418 Zimmerman RdDavie County, NC Tax Parcel Report Wednesdav, October 12, 2016
Parcel Number:
NCPIN Number:
Account Number:
Listed Owner 1:
Mailing Address 1:
City:
State:
Zip Code:
Legal Description:
Assessed Acreage:
Deed Date:
Deed Book / Page:
Plat Book:
Plat Page:
Buiiding Value:
WARNING: THIS 1S NOT A SURVEY
Parcel Information
190000002103 Township:
5798279157 Municipality:
72167000 Census Tract:
SWAIM JIMMY D Voting Precinct:
418 ZIMMERMAN ROAD Planning Jurisdiction:
ADVANCE Zoning Class:
NC Zoning Overlay:
27006-0000 Voluntary Ag. District:
14.08 AC ZIMMERMAN RD Fire Response District:
Land Value:
Total Assessed Value:
9 �~'�' Davie County,
���N�'� NC
7.09 Elementary School Zone:
2/1998 Middle School Zone:
002000201 Soll Types:
Flood Zone:
Watershed Overlay:
0.00 Outbuilding 8� E�ctra
Freatures Value:
104980.00 Total Market Value:
32630.00
Fulton
3705&804
FULTON
Davie County
DAVIE COUNTY R-A
ADVANCE
SHADY GROVE
WILLIAM ELIIS
PaD,PcB2,PcC2
DAVIE COUNTY
26820.00
131800.00
No
r _. � . . ' . . , � . . . . . .. . � . _ � • .. :.4.� . . . . . . . . . . . - .. . . . . � �O .
AUTHORIZA'rioNNo: Q 5 6 � DAVIE COUNTY HEALTH DEPARTMENT
A� Environmental Health Section PROPERTY INFORMATION
Perrriittee's�. � �''"� ° P.O. Box 848
Name: ��f �?� ��._.J ��✓�i Mocksville, NC 27028 Subdivision Name:
.,..« Phone #: 704-634-8760
Directions to property: ��->�`tr ��': rt:�r+r �rr Section: Lot:
AUTHORIZATION FOR ...�-� Q 0 D OQ a I C•' �
WASTEWATER a Office PIN:# � 96 a
SYSTEM CONSTRUCTION ���
c.� .
oad Name: 7 i» t Y�� �'r'77'i�hZ�p: � 7 v n In
**NOTE** This Authorization for Wastewater System Construction MUST BE ISSUED by the Davie County Envuonmental Health Section 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 Permits. �
(In compliance with Article 11 of G.S. Chapter 130A, Wastewater Systems, Section .1900 Sewage Treatment and Disposal Systems)
lf ) )'� ***NOTICE*�* THIS AUTHORIZATION FOR WASTEWATER CONSTRUCTION
%� .�- t,.. �%'�?��� �> .� /-. %J, • IS VALID FOR A PERIOD OF FIVE YEARS.
ENVIRONMEN AL HEALTH SPECIALIST DATE ISSUED
._ . __
. �.,, .:
,. ,, _, , ,,.: _: . .:,. ,.. : �
_. .. '� __ �\\ . . . . . _ � . . . ; � � � s . - . � . . . . ,. _ .. . . _ � AF 'i � ..
DAVIE COUNTY HEALTH DEPARTMENT
�'�, �` :� ���" � IMPROVEMENT AND OPERATION PERMITS PROPERTY INFORMATION
.� Per�iiftee's :,__.. , �., . •
~Name: �. � • - , i % .� �' ,�-'r:'r�� Subdivision Name:
. �-.y: . " . . � . .
� � �f� . - . `. . . .
, Directions to property: « "=� -- ��� . �° - � %' Section: Lot:
IlVIPROVEMENT �-':� ;� � r{; r.� ,� . i i v,=:�
PERMIT a� Office PIN:# -
1��ad Name. �= � � � i : .:, , ,-,<, � ;Zi � ' 'r u; r�� �.
r � . p:
**NOTE** This Impmvement Pernut DOES NOT authorize the construction or installatiQn 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 pernut.
(In compliance with Article 11 of G.S. Chapter 130A, Wastewater Systems, Section .1900 Sewage Treatment and Disposal Systems)
�;'' �� y; . fi:�-� �. , ***NOTICE*** THIS PERMIT IS SUBJECT TO REVOCATION IF SITE
z ,� ,�.. f ,' ,�, . �;r � , :.• .f�. ,� ;� .. ; 'P' PLANS OR TI� INTENDED USE CHANGE. YOUR WASTEWATER
ENVIRONMENTAL HEALTH SPECIALIST DATE ISSUED SYSTEM CONTRACTOR MUST SEE THIS PERMIT BEFORE
INSTALLING THE SYSTEM.
