120 Linda Lane Lot 3Davie County. NC
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Tax Parcel Report
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Wednesday. November 9. 2016
9h All data is provided as is wtlhoutwerranty or guarantee of any kind ehher expressed or Implied Including but not limited tome
ADavie Couuty, Implied wamantho of menchantablllrywAhessfor a parNcularuse. All users of Davie County's GISwebsite shall hold harmleasthe
County of Davis, North Carolina, Its agents, consuhnrts, contractors or employe" mm any and allclaims or causes of action due to
1�T
r'pb S >,C oradsing out orthe use or inability to usethe GIS data provided by this wobslts.
WARNING: THIS IS NOT A SURVEY
-
__ - Parcel Information_.
Parcel Number:
1616OA0003
Township:
Mocksville
NCPIN Number:
5758037648
Municipality:
Account Number:
82529053
Census Tract:
37059-805
Listed Owner 1:
FREHEIT THEODORE
Voting Precinct: NORTH
MOCKSVILLE COUNTY
Mailing Address 1:
120 LINDA LANE
Planning Jurisdiction:
Davie County
City: MOCKSVILLE
Zoning Class: DAVIE COUNTY R -A
State:
NC
Zoning Overlay:
Zip Code:
27028-0000
Voluntary Ag. District:
No
Legal Description:
LOT 3 CAROLINA HOME PLACESECTION ONE
Fire Response District:
MOCKSVILLE
Assessed Acreage:
0.50
Elementary School Zone:
CORNATZER
Deed Date:
1/1993
Middle School Zone:
WILLIAM ELLIS
Deed Book I Page:
1993EO200
Soil Types: GnB2,GnC2,GaD
Plat Book:
0005
Flood Zone:
Plat Page:
196
Watershed Overlay:
DAVIE COUNTY
Building Value:
159830.00
Outbuildi Va &extra
FaturesLand
4060.00
Value:
17000.00
Total Market Value:
180890.00
Total Assessed Value: 180890.00
9h All data is provided as is wtlhoutwerranty or guarantee of any kind ehher expressed or Implied Including but not limited tome
ADavie Couuty, Implied wamantho of menchantablllrywAhessfor a parNcularuse. All users of Davie County's GISwebsite shall hold harmleasthe
County of Davis, North Carolina, Its agents, consuhnrts, contractors or employe" mm any and allclaims or causes of action due to
1�T
r'pb S >,C oradsing out orthe use or inability to usethe GIS data provided by this wobslts.
:. DAVIE COUNTY ENVIRONMENTAL HEALTH
P.O. Box 848/210 Hospital Street
Mocksville, NC 27028
(336)751-8760 Fax # (336)751-8786
OPERATIONPERNIIT
Account #: 989900156
Billed To: Louise Mise
Reference Name:
Proposed Facility: Residence
ATC Number: 4574
Tax PIN/EH #:
Subdivision Info:
Location/Address:
Property Size:
5758-03-7648
Carolina Home Place Lot # 3
132 Linda Lane -27028
**NOTE** The issuance of this Operation Permit shall indicate the system described on the ATC 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.
System Type: S.T. Manufacturer5� Tank Date Tank Size6 cj o
Pump Tank Size
System Installed By: f , , ti[cTf c, tn -,ALL E.H. Specialist: g k ,ate: 3 — 0-7
DCHD 11106 (Revised)
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DCHD 11106 (Revised)
DAVIE COUNTY ENVIRONMENTAL HEALTH ??
P.O. Box 848/210 Hospital Street U 1700 7
Mocksville, NC 27028
(336)751-8760 Fax # (336)751-8786
AUTHORIZATION FOR WASTEWATER SYSTEM CONSTRUCTION
Account #: 989900156
Tax PIN/EH #:
5758-03-7648
Billed To: Louise Mise
Subdivision Info:
Carolina Home Place Lot # 3
Reference Name:
Location/Address:
yZf Linda Lane -27028
.Proposed Facility: Residence
Property Size:
ATC Number: 4574
**NOTE** This Authorization to Construct (ATC) MUST BE ISSUED by the Davie County Environmental
Health Section prior to issuance of any building permit(s), (in compliance with Article 11 of G.S. Chapter 130A
Wastewater Systems, Section .1900 Sewage Treatment and Disposal Systems). THIS AUTHORIZATION TO
CONSTRUCT IS VALID FOR A PERIOD FIVE YEARS. This ATC is subject to revocation if site plans, plat or
the intended use change.
Residential Specification: Building Type J #People _#Bedrooms 3 #Baths Z
Basement w/Plumbing: _ Basement/No Plumbing _
Commercial Specification: Facility Type #People #People/Shift _ #Seats
Lot Size Type Water Supply Design Wastewater Flow (GPD) _ Site: New Repair_
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System Specifications: Tank SizeGAL. Pump Tank_ GAL. Trench Width -IC' Trench Depth -5c,
Rock Depth I l" Linear Ft. W O
Other:
Required Site Modifications/Conditions:
Contact the Davie County Environmental Health Section for final inspection of this system between
8:30 — 9:30am. on the day of installation. Telephone # (336)751-8760.
