1874 Sheffield RdDavie County, NC
Tax Parcel Report 6431 Thursday, October 6, 2016
Parcel Number:
NCPIN Number:
Account Number:
Listed Owner 1:
Mailing Address 1:
City: MOCKSVILLE
State:
WARNING: THIS IS NOT A SURVEY
Parcel Information
F10000001601 Township: Clarksville
5801105123 Municipality:
42200000 Census Tract: 37059-801
KEATON J W Voting Precinct: CLARKSVILLE
188 CAMBRIDGE LN Planning Jurisdiction: Davie County
Zoning Class: DAVIE COUNTY R-20
NC Zoning Overlay:
Zip Code: 27028-0000 Voluntary Ag. District:
Legal Description: 1.125 AC SHEFFIELD RD LIFE ESTATE Fire Response District:
Assessed Acreage: 0.98 Elementary School Zone
Deed Date:
Deed Book / Page:
Plat Book:
Plat Page:
Building Value:
Land Value:
Total Assessed Value:
5/2013
Middle School Zone:
009260271
Soil Types:
Flood Zone:
Watershed Overlay:
44090.00
Outbuilding & Extra
Freatures Value:
17550.00
Total Market Value:
61640.00
No
SHEFFIELD - CALAHALN
WILLIAM R DAVIE
NORTH DAVIE
PcC2,CeB2
DAVIE COUNTY
0.00
61640.00
Davie County,
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
NCor
arising out of the use or Inability to use the GIS data provided by this website.
Davie County Health Department
18 t� Environmental Health Section
P.O. Box 848
C�
210 Hospital Street `
Courier # : 09-40-06 1911
Mocksville, NC 27028
Phone: (336) - 753 - 6780 ON-SITE WASTEWATER CERTIFICATION Fax: (336) - 753-1680
(Check One) Replacement Remodeling Reconnecttiioonn
Name: K :Q%� l C) !j� Phone Number 3 4� -Y9 9 `7 7 �Z ( (Home)
Mailing Address: I�7 s ��� ti l 1 meh 33 4, 11 V—W 317 (Work)
lff}/Zlkqil} �— �� �� Email Address: X
Detailed Directions To Site: 12 le- p 0. (k_ 5 ae.<L
Property Address: ` S'14 S'�j � � �.�"� (� )Z 1424'\ UN y YL C -j
Please Fill In The Following Information About The EXISTING Facility:
Name System Installed Under: Type Of Facility: 'Q,Wl, Ly,`
Date System Installed (Month/Date/Year):
Number Of Bedrooms: -j Number Of People: 1
Is The Facility Currently Vacant?
^ Yes No If Yes, For How Long? 4 Yt1 U
Any Known Problems? Yes (`J If Yes, Explain:
Please Fill In The Following Information About The NEW Facility:
Type Of Facility: Number Of Bedrooms:_?>Number of People I
Pool Size: Garage Size: Other:
Requested By: Date Requested:
(Signature)
For Environmental Health Office Use Only
pproved Disapproved
Comments:
Environmental Health
Date:
*The signing of this form by the Environmental Health Staff is in no way intended, nor should be taken as a guarantee
(extended or limited) that the on-site wastewater system will function properly for any given period of time.
Payment: Cash,� ,,t�he p Money Order # ( KTI /��r' I Amount:$ vV
Paid By: G� CoieC� Received By:
Account #: A5"7`1' Invoice #:
Date:
-lk-
X
x
a /I4
fill
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0
DAVIE COUNTY HEALTH DEPARTMENT
IMPROVEMENT PERMIT and OPERATION PERMIT
IMPROVEMENT PERMIT
—Xo
**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 ��% �0' = C �' `'� PROPERTY ADDRESS '1tr FP; c I b JI P %D G? V DATE
LOCATION-,�� `).1 ''�`w ?.:� »�;:'�, Y=c.�. Ll A-
SUBDIVISION NAME LOT NUMBER SEC./BLOCK NUMBER
RESIDENTAL SPECIFICATION: BUILDING TYPE ��•t� °r''' # BEDROOMS # BATHS # OCCUPANTS GARBAGE DISPOSAL: Yes;
COMMERCIAL SPECIFICATION: FACILITY TYPE # PEOPLE # PEOPLE/SHIFT # SEATS INDUSTRIAL WASTE: Yes/No
LOT SIZE .°.- >`� TYPE WATER SUPPLY L n DESIGN WASTEWATER FLOW (GPD) `' �� NEW SITE ' REPAIR SITE
SYSTEM SPECIFICATIONS: TANK SIZE N`)") SAL. PUMP TANK GAL. TRENCH WIDTH r ROCK DEPTH _ LINEAR FT.
OTHER
REQUIRED SITE MODIFICATIONS/CONDITIONS:
***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.
Llo;
,--P L1 '
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
SYSTEM jNSTALI
EU 0,0
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Ev i•r�,•�00-,`
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AUTHORIZATION NO. O 1A J-1 OPERATI6N PERMIT BY �aDATE ! C
WHE 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 EVALUATIONAMPROVEMENT PERMIT & ATC
Davie County Health Department F
Environmental Health Section t
P.O. Box 848
Mocksville, NC 27028
(704) 634-8760
****IMPORTANT****
THIS APPLICATION CANNOT BE PROCESSEBrl
THE REQUIRED INFORMATION IS PROVIDED.
