240 Tall Timbers DrDavie County, NC . , Tax Parcel Report Tuesday, October 11, 2016
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Parcel Information
Parcel Number: F20000003003 Township:
NCPIN Number: 5811117088 Municipality:
Account Number: 51676920 Census Tract:
Listed Owner 1: MOORE BRADLEY S Voting Precinct:
Mailing Address 1: 240 TALL TIMBERS DRIVE Planning Jurisdiction:
City: MOCKSVILLE Zoning Class:
State: NC Zoning Overlay:
Zip Code: 2702&5923 Voluntary Ag. District:
Legal Description: 3.00 AC TALL TIMBERS DR Fire Response District:
Assessed Acreage: 2.81 Elementary School 2one:
Deed Date: 7/1987 Middie School Zone:
Deed Book / Page: 001380554 Soil Types:
Plat Book: Flood Zone:
Plat Page: Watershed Overlay:
Building Value:
Land Vatue:
Total Assessed Value:
9� � Davie County
�
�o��� NC
0.00 Outbuilding & Extra
Freatures Value:
28340.00 Total Market Value:
32840.00
Clarksville
37059-801
CLARKSVILLE
Davie County
DAVIE COUNTY R-A •
SHEFFIELD - CALAHALN
WILLIAM R DAVIE
NORTH DAVIE
Mn62
DAVIE COUNTY
!f.��i��iI�7
32840.00
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":. A��'xoR�zA'r�oN No: Q 5 4 4 DAVIE COUNTY HEALTH DEPARTMENT ,�t ��°���' � �✓ c
�' ' � Environmental Health Section PROPERTY INFORMATION
Perc�ittee's �{� 4� R� P.O. Box 848
Name: +f R �° t`� �� Mocksville, NC 27028 Subdivision Name:
� Phone #: 704-634-8760
Directions to property: ���� fi� �� �..� =>..�aa`,�•. Section: Lot:
t��. ~� AUTHORIZATION FOR i
`'�._.�r.�4'��' ��Ce�.�� c_ ..�-`�.. v�.,a�t..,��,..Q.,'�5. WASTEWATER Tax Office PIN:# �Y }� _ �— _ b � �L
` ....- ,.� �
SYSTEM CONSTRUCTION
� C�e+��+\1 ` �h.��'"�T� � �� - 0.l.a�t'a. 1 ~ ' cj�� �� �'1
Road Name: c�` � � r�h x:.;� Zip: t--�
**NOTE** This Authorization for Wastewater System Construction MUST BE ISSLTED by the Davie County Environmental Health Section pripr
to issuance of any Building'Pernuts. This Form/Authorization Number should be presented to the Davie County Building Inspections
Office when applying for Building Pernuts. '
(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
``_ , r_ � � >• ,,*.-,�� '`}•�+�."lw L�- ,�+ -f � �o � IS VALID FOR A PERIOD OF FIVE YEARS. . .
ENVIRONMENTAL HEALTH SPECIALIST DATE ISSUED
_
� ..t ; _ ��
�' - � s,�.:.:. :, , , V ; . ... -�r l ,�f.,, , c, t;� � �� °
=-� y 1�' _ �` DAVIE COUNTY HEALTH DEPARTMENT r
�., -...�-�'�" - '" `'�R' IMPROVEMENT AND OPERATION PERMITS PROPERTY INFORMATION
Perr�itt '.s% �'' '~
�i'', �.
` Name: " _��;, . :.� t.:. � i,`.�`� ;; �
Directioris to property: � '' � �' ! � � ' • F
`,,
- `�; ,"� .�� ,5 , `4'+. .�' �
� ���� c;�a.,,�� s`�.��, i �<;;��:�� , �' ,> . <�»�����
Subdivision Name:
Section: Lot:
Il14PROVEMENT
PERMIT Tax Office PIN:# � � i l - i � - � �� ��` �
� Road Name o����� �� e����t. Zip; �` 7...:� �
*.*NjOTE** This Improvement Pernut DOFS NOT authorize the construction or installation of a septic tanlc system or any wastewater system. An
� AUTHORIZATION FOR WASTEWATER SYSTEM CONSTRUCTION must be obtained from this Department prior to the
conshuction/installation of a system or the issuance of a building pernut.
(In compliance with Article 11 of G.S. Chapter 130A, Wastewater Systems, Section .1900 Sewage Treatment and Disposal Syste�ns)„�'
-�=-�-- - ***NOTICE*** THIS PERNIIT IS SUBJECT TO REVOCATION IF SITE
�. , ,. ; - ..` ,` ; :._a.. �.] . j,, .' �,,,, PLANS OR THE INTENDED USE CHANGE. YOUR WASTEWATER
ENVIRONMENTAL HEAI:TH SPECIALIST DATE ISSUED SYSTEM CONTRACTOR MUST SEE THLS PERNIIT BEFORE
INSTALLING THE SYSTEM.
RESIDENTIAL SPECIFICATION: BUILDING TYPE M���'�'`�# BEDROOMS �# BATHS '�. # OCCUPANTS � GARBAGE DISPOSAL: Yes o, o
COMMERCIAL SPECIFTCATION: FACILTI'Y TYPE # PEOPLE # PEOPLElSHIFI' # SEATS INDUSTRIAL WASTE: Yes or No
LOT SIZE �.3 TYPE WATER SUPPLY �<z`i�� DESIGN WASTEWATER FLOW (GPD) NEW SITE�_ REPAIR STI'E
SYSTEM SPECIFICATIONS: TANK SIZE bbD GAL. PUMP TANK GAL. TRENCH WIDTH � 1 ROCK DEPTH •���� LINEAR FT. � 0� �
REQUIRED SITE MODIFICATIONS/CONDTI'IONS:
�
IMPROVEMENT PERMIT LAYOUT
**CONTACT A REPRESENTATIVE OF THE DAVIE COUNTY HEALTH DEPARTMENT FOR FINAL INSPECTION OF THIS SYSTEM
BETWEEN 830 - 9:30 A.M. OR 1:00 - 1:30 P.M. ON THE DAY OF INSTALLATION. TELEPHONE # IS (704) 634-8760.
I OPERATION PERMIT
� S
SYSTEM INSTALLED BY: �� � ��+
� �, a �,� �
AUTHORIZATION NO. C.��� OPERATION PERMIT BY: C. _ DATE: _�� 1� � I?�
�
**THE ISSUANCE OF THIS OPERATION PERMIT SHALL INDICATE THAT THE SYSTEM DESCRIBED ABOVE HAS BEEN INSTALLED IN COMPLIANCE
WITH ARTICLE 11 OF G.S. CHAP'TER 130A, SECTION .1900 "SEWAGE TREATMENT AND DISPOSAL SYSTEMS", BUT SHALL IN NO WAY BE TAKEN AS A
GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORII.Y FOR ANY GIVEN PERIOD OF TIlvIE.
DCHD OS/96 (Revised)
- , � �� ��.��
'�� � APPLICATION FOR SITE EVALUATION/IMPROVEMENT PERMIT &
�� � � Davie County Health Department
�� Environmental Health Section
o, �� �,
�1 �--� P. O. Box 848
U � � Mocksville, NC 27028
� (704)634-8760
****IMPORTANT**** THIS APPLICATION CANNOT BE PROCESSED UNL
ALL THE REQUIRED INFORMATION IS PROVIDED.
1. Name to be Billed ��5�� N �� �� d d ��' Contact Person _
L/ � ,
Mailing Address � 7� �C� ll �/ /�'( � Q �S �� ' Home Phone _
�cc��a��
1
' OCT I 0 I���
�
�
%.� ��� �f''lo�ce
�1 � a -'� 3�3
City/State/Zip 1' I�YI' F'15 (r�(��l L• ����_ Business Phone �5 d^�� ��
2. Name on PermidATC if Different than Above ,
Mailing Address
3. Application For: ❑ Site Evaluation
City/State/Zip
❑ Improvement Permit & ATC
� Both
4. System to Serve: ❑ House � Mobile Home ❑ Business ❑ Industry ❑ Other
5. If Residence: # People � # Bedrooms �� # Bathrooms �
t� Dishwasher ❑ Garbage Disposal � Washing Machine ❑ Basement/Plumbing ❑ Basement/No Plumbing
6. If Business/Other:
# Commodes
If Foodservice:
Specify type
# Showers
# Seats
# People # Sinks
# Urinals
Estimated Water Usage (gallons per day)
# Water Coolers
7. Type of water supply: ❑ County/City � Well ❑ Community
8. Do you anticipate additions or expansions of the facility this system is intended to serve? ❑ Yes f�f No
If yes, what type?
PROPERTY INFORMATION REQUIRED: '�'�* IMPORTANT *** A PLAT OF THE PROPERTY MUST BE
SUBMITTED WITH THIS APPLICATION.
Property Dimensions: � � C%2-e--
Tax Office PIN: # �� r I = � I - r� o� ;
Property Address: Road Name //'% �� ��i'l-� � l� �� r"
City/Zip �OC �s �/ r//�-- ,� / d��
If in Subdivision provide information, as follows:
Name:
Section:
Lot #:
WRITE DIRECTIONS (from
Mocksville) TO PROPERTY:
i� 4., �T(�)1 ��� E
qn �` D �P�,� C'1-c�l�
J
Me �-�- 1 e-Ff n r��
f.�� . r_� ► �-�-� . � � -F'+-
���
This is to certify that the information provided is correct to the best of my knowledge. I understand that any permit(s) issued hereafter
aze 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 upon above described property located in Davie County
/ / % `-�J
and owned by �� 7'i Q' �- �� ra- �/ e�1 �`�� ��e- to conduct all testing procedures
as necessary to determine the site suitability.
DATE �� l �� 9� SIGNATURE
Revised DCHD (06-96)
' ��f - ��/6
� �' �
.a . S 85° 15' 13�� E P�P . . ':
i ;_ , + 449.'65 ---' : �
$ ` 30.06 L � ,
�' EIP ,
i • .
N� � . ",
m ' �
�, � s
�� � � ��
AREA� = 3. 000 AGRES N
a. � c�. �
_ a �`� Nj` - .
N M.E STANLEY -_. , -
J � . ' �' - • _ .
Q D6.92 PG.208 � � �Q �
F- 3 �,9
0
` F' 528.88
�;
t N�P ---«--- N�85° 15` 13� W � 560.85 TOTAL a��P � �
� � _ � ..�,�?.�..tx�"�`r�.,a�:.��.::;-..: �M=.�,.�-,�_--'a'' � ^� - � .
. TO BE CONVEYED T 1 {%�" � •�, av -� •�` ' • N
BRADLEY MOORE 1 ,.' d, c►�
" ���� J fl��.e. � �` Q
rn . �� S' . '-=� �,
- AREA = 3. 00� AG�tE c F� r�} fl��`� y ; 9__� _..._.�_ -M_ ��_. �
w � � ����� � <
• a, � `'` � �,
,P �� �,/--� a a5 = LEGEND
�' - �7� � �-�-� - �-�r - 2.20
oS 81 ° 53` 44 �� E—'' _ 660.06 TOTAL ��,, NIP � N O EIP = EXISTING
O O �• O PIP = PLACED
' Z � � . O NIP =NEW IRON
' �_ � + = POIN T IN
`° AREA = 2.522 ACRES � W�
o�,r
E�P 667. 14 � 30•� � NOTE : ALI. AREAS tNC
` N 81° 53 � 44�� W _ 697.93 i�TAL • EIP OF TALL TIMB
� . HOMESTEAD l.A
. , -
� .
= W TAX MAP = F- 2 PARCEL
� �, n BRUCE R. SANDS � TOLERANCES REVISIONS • M.E. ST
'� � DB.126 PG. 787 � � -� SURVEY FOR :
;. a �ci . . . - ��x��•, �• ��,��� No. `.� owTe-. . er �-- {. , _ � BRADLE
� � M , �ec�n�wc. . ; � BEING �.3..,'7RACTS TOTAL AF
: o - � + `ME: STANLEY •'PROPERT
'� �, _ • Z _ . . . . . . . _ . . � " . - . � 2 � , . � . - � . � �
- . � ,, .
- , „
�- � � DAVIE COUNTY HEALTH DEPARTMENT
� ' � Environmental Health Section
Soil/Site Evaluation
NAME v'A so N ��.�r� �oa{�q DATE EVALUATED I� ` �� 9�
ADDRESS S fl i'� `� PROPERTY SIZE i�9-
PROPOSED FACIILTY �` � v`�'�� � LOCATION OF SITE ��'�1 �� ���-S ��
Water Supply: On-Site Well ✓ Community Public
Evaluation By�.t-- Auger Boring � Pit Cut
FACTORS 1 2 3 4
Landsca e osition
Slo e 7. —' —
HORIZON I DEPTH G, " �• `'
Texture rou tL C �-
Consistence -�
Structure '�- C�.
Mineralo :( 1:►
HORIZON II DEPTH 1�'
Texture rou
Consistence '�.
Structure 6 ' �`
Mineralo '.) .
HORIZON III DEPTH
Texture rou
Consistence
Structure
Mineralo
HORIZON IV DEPTH
Texture rou
Consistence
Structure
Mineralo
SOIL WETNESS
RESTRICTIVE HORIZON ' —
SAPROLITE —' —
CL�SSIFICATION � • •�
LONG-TERM ACCEPTANCE RATE ,� .�1
SITE CLASSIFICATION: �� EVALUATED BY: C`���m�4� `�►.�
LDNG-TERM ACCEPTANCE RATE: �� OTHER(S) PRESENT: __�w ���
REMARKS: �c�-�Q.a��—�_�=����i � ��.9��i��
LEGEND
Landscape Position
R-Ridge 5-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-Silt,y �;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
,iC--SYngle grain M-Massive CR-Crumb GR-Granular ABK-Mgular blocky
SBK-Subangular blocky PL-Platy PR-Prismatic
Mi neralo�y
1:1, 2:1, Mixed
Notes
H orizon 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 wate�' 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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