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209 Meadow Glen LnDavie County, NC Tax Parcel Report d l V I Fridav, September 30, 2016 WARNING:THIS 1S NOTA SURVEY Parcel Information Parcel Number: D20000003807 Township: Clarksville NCPIN Number: 5812130183 Municipality: Account Number: 82527134 Census Tract: 37059-801 Listed Owner 1: SHERDEN ANNETTE M Voting Precinct: CLARKSVILLE Mailing Address 1: 209 MEADOW GLEN LANE Planning Jurisdiction: Davie County City: MOCKSVILLE Zoning Class: DAVIE COUNTY R -A State: NC Zoning Overlay: Zip Code: 27028-0000 Voluntary Ag. District: No Legal Description: 11.032 AC LIBERTY CHURCH Fire Response District: WILLIAM R. DAVIE Assessed Acreage: 11.16 Elementary School Zone: WILLIAM R DAVIE Deed Date: 10/2006 Middle School Zone: NORTH DAVIE Deed Book / Page: 006850565 Soil Types: MnB2,GrB,MdB,MdD,ChA Plat Book: Flood Zone: Plat Page: Watershed Overlay: DAVIE COUNTY Building Value: 134860.00 Outbuilding & Extra Freatures Value: 13460.00 Land Value: 94970.00 Total Market Value: 243290.00 Total Assessed Value: 243290.00 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 l+pC NAY NC or arising out of the use or inability to use the GIS data provided by this website. ---All IWORIZATIONtNO: 0769 DAVIE,COUNTY HEALTH DEPARTMENT Environmental Health Section PROPERTY INFORMATION Permitt6e'9 P.O. Box 848 `�� a fe t% %'fir 1� "• Name: ►�� s� Y1,G Jr J � '�, �' Mocksville, NC 27028 Subdivision Dame: t��l t �+ ` Phone#:704-634-8760 N'd��"� Directions to property: � � C� / f� - �` � Section: Lot: AUTHORIZATION FOR d WASTEWATER Tax Office PIN:# SYSTEM CONSTRUCTION Road Nam **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) (� • . *� c� ***NOTICE*** THIS AUTHORIZATION FOR WASTEWATER CONSTRUCTION - 11."7 IS VALID FOR A PERIOD OF FIVE YEARS. k ENVIRONMENTAL HEALTH SPECIALIST. DATE ISSUED y DAVIE COUNTY HEALTH DEPARTMENT �' ' "`' � rt� IMPROVEMENT AND OPERATION PERMITS PROPERTY INFORMATION yPermjttee Name- : r ' C: �• i±�' L';'_ Subdivision Name Directions to property: / i - t ` c - Section: Lot: IMPROVEMENT PERMIT Tax Office PIN:# t 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/mstallation 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 } °. }•� f..^F 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 N M)7— # BEDROOMS -'�- # BATHS # OCCUPANTS GARBAGE DISPOSAL: Yes O&C-, COMMERCIAL SPECIFICATION:, FACILITY TYPE # PEOPLE # PEOPLE/SHIFI' # SEATS INDUSTRIAL WASTE: Yes or No LOT SIZE TYPE WATER SUPPLY DESIGN WASTEWATER FLOW (GPD) e� t! NEW SITE REPAIR SITE SYSTEM SPECIFICATIONS: TANK SIZE �b GAL. PUMP TANK 1 —)1 GAL. TRENCH WIDTH - % /` ROCK DEPTH l LINEAR FE -9 OTHER REQUIRED SITE MODIFICATIONS/CONDITIONS: IMPROVEMENT PERMIT LAYOUT .Y1 G eel pj **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: I Fvlt.� Eut 1J )ODI g AUTHORIZATION NOy3 � 1 OPERATION PERMIT BY:(1�� DATE: O **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) APPLICATION FOR SITE EVALUATIONAMPROVEMENT PERMIT & ATC ' Davie County Health Department Environmental Health Section P.O. Box 848 Mocksville, NC 27028 (704) 634-8760 ****IMPORTANT**** THIS APPLICATION CANNOT BE PROCESSED UNLESS ALL THE REQUIRED INFORMATION IS PROVIDED. 