVEY
AlldataIsprovided as Is without warranty or guarantee of any kind either expressed or Implied Including but not limited to the
Implied warranties of merchantability or fitness for a particular use, All users of Davie County's GIS website shall hold harmless the
Parcel
Information
Parcel Number:
K300000048
Township:
NCPIN Number:
5727643037
Municipality:
Account Number:
82532462
Census Tract:
Listed Owner 1:
LUPER STEPHEN JAY
Voting Precinct:
Mailing Address 1:
1903 JERICHO CHURCH ROAD
Planning Jurisdiction:
City: MOCKSVILLE
Zoning Class:
State:
NC
Zoning Overlay:
Zip Code:
27028-0000
Voluntary Ag. District:
Legal Description:
15.307 AC JERICHO CHURCH
Fire Response District:
Assessed Acreage:
11.63
Elementary School Zone:
Deed Date:
12/2014
Middle School Zone:
Deed Book / Page:
2014E1229
Soil Types:
Plat Book:
Flood Zone:
Plat Page:
Watershed Overlay:
Building Value:
Land Value:
Total Assessed Value:
109570.00 Outbuilding & Extra
Freatures Value:
108950.00 Total Market Value:
221360.00
i'18110 79
E
E18213 Is -
1823; 1813 t`
Mocksville
37059-801
SOUTH MOCKSVILLE
Davie County
DAVIE COUNTY R -A
I
177E
i
We
CENTER, MOCKSVILLE
COOLEEMEE,MOCKSVILLE
SOUTH DAVIE
SeB,EnB,IrB,EnC
DAVIE COUNTY
2840.00
221360.00
Davie County,
AlldataIsprovided as Is without warranty or guarantee of any kind either expressed or Implied Including but not limited to the
Implied warranties of merchantability or fitness for a particular use, All users of Davie County's GIS website shall hold harmless the
E@1
NC
County of Davie, North Carolina, its agents, consultants, contractors or employees from any and all claims or causes of action due to
or arising out of the use or Inability to use the GIS data provided by this website.
.r
;4 DAVIE COUNTY HEALTH DEPARTMENT
' r IMPROVEMENT PERMIT and OPERATION PERMIT
IMPROVEMENT PERMIT
**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)
J -5 �7��x
NAME )' �//�' �G C��f PROPERTY ADDRESS >.IC1Na d 71r1C- I - DATEea
�r'9
LOCATION �r''���'�4 ` fJ,� /F �� �i°✓y �o//,_�
SUBDIVISION NAME LOT NUMBER SEC./BLOCK NUMBER
RESIDENTAL SPECIFICATION: BUILDING TYPE # BEDROOMS # BATHS ,*,9 # OCCUPANTS __L GARBAGE DISPOSAL: Yes/6
COMMERCIAL SPECIFICATION: FACILITY TYPE # PEOPLE # PEOPLE/SHIFT # SEATS INDUSTRIAL WASTE: Yes/No
LOT SIZE �5��� TYPE WATER SUPPLY !_ DESIGN WASTEWATER FLOW (GPD) r. 100 NEW SITE !/' REPAIR SITE
SYSTEM SPECIFICATIONS: TANK SIZE A;�9 GAL. PUMP TANK GAL. TRENCH WIDTH Sri ROCK DEPTH �� " LINEAR FT. 'i�1JD
oTHE
REQUIRED SITE MODIFICATIONS/CONDITIONS:
***THIS PERMIT IS SUBJECT TO REVOCATION IF SITE PLANS OR THE INTENDED USE CHANGE. YOUR WASTERWATER SYSTEM CONTRACTOR MUST
SEE THIS PERMIT BEFORE INSTALLING THE SYSTEM.
IMPROVEMENT PERMIT BY / ✓,. J
**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 OFJIWfALLATIr.EPHONE # IS (704) 634-8760.
I
OPERATION PERMIT S IN BY—�rXY 3;
ld ee w /,
AUTHORIZATION NO. & /Z? G OPERATION PERMIT BY ��1' � 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 Departeen 1r`
ENVIRONMENTAL HEALTH SECTION
P.O. Box 665
Mocksville, N.C. 27028
AUTHORIZATION FOR WASTEWATER SYSTEM CONSTRUCTION
(Issued in compliance with Article 11 of
G.S. Chapter 13OA, Wastewater Systems)
***This Authorization For Wastewater System Construction oust 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.***
..f / AUTHORIZATION NUMBER
E
NAM/r'!/P -Cly .�r/` DATE / as`71.
