115 Long Meadow Road Lot 43Davie County, NC Tax Parcel Report Wednesday. December 28. 2016
WARNING: 1711515 NOTA SURVEY
Parcel Information
Parcel Number:
H5010A0043
Township:
Mocksville
NCPIN Number:
5749076924
Municipality:
Account Number:
36351500
Census Tract:
37059-806
Listed Owner 1:
HOLLAND ROBERT S
Voting Precinct: NORTH MOCKSVILLE COUNTY
Mailing Address 1:
115 LONGMEADOW ROAD
Planning Jurisdiction:
Davie County
City: MOCKSVILLE
Zoning Class: DAVIE COUNTY R -A
State:
NC
Zoning Overlay:
DAVIE COUNTY QD
Zip Code:
27028-4260
Voluntary Ag. District:
No
Legal Description: LOT
43+ FARMLAND ACRES SECTION FIVE
Fire Response District:
MOCKSVILLE
Assessed Acreage:
6.64
Elementary School Zone:
MOCKSVILLE
Deed Date:
3/1997
Middle School Zone:
SOUTH DAVIE
Deed Book I Page:
001930420
Soil Types: SeB,PaD,MsC,CeB2,ChA
MsD
Plat Book:
0006
Flood Zone:
Plat Page:
021
Watershed Overlay:
DAVIE COUNTY
Building Value:
Outbuilding 8r Extra
Freatures Value:
Land Value:
Total Market Value:
Total Assessed Value:
EO
Davie County,
�T
l� C
All data Is provided as Is without warranty or guarantee of any Idnd either expressed or implied Including but not limited to the
Implied warranties of merchantability or fitness for a particular use. All 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 all claims or causes of action due to
or arising out of the use or Inability to use the GIS data provided by this websfte.
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+ DAVIE COUNTY HEALTH DEPARTMENT p ~ 3• :
A
IMPROVEMENT AND OPERATION PERMITS PROPERTY INFORMATION
Nd�l Subdivision Name:'4dAl AL`S
,R,,
Directions to property: I ' - i t J� Section: /`� "Lot:.
_ IMPROVEMENT
!7A PERMIT Tax Office PIN:# - -
Road Nadine Nl /! C' a �1p,��"t r
A*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)
r - ***NOTICE*** THIS PERMIT IS SUBJECT TO REVOCATION IF SITE
,r r / ) 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 # BEDROOMS # BATHS_ # OCCUPANTS GARBAGE DISPOSAL: Yes or No
COMMERCIAL SPECIFICATION: FACILITY TYPE # PEOPLE # PEOPLEISHIFT # SEATS INDUSTRIAL WASTE: Yes or No
LOT SIZE \ TYPE WATER SUPPLY DESIGN WASTEWATER FLOW (GPD) NEW SITE REPAIR SITE 1z
SYSTEM SPECIFICATIONS: TANK SIZE GAL. PUMP TANK GAL. TRENCH WIDTH - <� ^ ROCK DEPTH -� LINEAR FT.
REQUIRED SITE MODIFICATIONS/CONDITIONS:
i
IMPROVEMENT PERMIT LAYOUT .
41
11VIA, &J
�Y
**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:
7b x
`r
F
AUTHORIZATION NO. OPERATION PERMIT BY: y DATE: 'LZ
**THE ISSUANCE OF THIS OPERATION PERMIT SHALL INDICA AT THE SYSTEM DESCRIBED ABOVE HAS BEEN INSTALLED IN COMPLIANCE
WITH ARTICLE 11 OF G.S. CHAPTER 130A, SECTION .1900 "SE E TREATMENT AND DISPOSAL SYSTEMS", BUT SHALL IN NO WAY BETAKEN AS A
GUARANTEE THAT THE SYSTEM WELL FUNCTION SATISFACTORILY FOR ANY GIVEN PERIOD OF TIME.
