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1275 Junction Road Lot 19Davie 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 / Page: Plat Book: Plat Page: Building Value: WAKNiNG: THIS IS NUT A SURVEY Parcel Information M401 OA0019 Township: Mocksville 5726903300 Municipality: 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-20 NC Zoning Overlay: DAVIE COUNTY CZOD Land Value: Total Assessed Value: 27014-0000 Voluntary Ag. District: LOT 19 GRANT HEIGHTS.86 ac Fire Response District: 0.79 Elementary School Zone: 8/2011 Middle School Zone: 008660452 Soil Types: 10 Flood Zone: 371 Watershed Overlay: Outbuilding & Extra Freatures Value: Total Market Value: No COOLEEMEE COOLEEMEE SOUTH DAVIE GnB2,GnC2 DAVIE COUNTY All data Is provided as is without warranty or guarantee of any kind either expressed or Implied Including but not limited to the Davie County, Implied warranties of merchantability orfitness fora 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 npU��� j or arising out of the use or Inability to use the GIS data provided by this website. AUTHOR?„ATION NO: 07,17 DAVIE COUNTY HEALTH DEPARTMENT 1 b Environmental Health Section PROPERTY INFORMATION Permittee's �� / P.O. Box 848 �. Name: h'��/Lf� Mocksville, NC 27028 Subdivision Name:. --� Phone #: 704-634-8760 Directions to property: Section: % Lot: �l {rt2'jiS� AUTHORIZATION FOR , WASTEWATER Tax Office PIN:# gr1�"�S f - r SYSTEM CONSTRUCTION ''��%y {//n RoadName:01:ll"b'�1`'.l�il�'t **NOTE** This Authorization for Wastewater System Construction MUST BE ISSUED by the Davie Cotay 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 DAVIE COUNTY HEALTH DEPARTMENT IMPROVEMENT AND OPERATION PERMITS PROPERTY INFORMATION Perttes -Name: _, 1 Subdiyision Name: Directions to property:1! / 1/� f T� Section: Lot: %' f IMPROVEMENT PERMIT Tax Office PIN:#.` Road Name i �' � , f t }�t`"�Ip:: =; / **NOTE** This Improvement Permit DOES NOT authorize the construction or installation of a septic tanUystem 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 l 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 A) & # BEDROOMS -.S' # BATHS �7-2— # 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. TRENCHWIDTH ROCK DEPTH X," LINEAR FI'. �n 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 44 SYSTEM INSTALLED BY: H o vs -R ;,� AUTHORIZATION NO."OPERATION PERMIT BY: a � DATE: ` - ?� **THE ISSUANCE OF THIS OPERATION PERMIT SHALL INDICA THAT SYSTEM D RIBED ABOVE HAS BEEN INSTALLED IN COMPLIANCE WITH ARTICLE 11 OF G.S. CHAPTER 130A, SECTION .1900 "SE GE TRE TMENT AND DI SAL SYSTEMS", BUT SHALL IN NO WAY BE TAKEN AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFA RILY FO ANY GIVEN PE D OF TIME. DCHD 05/96 (Revised) VI­-41� s ~ APPLICATION FOR SITE EVALUATION/IMPROVEMENT PEI�Lnl Davie County Health Department Environmental Health Section P. O. Box 848 Mocksville, NC 27028 (704)634-8760 ****IMPORTANT**** THIS APPLICATION CANNOT BE PROCESSED UNLESS ALL THE REQUIRED INFORMATION IS PROVIDED. 1. Name to be Billed Contact Person RO 9 . P. t' S >1LOM,9/J Mailing Address R b Any- , 1371 Home Phone QRq-01 ZZr7 City/State/Zip OAOOp nor -45' Jam& o� ~% /`Y Business Phone Q2q— 0,55t 2. Name on Permit/ATC if Different than Above �fY7r- AS PAnur If yes, what type? PROPERTY INFORMATION REQUIRED: *** IMPORTANT *** A PLAT OF THE PROPERTY MUST BE SUBMITTED WITH THIS APPLICATION. Property Dimensions: I (XalL Mailing Address City/State/Zip PIN: # �p 3. Application For: ElSite Evaluation XtyImprovement Permit & ATC ❑ Both 4. System to Serve: ❑ House W"'Mobile Home ❑ Business ❑ Industry ❑ Other 5. If Residence: # People 13_ # Bedrooms �_ # Bathrooms If in Subdivision provide information, as follows: ❑ Dishwasher ❑ Garbage Disposal t1lWashing Machine ❑ Basement/Plumbing ❑ Basement/No Plumbing 6. If Business/Other: Specify type 1i LA # People # Sinks # Commodes # Showers # Urinals # Water Coolers If Foodservice: # Seats Water Usage (gallons per day) � 7 --Estimated 7. Type of water supply: CoC�]' unty/City ❑ Well ❑ Community 2 8. Do you anticipate additions or expansions of the facility this system is intended to serve? ❑ Yes No If yes, what type? PROPERTY INFORMATION REQUIRED: *** IMPORTANT *** A PLAT OF THE PROPERTY MUST BE SUBMITTED WITH THIS APPLICATION. Property Dimensions: I (XalL Y 3()r) • 5 D 1 WRITE DIRECTIONS (from PIN: # �p - o ; Mocksville) TO PROPERTY. Tax Office _c5rl,') - s�3� 1 _rUR/J Lc -r -r on/ Property Address: Road Name ti ti _ 1 1JUAJ(f1_i or1_J R-6, City/Zip moc sus 1 , N C- If in Subdivision provide information, as follows: 1 Name: aP2flrv7' NC�CT M 7-S Lot #: OI 1 Section: � 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 CountyHealthDepartment to enter upon above described property located in Davie County and owned by Lrr �t.,L,ri )ft l to conduct all testing procedures as necessary to determine the site suitability. DATE COsrl SIGNATURE Revised DCHD (06-96) r DAVIE COUNTY HEALTH DEPARTMENT Environmental Health Section Soil/Site Evaluation NAME DATE EVALUATED1�� ADDRESS PROPERTY SIZE t)4C PROPOSED FACIILTY LOCATION OF SITE D NndY1 d10A /101 Water Supply: On -Site Well _ Community Public Evaluation By: Auger Boring Pit , / Cut FACTORS 1 2 3 4 Landscape position Sloe % HORIZON I DEPTH Texture group Consistence Structure Mineralogy HORIZON II DEPTH Texture group Consistence Structure / ✓ Mineralogy•/ i.• 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 (01-901 k� EVALUATED BY: '/� /Z OTHER(S) PRESENT: 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 CONSISTENCE Moist VFR- Vc-y friable FR -Friable FI -Finn 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 Mineralo¢y 1:1, 2:1. 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