2993 US Highway 601 South Lots 38-39Davie County, NC, i Tax Parcel Report Thursday, November 3. 2016
WAKNMG: '1'li1S 1S NUT A SURVEY
Parcel Information
Parcel Number:
M50000003305
Township:
Jerusalem
NCPIN Number:
5745877122
Municipality:
Account Number:
38427830
Census Tract:
37059-807
Listed Owner 1:
HUNT RONALD DOUGLAS
Voting Precinct:
JERUSALEM
Mailing Address 1:
2993 US HIGHWAY 601 SOUTH
Planning Jurisdiction:
Davie County
City: MOCKSVILLE
Zoning Class: DAVIE COUNTY R-20
State:
NC
Zoning Overlay: DAVIE COUNTY CZOD
Zip Code:
27028-0000
Voluntary Ag. District:
No
Legal Description:
LOTS 38-39 HWY 601
Fire Response District:
JERUSALEM
Assessed Acreage:
0.68
Elementary School Zone:
COOLEEMEE
Deed Date:
/
Middle School Zone:
SOUTH DAVIE
Deed Book / Page:
Soil Types:
WeB,CeB2
Plat Book:
0004
Flood Zone:
Plat Page:
048
Watershed Overlay:
DAVIE COUNTY
Building Value:
75040.00
Outbuilding & Extra
Freatures Value:
9900.00
Land Value:
15000.00
Total Market Value:
99940.00
Total Assessed Value:
99940.00
161
Davie County,
NCor
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DAVIE COUNTY HEALTH DEPARTMENT
✓ IMPROVEMENTS -PERMIT AND CERTIFICATE OF COMPLETION
V %� b
* NOTE: Issued in Compliance With Article I I of G.S. Chapter 130a y
anitary Sewage Systems sts Permit Number
Name 1r> 7f t >D /f..>: , %ter 1 Date ,,�'Q'" '�c�'/ N2 7 7 4 6' �-
Location�
Subdivision Name
Lot No. Sec. or Block No.
Lot SizeHouse Mobile Home
No. Bedrooms J' —.No. Baths R— No. in Family.
Garbage Disposal YES p NO 0 --
Auto Dish Washer YES NO ❑
Auto Wash Ma -hive YES g NO ❑
Type Water Supply
Business _— Industry
Public Assembly Other_
Specifications for System:
*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.
r -
r
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.,
1:00-1:30 P.M. or 4:30-5:00 P.M. on day of completion. Telephone Number: 704-634-5985.
Final Installation Diagram:
System Installed by
Certificate of Completion ► Date low 1
'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.
00
l A"
APPLICATION FOR SITE EVALUATION/IMPROVEMENTS PERMIT
►�;,� Davie County Health Department
Environmental Health Section
S i P. O. Box 665
Mocksville, NC 27028
1. Application/Permit Requested By
Mailing Address ��L • �� f Home Phone``���?�
Business Phone
2. Name on Permit if Different than Above
3. Application for: 111'C eneral Evaluation peptic Tank Installation Permit
4. System to Serve: ❑ House ❑ Mobile Home ❑ Place of Public Assembly
❑ Business ❑ Industry//�� ❑ Other ❑ Unknown
s�r�irl
5. If house, mobile home: Subdivision ra,4 yy�� ' ` Section Lot #
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
7. Type of water supply: 2-1 ublic ❑ Private
8. Property Dimensions / AC Sewage Disposal Contractor
9. Do you anticipate additions/expansion of the facility this sytem is intended to serve? ❑ Yes Q-ITo
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:
uin
This is to certify that the information provided is correct to the best of my knowledge, and 1 underste
incurred from this appli�catign.�
DATE 'Ul�l SIGNATURE
I am responsible for all charges
CONSENT FOR SITE EVALUATION 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 (193)
❑ 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 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: 2-1 ublic ❑ Private
8. Property Dimensions / AC Sewage Disposal Contractor
9. Do you anticipate additions/expansion of the facility this sytem is intended to serve? ❑ Yes Q-ITo
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:
uin
This is to certify that the information provided is correct to the best of my knowledge, and 1 underste
incurred from this appli�catign.�
DATE 'Ul�l SIGNATURE
I am responsible for all charges
CONSENT FOR SITE EVALUATION 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 (193)
ti APPLICATION FOR SITE EVALUATION/IMPROVEMENTS PERMIT
Davie County Health Department
Environmental Health Section [9=
P. O. Box 665Mocksville, NC 27028
1. Application/Permit Requested By %,AKQ C-0 r r* I
Mailing Address�"� `� X 3 3:7 !Dcaue Home Phone -2 eFV --? y %,F
Business Phone % -2,F4- -2v gF b
2. Name on Permit if Different than Above
3. Application for: JU eneral Evaluation ❑ Septic Tank Installation Permit
4. System to Serve: ❑ House
9/Mobile Home ❑ Place of Public Assembly
❑ Business ❑ Indust A[I Other n nown
5. If house, mobile home: Subdivision l>%l Gyd d,ofly
J Section Lot #
No. of People
No. of Bedrooms
No. of Bathrooms {{��
Dwelling Dimensions N� ��-�-� A -Q-
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
7. Type of water supply: IPublic ❑ Private
8. Property Dimensions I a-cj • Sewage Disposal Contractor
❑ Basement/Plumbing
❑ Basement/No Plumbing
❑ Washing Machine
❑ Dishwasher
❑ Garbage Disposal
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 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:
Lo 0
This is to certify that the information provided is correct to the best of my
incurred fro this application.
