219 Oak Grove Church RdDavie County, NC r
Tax Parcel Report 1 63� Wednesday, October 5, 2016
WARNING: THIS IS NOT A SURVEY
Parcel Information
Parcel Number: G500000141 Township:
NCPIN Number: 5749388089 Municipality:
Mocksville
Account Number: 8300074 Census Tract: 37059-805
Listed Owner 1: MCDANIEL RANDY DEAN SR ETAL Voting Precinct: NORTH MOCKSVILLE COUNTY
Mailing Address 1: 474 BETHEL CHURCH ROAD Planning Jurisdiction: Davie County
City: MOCKSVILLE Zoning Class: DAVIE COUNTY R -A
State: NC Zoning Overlay: DAVIE COUNTY QD
Zip Code:
27028-0000
Voluntary Ag. District:
No
Legal Description:
6.09 AC OAK GROVE CHURCH
Fire Response District:
MOCKSVILLE
Assessed Acreage:
5.85
Elementary School Zone:
MOCKSVILLE
Deed Date:
4/2010
Middle School Zone:
SOUTH DAVIE
Deed Book / Page:
2010EO240
Soil Types:
WeC,WeB
Plat Book:
Flood Zone:
Plat Page:
Watershed Overlay:
DAVIE COUNTY
Building Value:
1310.00
Outbuilding & Extra
0.00
Freatures Value:
Land Value:
53060.00
Total Market Value:
54370.00
Total Assessed Value:
54370.00
a
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
F - County of Davie, North Carolina, Its agents, consultants, contractors or employees from any and all claims or causes of action due to
NCor arising out of the use or Inability to use the GIS data provided by this website.
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AUTHORIZATION NO:DAVIE CUNTY HEALTH DEPARTMENT
Environmental Health Section PROPERTY INFORMATION
Permittee's .. 'T •% P.O: Box 848 fir•-.� _�
Name:/� /�r�� Mocksville, NC 27028 Subdivision Name:
f di3 Phone # 336-751-8760 p
Directions to property: el:: ' C.'t�%V t Section: Lot:
AUTHORIZATION FOR
.'G WASTEWATER Tax Office PIN:#f
SYSTEM CONSTRUCTION 'QQ�jy N
Road Name: ���,�.�RO���-�• t`zip: Vr�
**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 I 1 of G.S. Chapter 130A, Wastewater Systems, Section .1900 Sewage Treatment and Disposal Systems)
***NOTICE*** THIS AUTHORIZATION FOR WASTEWATER CONSTRUCTION
IS VALID FOR A PERIOD OF FIVE YEARS.
ENVIRONMENTAL HEALTH SPECIALIST DATE ISSUED
**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 I I of G.S. Chapter 130A, Wastewater Systems, Section .1900 Sewage Treatment and Disposal Systems)
***NOTICE*** THIS PERMIT IS SUBJECT TO REVOCATION IF SITE
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 I!Z # BEDROOMS _T— # BATHS -,—,?— # OCCUPANTS —$-- GARBAGE DISPOSAL: Yes or No
COMMERCIAL SSPECIFICATION: FACILITY TYPE # PEOPLE # PEOPLE/SHIFT # SEATS INDUSTRIAL WASTE: Yes or No
LOT SIZE 17 L TYPE WATER SUPPLY ed�_ DESIGN WASTEWATER FLOW (GPD) � NEW SITE—,e' REPAIR SITE
SYSTEM SPECIFICATIONS: TANK SIZE P GAL. PUMP TANK GAL. TRENCH WIDTH , ROCK DEPTH LINEAR FT.
OTHER
REQUIRED SITE MODIFICATIONS/CONDITIONS:
"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.
I OPERATION PERMIT
SYSTEM INSTALLED BY:
AUTHORIZATION NO. .'-1� OPERATION PERMIT BY: -DATE: 6
"THE ISSUANCE OF THIS OPERATION PERMIT SHALL INDICATE THAT THE SYSTEM DESCRIBED ABOVE HAS BEEN INSTALLED IN COMPLIANCE
WITH ARTICLE I I 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)
DAVIE
BOUNTY HEALTH DEPARTMENT;
IMPROVEMENT
AND OPERATION PER1biITS '' PROPERTY INFORMATION
'---Permittee's
,.,Name.: l` �'. r'�'%�
%it�f ` C`'f 7
Subdivision Name.
