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1276 Junction RdDavie County. NC Tax Parcel Report 114 1�L- Thursday, Sentember 29, 2016 WAKAnG: THIS IS 1VUI' A SURVEY Parcel fnformation Parcel Number: M400000008 A Township: Mocksville NCPIN Number: 5726800145 Municipality: Account Number: 15412000 Census Tract: 37059-801 Listed Owner 1: CLARK OZENER Voting Precinct: SOUTH CALAHALN Mailing Address 1: PO BOX 1072 Planning Jurisdiction: Davie County City: MOCKSVILLE Zoning Class: DAVIE COUNTY R-A,R-20 State: NC Zoning Overlay: DAVIE COUNTY CZOD Zip Code: 27028-5443 Voluntary Ag. District: No Legal Description: 20.40 AC JUNCTION RD LOT 5 ERWIN Fire Response District: COOLEEMEE Assessed Acreage: 25.46 Elementary School Zone: COOLEEMEE Deed Date: 9/2015 Middle School Zone: SOUTH DAVIE Deed Book / Page: 010010090 Soil Types: GnB2,GnC2,EnB,EnC,GaD,WATER,MsD Plat Book: 0003 Flood Zone: Plat Page: 025 Watershed Overlay: DAVIE COUNTY Building Value: 0.00 Outbuilding & Extra Freatures Value: 4500.00 Land Value: 183890.00 Total Market Value: 188390.00 Total Assessed Value: 26180.00 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 County of Davis, 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. l ON-SITE WASTEWATER CERTIFICATION (Check One) Replacement Remodeling Reconnection Name:'�Phone Number/��1(Home) Mailing Address: 1:-7 % (Work) X6 Ms-✓ -, I � }y Email Address: Detailed Directions To Site: Property Please Fill In The Following I—n o // /- ' n Abo ut The EXISTING Facility: Name System Installed Under: t-. "al `l i f} Type Of Facility: Date System Installed (Month/Date/Year): Number Of Bedrooms: Number Of People: Is The Facility Currently Vacant? Yes o If Yes, For How Long? Any Known Problems? YesNo If Yes, Explain: .25A& Please Fill In The Following Inform tion About The NEW Facility: Lt Type Of Facility: 0ltx Cir i o27Co�. Number Of Bedrooms: Number of People Pool Requested By: Garage .Size: Other; Date Requested: For Environmental Health Office Use Only p rov Disapproved � Continents: A�kq S .C�,7` �� .. % Ii�a/2! -5� � �/A /'' Environmental Health Specialist Date: 4-1 — R *The signing of this form by the Environmental Health Staff is in no way intended, nor should be taken as a guarantee (extended or limited) that the on-site wastewater system will function properly for any given period of time. Payment:. Cash Check Money Order #, Amount:$ Paid By: Received By:_ Account #: Invoice #: Date: Davie County Health Department 406 j` Environmental Health Section 41 P.O. Box 848 210 Hospital Street Q U Courier # : 09-40-06 + c Mocksville; NC 27028 1, Phone: (336).- 753 - 6780 Fax: (336) - 753-1680 ON-SITE WASTEWATER CERTIFICATION (Check One) Replacement Remodeling Reconnection Name:'�Phone Number/��1(Home) Mailing Address: 1:-7 % (Work) X6 Ms-✓ -, I � }y Email Address: Detailed Directions To Site: Property Please Fill In The Following I—n o // /- ' n Abo ut The EXISTING Facility: Name System Installed Under: t-. "al `l i f} Type Of Facility: Date System Installed (Month/Date/Year): Number Of Bedrooms: Number Of People: Is The Facility Currently Vacant? Yes o If Yes, For How Long? Any Known Problems? YesNo If Yes, Explain: .25A& Please Fill In The Following