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559 Ratledge RdDavie Countv. NC Tax Parcel Report 6 01 Thursday. October 6, 2016 WAlC1V11V1i: 1111N 1J 1VV7 A NUKVLY Parcel Information Parcel Number: L30000002011 Township: Mocksville NCPIN Number: 5726176578 Municipality: Account Number: 82516424 Census Tract: 37059-801 Listed Owner 1: NUCKOLLS PEGGY D Voting Precinct: SOUTH CALAHALN Mailing Address 1: 559 RATLEDGE ROAD Planning Jurisdiction: Davie County City: MOCKSVILLE Zoning Class: DAVIE COUNTY R -A State: NC Zoning Overlay: Zip Code: 27028-5428 Voluntary Ag. District: No Legal Description: 5.344 AC RATLEDGE RD Fire Response District: SCOTCH - IRISH Assessed Acreage: 4.92 Elementary School Zone: COOLEEMEE Deed Date: 3/2001 Middle School Zone: SOUTH DAVIE Deed Book / Page: 003620273 Soil Types: EnB,MsC Plat Book: Flood Zone: Plat Page: Watershed Overlay: DAVIE COUNTY Building Value: 278230.00 Outbuilding & Extra Freatures Value: 25000.00 Land Value: 58050.00 Total Market Value: 361280.00 Total Assessed Value: 361280.00 I.v 9 Ines F 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 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. Davie County Health Department Environmental Health Section t ".� P.O. Box 848 210 Hospital Street �a Courier #: 09-40-06 U Mocksville, NC 27028 - Phone: (336) - 753 - 6780 Fax: (336) - 753-1680 ON-SITE WASTEWATER CERTIFICATION (Check One) Replacement Remodeling Reconnection Name: �` © i .k' Phone Number �3 --3&--3 �' ��l', (Home) Mailing Address: (Work) Email Address: Detailed Directions To Property Address:_ 4— Please Fill In The Following Information About The EXISTING Facility: Name System Installed Under: t �U�. 1L Nl jC 4Ls Type Of Facility: Date System Installed (Month/Date/Year): ad V Number Of Bedrooms:__y Number Of People: Is The Facility Currently Vacant? Yes Any Known Problems? Yes 0 0 If Yes, For How Long? If Yes, Explain: Please Fill In The ollowing Information About The NEW Facility: Type Of Facility: L,4401161 -11 - Number Of Bedrooms: Number of People. Pool Si Garage Size: Other: Requested By / �� Date Requested (SiMture) For Environmental Health Office Use Only Environmental Health Specialist �/{�� Date: .46 Paid By: Received By: Account #: Invoice #: 1.11 40" Davie County Health Department Environmental Health Section P.O. Box 848 -ry C� 210 Hospital Street p U IryCourier #: 09-40-06 Mocksville, NC 27028 Phone: (336) - 753 - 6780 Fax: (336) - 753-1680 ON-SITE WASTEWATER CERTIFICATION �(Check One) Replacement Remodeling Reconnection Name: l.1t2�5 a,, JOCCo6`1 k)Vzj j,5 Phone Number "33 6, yCG " `L3 Sy (Home) Mailing Address: 5ssq �AT t4 bCd. it t� . '33 b " 7 S�3 - G o 1`4 (Work) / 9CAe.Vt$-L& N4 Detailed Directions To Site: PropertyAddress: SY9 Arai -34(, Q.o . Please Fill In The /1/ Following Information About The 1 EXISTING Facility: Name System Installed Under: CAP-ts j" PEGt' `'1 r.LfiWa%'" Type Of Facility: SIM64�6- A•hiVy DVD- 44-1— Date System Installed (Month/Date/Year): 2O zo Number Of Bedrooms:___q Number Of People: Is The Facility Currently Vacant? Yes N� If Yes, For How Long?