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423 IJames Church Road Lot 18Davie County, NC Tax Parcel Report Wednesday, December 28, 2016 I r 1 I I IJANTES CI-IURC14 RD 453 445 437 I--431 423 ; 403 ; 395 1 1 , i 1 I 1 i i 1 r 411 i I 1 � I 1� I 1 5 I+ \ 5 r` E01 All data Is provided as Is without warranty or guarantee of any idnd either expressed or Implied Including but not limited to the Davie County, Implied warranties of merchantability or litness for a particular use. Au users of Davie County's GIS website shall hold harmless the County of Davie, North Carolina, Its agents, consultants, contractors or employees from any and ag 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. WARNING: THIS IS NOT A SURVEY Parcel Information Parcel Number: G3060B0018 Township: Mocksville NCPIN Number: 5820115440 Municipality: Account Number: 71168000 Census Tract: 37059-806 Listed Owner 1: STILES DIANNE H Voting Precinct: NORTH MOCKSVILLE COUNTY Mailing Address 1: 423 IJAMES CHURCH ROAD Planning Jurisdiction: Davie County City: MOCKSVILLE Zoning Class: DAVIE COUNTY R -A State: NC Zoning Overlay: Zip Code: 27028-0000 Voluntary Ag. District: No Legal Description: LOT 18 FOREST BROOK Fire Response District: CENTER Assessed Acreage: 0.74 Elementary School Zone: WILLIAM R DAVIE Deed Date: / Middle School Zone: NORTH DAVIE Deed Book / Page: Soil Types: CeB2 Plat Book: 0006 Flood Zone: Plat Page: 138 Watershed Overlay: DAVIE COUNTY Building Value: Outbuilding & Extra Freatures Value: Land Value: Total Market Value: Total Assessed Value: E01 All data Is provided as Is without warranty or guarantee of any idnd either expressed or Implied Including but not limited to the Davie County, Implied warranties of merchantability or litness for a particular use. Au users of Davie County's GIS website shall hold harmless the County of Davie, North Carolina, Its agents, consultants, contractors or employees from any and ag 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. wd+M,.:`•1.�a. i�i'T we ry -.�.4 trf3Yi�q.#P"^• nst'rilrmr,4. �;,;,�.,;.I f�..�E:'-<Tryl�ry�,.1 'c !*.L'i'. 1 ..,. _r..:..� y N'kYkSF :+", � + �_� ..:' ::..p � w .,= 'r'r: r t ; ,. �dX AUTHQRIZATION NO: Q 9 , DAVIE COUNTY HEA4-11 DEPARTMENT b� Environmental Health Section PROPERTY INFORMATION Permittee' cc� P.O. Box�848 Name: \�Y h9� cam-.- �� % Mocksville, NC 27028 Subdivision Name: Phone 704-634-8760 c� Directions to property: Iy °Section: Lot: b AUTHORIZATION FOR WASTEWATER Tax Office PIN:# SYSTEM CONSTRUCTION Road Name us " zip: '110-"l **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) ***NOTICE*** THIS AUTHORIZATION FOR WASTEWATER CONSTRUCTION IS VALID FOR A PERIOD OF FIVEYEARS. ENVIRONMENTAL HEALTH SPECIALIST DATE ISSUED s' 3'. .hww Y��vy r;� �/vb=}a-�,a�r.c�r'iv,�, `P�GzC `1't#'a 1 Y+.�n,. aaiF •.x;, m.tf:.. ,�. 9,: :.•, � .