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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----"'"°"'"'"__"_.._...�'""_"^ ` �,,,,,,,�.�......�..-� } /� �-"'`�� ��,,,.,—,..,,,.-.-�-----•^^""�.."" '".,.... �.«. �� � �G �i i. �,,,.,.•• �:.-'' �-r ' 1 v �_ �-�-�~•• � ,,,�....,,,,,...,. --,.- � � ������✓�� , 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 ■■�����■��■��■�������■��������������■��■ ������■��� ����■ ��■ ��■ ■■���������\������■��rN�����������n\�■ ■������■ ���������������■ ■■■������■�■ ■��■■���������������������������������■��■������■��� ■■�■��■■■����■■����������������■ ■■����� ■ ■���■��������������■■ ■���■�����■��■��■�■������/���������■���������������■������■��■��■ ■������■■����■��■���������������■��������������■����■�■���■������■ ■��■��■���������■■�����■����������������■������■■�����■�����■��■�■ ...........................................�........ ............. .......................................... ....■...�............. .■.................................. ............... ............. ■�������������■�����■������������N��■����■�■����■ �■�����������■ ■���������������■������■���■���■ ��������������■�� ���■���■■����■ ■�■■■�������■��������■����■�■�����\�����������■������■�����■�����■ ■�■■�����■■■����■���������■ ��������������■���� ���■ ���� �������� ■�������������■������������������������������■ ������N �■����■�■ ■■����s�������������■■����■■���■����������■������������������■■ ■���■��■�������■����������_�■����■������ ��� ■ � �■� ■�■■��n ■■ ■��■■����■■■���������■■��■ ■������■�����■�■������ ��■��������■���■ ■■����■����■�����������■������������■������■�■s������������■���■ ■�■■■�����■���■���������■■�■��■ ��������■�����__ _ ■��������■��■ ■��■������■■���■��������■�������■����■�■���N�■ ■ �■��H�������� ■�■�������■���������������������\���■���■������ � �������■���■�� ■�������■����■������■���������■��■����H�������■�■ ■■��■�� ������� ■�����■■����������■��■■�����■����■ ■ ■■���■ ■ �u������■ ■ ����■ .............................................C......�..... .._.._. ■���■���■�■�■��■■��■������■�■����������������=n���� ���■���� _��■ ■����■�A��■■■��■������h�����■■������Hv� �N�������■���0 ■�� ■������■�����■■������������■■��■ ■���N�� ■ N�■��■■���������� ■■�������������■�����N������������M��������\�■������������■��� ■���������������■��■��h�■■��������■���N������� �■� ��� �■�■�� ........................................■.....■.■ ....C..■..■1 .....■........■.■........................■.■..■■_ ��.._.........0 �����N������n���������������������������[���� ��������������� ■��������������������u���\7���� ���������+�■�u��������■���■■■ ■�H�����■����������■■�■���I�:►9/�■�����N�����% ��N���� ���■��\ �■■ v■��u��H�h��■■��■�iif.��■■�������/�N�/�� �M�n ��■���■�� ■�������■�■�������■���■�������������r� ��0������■ ��� ����■■� ■■������■��������■����■�����■■�u ■ ���� ■ ■ ■����■����� ����������������N�����Mh���■���� ■ ���� ��������� ■��■��������■■�������■����■�������� �� N �� �.■.�■■■�� �■�����������■������������������N �� � ��� ������ �������....�� ■���������N������■����■�i��iiii��■���� ■ ��� ��■�■�� ■■�����■��������■�■■���nM��■��■■■�■�� ■N�i■■� ����■■�� ■��o�■�����■u����������i��u�������u ■� �������■ ■e■�■■■������n���������i�������� ■ ■ ■■ �a�� �� ■■��■��������■■����■���i����=u■��■ ■�i �■ �������� :::::::C::::::::::::::D�::::.:::' :�C�:::::�� .......................��........ ...... . ... :::::::::':::�:�::::::��:::_::: .. ...� ��.��: ■�■���■��_�■�����au��n�U���a� � n� a■�■��� ■��■�������������u��■■ir_====�:..� � �� n����� ................................�. ._ ........ ................................ . . =:�.C::: ■■■�■�v������/H���������■■��\� ■ ■ ■������u��■■���q����������� �� Y�:■��■�� ��■��v� ���� ....... 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