Inform tion About The NEW Facility: Lt Type Of Facility: 0ltx Cir i o27Co�. Number Of Bedrooms: Number of People Pool Requested By: Garage .Size: Other; Date Requested: For Environmental Health Office Use Only p rov Disapproved � Continents: A�kq S .C�,7` �� .. % Ii�a/2! -5� � �/A /'' Environmental Health Specialist Date: 4-1 — R *The signing of this form by the Environmental Health Staff is in no way intended, nor should be taken as a guarantee (extended or limited) that the on-site wastewater system will function properly for any given period of time. Payment:. Cash Check Money Order #, Amount:$ Paid By: Received By:_ Account #: Invoice #: Date: F.C.L.) afRN...'.rr r ftp .tt "1234 -'''� 132 P 6 a 1247 .. r 1755 / •,1244 1246 '_1275 f ' �>? c 1293 x` V1 ' 1297 ai9 1309 • �l� zas - .1313 (L OD All data is provided as Is without warranty or guarantee of any kind either expressed or implied Including but not limited to the Implied1V warranties of merchantability or fitness for a particular use. Ag users of Davie County's GIS webslte 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 or arising out printed :A r 03, 2014 of the use or Inability to use the GIS data provided by this website. p .A = ..y 0 _ Z�' ` N NO: DAVIE COUNTY HEALTH DEPARTMENT ,r Environmental Health Section PROPERTY INFORMATION Perfttee s P.O. Box 848 Names' s t Mocksville, NC 27028 Subdivision Name: Phone #: 704-634-8760 Dircction& oproperty: �/Ii+l��t�,. (/,: Section: Lot: AUTHORIZATION FOR WASTEWATER Tax Office PIN:"'�"�' - T SYSTEM CONSTRUCTION Road Name: ' 4:- F **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) s -f ***NOTICE*** THIS AUTHORIZATION PER FOR WASTEWATER CONSTRUCTION fes'' J � IS VALID FOR A PERIOD OF FIVE YEARS. VIRONMENTAL HEA SPECIALIST DATE ISSUED Yes or No, ,, COMMERCIAL SPECIFICATION: FACILITY TYPE # PEOPLE # PEOPLE/SHIFT # SEATS � INDUSTRIAL WASTE: Yes or No LOT SIZE D 'TYPE WATER SUPPLY (.A d DESIGN WASTEWATER FLOW (GPD) `�� NEW SrTE 4NDREPAIR SITE SYSTEM SPECIFICATIONS: TANK SIZE!' GAL. PUMP TANK GAL. TRENCH WIDTH ` ROCK DEPTH LINEAR FT. OTHER REQUIRED SITE MODIFICATIONSICONDITIONS: **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 SYSTEM INSTALLED BY: �a AUTHORIZATION N0. - 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 BETAKEN ASA GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORILY FOR ANY GIVEN PERIOD OF TIME. DCHD 03/96 (Revised) ); •'.♦ � iro tl"'i, r)r�:aY,y }zsa �� dpi -.. oq. r:°;i .+) .�. "1.1 f '' ,.s �q. � ,.,� .y .r•t. _, .y , - -..:. .. v y. .. ��Y � r Lspi Ce ,,t`r'w `§ 'r v` _ ••r �/, j 01 ` AIJTHORjZT,.ICN NO. DAVIE COUNTY HEALTH DEPARTMENTi .141 2 Environmental Health Section PROPERTY INFORMATION Permitte 's . P.O: Box 848 Name' Mocksville, NC 27028 Subdivision Name: Phone #: 704-634-8760 Directionsto property:_W��n,. (��' �r r� Section: Lot: AUTHORIZATION FOR WASTEWATER SYSTEM CONSTRUCTION'""' �' 1� Tax Office PIN: �i Road Name: 1 , 1P:'� 0 **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 Fonn/Awhorization 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) 3 ` / ***NOTICE*** THIS AUTHORIZATION FOR WASTEWATER CONSTRUCTION IS VALID FOR A PERIOD OF FIVE YEARS. ENVIRONMENTAL HEALT SPECIALIST DATE ISSUED �,�yj.. n � l i,,,;.w+, y � .