' Directions to property:
�' �'-
" � r' t"
Section: F/ Lot:
_
IMPROVEMENT
PERMIT Tax Office PIN:#
**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 I I of G.S. Chapter 130A, Wastewater Systems, Section .1900 Sewage Treatment and Disposal Systems)
***NOTICE*** THIS PERMIT IS SUBJECT TO REVOCATION IF SITE
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 I!Z # BEDROOMS _T— # BATHS -,—,?— # OCCUPANTS —$-- GARBAGE DISPOSAL: Yes or No
COMMERCIAL SSPECIFICATION: FACILITY TYPE # PEOPLE # PEOPLE/SHIFT # SEATS INDUSTRIAL WASTE: Yes or No
LOT SIZE 17 L TYPE WATER SUPPLY ed�_ DESIGN WASTEWATER FLOW (GPD) � NEW SITE—,e' REPAIR SITE
SYSTEM SPECIFICATIONS: TANK SIZE P GAL. PUMP TANK GAL. TRENCH WIDTH , ROCK DEPTH LINEAR FT.
OTHER
REQUIRED SITE MODIFICATIONS/CONDITIONS:
"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.
I OPERATION PERMIT
SYSTEM INSTALLED BY:
AUTHORIZATION NO. .'-1� OPERATION PERMIT BY: -DATE: 6
"THE ISSUANCE OF THIS OPERATION PERMIT SHALL INDICATE THAT THE SYSTEM DESCRIBED ABOVE HAS BEEN INSTALLED IN COMPLIANCE
WITH ARTICLE I I 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)
ld
APPLICATION FOR SITE EVALUATIONAMPROVEMENT PERMI C t
Davie County Health Department
Environmental Health Section rt
P. O. Box 848, " 1 1998
Mocksville, NC 27028
(�X L HEALTH
(336)751-8760�::�:;;'at�TA
r±%'/1F COU€JTY
****IMPORTANT**** THIS APPLICATION CANNOT BE PROCESSE 'ITNT, S
'' II A` LL THE REQUIRED INFORMATION IS PROVIDED.(� (� \ _ -}-
1. Name to be Billed pbo r t tot l `- o n Contact Person Co Qty t3 ( 1'1 obey 1
"
Mailing Address v( q l J 0 I 1 C'�C uye. (2 h • 1'Y - 7 - Home Phone -TS 1 'G -7 35
City/State/Zip 1 1 1�1�5 U t i°� ' V l Zl�Business Phone -IS2-7
2. Name on Permit/ATC if Different than Above
Mailing Address City/State/Zip
3. Application For: ❑ Site Evaluation ❑ Improvement Permit & ATC --toth
4. System to Serve: House ❑ Mobile Home ❑ Business ❑ Industry ❑ Other
5. If Residence: - # People # Bedrooms 3 # Bathrooms Z
((Dishwasher ❑ Garbage Disposal @ Washing Machine ❑ Basement/Plumbing ❑ Basement/No Plumbing
6. If Business/Other: Specify type # People # Sinks
# Commodes
If Foodservice:
7. Type of water supply:
# Showers
# Seats
County/City
# Urinals
Estimated Water Usage (gallons per day)
❑ Well
# Water Coolers
❑ Community
8. Do you anticipate additions or expansions of the facility this system is intended to serve? ❑ Yes 6J -,'No
If yes, what type?
E I THER A PLAT OR SITE PLAN
PROPERTY INFORMATION REQUIRED: *** IMPORTANT *** A PAAR3M THE PROPERTY MUST BE
SUBMITTE WITH THIS APPLICATION.
, -75)-
Property Dimensions: A 4 -3T/ /�G�G� I WRIT IRECTIONS`(6m
iQ- DI Mocksville) TO PROPERTY:
Tax Office PIN: # '�' F
R Fo- ,' 3 m I es
Property Address: Road Name
City/Zip
If in Subdivision provide information, as follows:
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 Authori2ed Representative of the Davie County Health Department to enter upon above described property located in Davie County
and owned by
as necessary t determine the site suitability.
DATE SIGNATURE J:JJ
Revised DCHD (06-96)
YOU MANY USE THE BACK OF THIS FORM FOR DRAWING YOUR SITE PLAN.
conduct all testing procedures
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CENTER OF RD. LINE N 06'22* 44" E-
/ 32.97 239.64
AREA - 0.758 ,ACRE
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AREA - 1.634 ACRE
W -LU E ! 42 R/W
JOHN N. McDANIEL
D.B. 66 P. 3
D.B. 58 P. 523
D.B. 124 P. 362
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DAVIE COUNTY HEALTH DEPARTMENT
Environmental Health Section SECTION LOT
Soil/Site Evaluation
APPLICANT'S NAME a �'/ DATE EVALUATED :�����
PROPOSED FACILITY �D{S�' PROPERTY SIZE
SUBDIVISION ROAD NAME ��J� (�v✓t?i �N
Water Supply: On -Site Well Community Public !/
Evaluation By: Auger Boring Pit 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
r
/
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
,3
SITE CLASSIFICATION: C1��
LONG-TERM ACCEPTANCE RATE:
REMARKS:
DCHD (01-90)
EVALUATION BY: /W.
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
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