264 Oak Grove Church RdDavie County. NC
Tax Parcel Report Hoy Wednesday. October 5. 2016
WARNING:THIS IS INOT A SURVEY
Parcel Information
Parcel Number:
H50000003102
Township:
Mocksville
NCPIN Number:
5749470470
Municipality:
Account Number:
82528501
Census Tract:
37059-805
Listed Owner 1:
REAVIS JOE NATHAN
Voting Precinct: NORTH MOCKSVILLE COUNTY
Mailing Address 1:
264 OAK GROVE CHURCH 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:
0.91 AC OAK GROVE CHURCH
Fire Response District:
MOCKSVILLE
Assessed Acreage:
0.86
Elementary School Zone:
MOCKSVILLE
Deed Date:
7/2007
Middle School Zone:
SOUTH DAVIE
Deed Book / Page:
007230868
Soil Types:
WeB
Plat Book:
Flood Zone:
Plat Page:
Watershed Overlay:
DAVIE COUNTY
Building Value:
76210.00
Outbuilding & Extra
Freatures Value:
1760.00
Land Value:
21110.00
Total Market Value:
99080.00
Total Assessed Value:
99080.00
91.E 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
�T
nOUty� 1\ C or arising out of the use or Inability to use the GIS data provided by this website.
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AUTH(rIz�TION NO: 170C DAVIE C UNTY HEALTH DEPARTMENT
lEnvironmental Health Section PROPERTY INFORMATION
Permittee's P.O. Box 848
Name: Mocksville, NC 27028 Subdivision Name:
S./,ft l Phone # 336-751-8760
Directions to property: C � /'dl/'G' Section: Lot:
AUTHORIZATION FOR
WASTEWATER
SYSTEM CONSTRUCTION Tax Office PIN:#� 4- - !
Road Name f .,^� Q" ,E. . ,,_� Zip.
-�
**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 11 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
0 0 DAVIE CpUNTY HEALTH DEPART)IENT
_ •�:K - - �'
IMP
EMENT AND OPERATION PERMfh�
,
Perrmtfe, '
19,Narpe: /i
Directions -to property:
IMPROVEMENT
PERMIT
r0
PROPERTY INFORMATION
Subdivision Name:
Section: Lot:
Tax Office PIN:, e .,K
Road Name:('— , r r:5a`rca ^zip:t:
**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)
/ r.. ***NOTICE*** THIS PERMIT IS SUBJECT TO REVOCATION IF SITE
- d �,., f• t'" PLANS OR THE INTENDED USE CHANGE. YOUR WASTEWATER
SYSTEM CONTRACTOR MUST SEE THIS PERMIT BEFORE
ENVIRONMENTAL HEALTH SPECIALIST DATE ISSUED QQ INSTALLING THE SYSTEM.
RESIDENTIAL SPECIFICATION: BUILDING TYPE _,!�W# BEDROOMS% # BATHS __ # OCCUPANTS_ GARBAGE DISPOSAL: Yes or No
COMMERCIAL SPECIFICATION: FACILITY TYPE # PEOPLE # PEOPLE/SHIFT # SEATS , /INDUSTRIAL WASTE: Yes or No
LOT SIZE. _!=, TYPE WATER SUPPLY / DESIGN WASTEWATER FLOW (GPD)NEW SITE REPAIR SITE
SYSTEM SPECIFICATIONS: TANK SIZE GAL. PUMP TANK -GAL. TRENCH WIDTH S / ROCK DEPTH 4:2 LINEAR FT.
OTHER ` 1�.�r/.l f` f� `!( ( i� i(✓ /.� ��
"CONTACT A REPRESENTATIVE OF THE DAVIE COUNTY HEALTH
BETWEEN 8:30 - 9:30 A.M. OR 1:00 - 1:30 P.M. ON THE DAY
Q
OPERATION PERMIT
,NT FOR FINAL INSPECTION OF THIS SYSTEM
TION. TELEPHONE # IS (336)751-8760.
AUTHORIZATION N0. OPERATION PERMIT BY: DATE/GZO
"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)
- � 6 " Poyvs 1 -0
(�U `/ ai174PC -x
APPLICATION FOR SITE EVALUATION/IMPROVEMENT PERMIT &
Davie County Health Department
v A01p0_5'
(Environmental Health Section 1,U P.O. Box 848/210 Hospital Street
4i Mocksville, NC 27028
��r �/336)751-8760
***IIdPORTGT*ANO ** THIS APPLICATION CANNOT BE PROCESSED UNLESS ALL THE REQUIRED
INFORMATION IS PROVIDED. Refer to the INFORMATION BULLETIN for instructions.
