187 Meadow Glen LnDavie County, NC
Tax Parcel Report 161 X Friday. September 30. 2016
WARNING: THIS IN NOTA NUKVEY
Parcel Information
Parcel Number: D20000003810 Township: Clarksville
NCPIN Number: 5812136172 Municipality:
Account Number: 81294120 Census Tract: 37059-801
Listed Owner 1: YELLICK DOUGLAS K Voting Precinct: CLARKSVILLE
Mailing Address 1: 187 MEADOW GLEN LANE Planning Jurisdiction: Davie County
City: MOCKSVILLE Zoning Class: DAVIE COUNTY R-A,R-20
State:
NC
Zoning Overlay:
Zip Code:
27028-5884
Voluntary Ag. District:
No
Legal Description:
15.92 AC LIBERTY CHURCH
Fire Response District:
WILLIAM R. DAVIE
Assessed Acreage:
16.67
Elementary School Zone:
WILLIAM R DAVIE
Deed Date:
10/1997
Middle School Zone:
NORTH DAVIE
Deed Book / Page:
001970728
Soil Types: MnB2,GrB,WATER
Plat Book:
Flood Zone:
Plat Page:
Watershed Overlay:
DAVIE COUNTY
Building Value:
259080.00
Outbuilding & Extra
Freatures Value:
49450.00
Land Value:
123170.00
Total Market Value:
431700.00
Total Assessed Value:
431700.00
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
1\
7� C County of Davie, North Carolina, Its agents, consultants, contractors or employees from any and all claims or causes of action due to
1. or arising out of the use or Inability to use the GIS data provided by this website.
AUTHORIZATION NO: I DAVIE COUNTY HEALTH DEPARTMENT 3, 3c----)
Environmental Health Section PROPERTY INFORMATION
Permittea's T P.O. Box 848
Name:--yy�L/�� �L�-t-�� i� Mocksville, NC 27028 Subdivision Name:
/Directions to property: �'� TC Phone #: 704-634-8760 Section: Lot:
!� AUTHORIZATION FOR ?
I� Qf� ��� tJra +•'r'�'£..�:� WASTEWATER Tax Office PIN:#
SYSTEM CONSTRUCTION
Road Name ✓q r
**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�8, Chapter 130A, Wastewater Systems, Section .1900 Sewage Treatment and Disposal Systems)
t
***NOTICE*** THIS AUTHORIZATION FOR WASTEWATER CONSTRUCTION
C7i '� 7 IS VALID FOR A PERIOD OF FIVE YEARS.
N
ENVIROENT4 HEALTH SPECIALIS DATE If SUED
` 0 7 �DAVIE COUNTY HEALTH DEPARTMENT
�- IMPROVEMENT AND OPERATION kRMITS PROPERTY INFORMATION
Name:
Diregtions to property: $; t tr l `i
}} ,
1
IMPROVEMENT
PERMIT
Subdivision Name. 1'` w e z s S �n, w/ �•'
Section: Lot:
Tax Office PIN:#
rl 4^
Road Name. 1 ; r. rk ' s f -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 I 1 of G.S. Chapter 130A, Wastewater Systems, Section .1900 Sewage Treatment and Disposal Systems)
***NOTICE*** THIS PERMIT IS SUBJECT TO REVOCATION IF SITE
_ „k € a . / ` �' - - t •r:._ r; PLANS OR THE INTENDED USE CHANGE. YOUR WASTEWATER
ENVIRONMb4AL HEALTH $PECIAE°ISDATE I$SUED SYSTEM CONTRACTOR MUST SEE THIS PERMIT BEFORE
L INSTALLING THE SYSTEM.
RESIDENTIAL SPECIFICATION: BUILDING TYPE '� # BEDROOMS 4: -# BATHS r # OCCUPANTS — 1!�/ GARBAGE DISPOS Yes or No
COMMERCIAL SPECIFICATION: FACILITY TYPE COPEOPLE # PEOPLE/SHIFT # SEATS INDUSTRIAL WASTE: Yes or No
LOT SIZE .i TYP WATER SUPPLY *-� DESIGN WASTEWATER FLOW (GPD) /. NEW SITE � `r REPAIR SITE
iw`L 4 ,t i
SYSTEM SPECIFICATIONS: TANK SIZE GALL. PUMP TANK GAL. TRENCH WIDTH 3.� ROCK DEPTH _L LINEAR FT.