1. Name to be Billedjr%CL ►'G
Mailing Address 1C,� h P Tt -P I sj -4'-'>a,
City/State/Zip V I / I •P, tyS CQ 7 �)' . �
2. Name on Permit/ATC if Different than Above
Mailing Address
3. Application For: [ ] Site Evaluation
Contact Person��J:CG 13�1L�J��-fZ
Home Phone 70 _ l (9,1" -77 7
Business Phone
City/State/Zip
[ ] Improvement Permit & ATC 111"Both
4. System to Serve: [ ] House [x4 Mobile Home [ 1 Business [ ] Industry [ ] Other
5. If Residence: # People c)-, # Bedrooms # Bathrooms_ [vfbishwasher [ ] Garbage Disposal
[Washing Machine [ ] Basement/Plumbing [ ] Basement/No Plumbing
6. If Business/Other: Specify type # People VP #Sinks # Commodes
# Showers # Urinals # Water Coolers
If Foodservice: # Seats Estimated Water Usage (gallons per day)
7. Type of water supply: [vrcounty/City [ ] Well [ ] Community
8. Do you anticipate additions or expansions of the facility this system is intended to serve? [ ] Yes [vJjo
If yes, what type?
PROPERTY INFORMATION REQUIRED: *** IMPORTANT *** A PLAT OF THE PROPERTY MUST BE
SUBMITTED WITH THIS APPLICATION.
Property Dimensions: i <J Y P S 'WRITE DIRECTIONS (�frro(-m Mocksville) TO PROPERTY:
Tax Office PIN: #5qoI - �_ - �� I �Fb fp 4 SIJ 4n 5
Property Address: Road Name 11e� e���• [�' f o K. f Y��j /e S �h
City/Zip M6LkS� A!C -)A'95? TI a � + D -C C'O s S rC1nn Mr','I
If in Subdivision provide information, as follows: 1 �ia` r\ h to r c L .
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
ve of the Davie County Health Department to enter upon above described property located in Davie County and owned
by' .VC>,,r n Q I l—k T Q C
DATE '7 - 17 - 1 SIGN
Revised DCHD (06-96)
to conduct all testing plocedures as necessary to determine the site suitability.
TAX 0 <<-eTSIJ 6, vim- Sp1_10-x131
W W. SMITH
116.16 750.50
TOTAL
123.00
N
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336.34
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AREA = 2.037 ACRES
2 (INCLUDES S.R. 1306 RIW) \
B0.71
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S 83 45 25 W
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0 = EXISTING IRON
• = PLACED IRON PIN
O = NAIL & CAP IN (j_ ROAD
nip = NEW IRON PIN
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336.34
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v
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AREA = 2.037 ACRES
2 (INCLUDES S.R. 1306 RIW) \
B0.71
103.64 --S BY 57' 09 W
S 83 45 25 W
N
O
O
a
O�
r
m
Z
ALFRED H. TUTTEROW'
D.B. 88 PG.2B6
P J
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Q—
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0 = EXISTING IRON
• = PLACED IRON PIN
O = NAIL & CAP IN (j_ ROAD
nip = NEW IRON PIN
o .�T Ai r. onAn
• t
DAVIE COUNTY HEALTH DEPARTMENT
• Environmental Health Section
Soil/Site Evaluation
NAME DATE EVALUATED
ADDRESS PROPERTY SIZE �•'J oL^*"
PROPOSED FACIILTY �"` LOCATION OF SITE
Water Supply:
On -Site Well _
Community
Public
Evaluation ByCk2\.
Auger Boring
Pit
Cut
FACTORS
1
2 3 4
Landscape position
Slope Z
'1 'v
(`
HORIZON I DEPTH
"
Texture group
(tL
C �-
Consistence
L
Structure
L'
Mineralogy
HORIZON II DEPTH
Texture groupC
Consistence
Structure
Mineralogy
HORIZON III DEPTH
Texture group
Consistence
Structure
Mineralogy
HORIZON IV DEPTH
Texture group
Consistence
Structure
Mineralogy
SOIL WETNESS
IS'S
5S
RESTRICTIVE HORIZON
SAPROLITE
CLASSIFICATION
LONG-TERM ACCEPTANCE RATE
SITE CLASSIFICATION: EVALUATED BY:
LONG-TERM ACCEPTANCE RATE: OTHER(S) PRESENT: N609
REMARKS:.
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.D. Box 665
Mocksville, N.C. 27028
AUTHORIZATION FOR WASTEWATER SYSTEM CONSTRUCTION
(Issued in compliance with Article 11 of
G.S. Chapter 13OA, Wastewater Systems)
***This Authorization For Wastewater System Construction oust 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.***
e ` e �� b AUTHORIZATION Nle BER
NAME W e 1 m� 1
NAME ON IMPROVEMENT PERMIT (If different than above)
SITE LOCATION S q-!.:— C; v \ x R 0 a
COMMENTS/CONDITIONS ON AUTHORIZATION TO CONSTRUCT WASTEWATER SYSTEM
**WICEfm* THIS AUTHORIZATION FOR WASTEWATER SYSTEM CONSTRUCTION IS VALID FOR A PERIOD OF FIVE (5) YEARS.
ENVIRON ENTAL HEALTH SPECIALIST DATE
DCHD 10/95