271 Mr Henry RdDavie -County, NC
S
Tax Parcel Report d ',� OSI Fridav, September 30, 2016
WAK1V11VG: lH1J 1S iNUl' A NUKVLY
Parcel Information
Parcel Number:
K30000000106
Township:
Calahaln
NCPIN Number:
5717521651
Municipality:
Account Number:
5190310
Census Tract:
37059-801
Listed Owner 1:
BAYSINGER THOMAS BRIAN
Voting Precinct:
SOUTH CALAHALN
Mailing Address 1:
271 MR HENRY ROAD
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:
10.00 AC MR HENRY RD
Fire Response District:
COUNTY LINE
Assessed Acreage:
9.89
Elementary School Zone:
COOLEEMEE
Deed Date:
1/1997
Middle School Zone:
SOUTH DAVIE
Deed Book I Page:
001920520
Soil Types: GnB2,EnB,MsC,MsD
Plat Book:
Flood Zone:
Plat Page:
Watershed Overlay:
DAVIE COUNTY
Building Value:
175190.00
Outbuilding & Extra
Freatures Value:
1110.00
Land Value:
67990.00
Total Market Value:
244290.00
Total Assessed Value:
244290.00
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.
" 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
LOCATION
SUBDIVISION NAME
PROPERTY ADDRESS Mg. Pt'l rll Pd. DATE
LOT NUMBER
SEC./BLOCK NUMBER
RESIDENTAL SPECIFICATION: BUILDING TYPE ��� # BEDROOMS # BATHS --9 # OCCUPANTS GARBAGE DISPOSAL: Yes/,
VX0
COMMERCIAL SPECIFICATION: FACILITY TYPE # PEOPLE # PEOPLE/SHIFT # SEATS INDUSTRIAL WASTE: Yes/No
LOT SIZE 2211C TYPE WATER SUPPLY DESIGN WASTEWATER FLOW (GPD) NEW SITE !/ REPAIR SITE
i
SYSTEM SPECIFICATIONS: TANK SIZE , GAL. PUMP TANK GAL. TRENCH WIDTH ROCK DEPTH _ � LINEAR FT. fWe
OTHER V_/ Ara.- .- r
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.
r -
IMPROVEMENT PERMIT BY Aln,
**CONTACT A REPRESENTATIVE OF THE DAVIE CITY 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) 634-6760.
OPERATION PERMIT
AUTHORIZATION NO. 0 3 OJ)
**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 10/95
tic
Davie County Health Department
ENVIRONMENTAL HEALTH SECTION
r P.D. Box 665
Mocksville, N.C. 27028
J�
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 NMER
NAMEl'i �? DATE
NAME dN IMPROVEMENT PERMIT (If different than above)
SITE LOCATION
COMMENTS/CONDITIONS ON AUTHORIZATION TO CONSTRUCT WASTEWATER SYSTEM
***NOTICE*** THIS AUTHORIZATION FOR WASTEWATER SYSTEM CONSTRUCTION IS VALID FOR A PERIOD OF FIVE (5) YEARS.
ENVIRONMENTAL HEAL CIALIST DATE
DCHD 10/95
APPLICATION FOR SITE EVALUATION/IMPROVEMENTS
Davie County Health Department
Environmental Health Section
P. O. Box 665
Mocksville, NC 27028
1. Application/Permit Requested By
Mailing Address
Woo
2. Name on Permit if Different than Above
3. Application for: {
4. System to Serve: 9" ouse
❑ Business ❑ Industry
5. If house, mobile home: Subdivision
No. of People
No. of Bedrooms 11
No. of Bathrooms
Dwelling Dimensions ) ✓ `f'
�bsy
al Evaluations`
❑ Mobile Home
❑ 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
7. Type of water supply: ❑ Public
No. of Sinks
No. of Urinals
dAPR (19°„
Home Phone 1 ?Oq )
Business Phone(70) i -7S '01f II.
Tank Installation Permit
No. of Water Coolers
Water Usage Figures
rivate
8. Property Dimensions 10 Ac. Sewage Disposal Contractor
9. Do you anticipate additions/expansion of the facility this sytem is intended to serve?
If yes, what type?
❑ Place of Public Assembly
❑ Unknown
Section Lot #
❑ Yes
❑ Basement/Plumbing
M,19Ba�asement/No Plumbing
Ei? ashing Machine
Dishwasher
❑ Garbage Disposal
❑ Community
'NOTE: Improvements Permits shall be valid from date issued. Improvements Permits are subject to
revocation, if site plans or the intended use change. Effective October 1, 1989.
Directions to Property: %
D'n'Vie-
PROPERTY
INFORMATION REQUIRED:
Tax Office PIN: #5717-5a 1/W
PROPERTY ADDRESS, as follows:
��p2 fill I d Road Name:
M .Q!)
