178 Midway DrDavie County, NC
Tax Parcel Renort ) :1l 1 Friday. September 30. 2016
WA"11NU: '1'H1S 1S NUII' A SURVEY
- Parcel Information
Parcel Number: K10000000502 Township: Calahaln
NCPIN Number: 4797453303 Municipality:
Account Number:
53832180
Census Tract:
37059-801
Listed Owner 1:
NEUMANN MARY LEE M
Voting Precinct:
SOUTH CALAHALN
Mailing Address 1:
178 MIDWAY DRIVE
Planning Jurisdiction:
Davie County
City: STATESVILLE
Zoning Class:
DAVIE COUNTY R -A
State:
NC
Zoning Overlay:
Zip Code:
28625-0000
Voluntary Ag. District:
Legal Description:
0.154 AC MIDWAY DR
Fire Response District:
COUNTY LINE
Assessed Acreage:
0.15
Elementary School Zone:
COOLEEMEE
Deed Date:
7/1985
Middle School Zone:
SOUTH DAVIE
Deed Book / Page:
001270592
Soil Types:
Ce62
Plat Book:
Flood Zone:
Plat Page:
Watershed Overlay:
DAVIE COUNTY
No
Building Value: 0.00 Outbuilding & Extra 0.00
Freatures Value:
Land Value: 2890.00 Total Market Value: 2890.00
Total Assessed Value: 2890.00
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 the
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County of Davie, North Carolina, Its agents, consultants, contractors or employees from any and all claims or causes of action due to
or the Inability to the GIS data by this
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arising out of use or use provided website.
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AU60RI ,ATION NO: 1599 DAVIE COUNTY HEALTH DEPARTMENT
,Environmental Health Section
Permitfee's P.O. Box 848
PROPERTY INFORMATION
Ndme:`f t e'� ✓`'.+//f""!� Mocksville, NC 27028 Subdivision Name:
Phone # 336-751-8760
Directions toproperty: `� fc� �r ,��'"c"{ Section: Lot:
AUTHORIZATION FOR
r' . WASTEWATER .�' n
SYSTEM CONSTRUCTION Tax Office P N:# /' %
e
`^ 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 Permits.
(In compliance with Article l l of G.S. Chapter 130A, Wastewater Systems, Section .1900 Sewage Treatment and Disposal Systems)
.—, ***NOTICE*** THIS AUTHORIZATION FOR WASTEWATER CONSTRUCTION
'r;%^,l, .:'C�'r i %_ � ✓.lam r , " IS VALID FOR A PERIOD OF FIVE YEARS.
AL HEALTA SPECIALIST DATE ISSUED
, . k• , .. .. ,;.r :;E � �Y. `, .,".' c,r I' r n � ♦y� ''i tia 't` ... .. z 1. .. ,
DAVIE of OU iTY HEALTH DEPARTMENT
IMPROVEMENT AND OPERATION fEIf�*S PROPERTY INFORMATION
Perin ee s
Name 9/Zig, za, AlLw4rul-01 Subdivision Name:
Directions to property: �. �' , - :'� Section: Lot:
IMPROVEMENT _
PERMIT Tax Office PIN#—
#�
wetm ,J'='
Road Name: 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 11 of G.S. Chapter 130A, Wastewater Systems, Section .1900 Sewage Treatment and Disposal Systems)
r•. "ii ' � ...tom ef'`�! i�f� �:
ENVIRONMENTAL HEALTH SPECIALIST DATE ISSUED
***NOTICE*** THIS PERMIT IS SUBJECT TO REVOCATION IF SITE
PLANS OR THE INTENDED USE CHANGE. YOUR WASTEWATER
SYSTEM CONTRACTOR MUST SEE THIS PERMIT BEFORE
INSTALLING THE SYSTEM.
RESIDENTIAL SPECIFICATION: BUILDING TYPE _ / # BEDROOMS -Y # BATHS 4_ # OCCUPANTS / GARBAGE DISPOSAL: Yes or No
COMMERCIAL SPECIFICATION: FACILITY TYPE # PEOPLE # PEOPLE/SHIFT / # SEATS INDUSTRIAL WASTE: Yes or No
LOT SIZE FA C TYPE WATER SUPPLY �� �� DESIGN WASTEWATER FLOW (GPD) �G^ NEW SITE REPAIR SITE
SYSTEM SPECIFICATIONS: TANK SIZE PIN) GAL. PUMP TANK GAL: TRENCH WIDTH Jl ' ROCK DEPTH Ion / LINEAR FT. fir!)/
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 (336)751-8760.
OPERATION PERMITl IOU -7Pac4-1r 1 LACAa{.
SYSTEM INSTALLED BY:
Z.Z33UQ
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7S-1 =crrz-t"
N Z.
Roa5,5—o
(Nor rayl S►ro'
F2oa r
AUTHORIZATION NO. ` OPERATION PERMIT BY: :3 �" �y DATE:
"THE ISSUANCE OF THIS OPERATION PERMIT SHALL INDICA 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 03/96 (Revised)
'
. s APPLICATION FOR SITE EVALUATION/IMPROVEMENT PERMIT CR B R t
Davie County Health Department
Environmental Health Section �1'r
P.O. Box 848/210 Hospital Street ALIG 1 3 1998
Mocksville, NC 27028
(336) 751-8760 F1JV1RnNP!V1TA1 urwrij
I ***IMPORTANT*** THIS APPLICATION CANNOT BE PROCESSED UNLESS ALL THE REQUIRED I
INFORMATION IS PROVIDED. Refer to the INFORMATION BULLETIN for instructions. i
1. Name to be Billed
Mailing Address
0" G42 U / I11W . Contact Person
(/I,/ t(_. �`K U Home Phone
City/State/ZIP Jrly(ii(.51%�i /N -Cf Z�Oz � Business Phone P , /3fs—
2. Name on Permit/ATC if Different than
�e
AbovT I�
Mailing Address /)I
(,V
3. Application For: 4ite Evaluation
4. system to service: Ih: House ❑ Mobile Home
5. If Residence: /# People
City/State/Zip
❑ Improvement Permit/ATC ❑ Both
❑ Business ❑ Industry ❑ Other
# Bedrooms 3 # Bathroomsy
❑ Dishwasher ❑ Garbage Disposal ❑ Washing Machine ❑ Basement/Plumbing ❑ Basement/No Plumbing
6. If Business/Industry/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
a. Do you anticipate additions or expansions of the facility this system is intended to serve? ❑ Yes ❑ No
If yes, what type?
***IMPORTANT*** CLIENTS MUST COAiPLETE THE REQUIRED PROPERTY INFORMATION REQUESTED
BELOW. Either a PLAT or SITE PLAN MUST BE SUBMITTED by the client with THIS APPLICATION.
Property Dimensions: 3 • Ncgtt2
Tax Office PIN: # Y797- z/ -S - 3.3-03 Q
Property Address: Road Name 5t� `'J I i I O
1 *7�f w O
City/Zip KO, -k!5 4. C
If in a Subdivision provide information, as follows:
Name:
Section: Block: Lot:
WRITE DIRECTIONS (from Mocksville) to PROPERTY:
41 (o�� : 6p'-1— 1 QZ. — & ¢— tJ .
/� —C44IW � Z
CA I�'l+elway C un aw�b ` Ttt*ue L � 41--
V V
(0— CAA&✓C
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 De artment
to enter upon above described property located in Davie County and owned by
to conduct all testing procedures as necessary to determine the site suiti ty.
�.
DATE S " - / 3 — � S SIGNATURE od
THIS AREA MAY BE USED FOR DRAWING YOUR SITE PLAN:
Revised DCHD (07/98)
Account No.
Invoice No. ��
TUTTEROW SUP.VMNO CO.
P.09,.F 6 'O ! 1?9 r
MOC'KSVIU.r '� AI)
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IWTELEDY4NATIONAL NO. 183A -17X22
NIP
p9 O 53 50 c
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EIP= Existing iron
pino
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NIP= New iron pin
-Ap
S 10 5g
440
-► EIP
R/R = Railroad spike
<
0
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R/W = Right of way
monument
-
3 V'
- DB
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point in Center
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AREA= 3.000
ACRES
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AREA INCLUDES S. R. 1178
R/W 0
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DAV I E CO-
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/ N 19 13' 24" w
N 190 13' 24" W
78.60
125.00
2
N 460 37' 26" E _1
30.76 EI
TUTTEROW SUP.VMNO CO.
P.09,.F 6 'O ! 1?9 r
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IWTELEDY4NATIONAL NO. 183A -17X22
DAVIE COUNTY HEALTH DEPARTMENT
Environmental Health Section
Soil/Site Evaluation
APPLICANT'S NAME 1V10 rmRa/
PROPOSED FACILITY
SUBDIVISION
Water Supply:
Evaluation By
On -Site Well Community
Auger Boring f/ Pit
SECTION LOT,
DATE EVALUATED 19' �; 2% WL
PROPERTY SIZE -The
ROAD NAME %I79
Public
Cut
FACTORS
1 2 3 4 5 6 7
Landscape position
L
Sloe %
HORIZON I DEPTH
Texture group
Consistence
Structure
Mineralogy
HORIZON II DEPTH
Texture group
Consistence
✓
Structure
I /
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
i
SITE CLASSIFICATION:
LONG-TERM ACCEPTANCE RATE:
REMARKS:
LEGEND
DCHD (01-90)
Landscape Position
EVALUATION BY: A
OTHER(S) PRESENT:
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
Mineralog
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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