%� • X �,��ra.7 A � r � r":{.... •r „ r.:..i F .. r.:_ � F4. . _ , t„ � ,,.i 1 -� x4-12 DAVIE COUNTY HEALTH DEPARTMENT, 'IMPROVEMENT AND OPERATION PERMITS PROPERTY INFORMATION 'Name t, f Subdivision Name: i fib , r Directions to property:' ; •'� . Section: Lot: IlVIPROVEMENT r r .PERMIT Tax Office PIN: "1�, Road Name: ` MA1f' 4,j YIl Z�iP k - -I **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 pen -nit. (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 IN'T'ENDED USE CHANGE. YOUR WASTEWATER ENVIRONMENTAL HEAL SPECIALIST DATE ISSUED SYSTEM CONTRACTOR MUST SEE THIS PERMIT BEFORE ' INSTALLING THE SYSTEM. RESIDENTIAL SPECIFICATION: BUILDING TYPE # BEDROOMS # BATHS _� # OCCUPANTS �� GARBAGE DISPOSAL: Yes or No COMMERCIAL SPECIFICATION: FACILITY TYPE/J # PEOPLE # PEOPLFJSHIFT # SEATS INDUSTRIAL WASTE: Yes or No LOT SIZE 6I TYPE WATER SUPPLY ` DESIGN WASTEWATER FLOW (GPD) NEW SITE REPAIR SITE SYSTEM SPECIFICATIONS: TANK SIZE �� GAL. PUMP TANK GAL. TRENCH WIDTH �� ROCK DEPTH LINEAR FT. 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 SYSTEM INSTALLED BY: Aj g� 9� 9a AUTHORIZATION NO. I`l� OPERATION PERMIT BY: DATE: d7 "*THE ISSUANCE OF THIS OPERATION PERMIT SHALL INDICATE THAT THE SYSTEM DESCRIBED ABOVE HAS BEEN INSTALLED INCOMPLIANCE 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 PERMIT & ATC 0Z�•g°�6 Davie County Health Department vironmental Health Section d �p PSG P.O. Box 848 MAY - 4 Mocksville, NC 27028 (704) 634-8760 !out �;�'�Q1MEF7TAt 'dI ****IMPORTANT**** THIS APPLICATION CANNOT BE PROCESS LL THE REQUIRED INFORMATION IS PROVIDED. 1. Name to be Billed ea, Y�'1 f.Cf /"d.^,P /�% �•�/ems Mailing Address / -V/o ,(� At Irl" 9 o d A4or--, City/State/Zip /VoGrSe/r'/ZP 17d, 2:%t) a a 2. Name on Permit/ATC if Different than Above Mailing Address Contact Person ti K Home Phone 3.5 6, `755 - ' —C7 r�,5 Business Phone L -1-9 Jt to .3 3- 5 33 1 City/State/Zip 3. Application For: [✓j Site Evaluation [ ] Improvement Permit & ATC 4. System to Serve: [ J House [VI Mobile Home [ ] Business [ ] Industry [ ] Other [Both 5. If Residence: # People Jr' # Bedrooms_ # Bathrooms_ [ ] Dishwasher [ ] Garbage Disposal [ q 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: [✓J County/City [ ] Well [ ] Community 8. Do you anticipate additions or expansions of the facility this system is intended to serve? [.-' Yes If yes, what type? N5+nV tin =. ;r [ ] No EITHER A PLAT OR SITE PLAN PROPERTY INFORMATION REQUIRED: *** IMPORTANT **OAXM OF THE PROPERTY MUST BE SUBMITTED WITH THIS APPLICATION. Property Dimensions: 0t- VUL,o WRITE DIRECTIONS (from Mocksville,) TOCPROPERTY: Tax Office PIN: #�^^ -� ; tool 'b C'L-aa cUnra. Rd On Property Address: Road Dame lit) 0L” -M�u 44' 1 cL City/Zip A 70 a d4 . ; b tJ Wn%te'. Q-rnme •tr, on P- t a hi If in Subdivision provide information, as follows: e V7T Name: Section: Lot#: -5ma i l 20 D (LiC��lec� JJ 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 f 7—' rif- iZ 3- C-1 ,9p A� to conduct all testing procedures as necessary t determine the site suitability. DATE -5— 4 — 9 b SIGNATURE nA.A. AP 1, Q-A I d, - & 0,LA h ) Revised DCHD (06-96) AA4 . THIS AREA MAY BE USEI) FOR IVAWINC YOUR SITE PLAN: 5 ChAl