_ Any Known Problems? Yes @ If Yes, Explain: Please Fill In TheFollowingInformation About The NEW Facility: Type Of Facility: i rA tea. ." r10- 4, 50 C a Number Of Bedrooms: Number of People Pool Size: 16'x S3 Garage Size: Other: Zo X L1 z) Requested By: k.1—I�J�/� Date Requested: *7 / I 13 For Environmental Health Office Use Only Approved Disapproved Comments: -5,0/ ia,1Z 7/�&411 15:e.4 Z Environmental Health Specialist I *The signing of this form by the Environmental Health Staff is in no way intended, nor should be taken as a guarantee I (extended or limited) that the on-site wastewater system will function properly for any given period of time. Payment: Cash Check Money Order #, Amount:$ Paid By: Received By: Account #: Invoice #: jw Chi iWL 3 AUTHORIZATION FOR WASTEWATER SYSTEM CONSTRUCTION (Issued in compliance with Article 11 of S.S. Chapter 130A, Wastewater Systems) ***This Authorization For Wastewater System Construction must be issued by the Davie County Environmental Health Section prior to issuance of any Building Permits. This Fore/Authorization Number should be presented to the Davie County Building Inspections Office when applying for Building Permits.*** AUTHORIZATION NUMBER NAME Ala L4 wlr , /n DATE ll --;91— &'�.r ' NAME ON IMPROVEMENT PERMIT (If different than above) SITE LOCATION COMMENTS/CONDITIONS ON AUTHORIZATION TO CONSTRUCT WASTEWATER SYSTEM ***NDTICE*** THIS AUTHORIZATION FOR- TEWATER SYSTEM CONSTRUCTION IS VALID FOR A PERIOD OF FIVE (5) YEARS. ENVIROIENTAL HEALTH SPECIALIST DATE DCHD 10/95 DAVIE COUNTY HEALTH DEPARTMENT IMPROVEMENT PERMIT and OPERATION PERMIT IMPROVEMENT PERMIT **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) NAME �/� PROPERTY ADDRESS DATE LOCATION SUBDIVISION NAME LOT NUMBER SEC./BLOCK NUMBER I RESIDENTAL SPECIFICATION: BUILDING TYPE # BEDROOMS # BATHS # OCCUPANTS J GARBAGE DISPOSAL: Yes(to COMMERCIAL SPECIFICATION: FACILITY TYPE # PEOPLE # PEOPLE/SHIFT # SEATS INDUSTRIAL WASTE: Yes/No LOT SIZE --<7' 4e TYPE WATER SUPPLY DESIGN WASTEWATER FLOW (GPD)-�I?X FEW SITE REPAIR SITE SYSTEM SPECIFICATIONS: TANK SIZE 212 GAL. PUMP TANK GAL. TRENCH WIDTH _ %/, �� ROCK DEPTH��LIINEAR FT. �[ OTHER & k -t REQUIRED SITE MODIFICATIONS/CONDITIONS: ***THIS PERMIT IS SUBJECT TO REVOCATION IF SITE PIANS OR THE INTENDED USE CHANGE. YOUR WASTERWATER SYSTEM CONTRACTOR MUST SEE THIS PERMIT BEFORE INSTALLING THE SYSTEM. IMPROVEMENT PERMIT BYV� *8309x30 A�M�OR1A00u1:� P. M. ONV�THH DAYYOF�INSTALLATION.TTELEPHONE #MENT FOR FINAL IIS(704�6�-8768,THIS SY5TEM BETWEEN OPERATION PERMIT I I 1 SYSTEM INSTALLED BY AUTHORIZATION N0. _60OPERATION PERMIT B DATE taba, **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 DAVIE COUNTY HEALTH DEPARTMENT '. IMPROVEMENT PERMIT and OPERATION PERMIT ,-IMPROVEMENT PERMIT **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) NAME :�'a C� G9 :: �,G%�;.