200 Odell Myers RdDavie County, NC r Tax Parcel Report 0 NO Wednesday, October 5, 2016
Parcel Number:
NCPIN Number:
Account Number:
Listed Owner 1:
Mailing Address 1:
City:
State:
Zip Code:
Legal Description:
Assessed Acreage:
Deed Date:
Deed Book / Page:
Plat Book:
Plat Page:
Building Value:
WARNING:THIS 15 NOTA SURVEY
Parcel Information
H80000003003
Township:
5789540424
Municipality:
82532937
Census Tract:
FRAYER PAUL D
Voting Precinct:
200 ODELL MYERS RD
Planning Jurisdiction:
ADVANCE
Zoning Class:
NC
Zoning Overlay:
27006
Voluntary Ag. District:
1.039 AC ODELL MYERS RD
Fire Response District:
Land Value:
Total Assessed Value:
1.10
Elementary School Zone;
10/2012
Middle School Zone:
009040772
Soil Types:
Flood Zone:
Watershed Overlay:
65980.00
Outbuilding & Extra
Freatures Value:
25480.00
Total Market Value:
94510.00
Shady Grove
37059-804
EAST SHADY GROVE
Davie County
DAME COUNTY R -A
ADVANCE
SHADY GROVE
WILLIAM ELLIS
PaD,PcB2,PcC2
DAME COUNTY
3050.00
94510.00
9tuMl�
No
Davie County,
j�(�
` C
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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.
A�RIZATfON NO;
0940 DAVIE COUNTY HEALTH DEPARTMENT
Environmental Health Section PROPERTY INFORMATION
Permittee's;e�� P.O. Box 848 43 Q
Name: Mocksville, NC 27028 Subdivision Name:
Phone #: 704-634-8760
r Directions to property: (, 44L• TO
,,{ AUTHORIZATION FOR
2.: t'ci, t -t— �" yc.. is WASTEWATER
SYSTEM CONSTRUCTION
Section: Lot: � �, !� .,an PF
Tax Office PIN:# S 7 - 11,q- �i�"� 7
too
Road Name: 6h&LMVt9fi 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
r . ; DAVIE COUNTY HEALTH DEPARTMENT
IMPROVEMENT AND OPERATION PERMITS PROPERTY INFORMATION ll
PernIMe's�
'
--Name
Directiorg to property:
Subdivision Name:
Section: Lot:
IlVIPERNIIT Tax Office PIN:# 12r,
Road Name: R�" a'a.� :%t I . n!" Zin: � /'� h 6{,
**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 "i::. (° C ` r" ' fir'/ 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 _ # BEDROOMS 25
# BATHS -2--- # OCCUPANTS GARBAGE DISPOSAL: Yes or No
COMMERCIAL SPECIFICATION: FACILITY TYPE # PEOPLE # PEOPLE/SHIFT # SEATS INDUSTRIAL WASTE: Yes or No
LOT SIZE/ 0.7 lp
4C TYPE WATER SUPPLY TJELL — DESIGN WASTEWATER FLOW (GPD) 5(11Q> NEW SITE ---# REPAIR SITE
ouo SYSTEM SPECIFICATIONS: TANK SIZE GAL. PUMP TANK GAL. TRENCH WIDTH - ROCK DEPTH ( LINEAR Fr.,
OTHER i"% ` XN
REQUIRED SITE MODIFICATIONS/CONDITIONS:
IMPROVEMENT PERMIT LAYOUT
b
"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
� ani
Is
R6C,k
SYSTEM INSTALLED BY: V!,Z, •r.
F—
N. m d ��
- co,
AUTHORIZATION NO. NN� OPERATION PERMIT BY:Q.�DATE:
2`4 '91�
"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 PERMIT & ATC
Davie County Health Department
G �(, Environmental Health Section
le ' P.O. Box 848
QS Mocksville, NC 27028
1 M (704) 634-8760 l
****IMPORTANT**** THIS APPLICATION CANNOT BE PROCESSED UNLESS ALL
THE REQUIRED INFORMATION IS PROVIDED.
Vf' Name to be Billed M 6 C'X-0Sp—
L,Mailing Address 0e
City/State/ZipMDC�r-dDlta U.
2. Name on Permit/ATC if Different than Above
Mailing Address
3. Application For: W Site Evaluation
`Contact Person I b77N,hrr7 6rcoS
L- Home Phone (0 - `4-- 3 3 A 3
Business Phone
City/State/Zip
[ ] Improvement Permit & ATC
4. System to Serve: [ ] House KMobile Home [ ] Business [ ] Industry [ ] Other
[ ] Both
5. If Residence: # People # Bedrooms # Bathrooms [ ] Dishwasher [ ] Garbage Disposal
[ ] 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 M Well [ ] Community
8. Do you anticipate additions or expansions of the facility this system is intended to serve? [ ] Yes [ ] No
If yes, what type?
