155 S M Whitt Dr (2)Davie County, NC Tax Parcel Report (� 3 5 N Thursday, October 6, 2016
WARNING: THIS IS NOT A SURVEY
lldataisprovided 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
161
Parcel Information
County of Davie, North Carolina, Its agents, consultants, contractors or employees from any and all claims or causes of action due to
Parcel Number:
K40000000102
Township:
Mocksville
NCPIN Number:
5727707587
Municipality:
Account Number:
78883180
Census Tract:
37059-801
Listed Owner 1:
WHITT RICHARD H JR
Voting Precinct:
SOUTH MOCKSVILLE
Mailing Address 1:
165 S M WHITT DRIVE
Planning Jurisdiction:
Davie County
City: MOCKSVILLE
Zoning Class:
DAVIE COUNTY R -A
State:
NC
Zoning Overlay:
Zip Code:
27028-5436
Voluntary Ag. District:
No
Legal Description:
33.41 AC OFF JUNCTION RD
Fire Response District:
COOLEEMEE
Assessed Acreage:
13.36
Elementary School Zone:
COOLEEMEE
Deed Date:
9/1990
Middle School Zone:
SOUTH DAVIE
Deed Book / Page:
001560357
Soil Types: IrB,EnB,EnC,ChA,MsD
Plat Book:
Flood Zone:
Plat Page:
Watershed Overlay:
DAVIE COUNTY
Building Value:
124690.00
Outbuilding & Extra
Freatures Value:
13280.00
Land Value:
69130.00
Total Market Value:
207100.00
Total Assessed Value:
207100.00
Davie County,
lldataisprovided 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
161
County of Davie, North Carolina, Its agents, consultants, contractors or employees from any and all claims or causes of action due to
NC
or arising out of the use or Inability to use the GIS data provided by this website.
'AOTHORIZATION NO. 1 3 0DAVIE COUNTY HEALTH DEPARTMENT
Environmental Health Section PROPERTY INFORMATION
Permittee'sl --�--. P.O. Box 848
Name:%-, t / !/i/�%. �/� Mocksville, NC 27028 Subdivision Name:
Directions to property: �=^ Sr ✓' ft4' Phone # 336-751-8760 Section: Lot:
7 AUTHORIZATION FOR
WASTEWATER Tax Office PIN:# S—V%- d
SYSTEM CONSTRUCTION --�
Road Name:'�-/ .f.;/! / fr zip: -?'7e)4
**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 9PtCIALIST DATE ISSUEb
1 ; 5 DAVIE COUNTY HEALTH DEP RTMENT
t' .t f.� IMPROVEMENT AND OPERATION OERMTI;� PROPERTY INFORMATION
4
Permittees
Narrfe- s t f /i' Subdivision Name:
Directions to property: / Section: Lot:
IMPROVEMENT
PERMIT Tax Office PIN:#
Road Name. - Zi
**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
PLANS OR THE INTENDED USE CHANGE. YOUR WASTEWATER
ENVIRONMENTAL ,HEALTH SPECIALIST DATE ISSUEb SYSTEM CONTRACTOR MUST SEE THIS PERMIT BEFORE
INSTALLING THE SYSTEM.
RESIDENTIAL SPECIFICATION: BUILDING TYPE JY # BEDROOMS # BATHS _ # OCCUPANTS–_ GARBAGE DISPOSAL: Yes or No
COMMERCIAL SPECIFICATION: FACILITY TYPE - # PEOPLE # PEOPLE/SHIFT # SEATS INDUSTRIAL WASTE: Yes or No
LOT SIZE ✓ !l �TYPE WATER SUPPLY _ DESIGN WASTEWATER FLOW (GPD) 3G d NEW SITE REPAIR SITE
SYSTEM SPECIFICATIONS: TANK SIZE /1 PD GAL. PUMP TANK GAL. TRENCH WIDTH ROCK DEPTH AV LINEAR FT.
OTHER 4At ,-1L Xt1Y+ t6 111V cr J v& -C
REQUIRED SITE MODIFICATIONS/CONDITIONS:
IMPROVEMENT PERMIT LAYOUT. *APPROVED EFFLUE[1'ii FIL' ERE g IST,n(S) IF G• 1 C LUIZ FIIIISUED GRADc.�
"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 (WG4}6348�60
11IT313-:NII111M
OPERATION PERMIT \ 1 ���
SYSTEM INSTALLED BY: `G
AUTHORIZATION NO.'`5`'S4 OPERATION P:
"THE ISSUANCE OF THIS OPERATION PERMIT SH!
WITH ARTICLE 11 OF G.S. CHAPTER 130A, SECTION
GUARANTEE THAT THE SYSTEM WILL FUNCTION-
DCHD 05/96 (Revised) `4
t O
01- o 105
�-v TpI� itio-Rsto-3 _
�r. —:;?DATE:
THE SYSTEM DESCRIBED ABOVE HAS BEEN INSTALLED IN COMPLIANCE
RTMENT AND DISPOSAL SYSTEMS", BUT SHALL IN NO WAY BE TAKEN AS A
,R ANY GIVEN PERIOD OF TIME.
APPUCA710N FOR SITE EVALUATION/IMPROVEMENT PERMIT do A
Davie County Health Department
• • Environmental Health SmWon
P.O. Box 848/210 Hospital Street
Mockaville, NC 270!13
(336)751-8760
APR 16 1999
EI�VIRONt�1ENTAL,HEALTH
***II►�ORTAPIT*** THIS APPLICATION CANNOT BE PROCESSED UNLESS ALL 9iWTMQUIRED
INFORMATION IS PROVIDED. Refer to the INFORMATION BULLETIN for instructions.