DCHD 05/96 (Revised)
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2 01
DAVIE COUNTY HEALTH DEPARTMENT
IMPROVEMENT AND OPERATION PERMITS PROPERTY INFORMATION
Pe s-
. Subdivision Name
Directions to oroperty: .0 9 C� 77J [ ���q� Section: ,� `Lot:
r IMPROVEMENT
9h Ll � �s�Y PERMIT Tax Office PIN:# _
A5
. �21 % eo
Road Name:
j**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/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)
f ' ***NOTICE*** THIS PERMIT IS SUBJECT TO REVOCATION IF SITE
`e 14,'s �- f r' PLANS OR TILE INTENDED USE CHANGE. YOUR WASTEWATER
ENVIRONMENTAL HEALTH SPECIALIST DATE ISSUED SYSTEM CONTRACTOR MUST SEE THIS PERMIT BEFORE
INSTALLING THE SYSTEM.
RESIDENTIAL SPECIFICATION: BUILDING TYPE , ff # BEDROOMS y7 # BATHS,—j� # OCCUPANTS GARBAGE DISPOSAL: Yes or No
COMMERCIAL SPECIFICATION: FACILITY TYPE # PEOPLE # PEOPLE/SHIFT # SEATS INDUSTRIAL WASTE: Yes or No
LOT SIZE TYPE WATER SUPPLY DESIGN WASTEWATER FLOW (GPD) NEW SITE REPAIR SITE
SYSTEM SPECIFICATIONS: TANK SIZE GAL. PUMP TANK GAL. TRENCH WIDTH ROCK DEPTH LINEAR FT.[�?
REQUIRED SITE MODIFICATIONS/CONDITIONS:
IMPROVEMENT PERMIT LAYOUT
�X�57iaJ�
/ gSx3YY�
rJs'SX X?'
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j
O
"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.
AUTHORIZATION NO. 0 900 OPERATION PERMIT BY?ETREA=TMENT7AND
DATE:
"THE ISSUANCE OF THIS OPERATION PERMIT SHALL INDICSYSM DESCRIBED ABOVE HAS BEEN INSTALLED IN COMPLIANCE
WITH ARTICLE 11 OF G.S. CHAPTER 130A, SECTION .1900 "SE 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 05196 (Revised)
DAVIE COUNTY ENVIRONMENTAL HEALTH SECTION 7o f/_ 3 = 3.
APPLICATION FOR IMPROVEMENT PERMIT (REPAIR) AW- 20
NAME &Gt1- 11.011 ml PHONE NUMBER
ADDRESS //J' ,/N�lk- SUBDIVISION NAME 64MI&I QG�►-
AVf'? &')1C /L(, Z%JLf- LOT # ?-3
DIRECTIONS TO SITE Woe/,V' % A 4*4 ZA' A-iu�l� /`K
r -
DATE SYSTEM INSTALLED S-q�� NAME SYSTEM INSTALLED UNDER
TYPE FACILITY /` NUMBER BEDROOMS 3 NUMBER PEOPLE SERVED o'I'
TYPE WATER SUPPLY" SPECIFY PROBLEM OCCURRING
(�r1C�l
DATE REQUESTED ��" ?'7' INFORMATION TAKEN BY
This is to certify that the information provided is correct to the best of my knowledge, and that I understand I am responsible for all charges incurred from this application.
SIGNATURE OF OWNER OR AUTHORIZED AGENT
Rev. 1/93
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T7,11r. ON 0: 0800 DAVIE COUNTY HEALTH DEPARTMENT
Environmental Health Section PROPERTY INFORMATION
Permittee's � � �' /% � P.O. Box 848
eNam.: Q ,iCj�'i Mocksville, NC 27028 Subdivision Name:
��IJ��Caef�S
✓�' Phone �(/�
Directions to property: �'��rD1?,�rai�� #:704-634-8760 Section: ` Lot:—,Ao
HCl
AUTHORIZATION FOR
7, 6:—��+�--�a�%� WASTEWATER Tax Office PIN:# - -
��— SYSTEM CONSTRUCTION
Road NNacme:�p•
**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 FIVE YEARS.
ENVIRONMENTAL HEALTH SPECIALIST DATE ISSUED
rDavie Counfy .1-lea�fir �De ari n
and Nome Xealfki yency
210 HOSPITAL STREET/ P.O. BOX 665
MOCKSVILLE. N.C. 27028
PHONE: (704) 634.5985
August 20, 1993
Lorri Blackwood
141 E. Lexington Rd.
Mocksville, HC 27028
Re: Site Evaluation
Farmland Acres
Dear Ms. Blackwood:
As requested, a representative from this office visited the aforementioned
site on August 17, 1993. Based upon the information provided on the
application for a site evaluation and after an evaluation was completed, the
site was found to be provisionally suitable for the installation of an on-site
sewage disposal system.
