956 Main Church RdDavie Countv. NC Tax Parcel Report 16 '))1 Friday. September 30. 2016
WAR1 ENG: THIS 1S NOTA SURVEY
Parcel Information
Parcel Number:
G40000003417
Township:
Mocksville
NCPIN Number:
5739294293
Municipality:
Account Number:
8302272
Census Tract:
37059-806
Listed Owner 1:
SHORES JAMES DEAN
Voting Precinct: NORTH MOCKSVILLE COUNTY
Mailing Address 1:
956 MAIN CHURCH ROAD
Planning Jurisdiction:
Davie County
City: MOCKSVILLE
Zoning Class:
DAVIE COUNTY R -A
State:
NC
Zoning Overlay:
Zip Code:
27028
Voluntary Ag. District:
No
Legal Description:
1 AC MAIN CHURCH RD
Fire Response District:
WILLIAM R. DAVIE
Assessed Acreage:
1.00
Elementary School Zone:
WILLIAM R DAVIE
Deed Date:
4/2012
Middle School Zone:
NORTH DAVIE
Deed Book / Page:
008870416
Soil Types:
GnB2
Plat Book:
Flood Zone:
Plat Page:
Watershed Overlay:
DAVIE COUNTY
Building Value:
12610.00
Outbuilding & Extra
0.00
Freatures Value:
Land Value:
17010.00
Total Market Value:
29620.00
Total Assessed Value:
29620.00
161
Davie County,
1�TAll
l� C
data Is provided 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 harmlessthe
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.
tv
"Irl - 'i 7/13
Davie County Health Department
Environmental Health Section
P.O. Box 848
210 Hospital Street
Courier # : 09-40-06 C
Mocksville, NC 27028
Phone: (336) - 753 -.6780 ON-SITE WASTEWATER CERTIFICATION Fax: (336) - 753-1680
(Check One) Replacement Remodeling Reconnection
Name: e [_ 7- 1:�� O i- C2 Phone Number �/2 (Home)
Mailing Address:_U/Ck7 yid 356 %39'I'-.30ee9 (Work)
Email Address:
Detailed Directions To Site: Y-10
0 7 /? ;?;)if C,rrCA--
Property A dress:
t..
L '
/Please Fill In Inf G Facility:
--Name System Installed Under: �j 71 67 , r, ?- 2 G 2'^.-12 5' Type Of Facility: sr= ,r? 7'1,e-
Date
"ie-
Date System Installed (Month/Date/Year): j l Number Of Bedrooms: Number Of People: C.
Is The Facility Currently Vacant? Ygc,, No If Yes, For How Long? 7^'1 l'1 7
3
Any Known Problems? Yes C�o If Yes, Explain:
• i
Please Fill In The Following Informatioon About The NEW Facility: ` +
Type Of Facility: '1 0 1,4 K NuMbeer Of Bedrooms: Number of People t
Pool Size: / lj -Garage Size: q d
.G .�,�, U Other: r ! i' `'i i
Requested By:__�� 3� S c r� S%t �, Y� 5 Date Requested: % ,.� U 1,2
(Signature) v
. -�- �---
!-for Environmental Health Office Use Urily/'+
t
(Approved Disapproved
Goinments:
Environmental Health Specialist ( ,� ���f`'i�t{�r,C Date:
*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 Peck
Money Order # i Amount:$ ()O, V V Date: 3
Paid By: �.1 3, i- 4 { P5 1+. ' Received By.
l/ / / c,
Account #: 5 i5 J y Invoice #:
GoMAPS - Davie County NC Public Access
***WARNING: THIS IS NOT A SURVEY!*** Monday, March 12 2012
This map is prepared for the inventory of real property found within this jurisdiction, and is compiled from recorded
deeds, plats, and other public records and data. Users of this map are hereby notified that the aforementioned public
primary information sources should be consulted for verification of the information contained on this map. The
County and mapping company assume no legal responsibility for the information contained on this map.
WATERSHED STRUCTURES
WATER BODIES
COUNTY BOUNDARY
Ft
ADDRESS
/
DRIVES
J
STREETS
RAILROAD CENTERLINE
PARCELS
CITY—LIMITS
BERMUDA RUN
COOLEEMEE
DAVIE COUNTY
MOCKSVILLE
nccounties
DAV I E
<all other values>
***WARNING: THIS IS NOT A SURVEY!*** Monday, March 12 2012
This map is prepared for the inventory of real property found within this jurisdiction, and is compiled from recorded
deeds, plats, and other public records and data. Users of this map are hereby notified that the aforementioned public
primary information sources should be consulted for verification of the information contained on this map. The
County and mapping company assume no legal responsibility for the information contained on this map.
I, C. Ray Cates, cer" that thls plat was drown under my
supervision from an actual r.nvey supervision under my supesion (deed description
recorded In Book 71, Page 251, etc.) (09w); that the boundaries not
surveyed are clearly Indicated as drawn from Ydaxrnotion found In Book
Papa_g!._octad
that the ratio of precision as colculated to 1:10,000; that this _
Plat was prepared In accordance with C.S. 47-30 as amended. Witness my prig ec' p
dgnature, registration number and seat i � CAR0/ Rye`
this
24th Se t. day t>< P A0�`�9% _ � �r'��a °•�,cJTe. `• '6'
• r •
,c V 6•
°
Seal or Stamp m°
1 e SEAL °� s
L-26232623 �o
• e
Registration Number J "�
IY
Parcel 34
NIP S 63°36'10"E
252.15'
I j
�O
� GO
M
Location Map
NOTE _ THIS PEAT IS SUB
R IGPT ` OF WA'r OF RE:. C:kD
Parcel '39 �j
Richard l Sh o
ores, S. Jr. N
o
cD
N � l
z
�Z,
N I �
Parcel 39.01 N f
D•8e 78;7 Sumrriers 1-1
rTl
rebor found
2.000 Ac res by a".
.I
173, 0g•
N s7°?3rs
parcel 34.01
orinie Shores
D'F3. 148 — 139
50 Q
50 100 150
ERAP20-GLE
_ _ _
--- -- -
— EEE
LEGEND-
_ R/W -Right-of-Way
EIP---.-Existing Iron Pipet
EIR - Existing Iron Rebar
� -Center Line
- enter l,i e
P - dge of �ovement
P - Point
CLI - Concrete Monument
_ ace o Curb
ower Pole
NIP - New Iron Placed
Pit - Property L Ime
� p -fight Pole
LIH - Hole
R - Radiuu
Radius
C A - Controlled Access
CH - Chord Distance
RCP - Reinforced Concrete Pipe
P/O - Part of
CLIP - Corrugated Metal Pipe
SE - Sight Easement
CCP- Corrugated Plastic Pipe
P _ Reed Book
. rebor fr,und
TH13 SURVEY IS SUS,.ECT TO
Al+D ACG/RAIE TFTIE SEARCH
M
-F- 100 year Flood Boundary
-0-
-0- Overhead Utilities - once Posta rebar founds - 1' NIP
-X- Fence -S- ewer Line 1
L.1
I
El
p r
nail do cap
�8 21 °sound 35.50' Point
_. nail do cnrt AI c. ei.�.�.-..- .. .
BK852PG31b
E,' � ibii
A
BEGINNING at a new iron pin, a new corner with Richard Shores,
Jr. and the grantors and grantees; running thence South 57 degrees
20 minutes 45 seconds East 172.97 feet to a New Iron Pin; running
thence -South 27 degrees 16 minutes 14 seconds West 225.77 feet to a
new iron pin; running thence South 27 degrees 16 minutes 14 seconds
30.13 feet to a nail and cap in the right of way of State Road 1405;
running thence.North 57 degrees .20 minutes 4.5 seconds West 169.00
feet to a nail and cap in the right of way, a new corner with Richard
I. Shores, Jr.; running thence North 26 degrees 23 minutes 09 seconds
East 30.1:8 feet to anew iron pin (in this line is a 20 foot easement,
10 feet on this property said easement retained by the grantors);
running thence North 26 degrees 23 minutes 09 seconds East 256.30 feet
(with the same'easement) to the point and place of Beginning. This
description from a survey by Grady L. Tutterow, Registered Land
Surveyor, dated February 7, 1980 and containing by his computer 1.00
acres. This tract taken from the property df grantors and for back
description see Deed Book 71, page 251.
Save and except the 20 foot easement, 1'0 foot on this property
retained by the grantors.
-AUTHORIZATION NO: t .0 3 7
DAVIE COUNTY HEALTH DEPARTMENT
Environmental Health Section PROPERTY INFORMATION
"mermittee's P.O. Box 848
r' Name: Mocksville, NC 27028 Subdivision Name:
a Phone #: 704-634-8760
Directions to property: `i ll,'& ` Section: Lot:
AUTHORIZATION FOR
WASTEWATER Tax Office PIN:#0
SYSTEM CONSTRUCTION �—
Road Name: 4ir 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 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.
