1165 Junction Rd, 107 Grant Trl Lot 5Davie County, NC Tax Parcel Report Tuesday, January 3. 2017
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:
WARNIA T: '11115 IS NO1' A SURVEY
COOLEEMEE
Parcel Information
SOUTH DAVIE
M401 OA0005
Township:
Mocksville
5726819631
Municipality:
DAVIE COUNTY
82516538
Census Tract:
37059-801
SPILLMAN ROGER P
Voting Precinct:
SOUTH CALAHALN
PO BOX 738
Planning Jurisdiction:
Davie County
COOLEEMEE
Zoning Class: DAVIE COUNTY R-A,R-20
NC
Zoning Overlay:
DAVIE COUNTY CZOD
27014-0000
Voluntary Ag. District:
No
LOT 5 GRANT HEIGHTS 1.777 ac
Fire Response District:
COOLEEMEE
Land Value:
Total Assessed Value:
1.78 Elementary School Zone:
COOLEEMEE
12/2013 Middle School Zone:
SOUTH DAVIE
009450577 Soil Types:
GnB2
10 Flood Zone:
371 Watershed Overlay:
DAVIE COUNTY
Outbuilding & Extra
Freatures Value:
Total Market Value:
[-I 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, I 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
oNC or arising out of the use or Inability to use the GIS data provided by this website.
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AUTI�RIZARI'I N NO: DAVIE COUNTY HEALTH DEPARTMENT
�r mud
Environmental Health Section PROPERTY IW,
: RMATION
Permittee's'G`! Lr - -��i� r. ,•1i; -r'; / P.O. Box 848
Name: `! 7 . i / Mocksville,NC 27028 Subdivision Name)
Directions to property:
Phone #: 704-634-8760 r!
Section: Lox:-�.
AUTHORIZATION FOR ,' C ,! .16' S--7-
WASTEWATER Tax Office PI - ,�-J�-_
SYSTEM CONSTRUCTION «trd� �kC
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 1,1 pf 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
� s,. �"
DAVIE COUNTY HEALTH DEPARTMENT
IMPROVEMENT AND OPERATION PERMITS PROPERTY INFORMATION
Permittees
Name: �1� r Subdivision Name:
Directions to property: `•- i _ f Section: Lot:
IMPROVEMENT
PERMIT Tax Office PIN:#,�=- -
Road Name: '`�, !z • �. t ' `'Lip:
**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
_ s ± . ✓ x , ' PLANS OR THE INTENDED USE CHANGE. YOUR WASTEWATER
ENVIRONMENTAL HEALTH SPECIALIST DATE ISSUED SYSTEM CONTRACTOR MUST SEE THIS PERMIT BEFORE
INSTALLING THE SYSTEM.
.r
RESIDENTIAL SPECIFICATION: BUILDING TYPE i-� + # BEDROOMS 1 f # BATHS - # OCCUPANTS GARBAGE DISPOSAL: Yes or No
COMMERCIAL SPECIFICATION: FACILITY TYPE # PEOPLE # PEOPLE/SHIFT # SEATS INDUSTRIAL WASTE: Yes or No
LOT SIZE P t� ( TYPE WATER SUPPLY ` DESIGN WASTEWATER FLOW (GPD) Q.S"/ 1lJ NEW SITE REPAIR SITE
SYSTEM SPECIFICATIONS: TANK SIZEL r21 &GAL. PUMP TANK GAL. TRENCH WIDTH I:Ft ROCK DEPTH f.-) LINEAR FT. •S Dd
OTHER
REQUIRED SITE MODIFICATIONS/CONDITIONS:
IMPROVEMENT PERMIT LAYOUT
"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:.
elt C
AUTHORIZATION NO.l �/T OPERATION PERMIT BY: '� DATE: / ✓�� l f
"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)
r� z. APPLICATION FOR SITE EVALUATIONAMPROVEMENT PERMI 0 U R
Davie County Health Department
Environmental Health Section
T
P. O. Box 848 JUN - 31998
Mocksville, NC 27028
(704) 634-8760 ENVIRMtIENTAL HEALTH
****IMPORTANT**** THIS APPLICATION CANNOT BE PROCESSED UNLESS
1
ALL
� THE REQUIRED INFORMATION IS PROVIDED.
1. Name to be Billed 0 v/� M vY "WW J Contact Person
Mailing Address PO Joa —139 Home Phone
City/State/Zip d W mee ' "� /Dl Business Phone ��'T ' -IW l
2. Name on Permit/ATC if Different than Above
If yes, what type?
PROPERTY INFORMATION REQUIRED: *** IMPORTANT *** A PLAT OF THE PROPERTY MUST BE
SUBMITTED WITH THIS APPLICATION.
Property Dimensions:
Mailing Address
Ci
1 WRITE DIRECTIONS (from
3.