E I THEM A PLAT OR SITE PLAN
PROPERTY INFORMATION REQUIRED: *** IMPORTANT *** A LI WOF THE PROPERTY MUST BE
SUBMITTED WITH TMS APPLICATION.
i"Property Dimensions: 1/)S IXC WRITE DIRECTIONS (from ocksville) TO PROPERTY:
V fax Office PIN: #S]J�g . - 4q
Property Address: Road Name 601e l v 'ecl nS % If
p� L
City/Zip �✓l'e /'G'f-� aJcrr44-k 4
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 Authorized
Representative of the Davie County Health Department to enter upXi abo/escribed property located in Davie County and owned11,
by to
XDATE �Z-ab7 SIGNATURE
`Revised D HD (06-96)
THIS AREA MAY 13E USEb FOR DRA WI NC YOUR SITE 1 "_AN:
as necessary to determine the site suitability.
DAVIE COUNTY HEALTH DEPARTMENT
Environmental Health Section SECTION
Soil/Site Evaluation
APPLICANT'S NAME CU o'_5' P
PROPOSED FACILITY
SUBDIVISION
Water Supply
On -Site Well Community,
Evaluation By: Auger Boring Lr Pit
LOT
DATE EVALUATED
PROPERTY SIZE
ROAD NAME
Public
Cut
FACTORS
1 2 3 4 5 6 7
Landscape position
Sloe %
HORIZON I DEPTH
Texture group
Consistence
Structure
Mineralogy
HORIZON II DEPTH
Texture groupG
Consistence
Structure
<
Mineralogyi
HORIZON III DEPTH
Texture group
Consistence
Structure
Mineralogy
HORIZON IV DEPTH
Texture group
Consistence
Structure
Mineralogy
SOIL WETNESS
RESTRICTIVE HORIZON
SAPROLITE
CLASSIFICATION
S
LONG-TERM ACCEPTANCE RATE
i
SITE CLASSIFICATION: �5
LONG-TERM ACCEPTANCE RATE:
REMARKS:
DCHD (01-90)
EVALUATION BY: A!V
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
■
■
■ENE■
■E■■■
■ENE■
■E■■■
SEMEN
SEMEN
■■N■■
■■■N■
■■■■■
■E■E■
MEMO
■E■■
■■■■
■■■■
■■■■
NONE
NONE
■■■■
■■■■■■■■■■■■■■■■■■■■■■■■
SSSS■■M■■■■■■■■■■■■■■■■■
■■■■■■■■■■■■■■■■■■■■■■■■
■■■■■■■■■■■■■■■■■■■■■■■■
■■■■■■■■■■■■■■■NEN■■■■■■
■■■■■■■
■■MESE■
■■■■■M
■■■■■■■■■■■■■■■■■■■■■■■■■■■■■
■■■■■■■■■■■■■■■■■■■■■■■■■■■■■
■■■■■E■■■ ■■■■■■■■■■■■■■E■■■
■■■■■■■■■■■■■■■■■■■■■■■■■■■■■
■■■■■■■■■■■■■■■■■■■■■■■■■■■■■
■■■■■■■■■■■■■■■■■■■■■■■■■■■■■
■■■■■■■■■■■■■■■■■■■■■■■■■■■■■
■■■■■■■■■■■■■■■■■■■■■■■■■■■■■
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■■E■■■■■■■■■■■■■■■■
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C
'TRACT
,D BY
r
IS. R. 1649
LL MyERS' ROA
S 83.30' • E
63, 05 __ -' 154,12 D
a91,07 S 78.30'25' E
'.. 1'., 85,00
VEYING CO.
. 1997
I tO
o�
�o
/ 0.25Iron f
J44 c-'4, 0
AREA = 1.039 ACRES
(INCLUDES S.R. 1649 R/W)
n�
L J 4
r_
lUe T-erke A
b'
/ hC
h
roh � p
now Iron/ r� y p
aet ti J .�
9SS6c' / O
O F.
L R ES
20' PROPOSED
• Davie County Heafth Department
and Home Heafth Agency
Environmenta(Heafth Section
P.O. BOX 848 / 210 HOSPITAL STREET
COURIER #09-4-06
MOCKSVILLE, N.C. 27028
PHONE: (704) 634-8760
May 5, 1997
John Grose
331 Park Ave.
Mocksville,. HC 27028
1
Re: Site Evaluation
Odell Myers Road
Dear Mr. Grose:
} 4-
C)
-o `l b
As requested, a representative from this office visited the
aforementioned site on May 5, 1997. Based upon the information
provided on the application for site evaluation and after the eva'luatior�,
was completed, the site was found to'be provisionally suitable for the
installation of an 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(s)