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467 Liberty Church RdDavie County, NC Tax Parcel Report rr� 476 46? Monday, October 3, 2016 459 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 no f, pCi NC or arising out of the use or Inability to use the GIS data provided by this website. WARNING: THIS IS NOT A SURVEY Parcel Information Parcel Number: E300000122 A Township: Clarksville NCPIN Number: 5811665785 Municipality: Account Number: 51048000 Census Tract: 37059-801 Listed Owner 1: MILLER RANDALL A Voting Precinct: CLARKSVILLE Mailing Address 1: 469 LIBERTY CHURCH ROAD Planning Jurisdiction: Davie County City: MOCKSVILLE Zoning Class: DAVIE COUNTY R-20 State: NC Zoning Overlay: Zip Code: 27028-0000 Voluntary Ag. District: No Legal Description: 0.994 AC LIBERTY CHURCH Fire Response District: WILLIAM R. DAVIE Assessed Acreage: 0.86 Elementary School Zone: WILLIAM R DAVIE Deed Date: 6/1977 Middle School Zone: NORTH DAVIE Deed Book / Page: 001020096 Soil Types: MnB2 Plat Book: Flood Zone: Plat Page: Watershed Overlay: DAVIE COUNTY Building Value: 103100.00 Outbuilding & Extra Freatures Value: 0.00 Land Value: 18010.00 Total Market Value: 121110.00 Total Assessed Value: 121110.00 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 Davie, North Carolina, Its agents, consultants, contractors or employees from any and all claims or causes of action due to no f, pCi NC or arising out of the use or Inability to use the GIS data provided by this website. ? v AUTHORIZ,�TION DAVIE COUNTY HEALTH DEPARTMENT Environmental Health Section PROPERTY INFORMATION Permittees „ �. _r „�_ P.O. Box 848 Name: i-=* M. cksville, NC 27028 Subdivision Name: f Phone #: 704-634-8760 Directions to property: Section: " Lot: AUTHORIZATION FOR WASTEWATER SYSTEM CONSTRUCTION Tax Office PIN:#, � f - Road Na e: ?!�'f� ldp� **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 SPECIALIST DATE ISSUED �� y ✓ DAVIE COUNTY HEALTH DEPARTMENT IMPROVEMENT AND OPERATION PERMITS Permitter S. PROPERTY INFORMATION Name: ,r "" '"` Subdivision Name: Directions to property: ��` a °� ."' Section: " Lot: IMPROVEMENT r• { PERMIT Tax Office PINI -11 _ _ 6,r- � Road Name: **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) ***NOTICE*** THIS PERMIT IS SUBJECT TO REVOCATION IF SITE PLANS OR THE INTENDED USE CHANGE. YOUR WASTEWATER ENVIRONMENTAL HEALTH 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� # PEOPLE # PEOPLE/SHIFT # SEATS INDUSTRIAL WASTE: Yes or No LOT SIZE P "'C TYPE WATER SUPPLY ( /i7 DESIGN WASTEWATER FLOW (GPD) NEW SITE REPAIR SITE SYSTEM SPECIFICATIONS: TANK SIZE 4J � GAL. PUMP TANK GAL. TRENCH WIDTH ROCK DEPTH 21=� LINEAR FT., REQUIRED SITE MODIFICATIONS/CONDITIONS: IMPROVEMENT PERMIT LAYOUT r - "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: j,(J (p0 i lao�0 Oor�K 4— JA ` S ITrG AUTHORIZATION NO. I ` OPERATION PERMIT BY: TE: "THE ISSUANCE OF THIS OPERATION PERMIT SHALL INDICATE THAT THE SYSTEM DESCRIB D 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) A. APPLICATION FOR SITE EVALUATIONAMPROVEMENT +' Davie County Health Department Environmental Health Section P.O. Box 848 Mocksville, NC 27028 (704) 634-8760 r. ****IMPORTANT**** THIS APPLICATION CANNOT BE PROCESSED 1 THE REQUIRED INFORMATION IS PROVIDED. 