411 Mr Henry RdDavie County, NC Tax Parcel Report 12 K0 Friday, September 30, 2016
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WARNING: THIS IS NOT A SURVEY
Parcel Information
Parcel Number: K30000000308 Township: Calahaln
NCPIN Number:
5717515197
Municipality:
Account Number:
36192000
Census Tract:
37059-801
Listed Owner 1:
HOFFMAN JEFFREY L
Voting Precinct:
SOUTH CALAHALN
Mailing Address 1:
411 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:
.977 AC MR HENRY RD
Fire Response District:
SCOTCH - IRISH
Assessed Acreage:
0.96
Elementary School Zone:
COOLEEMEE
Deed Date:
7/1999
Middle School Zone:
SOUTH DAVIE
Deed Book / Page:
003080126
Soil Types:
GnB2
Plat Book:
Flood Zone:
Plat Page:
Watershed Overlay:
DAVIE COUNTY
Building Value:
108310.00
Outbuilding & Extra
Freatures Value:
6190.00
Land Value:
18430.00
Total Market Value:
132930.00
Total Assessed Value:
132930.00
C�pUx�i
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 4
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.
UTHORIZATION NO: 1 2 0 D DAVIE COUNTY HEALTH DEPARTMENT Z' 3o
Environmental Health Section PROPERTY INFORMATION
Piltee' , . P.O. Box 848
Name: 1 Mocksville, NC 27028 Subdivision Name:
Phone #: 704-634-8760
Directions to property: ✓� /� t �'�% Section: Lot:
.� AUTHORIZATION FOR
WASTEWATER
SYSTEM CONSTRUCTION Tax O f ce PI
" `
Road la ���r « c-41 ,- r Q
p•
**NOTE** This Authorization for Wastewater System Construction MUST BE ISSUED by the Davie County Environmental Health Section prior
to issuance of any Building Pen -nits. This Form/Authorization Number should be presented to the Davie County Building Inspections
Office when applying for Building Permits.
(In compliance with Article 11 of G.S. Chapter 130A, Wastewater Systems, Section .1900 Sewage Treatment and Disposal Systems)
//., ***NOTICE*** THIS AUTHORIZATION FOR WASTEWATER CONSTRUCTION
1�Z' IS VALID FOR A PERIOD OF FIVE YEARS.
ENVIRONMENTAL HEALtfi SPECIALIST DATE ISSUED
t
J# , 0 0 DAVIE COUNTY HEALTH DEPA TMENT =�
IMPROVEMENT AND OPERATION: RMf`fS PROPERTY INFORMATION
Name =� tYY�?' c,�„�;,,;;,.,, T.r".,P•
Directions to property:�'-
Section: Lot:
IMPROVEMENT
PERMIT Tax Office PhA �
J
/
/
ieA
�'�"�.'. �.u'»L'Jr'/ �'� C�..... load `ame•,%`,��.��•y�f/+d`�%� f4'�Ip: •r.="e d,^I -�
**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)
/ ***NOTICE*** THIS PERMIT IS SUBJECT TO REVOCATION IF SITE
. ! 'r��^ ! ✓; `' 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 1/ # BEDROOMS, ---7 # BATHS -2 # OCCUPANTS GARBAGE DISPOSAL: Yes or No
COMMERCIAL SPECIFICATION: FACILITY TYPE # PEOPLE # PEOPLE/SHIFT # SEATS INDUSTRIAL WASTE: Yes or No
t
LOT SIZE 1 TYPE WATER SUPPLY G'✓�DESIGN WASTEWATER FLOW (GPD) _ i l., � NEW SITE L% REPAIR SITE
SYSTEM SPECIFICATIONS: TANK SIZE GAL. PUMP TANK GAL. TRENCH WIDTH i� ROCK DEPTH LINEAR FF - 30 `
OTHER
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 ,
*b SYSTEM INSTALLED BY:.. 1M..�1.n'/ 'Fwty.a&
40
r LIniG`nlnT � 1
qa a r i"!; pex
80 -rAA)4 04)'C y.
000sc
AUTHORIZATION • • OPERATION PERMrr BY:
.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)
APPLICATION FOR SITE EVALUATIONAMPROVEMENT
' Davie County Health Department
Environmental Health Section
P.O. Box 848
Mocksville, NC 27028
(704) 634-8760
****IMPORTANT**** THIS APPLICATION CANNOT BE PROCESSED UNLESS ALL
THE REQUIRED INFORMATION IS PROVIDED.
1. Name to be Billed �i'�P N.tli�'4/ o �V Contact Person r�?t /�ivi�i ti9T`oy
Mailing Address yS�e �a,t�+rla.yd Ro% Home Phone
City/State/Zip ewfxv�tlls .4-14e, -'z 70.78 Business Phone
2. Name on Permit/ATC if Different than Above
Mailing Address
City/State/Zip
3. Application For: b] Site Evaluation [ ] Improvement Permit & ATC [Both I(
4. System to Serve: P] House [ ] Mobile Home [ ] Business [ ] Industry [ ] Other
5. If Residence: # People # Bedrooms _ # Bathrooms.;_ W Dishwasher [ ] Garbage Disposal
.PS] Washing Machine [ ] Basement/Plumbing [ ] Basement/No Plumbing
6. If Business/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 [X] Well [ ] Community
8. Do you anticipate additions or expansions of the facility this system is intended to serve? [ ] Yes X No
If yes, what type?