OTHER .1� ivy i ,t�Tl ONO�CG-
REQUIRED SITE MODIFIC ATIONS/CONDITIONS: IN)SIALt- ),��V t u c'p� CL,--%TpC3�,2 , jtt'CC- IS ! Ur(-
IMPROVEMENT PERMIT LAYOUT
e"
I1 p�15�
fr I
60
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1
s-
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60
-'OWItT "►��7ALL51JA1,LCa-X
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**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: D413 P3 Y 0" ( TA iLy 2—
-FA "3 V 1>0N t- 2� 130
AUTHORIZATION NO. OPERATION PERMIT BY: DATE: /0
**THE ISSUANCE OF THIS OPERATION PERMIT SHALL INDICATE THAT THE SYSTEM DEC ED ABOVE EN 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)
APPLICATION FOR SITE EVALUATIONAMPROVEMENT PE
Davie County Health Department17SEP
[ (`
`Jt9�, Environmental Health Section
e �'��\ P.O. Box 848 2 3I997 NI
` Mocksville, NC 27028
(704)634-8760
****IMPORTANT**** THIS APPLICATION CANNOT BE PROCESSED UNLESS ALL
THE REQUIRED INFORMATION IS PROVIDED.
1. Name to be Billed I Gt S 111J' .
Mailing Address �.O, 1 s-
�}
City/State/Zip I Y ccksy l to , U6, -%(oug
2. Name on Permit/ATC if Different than Above
Mailing Address
3. Application For: [-]-Site Evaluation
Contact Person oc Na,,t ! l 1 &
Home Phone `70 '401 - %D (77
Business Phone 1 -WO P17Uju:so
8 Zq
City/State/Zip
[J Improvement Permit & ATC
[Both
4. System to Serve: L, 'Rouse [ ] Mobile Home [ ] Business [ ] Industry [ ] Other
5. If Residence: # People " _ # Bedrooms �i-J# Bathrooms � [L] -Dishwasher [t rGarbage Disposal
[1,]�Washing Machine [ L]-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: mtounty/City [ ] Well [ ] Community
8. Do you anticipate additions or expansions of the facility this system is intended to serve? [ ] Yes [Li -No
If yes, what type?
EITHER A PLAT OR SITE PLAN
PROPERTY INFORMATION REQUIRED: *** IMPORTANT **XXFUAT OF THE PROPERTY MUST BE
SUBMITTED WITH THIS APPLICATION.
Property Dimensions: 5• ?18r 4e-rc 5 ; WRITE DIRECTIONS (from Mocksville) TO PROPERTY:
Tax Office PIN: # - C gJ ! «• y 1,01 `%O L%6er-t„ Clu," R2
Property Address: Road ]lame MCa-Aoun 6rt Crn "E L e.4 �rrr� m L b e c C 9u. c l� crn
City/Zip 64ew, t,,Ct&1y-,
If in Subdivision provide information, as follows:
Name:
Section: Lot #: I;
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 �Qlr+b 1171T� s 6&V it e�l to conduct all testing procedures as necessary to determine the site suitability.
DATE SIGNATURE���
Revised DCHD (06-96)
THIS AREA MAY $E USEb FOR bRAIVINC7 YOUR SITE PLAN:
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LEGEND
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DAVIE COUNTY HEALTH DEPARTMENT
Environmental Health Section SECTION LOT r
Soil/Site Evaluation
APPLICANT'S NAME 00co Ye LLICX DATE EVALUATED Zai 7
j9z�Y
PROPOSED FACILITY i Js� PROPERTY SIZE r �<_
SUBDIVISION ROAD NAME
Water Supply: On -Site Well / Community
Evaluation By: Auger Boring ✓ Pit
Public
Cut
FACTORS
1
2
3 4 5 6 7
Landscape position
S
S
L
Sloe %
%
HORIZON I DEPTH
0-10
D -I
0--10
Texture group
CC1L
5
Consistence
S
O
Structure
C_�M
Mineralogy
1: !
! ;
HORIZON II DEPTH
1Q -Z4
I 2 -? O
Texture group
sc,
G
C_
Consistence
; <ss
s
Structure
C'10
Z
.,N4
Mineralogy
j: 1
: `
1:
HORIZON III DEPTH
Z_ J--
So -14-o
-?.Z,
Texture group
S'C V I)
d"t <
C�_ +c -Q
Consistence
S
Structure
sb k
QfLk
�t �
Mineralogy
:
Il
,I
HORIZON IV DEPTH
:�>?.�
Texture groupt
Consistence
Structure
Mineralogy
SOIL WETNESS
RESTRICTIVE HORIZON
SAPROLITE
CLASSIFICATION
LONG-TERM ACCEPTANCE RATE
O, 3
3.
SITE CLASSIFICATION: P 5
LONG-TERM ACCEPTANCE RATE: ora
REMARKS:
DCHD (01-90)
EVALUATION BY: G4AAA1T
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
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
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