If you have any questions, please feel free to contact this office.
Sincerely,
Robert B. Hall, Jr., R.S.
Environmental Health Section
RH/vd
Enclosure
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MEN
DAVIE COUNTY HEALTH DEPARTMENT
Environmental Health Section
Soil/Site Evaluation
NAME "91,te&eIcr
ADDRESS
PROPOSED FACIILTY
DATE EVALUATED Z' 1221i�?
PROPERTY SIZE J- Z2C
LOCATION OF SITE Qin
Water Supply: On -Site Well Community Public
Evaluation By: Auger Boring �' Pit Cut
FACTORS I
2
3
4
Landsca a osition 1
L
Slope %
'U
HORIZON I DEPTH 61.
Texture group 5-L
L
"'-
Consistence
Structure
Mineralogy
HORIZON II DEPTH
b'
Texture group 14Q
Consistence =a
te,✓�
i^
Structure T.46
/
•Y
Mineralogy 'J.t
HORIZON III DEPTH
Texture group
Consistence
Structure
Mineralogy
HORIZON IV DEPTH
Texture group
Consistence
Structure
Mineralogy
SOIL WETNESS
RESTRICTIVE HORIZON
SAPROLITE
CLASSIFICATION
LONG-TERM ACCEPTANCE RATE
SITE CLASSIFICATION: EVALUATED BY:
LONG-TERM ACCEPTANCE RATE: / OTHER(S) PRESENT:
REMARKS:
LEGEND
Landscape Position
R -Ridge S7 -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(01-901
1
APPLICATION FOR SITE EVALUATION/IMPROVEMENTS PERMIT
/%)r t/- + �� Davie County Health Department
® �� Environmental Health Section EMED
(�?fl P. O. Box 665
Mocksville, NC 27028 JUL 291993
1. Application/Permit Requested ByP– C �.Jad
Mailing Address
�y t� ' D 5 V; Io� �a
Home Phone 1 b 't �D 3 3 1.0 01 Business Phone —'7(-)V 3 ti� 59 3[�
2. Name on Permit if Different than Above
3. Application/Permit for: General Evaluation ❑ Septic Tank Installation
4. System to Serve: House ❑ Mobile Home ❑ Place of Public Assembly
❑ Business ❑ Industry �❑ Other ❑ Unknowri 1�.
5. If house, mobile home: Subdivision E0.�atJc1 � 25 z\J
__ rr Lo q 4 ❑ Basement/Plumbing
No. of People 3 ury Q s�e>J� ❑ Basement/No Plumbing
No. of Bedrooms J +I achine
No. of Bathrooms a 0(2-, OL Dishwasher
Dwelling Dimensions l$ U O` a l D c � Garbage Disposal
0 If business, industry, place of public assembly, other: Specify type
No. of People Served
No. of Commodes
No. of Lavatories
No. of Showers
No. of Sinks
No. of Urinals
No. of Water Coolers
Water Usage Figures
7. Type of water supply: Public ❑ Private
8. Property Dimensions Z, L QC U-6 Sewage Disposal Contractor
9. Do you anticipate additions/expansion of the facility this sytem is intended to serve? ❑ Yes 7 No
If yes, what type?
❑ 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:
l
This is to certify that the information provided is correct the
incurred from N972g'_5
ic
of my knowledge,
SIGNATURE
CONSENT FOR SITE EVALUATION TO BE DONE ON ABOVE DESCRIBED PROPERTY
for all charges
MUST CHECK ONE: ❑ 1. 1 OWN the property. X2. 1 DO NOT OWN the property.
