2433 Liberty Church RdDavie County, NC
Tax Parcel Report -�Oaj 4 Monday, October 3, 2016
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WARNING: THIS IS NOT A SURVEY
Parcel Information
Parcel Number: 8200000011 Township:
NCPIN Number: 5803589514 Municipality:
Clarksville
Account Number:
82518090
Census Tract:
37059-801
Listed Owner 1:
LIBERTY BAPTIST CHURCH
Voting Precinct:
CLARKSVILLE
Mailing Address 1:
2433 LIBERTY CHURCH ROAD
Planning Jurisdiction:
Davie County
City: MOCKSVILLE
Zoning Class: DAVIE
COUNTY R-A,R-20
State:
NC
Zoning Overlay:
Zip Code:
27028-0000
Voluntary Ag. District:
No
Legal Description:
6.25 AC LIBERTY CHURCH RD
Fire Response District:
LONE HICKORY
Assessed Acreage:
5.47
Elementary School Zone:
WILLIAM R DAVIE
Deed Date:
1/2002
Middle School Zone:
NORTH DAVIE
Deed Book I Page:
004030507
Soil Types: MnC2,MnB2,MdB,MdC
Plat Book:
Flood Zone:
Plat Page:
Watershed Overlay:
DAVIE COUNTY
Building Value:
340350.00
Outbuilding & Extra
Freatures Value:
28030.00
Land Value:
42150.00
Total Market Value:
410530.00
Total Assessed Value:
410530.00
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, 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.
LOCATION
ADDRESS
/o a z A4 --p Zvi 4° .
OWNERL�u�e.0WHITE
PRIVY: 7 / SEPTIC TANK: B�f� �oms Qr�y FHA CASE NUMBER
Type ✓ Material /
wood concrete
Number
New
Repaired
WATER SUPPLY:
Source
If well, type
(Do red)
L/ (Drilled)
(Dug)
Distance from nearest
pollution '!� O ft.
Form No. 473 (Rev. 9/58)
Dimensions
Vol ume "DO
date
Type secondary
date treatment
nitrif 6ation line
No. of bedrooms 4[ 19- e
VA CASE NUMBER
filter trench
Permit Number Date —�
Approved Date
Approved by
Contractor or Plumber v —
c
Address �
Remarks
SEWAGE DISPOSAL RECORD
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• AUTHOR ZA'TION NO: 1 jtQ DAVIE COUNTY HEALTH DEPARTMENT
-, Environmental Health Section PROPERTY INFORMATION
Perlti—itie-e-"sj P.O. Box 848
Name: -- Y.; e /' !!(, Mocksville, NC 27028 Subdivision Name:
V% Phone # 336-751-8760
Directions to property: Section:
AUTHORIZATION FOR
/vi/' WASTEWATER
SYSTEM CONSTRUCTION Tax Office PIN:#—
Lot:
Road Name: Zip:
**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 Pen -nits.
(In compliance with Article 11 of G.S. Chapter 130A, Wastewater Systems, Section.] 900 Sewage Treatment and Disposal Systems)
***NOTICE*** THIS AUTHORIZATION FOR WASTEWATER CONSTRUCTION
IS VALID FOR A PERIOD OF FIVE YEARS.
ENVIRONMENTAL I A DATE ISSUED
611 DAVIE COUNTY HEALTH DEPARTMENT
r� IMPROVEMENT AND OPERATION PERMITS PROPERTY INFORMATION
.Peftittee's
Name f f. ,/ `�'- !` ,!fes.' J Subdivision Name:
Directions to Property: -0Section: Lot:
% IMPROVEMENT
�' ( f ✓' �� f "// PERMIT
Tax Office PIN:# - -
Road Name: Zip:
**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 1 I of G.S. Chapter 130A, Wastewater Systems, Section .1900 Sewage Treatment and Disposal Systems)
ENVIRONMENTAL HEALTH SP CIALIST DATE ISSUED
RESIDENTIAL SPECIFICATION: BUILDING TYPE # BEDROOMS
***NOTICE*** THIS PERMIT IS SUBJECT TO REVOCATION IF SITE
PLANS OR THE INTENDED USE CHANGE. YOUR WASTEWATER
SYSTEM CONTRACTOR MUST SEE THIS PERMIT BEFORE
INSTALLING THE SYSTEM.
# BATHS # OCCUPANTS GARBAGE DISPOSAL: Yes or No
'�#PEOPLE J�� / �.