RESIDENTIAL SPECIFICATION: BUILDING TYPE .� # BEDROOMS„ S> # BATHS .�. # OCCUPANTS � GARBAGE DISPOSAL: Yes or No
COMMERCIAL SPECIFTCATION: FACILITY TYPE # PEOPLE # PEOPLE/SHIFT # SEATS INDUSTRIAL WASTE: Yes or No
� 4, �' t-""�' r'
LOT SIZE �"� � TYPE WATER SUPPLY ��%'� DESIGN WASTEWATER FLOW (GPD) -., a'% � NEW STI'E t--^'� REPAIR STfE
J
SYSTEM SPECIFICATIONS: TANK SIZE f'!-S� GAL. PUMP TANK GAL. TRENCH WIDTH ...��'� ROCK DEPTH .�' %�LINEAR Ff. �-r� >�-' �
OTHER
REQUIRED SITE MODIFICATIONS/CONDITIONS: _
I IMPROVEMENT PERMIT LAYOUT
.w----"'"°"'"'"__"_.._...�'""_"^
` �,,,,,,,�.�......�..-� } /�
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�_ �-�-�~•• �
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�
� ������✓�� , GJ�f
�
**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 PERMTT
SYSTEM INSTALLED BY:
AUTHORIZATION N0. W"' I OPERATION PERMIT BY: 1���'�l DATE: ��/,�/��
**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 OS/96 (Revised)
' APPLICATION FOR SITE EVALUATION/IMPROVEMENT PERMIT & ATC
� ' � Davie County Health Department ����/,l
Environmental Health Section 5�f'
P. O. Box 848
Mocksville, NC 27028
(704) 634-8760
'�***IMPORTANT**** THIS APPLICATION CANNOT BE PROCESSED UNLESS
ALL THE REQUIRED INFORMATION IS PROVIDED.
1. Name to be Billed `-� e�� y +�/ .J�,A,)%�/N"'� Contact Person
Mailing Address �� � �� i� �) L;� l�!! �S �„� Home Phone �� �✓ ��� J
.,�� ,�� � 1/�': C� � 9rr� - 7� a - �� /�
City/State/Zip f� Business Phone
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: 0 House � Mobile Home ❑ Business ❑ Industry ❑ Other
5. If Residence: # People � # Bedrooms � # Bathrooms _�
Dishwasher ❑ Garbage Disposal �Washing Machine ❑ BasementJPlumbing ❑ BasementJNo Plumbing
6. If Business/Other:
# Commodes
If Foodservice:
7. Type of water supply:
Specify type
# Showers
# Urinals
# People # Sinks
# Seats Estimated Water Usage (gallons per day)
❑ County/City ell
# Water Coolers
8. Do you anticipate additions or expansions of the facility this system is intended to serve?
If yes, what type?
❑ Community
❑ Yes ��
PROPERTY INFORMATION REQUIRED: *** IMPORTANT *** A PLAT OF THE PROPERTY MUST BE
SUBMITTED WITH THIS APPLICATION.
Property Dimensions: ���C
Tax Ofiice PIN: #,� �'d�� ��� �-� � � -
Property Address: Road Name �j�'lJ,�B_�C%'���
City/Zip � G'��i�N�°� /�t � �
� If in Subdivision provide information, as follows:
Name:
Section:
Lot #:
WRITE DIRECTIONS (from
Mocksville) TO PROPERTY:
ii /! ' / /i �IL�." '7
� ; ►
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 Representative of the Davie County Health Department to enter upon above described property located in Davie County
and owned by
as necessary to determine the site suitability.
DATE ���3 /�� SIGNATURE
Revised DCHD (06-96)
,i�!1 /✓�
conduct all testing procedures
J
� y DAVIE COUNTY HEALTH DEPARTMENT
' ' � Environmental Health Section
Soil/Site Evaluation
NAME C�Is1%"�� DATE EVALUATED /�� /
ADDRESS PROPERTY SIZE � �n
PROPOSED FACIILTY �/� � LOCATION OF SITE �i7�Z��orhfl� �
Water Supply: On-Site Well _ Community Public
Evaluation By: AugerBoring �/ Pit Cut
FACTORS 1 2
Landsca e osition
Slo e z '' 2
HORIZON I DEPTH
Texture rou
Consistence
Structure
Mineralo
HORIZON II DEPTH t
Texture rou
Consistence
Structure �'�.0 S/,,,t
Mineralogy
HORIZON III DEPTH
Texture group
Consistence
Structure
Mineralo�y
HORIZON IV DEPTH
Texture group
Consistence
Structure
Mineralogy
SOIL WETNESS
RESTRICTIVE HORIZON
SAPROLITE
CLaSStFICATION
TANCE RATEI �
SITE CLASSIFICATION: � EVALUATED BY: �
LANG-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-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--Single grain M-Massive CR-Crumb GR-Granular ABK-MQular blocky
SBK-Subangular blocky PL-Platy PR-Prismatic
Mi neralo�cy
1:1, 2:1. Mixed
Notes
}iorizon 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 ch�oma 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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