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228 Meadow Glen LnDavie County, NC Tax Parcel Report 6A J) Friday. September 30. 2016 WARAIAG: THIS 1S AUT A SURVEY Parcel Information Parcel Number: D20000003808 Township: Clarksville NCPIN Number: 5812134716 Municipality: Account Number: 82528054 Census Tract: 37059-801 Listed Owner 1: BAUCOM LISA NICOLE Voting Precinct: CLARKSVILLE Mailing Address 1: 228 MEADOW GLENN LANE Planning Jurisdiction: Davie County City: MOCKSVILLE Zoning Class: DAVIE COUNTY R-A,R-20 State: NC Zoning Overlay: Zip Code: 27028-0000 Voluntary Ag. District: No Legal Description: 7.006 AC OFF LIBERTY CHR Fire Response District: WILLIAM R. DAVIE Assessed Acreage: 7.27 Elementary School Zone: WILLIAM R DAVIE Deed Date: 5/2007 Middle School Zone: NORTH DAVIE Deed Book / Page: 007120215 Soil Types: MnB2,GrB,MdD Plat Book: Flood Zone: Plat Page: Watershed Overlay: DAVIE COUNTY Building Value: 182770.00 Outbuilding & Extra Freatures Value: 84910.00 Land Value: 60670.00 Total Market Value: 328350.00 Total Assessed Value: 328350.00 q �� /E, r'p �� N.�'� Davie County, NC All 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 harmless the 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. "AUTHORIZATION NO: 0553 DAVIE COUNTY HEALTH DEPARTMENT AOD 1Ao" Environmental Health Section PROPERTY INFORMATION Pertaitteels P.O. Boz 848 Q Name: (f�+P A � .✓P/,b 1^U_ _ _ Mocksville. NC 27028 Subdivision Name: X- o /�%.N✓�.^ Phone #: 704634-8760 Directions loproperty: /6 /� Section: Lor AUTHORIZATION FOR �9 p 2 LCl 11 k/iCilarn� �l klJ WASTEWATER I�"� Tax Office PI :k 5e1;1 . 1` STJ SY'STEA7 CON........ -^ - t `^� � Road Name:- i, m: A'. I 64 **NOTE -I This Authorization for Wastewater System Construction MUST BE ISSUED by the Davie County Environmental Healtft Scetion prior to issuance of any Building Permits. This Fonn/Authorization Number should be presented to the Davie County Building Inspections Office when applying for Building Pennies. (In compliance with Article 11 of G.S. Chapter 130A. Wastewater Systems. Stsaion .IOW Sewage Treatment and Disposal Systems) "'NO tree••• -I IM AUI HURI/,A'1'ION FUR WAS[ 10 IS VALID FOR A PERIOD OF F'IVE`. DMT ISSUED _ DAVIE COUNTY HEALTH DEPARTMENT P oa Y-0 _ IMPROVEMENT AND OPERATION'PERMIT5 PROPERTY INFORMATION Peri�iittee�s' "�; Name l��t n E? RAI Directfons to property: / C/� c Subdivision Name: – n /�-4 a.✓.-+– Section: Lot: IMPROVEMENT .q PERMIT Tax Office P :# Road Name: **NOTE** This Improvement Permit DOES NOT authorize the construction or installation of a septic tank system or any wastewate 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) ; FI z 1 " ; ***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 # OCCUPANTS GARBAGE DISPOSAL: Yes or No COMMERCIAL SPECIFICATION: FACILITY TYPES # PEOPLE # PEOPLEISHIFI'# SEATS INDUSTRIAL WASTE: Yes or No LOT SIZE TYPE WATER SUPPLY !J DESIGN WASTEWATER FLOW (GPD) NEW SITE t-� REPAIR SITE SYSTEM SPECIFICATIONS: TANK SIZE J GAL. PUMP TANK GAL. TRENCH WIDTH rl' ROCK DEPTH V LINEAR FT M 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 SYSTEM INSTALLED BY:�%`� I u u i �jL'��12 �1 - < i L--� /3 10VI I Hoosf AUTHORIZATION NO.53 OPERATION PERMIT B (:��DATE: / O .1 K/ I C -)I I "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) s 1. 