EITHER A PLAT OR SITE PLAN
PROPERTY INFORMATION REQUIRED: *** IMPORTANT **'g4Y Uff OF THE PROPERTY MUST BE
SUBMITTED WITH THIS APPLICATION.
Property Dimensions: f 7 3 X 3� .1[ //* 'WRITE DIRECTIONS (from Mocksville) TO PROPERTY:
Tax Office PIN: # ✓477!7 - S - 57 r, d 1" Ghee 441
Property Address: Road ame 14a 1 iza l /5)4 La7-
City/Zip /L:OClCftlirlIL g70� 8' a �t/ /�f �- ccf'7��11! By e&I�i
If in Subdivision provide information, as follows: Ckd[ry l /za.
Name:
Section: '
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 / 'Y�'�G�t e —Y -*N 1 —Y-No1�%� to conduct all testing procedures as necessary to determine the site suitability.
DATE l ! ' / SIGNATURE --2'—,6* /....tom•-�r�-sem
Revised DCHD (06-96)
THIS AREA MAY BE USEb FOR 1)RAlVINC YOUR SITE PLAN:
DAVIE COUNTY HEALTH DEPARTMENT
Environmental Health Section SECTION LOT
Soil/Site Evaluation
APPLICANT'S NAME DATE EVALUATED
PROPOSED FACILITY 1!4z PROPERTY SIZE -?1�,/�C'
SUBDIVISION
Water Supply: On -Site Well
Evaluation By: Auger Boring
ROAD NAME or
Community
Pit -�
Public
Cut
FACTORS
1
2 3 4 5 6 7
Landscape position
Slope %
HORIZON I DEPTH
Texture group
Consistence
Structure
Mineralogy
HORIZON II DEPTH
f—
r
Texture group
C
Consistence
Structure
. T
STIT—
Mineralo
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
SITE CLASSIFICATION: EVALUATION BY: "J&2_4
LONG-TERM ACCEPTANCE RATE: l OTHER(S) PRESENT:
REMARKS:
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 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
DCHD (01-90)
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-- ._._.� Lot 2
CRs
Part of Tax Lot 3.06
,5� 1.177 Acres +/- r
-A6 s\ o�
PP/7r1e. Ped.
T -Bar w/cap ` Lot 1
1- Part of Tax Lot 3.06
1.108 Acres +/-
NOS°S� O `Y
Tax Lot 58.05 f
Tax Map K-2 F8f tt
n/f Vera Call Koontz Ijomes +ii•
OB 183 O PG 851 '
Tie line
'Y
S 25.09'05"E 984.41'
"K -Nail Set
r/- S.R. 1143 de
S.R. 1144
IRS
Tax Lot 3.01
Tax Map K-3
n/f Wayne M. Waller, Sr.
and Wife Mary T. Waller
DB 198 O PG 760
I le
`► SOS°� Gas
369 O?S,
Tax Lot
^ lox Map
3IRS � Maly U. Pe
3 OB 200 O
v`� n Tie I
\ y `� 313.
Bar w/cap N � 9
�S E
" _T_Bar w/cap
Mr. Henry Road S.R. 1143
60' Public R/W 20'+/- Pavement
o°,s",w,nnm
CAR
Q`
"•a
d+t� i
p \STF4r '4
I declare at n F11
we survey}d Uts PrQP32showit or@
s
this plat: s old 1,�Q_r ti?
lo N OsNe
?810.
J, 3 f
.ie.
I Tax Lot 60
0 Tax Map K-2
n/f Fred Ellis Cart-
and Wife
Ola K. Cartner
D6 57 0 PG 181,
Plot Revision: 2-12-98 y M
Adjoining Property Information Correction
for Tax Lot 58.05, Map K-2
LEGEND
/w - RigM-of-way
.P - Esistinq kon Pip•
e«eiil•
- C t tine
Ed9a Pavement
(L
-�i
IR - Evistinq kan Retbar
'
EP - of
FC -Fou of Curb
`
-Poet
U - tld�wn•nt
PP - P�"er Pd°
tt�1�aaaahnnl Pd°
1#let
RS - Iren Retar Set 1/TM_
�/ L - Proarly Lim
RoOw°
—Chord Distoncs
M
: A - Controlled Access
P 0 Port of
tCP - Resdorced Concrete Pipe
- SigM Easement
:up - Cortugated Yetd Pip•
OB - Oaed Book
;PP - Compotoa =Pipe
Pe - Plot Book
CO - Catch Basin
-F- 100 year Flood Boundory
FP -�mce Post
0- Ove Mod UELties
-z- Fence
S- '« l
BoC - k of Curb
IRS
Tax Lot 3.01
Tax Map K-3
n/f Wayne M. Waller, Sr.
and Wife Mary T. Waller
DB 198 O PG 760
I le
`► SOS°� Gas
369 O?S,
Tax Lot
^ lox Map
3IRS � Maly U. Pe
3 OB 200 O
v`� n Tie I
\ y `� 313.