1. Name to be Billed n ✓1 e --He yY1 L v,4 k e r Contact Person S cc me— Mailing Address 0110 - 2 CheS4.er4--011 Po cxj Q Home Phone '1 )0 — &0 City/State/Zip i�C - 2`)1 b f Business Phone DO 2. Name on Permit/ATC if Different than Above Mailing Address City/State/Zip 3. Application For: [ ] Site Evaluation [ ] Improvement Permit & ATC 4. System to Serve: [House [ 1 Mobile Home [ ] Business [ ] Industry [ ] Other Both 5. If Residence: # People # Bedrooms a # Bathrooms [ ] Dishwasher [ 1 Garbage Disposal [ V1 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 [ ] Well [ ] Community 8. Do you anticipate additions or expansions of the facility this system is intended to serve? ( ] Yes [v] No If yes, what type? EITHER A PLAT OR SITE PLAN PROPERTY INFORMATION REQUIRED: *** IMPORTANT *** XIMAIVOF THE PROPERTY MUST BE y SUBMITTED WITHTIHItS APPLICATION. Property Dimensions: 1 CLCrtS WRITE DIRECTIONS (fr 1 ocksville) TO PROPERTY: Tax Office PIN: # °[ I g S ; W 1 O 1 �i'c ,{ � U1 i.� �S Property Address: Road NameMeadow % (en La rie /� pD OYt'� UbetAj �t L'Lf' �' F'F � City/Zip N D�S Vl 1( ! UC 39Da o n� I'1 4' o�� 3 YYV1 ICS 421V'vi If in Subdivision provide information, as follows: 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. 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 properjlocated in Davie County and owned by. DA Revised DCHD (06-96) q to duct all testing procedurrps as neces o d t ine the site suitability. SIGNATURE ( i/VILLt i?►/ �r �/1 THIS AREA MAY 13E USED FOR DRAWIN(5 YOUR SITE PLAN: APPLICATION FOR SITE EVALUATION/IMPROVEMENTS PER OCT _ 2 2`3 Davie County Health Department Environmental Health Section P. O. Box 665 Mocksville, NC 27028 FtJ 1u1u�gL� -Lt-4E P- 1. Application/Permit Requested By ��� u k ��� Awxobm _� Mailing Address 3�>p S I 42-- Home Phone (('' Business Phone 2. Name on Permit if Different than Above 1—t [V W VA t 3. Application for: General Evaluation 4. System to Serve: House ❑ Business ❑ Industry 5. If house, mobile home: Subdivision No. of People No. of Bedrooms 1� No. of Bathrooms L Dwelling Dimensions Q l�eeaE' ❑ Septic Tank Installation Permit ❑ Mobile Home ❑ Place of Public Assembly ❑ Other 6. If business, industry, place of public assembly, other: Specify type No. of People Served No. of Commodes No. of Lavatories No. of Showers No. of Sinks No. of Urinals No. of Water Coolers Water Usage Figures 7. Type of water supply: ,Public ❑ Private 8. Property Dimensions �� X t3 Z �', Sewage Disposal Contractor ❑ Unknown Section Lot # ❑ Basement/Plumbing ❑ Basement/No Plumbing VWashing Machine V Dishwasher ❑ Garbage Disposal 9. Do you anticipate additions/expansion of the facility this sytem is intended to serve? ❑ Yes 1 No If yes, what type? ❑ Community '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. J!KUJ hi.'lY LN1 U1Q1N1:1UN lii::lUlhi:ll: Directions to ,Property: Tax Office PIN �1 tJ�)Z ' 1� • `� l 0� Road Naine DIFE )—k1>E-12-W Q . Box # (if available) city 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 appli-cation. • q�— DATE N SIGNATURE CONSENT FOR SITE EVALUATION TO BE DONE ON ABOVE DESCRIBED PROPERTY MUST CHECK ONE: ❑ 1. 1 OWN the property. X2. I 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 representati a of the Davie County Health Department to enter upon above described property located in Davie County and owned by Rte /. D -�, e 1k-V--LL-i �— �SX31A321V—ln 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) 21. 