City: ff)0C.
V SUBMIT A PLAT WITH THIS APPLICATION.
Revisions effective October 1, 1995.
This is to certify that the information provided is correct to the best of my wledc
incurred fro thip application.
4%2
DATE
I understand I am responsible for all charges
SIGNATURE
CONSENT FOR SITE EVALUATION TO BE DONE ON ABOVE DESCRIBED PROPERTY
MUST CHECK ONE: ❑ 1. 1 OWN the property. ❑ 2. 1 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 County Health Department to enter upon above described
property located in Davie County and owned by
to conduct all testing procedures as necessary to determine said site's suitabilit for
�a�ground absorption sewage treatment
and disposal ystem
DATE V SIGNATURE
DCHD (1193)
APPLICATION FOR SITE EVALUATION/IMPROVEMENTS PERMIT, M' E OQ9F
Davie County Health Department
Environmental Health Section JUQ 2 cy ; .
U 133
P. O. Box 665
Mocksville, NC 27028 ----
►y
1. Application/Perrr
Mailing Address
Home Phone
2. Name on Permit if Different than Above
3. Application/Permit for:
4. System to Serve:ouse
❑ Business ❑ Industry
5. If house, mobile home: Subdivision
No. of People
No. of Bedrooms
No. of Bathrooms
Dwelling Dimensions
❑ General Evaluation
❑ Mobile Home
❑ 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 NJ Private
8. Property Dimensions - - Z D Sewage Disposal Contractor
IE- Septic Tank Installation
❑ Place of Public Assembly
❑ Unknown
Section Lot #
❑ Basement/Plumbing
❑ Basement/No Plumbing
❑ Washing Machine
❑ Dishwasher
❑ Garbage Disposal
9. Do you anticipate additions/expansion of the facility this sytem is intended to serve? ❑ Yes ❑ No
If yes, what type?
7
❑ 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.
Directions to Prop
bt ka '
� k t
SaA,� - 9
This is to certify that the information provided is correct to the best of my knowledge, and I understand I am
incurred fr/gp_i thisa lic%t'on. �f
y /� IJ
DATE &bNATURE ,
CONSENT FOR SITE EVALUATION TO BE DONE ON ABOVE DESCR�I_BEEDDPROPERTY
MUST CHECK ONE: El 1. 1 OWN the property. 621 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 av' unty He It Departm t to ente-upon above described
property located in Davie County and owned by
to conduct all testing procedures as necessary to determ' e s id i su' ability or a grou bsorption sew ge treatment
and disposal system../
In '" b -9
DATE SIGN TUR
DCHD (12-90)
M
DAVIE COUNTY HEALTH DEPARTMENT
Environmental Health Section
Soil/Site Evaluation
NAME ,�GI'/���✓�P�"'
ADDRESS
PROPOSED FACIILTY
DATE EVALUATEDl.-2
PROPERTY SIZE
LOCATION OF SITE���`'�
Water Supply: On -Site Well // Community Public
Evaluation By: Auger Boring (/ Pit Cut
FACTORS
1
2
3
4
Landscape position
2—
L
4--
2—
Slope Z
l
%
d
HORIZON I DEPTH
Texture group
,r'
Consistence
Structure
MineralogX
HORIZON II DEPTH
.7
Texture group
Consistence
,
Structure
m
Mineralogy
HORIZON III DEPTH
Texture group
Consistence
Structure
Mineralogy
HORIZON IV DEPTH
Texture group
Consistence
Structure
Mineralogy
SOIL WETNESS
RESTRICTIVE HORIZON
SAPROLITE
CLASSIFICATION
*
,t<
LONG-TERM ACCEPTANCE RATEI
e
,
SITE CLASSIFICATION: 4-"5-
✓ y`a -
LONG-TERM ACCEPTANCE RA
REMARKS:
DCHD(01-90)
EVALUATED BY:
OTHER(S) PRESENT:
LEG
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
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
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
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•,' _ Davie Counly Yfealtir Department
and .tome Aeall§i ��yeng
210 HOSPITAL STREET/ P.O. BOX 665
MOCKSVILLE. N.C. 27028
PHONE: (704) 634-5985
July 28, 1993
Brian Baysinger
c/o Howard Realty
330 S. Salisbury St.
Mocksville, HC 27028
Re: Site Evaluation
Mr. Henry Road
Dear Mr. Baysinger:
As requested, a representative from this office visited the aforementioned
site on July 26, 1993. Based upon the information provided on the application
for a site evaluation and after an evaluation was completed, the site was found
to be provisionally suitable for the installation of a modified, oversized on-
site sewage disposal system.
If you have any questions, please feel free to contact this office.
Sincerely,
Robert B. Hall, Jr., R.S.
Environmental Health Section
RH/wd
Enclosure