NAME ON IlPRDVEMENT PERMIT (If /different than above)
SITE LOCATION �/7
COMMENTS/CONDITIONS ON AUTHORIZATION TO CONSTRUCT WASTEWATER SYSTEM
***NOTICE*** THIS AUTHORIZATION FOR WASTEWATER SYSTEM CONSTRUCTION IS VALID FOR A PERIOD OF FIVE (5) YEARS.
ENVIdPWAL HFAN SPECIALIST DATE
DCHD 10/95
-+; APPLICATION FOR SITE EVALUATION/IMPROVEMENTS PERMIT
Davie County Health Department
Environmental Health Section / -2 9
P. O. Box 665 cC
Mocksville, NC 27028
1. Application/Permit Requested By
Mailing Address e) 3.
2. Name on Permit if Different toan Above
3. Application for: ❑ General Evaluation
4. System to Serve
❑ Business
❑ House
❑ Industry
5. If house, mobile home: Subdivision
Home Phone e�,-? 4i -,2 �3l
Business Phone
Septic Tank Installation Permit
Mobile Home ❑ Place of Public Assembly
❑ Other ❑ Unknown
No. of People D AZE
No. of Bedrooms 7-4,0 0
No. of Bathrooms %LCJ 0
Dwelling Dimensions fi V4,e Gv, We ,1_3�7oAl 13115,.-n e
6. If business, industry, place of public assembly, other: Specify type
No. of People Served
No. of Commodes
No. of Lavatories ,%-i re C
Section Lot #
❑ Basement/Plumbing
❑ Basement/No Plumbing
Washing Machine
❑ Dishwasher
❑ Garbage Disposal
No. of Sinks
No. of Urinals tii1�
No. of Water Coolers i✓U-v.y
No. of Showers .7wo WV
ater Usage Figures �U� C
7. Type of water supply: Public / ❑ Private [ICommunity
8. Property Dimensions ��9(d,T O Sewage Disposal Contractor
9. Do you anticipate additions/expansion of the facility this sytem is intended to serve? ❑ Yes ,9 No
If yes, what type?
"NOTE: . Improvements Permits are subject to
revocation, if site plans or the intended use change. Effective October 1, 1989. 1 1
Directions to Property: PROPERTY INFORMATION REQUIRED:
Tax Office PIN # 5 -Pa -/"7
CY Road Name Ti;,e o CA
Box # (if available)
City ks!/ ll
To
�P�
Jf
l�
This is to certify that the information provided is correct to the best of my knowledge, and I understand I am responsible for all charges
incurred from this application.
DATE SI ATURE
CONSENT FOR SITE EVALUATION TO BE DONE ON ABOVE DESCRIBED PROPERTY
MUST CHECK ONE: ❑ 1. 1 OWN the property. �;6 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 He th Department to enter upon above described
property located in Davie County and owned by rzLefl:A._ cYw &, c
to conduct all testing procedures as necessary to determine said site's suitability for a ground absorption sewage treatment
and disposal system.
J' f DATE SIPN ATr E G�
DCHD (1/93)
DAVIE COUNTY HEALTH DEPARTMENT
Environmental Health Section
Soil/Site Evaluation
NAME �ICGtC /XPi' DATE EVALUATED
ADDRESS
PROPOSED FACIILTY
PROPERTY SIZE
LOCATION OF SITE
Water Supply: On -Site Well t/ _ Community Public
Evaluation By: Auger Boring 4--- Pit Cut
FACTORS 1 2 3 4
Landscape position L �.
Slope %
HORIZON I DEPTH
Texture group
Consistence
Structure
MineralogX
HORIZON II DEPTH
Texture group
Consistence
Structurele f%
MineralogX
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: e >"O & EVALUATED BY: M ,/
LONG-TERM ACCEPTANCE RATE:
REMARKS:
DCHD(01-901
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 :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
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