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1420 Main Church RdDavie C6uhty. NC Tax Parcel Report Al W Friday. September 30. 2016 WAKINIINU: lrllN IN 1V U1 A JUAV h I Parcel Information Parcel Number: G4080A003202 Township: Clarksville NCPIN Number: 5820832317 Municipality: Account Number: 82526379 Census Tract: 37059-801 Listed Owner 1: ELLIS RONALD ALEXANDER Voting Precinct: NORTH MOCKSVILLE COUNTY Mailing Address 1: 1420 MAIN CHURCH ROAD Planning Jurisdiction: Davie County City: MOCKSVILLE Zoning Class: DAVIE COUNTY R-12 State: NC Zoning Overlay: Zip Code: 27028-0000 Voluntary Ag. District: No Legal Description: 0.689AC MAIN CHURCH ROAD Fire Response District: WILLIAM R. DAVIE Assessed Acreage: 0.68 Elementary School Zone: WILLIAM R DAVIE Deed Date: 6/2006 Middle School Zone: NORTH DAVIE Deed Book / Page: 006650169 Soil Types: PcC2,RnD Plat Book: Flood Zone: Plat Page: Watershed Overlay: DAVIE COUNTY Building Value: 71410.00 Outbuilding & Extra Freatures Value: 3310.00 Land Value: 13000.00 Total Market Value: 87720.00 Total Assessed Value: 87720.00 161 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. AUTF RIZVION NO. 0558 DAVIE COUNTY HEALTH DEPARTMENT Environmental Health Section PROPERTY INFORMATION Permitfee's P.O. Box 848 Name: ' . /7/i _ /Mocksville, NC 27028 Subdivision Name: Phone #: 704-634-8760 Directions to property:,C- -'L Section: Lot: AUTHORIZATION FOR WASTEWATER Tax Office PIN:#� SYSTEM CONSTRUCTION Road Name:1f'1A-111A -? - Zip: 970,4 **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 �i 'Z se -�a'4 IS VALID FOR A PERIOD OF FIVE YEARS. ENVIRONMENTAL HIrALTH SPE AC Al S DATE ISSUED DAVIE COUNTY HEALTH DEPAYTMENT . �, IMPROVEMENT AND OPERATION PERMITS PROPERTY INFORMATION Permiftee'�s K - Name . J � �:'�� 1?'� •�,�� f . ! Directions to property: ' IMPROVEMENT PERMIT. Subdivision Name: -Section: Lot: ' Tax Office PIN:#-/,) Road Zip: I r 66 41 1 **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 ',,, j�//� ,� tI •�'- �, PLANS OR THE INTENDED USE CHANGE. YOUR WASTEWATER ENVIRONMENTAL HEkrm SPECI I f DATE ISSUED SYSTEM CONTRACTOR MUST SEE THIS PERMIT BEFORE INSTALLING THE SYSTEM. RESIDENTIAL SPECIFICATION: BUILDING TYPE, # BEDROOMS -? # BATHS 42 # OCCUPANTS 2 GARBAGE DISPOSAL: Yes or No COMMERCIAL SPECIFICATION: FACILITY TYPE # PEOPLE # PEOPLE/SHIFT # SEATS INDUSTRIAL WASTE: Yes or No LOT SIZE TYPE WATER SUPPLY /'6, DESIGN WASTEWATER FLOW (GPD) '-,/31 NEW SITE l�� REPAIR SITE r SYSTEM SPECIFICATIONS: TANK SIZE/ ,(/ GAL. PUMP TANK , GAL. TRENCH WIDTH ,ROCK DEPTH LINEAR FT. OTHER �-'147 J i REQUIRED SITE MODIFICATIONS/CONDITIONS: cJ el," Y> P L:'/ % %/ l Ii s: r 7� /f r / � : `' - J/ � D" l f IMPROVEMENT PERMIT LA UT � pet'. c fo fit g rte �oT --- Ile "CONTACT A REPRESENTATIVE OF THE f AVIE 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 PE /- D -`�D 1 d A fiJ 14;4 �klq 1 .1 00 )1 A rj .sly 40 I)e / !V, S j 41,) SYSTEM INSTALLED BY: S i 24b A A,` 6, �ZS ► eO AUTHORIZATION NO. f75� " OPERATION PERMIT B�14 ��ls DATE: %i (o 3xfl "THE ISSUANCE OF THIS OPERATION PERMIT SHALL INDICAM BED 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. - ► Ptec.E PJMPTA,3► 700 Z,",feG DCHD 05/96 (Revised) �, . / ' 0�� APPLICATION FOR SITE EVALUATION/IMPROVEMENTS PERMIT l.le Davie County Health Department s Environmental Health Section P. O. Box 665 3 Mocksville, NC 27028 At q� �- ) vw� Mv 1. Application/Permit Requested By Mailing Address 3 V 7 -- Business Business Phone Home Phone 2yq- V '5-62- 2. Name on Permit if Different than Above 3. Application for: ZI General Evaluation 4. System to Serve: ❑ House ❑ Business ❑ Industry 'eptic Tank Installation Permit ,Mobile Home ❑ Place of Public Assembly ❑ Other ❑ Unknown 5. If house, mobile home: Subdivision 9. Section Lot # ❑ Basement/Plumbing No. of People ❑ B N PI No. of Bedrooms No. of Bathrooms Dwelling Dimensions X, din 6. If business, industry, place of public assembly, other: Specify type No. of People Served No. of Commodes No. of Lavatories No. of Showers _ 7. Type of water supply: ❑ Public asement/ o umbmg ❑ Washing Machine ❑ Dishwasher ❑ Garbage Disposal No. of Sinks No. of Urinals No. of Water Coolers Water Usage Figures j < Private ❑ Community 8. Property Dimensions 4AnaA-V r f-iZ'2X 2 oo " Sewage Disposal Contractoi 9. Do you anticipate additions/expansion of the facility this sytem is intended to serve? If yes, what type? ❑ Yes No 'NOTE: Improvements Permits shall be valid for a period of 5 years from date issued. Improvements Permits are subject to revocation, if site plans or the intended use change. Effective October 1, 1989. PROPERTI/ INFORMATION REQUIRED: Directions to Property: o f 14a e- /h 7--0 cAAA /Zd - 7"u•�,✓ 2 i S h f ©AJ CA .t/xf _ C-, R dDla rx . 4 4 , XC `7 I;Y q .1 Al -e h , R�1. ,c x1'. i`Ii & Av l-"Pf b^l 44' A., 0Ch,l2J. G.� (1-, 7-A<%L.1 2E ;Ir Tax Office PIN: #-5ZZD-Y3-S 2My PROPERTY ADDRESS, as follows: Road Name: MWIA) �7,• If4l. City: %ZUC.lk-,-V 1e, SU13MIT A PLAT WITH THIS APPLICATION. Revisions effective October 1, 1995. 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 1001 SI NATURE CONSENT FOR SITE EVALUATION TO BE DONE ON ABOVE DESCRIBED PROPERTY MUST CHECK ONE: (� 1. 1 OWN the property. ❑ 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 Health Department to enter upon above described property located in Davie County and owned by to conduct all testing procedures as necessary to determine said site's suitability for a ground absorption sewage treatment and disposal system. DATE SIGNATURE DCHD (1193) s�A"I rLrLh r6'i W v � r o, h \ !` ca �, d ti 'fin N �co 85 �IcD U N Pcl, O "M w. 163 5 150 M `t c 113.5 v 200 CO v N ~ ►O t �' W Q N N N to �J1 u o � - N p — '1 151.6 —224.2 d �, Mrl p N 0 U N r � I O Ocd I c 200 1 67 — M ?.00' ri 209 THIRD ST. 172 _ 200 U) ^IN 200N 204 0)�? 00 N iii r� I N M -------------- fi c_) C.) 0 OI _ pl C ) M M N • c.t _ W � f 0 C) a Q Ta G)200 co N I v 175 N _ � U � c I cd 001 u , a V I SIN) N N -� in n� t l r DAVIE COUNTY HEALTH DEPARTMENT Environmental Health Section Soil/Site Evaluation NAME d �` v DATE EVALUATED Zoy ADDRESS PROPERTY SIZE /A(2- PROPOSED ACPROPOSED FACIILTY ;tp4 LOCATION OF SITE e5 ( oeo .C.y_ Water Supply: On -Site Well _ Community Public 4.