� PROPERTY ADDRESS1. % �) C t DATE LOCATION �~/y �� :•� � il.� l' .� f� ' . SUBDIVISION NAME LOT NUMBER SEC./BLOCK NUMBER RESIDENTAL SPECIFICATION: BUILDING TYPE _ # BEDROOMS # BATHS t'f, # OCCUPANTS % GARBAGE DISPOSAL: Yeses) COMMERCIAL SPECIFICATION: FACILITY TYPE # PEOPLE # PEOPLE/SHIFT # SEATS INDUSTRIAL WASTE: Yes/No LOT SIZE S �i" TYPE WATER SILLY DESIGN WASTEWATER FLOW (GPD) NEW SITE /REPAIR SITE SYSTEM SPECIFICATIONS:; TANK SIZE 6AL: PUMP";_TANK SAL. TRENCH WIDTH �` ROCK DEPTH � //LINEAR FT. OTHER s � �v,%* 1,1 ,441 REQUIRED SITE MODIFICATIONS/CONDITIONS: ***THIS PERMIT IS SUBJECT TO REVOCATION IF SITE PIANS OR THE INTENDED USE CHANGE. YOUR WASTERWATER SYSTEM CONTRACTOR MUST SEE THIS PERMIT BEFORE INSTALLING THE SYSTEM. IMPROVEMENT PERMIT BY '� f.�'7) / / **CONTACT A REPRESENTATIVE DAVE TY HEALTH DEPARTMENT FOR FINAL INSPECTION OF THIS SYSTEM BETWEEN 8:30-9:30 A.M. OR 1:00-1: P. . ONJ DAY OF INSTALLATION. TELEPHONE # IS (704) 634-8760. OPERATION PERMIT SYSTEM INSTALLED BY G' AUTHORIZATION N0._enE&OPERATION PERMIT B' / I./ DATE Ys **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 EVALUATION/IMPROVEMENTS PEI Davie County Health Department Environmental Health Section P. O. Box 665 Mocksville, NC 27028 1. Application/Permit Requested By t� ` Mailing Address nrn n Home Ph VQ) C— Business Phone 2. Name on Permit if Different than Above 3. Application for: ❑ General Evaluation 2'Septic Tank Installation Permit 4. System to Serve: House ❑ Business ❑ Industry 5. if house, mobile home: Subdivision ❑ Mobile Home ❑ Place of Public Assembly ❑ Other ❑ Unknown No. of People 0— J� No. of Bedrooms "/ �/ No. of Bathrooms �r( a - Dwelling Dimensions 6. If business, industry, place of public assembly, other: Specify type No. of People Served No..of Commodes No. of Lavatories No. of Sinks _ No. of Urinals No. of Water Coolers No. of Showers Water Usage Figures Section Lot # NBasement/Plumbing ❑ Basement/No Plumbing CX Washing Machine X Dishwasher ❑ Garbage Disposal 7. Type of water supply: ❑ Public A Private 8. Property Dimensions i 3 y L% Gi G v e5 • Sewage DContractor 9. Do you anticipate additions/expansion of the facility this sytem is intended to serve? ❑ Yes If yes, what type? No PROPERTY INFORIIATION REQUIRED: ❑ Community Directions to Property: Tax Office PIN // 57(:� -Z7 —5 327 Road Name 1)v1z'LEG6: 1qZl , (if available) e" � .'a•� ��J , -�a �iGN� City oi✓ �/974CG �. �� i�,o/ZoX . /�ti<<c oma✓ LC�i f/a`...42L1 v 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 incurred from this application. Q -5 - DATE SIGNATURE CONSENT FOR SITE EVALUATION TO BE DONE ON ABOVE DESCRIBED PROPERTY MUST CHECK ONE: ❑ 1. 1 OWN the property. ❑ 2. 1 DO 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 represent ive of the Davie County Healt Department to enter upon above described property located in Davie County and owned by O to conduct all testing procedures as necessary totermine said site's suitability for a ground absorption sewage treatment and disposal system. -��-gs �?