106 Childrens Home Road Site 1Davie County, NC 4 Tax Parcel Report Wednesday, November 2, 2016
WARNIN T: '11t11S 1S NOTA SURVEY
Parcel Information
Parcel Number:
B30000000614
Township:
Clarksville
NCPIN Number:
5813894141
Municipality:
Account Number:
2074000
Census Tract:
37059-801
Listed Owner 1:
ANDREWS TIMOTHY M
Voting Precinct:
CLARKSVILLE
Mailing Address 1:
194 JONES DRIVE
Planning Jurisdiction:
Davie County
City: WINSTON SALEM
Zoning Class: DAME
COUNTY R-A,R-20
State:
NC
Zoning Overlay:
Zip Code:
27107-8838
Voluntary Ag. District:
No
Legal Description:
2.00 AC CHILDRENS HOME RD
Fire Response District:
COURTNEY
Assessed Acreage:
1.96
Elementary School Zone:
WILLIAM R DAVIE
Deed Date:
4/1998
Middle School Zone:
NORTH DAVIE
Deed Book / Page:
002010598
Soil Types:
Mn132,MdC
Plat Book:
Flood Zone:
Plat Page:
Watershed Overlay:
DAVIE COUNTY
Building Value:
52900.00
Outbuilding & Extra
Freatures Value:
0.00
Land Value:
16000.00
Total Market Value:
68900.00
Total Assessed Value:
68900.00
1:01
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County of Davie, North Carolina, its agents, consultants, contractors or employees from any and all claims or causes of action due to
NC or arising out of the use or Inability to use the GIS data provided by this website.
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AUTHORIZATION No: 18.8',DAVIE COUNTY HEALTH DEPARTMENT /ed a I
- Environmental Health Section PROPgRTY INFORMATIONL
Permittee's P.O. Box 848 ' ACIP0 rn
Name: � ?-mm,-57 Mocksville, NC 27028 Stibdivisio Name:
Phone #: 704-634-8760LG"
Directions to property: e'/%�/.^ {`��.�.��.*r Section: Lot:
AUTHORIZATION FOR
WASTEWATER
SYSTEM CONSTRUCTION Tax Office PIN:#92
R
Road Name: ' " ip; , 9-
**NOTE** This Authorization for Wastewater System Construction MUST BE ISSUED by the Davie County Environmental Health Section prior
to issuance of any Building Permits. 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)
f ***NOTICE*** THIS AUTHORIZATION FOR WASTEWATER CONSTRUCTION
f IS VALID FOR A PERIOD OF FIVE YEARS..
ENVIRONMENTAL HEALT SPECIALIST DATE ISSU
,.r � 'nom � . ., y � .T rt,�y....»w..t .r ••.�`s'w..rw�.- rwr-. -v• -..�a. - .... ., ,.... . .. , .. .v. -
t DAVIE COUNTY HEALTH DEPARTMENT, / „.� c,
IMPROVEMENT AND OPERATION PERMITS ROPER INF6RMATIO
Permittees r .'�3 i'14 � f) t'.• " " "` ': x
Name:, t See
sion Name:
Directions to property: .✓ `�. f'' �. ,xy `' Section: L'ot:
IMPROVEMENT
PERMIT Tax Office PIN:#
Road Name• �,Fip:
)
**NOTE** This Improvement Permit DOES NOT authorize the construction or installation 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 permit.
(In compliance with Article 11 of G.S. Chapter 130A, Wastewater Systems, Section .1900 Sewage Treatment and Disposal Systems)
***NOTICE*** THIS PERMIT IS SUBJECT TO REVOCATION IF SITE
J PLANS OR THE INTENDED USE CHANGE. YOUR WASTEWATER
ENVIRONMENTAL HEALTW SPECIALIST DATE ISSU D SYSTEM CONTRACTOR MUST SEE THIS PERMIT BEFORE
INSTALLING THE SYSTEM.
RESIDENTIAL SPECIFICATION: BUILDING TYPE # BEDROOMS 17 # BATHS A- # OCCUPANTS �� GARBAGE DISPOSAL: Yes or No
COMMERCIIA�L SPECIFICATION: FACILITY TYPE # PEOPLE # PEOPLE/SHIFT # SEATS INDUSTRIAL WASTE: Yes or No'
LOT SIZE TYPE WATER SUPPLY DESIGN WASTEWATER FLOW (GPD) �-,& 10_ NEW SITE REPAIR SITE
SYSTEM SPECIFICATIONS: TANK SIZE S00
�yOy GAL. PUMP TANK GAL. TRENCH WIDTH � ROCK DEPTHS LINEAR FT.
