415 Merrells Lake RdDavie County, NC
Tax Parcel Report 46x.4 Fridav, September 30, 2016
WAK1V11V1T: IHIN 1N iVUl A NUKVISY
Parcel Information
Parcel Number:
1700000013
Township:
Fulton
NCPIN Number:
5768534276
Municipality:
Account Number:
8305643
Census Tract:
37059-804
Listed Owner 1:
SEIVERS MARK
Voting Precinct:
FULTON
Mailing Address 1:
415 MERRELLS LAKE ROAD
Planning Jurisdiction:
Davie County
City: MOCKSVILLE
Zoning Class:
DAVIE COUNTY R-20
State:
NC
Zoning Overlay:
Zip Code:
27028
Voluntary Ag. District:
No
Legal Description:
4.8 AC MERRELLS LAKE RD
Fire Response District:
FORK
Assessed Acreage:
4.86
Elementary School Zone: CORNATZER
Deed Date:
10/2015
Middle School Zone:
WILLIAM ELLIS
Deed Book / Page:
010020816
Soil Types:
GnB2,GnC2,GaD
Plat Book:
Flood Zone:
Plat Page:
Watershed Overlay:
DAVIE COUNTY
Building Value:
66720.00
Outbuilding & Extra
2970.00
Freatures Value:
Land Value:
49240.00
Total Market Value:
118930.00
Total Assessed Value:
118930.00
Davie County,
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 theNC
161
County of Davie, North Carolina, Its agents, consultants, contractors or employees from any and all claims or causes ofactiondue to
or arising out of the use or Inability to use the GIS data provided by this website.
DAVIE COUNTY HEALTH DEPARTMENT
+ IMPROVEMENT PERMIT and OPERATION PERMIT
IMPROVEMENT PERMIT
**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 11 of G.S. Chapter 130A, Wastewater Systems, Section .1900 Sewage Treatment and Disposal Systems)
NAME \ . �jR� 5 \ 'A� PROPERTY ADDRESS ` ` `� P�P� e\\s & � DATE - /
I
V FAQ
LOCATION k (-1
SUBDIVISION NAME LOT NUMBER SEC./BLOCK NUMBER
RESIDENTAL SPECIFICATION: BUILDING TYPE # BEDROOMS L,,3 t BATHS t OCCUPANTS GARBAGE DISPOSAL: YesQ
COMMERCIAL SPECIFICATION: FACILITY TYPE # PEOPLE Q # PEOPLEISHIFT SEATS INDUSTRIAL WASTE: Yes/No
LOT SIZE TYPE WATER SUPPLY DESIGN,WASTEWATER FLOW (GPD) 340 , NEW SITE REPAIR SITE
SYSTEM SPECIFICATIONS: TANK,SIZE i P. GAL. PR)P TAW GAL. TRENCH WIDTH .3 � ROCK DEPTH LINEAR FT.
Lr
OTHERy
REQUIRED SITE MODIFICATIONS/CONDITIONS:
***THIS PERMIT IS SUBJECT TO REVOCATION IF SITE'PLANS•OR THE INTENDED USE CHANGE. YOUR WASTERWATER SYSTEM CONTRACTOR MUST
SEE THIS PERMIT BEFORE INSTALLING THE SYSTEM.
..q eQ Com_
IMPROVEMENT PERMIT BY C:�`�n �`
**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
AUTHORIZATION NO. (')l
SYSTEM INSTALLED BYt^c�
DATE S- 4 - / 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 FRICTION SATISFACTORILY FOR ANY GIVEN PERIOD OF TIME.
DCHD 10/95
Davie County Health Department
ENVIRONMENTAL HEALTH SECTION
P.O. Box 665
Mocksville, N.C. 27028
AUTHORIZATION FOR WASTEWATER SYSTEM CONSTRUCTION
(Issued in compliance with Article 11 of
G.S. Chapter 130A, Wastewater Systems)
***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.***
` AUTHORIZATION NUMBER
NATE Y, s CDATE
NAPE ON IMPROVEMENT PERMIT (If different than above) er
SITE LOCATION � ` � -Q Q`\y ?1 ��e hc� . `%�9 o C �� 1�/ Ile
COMMENTS/CONDITIONS ON AUTHORIZATION TO CONSTRUCT WASTEWATER SYSTEM
woll
APPLICATION FOR SITE EVALUATION/IMPROVEMENTS P(�
Davie County Health Department @ L5 ow
Environmental Health Section D
P. O. Box 665 OCT - 9 19.0,57
Mocksville, NC 27028
1. Application/Permit Requested By
�1 /%l7rlS C9� 5'S f
Mailing Address y�S /' �'�%rr ►'c 15 C ra 1 d Home Phone( 910 �-;T'//4
�/ Sc�a f' l� /✓-� - a 7J �- Business PhoneO?10) r-73
2. Name on Permit if Different than Above ����
3. Application for: ❑ General Evaluation ti Septic Tank Installation Permit
4. System to Serve: C -louse ❑ Mobile Home ❑ Place of Public Assembly
❑ Business ❑ Industry
o ❑ Other [I Unknown
5. If house, mobile home: Subdivision `'mss , Section Lot #
❑ Basement/Plumbing
No. of People ❑ Basement/No Plumbing
No. of Bedrooms 3 gil*ashing Machine
No. of Bathrooms .::L- WYDishwasher
Dwelling Dimensions _ ❑ Garbage Disposal
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: t7 Public ❑ Private
8. Property Dimensions 3. 2 de- Sewage Disposal Contractoi
9. Do you anticipate additions/expansion of the facility this sytem is intended to serve?
If yes, what type?