— Evaluation By: Auger Boring �/ Pit Cut FACTORS 1 2 3 4 Landscape position Slope % fo HORIZON I DEPTH Texture group Consistence Structure Mineralogy HORIZON II DEPTH r Texture group C. Consistence Structure Ile 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 'CZ I SITE CLASSIFICATION: LONG-TERM ACCEPTANCE RATE: REMARKS: DCHD(01-901 EVALUATED BY: A l� 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 'r-fil- 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 ■��■��■��/�� ■��■ ■�� N��/�� /�� h�� ■��■��■��v�� ■�� u �� ■ ■ �� /��u�� ........................................�CCC�:C.=...�............ ........................................ ... .................... ............................................�..................... ■��H■��\�� ■ ��■��li�� ■��■��■�� ■�� ■��■��■�� ■��■��N��■�� ■� ■��■��v��■�� ■��■��■��/■��\��■�� ■�� ■�� ■�� u�� u ■ ■� �� ■��■�/�■��n�� /�■� N �� :::::::::::::C=................._.....��..Z�:�'=�':��C.....�.. ��_�� ■ ■ u��n �� ■�� u�� ■�� in��s�u��u��■� �■��■�� ■i�� ■�uNu�� \�� ■�� ■ ��N �� ■��■��■��■■.�� ■��N�� H�� ■ �/■�� ■��■��n��■��=��i��_� u= ��C=��i�� .................................. ..■...■...C'C.". �:C.. .. ..=■C�C ......................................■■...... . ........ ............................... ....... ....�............._... ��■��■��n��i'�i��w�'�i'�� u��u=n� ■��■�� ■��N��■��M�� ■ � ��v��h��■��v�� ...s... ...........�............................ . ....�..�...� ....................�..........................■ �.. , ■........0 ...................��.................■■ ■.■.. . .�'3.. ....■.. ��H��n ��►��u��n� ��NN� uC�� ■■■■■■■■■■■■■.. ■..�....■■■■■■■ ....�5 .....� ��■■■■■■■ ■�H�� v��u��■ ��av ��Ni�� v��v�HH�n��N��N��■n.�� ■��■��■�� r��lN�U� ■ ■ �� i��V�u��■��\��o�� -- � �� ■�� e��■��■��uCun��r.��■��'iii �i ■ u�� ■��■��u�� nu n��U�� i ��_�� n��.■■��■�■��H■11�� ■� ■ ■ �.■�� ■�� W�� u�� ■�i��■ ■ �e��i��■�i■ �� o� ' �ui � � �iiiii ' ��u�U��u=��i�� i �� H�11� �� ............�............�..�.... ... . 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Davie County Health Department - and Home Heafth Agency Environmenta[ eafth Section P.O. BOX 848 / 210 HOSPffAL STREET COURIER #09-4-06 MOCKSVILLE, N.C. 27028 PHONE: (704) 634-8760. June 25, 199E Grady A. Hodsford 347 Cana Rd. Mocksville, NC 27028 Re: Site Evaluation Main Church Road Extension Tax PIN: #5820-83-5244 Dear Mr. Bodsford: As requested, a representative from this office visited the aforementioned site on June 21, 1996. Based upon the information provided on the application for site evaluation and after the evaluation was completed, the site was found to be provisionally suitable for the installation of an on—site sewage disposal system. If you have any questions, please feel free to contact this office. Sincerely, ,s Robert B. Hall, Jr., R. S. Environmental Health Section RH/wd Enclosure(s)