COMMERCIAL SPECIFICATION: FACILITY TYP # PEOPLE/SHIFT # SEATS,L--t%S INDUSTRIAL WASTE: Yes or No
LOT SIZE TYPE WATER SUPPLY 111DESIGN WASTEWATER FLOW (GPD) ✓� NEW SITE REPAIR SITE
r
SYSTEM SPECIFICATIONS: TANK SIZE A&GAL. PUMP TANK GAL. TRENCH WIDTH % 40 / ROCK DEPT4 �LINEAR FT1!0_
OTHER
REQUIRED SITE MODIFICATIONS/CONDITIONS:
IMPROVEMENT PERMIT LAYOUT*RFFRDVED EFFLUENT FILTER= *RISER(S) IF 611 BELU4 FiFsI,];s:^D GRADE*
y
0
"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 s, r, 64P8%',
(336751-8760
OPERATION PERMIT
SYSTEM INSTALLED BY:
G
AUTHORIZATION NO W 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 05/96 (Revised)
.01
Cs
j 3 PU TION FOR SITE EVALUATION/IMPROVEMENT PERIi3fi & ATC •
V� a Davie County Health Department
Environmental Health Section
P.O. Box 848/210 Hospital Street
(.IDI q Mocksville, NC 27028
�) 1,4I'A
�A (336)751-8760
e
***IMPORTANT*** THI6 APPLICATION CANNOT BE PROCESSED UNLESS ALL THE REQUIRED
INFORMATION IS PR'OpuVIDED. Reefer to the INFO ION BULLETIN for
instructions.
1/Xlame to be Billed �" I T ontact Person
Mailing Address Home Phone
City/State/ZIP Bu ' ness phong
2. Name on Permit/ATC if Different thanove
t,4—f & . 440 �X �. z �,
Mailing Address _A
Application For:i_^Site
;` t ti/state/zip LL ✓v Ci /C. . %��l/
Improvement Permit/ATC [I Both
4, System to Service: ❑ House ❑ Mobile Home ❑ Business ❑ Industry 0 Other C`�-Qwc�
5. If Residence: # People # Bedrooms # Bathrooms
,_--O,Dishwasher ❑ Garbage Disposal ❑ Wajs�hiing- Machine ❑ Basement/Plumbing rl Basement/No Plumbing
trY/ Specify type �-` ��' \ 1-,Z5 # Sinks
6. If Business/Indus Other: S ecif # People
# Commodes # Showers #Urinals # Water Coolers
IF FOODSERVICE: # Seats Estimated Water Usage (gallons per day)
7. Type of water supply: ❑ County/City N1 Well ❑ Community
t_D o you anticipate additions or expansions of the facility this system is intended to serve? ❑ Yes
If yes, what type?
***IMPORT, CLl LETETHE REQUIRED PROPERTY INFORMATION REQUESTED
BELOW.( Either a PLAT or SITE PLAN MUST SUBMI7TED by the client with THIS APPLICATION.
L- roperty Dimensions: JJX4T-"IRECTIONS (from Mocksville) to PROPERTY: �•
Pr Address: RoadName �� `oe z ��y GEir �C�, Sam o`o • �� �'`�� "� �^'
City/Zip
If' x Subdivision provide information, as follows:
Name:
Section: Block: Lot: Dat 'roperty 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 run 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 suitability.
I�NATURE .
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).
Revised DCHD (07/99)
Site Revisit Charge
Datc(s):
Client Notification Date:
EHS:
Account No. 15
Invoice No.
(190)
(320)
W
�W
427
(5.26A)
121 1 a�
2 79 CD
247
I
320)
00
4.90 A If
LO2%
ter,
/lA nA
699.65
2
c
c
00
4.90 A If
LO2%
ter,
/lA nA
699.65
2
DAVIE COUNTY HEALTH DEPARTMENT
Environmental Health Section
SoiVSite Evaluation
APPLICANT INFORMATION
Account #: 990001715
Billed To: Wishon & Carter Builders
Reference Name:
Proposed Facility: Church Property Size
PROPERTY INFORMATION
Tax PIN/EH #: 5803-58-9514
Subdivision Info:
Location/Address: Liberty Ch Rd -27028
4 acres 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
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 RA'
REMARKS:
LEGEND
Landscape Position
EVALUATION BY:
OTHER(S) PRESENT:
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)