2. 3. 4. APPLICATION FOR SITE EVALUATIONAMPROVEMENT PERMIT Davie County Health Department Environmental Health Section P. O. Box 848 Mocksville, NC 27028 (704) 634-8760 :ATC p 1E@[E0d[E h oct' i � ins D II ****IMPORTANT**** THIS APPLICATION CANNOT BE PROCESSEq UNLESS /,A/LL THE REQUIRED INFORMATION IS PROVIDED. 410 Name to be Billed A�L t Contact Person C5W/)9C Mailing Address Lgol -- c-3 / --� Al -'6y (-�2='E Home Phone(9/D� City/State/ZipG't/�' %Q/V�g�_�/�i � Business Phone (91D 011 576 / Name on Permit/ATC if Different than Above(yJO) 917-F161 Mailing Address City/State/Zip Application For: Site Evaluation Improvement Permit & ATC System to Serve: d House ❑ Mobile Home ❑ Business ❑ Industry 5. If Residence: # People # Bedrooms a Dishwasher C"Garbage Disposal Ur Washing Machine U Basement/Plumbing 6. If Business/Other: Specify type AMA? # People _ # Commodes If Foodservice: 7. Type of water supply: # Showers # Seats 3 County/City # Urinals Estimated Water Usage (gallons per day) ❑ Well &01 -A - El Other # Bathrooms ❑ Basement/No Plumbing # Sinks # Water Coolers 8. Do you anticipate additions or expansions of the facility this system is intended to serve? If yes, what type? I ❑ Community ❑ Yes No PROPERTY INFORMATION REQUIRED: *** IMPORTANT *** A PLAT OF THE PROPERTY MUST BE SUBMITTED WITH THIS APPLICATION. Property Dimensions: /► l �/14elfE� Tax Office PIN: # -J O - - 1 1 Property Address: Road Name g!?T GF p RCFC X38 1 City/Zip 77`11 I 1 If in Subdivision provide information, as follows: 1 X14 /3� ' J/77 Name: 1 . 1 Section: Lot #: LO 1 1 WRITE DIRECTIONS (from Mocksville) TO PROPERTY: 11tJV / 1lloR7!! - LEGT "' 1_7-66,e ('/Iu/O[ RL) . " /_coK Fo4 j77{r,&E OV# RED �GgGS ACROSS 6 J CEF> 1)Aeb /'4&23� XrsT 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 conduct all testing procedures as necessary to determine the the siitte suitability. / DATE - � f 7 �((1_ SIGNA Revised DCHD (06-96) y /Ty ??? 03E 763 35. Parcel 38.03 / \ Fred M. L — 124 D.B. 116 124 rt 03 41 .J.2, m 9 Parcel 38.01 Stephen S. Rich o 4 O 19.984 AGES 1038.9'0. 1088 90' y O 15.480 ACRES s+ D.B. 175 — 715 h o Ir N jr;,. ? c } ♦ i�JF 4 = Oi• 5�. b H Pond h �� S 73y S N 15° (approx. location) -10° 62� 3 84 01 40"E of 854.29'�0 7.006 Acres A s �� rip b 4 �r% . 