�N^tf h' V ��°- -w e5 �1 r-'r(''�� � J{3:_x4,. "�; `•d.. `4 z, '� '.i5 tf •%.,.1"i''+� H ? ;'.,��{•/��I -, S'6 •� L/ �U • ' O ,I)AVIE COUNTY HEALTH DEPARTMENT 1. 1 IMPROVEMENT AND OPERATION PERMITS PROPERTY INFORMATION Name~ Subdivision Name: Fg s 2 Directions to property.' l �+''� ft . Section: " Lot: , IMPROVEMENT r PERMIT Tax Office PIN:# 131 r RoadName.-� **NOTE** This Improvement Permit DOES NOT authorize the construction or installation of aseptic tank system or any wastewater system. An AUTHORIZATION FOR WASTEWATER SYSTEM CONSTRUCTION must be obtained from this Department prior to the construction/mstallation 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 T%atment and Disposal Systems) . ; ***NOTICE*** THIS PERMIT IS SUBJECT TO REVOCATION IF SITE ;•.1, ., �� : Via, t { PLANS OR THE INTENDED USE CHANGE. YOUR WASTEWATER ENVIRONMENTAL HEALTH SPECIALIST DATE ISSUED SYSTEM CONTRACTOR MUST SEE THIS PERMIT BEFORE " INSTALLING THE SYSTEM: RESIDENTIAL SPECIFICATION: BUILDING TYPE r' \kot0-W BEDROOMS �_ # BATHS # OCCUPANTS GARBAGE DISPOSAL: Yes olQj) COMMERCIAL SPECIFICATION: FACILITY TYPE # PEOPLE # PEOPLE/SHIFT # SEATS INDUSTRIAL WASTE: Yes or No t� ' LOT SIZEDTYPE WATER SUPPLY' DESIGN WASTEWATER FLOW (GPD) O NEW SITE REPAIR SITE z. SYSTEM SPECIFICATIONS: TANK SIZE 000 GAL. PUMP TANK GAL. TRENCH WIDTH ROCK DEPTH LINEAR FT. OTHER :...` r REQUIRED 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. SYSTEM INSTALLED BY: Is " $U RIS 4r rZfi AUTHORIZATION NO.� b� OPERATION PERMIT BY: '�'�'�` DATE:' b **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) APPLICATION FOR SITE EVALUATIONAMPROVEMENT PERMIT & ATC ****IMPORTANT**** Davie County Health Department2 Environmental Health Section '177] L5 P.O. Box 848 Mocksville, NC 27028 JUL 2 i (704) 634-8760 THIS APPLICATION CANNOT BE PROCESS THE REQUIRED INFORMATION IS PROVIDED. 1. Name to be Billed A�A;,�, /'/, •S'r -r4.'S Mailing Address 3368 Tc/5�11%/A'16-1 /9S7" City/State/ZipLIG /lJi�iL��, aV �. 2 ?d Z 2. Name on Permit/ATC if Different than Above Mailing Address 3. Application For: [ ] Site Evaluation Contact Persor>rJL*i�.5ti �— Home Phone 29r' F Z41/7 Business Phone City/State/Zip [ mprovement Permit & ATC [ ] Both 4. System to Serve: [ ] House [ Iobile Home [ ] Business [ ] Industry [ ] Other 5. If Residence: # People 3 # Bedrooms3 # Bathrooms 2 [ ] Dishwasher [ ] Garbage Disposal [11'W-ashing 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 [ ] Well [ ] Community 8. Do you anticipate additions or expansions of the facility this system is intended to serve? [ ] Yes [(moo If yes, what type? PROPERTY INFORMATION REQUIRED: *** IMPORTANT *** A^VfkyFOF THE PROPERTY MUST BE ` SUBMITTED WITHAPPLICATION. aa i Property Dimensions: �/8 U 1, WRITE DIRECTION (fromL-0-cksvifle) TO PROPERTY: Tax Office PIN: #, Z D - 2 0 - �% 7 7 V D 7)v © � S Property Address: Road Nama_p dg�'g- Gy �� �i �` ��7'S e7A) Lia City/Zip /�`orl�'. �•� ; If in Subdivision provide information, as follows: Name: 4,Ieerr &eod L✓ Section: _ Lot #: ; 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 ve of the Davie County Health Department to enter upon above described property located in Davie County and owned by LG�,�C�iUL �.