930 Yadkin Valley RdDavie Countv. NC,
�
Tax Parcel Rennrt
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:
Building Value:
Land Value:
Total Assessed Value:
WARNING: TffiS IS NOT A SURVEY
Parcel Information
B70000009201 Township:
5863936831 Municipality:
Farmington
40090000 Census Tract: 37059-802
JOHNSON CECIL RAY JR Voting Precinct: FARMINGTON
930 YADKIN VALLEY ROAD Planning Jurisdiction: Davie County
ADVANCE 2oning Class: DAVIE COUNTY R-A
NC Zoning Overlay: DAVIE COUNTY QD
27006-0000 Voluntary Ag. District:
1.72 AC YADKIN VALLEY RD Fire Response District:
9`'�'�' Davie County,
"o�N�� i NC
1.64 Elemerrtary School Zone:
12/1986 Middle School Zone:
001340836 Soil Types:
Flood Zone:
Watershed Overlay:
101210.00 Outbuilding & Extra
Freatures Value:
38290.00 Total Market Value:
140450.00
No
SMITH GROVE
PINEBROOK
NORTH DAVIE
ApB,WeC
DAVIE COUNTY
140450.00
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��nu�Ho�ifzririOiv�NO:: '1;56yn DAVIE•COUNTYHEALTH'DEPARTMENT
� `"'�- � i � ' �Enviionmmml NeiltB Sectloo �PROPERTY`INFORMATION
Fertniiieeizn � -. P.O.Box'848 �
• ' .Neme_': —'/ .iA%!.� TO//ii.r0� ,,;,R Mocksville:NE27028 SubdiviRion.Name:
' Phane N 336751-876U
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� �•"N07E••71iixAuthnri�r�iunFor.WsateweterSyslemConx�rivaion;Ml�1ST�BE!ISSUED,IiyiheDavie.CoumyEnvironmemd'Heahh5eclionprior
�u�iasuanceol'en Buildi, Pe�mits,Th�x�Enr"�NAu�lioriu�iiwi�Nu'mlier.sFioulAbe' Ded•`tolhe�DavieCain Buildi� I���" �ons
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�.//�� •�� _ / '"••N07ICE���7NI5'AUTHORI7ATION�FOR�WASIBWATERCONSTRUGIION
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,ENVIRONMENTr11.XF.A1:'I'H�� DA'fF.I35UED � �
c ,r.. •-.r.�1 �, 4 i� (' � 1 �t^ � .l . " � � ._ . � _ . . .- t . . . _ � . . . � /� /� ' � „ ' f('� � ( 1 ' .
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� , i,� � c��i DAVIE COUNTY HEALTH DEPARTMENT
E' �"`= �`. � "" ' TMPROVEMENT AND OPERATION PERMITS PROPERTY INFORMATION
,
� � Permittee's �.� j _ ,r �.,,. , ' �
A • -LQame: ; � : ' / � X -� .° � r' A � _. Subdivision Name:
;j �/ „�; .