C
DA E
and I ndersta I am responsible for all charges
SIGNATURE
CONSENT FOR SITE EVALUATION TO BE DONE ON ABOVE DESCRIBED PROPERTY
MUST CHECK ONE: K(1. I OWN the property. ❑ 2. 1 DO NOT OWN the property.
If you checked Box #2, the rest of this form MU T 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 disposals tem.
DATE SIGNATURE
DCHD (1193)
ti
NAME < (%�1Ly </
ADDRESS
PROPOSED FACIILTY
DAVIE COUNTY HEALTH DEPARTMENT
Environmental Health Section
Soil/Site Evaluation
DATE EVALUATED
PROPERTY SIZE
LOCATION OF SITE
Water Supply: On -Site Well Community Public-)-,-
Evaluation
ublic/Evaluation By: Auger Boring L1__' Pit Cut
FACTORS 1 2 3 4
Landscape position
Sloe Z
HORIZON I DEPTH
Texture group
Consistence
Structure
Mineralogy
HORIZON II DEPTH
Texture group
Consistence i
Structure /C S
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 Al
Y I 1Z S'
SITE CLASSIFICATION: ` p A EVALUATED BY: Ala, f
LONG-TERM ACCEPTANCE RATE: _z��l ,� 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 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
Dame County Aealtft Department
and .dome NealtF A-elu y
210 HOSPITAL STREET/ P.O, Box 665
MOCKSVILLE, N.C. 27028
PHONE: (704) 634.5985
May 31, 1994
David Correll
Rt. 4
Mocksville, NC 27028
Re: Site Evaluation
Boxwood Acres/Lot 38-39
Dear Mr. Correll:
As requested, a representative from this office visited the aforementioned
site on May 27, 1994. Based upon the information provided on the
application for a site evaluation and after the evaluation was completed, the
site was found to be provisionally suitable in the back only for the
installation of an on—site sewage disposal system.
If you have any questions, please feel free tc contact this office.
Sincerely,
��X_ .;vaA
Robert B. Hal 1, Jr. , R. S.
Environmental Health Section
RH/wd
Enclosure
APPLICATION FOR SITE EVALUATION/IMPROVEMENTS PERMIT
• Davie County Health Department
Environmental Health Section
P. O. Box 665
Mocksville, NC 27028
1. Application/Permit Requested By /✓/t/1C
Mailing Address %�� en2lvi1- ZG-�
t4 10 Home Phone
G/CSy/LCC /t/C Z7 2 Business Phone
2. Name on Permit if Different than Above ;P0,1V K/, ,41,0 �' f�ti ir�✓�
3. Application for: ❑ General Evaluation Septic Tank Installation Permit
4. System to Serve: [.VHouse ❑ Mobile Home ❑ Place of Public Assembly
❑ Business ❑ Industry ❑ Other ❑ Unknown
5. If house, mobile home: Subdivision Bmwoeo QC2CS Section_ Lot # 3f 439
No. of People
No. of Bedrooms
No. of Bathrooms
Dwelling Dimensions
iQl LK
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
7. Type of water supply: X Public ❑ Private
8. Property Dimensions /O0 rX 300 Sewage Disposal Contractor
❑ Basement/Plumbing
❑ Basement/No Plumbing
Washing Machine
Dishwasher
❑ Garbage Disposal
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 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:
601
sou /17
T2d�" /�70Gi�SviC L L=
G
p
5' vJ
J
�i�AA 47L
erlC;#i5
�
G l r}FTCf!
/0 21-5 ori lL"cT
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.
DATE SIGNATUR
CONSENT FOR SITE EVALUATION TO BE DONE ON ABOVE DESCRIBED PROPERTY
MUST CHECK ONE: ❑ 1. 1 OWN the property. ❑ 2. 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 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 (1/93)