204 Long Meadow Road Lot 37Davie County, NC I iTax Parcel Report Wednesday, December 21, 2016
WARN ILN T: '1'Nl�!i lit NOT A,UKVEY
Parcel Information
Parcel Number: H501OA0037 Township: Mocksville
NCPIN Number: 5749062656 Municipality:
Account Number: 59148870 Census Tract: 37059-806
Listed Owner 1: RAISBECK ROBERT H JR Voting Precinct: NORTH MOCKSVILLE COUNTY
Mailing Address 1: 204 LONG MEADOW ROAD Planning Jurisdiction: Davie County
City: MOCKSVILLE Zoning Class: DAVIE COUNTY R -A
State: NC Zoning Overlay: DAVIE COUNTY QD
Zip Code: 27028-0000
Voluntary Ag. District:
No
Legal Description: LOT 37 FARMLAND ACRES SECTION FIVE
Fire Response District:
MOCKSVILLE
Assessed Acreage: 5.17
Elementary School Zone:
MOCKSVILLE
Deed Date: 12/1995
Middle School Zone:
SOUTH DAVIE
Deed Book / Page: 001840389
Soil Types: SeB,EnB,MsC,MsD
Plat Book: 0006
Flood Zone:
Plat Page: 021
Watershed Overlay:
DAVIE COUNTY
uildin& Extra
Building Value:
FOreatur s Va Value:
Land Value:
Total Market Value:
Total Assessed Value:
161
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, Impliedwaranties of merchantability orfitness 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 anyand all claims orcauses 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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DAVIE COUNTY HEALTH DEPARTMENT
IMPROVEMENTS PERMIT AND CERTIFICATE OF COMPLETI N
O
*NOTE: Issued in Compliance With Article II of G. . Chapter 130a
anitafylsew Pcs!st�yn���r f _ Permit ber
Name ` Gt' iC Alt"111 Date ��1 // �� Np �W 4
Location G �77� .Cf/i�C' "T• k�f Jc,,2��
Subdivision Name Lot No. Sec. or Block No.
Lot Size House Mobile Home Business Speculation
No. Bedrooms 3 No. Baths _�� No. in Family a _
Garbage Disposal YES ❑ NO ❑
Specifications for S.
Auto Dish Washer YES NO ❑�}��,�'/o'%'-�P/ �d,�'r`S
Auto Wash Ma^hine YES 4,AO
❑
Type Water Supply
*This permit Void if sewage system described below is not inst Iled within 5 years from date of issue.
This permit is subject to revocation if site plans or the intengeuse change.
Improvements permit by
*Contact a representative of the Davie County Health Dep
9:30 A.M. or 1:00-1:30 P.M. on day of completion. Tele
I_
� 7
Final Installation Diagram:
0
t for final inspection of this system between 8:30 -
Number 704-634-5985.
Installed by
d
1�
�JG
Certificate of Completion 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.
DAVIE COUNTY HEALTH DEPARTMENT
Environmental Health Section
Soil/Site Evaluation
NAME _ il,iT/1 �L' `< DATE EVALUATED--��_9�
ADDRESS PROPERTY SIZE
PROPOSED FACIILTY —� LOCATION OF SITEri��.4��✓
Water Supply: On -Site Well Community Public c
Evaluation By: Auger Boring t/ Pit Cut
FACTORS
1 2 3 4
Landscape position
/1
Sloe %
HORIZON I DEPTH
Texture group
Consistence
Structure
Mineralogy
HORIZON II DEPTH
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
LONG-TERM ACCEPTANCE RATE
SITE CLASSIFICATION: EVALUATED BY: Z41,15 //
LONG-TERM ACCEPTANCE TE: OTHER(S) PRESENT:
REMARKS: et /
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 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
Mineraloity
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
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• APPLICATION FOR SITE EVALUATION/IMPROVEMENTS
Davie County Health Department
Environmental Health Section
P. O. Box 665 NOY 12 1992-
Mocksville, NC 27028
1. Application/Permit Requested By nQ
Mailing Address_
Home Phone `—S Business Phone
2. Name on Permit if Different than Above
3. Application/Permit for: ❑ General Evaluation eptic Tank Installation
4. System to Serve: [j Nouse ❑ Mobile Home ❑ Place of Public Assembly
❑ Business ❑ Industry ❑ Other ❑ Unknown
t�-
5. If house, mobile home: Subdivision t ,K tYN NoQ A- Section Lot #
No. of People a
No. of Bedrooms _
No. of Bathrooms 142
Dwelling Dimensions CA )� :5 �
6. 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
❑ Basement/Plumbing
❑ Basement/No Plumbing
"ashing Machine
ishwasher
❑ Garbage Disposal
7. Type of water supply:ublic ❑ Private ❑ Community
8. Property Dimensions s Sewage Disposal Contractor
9. Do you anticipate additions/expansion of the facility this sytem is intended to serve? ❑ Yes ti, -
If yes, what type?
`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:
Mkt
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
incurred from this application.
DA E
CONSENT FOR SITE EVALUA TO BE DONE ON ABOVE DESCRIBED PROPERTY
MUST CHECK ONE: 1. I OWN the property. ❑ 2. I 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 representative of the Davie County Health Department to enter upon above described
property located in Davie County and owned by
to conduct all testing procedures as necessary to determine said site's suitability for a ground absorption sewage treatment
and disposal system.
DATE SIGNATURE
DCHD (12-90)