Directions to property: a�e !' r�� Section: Lot:
� r -'d �
Il14PROVEMENT
PERMIT Tax Office PIN:# '" �. ' �°"� - �' %
Road Name: { � - � Zip: �� %'��' ��
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**NOTE** This Improvement Pemut DOES NOT authorize the consm►ction or installation of a septic tank system or any wastewater system. An
AUTHOWZATION FOR WASTEWAT'ER SYSTEM CONSTRUCITON must be obtained from this Department prior to the
construcdon/installation of a system or the issuance of a building pernut
(In compliance with Article 11 of G.S. Chapter 130A, Wastewater Systems, SecUon .1900 Sewage Treatment and Disposal Systems)
' - , "`**NOTICE*** THI.S PERNIIT IS SUBJECT TO REVOCATION IF STI'E
-`' ""�r ,,. „r'� �` t,r''f`%r, "",, j' PLANS OR TI-� IlVTENDED USE CHANGE. YOUR WASTEWATER
ENVIRONMENTAL HEALTH SPE�IALIST DATE ISSUED SYSTEM CONTRACTOR MUST SEE THIS PERMTf BEFORE
INSTALLING TIIE SYSTEM. �
RESIDENTIAL SPECIFICATION: BUILDING TYPE �# BEDROOMS �# BATHS �# OCCUPANTS _� GARBAGE DISPOSAL: Yes or No
COMMERCIAL SPECIFICATION: FACILTTY TYPE # PEOPLE # PEOPLFJSHIFT # SEATS INDUSTRIAL WASTE: Yes or No
LOT SIZE ��� � TYPE WATER SUPPLY j DESIGN WASTEWATER FLOW (GPD) � NEW SITE� REPAIR SITE
���7� �. ��
SYSTEM SPECIFICATIONS: TANK SIZE��(BLGAL. PUMP TANK GAL. TRENCH WIDTH � ROCK DEPTH � LINEAR Ff. \��� /
OTHER
REQUIRED SITE MODIFICATIONS/CONDITIONS:
IMPROVEMENTPERMTTLAYOUT���"1..�?}Z�WED E�FLLiL-I+IT FILTER� ��dIS�R(S) IF 6" Fi�l..0:� FIt�lISL�iJ GRAD��
(�l ���GV �'/�/�J U.S� �7 F' U )� ��r�tSr ��`�' p�� t,ve �
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**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 (,�Q4Z bc34}$�CQ;;
(33f,) 7S1—A7E��
I OPERATION PERMIT
JJ
�
'ALLED BY:
AUTHORIZATION NO. �OPERATION PERMIT BY: ��/�IL�� DATE: ��
**THE ISSUANCE OF THIS OPERATION PERMIT SHALL INDICATE THAT THE SYSTEM DESCRIBED ABOVE HAS BEEN INSTALLED IN COMPLIANCE
WITH ARTICLE 1 I 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 OSN6 (Revised)
.., � , � .
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�� \" _1 �� �a�P
�PIJ(:A110N FUIi SITE EVAI.UATIUN/IMPROVEXIENT PEAMIT & ATC
, Davie County Health Department
Environmenta/Hea/tfi Secifon
P.O. Box 8�8/210 Hospftal Street
Moakaville, NC 27028
(336)751-8760
'**� THZ3 APPLICATIQN CANNOT BE PROG',ESSED L1NLE33 ALL THE REQZIZRED
IS PROVIDED. Refer to the INFORMATION BOLLETIN for instrnctions.
C� ',� �' s,e
1. pame co be S�ilee �/ e �J�d �✓ contaet pers�
Hailing Address / �v 7 �% (J� 1 /� I/��I.� Y /1 !l� � Home ghone f %D ' �'� �(�'
City/8tate/ZI? !'l (1�/�ii✓L�� /l� � � /0!� !A Susiness phone
Z. liame on pesmit/AtC i! Dltterent than Abwe
1lailing /�ddresa City/8tate/Sip
3. �pplicatioa Sor: �3ite Evaluation � Improvement Penait/ATC 0 Both
4. sy.tem to service: �Housa 0 Mobile Home I] Busineas 0 Industry ❑ Other
s. If itesidence: # People !2 i Bedrooms � � Bathrooms �
0 Dishxasher 0 Oubaqe Diaposal �Naahittg 1lachiae U Base�r�t/Plnmbinq 0 8aa�ment/No Plw�ing
6. i! Bnsiness/Industry/Other: Speci�y type
• Commodea
f Shcwers
� Urinals
f peo�ple
+ Nater Coolera
IP FOOD3ERVICB: � Seats Estimated Water Usage (Qailons per day)
7. 1�ps of Mater supplp: ,� Connty/City
e. Do you anticipate addition� or e:panaions of the iacility this ayatem Ia intended to aervei
lf yes, what lype'
0 Co�unity
U Ye� �No
•"•IMPQRTANT"" • CLIENTS lllUST C011lPLETE TNE REQUIRED PROPLRTY 1NFORMATION RLQUESTED
BELOW. Eit6er a PI.AT or SITE PI.AN MUST BESUB�tITTED by the client with THIS APPLlCATION.