�NN %% �+ J/c�L �o conduct all testinWcedures as necessary to determine the site suitability. Revised DCHD (06-96) THIS AREA MAY 13E USED F01Z DRAIVINCj JOUI? SITE PIAN: L 8:.i:,j, 3'..2, .,r.... s,-i• r. r.. .,. 1!r^.,v1 „ur Kej cr 1 '("!q F r..�t,., firs w.l'r ,f;,4',•..":+iF'; IV4 .-i: y�,:`y:'.x Ira d:4;4`ktt a� i -:"-.a ,k,"� '.ti„x t i Y �}.y.;!. 4.. .' '... ;.., .y +. r_.r:,✓�q at :.�,,,?.y,s..,,,:,, ,,{rs?!' 'M ,v,.;•r 5 wr". x,:A l {):;`,r,g.a)q..sr.,j i i,,.t` �„ 3 r. k. f ar .q. k 1.. a ly f ..tr (t' 1, .. r;'t' .!'.-;',,. its rJ Ti y,,,;,. * F -'.nr+ e ,yv f rrly .!' e. :, o,,r wit :,r w r ,ry, ., #'y �syrd' r:,t- 'ir-V ) t, z,ti Y,•h.^."•rz!-{ ., tl_t a{ 1 Lx, ..4 t, 1 •1 }5�- r,,`y ,p;t t"4'Yy a. swt !Pi%ir t,a. 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I ,r''f. y'>, :.'tom" t ;`.�5:' ba.s7.-Ft;r! f .yt [ r�` ,`, � 7 ...i -r- [t1. ...J s !�y�L I. ,;[§';, Yas •v r x,t .' IT -.:i. f r t ;s.. .'.s ✓ .' 7 '1,[ rr tr: "�, e ,.}v n f. .. +' r ar A;rL -rr,11 tix' s J v fi' ,t 3 ;:?^;t;,e :F..% 1 , y T < ! '•rti.;R It k[;,::a es r .-:Cbn �'Yr.,�S fNf tt y r Y ..i;•, }rt ..[� `.qy� w,f .aat,>a tF r','Sr',?^ a.lh.{ x'.�'.e YS gYtt]t`+•'+} w e :'J1 "�d�$9xT4'.`ra r+•,�?t� t o- L`a , .i M, t ;x ,rrs. ,.n+ !' vJ { 'r r'.c,r y'.. lz'*t• .ry a kro 1,.... > :P. "rti... . "'i7... 2-. t taw.,r f.r .,1.. _, ., :r"`. `.j> ... z:d „s.,q; ...., ,i,." +st-,r.' :Ra`+, - ,'a', f,. s ,r•.,,�. _ APPLICATION FOR SITE EVALUATION/IMPROVEMENTS Davie County Health Department Environmental Health Section P. O. Box 665 Mocksville, NC 27028 1. Application/Permit Requested By 4 a) e V Mailing Address Ck t o g( Home Phone `l t�`�� rl �'� Business Phone �. 2. Name on Permit if Different than Above 3. Application/Permit for: General Evaluation 4. System to Serve: �1 House C El Mobile Home ❑ Business ❑ Industry r� R �� 1:3Oth r 5. If house, mobile home: Subdivision a PIEf'�hOT M 'r,", „I W 17 A IG COM4I i H'L','JL7i ❑ Septic Tank Installation )' Is ❑ Place of Public Assembly ❑ Unknown _ Section Lot # -❑ Basement]Plumbing. No. of People ❑ Basement/No Plumbing No. of Bedrooms ❑ Washing Machine No. of Bathrooms ❑ Dishwasher Dwelling Dimensions ❑ Garbage Disposal 6. If business, Industry, place of public assembly, other: Specify type No. of People.Served No. of Sinks _ No. of Commodes No. of Urinals No. of Lavatories No. of Water Coolers No. of Showers Water Usage Figures 7. Type of water supply: P(Public ❑ Private 8. Property Dimensions -Sewage Disposal Contractor 9. Do you anticipate additions/expansion of the facility this sytem is intended to serve? ❑ Yes 11 line whnf Finn? - ❑ No ❑ Community 'NOTE: .Improvements Permits shall be valid for a period of 5 years from date issued. Improvements Permits are subject to revocation, if site plans or the Intended use change. Effective October 1, 1989. Directions to Property: Y" IV 01 '"� li %t 11 c C. -116 .