6' Fred M. Lashmit v' 95'7 ACRES D.B. 116 -124 \ Z \ .1 n9 s �t ry 76335 %~� 41,3 i4 \\ 2• 5i Parcel 38.01 o y`a0� C1 Stephen S. Rich s D.B. 175 — 715 0 0 A.9. ACRES �' b 8 " � I o 0 N I n Pond a S7,3.1 /y 75\ (approx. location)- y ry° 6?7 CO74 S f 43 9625' f S 84�40,.E . Ev \ I 01' P 2 V Iq 54.29' N6 g�.�v _ 757.006 ACRES FIP Nq EIP Sf 7088.90. 1038.90• 088.90. n bA 3a. c g y6 N b �, 50.0p' I s sg,s�� •° o i b?? ZI) 33., ary ry� .h .sy .rye aF y y^ of �jsb , e'JJ ,�f C NIP tzb9 jJ. g�?y. ff N G ~v N RES��e ````� J*Bs. . � P to B o ,N' D A 16� O W O 2 • C y o o� zm 0 2.617 ACRES 2 11.032 ACRES 15.928 ACRES 0 0 13'20"W 1364.26' NIP 285.46' 314.73' �p NIP 302.71' Elp 135.16' UP 161.50- N 86°30110' 617.44' N 86°47'20"W N 86'18'20" on. round 20 Hanes Parcel 20 I John C. Hanes I o 340 n D.B. 100 — 689 a) I N=I oI .i I � m NUoO N �• Um I p Cm II 0_00 U- JO I, C. Ray cww% W" Vet tli piOt dgOn undo try r..ord.d ti leek in Po" 377. ft.) (~). tld t. WrAge o not 'urvey.d Or..I..iy k+dle04d e. drOOn rlO,n kdenneeon teund ti loek Pop. U+.! tir totle W pr.oYen r eOlaleb0 M t:t0A00: that — pet .e. pnip , 1.9 .. da — WM o.3. 47-30 m .nw,dd M7tn... ny odpk,d .Ivn.k... r"W"l...... w Ow ..d Logo tld. Z�dq of �� A.D. . Seal or Stamp >. 2623 e�` ��'il l- ,t ��. DAVIE COUNTY HEALTH DEPARTMENT Environmental Health Section Soil/Site Evaluation Annette Luther NAME 5812-1.5-9185 (Mocksville) ADDRESS PROPOSED FACIILTY House DATE EVALUATED / 0- 11.032 -11.032 Acres PROPERTY SIZE LOCATION OF SITE Off Liberty Church Rd Water Supply: On -Site Well Community Public Evaluation By:t' Auger Boring Pit Cut FACTORS 1 2 3 4 Landscape position 5 S Slope 7. 16 ° HORIZON I DEPTH '' " t' Texture groupL C1_.. L Consistence F'Z Structure C Mineralogy HORIZON II DEPTH Texture groupC Consistence _ Structure k A MS Mineralogy HORIZON III DEPTH Texture group Consistence Structure Mineralogy HORIZON IV DEPTH Texture group Consistence Structure Mineralogy SOIL WETNESS RESTRICTIVE HORIZON — — — SAPROLITE — — - CLASS.IFICATION .S ,S LONG-TERM ACCEPTANCE RATE. 5 - SITE CLASSIFICATION: °ate ' _'�) " EVALUATED BY: CC LONG-TERM ACCEPTANCE RATE: OTHER(S) PRESENT: REMARKS:��.�- N� .\ o,`,s�- -�' 75z`�N"s 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 :lay 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 Ilorizon 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 (01-901 ■���������������������������������■����������������������■ ���A��■ ■■��■��������■��■■■�■��������������n�■��������������������������■ ■��■�\■���■��■��■■■���■��������■ ■���■�r�����������������0������■ ■�������■■�■■�����������■�������������■������������■������������■ ■��������������■���������■����������■������■■��������������������■ 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Davie County Health Department and Home .health Agency Environmenta(Health. Section P.O. Box 848 / 210 HOSPITAL STREET COURIER #09-40-06 MOCKSZLE, N.C. 27028 PHONE: (704) 694-8760 October 8, 1996 Annette Luther c/o Howard Realty Attn: Connie Kowalske 330 S. Salisbury St. Mocksville, NC 27028 Re: Site Evaluation Liberty Church Road Tax PIN: #5812-15-9185 Dear Client: As requested, a representative from this office visited the aforementioned site on October 3, 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 'Pis office. Sincerely, Charles E. Little, R.S. Environmental Health Section CL/wd Enclosure(s)