Prope�ty Dimenaiona: �JD /` � 3 �
Ta:Otiice PIN: # �J SL�� -93 ��3 /
Prnperty Addresa: Road Name d `"� �//C I� Q,
City/Zip /� � 1/�%i✓C'C ' 2r%D �
If in a Subdivision provide information, Aa follows:
N ame:
Section: Biock: Lot:
WRITE D[RECtIONS (fmm Mock:vllle) to PROPERIY:
�/.'S� /d ��! � /v��y sq C'�'O5�`
.�'�� �E'�% rP�'����r" ,i,S .99��,�
(�//�� ��.�/�-s a� �'.��,�r
�l/�T�L-" f�P�ME ��H s� �� STa �r
�',s��'%' ���'UF
DAte Property Flagged: � � �T_
Thi� is to certify ihat the ioformation prnvided is correct to the best of my knowledga I understand t6at any permi!(a)
issned 6ereatter arc subject to au�pension or revocation, if t6e site piwna or intended use c6ange, or i� t6e iaformation
submitted in tbis application ia talsitied or c6�nged I, olso, anderstand thall am responsible for a/! cbarges irrcurred from
this applicatio». I, 6ereby, give coneeot to the Aut6oriud Repreaentative of f6e Davie County Healt6 Department ,/
to enter upon above described property located in Davie County and owoed b�- �E'� L t���� �r�sd�
to conduct all testiug procedures as aece�aary to determine t6e site auitabil'h-.
�
DATE '�- �v � � SIGNATURE ��''�
TflIS AREA MAY BE USED FOR DRAWINC YOUR St7'E PLAN ([nc ude a11 of e following: E�ating and proposed
property lines and dimenaiona, atructurcs, eetbscks, and aeptic locations).
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Revised DCND (07/98)
Account No. �`��
Invoice No. (� �4
�49
o ��8 l�+
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(1.64A1
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f',���- a �
This map is for PERC TEST
'� n D�?'t�� l✓,q 1/ and BUILDING PERMIT purposes
�G(t�(�/� � only. The Davie County
L,v�� / 4 nE Tax Administrator's Office
assumes no liability for any
. ��af��j information contained on this map
SR
� COUNTY-ID:670000009201
._ � ��
�9�i ��N
' �//_ Apri130,1999 4:01 PM
MIRAc �� ,(�.
- /` ,O, Parcel Identification Number
' � 5883-93-8831
4
' � DAVIE COUNTY HEALTH DEPARTMENT
Environmental Health Section SECTION LOT
Soil/Site Evaluation
APPLICANT'S NAME �/ l/�%1�3Z
PROPOSED FACILITY
SUBDIVISION
Water Supply: On-Site Well Community
Evaluation By: Auger Boring °'� Pit
a a.n�ui �.
•t����s�w� r� s r�rrrvr•t•
SOIL WETNESS
DATE EVALUATED ��,��/�
PROPERTY SIZE ����'
ROAD NAME
Public [�
Cut
SITE CLASSIFICATION: /�' � EVALUATION BY: .�`!/
�
LONG-TERM ACCEPTANCE RATE: � OTHER(S) PRESENT:
REMARKS:
DCHD (O1-90)
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
Wet
NS - Non sticky
NP - Non plastic
FR - Friable FI - Firm VFI - Very firm EFI - Extremely firrn
SS - Slightly sticky S- Sticky VS - Very Sticky
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
Mineralo�v
1:1, 2:1, Mixed
Notes
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 - gaUday/ft2
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