Msl� RwA 9716 Gn82' 1,4 �, ,/ I \ n9035 EnB nrsra, 9623 En 1. na�av wa• 9 a 3991 9 2 971 963 1 9433 at O 9322 9199 » �1gg rnB2� M mr n�V 1� n 2 -VA 617 'may, 4694 , 1�5 n 11 1997 _ MsD sDao 3972 Ma B 4609 GnC2 1.85 A�� 0366 fFAp� � Cc' ChA6171 This map is for PERC TEST and BUILDING PERMIT purposes only. The Davie County Tax Administration Office assumes no liability for any information on this map. COUNTY ID: M400000008 May 04,1998 9:32 AM Parcel Identification Number 5726-80-0145 DAVIE COUNTY HEALTH DEPARTMENT Environmental Health Section SECTION LOT Soil/Site Evaluation APPLICANT'S NAME 4V4' l/';kZ_ PROPOSED FACILITY SUBDIVISION Water Supply: On -Site Well Community Evaluation By: Auger Boring A-'�__ Pit DATE EVALUATED PROPERTY SIZE ROAD NAME _� Public Cut - FACTORS 1 2 3 4 5 6 7 Landscape position Sloe % HORIZON I DEPTH Texture group Consistence Structure Mineralogy HORIZON II DEPTH Texture group Consistence 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 SITE CLASSIFICATION: LONG-TERM ACCEPTANCE RATE: ' S S REMARKS: DCHD (O1-90) EVALUATION BY:/Ict��/ 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 ■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■ ■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■ ■■■■■■■■■■■■■■■■■■■■■■■■■ ■■■■■■■■■■■■ ■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■ ■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■ ■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■ ■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■ ■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■ ■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■ ■■■■■■■■■■■■■■■■■■■■■■■■■ ■■■■■■■■■■■■ ■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■ ■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■ ■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■ ■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■ ■■■■■■■■■■■■■■■■■■■■■■■■■ ■■■■■■■■■■■■ ■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■ ■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■ ■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■ ■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■ ■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■ ■■■■■■■■■■■■■■■■■■■■■■■■■ ■■■■■■■■■■■■ ■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■ ■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■ ■■■■■■■■■■■■■■■■■■■■■■■■■ ■■■■■■■■■■■■ ■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■ ■■■M■■■■■■■■■■ ■■M■■■■■■■■■■■ ■■■■■■■■■■■■■■ ■■■■■■■M■■■■■■ ■■EO■■■■■■■■■■ ■■■■■■EAMM■■■■ ■M■■■MUXEMM■■■ ■MMMMMSMAMM■■■ ■M■MME■■■E■MM■ ■■■■■■■■■■■■■■ ■■■■■■■■■M■■■■ ■MMM■■■■■■■■■■ ■■EMM■■■■■■■■■ ■■■■■■■■■■■■ ■■■■■■■■■■■■■■■■■■■■■■■ ■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■ ■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■ ■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■ ■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■ ■■■■■■■■■■■■ ■■■■■■■■■■■■■■■■■■■■■■■ ■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■ ■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■ ■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■ ■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■ MEMO■■■■■ ■■■■MEMO■ ■■■■■■■■■ ■■■■■■■■■ ■■■■■E■■■ ■■■■■■M■■