141 Sunburst Lane Lot 1Davie County, NC t Tax Parcel Report 1661A Monday, October 3, 201 c
WARNING: THIS IS NOT A SURVEY
y„Parcel Information,
Parcel Number:
M40000002401
Township:
Jerusalem
NCPIN Number:
5735384450
Municipality:
Account Number:
82526163
Census Tract:
37059-807
Listed Owner 1:
PRICE ANGELA QUEEN
Voting Precinct:
COOLEEMEE
Mailing Address 1:
141 SUNBURST LANE
Planning Jurisdiction:
Davie County
City: MOCKSVILLE
Zoning Class:
DAVIE COUNTY R -A
State:
NC
Zoning Overlay:
DAVIE COUNTY CZOD
Zip Code:
27028-0000
Voluntary Ag. District:
No
Legal Description:
PARCEL 1 SUNBURST DOWNS
Fire Response District:
COOLEEMEE
Assessed Acreage:
5.31
Elementary School Zone:
COOLEEMEE
Deed Date:
4/2005
Middle School Zone:
SOUTH DAVIE
Deed Book / Page:
006010880
Soil Types: RnC,GnB2,PcC2,GnC2,CeB2
Plat Book:
0007
Flood Zone:
Plat Page:
164
Watershed Overlay:
DAVIE COUNTY
Building Value:
60380.00
Outbuilding & Extra
150.00
Freatures Value:
Land Value:
30080.00
Total Market Value:
90610.00
Total Assessed Value: 90610.00
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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
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NC
County of Davie, North Carolina, Its agents, consultants, contractors or employees from any and all claims or causes of action due to
the Inability to the GIS data by this
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or arising out of use or use provided website.
Davie County Health Department
is36Environmental Health Section
P.O. Box 848`
�210 Hospital Street
r} 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: �1��%� �l �� C� _Phone Number 7(,W-) 7 d7,,1 VV0 (Home)
Mailing Address: Yl �(Wlf fig'- (Work)
1 d 645 (1/ /%9 & C 27dN" Email Address:
Detailed Directions To
Property Address: �3/w/ 7� >a -
Please Fill In The Following Informjjation About The EXISTING Facility: Name System Installed Under: {'l %i N010 � ,5�6� � tp nd Type Of Facility: /V� 6%S611
Date System Installed (Month/Date/Year): / q ! q Number Of Bedrooms: 3 Number Of People:
Is The Facility Currently Vacant? YesNo If Yes, For How Long?
Any Known Problems? Yes oNoIf Yes, Explain:
Please Fill In The Following Information About The NEW Facility: /�
Type Of Facility: '!A fae � G(! �(i1J Al 30)(50 Number Of Bedrooms/'C� Number of People--(9—
Pool
eoplePool Size: Garage Size: Other:
Requested B . f Date Requested:
Approved isapproved
Environmental Health
For Environmental Health Office Use Only
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*The signing of this form by the Environmenta eaI ay 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 Money Order # Amount:$ Date:
Paid By: Received By:
Account #: Invoice #:
J•
0
an�
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AUTHORIZATION NO 1 - Q 7A DAVIE COUNTY HEALTH DEPARTMENT
Environmental Health Section PROPERTY INFORMATION
Permittee' i (� P.O. Box 848
Name: [ILA.-Trk-i !-1ra�c f Y Mocksville, NC 27028 Subdivision Name: SL4 a -s �pwh3
Phone # 336-751-8760
Directions to property.. =S(n:C`� �T G Section: Lot:
AUTHORIZATION FOR
y ?i a�Cf� ,�J'GrI" "''> 1, �- n`� WASTEWATER Tax Office PIN:#�7%? 1(2 L�2�
SYSTEM CONSTRUCTION ` —
(�.l CY'-c'•n- ��cCCrLK vltt�rl{{i1u_t c .) l,t,
Road Name�3f�it3��� 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 1pf G.S. Chapter 130A, Wastewater Systems, Section .1900 Sewage Treatment and Disposal Systems)
77 ***NOTICE*** THIS AUTHORIZATION FOR WASTEWATER CONSTRUCTION
fes~
IS VALID FOR A PERIOD OF FIVE YEARS.
ENVIRONMEN-TAL HEALTH SPEC ISt DATt ISS ED
;rd
571 3'
R j0 7A DAVIE COUNTY HEALTH DEPARTMENT
1. IMPROVEMENT AND OPERATION PERMITS PROPERTY INFORMATION
Permlttee`s ', 1 y.
1 r ` . r.. 1' Subdivision Name: Su I u rs ►i Dpw I
Directions to property: Section:!- Lot:
IMPROVEMENT
PERMIT Tax6ffice PIN:# 1 -
1
lt/ti.i,:( 4.. +_ (.'( �.�..
Road Name f Zip:
d
**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 t ; • "'a 1 c; 9 PLANS OR THE INTENDED USE CHANGE. YOUR WASTEWATER
ENVIRONMENTAL HEALTH SPECIALIST DATE ISS ED SYSTEM CONTRACTOR MUST SEE THIS PERMIT BEFORE
INSTALLING THE SYSTEM.
RESIDENTIAL SPECIFICATION: BUILDING TYPE M 1- # BEDROOMS # BATHS # OCCUPANTS GARBAGE DISPOSAL: Yes o(No
COMMERCIAL SPECIFICATION: FACILITY TYPE # PEOPLE—# PEOPLE/SHIFT # SEATS INDUSTRIAL WASTE: Yes or No
�. :,c_
LOT SIZE TYPE WATER SUPPLY L ( DESIGN WASTEWATER FLOW (GPD) `' a t NEW SITE ✓REPAIR SITE
.! ?� r
SYSTEM SPECIFICATIONS: TANK SIZE i�Y)GAL. PUMP TANK GAL. TRENCH WIDTH,,+ ROCK DEPTH LINEAR FT.
OTHER
REQUIRED SITE MODIFICATIONS/CONDITIONS: ° `�� t �u. U C- �` `�� U J� Y— �-� n `-- �` +^ s• 11�-i
W;rLL.,
IMPROVEMENT PERMIT LAYOUT r�ppR[I4'CD EFFL mT FILYir - emrsEms) IF G' ` I1mu-.i FI1}ISii :i} Giy.' DIEk
Ipso
5
-5 d
N
r1
"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 t7U4)fW1E26(U
tea}�51–FIi6'.l
OPERATION PERMIT ')a 1
�r
SYSTEM INSTALLED BY: SP� L
W'
1,- 1+
ek-Z,4T
1-297
AUTHORIZATION NO.15e6 A, OPERATION PERMIT BY: DATE: v
"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)
i APPLICATION FOR Davie County Health Department
� PERMIT & ATC
r
Environmental Health Section
P.O. Box 848/210 Hospital Street
Mocksville, NC 27028
(336)7;1-876OENVIRONMENTAL HEALTH
DAVIE COUNTY
***XWORTANT*** THIS APPLICATION CANNOT BE PROCESSED UNLESS ALL THE REQUIRED
INFORMATION IS PROVIDED. Refer to the INFORMATION BULLETIN for instructions.
1. Name to be Billed Tj��Q �Z�%i2y��( `��/+ W� �(�lC/1�� Contact Person
Hailin j Address 1 O ' r` ' 1 -3 Z /\ ' / Home Phone
Cit_: /State/ZIP �O U Q,.OU - C a%v 14 Business Phone
2. Names on Permit/ASC if Different than Above
Yr.:.ling Address City/State/Zip
3. ,;application For: U Site Evaluation ❑ Improvement Permit/ATC 0 Both
4. System to Service: ❑ House Mobile ,, Home ❑ Business ❑ Industry ❑ Other
S. If Residence: # People # Bedrooms -! # Bathrooms
V/ Dishwasher 0 Garbage Disposal if washing !machine 0 Basement/Plumbing 0 Basement/No Plumbing
6. If Business/Industry/Other: Specify type # People # Sinks
#'Commodes # Showers # Urinals # Rater Coolers
IF FOODSERVI-">E # Seats
7. Type of Water supply:
Estimated Water Usage (gallons per day)
❑ County/City
0 well
3. Do yo6.1 anticipate additions or expansions of the facility this system is intended to serve?
If yes, what type?
0 Cou comity
❑ Yes 00
***1MPDRTANT***CLIENTS MUST COMPLETE THE REQUIRED PROPERTY INFORMATION REQUESTED I
BELOW. Either a PLAT or SITE PLAN �IIUST BESUBAIITTED by the client with THIS APPLICATION.
rams n:Propety Dimensions: ?'�
Tax Office PIN: # al 3S :� b QA -7 •DD lop
rn12p 4-M y _
Property Address: Road Name ;7 � ErL 4U
City/Zip
If in a Subdivision provide information, as follows:
Name:
-ri act
Section: Block: IZ6.
WRITE DIRECTIONS (from Mocksville) to PROPERTY:
Date Property Flagged: 3 �-'2 r
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 r on ' le for all charges incurred from
this application. I, hereby, give consent to the Authorized Representative of the e ounty flealth rime
to enter upon above described properly/ located in Davie County and owned by ,�
to conduct all testing procedures as necessary to determine the site sui lity. _
DATE -S' 2Z- / % SIGNATURE
THIS AREA MAY BE USED FOR DRAWING YOUR SITE PLAN (Inc`i t>i�e all of the following: Existing and proposed
property lines and dimensions, structures, setbacks, and septic locations).
Account No. bd 3
Revised DCHD (07/98) Invoice No. 6516
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� CURVE DATA
' R = 2691.63' ���
; T = 400.00' ; - ' '�,�;;�,
��;5 L = 794.19' . � -
6. 0= 16•54'20.. �' '
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APPLICANT'S NAME
PROPOSED FACILITY
SUBDIVISION
DAVIE COUNTY HEALTH DEPARTMENT
Environmental Health Section SECTION LOT
Soil/Site Evaluation
DATE EVALUATED
PROPERTY SIZE
ROAD NAME
Water Supply: On -Site Well Community Public
Evaluation By: Auger Boring Pit Cut_
FACTORS
1
2 3 4 5 6 7
Landscape position
Slope %
o
-2370
HORIZON I DEPTH
eq —to
Texture group
6�
Consistence
Structure
Mineralogy
HORIZON II DEPTH
Texture group
Consistence
Structure
Mineralogy/
' 1
HORIZON III DEPTH
Texture group
_
X
Consistence
Structure
G
G
Mineralogy
HORIZON IV DEPTH
Texture group
Consistence
Structure
Mineralogy
SOIL WETNESS
RESTRICTIVE HORIZON
SAPROLITE
CLASSIFICATION
LONG-TERM ACCEPTANCE RATE I
tv
V .
SITE CLASSIFICATION:
LONG-TERM ACCEPTANCE RATE:
REMARKS:
DCHD (01-90)
EVALUATION BY:
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
Mineraloev
1:1, 2:1, Mixed
Notes x,
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
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