215 McCullough Rdf
Davie County, NC
Tax Parcel Renort A M 1 0 Friday. September 30. 2016
WA"IiNli: ltilv'N 1N 1rV 1 A Z!OUKVLl Y
..... ..... ........_ .
Parcel Information
Parcel Number: K516OA0001 Township: Jerusalem
NCPIN Number: 5747001417 Municipality:
Account Number:
82531131
Census Tract:
37059-807
Listed Owner 1:
WARD VIVIAN MICHAEL
Voting Precinct:
COOLEEMEE
Mailing Address 1:
1800 US HIGHWAY 601 SOUTH
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:
LOT 109+P/O 108 ANDERSON
Fire Response District:
JERUSALEM
Assessed Acreage:
0.39
Elementary School Zone:
COOLEEMEE
Deed Date:
12/2008
Middle School Zone:
SOUTH DAVIE
Deed Book / Page:
2009EO026
Soil Types:
GnB2,GnC2
Plat Book:
0001
Flood Zone:
Plat Page:
097
Watershed Overlay:
DAVIE COUNTY
Building Value: 31650.00 Outbuilding & Extra 0.00
Freatures Value:
Land Value: 8390.00 Total Market Value: 40040.00
Total Assessed Value: 40040.00
E@1
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. Ail 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.
Permittci,,'s - -- ''' DAVIE COUNTY HEALTH DEPARTMENT
Name:'"`' r,�ac! : r' . r (�r' ( Environmental Health Section PROPERTY INFORMATION
,r P.O. Box 848
Directions to property:` ! °` I �/f Mocksville NC 27028 Subdivision Name:
Phone #: 336-751-8760
Section: Lot: _
AUTHORIZATION FOR
WASTEWATER
Tax Office PIN:# . -
SYSTEM CONSTRUCTION ,
I ,1,, I
AUTHORIZATION NO: 002975 A Road Name: f b �t=
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 .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
RESIDENTIAL SPECIFICATION: BUILDING TYPE # BEDROOMS # BATHS i # OCCUPANTS GARBAGE DISPOSAL: Yes or No
COMMERCIAL SPECIFICATION: FACILITY TYPE # PEOPLE # PEOPLE/SHIFT # SEATS INDUSTRIAL WASTE: Yes or No
LOT SIZE cl TYPE WATER SUPPLY t C�) DESIGN WASTEWATER FLOW (GPD) C' t� NEW SITE REPAIR SITE y
SYSTEM SPECIFICATIONS: TANK SIZE GAL. PUMP TANK�GAL. TRENCH WIDTH 3 cP ROCK DEPT414
LINEA FT. (
o� ) S (,
OTHER
REQUIRED SITE MODIFICATIONS/CONDITIONS: r 1Z4 C \� C� to 15 [ A (i (" F' 0o 1'/ rr 111 ,,1 y
IMPROVEJENT PERMIT LAYOUT t I"
1119 V
Cj
n ,
Q uv�
I
FOR FINAL INSPECTION OF THIS SYSTEM PLEASE CALL BETWEEN 8:30 - 9:30 A.M. ON THE DAY OF INSTALLATION. TELEPHONE # IS (336) 751-8760.
OPERATION PERMIT I �(�
`✓ � SYSTEM INSTALLED BY: A r^ '{i,
a�
it..j A��;
l4-'
r
V�6
AUTHORIZATION NO. OPERATION PERMITYDATE.
"THE ISSUANCE OF THIS OPERATION PERMIT SHALL INDICATE THAT THE SYSTEM DESCRIBED ABOVE HAS BEEN INSTALLED IN COMPLIANCE
WITH ARTICLE 1 I 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 02/02 (Revised) fieeT, -it 5og3 ru.#06-37
Perinij'S""_ DAVIE COUNTY HEALTH DEPAR MEET
Named` ' �' E ` 1 Environmental Health Sectioh � I r)1A PROPERTY INFORMATION
P.O. Box 848
Directions to property: f r' fes, Mocksvihe, NC 27028 Subdivision Name:
Phone #: 336-751-8760 1
Section: Lot:
AUTHORIZATION FOR
WASTEWATER Tax Office PIN:#
SYSTEM CONSTRUCTION ee
AUTHORIZATION NO: 0 0 V 3 7 J A 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 I 1 of G.S. Chapter 130A, Wastewater Systems, Section .1900 Sewage Treatment and Disposal Systems)
L; ` r -, r �r''�- "= ' ✓ Y r C,., ***NOTICE*** THIS AUTHORIZATION FOR WASTEWATER CONSTRUCTION
r ±" -• r 't ,� 'r ..:, r'C i ""' '.. IS VALID FOR A PERIOD OF FIVE YEARS.