OTHER
REOUIRED SITE MODIFICATIONS/CONDITIONS:
"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
SYSTEM INSTALLED BY:
A. -Vin It)- �117
AUTHORIZATION NO, y�z� OPERATION PERMIT BY: /!/ 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 05/96 (Revised)
w
APPLICATION FOR SITE EVALUATIONAMPROVEMENT PE
' Davie County Health Department
Environmental Health Section 0 ��
7
P.O. Box 848
Mocksville, NC 27028
(704) 634-8760
****IMPORTANT**** THIS APPLICATION CANNOT BE PROCESSED UNLESS A
THE REQUIRED INFORMATION IS PROVIDED.
1. Name to be Billed iI rn 6Y.x� Contact Person '' II Cl a amoc—=)
Mailing Address 5-1 Home Phone N' 01!0
City/State/ZipCJ i
Business Phone
2. Name on Permit/ATC if Different than Above
Mailing Address City/State/Zip
3. Application For: [ ] Site Evaluation [ mprovement Permit & ATC
[ ] Both
4. System to Serve: [ ] House [VIIM*'obile Home [ ] Business [ ] Industry [ ] Other
5. If Residence: # People # Bedrooms # Bathrooms [hwasher [ ] Garbage Disposal
[Washing Machine [ ] Basement/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 [1�}<ell [ ] Community
8. Do you anticipate additions or expansions of the facility this system is intended to serve? [ ] Yes [ ' ] No
If yes, what type?
EITHER A PLAT OR SITE PLAN
PROPERTY INFORMATION REQUIRED: *** IMPORTANT ***-VnWAY' OF THE PROPERTY MUST BE
SUBMITTED WITH THIS APPLICATION.
Property Dimensions: (10 ff f7) WRITE DIRECTIONS (from Mocksville) TO PROPERTY:
Tax Office PIN: #5!R.1a - -
Property Address: Road 14ame CEI
vv�
City/Zip �l S me
If in Subdivision provide information, as follows:
Name:
_L. �s
Section: .. Lot #: � 6 I Tom—
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 De County Health Department to enter upon above described property located in Davie County and owned
by . J a ' to conduct all estin procedures as necessary to determine the site suitability.
DATE SIGNATURE
Revised DCHD (06-96)
THIS AREA MAY 13E USED FOR DRAWING YOUR SITE PLAN:
V
V
.00
APPLICATION FOR SITE EVALUATIONAMPROVEMENT PERMIT & ATC
It Davie County Health Department
Y ^ '
Environmental Health Section f
1 eP/'V P.O. Box 848
t Mocksville, NC 27028OGT i 7 1997
(704) 634-8760 1 ! PN I -/
****IMPORTANT**** THIS APPLICATION CANNOT BE PROCESSIEW
THE REQUIRED INFORMATION IS PROVIDED.
1. Name to be Billed B o � e v Pe -Al jS JA Contact Persona) 16e, 56 T e ,—
Mailing Address aIJ/8 14ujN 191' Home Phone ' 9g- 77.-3
City/State/Zip Q J V A (J C f A]• Q• -2 % b O t!o Business Phone 9 ! ls'— r� S3 t -A
2. Name on Permit/ATC if Different than Above �"TA M .
Mailing Address cS%1 /'\t City/State/Zip c5'/4 M -e-
3. Application For: QdSite Evaluation [ ] Improvement Permit & ATC [ ] Both
4. System to Serve: [ ] House Mobile Home [ ] Business [ ] Industry [ ] Other
5. If Residence: 3 # People_ # Bedrooms .O— # Bathrooms Dishwasher [ ] Garbage Disposal
pd"Washing Machine [ ] Basement/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 W Well [ ] Community
8. Do you anticipate additions or expansions of the facility this system is intended to serve? [ ] Yes 0 No
If yes, what type?
rt!'J
EITHER A PLAT OR SITE PLAN
PROPERTY INFORMATION REQUIRED: *** IMPORTANT ***�C.F'.Y. T OF THE PROPERTY MUST BE
SUBMITTED WITH THIS APPLICATION.
Property Dimensions: �� r e T✓/1C�S cC` 3f1C'�s % WRITE DIRECTIONS (from Mocksville) TO PROPERTY:
Tax Office PIN: #,S-913 _ - Z? - 3((g 4 ! ; % o) 140 ✓i� k Ap N i ] J r ey r r
Property Address: Road Dame o h i v e ms b4 o m,-- % A 1-1 a o_ /J / e g TVIV
city/zip O OC KS l/i 11
If in Subdivision provide information, as follows:
Name:
Section:
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 13—a h /T�/;Za5 to cqfflduct all testingocedures as necessary to determine the site suitability.
DATE f' U "' %� `i f SIGNATURE _ D d ' ak/-c.
