253 Nolley Rd Davie County,NC Tax Parcel Report Thursday, December 15, 2016
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=' WARNING: THIS IS NOT A SURVEY
Parc
- el Information
Parcel Number: -.;M400000078 Township: Jerusalem
NCPIN Number: 5736409021 Municipality:
Account Number: --82519941 Census Tract: 37059-807
Listed Owner9: SAWS LP Voting Precinct: COOLEEMEE
Mailing Address-1: PO-BOX 738 Planning Jurisdiction: Davie County
City:,- ; COOLEEMEE"=- Zoning Class: DAVIE COUNTY R-A
State: __. NC Zoning Overlay: DAVIE COUNTY CZOD
Zip Code:_ 27014-0000 Voluntary Ag.District: No
Legal Description:`- _ LOT 19 WILDWOOD' Fire Response District: COOLEEMEE
Assessed Acreage: 0.46Elementary School Zone: COOLEEMEE
Deed Date: - ._ _9/2003 Middle School Zone: SOUTH DAVIE
Deed Book/Page: 005120351 Soil Types: PcC2,CeB2
Plat Book: Flood Zone:
Plat Page: Watershed Overlay: DAVIE COUNTY
Building Value: Outbuilding&Extra
Freatures Value:
Land Value: Total Market Value:
Total Assessed Value:
All data is provided as Is without warranty or guarantee of any kind either expressed or implied Including but not limited to the
Davie County, 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
�OUp1'� NC or arising out of the use or Inability to use the GIS data provided by this website.
DAVIE COUNTY HEALTH DEPARTMENT Y /
_��,-r•*tom -" .. ,
IMPROVEMENT PERMIT and OPERATION PERMIT
IMPROVEMENT PERMIT r
**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)
o /
NAME C ----,PROPERTY ADDRESS- '_' DATE
LOCATION
SUBDIVISION NAME LOT NUMBER SEC./BLOCK NUMBER
RESIDENTAL SPECIFICATION:BUILDING .,& # BEDROOMS '' # BATHS # OCCUPANTS GARBAGE DISPOSAL: Yes
COMMERCIAL SPECIFICATION: FACILITY TYPE #,PEOPLE-'" -" 41PEOGLEAHIFT # SEATS INDUSTRIAL WASTE: Yes/No
LOT SIZE TYPE WATER SUPPLY /'6 DESIGN WASTEWATER FLOW (GPD) NEW SITE REPAIR SITE
SYSTEM SPECIFICATIONS: TANK SIZE r�L GAL. PUMP TANK GAL. TRENCH WIDTH _ ' ROCK DEPTH >> "LINEAR FT. &4L
OTHER
1 REQUIRED SITE MODIFICATIONS/CONDITIONS: ��/ 9'! T+9/' ' �s/1)',Qi �/P /�r� r at��r.�'• t� d� �"y I!/�
***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.
IMPROVEMENT PERMIT BY
**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 S STEM INSTALLED BY 11,0316,D FDSfiE�-
Z�3
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C, CCnr�-
AUTHORIZATION N0. p�j �_ OPERATION PERMIT BYIJ DATE
**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
APPLICATION FOR SITE EVALUATIONIIMPROV19MENTS PERM LS @ L5 WE
J
JII of r Davie County Health Department
Environmental Health Section SEP 2 5 W
P. O. Box 665
Mocksville, NC 27028
10LJ Pol
1. App lication/Permit Requested By
Mailing Address Home Phone V
�.�• �,?`�Oo2 8 Business Phone
2. Name on Permit if Different than Above
3. Application for. f ❑General Evaluation Uft/eptic Tank installation Permit
?j 4. System to Serve: ❑ House 04obile Home ❑ Place of Public Assembly
I ❑ Business ❑ Industry ❑ Other ❑ Unknown
i
I 5. If house, mobile home: Subdivision Section Lot#
❑ Basement/Plumbing
No.of People • 3 ❑ Basement/No Plumbing
i
No.of Bedrooms VWashing Machine
j No.of Bathrooms, ❑ Dishwasher
Dwelling Dimensions ❑ Garbage Disposal
6. If business, industry, place of public assembly, other: Specify type
No. of Pegple Served No. pf Sinks
No. of Commodes Flo.of urinals
No.of Lavatories Np.'of Water Coolers
No. of Showers Water Usage Figures
7. Type of water supply: WP'U'blic ❑ Private ❑.Community
8. Property Dimensions Sewage Disposal Contractor
9. Do you anticipate additions/expansion of the facility this sytem is intended to serve? ❑ Yes ❑ No
0
If yes,what type?
'NOTE: Improvements Permits shall be valid for a period of 5.years from date issued. Improvemqnts Permits are subject to
revocation, if site plans or the intended use change. Effective October 1, 1989.
Directionq to Property: _ G `JGt G�• rn
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
i re r this application. _
DATE SIGNATURE
CONSENT FOR SITE EVALUATION SQ BE DONE Q[`(ABOVE DESCRIBED EROPERTY
MUST CHECK ONE: l/1. 1 OWN the property. ❑ 2. I,DQ 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 abgve described
property located in Davie County and owned by
to conduct all testing procedures as necessary to determine said site's suitability for a ground absorption sewage treatment
and disposal system.
DATE SIGNATURE
WHD(1M
- DAVIE COUNTY HEALTH DEPARTMENT
Environmental Health Section
. Q Soil/Site Evaluation
NAME T/� ��g' DATE EVALUATED
ADDRESS PROPERTY SIZE �/,��
PROPOSED FACIILTY LOCATION OF SITE
Water Supply: On-Site Well _ Community Public
Evaluation By: Auger Boring �/ Pit Cut
FACTORS 1 2 3 4
Landscape position
Sloe %
HORIZON I DEPTH
Texture group
Consistence
Structure
Mineralogy
HORIZON II DEPTH C
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: EVALUATED BY:
LONG-TERM ACCEPTANCE RAT��%j•' a � OT/HER(S) PRESENT:
REMARKS: r P l.!/v9I�r�1er14 Ae !'Nhtod�X loin Tl'��
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 ;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
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(01-901
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Davie County Health Department
ENVIRONMENTAL HEALTH SECTION
P.O. Box 665
Mocksville, N.C. 27028
"r AUTHORIZATION FOR WASTEWATER SYSTEM CONSTRUCTION
(Issued in compliance with Article 11 of
B.S. Chapter 130A, Wastewater Systems)
***This Authorization Far 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 Bu' dinP rmits.+**
'4A IVAUTHORIZATION NUMBER
NATYi
E 1 DATE
NAME ON IMPROVEMENT PERMIT (If different than above)
SITE LOCATION( .I�D�,�� /r��9Cl " !a f%s'�" Td
MM ENTS/CONDITIONS ON AUTHORIZATION TO CONSTRUCT WASTEWATER SYSTEM
i e I
**OWICEt** THIS AUTHORIZATION FOR WASTEWATER SYSTEM CONSTRUCTION IS VALID FOR A PERIOD OF FIVE (5) YEARS.
ENVIRONMENTAL HEALTH SPECIALIST DATE
DCHD 10/95