Application For:
itty/State/Zip
ElW Site Evaluation Improvement Permit & ATC
❑ Both
4.
System to Serve:
❑ House Mobile Home ❑ Business ❑ Industry ❑ Other
5.
If Residence:
# People # Bedrooms 3 #
Bathrooms
C -Dishwasher
❑ 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 ❑ Well
❑ Community
1
all
8.
Do you anticipate
additions or expansions of the facility this system is intended to serve?
❑ Yes o
If yes, what type?
PROPERTY INFORMATION REQUIRED: *** IMPORTANT *** A PLAT OF THE PROPERTY MUST BE
SUBMITTED WITH THIS APPLICATION.
Property Dimensions:
1 WRITE DIRECTIONS (from
�n
"'
�/
O
/
V, q �� `
1 Mocksville) TO PROPERTY:
Tax Office PIN: # —S� -
_
1
Property Address: Road Name
1
_
City/Zip
1
If in Subdivision provide information, as follows:
1
l
�
Name:
1
Section:
Lot #:
1
1
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 SG��.�&Wma'ii c to conduct all testing procedurels
as necessary to determine the site suitability. DATE & -a' -qg SIGNATUREJaJA
Revised DCHD (06-96)
/A111. 746- � O
DAVIE COUNTY HEALTH DEPARTMENT _
Environmental Health Section SECTION _ LOT
Soil/Site Evaluation
APPLICANT'S NAME DATE EVALUATED
PROPOSED FACILITY PROPERTY SIZE
SUBDIVISION
ROAD NAME14
Water Supply: On -Site Well
Community
Public
Evaluation By: Auger Boring Pit i--- Cut
FACTORS 1 2 3 4 5 6 7
Landscape position
Slope %
HORIZON I DEPTH
Texture group
Consistence
Structure
Mineralogy
HORIZON II DEPTH
Texture group
Consistence
Structure ll
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:
LONG-TERM ACCEPTANCE RATE:
REMARKS:
DCHD (01-90)
LEGEND
Landscape Position
EVALUATION BY:
OTHER(S) PRESENT:
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
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Davie County, NC Tax Parcel Report Wednesday January 4. 2017
Parcel Number:
NCPIN Number:
Account Number:
Listed Owner 1:
Mailing Address 1:
City:
State:
Zip Code:
Legal Description:
Assessed Acreage
Deed Date:
Deed Book I Page:
Plat Book:
Plat Page:
Building Value:
WARNING: THIS 1S NOT A SURVEY
COOLEEMEE
Parcel Information
SOUTH DAVIE
M401 OA0005
Township:
Mocksville
5726819631
Municipality:
DAVIE COUNTY
82516538
Census Tract:
37059-801
SPILLMAN ROGER P
Voting Precinct:
SOUTH CALAHALN
PO BOX 738
Planning Jurisdiction:
Davie County
COOLEEMEE
Zoning Class: DAVIE COUNTY R -A R-20
NC
Zoning Overlay:
DAME COUNTY CZOD
27014-0000
Voluntary Ag. District:
No
LOT 5 GRANT HEIGHTS 1.777 ac
Fire Response District:
COOLEEMEE
Land Value:
Total Assessed Value:
1.78 Elementary School Zone:
COOLEEMEE
12/2013 Middle School Zone:
SOUTH DAVIE
009450577 Soil Types:
GnB2
10 Flood Zone:
371 Watershed Overlay:
DAVIE COUNTY
Outbuilding & Extra
Freatures Value:
Total Market Value:
Davie County,
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 Courdys GIS website shall hold harmlessthe
4County
N C
of Davie, North Carolina, its agents, consultants, contractors or employees from any and all claims or causes of action due to
�UN�
or arising out of the use or Inability to use the GIS data provided by this website.
R
TmnonuCWWT DCDMTT
DAVIE COUNTY HEALTH DEPARTMENT
IMPROVEMENT PERMIT and OPERATION PERMIT
**NOTE** This improyeaent 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)
NAME PROPERTY ADDRESS . U n , a h, a '14';s a DATE
LOCATION 4p,
ri - -- -- - -- ---
SUBDIVISION NAME LOT LOT NUMBER � SEC./BLOCK NUMBER
RESIDENTAL SPECIFICATION: BUILDING TYPE # BEDROOMS,-? # BATHS # OCCUPANTS GARBAGE DISPOSAL: Yes/No
�A
COMMERCIAL SPECIFICATION: FACILITY TYPE # PEOPLE # PEOPq-E/SHIFT # SEATS INDUSTRIAL WASTE: Yes/No
LOT SIZE TYPE WATER SUPPLY DESIGN WASTEWATER FLOW (GPD) ?, Z NEW SITE Y REPAIR SITE \
SYSTEM SPECIFICATIONS: TANK SIZE �&r• GAL. PUMP TANK GAL. TRENCH WIDTH 2 ROCK DEPTH _/2L LINEAR FT.�
y,
OTHER
REQUIRED SITE MODIFICATIONS/CONDITIONS:
***THIS PERMIT IS SUBJECT TO REVOCATION IF SITE PLANS OR THE INTENDED USE CHANGE. YOUR WASTERWATER SYSTEM. CONTRACTOR MUST
SEE THIS PERMIT BEFORE INSTALLING THE SYSTEM.