Bar w/cap N � 9
�S E
" _T_Bar w/cap
Mr. Henry Road S.R. 1143
60' Public R/W 20'+/- Pavement
o°,s",w,nnm
CAR
Q`
"•a
d+t� i
p \STF4r '4
I declare at n F11
we survey}d Uts PrQP32showit or@
s
this plat: s old 1,�Q_r ti?
lo N OsNe
?810.
J, 3 f
.ie.
I Tax Lot 60
0 Tax Map K-2
n/f Fred Ellis Cart-
and Wife
Ola K. Cartner
D6 57 0 PG 181,
Plot Revision: 2-12-98 y M
Adjoining Property Information Correction
for Tax Lot 58.05, Map K-2
r
APPLICATION FOR SITE EVALUATIONAMPROVEMENT PEI T & ATC
.. Davie County Health Department M � [E 0 1v% ls
Environmental Health Section -
P.O. Box 848 JAN 2 71 2'
Mocksville, NC 27028
(704) 634-8760
****IMPORTANT**** THIS APPLICATION CANNOT BE PROCESSED UNLESS ALL
THE REQUIRED INFORMATION IS PROVIDED.
1. Name to be Billed J i tv, �L Yl I� i t3 d f h/
Mailing AddressL5:0—r '*l
City/State/Zip t--120 C-�i S le I A YVG
2. Name on Permit/ATC if Different than Above
Mailing Address
3. Application For: D Site Evaluatio
4. System to Serve: 1' House [ ]
5. If Residence: # People
Contact Person
Home Phone ��� — �a T
Business Phone
City/State/Zip
n [ ] Improvement Permit & ATC [ ] Both
Mobile Home [ ] Business [ ] Industry [ ] Other
# Bedrooms # Bathrooms !P� ;:] Dishwasher [ ] Garbage Disposal
[ ] Washing Machine [ ] Basement/Plumbing Qq Basement/No Plumbing
6. If Business/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
8. Do you anticipate additions or expansions of the facility this system is intended to serve? [ ] Yes [ ] No
If yes, what type?
EITHER A PLAT OR SITE PLAN
PROPERTY INFORMATION REQUIRED: *** IMPORTANT ***XSY.IHMV OF THE PROPERTY MUST BE
SUBMITTED WITH THIS APPLICATION.
Property Dimensions: - WRITE DIRECTIONS (from Mocksville) TO PROPERTY:
Tax Office PIN: #5717 - S - '��
Property Address: Road
City/ ip C��1 �/L ,c ®7�� d N tCi'7e Lf%`
If in Subdivision provide information, as follows: i ' d 24S dN M&
Name: ;
Section: Lot #:
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 to con uct all t ting proced es as necessary to determine the site suitability.
DATE SIGNATURE /- —� � � � \
.amu
Revised DCHD (06-96)
THIS AREA MAY BE USEb FOR bRAWINC7 YOUR SITE PLA14:
IN
6k(' \
m
DAVIE COUNTY HEALTH DEPARTMENT
Environmental Health Section SECTION LOT
Soil/Site Evaluation
APPLICANT'S NAME` " i DATE EVALUATED � /%�Y�
PROPOSED FACILITY PROPERTY SIZE -JI9 /Z 2:
SUBDIVISION ROAD NAME
Water Supply: On -Site Well Community Public
Evaluation By: Auger Boring C/ Pit Cut
FACTORS 1 2 3 4 5 6 7
Landscape position
Sloe %
HORIZON I DEPTH
Texture group
Consistence
Structure
Mineralogy
HORIZON II DEPTH
Texture group
Consistence /
Structure /
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
SITE CLASSIFICATION: cc
LONG-TERM ACCEPTANCE RATE:
REMARKS:
DCHD (01-90)
EVALUATION BY: I/yia //
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 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
i
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Davie County Heafth Department
and Come Health .agency
Environmental Health Section
P.O. Box 848 / 210 HOSPITAL STREET
COMER #09-4-06
MOCKSVILLE, N.C. 27028
PHONE: (704) 634-8760
February 12, 1998
Tim Pennington
450 Farmland Rd.
Mocksville, HC 27028
Re: Site Evaluation/2.1 Acres
Mr. Henry b Byerly Chapel Rds.
Tax PIH: #5717-51-5283 (Site 2)
Dear Client(s):
As requested, a representative from this office visited the
aforementioned site on February 11, 1998. Based upon the information
provided on the application for site evaluation and after the evaluation
was completed, the site was found to be provisionally suitable installation of
an on-site sewage disposal system.
If you have any questions, please feel free to contact this office.
Sincerely,
16_6ylod4l 4
Robert B. Hall, Jr., R.S.
Environmental Health Specialist
RH/vd
Enclosure(s)
cc: Zoning Office