If you checked Box #2, the rest of this form MUST be completed by the owner or a person authorized by the owner:
I hereby give consent to the authorized representativef the Dayyie County Health Department to enter upon above described
property located in Davie County and owned by �n14e 11
to conduct all testing procedures as necessary to determind said site's suitability for a ground absorption sewage treatment
and disposal system.
7 9- 9?
DATE
DCHD (12-90)
fM J -"a i rl 'i -'1 _.-� y.,,, � /.,�. Y d' fie- .ti -:,' '" r .. • - , .. .,.. � .. � , /:y -
.r;, DAVIE COUNTY `HEALTH DEPARTMENT
IMPROVEMENTS PERMIT AND CERTIFICATE OF COMPLETION
*NOTE: Issued in Compliance With Article II of G.S. Chapter 130a
Sanitary Sewage Systems i%' �' Permi111
t„ umber
Name % Date{/ / f
Location
Subdivision Name ✓ Lot No.� Sec. or Block No.
Lot Size House Mobile Homer Business Speculation
No. Bedrooms No. Baths. No. in Family _
Garbage Disposal YES NO ❑'
Specific tions for. -System:
Auto Dish Washer YES NO E]
Auto Wash Ma .hine YES NO ❑ �� ? k / ' ��
f
Type Water Supply __—
*This permit Void if sewage system described below is not installed within 5 years from date of issue.
This permit is subject to revocation if site plans or the intended use change.
Improvements permit by -- —_
*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 day of completion. Telephone Number 704-634-5985.
Final Installation Diagram:
System Installed by
Certificate of Completion _C Y y" Date���
*The signing of this certificate shall indicate that the system described above has been installed in compliance with
the standards set forth in the above regulation, but shall in NO way be taken as a guarantee that the system will function
satisfactorily for any given period of time.
s 1 dDIE COUNTY HEALTH DEPARTMENT
1.-/ c l �e
Name: - � �i � nvtronmental Health Section PROPERTY INFORMATION
��. fi 1:.�''P.O. Box 848
Directions toY✓ro ert f/{� Lr ! ` l ) C `
! ! ' � �`' � Mocksville, NC 2702E Subdivision Na
Phone #: 336-751-8760 /
Section: Lot:
AUTHORIZATION FOR
WASTEWATER Tax Office PIN:#
SYSTEM CONSTRUCTION - -
AUTHORIZATION NO: 002590 A Road Name: Zip:
**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.] 900 Sewage Treatment and Disposal Systems)
***NOTICE*** THIS AUTHORIZATION FOR WASTEWATER CONSTRUCTION
IS VALID FOR A PERIOD OF FIVE YEARS.
ENVIRONMENTAL HEALTH SPECIALIST DATE ISSUED
RESIDENTIAL SPECIFICATION: BUILDING TYPE # BEDROOMS T # BATHS # OCCUPANTS GARBAGE DISPOSAL: Yes or No
COMMERCIAL SPECIFICATION: FACILITY TYPE # PEOPLE # PEOPLE/SHIFT # SEATS INDUSTRIAL WASTE: Yes or No
LOT SIZE TYPE WATER SUPPLY DESIGN WASTEWATER FLOW (GPD) _ NEW SITE REPAIR SITE
SYSTEM SPECIFICATIONS: TANK SIZE GAL. PUMP TANK GAL. TRENCH WIDTI ROCK DEPTU�I' T�`d LINEAR FT. �
REQUIRED SITE MODIFICATIONS/CONDITIONS:
IMPROVEMENT PERMIT LAYOUT
0
156Y-?X/1�`,
FOR FINAL INSPECTION OF THIS SYSTEM PLEASE CALL BETWEEN 8:30 - 9:30 A.M. ON THE DAY OF INSTALLATION. TELEPHONE # IS (336) 751-8760.
OPERATION PERMIT
SYSTEM INSTALLED BY:
AUTHORIZATION NCE% /� PERATION 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 02/02 (Revised)
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