1. Name to be Billed n Q e N ''f .tact Person
Mailing Address ) Aw oL
7 `�1 / Some Phone
City/State/ZIP aS ?Jdb Business Phone
2. Name on Permit/ATC if Different than Above
Mailing Address
3. Application For:
4. System to Service:
5. If Residence:
❑ Site Evaluation
❑ House AMobile Home�# People
Dishwasher ❑ Garbage Disposal
6. If Business/Industry/Other
# Commodes
City/State/Zip
Improvement Permit/ATC
l❑`Business ❑ Industry
# Bedrooms
❑ Both
❑ Other
# Bathrooms s-
pl Washing Machine ❑ Basement/Plumbing ❑ Basement/No Plumbing
Specify type
# Showers
# Urinals
# People # Sinks
# Water Coolers
IF FOODSERVICE: # Seats Estimated Water Usage (gallons per day)
7. Type of water supply: ' County/City ❑ Well ❑ Community
8. Do you anticipaie additions or expansions of the facility this system is intended to serve? ❑ Yes �No
If yes, what type?
***IMPORTANT*** CLIENTS MUST COMPLETE THE REQUIRED PROPERTY INFORMATION REQUESTED
BELOW. Either a PLAT or SITE PLAN MUST BE SUBMITTED by the client with THIS APPLICATION.
Property Dimensions: n WRITE DIRECTIONS (from Mocksvil�le) to PROPERTY:
Tax Office PIN: # 5 / Z1 Y 7' W70 1. 00 L)o� rU
Property Address: Road Name �i�� G-'vJ t l�'I VJ t
City/Zip 04 Cr— 2,7o Z�K'
If in a Subdivision provide information, as follows:
Name:
Section: Block: Lot:
M00AW-DIMP
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 1 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 conduct all testing procedures as necessary to determine the site suitability.
DATE /-Z-�SIGNATURE
THIS AREA MAY BE USED FOR DRAWING YOUR SITE PLAN (Include all of the following: Existing and proposed
property lines and dimensions, structures, setbacks, and septic locations).
4
Account No.
Revised DCHD (07/98) Invoice No.
E - -•.
' LJnE' l
,'59'05"C --..
300:(YTAL S 03' 30' 00" W
WItM G. SUMMERS
D.8 PG.628
TFRow wilvEY1MG Co.
>UTt S BOX 129 F
SVii.a, N. C. 492.5616
344.38 TOTAL
TOLERANCES - REYtStt7tY5 � �/,�" L � A SURVEY i11fC � L A � R
uACEPT as roToo) NO DATE By G
OCC/MAL BEING 0.919AC. TAKEN FROM THE ROY A
t
+ ROPERTYJ D8. 50 PG. 268)', LYING IN t
TOWNSHIP pA>.�lE CO. N C.
FRACTIONAL ! DRAWN Alf SPH IFCALC 1� _ 40, MATERIA,
CHK'D �± DATC DRAW/Nt
ANGULAR A G LT a'� 20-83
TRACED ♦1►r�'p 698:
+ (f
DAME COUNTY HEALTH D'EPARTAiIEW
ENVIRONMENTAL HEALTH SECTION
P. 0. Box 848/210 Hospital Street
Courier #09-40-06
Modamille, NC 27028
Prime #: (338)751.8760
September 17,1998
Glenas M. McClamrock
179 Dusty Hill Road
Mocksville, NC 27028
Re: Site Evaluation/Approx. 1 Acre
Tax PIN: #5749-47-0470
Oak Grove Church Road
Dear Client(s):
As requested, a representative from this office visited the aforementioned site on
September 15, 1998. Based upon the information provided on the application for site
evaluation and after an evaluation was completed, the site was found to be
provisionally suitable on the upper right side for the installation of a modified,
oversized on-site sewage disposal system. There is a possibility you may have to
pump.
Before a representative of our office will revisit the site to issue an Improvement
Permit/Authorization to Construct the appropriate application must be completed in full
and submitted to this office. The location of the facility the system is to serve must be
staked off.
If you have any questions, please feel free to contact this office.
Sincerely,
0064x, he p
Robert B. Hall, Jr., R.S.
Environmental Health Specialist
RWwd
Enclosures
1• ' v R a ll U
APPLICATION FOR SITE EVALUATION/IMPROVEM�' PER RT9
00 Davie County Health Department
/J� j i' Environmental Health Section �! ' 2 �C
/�'(/" v- l P.O. Box 848/210 Hospital Street AUG 6
1;)
//� j Mocksville, NC 27028
(((/// 336 731-8760 °1ENTAL HEALTH
I/"" S
�,VIE COUNTY
*** PORTANT*** THIS APPLICATION CANNOT BE PROCESSED UNLESS ALL THE REQUIRED
INFORMATION IS PROVIDED. Refer to the INFORMATION BULLETIN for instructions.
1. Name to be Billed r:�4 eXkQ,$ i • l • M �Q y(�/`Y �L Contact Person
Mailing Address 1119 I) Lk,5 i ]�; � 1 �GC Home Phone
City/State/ZIP VA p el51)) NG o276a,P Business Phone g 4
2. Name on Permit/ATC if Different than Above
Mailing Address City/State/Zip
3. Application For: ,Site Evaluation ❑ Improvement Permit/ATC ❑ Loth
4. System to Service: ❑ House Mobile Home ❑ Business ❑ Industry ❑ Other
5. .��I///f Residence: # People A_ # Bedrooms 13 # Bathrooms
l Dishwasher ❑ Garbage Disposal I Washing Machine ❑ Basement/Plumbing ❑ BasEtment/No Plumbing
6. If Business/Industry/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 ❑ Comuwnity
s. Do you anticipate additions or expansions of the facility this system is intended to serve? ❑ Yes %No
If yes, what type?
'IMPORTANT'** CLIENTS MUST COMPLETE THE REQUIRED PROPERTY INFORMATION REQUESTED
BELOW. Either a PLAT or SITE PLAN MUST BE SUBMITTED by the client with THIS APPLICATION.
Property Dimensions: WRITE DIRECTIONS (from Mocksville) to PROPERTY:
Tax Office PIN: # , ' 7---7 # 9- 6 7 -0 4 70-P0/'6)4L`1!4 1$ N E, AID -01
�__�C,
Property Address: Road Name Nl1 -rroy � pj,,r_L p . a u,I a Imo-. -t . 6-v" 62A L
City/Zip M"5VAIL !V'7,6,R.2 (�5yay t lk Y X Lt�P�
If in a Subdivision provide information, as follows: A Uyu.i -L 6-V, Y.
Name:
Section: Block: Lot: Date Property Flagged:
This is to certifv 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 vie County Health D partment
to enter upon above described property located in Davie County and owned by c�a! '6'A C (I��C
to conduct all testing procedures as necessary to determine the site suitability-. ,� n
DATE K- A � -q9' SIGNATURE -'V&' liC
THIS AREA MAY BE USED FOR DRAMP!NG YOUR SITE PLAN (Include all of the following: Existing and proposed
property lines and dimensions, structures, setbacks, and septic locations).
Revised DCHD (07/98)
Account No.
Invoice No.
a S
DAVIE COUNTY HEALTH DEPARTMENT
Environmental Health Section SECTION LOT
Soil/Site Evaluation
17
APPLICANT'S NAME M1W"A mz le DATE EVALUATED
PROPOSED FACILITY PROPERTY SIZE
SUBDIVISION ROAD NAME 091c 6rA1e
Water Supply: On -Site Well
Community
Evaluation By: Auger Boring ✓ Pit
Public 4"_
Cut
FACTORS
1
2 3 4 5 6 7
Landscape position
L
Sloe %
S`
HORIZON I DEPTH
"
Texture group
_1?1Z S' L
Consistence
Structure
Mineralogy
HORIZON II DEPTH
.J '
g'• '
Texture group
4!�'
Consistence
Structure
7Z 4
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
d
SITE CLASSIFICATION: 2K fJn W, /)y r, (,'
LONG-TERM ACCEPTANCE RATE: I C
REMARKS:
DCHD (01.90)
GG
LEGEND
EVALUATION BY:
OTHER(S) PRESENT:
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
DO E —�
'59'05"E
—r
344.38 TOTAL
300.0'TAL �— S O3° 30� 00� W
WIIM G. SUMMERS
D.B P G. 628
TOLERANCES
l&XCcrT As NOTED' NO
DECIMAL I
h,It�t�i, ThIS MAP ± z
JAI HElG `URV�': FRACTIONAL
?rig,. C:;. 3
M ROM' SURVEYING CO. ±
T Roum b BOX 129 F ANGULAR
2 MOCKSVIuk. H• C• 492.56116 a
1 T
Q
(V
O W J
�g �6
41
o
t c�
1 �
0
SURVEY FOR: OcK
ELI Mc -AMR
REVISION`-' ��
DATE 6Y ROY A,W I LL7'AM S
SING 0.919AC. TAKEN FROM THE
ROPERTY,(DB. 50 PG. 268), LYING IN MOCKSVILLE
OWNSHIP DAVIE CO. N.C..
MATERIAL
SCALE 1„40'
DRAWN BY SPH
DRAWING NO
DATE
CMK'DG LT 4- 20-83
APP'D 6983 - 2s.
TRACED
September 17,1998
Glenas M. McClamrock
179 Dusty Hill Road
Mocksville, NC 27028
Re: Site Evaluation/Approx.1 Acre
Tax PIN: #5749-47-0470
Oak Grove Church Road
Dear Client(s):
As requested, a representative from this office visited the aforementioned site on
September 15, 1998. Based upon the information provided on the application for site
evaluation and after an evaluation was completed, the site was found to be
provisionally suitable on the upper right side for the installation of a modified,
t oversized on-site sewage disposal system. There is a possibility you may have to
pump.
Before a representative of our office will revisit the site to issue an Improvement
Permit/Authorization to Construct the appropriate application must be completed in full
and submitted to this office. The location of the facility the system is to serve must be
staked off.
If you have any questions, please feel free to contact this office.
Sincerely,
.0� &��A. ra't
Robert B. Hall, Jr., R.S.
Environmental Health Specialist
RH/wd
Enclosures