8 v� Otia hbry� � �i aR� y� h � ? s \. �p fv •�' ti e Ma J. Jr} .4 /v f b?7 50.0p, .y o n N 3 6� o nn O 0 to W o o, z ao 0 12.617 ACRES 2 11.032 ACRES 0 y J J *'ee• 0 15.928 ACRES N 87°13'20"W 1364.26' NIP 285.46' 314.73' EIP t N 86030 302.71' EIp 135.16' EIP 161.50' '10' 617.44' 86.479(1"W �I nom•. N M 0 0 hl DAVIE COUNTY HEALTH DEPARTMENT Environmental Health Section Soil/Site Evaluation NAME /QD/'y1 DATE EVALUATED `r ADDRESS PROPERTY SIZE PROPOSED FACIILTY LOCATION OF SITE f-/ 'r �N Ch . h L Water Supply: On -Site Well Community Public I -- Evaluation Evaluation By: Auger Boring a/ Pit Cut FACTORS 1 2 3 4 Landscape position Sloe % HORIZON I DEPTH Texture group Consistence Structure Mineralogy HORIZON II DEPTH 6 Z Texture groupC Consistence Structure i i9 ii J� Mineralogy, HORIZON III DEPTH Texture group Consistence Structure Mineralogy HORIZON IV DEPTH Texture group Consistence Structure Mineralogy SOIL WETNESS RESTRICTIVE HORIZON SAPROLITE CLASSIFICATION 73 /� LONG-TERM ACCEPTANCE RATE , SITE CLASSIFICATION: LONG-TERM ACCEPTANCE RATE: �� S REMARKS: DCHD (01-901 EVALUATED BY:�� 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 :lay loam- SIL -Silty loam CL -Clay loam SCL-Sandy clay loam SC -Sandy clay SIC -Silty clay C -Clay CONSISTENCE Moist VFR- Vl:.-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��■��■n�� ■��■��■ ■■�� ■��■��■�■��■��r��■■��■■ ■■■�■��■��■■��■��■��■��■ ■��■■��■��■■ ■��■��■��■■■�■��\�� ■��■■ ■��■��■��■��■��■��■��■��■�■■��■��■��■■ ■��■��■■■��■��■�■��■�� ■��■��■ ...........................................�C....... ............. .......................................... ........ ............. ..............................................■...._ ............. ■��■��■��■��■��N��■■■�■�■�� ■�■�■�■ ■��■��■■��■��■ ■��■�� ■��■��■�■ ■■��■■■�■��■��■��■■��■��\��■��■■�� ■��■■�� ■��■��■�� ■� �� ■■�■��■ ■\��■■��■��■�� ■N �■��■ ■��■��\��■��■�� ■■ ■�■��■�■��_��■■�■■ �� ■ � �� ■��n�i�■ ■�■�o��■��■��■ ■��■��■�� ■■■��■��■ ■■�■■��■��■�■■��■��■��■ ■■��■■��■■��■ ■��N�� ■��■��■ ■■■■�■��■��■■��■�� ■ ��N��■��■�� ■��■��■■��■��■ � ��■■�� ■■��■��■��■��.■��N��■ ��■��..■■�� ■��■��■��■�■��■ ■ ��\�� ■��■��■ ■ ��■ ■■■■��■��■��■��H��/��■��n��■��i�� ■��■■■��■��■��\��■■■��■��■ ■ ��■�� ■��n��\��■��■��Hv��N�� ■��■��■��■■��■��■�� ■��N�■ �� ■��■��\�■�■ ■��■��■��N��■■��■N■��■�� ............................................... ■.. ...�......� ■��■■■■N��u■�■�■��..•.■��■H�� ■�� ■ .........................��........:..........■■ �. .........0 ........................�.............�...�.....■C ■_.:_.._■...... ■��H��■��1■��■ ��■ ■ �� ■■�� ■�� .........................,.......�....�........._.........C........ ■�H■■�e��■■��■■�� ■■��iH�� ■��a�� ■■�■■�� ■��O��NNH�M��■��■��■��'��H��M��■�� ■��■ ��■■i0�■��r� ■�� ■ �� ■ ��■� ■��■��■��■■�� ■■� ■ ■ ��■�� :::::::::::::::::C:::C=::n:::::�_: _. :�CC�:� ■ �C: _:::: ■��.i�� ■ �� i��■■_ ��■��■��■��■�� u�■ ��i��■ , ■�� ' �� ■ �� ■■��■■ ■�■■■��N��v��fi�� ..��■�■ ■��■��■��■�■�H■��■■�� N�� ■■�� ■��■�■�■■�■u�� ■��■�� ■�■��■■�■��n��■� �� ■ �� ■ �� 8�� ■■ ■��■■��v�■��1��■��u��u �� ■��■ ■��■ ■■��v�i7��■ �■� �� ■ ■ �� ....... ..........�...� ....... .QCC.....�� ................................ ...... . ... .......................5�:::=::: .. 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