IMPROVEMENT PERMIT BYL/
**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
AUTHORIZATION NO. 016 V 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 10/95
Davie County Health Department =
ENVIRONMENTAL HEALTH SECTION
P.O. Box 665 Ujab
Mocksville, N.C. 27028 �4� 7+ /6
AUTHORIZATION FOR WASTEWATER SYSTEM CONSTRUCTION �p
>.
(Issued in compliance with Article 11 of
G.S. Chaptera130A, Wastewater Systems)
***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 whe applying for Building Permits.***
AUTHORIZATION NUMBER
NAME A DATE 0 a 10
NAME ON IMPROVEMENT PERMIT (If different than above) /' ��
SITE, LOCATION _ — LOIN �lj✓t �C� 64 n 4, %J
COMMENTS/CONDITIONS ON AUTHORIZATION TO CONSTRUCT WASTEWATER SYSTEM
APPLICATION FOR SITE EVALUATION/IMPROVEMENTS PE
Davie County Health Department VLg
Environmental Health Section
P. O. Box 665
Mocksville, NC 27028
1. Application/Permit
Re—ARtAd By
-= f,
MailingAddress !.� F� • 7 C> Home Phone
,INNt 1" ! i j, ��i�� �! Business Phone
AV
2. Name on Permit if Different than Above
3. Application for: ❑ General Evaluation Septic Tank Installation Permit
4. System to Serve: ❑ House L9° Mobile Home ❑ Place of Public Assembly
❑ Business ❑ Indust ❑ Other ❑ Unknown
5. If house, mobile home: Subdivision ��1i�� `'� ��i FIr Section Lot #
❑ Basement/Plumbing
No. of People ❑ Basement/No Plumbing
No. of Bedrooms `% ❑ Washing Machine
No. of Bathrooms ❑ Dishwasher
Dwelling Dimensions W')O I A 0A 41n, q X8bNA ❑ 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: EKPublic ❑ Private
8. Property Dimensions !�2 X CoSewage Disposal Contractor
9. Do you anticipate additions/expansion of the facility this sytem is intended to serve? ❑ Yes ❑ No
If yes, what type?
❑ Community
'NOTE: Improvements Permits shall be valid from date issued. Improvements Permits are subject to
revocation, if site plans or the intended use change. Effective October 1, 1989.
Directions to Property:
�-f 1
LtrG�U-yt-
This is to certify that the information provided is correct to the
incurred from this app kation.
DATE
Z
Wam
Tax Office PIN: #Th.,Lc+If,) fylAe4
PROPERTY AbbMS as follows:
Road Name: C"N. it (("n
City: 1�,1Il
'��:'.5E/r.
SUBMIT A PLAT WITH THIS APPLICATION.
Revisions effective October 1, 1995.
of my knowledge, and I
SIGNATURE
am responsible for all charges
CONSENT FOR SITE EVALUATION TO BE DONE ON ABOVE DESCRIBED PROPERTY
MUST CHECK ONE: ❑ 1. 1 OWN the property. 212. 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 representati tf1e�D yie Co �panto a ty er upon above described
property located in Davie County and owned by ll—�� I C
to conduct all testing procedures as necessary to de r in s i te' sbi nd bsorption sewage treatment
and disposal system. e of
Ytl wl 10
DATE IGNATURE
DCHD (1193)
DAVIE COUNTY HEALTH DEPARTMENT
Environmental Health Section
Soil/Site Evaluation
NAME
ADDRESS
PROPOSED FACIILTY
Water Supply: On -Site Well
Evaluation By: Auger Boring
DATE EVALUATED Vf al&
PROPERTY SIZE 1 tfi/G
LOCATION OF SITE
Community
Pit t/
FACTORS 1 2 3 4
Landscape position
Sloe %
HORIZON I DEPTH
Texture group
Consistence
Structure
Mineralogy
HORIZON II DEPTH 4V9 '' _�12
Texture group
Consistence
Structure i 4
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 ,
Public C/
Cut
SITE CLASSIFICATION: AJ EVALUATED BY:
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 ;lay loam, SIL -Silty loam CL -Clay loam SCL-Sandy clay loam
SC -Sandy clay SIC -Silty clay C -Clay
CONSItTENCE
Moist
VFR- Vc.-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(01-90)
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