1. llama to be Billed ? �ci-CXF Ac � � � 1 e � W � �� r � ; Contact person ► c/ n p t �^
Hailing AddressI �l sLLS Home Phone 33 0 Lo 1 i
City/state/ZIP O ay{�bv ►II (. ro (, 1 �,� Business Phcn�'.33 `lI uy 40 ex+ q o
2. Haar on Permit/ASC if Different than Above
Mailing Address
3. Application For: )(Site Evaluation
City/state/Zip
W iHgprovement Permit/ATC
6. system to service: J% House ❑ Mobile Home 0 Business 0 Industry
S. If Residence: # People_ # Bedrooms
eDishwasher e0arbage Disposal hl Washing Machine 0 Basement/Plumbing
6. If Business/Industry/Other: Specify type # People
# Commodes
# showers
# Urinals
FI Both
❑ Other
# Bathrooms a
j(Basement/Ho Plumbing
# Sinks
# Water Coolers
Ir rOODSERVICE: # Seats Estimated hater Usage (gallons per day)
7. Type of water supply: ❑ County/City 0 well 0 Community
e. Do you anticipate additions or expansions of the facility this system Is intended to serve! 0 Yes XNo
If yes, what type'
***IMPORTANT*** CLIE14TS MUST COMPLETETHE REQUIRED PROPERTY INFORMATION REQUESTED
BELLOW. es:mss: s PP 4T er SITE PLAN MV; VT ZESUBAIITTED P%y the client with THIS APPLICATION.
Property Dimensions: Acr eS DIRECTIONS (from Mocksville) to PROPERTY:
Tax Office PIN:04 J\"q 660 DDo p 1 as G,, l a ger°ck o &y A 2,- Apprat�
Property Address: Road NamD,J �°(S�u.
City/Zip (�oc,ko, - N � C-07�J$ a�8- `�'ca�el �, I t �, X L e.,
If in a Subdivision provide information, as follows: cpm �� PDQ (,t) t+41 �)C to
Name:y� �t'iaC (�1 rLpe,�}.� 0,, I ed`('
Section: Block: Lot: Date Property Flagged: 1 /i'
b3
This is to certify that the information provided is correct to the best or 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. 1, hereby, give consent to the Authorized Representative of the Dikyie County Health Deparlownt
to enter upon above described property located in Davie County and owned b. �T
to conduct/all testing procedures as necessary to determine the site suitability.
DATE ") �" 11 AT'URE-f jA
THIS AREA MAY BE USF,D'1'OR DRAWING YOUR SITE PIAN (Inclbde all of the following: Existing and proposed
property lines and dime 91ons, structures, setbacks, anser-c
ions).
C f�PP
L., �
JjjA r1 4G: n 1Z
,5*41
CCOUnt
Revised DCHD (07/98) Invoice No.
APPLICANT'S NAME
DAVIE COUNTY HEALTH DEPARTMENT
Environmental Health Section SECTION LOT.
Soil/Site Evaluation
PROPOSED FACILITY ,
SUBDIVISION
Water Supply:
Evaluation By:
On -Site Well
Auger Boring
DATE EVALUATED
PROPERTY SIZE
ROAD NAME <:S'//%
Community Public
Pit Cut
FACTORS 1 2 3 4 5 6 7
Landscape position
Sloe %
HORIZON I DEPTH
Texture group
Consistence
Structure
Mineralogy
HORIZON II DEPTH
Texture group
Consistence
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'AEA
SITE CLASSIFICATION;
WE
EVALUATION BY: a //
LONG-TERM ACCEPTANCE RATE: OTHER(S) PRESENT:
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 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
DCHD (O1-90)
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Phone: (336) - 753 -
unty Health Department
1 ental Health Section
P.O. Box 848
10 Hospital Street
urier # : 09-40-06
Mocksville, NC 27028
d� jy f
4 .,
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5{ t1 �ha�..hn sa• ax 1 �,
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Fax: (336) - 753-1680
ON-SITE WASTEW,,ATER CERTIFICATION FOR DWELLING
(Check One) PeplaceTiiiRemodeling Refonnection
Name: f !; AN r`Jv, , d �,Ll / / ���' ✓`lsnr j Phone Number -3, �y 2- ' Z3 7Y (Home)
Mailing Address:/S`5` S . /�'1. �..>> '1T 'Vi-; Work)
Detailed Directions To Site: vfs /N�,� %11 r>� 7�:✓ f�'��'-'f /�
Ix e . /Z2
LeP Ki -We, h/l Dom.
Property Address: Z S `a /7_7 / ' r ILL' r•
Please Fill In The Following Information About The EXISTING Facility:
• Name System Installed Under' 0"(d,0h / 11 ,J/�. - Type Of Facility:
Date System Installed (Month/Date/Year): M 0 �l1 Number Of Bedrooms: –.S Number Of People:
Is The Facility Currently Vacant? Yes If Yes, For How. Long?
Any Known Problems? Yes ON
Iff Yes, Explain:
Please Fill In The Following
�Information About The NEW Facility:
y Of Facility: / ���/� ll�i{� �Ji Number Of Bedrooms: ' Number of People
e ested By: i ate Requested:
(Signature)
� For Environmental Health Office Use Only
Approved Disapproved
Comments:
Environmental Health Specialist L%'i����% 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 Check 1/Money Order #
Amount:$
Paid By: Received By:
Account #: ''f Invoice #:
Date: