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291 Tatum Rdt Davie Countv, NC � Taa� Parcel Report Tuesday, October 1 l, 2016 WAK1VllVli: 'l�tll.�' l� 1VV�1� A ►�'UKV1i:Y Parcel Information Parcel Number: N50000007401 Township: NCPIN Number: 5744864705 Municipality: Jerusalem Account Number: 19056000 Census Tract: 37059-807 Listed Owner 1: CREWS ROBERT WINSTON SR Voting Precinct: JERUSALEM Mailing Address 1: 291 TATUM ROAD Planning Jurisdiction: Davie County City: MOCKSVILLE State: Zip Code: Legal Description: Assessed Acreage: Deed Date: Deed Book / Page: Plat Book: Plat Page: Building Value: Land Value: Total Assessed Value: Zoning Class: DAVIE COUNTY R-20 NC Zoning Overlay: DAVIE COUNTY CZOD 2702&0000 Voluntary Ag. District: No 6.00 AC TATUM RD Fire Response District: JERUSALEM 5.99 Elementary School Zone: COOLEEMEE 12/1993 Middle School Zone: SOUTH DAVIE 001720010 Soil Types: PaD,PcB2,PcC2 Flood 2one: Watershed Overlay: 424190.00 Outbuilding & Extra Freatures Value: 37990.00 Total Market Value: 462180.00 DAVIE COUNTY � � r. 462180.00 9�.� �, All daU Is proNded aa is rWthout warrarRy or guuantee oT any Idnd eftl�er exprcased or ImpliM Including but not Ifmfted to the Davie County� Implied warraMies of inerchaMabllfty or fttness for a particular usa All users of DaNe Count�s GIS website ahall hold harmless the Cowrty of Davte, North Caroline, ks ageMa, consultaMa, coMradors or employees from any and a0 clalma or causea of actlon due to �'p�N.� NC or arising out of the use or Inab0lty to use the GIS drta proWded by thls webslta ,.. a _ _ ....- ,.: , - .- ' ` ._. . � ' . '�, ... � � ..�.. . . _ . , ,. . � . , . -� . .._ .. . , . . . .. . .. ��i.T�.. .} f�y.i4�� +y /��_. I � AUTHORIZ'ATION NO: �� DAVIE COUNTY HEALTH DEPARTMENT 3:�� Environmental Health Section PROPERTY INFORMATION Permit:ee's �,� P.O. Box 848 Name: ��>��?�` ��1'rl1Y ��'�11 S Mocksville, NC 27028 Subdivision Name: � Phone #:704-634-8760 Directions to property: l,t�)`�� (�r�f —. `i t> Section: Lot: r �• AUTHORIZATION FOR 1 i�l. �a�c..�c L� ;"lti�"r.i l..i:..�l r�� WASTEWATER +^ ; r � SYS'TEM CONSTRUCTION nTax Office PIN:# -�� - ."��'', ts - � �7:.�''� �( � lt'� ��, � i� , �, -� r: �a ► t�� Z :, ��} d`� �oad N�'7'A Ta,E,� ,��r'� ziP: '2'7 � Z� **NOTE** This Authorization for Wastewater System Construction MUST BE ISSUED by the Davie County Environmental Health Secdon prior to issuance of any Building Pernuts. This Form/Authorization Number should be presented to the Davie County Building Inspections Office when applying for Building Permiu. (In compliance with.Article 11 of G.S. Chapter 130A, Wastewater Systems, Section .1900 Sewage Treatment and Disposal Systems) J ' /7 i ; 1"`�` � ***NOTICE*** THIS AUTHORIZATION FOR WASTEWATER CONSTRUCTION � �� --'�1--� � � �'i k..+� IS VALm FOR A PERIOD OF FIVE YEARS. tr � _.,�d� % � r, . � � . . . ENVIRON1t'IEN'f iiE�LTH SP �A IST DATE ISSUED . ,. �, _. � _, ,_ , R . � . ` _ , ;,,_,a;,; . . , _ . , . , , � y� > . . � � 4..1.f'.4. d ) 1,.•,: A! ZJ ♦ . . �+IT '4ns.+T�� . �� . Y� � Y"� � ..... ,� �� 7 L�.•��f' � _ ;".� , '� � � � DAVIE COUNTY HEALTH DEPARTMENT 3 :G� � �-"`t ` TMPROVEMENT AND OPERATION PERMITS PROPERTY INFORMATION _ ,.,,n:�" Permit�Ee' �"`s � : � " � Name.�; �"�u�'��:,�,'� �!-'lY�t�' �' db't,:;'� Directions to property:1 1�i.,��'� l°� 1` `�1 <.' � ,.,1+�. � { �;.�,,�: ,�; .�' '�i ;.��" rJ !.. c.t -� Z .,� , ��i'�%,�E '" �� +. i� �3 �a'� C� �� '"� �� L � �� Subdivision Name: .�� . Section Lot: Il1�PROVEMENT PERMIT Tax Office PIN:# �?�Ca-� _ t; (:� -�j'ft�;^� ��'�1" Road Name: �i � _� � �j't`� � �t� Zip: � Y� �:' � � **NOTE** This Impmvement Pernut DOFS NOT authorize the construction or installation of a septic tank system or any wastewater system. An AiJTHORIZATION FOR WASTEWATER SYSTEM CONSTRUCTION must be obtained from this Department prior to the construction/'uistalla6on 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 Systems) "'�"1 /" .-^�=�-�--,.,,, f „ ***NOTICE*** THIS PERMIT IS SUBJECT TO REVOCATION IF SITE , :' �� ;' .E; •'��-., _... - .. ' �3` � '? � PLANS OR THE INTENDED USE CHANGE. YOUR WASTEWATER : HEALTH SPE�IA�.IST DATE ISSUED SYSTEM CONTRACTOR MUST SEE THIS PERNIIT BEFORE INSTALLING TI� SYSTEM. RESIDENTIAL SPECIFICATION: BUILDING TYPE I'�� # BEDROOMS �# BATHS .� �= # OCCUPANTS � GARBAGE DISPOS�or No COMMERCIAL SPECIFICATION: FACILITY 1'YPE # PEOPLE # PEOPLFJSHIFf # SEATS INDUSTRIAL WASTE: Yes or No LOT SIZE �TYPE WATER SUPPLY DESIGN WASTEWATER FLOW (GPD) � D NEW SITE �REPAIR SITE �� i i ��,,� / SYSTEM SPECIFICATIONS: TANK SIZE �GAL. PUMP TANK GAL. TRENCH WIDTH —=� ROCK DEPTH �2 LINEAR FT. � OTHER � '� � �T�. � � Jr� ,�,� � �La:-'� -' (OO� � REQUIRED SITE MODIFICATIONS/CONDTI'IONS: �"'� 5T'��a�'"��"� ��'" ��t^k=� 1 S i F� f'� i��Js�= , ht 4��.11 ��3 1' ��C , � i t�o � � � �-�,Jt �:P/�+*1!0 IMPROVEMENT PERMIT LAYOUT **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 V:, ? T AUTHORIZATION NO. � / � OPERATION PERMIT SYSTEM INSTALLED BY: '�°'"i l V✓� � I L—L-L'"` �aA►� r�A� g -z..�.. **THE ISSUANCE OF THIS OPERATION PERMIT SHALL INDICATE THAT THE SYS'�'EM DESCRIBED AB��E WITH ARTICLE 11 OF G.S. CHAPTER 130A, SECTION .1900 "SEWAGE TREATMENT AND DISPOSAL SYS GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORILY FOR ANY GIVEN PERIOD OF TIME. DCHD OS/96 (Revised) DATE: EN INSTALLED IN COMPLIANCE SHALL IN NO WAY BE TAKEN AS A � '�***IMPORTANT**** FOR SITE EVALUATION/IMPROVEMENT PERMIT & ATC 3�� Davie County Health Department `� C�. ,�.�-�-Q 1g98 Environmental Health Section /+�ap� , P.O. Box 848 r� ��`/ v ^� Mocksville, NC 27028 h (704) 634-8760 I ,� � � � THIS APPLICATION CANNOT BE PROCESSED UNLESS ALL THE REQUIRED INFORMATION IS PROVIDED. 1. Name to be Bi11ed�0'�tl`'�T ��1�� I f�%T��Y +t�('onta�t F"ersons 1�� '� -� Mailing Address �!)Co1 �� ne.. �.�� c��. � Home Phone �,� � — 1.7��Z� City/State/Zip 1 �oc,�Cs �� L,!� C— Business Phone ��'� lZ—��tJ� "�ix.'F'. �'�0 1 2. Name on PermidATC if Different than Above Mailing Address City/State/Zip 3. Application For: [] Site Evaluation [] Improvement Permit & ATC Both 4. System to Serve: {�'�-Iouse [] Mobile Home [ J Business [] Industry [ J Other ^ � 5. If Residence: # People� # Bedrooms `T' # Bathroom 3�Z-[ ishwasher [�arbage Disposal k e+(��, ��. � � � e.:� _..-�- �ashing Machine [� ement/Plumbing [ ] Basement/No Plumbing 6. If Business/Other: Specify type # People #Sinks # Commodes # Showers # Urinals # Water Coolers If Foodservice: # Seats Estimated Water Usage (gallons per day) 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 � No If yes, what type? "� 5 i nc�-�s ; � `'� �y- �^�. p�+�, �+r -� G � cLi %i.�-. � _ rYs�zx��o �'`.. EZTHER rt PL.fIT OR SITE PLtIN PROPERTY INFORMATION REQUIRED: *** IMPORTANT **'�l�Gl�l'4' OF THE PROPERTY MUST BE 5UBMITTED WITH THIS APPLICATION. Property Dimensions: lL �� WRITE DIRECTIONS (from Mocksville) TO PROPERTY: Tax Office PIN: # 5 ��4- �c� - � �i S' � �'no � �.� �� , ^C.. �. c�� Property Address: Road �e 2�J � T�.�'�►�-� �s> , � ��n �' � �� r� ��^'� �� City/Zip �Uc, k-s�c�� 1�. ; �S � ��17i C.n '�i_7 � C--�� If in Subdivision provide information, as follows: 2, U2� �� S �"c_ c1� ko�.se. �-t� � �j,� ` Name: ; �'�� o `a"`e. v�'s'A c'� , � � Section: Lot #: ; This is to certify that the information provided is conect 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 Re esentative of the avie County Health Department to enter upon above described property located in Davie County and owned by o�-�' �� s t conduct all testing procedures as ces to determine the site suitability. DATE� 3 I�'� ,��`�� SIGNATURE �� ,� T.�-� Qt-�— Revised DCHD (06-96) TH I S AREA h!A J 13E USEb �'OR b21tt �V I NC� JOUR S I TE 1'Lttr': � bf L (p0 d, - - ��,4.��'��E,��L. � j� s� � ; � �_l. �.�- , �,��. � - � ` _� I� L _ �...�L ��J''� � V � ` � � �G� . � �� kv� �� v � � �� r � � �, � e.__ �� Z°�o' Zv �� e.�s� `` 1^ DAVIE COUNTY HEALTH DEPARTMENT . � Environmental Health Section SECTION LOT SoiUSite Evaluation APPLICANT'S NAME Y� C��_ DATE EVALUATED � I� I�� PROPOSED FACILITY R�-� PROPERTY SIZE ��L�S SUBDIVISION ROAD NAME �� Z� Water Supply: Evaluation By: ? On-Site Well Community, Auger Boring � Pit FACTORS Slope % HORIZON I DEPTH Texture eroua Structure HORIZON II DEPTH Texture group Consistence Structure HORIZON III DEPTH Texture group Consistence Structure HORIZON IV DEPTH Texture eroun Structure SOIL WETNESS RESTRICTIVE HORIZON SAPROLITE CLASSIFICATION LONG-TERM ACCEPTAT SITE CLASSIFICATION: RATE I t' -� 1 2 t� L _' n _ GL SC SS N f-,� �1 ` ` 'I, SG � SS F( SS if�k G� l: 1 1: f EVALUATION BY: S� �1�'�'G►-l�yt�l/ LONG-TERM ACCEPTANCE RATE: �D•� OTHER(S) PRESENT: (�I�,J i' ,1E:��1i�1J, '�� REMARKS: S�b�� 'U�.=�i �� Pi� 7L-' 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 Mineralogv 1:1, 2:1, Mixed Notes Horizon depth - In inches Depth of fill - In inches Restrictive horizon - T'hickness 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 - gaUday/ft2 DCHD (OL90) ■�■�■■■■■��■■ ■■■■■■■■■■�■■ ■��■��■��■ ■■■■■�■■■■�■■ r■�■�■�■■��■��■ ■■�■�■■■■■■■■�■■■�■■■■ ■■�■��■�■��■■��■■■■ ■■�■��■��■�■��■ ■■�■�■■■■■■■■�■■■�■!■■ ■■��■■■��■�■��L'�■ ■■�■■■■��■��■��`i ■■�■■■■■■■■■■■■■■�■I■�A ■��■■�■�■■■■��IC�� ■�■�■��■�■��■�I■�■ ■■■�■■■■�■�■■��■��9/.�i� ■�■�■■■■�■■■■■■■■�%Ilii��J ■�■�■■■■��■■■■■■■fIA�■ ■�■■■�■■��■■�■�■■�IGii■ ■�■�■�■■■■■■■■■■■■�I■C� ■�■��■■■��■■■■■■■L'�C� ■�■�■�■��■�■■�■ ■■■■■■■■■■■■■■■■ ■■��■��■■■■■■■�■ ■��■ ■�■■■■�■��■�■■ ■■■■■■■■■■■■ ■■ ■■�■■■■■■■■■■■�■ ■��■ ■■�■�■■■■■�■■■■■ ■��■��■ ■■■■�■�■��■■■■�■ ■■�■�■■■■■■■■■■■ ■■■■■■�■��■■��■��'�ll■■ ■��■��■��■��0��■�1��■■ ■��■�■��■■■��■��■��il■■ ■��■■■■■■■�■■■��■■■��1!':�■ ■��■��■��■■��■!I■E!■■ ■��■��■�■��■■■��i�67��■ ■��■��■�■��■■�■■��i�■ ■��■■■��■�■��■�■�■�G�■■ ■��■��■��■�■�■��■■■�■�I:�■■ ■��■��■�■�■■■■�■��■tJ��■ ■��■�■�■�■��■■■■■■ ■■�■�■■■�■�■�■��■■��■ ■�■ ■■■ ■■�■■■■■��■■■■■■■■■■�■■■■■■■�■■�■■■■�■��■��■■■ ■■�■�■�■��■■■■■�■■■��■■�■��■■■��■■■■■�■■■ ■■��■■�■��■■�■■��■■■��■■�■■■��■�■�■■��■�■■■ ■■■�■■■■■��■��■��■■■■■�■■■�■■■■�■�■�■��■�■■■ ■■��■■■■�■�■�■��■■■■�■�■��■■�■�■�■�■■■■■��■■ ■��■�■��■�■��■�■��■■�■��■��■ �� ■�■■��■■■■■■�■■■�■�■■■■■■■■■�■■■■�■�■■■■�■■■�■ ■�■■��■�■■�■�■■��■��■�■�■��■��■��■■■�■■�■■�■■ ■�■■■�■�■■■��■��■��■■■�■�■��■��■■■��■■�■■ ■■■■■■■�■■��■■��■��■■■■■■■■■■■■■�■■■�■��■