ENVIRONMENTAL HEALTH SPECIALIST DATE ISSUED
RESIDENTIAL SPECIFICATION: BUILDING TYPE 7 # BEDROOMS # BATHS ' # OCCUPANTS 4 GARBAGE DISPOSAL: Yes or No
COMMERCIAL SPECIFICATION: FACILITY TYPE # PEOPLE # PEOPLE/SHIFT # SEATS INDUSTRIAL WASTE: Yes or No
LOT SIZE TYPE WATER SUPPLY r-1 DESIGN WASTEWATER FLOW (GPD) t., �' NEW SITE REPAIR SITE
61
,.TANK ,
,/ r
SYSTEM SPECIFICATIONS. TANK SIZE I " GAL. PUMP TANK + GAL. TRENCH WIDTH G ROCK DEPTH % V/ LINEAR FI.
d� )
OTHER
-.( I rG lrl it''�-
REQUIRED SITE MODIFICATIONS/CONDITIONS: '7r' I) C 1 C' 61 k� 1'-s ( 4 I
IMPROVEMENT PERMIT LAYOUT
U
I,,
A
W�
�i
t' C'
112,
) `t ( ., e I(, r r
FOR FINAL INSPECTION OF THIS SYSTEM PLEASE CALL BETWEEN 8:30 - 9:30 A.M. ON THE DAY OF INSTALLATION. TELEPHONE # IS (336) 751-8760.
OPERATION PERMIT �t�
aM •' \✓ �� r V SYSTEM INSTALLED BY: a ` �
4
AUTHORIZRMIT B
ATION NO. OPERATION PEY: DATE:
"THE ISSUANCE OF THIS OPERATION PERMIT SHALL INDICATE THAT THE SYSTEM DESCRIBED ABOVE HAS BEEN INSTALLED IN COMPLIANCE
WITH ARTICLE 1 I 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 02/02 (Revised) p eef. -0 003 Vi a. *' 0537
DAVIE COUNTY HEALTH DEPARTMENT
Environmental Health Section
Soil/ Site Evaluation
APPLICANT INFORMATION
�yy �
Water Supply: On -Site Well Community
Evaluation By: Auger Boring Pit
-
PROPERTY INFORMATION
A0 0 C (asci I
�rz0�-S
Public
Cut
FACTORS 1 2 3 4 5 6 7
Landscape position C/
Slope %
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:
REMARKS:
LEGEND
EVALUATION BY: jdJ / • � S
OTHER(S) PRESENT:41/NOLot_�,,
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
CONSIST .N .E
Moist
VFR - Very friable FR - Friable FI - Firm VFI - Very firm EFI - Extremely firm
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
Mineral=
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 05/05 (Revicedl
NAM
ADDI
DAVIE COUNTY ENVIRONMENTAL HEALTH SECTION
• APPLICATION FOR IMPROVEMENT PERMIT (REPAIR)
ONE NUMBER 61-?-ZZz-
7 in -9
BDIVISION NAME
LOT #
DIRECTIONS TO SITE &DI S., & %1!I�L'�//�
,bei re Gi i(rei
DATE SYSTEM INSTALLED NAME SYSTEM INSTALLED UNDER
TYPE FACILITY NUMBER BEDROOMS NUMBERPEPEOPLE SERVED
TYPE WATER SUPPLY SPECIFY PROBLEM OCCURRING R
/1'I ale fa&' gu�1 "n4 aw hail Ave-<
V INFORMATION TAKEN BY
DATE REQUESTED6LOO
This is to certify that the information provided is correct to the best of my knowledge, and that I understand I am responsible for all charges Incurred from this application.
SIGNATURE OF OWNER OR AUTHORIZED AGENT
Rev. 1/93
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