Revised DCHD (06-96)
THIS AREA MAY BE USED FOR bRAWINC7 JOUR SITE PLAN:
io
71*�1�
DAVIE COUNTY HEALTH DEPARTMENT
` Environmental Health Section SECTION LOT
Soil/Site Evaluation
APPLICANT'S NAME r
PROPOSED FACILITY
SUBDIVISION
Water Supply: On -Site Well
Community,
DATE EVALUATED /D '02��%
PROPERTY SIZE
ROAD NAME
Public
Evaluation By: Auger Boring Pit Cut
FACTORS
1
2 3 4 5 6 7
Landscape position
.✓
Slope %
HORIZON I DEPTH
Texture group
Consistence
Structure
Mineralogy
HORIZON II DEPTH
I-
r
Texture group
Consistence
Structure
Mineralogy
HORIZON III DEPTH
Texture group
Consistence
Structure
Mineralogy
HORIZON IV DEPTH
Texture group
Consistence
Structure
Mineralogy
SOIL WETNESS
RESTRICTIVE HORIZON
SAPROLITE
CLASSIFICATION
P9
LONG-TERM ACCEPTANCE RATE
13
1-3
SITE CLASSIFICATION: EVALUATION BY: �v
LONG-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 - 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
Mineralogy
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 - gal/day/ft2
DCHD (01-90)
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Davie County Heafth Department
andHome Health Agency
Environmenta(Health Section
P.O. BOX 848 / 210 HOSPITAL STREET
COURIER #09-4-06
MOCKSVILLE, N.C. 27028
PHONE: (704) 634-8760
October 30, 1997
Boger Real Estate
5248 Hwy. 158
Advance, NC 27006
Re: 3 Site Evaluations
Childrens Home Rd.
Tax PIN: #5813-89-3844
Dear Client (s) :
As requested, a representative from this office visited the aforementioned
sites on October, 29, 1997. Based upon the information provided on the
application(s) for site evaluation(s),..and after the evaluations were completed,
the sites were found to be provisionally suitable for the installation mf an
on—site sewage disposal system on each site.
Before any permit(s) can be issued the appropriate application(s) must be
filled out and the house/mobile home 'location(s) staked off.
If you have any questions, please feel free to contact this office.
RH/wd
Enclosure(s)
cc: Zoning Office
Sincerely,
Robert B. Hall, Jr., R.S.
Environmental Health Specialist
CO 10 -
co -
co
CO 0
05 a -
Tax Lot 6
Tax Map B-3
R.S. Pratt Estate
This map or drawing and arq' accompanying
documents are furnished to the persons) named
thereon and no atterations or use by others
is permitted unless authorized by
Allied Land Surveying. PA
Map not for recordation.
Precision 1:10.000+
NOTE: ri ht—of—w
This property is subject to ail easements, g M,
streets and assessments, if any, as the some may appear of
record in the office of the Register of Deeds. Clerk of Court.
Town or County Tax Office or which may have been acquired by
prescriptive use.Ts ull and accuurate is iect to any title search. NOTacts umished
at may
be disclosed by af
as of this date.
Tax Lot 6.06
Tax Map B-3
Derek P. Scherer
a/w Virginia L Scherer
DB 187 0 PG 430
NOTu DB 187 0 PG 433
The property lines and property comers are the same.
Bearing basis for the McIntosh tract is Deed Book 128 O Page 384.
Bearing basis for the Scherer tract is Deed Book 120 0 Page 167.
1 /2"EIR 76.88'
S 8181 8'35"W 3 IRS
Te Line r
0 �,
NM
e M
ac N
0
Z
N 81038'35"E 673.00'
Part of Tax Lot 6
Tax Map B-3
2.00 Acres +/—
1 /2"EIR �0
Ny G
C5n
m
Tie Line 33.72'% .
N 8800620"E
-------------------------•-- ----�R X820
"PRIVATE" IRS Centerline of Proposed 50' R\W 6 493; 96
• S 84027'50"W 465.00' IRS N 8pe�
Tax Lot 6
Tax Map B-3
R.S. Pratt Estate
D8400PG612
t LEGEND aa Center Uns
i R/W — Right—of—Way C — Center Line
{ Elp — Existing Iron Pipe EP — Edge of Pavement
1 oR _ Existing Iron Rebar FC — Face of Curb
— Poo e
i P _ C�onerete PP Po?'e Monument —le
O
Joh ,Q/
C-) row/
1/2"EIR d `
1 /2"EIR
,s��{fNlllrr,,
.�``t CAROB :...
D /
w
`0
ClzarlerL� �n�z
part of Tax Lot E
Tax MOP B-3
Deed Book 40 0 Page