ENVIRONMENI`AL HEALTHSPECIALIST DATE ISSUED
"9` DAVIE COUNTY HEALTH DEPARTMENT
,, �- SRT • IMPROVEMENT AND OPERATION PERMITS
Jermiifee's
Name: �_r
Directions to property:
5;
PROPERTY INFORMATION
Subdivision Name:
Section: Lot:
IMPROVEMENT
PERMIT Tax Office PIN:#= r -'• -�"
Road Name: '& l 1,L.fl ,� � . � s I 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 fmm 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)
t _ s ***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 --:9--# OCCUPANTS a GARBAGE DISPOSAL: Yes or No
COMMERCIAL SPECIFICATION: FACILITY TYPE # PEOPLE # PEOPLE/SHIFT # SEATS INDUSTRIAL WASTE: Yes or No
LOT SIZ �J / A) TYPE WATER SUPPLY DESIGN WASTEWATER FLOW (GPD)2- ') NEW SITES REPAIR SITE
i
SYSTEM SPECIFICATIONS: TANK SIZE?)GAL. PUMP TANK GAL. TRENCH WIDTH �° ROCK DEPTH /i LINEAR FT. I i
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
TEM INSTALLED BY:
AUTHORIZATION NO. Ai2 OPERATION PERMIT BY: /(` T � DATE: �f
"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)
t
DAVIE COUNTY HEALTH DEPARTMENT
Environmental Health Section SECTION
Soil/Site Evaluation
APPLICANT'S NAME1 4re5'
PROPOSED FACILITY & /V
SUBDIVISION
Water Supply: On -Site Well
Community
Evaluation By: Auger Boring Pit
DATE EVALUATED
PROPERTY SIZE
ROAD NAME
Public
Cut
LOT
FACTORS 1 2 3 4 5 6 7
Landscape position L
Slope %
HORIZON I DEPTH
Texture group
Consistence
Structure
Mineralogy
HORIZON II DEPTH
Texture group
Consistence
Structure i
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: EVALUATION BY:
LONG-TERM ACCEPTANCE RATE: OTHER(S) PRESENT:
REMARKS:
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
DCHD (O1-90)
MOON
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• APPLICATION FOR SITE EVALUATIONAMPROVEMENT 22
Davie County Health Department L5 0
Environmental Health Section
D
P.O. Box 848 FAUG4 1997
�l Mocksville, NC 27028
(704) 634-8760
****IMPORTANT**** THIS APPLICATION CANNOT BE PROCESSED UNLESS ALL
THE REQUIRED INFORMATION IS PROVIDED.
1. Name to be Billed ze: n n 1'e- c rte) Contact Person
Mailing Address 9,rC &1,;A ! 1"244011 Home Phone 6 7 V .S
City/State/Zip 11-10 C /V vf��� 4/,L, g7o,2Z Business Phone
2. Name on Permit/ATC if Different than Above
Mailing Address
3. Application For: [1I -Site Evaluation
City/State/Zip
[ ] Improvement Permit & ATC [ ] Both
4. System to Serve: [ ] House [k]'Mobile Home [ ] Business [ ] Industry (] Other
5. If Residence: # People .Z # 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: [ ] County/City [LJ -Well [ ] Community
8. Do you anticipate additions or expansions of the facility this system is intended to serve? [ ] Yes [1-T'No
If yes, what type?
PROPERTY INFORMATION REQUIRED: *** IMPORTANT *** XMWOF THE PROPERTY MUST BE
r7 SUBMITTED WITHI,S APPLICATION.
Property Dimensions: G { V WRITE DIRECTIONS (I i ocksville) TO PROPERTY:
Tax Office PIN: #-
Property Address: Road Name/"t r` �. G , C�s �N��C �� c f Ci o .Ll
f a Sri.. �. ✓ G t/ �'�
City/zip n-LC,,C k5'vi'lle- �'[' 7cd F ; 611• C,
If in Subdivision provide information, as follows: L -/;Z) l d yC le X? Y
Name:
Section: Lot #: IeLr -e III
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 % - A h i'&- -52c 7'&) to conduct all testing procedures as necessary to determine the site suitability.
DATE 5' — C, - 2 7 SIGNATURE 1, r✓N^ trc P.. � ��,/�
Revised DCHD (06-96)
THIS A$EA MAY 13E USED FOR DItAIVINC JOUI? SITE PLAN: