145 Mocks Church Rd Davie �ounty, NC Tax Parcel Report l,O 0 0� Friday, September 30, 2016
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WAI2NING: THIS IS NOT A SURVEY
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Parcel Information
Parcel Number: F80000000803 Township: Shady Grove
NCPIN Number: 5870784314 Municipality:
Account Number: 56456000 Census Tract: 37059-803
Listed Owner 1: PHELPS CINDY R Voting Precinct: WEST SHADY GROVE
Mailing Address 1: C/O CINDY PHELPS HICKS Planning Jurisdiction: Davie County
City: ADVANCE Zoning Class: DAVIE COUNTY R-A,H-B-S
State: NC Zoning Overlay:
Zip Code: 27006-7618 Voluntary Ag.District: No
Legal Description: 2.68 AC MOCKS CHURCH RD Fire Response District: ADVANCE
Assessed Acreage: 2.68 Elementary School Zone: SHADY GROVE
Deed Date: 3/1989 Middle School Zone: WILLIAM ELLIS
Deed Book/Page: 001470624 Soil Types: Gn62,EnC
Plat Book: Flood Zone:
Plat Page: Watershed Overlay: DAVIE COUNTY
Building Value: 191890.00 Outbuilding&Extra 1370.00
Freatures Value:
Land Value: 48100.00 Total Market Value: 241360.00
Total Assessed Value: 241360.00
9�.ti��, Atl data le provlded aa is without warranry or guarantee of any kind either expressed or Implled Including but not Iimitad to the
Davie County� Implied warranties of inerchantab�iity or fitnesa for a paRlcular use.Ail users of Davie County's GIS webslte shail hold harmless the
County of Davle,North Carolina,Its agents,eonsultants,contractors or employees from any and all clalms or eauses of action due to
nO�,N.�'� NC or arising out of the use or Inability to use the GIS data provided by this website.
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' Davie County Health Departrnent
��i 6j� � Environmental Health Section �
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:; �r ;:: P.O.Box 848 _
'�''� 210 Hospital Sireet ''
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�� �.�, ���, Courier# : 09-40-06 �c���}
� . Mocksville,NC 27028 � � �
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Phone:(336)-753-6780 Fax:(336)-753-1680
ON-SITE WASTEWAT�R CERTIFICATION
(Check One) Replacement Remodeling Reconnection
Name: �A� j l-I u�v � tG U-.1 Phone Number ?j 3� -�`[�s�l�� (Home)
MailingAddress: ��� Ma�,� CI�,iNLCt�� lCcvED -33�-��73��58�"// (Work)
Email Address: �`�t�-�CS�7 Z��� �aCr�e� ,v1�,�
Detailed Directions To Site: /5� '�u gU� 5��7�-( � Pt}S� �f�C,c���(.�- �,�(nJ. �//}37
a� ��-�'� , /�.�ti�-�� a-.,,� ����.c��-s� l�.i c�i�i on� fv�.oeXs C7�v�c� 21J .
��N 02� o� ��Lr— 2cc► �[�
Properiy Address: � Yk� S ��2Ct� 1�Q . �,1/3�J c.� �l C 2�D�(o
Please Fill In The Following Information About The EXISTING Facility:
Name System Installed Under: l,tnlOv/ ��l���S Type Of Facility: ��✓s �
�—
Date System Installed(Month/Date/Year): �'Z��3 Number Of Bedrooms: � Number Of People: �
Tc ThP Farili}v_�nrrentiv Var,ant? Yes (No 1 Tf Yes.For How Lon�?
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Any Known Problems? Yes r N� If Yes,Explain:
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Please Fill In The Following Information About The NEW Facility:
Type Of Facility: G./�2.N�G►C- UN✓�-'r'r/+GE/r�J Nuinber Of Bedrooms:�Number of People�
Pool Size: Garage Size: � �.� Other:
Re uested By: �
q �iLc� Date Requested: �-/7-ZO!S
(Signature) �
For Environmental Health Office Use Only
Approved Disapproved
Comments:
. ,
Environrnenta.l Health Specialist Date: �� ��,� `l
*The signing of this form by the Environmental Health Staff is in no way intended,nor should be talcen as a guarantee
(extended or linnited)that the on-site wastewater system will function properly for any given period of time.
Payment: Cash Check Money Order # Amount:$ Date:
Paid By: Received By:
Account#: ��{���,(�°I Invoice#:
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s� Printed:Apr 17, 2015
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 inerchantability or fitness for a particular use. All users of Davie County's GIS website shali hold harmless the County of Davie,
North Carolina,its agents,consuitants,contractors or empioyees 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.
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`"�� ��"" .� - DAVIE COUNTY HEALTH DEPARTMENT
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._ -;�-. IMPROVEMENTS PERMIT AND CERTIFICATE OF COMPLETION
'NOTE�Issued in Compliance With Article I I of G S,j Chapter 130a ^
, �F` ,. , W f J j� Permit�Nu��er
Sanita.ry Sewage Systems,,, , �f M ,��'�� ��< � �f{ �� ,
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Location'� � —
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Subdivision Name Lot No. Sec. or Block No. •
,�'1 r��c:: �-„"
Lot Size `'"J' �, House � Mobile Home _r Business Speculation
No. Bedrooms .No. Baths � No. in Family _
,�''
Garbage Disposal YES NO ❑ Specifications for System: � .
Auto Dish Washer YES F NO ❑ �',G%t`%,>,;..�'�:�..�+;' �'�-,`-'"'%°
Auto Wash Ma;hine YES NO ❑ t� �;�;� �:�° , ,�" ;,
�..5"l.-;�.',.t�,�/.��
Type Water Supply ___
*This permit Void if sewage system described below is not installed within 5 years from date of issue.
This permit is subject to revocation if site plans or the intended use change.
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Improvements permit by -- —
'Coniact 2 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 day of completion. Telephone Number 704-634-5985.
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Final Installation Diagram: � System Installed by _�-'�� '�'��� 'S' r�'' '�
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Certificate of Completion f� f Date 7�-^�/��.?
•The signing of this certificate shall indicate that the system described above has been installed in compliance with
the standards set forth in the above regulation, but shall in NO way be taken as a guarantee that the system will function
satisfactorily for any given period of time.
. � APPLICATION FOR SITE EVALUATION/IMPROVEMENTS P RMIT
, . � Davie County Health Department
'' Environmontal Hoalth Soction
P. 0. Box 665 �� � `- �'�az
� �" Mock$ville, NC 27028
� � y . S DAVIECOUIS�.t i��„���; ;�P�f'T.
1 . Application/Permit Reque�ted By � ,
Mailinq Address � �. ��� �C ,`� L..'�C' "\ � _ \^C'e,
Home Phone -4 - �i�� � Business Phon� �����OL L
2. Name on Permit if Different than Above
3. Property Owner if Different than Above
4. Application/Permit For: � General Evaluation � S/Tank Installat�ion
5. System to Serve: [�Hause � Mabile Home � Business
� Industi•y u Other � Unknown
6. If house, mobile home: Subdivision 5ec. Lot�
No. of People � _ Dwellinc� Dimensions
No. of B�droom� � Fsasement/l�lumbing
Na. of Bathrooms �. Z �Basement/No Plumbiny
(� Washing Machine �Uishwasher � Garbage Gaspusal
7. If business, industry, other: Specify type
No. of People Served No. of Sinks
No. of Commodes No. of Urinals
No. of Lavatories Na. of Watar G�alers
No. of Showers
8. Type of water supply : V Public � Frivate � Communir.y
9. Property Dimensions ��.�+�v l�Z �. `���• `��, \ )
10. Sewage Disposal Contractoi�
11 . Do you anticipate additions/expan�ions of the facility this system is
intended to serva? G Yes � Na
If yes, what ty}�e?
�►NOTEs Itaprovemente Permlta shall be valid for A period ot 5
. years from date issued. Improvements Permits are subject
to revocation, if site plane or the intended use chanqe .
Effective October 1, 1989.
This is to cer•tify tnat tne informatior� provided is correct to tr�e
bast of my knowledqa, and I understand I am rE:sponsibla fc�r all
charges incurred from tt��is applicatian.
�.��.a \� �°��i� ' c . �
Uate Sign ture
Uir�ctions ta PropQrty :
��-�,U �� � �U� �+''��-� • ��.�i�l � ��� �, \ '`���`li�su..� C'�iC�,
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�1�.a.� `��.s� C�� Oa� �'�Y ��� ����C�.�s?.
DCHD (10-89)
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-f � -� DAVIE COUNTY HEALTH DEPARTMENT
,. - , -
' Environmental Health Section
Soil/Site Evaluation
NAME �/L P /�S' DATE EVALUATED �;��y� ""'�
ADDRESS PROPERTY SIZE ��i
PROPOSED FACIILTY -,/��/��� LOCATION OF SaTE
Water Supply: On-Site Well Community Public �
Evaluation By: AugerB�ring � Pit Cut
FACTORS 1 2 3 4
Landsca e osition L L �C .0
Slo e 7. -- — — —
HORIZON I DEPTH
Texture rou
Consistence
Structure
Mineralo
HORIZON II DEPTH �� S'`" �S'�'r �i�r'"
Texture rou �
Consistence i
Structure � S.,c� ,G S
Mineralo ,'i ,�! �
HORIZON III DEPTH
Texture rou
Consistence
Structure
Mineralo
HORIZON IV DEPTH
Texture rou
Consistence
Structure
Mineralo
SOIL WETNESS
RESTRICTIVE HORIZON
SAPROLITE
CLaSSIFICATION
LONG-TERM ACCEPTANCE RATE , � c
SITE CLASSIFICATION: P � EVALUATED BY: __ _ 174�
LONG-TERM ACCEPTANCE RATE: _� OTHER(S) PRESENT:
REMAR KS:
LEGEND
Lnndscnpe Position
R-Ridge S-Shoulder L-Linear slope FS-Foot slope N-Nose slope
• CC-Concave slope CV-Convex slope T-Tenace 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
Structurc
SC-Single grain M-Massive CR-Crumb GR-Granular ABK-Angular blocky
SBK-Subangularblocky PL-Platy PR-Prismatic
TJlincraloKy
1:1, 2:1, Mixed
Notes
fiorizon depth - In inches
Depth of fill - 1n inches
Restrictive horizon - Thickness and inches from land surface
Saprolite - S(suitable), U(unsuitable)
Soil wetness - Inches from land surface to free watet 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/ftz
DCHD(01-901
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