( A, (--Q(O DATE 000 SIGNATURE DCHD (1/93) `- DAVIE COUNTY HEALTH DEPARTMENT ` Environmental Health Section Soil/Site Evaluation NAME jk DATE EVALUATED ADDRESS PROPERTY SIZE PROPOSED FACIILTY LZ LOCATION OF SITE ^-'S`�� /ti's✓ Water Supply: On -Site Well LI -1, _ Community Public Evaluation By: Auger Boring t/ Pit Cut FACTORS 1 2 3 4 Landscape position ,L, Slope % HORIZON I DEPTH Texture group Consistence Structure Mineralogy HORIZON II DEPTH _tom 16 Texture group Consistence Structure 6le Mineralogy HORIZON III DEPTH Texture group Consistence Structure Mineralogy HORIZON IV DEPTH Texture group Consistence Structure Mineralogy SOIL WETNESS RESTRICTIVE HORIZON SAPROLITE CLASSIFICATION T LONG-TERM ACCEPTANCE RATE SITE CLASSIFICATION: LONG-TERM ACCEPTANCE RA E: -42 REMARKS:-errr�'r •l �`c DCHD(01-901 EVALUATED BY: HER(S) PRESENT: END 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 Mi neraloicy 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 ■��■�e��■��■��_■��■ ��a�■ ■■��N��■��■■ ��e�■ ■■��■��■��■■��■■ ■■��■■■��■��■�� ■��■�■��■■ ■��■��■�■�� ■��■�� ■��■��■��■��■��■��■�■ ■��■��■��■��■��■��■�■�■ ...........................................�..._.... ............. ...................................■.■.... ... ■... ...■......... ■�s�■��■��■■�� ■�� ■��■��■ ■�■��■��N�■�\��■ ��■�� ■��■��■��■��■ �� ■��■��■��■■■ ■�■��■��■��■��■ ��■■� ■��■■ ��■��■ ■��■ �� ■ ■��■■��■�■��_�� _��i��■n�i� ■��■��■■��■�� ■ ■ �■� ■�� ■■ ■■■��■��■�� ■ � ■��■�■■■��■��■��■��■� ��■■ ■��■�■��■■��■�■��■��u��■■ ■��■��■■��■■A�� ■��N�� ■��■ ■��■■��s■��■��■��■�� ■ �■��H��■ ■��■��■��l��■�� ■��■��■�■�■�■ ■��■�■��■��\�■.■�N�� ■��..�� iiiiiiiiiiiiiiiiii�iiiiiiiiiiii�iii:.:�:::.:ii: C:C:::.:_::_:: _ ■��■■��■��■��■■��■��■��=n�� ■ �■�■■■�■ _�■ ■■�O��n��■■��\■�h��■Hv� ��M��■�� ■� ■�■��■��■■��■■��\■�� ■��■�� ■ ��■�\�� ■��■��■N��■��N��■��■��■��■� � ■��■��■��■��h��■��■��N��■ �� ■� �� ............................................... . �....C...... � ...............................................�_ .._......... .....■.■..■....■■........................ .■... . .. .. ■...... ..........�....■■■.....■.■■n.....■■■■■■..■�.■■■■� .■C■■..=S■■.■..■ ■��u��l�i��u��■Nu �� ■��■��ii��■��■��■�7��■ ��H�� ■N� �■ �� 7�HN�n��■��■��■��N�� CH�� C !�■�■� ■��L'��■��■�■■��r� ■��■�� ■■��■■��■��■�■� ■ �� ■ ■ ��5� ■��■��■■�■�� ■ �■�■�■ ■��■��■■� �� H�■��■■ ■ �� ■�■�� ■��l��■��■�� ■�� p� ■� ■ ��■�■�� ■��■��■�� ■�� ■ , ■�� ■�� u�� ■� ■� �� ■��N��■��■��■��u�� ■��■■ ■��■��u�■�■��H��%� �� G� �N�� ■�� ■■■�■��N��■��■i"ii�� ■� �� ■�� ■��■��n��■��■��1■�� ■ �� ■�� \��■��■h�� ■�� ■ ■ �� ■�� ■ �� ■��v�� 0�� Q ��■�� ■�� 0��N�� ■��■��u■��s�i�� H■�u■�� iiiiiiiii=ii�i=iiuii��ii�iiiii=iii_�� ii i■ii�i�i ■�� au�m��:--:::.� �� ■ �■�■�� ■��■��u��.■.�■��n�■ N �� n��■�� ...............................�. ._ �....... ................. .............. . . ....... ■��v��H ��v■�� ■ v��U� ■�■��u■��q��\�� u�� ■�■�■u� �� ..._... 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