� I (e C. � r � q(,�'\ c C r � C. �=� ( t' � U� C 1 �) e_ (' Cl t-. V C 2 cI This is to certify that the information provided is correct to the best of my knowledge, and I understand I am responsible for all charges I urred from this application. i DATE e1i SIGNATURE CONSENT FOR SITE EVALUATION TO BE DONE ON ABOVE DESCRIBEp P Obi PERTY MUST CHECK ONE: ❑ 1. 1 QWN the property. ,u,/2. 1 DO NQT OWN the property. If you checked Box �/2, the rest of this form (yIQ5T be completed by the owner or a person authorized by the owner: 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 << . ><i y�, )__ r, r~ _, t to conduct all testing procedures as necessary to determine said site'A suitability for a ground absorption sewage treatment and disposal system. O AT SIG ATI RE DCHD (12.90) DAVIE COUNTY HEALTH DEPARTMENT Environmental Health Section Soil/Site Evaluation b NAME DATE EVALUATED - -n-g ^ '19 ADDRESS Q' a PROPERTY SIZE O)C 3SCJ PROPOSED FACIILTY " LOCATION OF SITE MX -5 r Water Supply: On -Site Well _ Comm it Public - Evaluation By: Auger Boring Pit 1Cut FACTORS 1 2 3 4 Landscape position Sloe % HORIZON I DEPTH I all t' Texture group L Cl._ Consistence " T� Structure C Mineralogy HORIZON II DEPTH �� Texture groupC Consistence N Z Structure k Mineralogy HORIZON III DEPTH Texture group Consistence Structure Mineralogy HORIZON IV DEPTH Texture group Consistence Structure Mineralogy SOIL WETNESS S _37 RESTRICTIVE HORIZON -' - SAPROLITE - - CLASSIFICATION •S 5 LONG-TERM ACCEPTANCE RATEI SITE CLASSIFICATION:y ' S • EVALUATED BY: LONG-TERM ACCEPTANCE RATE: �� OTHER(S) PRESENT:.�o REMARKS: 's". 41 LEGEND Landscave 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 ;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 3C --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 (01-901 1 ■■■■■■■■■■■■■■■■■■�;say■ME.■■■.■...■■■■■■■■■■.■■■■_■■■■■■■■ ■omEM■■ ■■■..■..■..■.■■■■.���.e■EM■.■M..■.■..H/■■■■■.■■■■■ SSSS■E■MEEEMM■M■ ■.■........■■■..■i■yrs■■MMEE.■M.■EE■■■■■■■■■■■■■■.■■■■■■■■■■■■■■■■■■ ■■■■■■■■■■■■■■■■■.■■■■■■■■■■■■■■ H■■■■■■..■..■■■■ ■M■MMEMMEMEMM■ ���������������������������������������������������■ MOMMEEMM■MMEM mommommommommommmmmmmmmmmmmmmmmmmmmmmmmm■.■■■■■■■■■■■■■■■■■■■■■■■■■M■■■M■■■■■E■■uH■I ■I ■I ii�in�ME ■■■■■■■■■■■■■■■■■■■E■■■M■■■E■■■■■■■M■■■■ ■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■MM■IM■■M■M■■M■M■■MM■ ■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■m■MME■■■■■■■■■■■■■■■■■■■■■■■■■■■■ ■■■■■■■■.■■■.■■■■.■■■■.■■■■.■.. 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