1. Name to be BilledWd tn ; /l a' Mailing Address *(OC�C/tLGi Z/' �(�� City/State/Zip i (it i iE (2, O�y 2. Name on Permit/ATC if Different than Above Mailing Address 3. Application For: [ ] Site Evaluation Contact Person Home Phone Business Phone City/State/Zip [ ] Improvement Permit & ATC [/Both 4. System to Serve: [ l House [Wfvfobile Home [ ] Business [ ] Industry [ ] Other 5. If Residence: # People --4—# Bedrooms_ # Bathrooms_ [-}-Dishwasher [ ] Garbage Disposal ['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: [„ ]bounty/City [ ] Well [ ] Community 8. Do you anticipate additions or expansions of the facility this system is intended to serve? [ ] Yes [ qNo If yes, what type? EITHER A PLAT OR SITE PLAN PROPERTY INFORMATION REQUIRED: *** IMPORTANT **'b' XTL) YI' OF THE PROPERTY MUST BE ,L SUBMITTED WITH THIS APPLICATION. 1W Property Dimensions: f�%g71 F59 x391 x z WRITE DIRECTIONS (from Mocksville)/-TO PROP Tax Office PIN: #s ti`1! /- / Q� �- Jr %� w Q Property Address: Road *ame (J0 7 Zgge RC 8�D City/Zip /� t D t/'Zr - If in Subdivision provide information, as follows: s /) 0"d- F�1RS7 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. 1, also, understand that I am responsible for all charges incurred from this application. I, hereby, give consent to the Authorized Repres �ta/tifve of the Davie County Health Department to enter upon above described property located in Davie County and owned by fi L to cgaduct all gating procedures as npcessary to determine the site suitability. SIGNATURE Revised DCHD (06-96) THIS AREA MAY BE USED FOR DRAWING YOUR SITE PLAN: 'PPZK ' 51+el /-1 $er2� a a. DAVIE COUNTY HEALTH DEPARTMENT Environmental Health Section Soil/Site Evaluation APPLICANT'S NAME �<�`e" PROPOSED FACILITY /22 SUBDIVISION Water Supply: On -Site Well Community Evaluation By: Auger Boring L,-" Pit SECTION LOT, DATEEVALUATED PROPERTY SIZE ROAD NAME �y�p��► L/� Public 41--l" Cut FACTORS 1 2 3 4 5 6 7 Landscape position 2— Slope .Slo e % HORIZON I DEPTH Texture group Consistence Structure Mineralogy HORIZON II DEPTH + t - 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: REMARKS: LEGEND DCHD (01-90) 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 ■O■M■M■EMEN■■■■ ■EMEMEME■■MM■M■ ■■EM■■E■E■ME■■■ ■EE■N■E■■EMEME■ ■EM■ME■EMEMEME■ ■■NEEM■■ME■■M■■ MENS■M■■■MEME■■ ■■■E■E■M■■■MMM■ ■■M■■■■■ME■E■■■ ■■MEM■■ME■ME■■■ ■EM■M■EM■■ME■E■ ■EMMEMME■■■■ME■ MENS■■■■EEE■E■■ ■■■E■M■■ENN■M■■ ■■■EMM■■■E■E■M■ ■■■■■■■NNE■M■■■ ■■M■M■■■EMEM■M■ ■■MMENEMEEME■E■ ■EN■E■E■■MMEME■ ■■■■■EME■MEME■■ ■■■E■ME■■■■■E■■ ■M■M■ENN■■■■M■■ ■■■E■E■■■■■M■M■ ■■MEMEMEME■■■M■ ■■M■■■■■M■ME■■■ ■E■■EE■ ■E■■■E■ ■■■M■■■ ■NME■■■ ■■■EO■■ ■■■■■E■ ■MM■ ■EE■ ■E■■ ■O■■ NOME ■■■■■■■■■EMOM■ ■■EMMEMEME■■M■ ■■E■E■■E■M■M■■ ■MOMMEMM■■■M■■ ■EM■EM■EMEMEM■ ■■■■■■■■■MMEM■ ■EMEM■■EM■EMM■ ■MM■■■M■MEM■M■ ■E■■■E■■■EM■M■ ■■MEMMEMME■■■■ ■■E■MEMEMM■M■■ ■■MEMEME■■■ME■ ■EMMEM■E■■■■E■ ■MME■E■■MEME■■ ■■■■■■■NOMMEN■ ■E■EMEM■■■E■M■ ■EMEMEMMOM■■M■ ■ME■■■■■MENME■ ■EMMEM■MEM■M■■ ■EMEMEMM■■■■■■ ■■■■11■■M■■ ■EN■IINE■■■ ■■■■UMMEM■ ■NNN11■■■M■ ■MMMIIMMMM■ ■E■EIIMM■E■ ■MEM11MEME■ EMSEEMEMEM 9:::ii■M■M■ ■M■■■MEM■■ ■■■■■■■E■■ ■EM■E■M■■ ■■M■E■■■■ ■■■■■■NE■ ■EME■M■M■ MEMMEMEME ■■■ME■EM■ ■OMME■E■■ ■■ME■■■N■ ■E■■■M■■■ ■EME■■■■■ ■■■■■■ME■ ■■