❑ Yes ? No
PROPERTY INFORMATION REQUIRED:
❑ Community
Directions to Property: Tax Office PIN*Z-711-V(
G(` ��lcc>►1 r dS �e •�� - /Y)e rYe lk LA H, R� P.oad Name 17erre l i5 � A%- �•
Box* (if available)
/%;4&lx� a n Me rr�-1 is I -A Ke R6 • /)D ni �
City
�%,v ,,/1; /.� vT ��' � Cir• s 1 p Sf.'`p
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 application.
DATE SIGNATURE
CONSENT FOR SITE EVALUATION TO BE DONE ON ABOVE DESCRIBED PROPERTY
MUST CHECK ONE: ❑ 1. 1 OWN the property.. 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 representative of the Davie C_Qunty Health Department to enter upon above described
property located in Davie County and owned by /E/-- - a,ae
to conduct all testing procedures as necessary to determine said site's suitability for a ground absorption sewage treatment
and disposal system.
i� /c�—
'DATE SIGNATURE
DCHD (1193)
238 d
i9 z ` 18.64 Ac -
f
co.
26.01 AC.
13Ac.
v
(18 AC.
18 AC
E
e
620 m
I x
h
1
297'
, -
2.76
hZ A Cl
I
1 (ZAC.)
�?
�,,
�8 0
� `� 338.58 cjti
t 3 �
i ` I
8
�
co Q ( 6374 ..'
c.7�.
70i
A
x.69 C. U x.63
3.01 3.46Ac.
707.14
-
- .3
�' 95 a "'
m.�iAi✓
_M
I
572
564 948
�, 'o
= oo
338.58
M
19.4
(19.4
-
;
9 Ac. (�AC.) 9
0
1 i
4 Ac
��ti 'b-7.9
��
465.56 i9.37Ac-
i 9.40AC .) I
M• g,
r
u �� .— �' 3.63 Ac. �'
f
60
677.4
�47 A.)
558.96
Q
I's
40"
v9
0L44 120 _ _ _ 37,12 , g
18.01
Q
17
52 .17AC), (2, Ac.)14 61
IO ACs2.OGAcC
(32 -AC.) 1171.04'%C\
'%C,, ?.37Ac.d
171 p
1
CD
4�
I
o
-
I%2 A3' 14.SAc•d
670 a
�9
'OD
594.11
0 9.19. C. —
ca rn 5C 2.92 d'..
,
o I.7Ac.d I_i o D
o - n p
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z
55111
02
"
13.83AC
aP J ,` 7
1479
1233
P T. ?_
J
SERVICE
PHOTOGRAPHY BY s�
INC.
H — 6
H �
ALSTER & ASSOCIATES, /''��
I —6
,I
K 409
COLUMBIA, SOUTH CAROLINA
kROLI NA
29720
DATE
OF PHOTOGRAPHY: MARCH 28, 1976
1 —6
J —,
r DAVIE COUNTY HEALTH DEPARTMENT
Environmental Health Section
Soil/Site Evaluation
NAME ��� DATE EVALUATED
ADDRESS S aC�� PROPERTY SIZE
PROPOSED FACIILTY LOCATION OF SITE
Water Supply: On -Site Well _ Community Public
Evaluation By:C Auger Boring Pit Cut
FACTORS
1
2 3 4
Landscape position
,.5
Slope %
5S — 150
°
HORIZON I DEPTH
Texture group
Consistence
Structure
C
MineralogX'
HORIZON II DEPTH
»
>
Texture group�.
Consistence
yr
Structure
Mineralogy;l
l
HORIZON III DEPTH
Texture group
Consistence
Structure
Mineralogy
HORIZON IV DEPTH
Texture group
Consistence
Structure
Mineralogy
SOIL WETNESS
SS
Ss
RESTRICTIVE HORIZON
�-
SAPROLITE
CLASSIFICATION
LONG-TERM ACCEPTANCE RATE
SITE CLASSIFICATION: S EVALUATED BY:
LONG-TERM ACCEPTANCE RATE: 114 OTHER(S) PRESENT: � h+
REMARKS: Zai. C 1 \11•\ � _��� �
LEGEND
Landscave 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- V ----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
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
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