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APPLICATION FOR SITE EVALUATION/IMPROVED
Davie County Environmental Health
P.O. Box 848/210 Hospital Street
Mocksville, NC 27028
(336)751-8760/ Fax (336)751-8786
ERMIT & ATC
JAi4 17 2uu/
WVIROPI�IL't:iAl. tl6',iTH
Application For: 0 Site Evaluation/Improvement Permit [Authorization To Consh'uct(ATC) 0 Both
Type of Application: ❑New System ❑Repair to Existing System ❑Expansion/Modification of Existing System or Facility .
***IMPORTANT'** THIS APPLICATION CANNOT BE PROCESSED UNLESS ALL OF THE REQUIRED
INFORMATION IS PROVIDED. Refer to the INFORMATION BULLETIN for instructions.
APPLICANT INFORMATION
Name to be Billed L D u is - S A; s e Contact Person ,'e -
Billing Address I ytlz J -,-"A4 L y> , Home Phone ' O or - 646-11f-
City/State/ZIP c,,, go, 1.4 4 i o- a i O ft Business Phone 43 (a 6=9 - y 74 d &1,1 Wogmob.I f
Name on Permit/ATC if Different than
Mailing Address
PKOPEK7'Y INFORMATION *Date House/Facility Corners Flagged 1
NOTE: A survey plat or site plan must accompany this application.
Included: 0 Site Plan OPlat(to scale)
(Permit is valid for 60 months with site plan, no expiration with complete plat.)
Owner's Name L o u .c e_ -S ^ ; s
Phone Number S30 - M 0.7 - O 6.0
Owner's Address I N R A-. ,J 4 1- A wo
City/State/Zip Ao G Ks
PropertyAddress/3D jjwdi9 A.Wiae-
City lbneAtatl. /mac, ado,$
Lot Size Tax PIN# 5169-0-7(48'
Subdivision Name(ifapplicable)_egrnLS/j,i4 }Fevr��f0)yyection/Lot#
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Directions To Site: US 1+wv le r4 "1`f] 8g:-±AeL- cJ
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If the answer to any of the following questions is "yes", supporting documentation must be attached.
Are there any existing wastewater systems on the site?
❑Yes 5Ko
Does the site contain jurisdictional wetlands?
❑Yes QND
Are there any easements or right-of-ways on the site?
❑Yes ONo
Is the site subject to approval by another public agency?
❑Yes E&
Will wastewater other than domestic sewage be generated?
❑Yes fdt<o
IF RESIDENCE FILL OUT THE BOX BELOW
# People # Bedrooms 3 # Bathrooms Garden Tub/Whirlpool aT-es ONo
Basement.OYes o Basement Plumbing: ❑Yes 2No
IP NUN -RESIDENCE FILL (JUTTHE BOX BELOW
Type of Facility/Business Total Square Footage of Building # People
# Sinks # Commodes # Showers # Urinals
Estimated Water Usage (gallons per day) (Attach documentation of similar facility water consumption)
FOODSERVICE ONLY: # Seats
Type system requested:�❑Conventional ❑Accepted ❑Innovative ❑Alternative ❑Other
Water Supply Type: fii- unty/City Water 0 New Well ❑Existing Well 0 Community Well
Do you anticipate additions or expansions of the facility this system is intended to serve? 0 Yes 0-110 _
If yes, what type?
This is to certify that the information provided on this application is true and correct to the best of my knowledge. I understand that
any permit(s) or ATC(s) issued hereafter are subject to suspension or revocation if the site is altered, the intended use changes, or if
the information submitted in this application is falsified or changed. I hereby grant right of entry to the Authorized Representative
of the Davie County Health Department to conduct necessary inspections to determine compliance with applicable laws and rules.
I understand that I am responsible for the proper identification and labeling of property lines and comers and locating and flagging
or takin a house/facilition, proposed�well location and the location of any other amenities.
• Site Revisit Charge
Prod rty owner's or or er's legal reprIe entanve signature
Date(s):
Client Notification Date:
Date EHS:
Sign given ❑Yes ONo Account # gJ001 t�&
Revised 11/06 Invoice #
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LEGEND SITE
a Iron pipe found S.S. San'rary Sewer
Iron Pepe fat P.S.SA- M.E P*W* SaaSaw. Lina Aces & uh D LN.
RNV RigM of Way Manaa
t Ean nt BETEL CH.
PVMT. Pavement S.R. State Road
0 Power Pole ,g Computed Point ( Not Set)
DRNG. Drainage ❑ Monument U. 64N
MAINT. Maintenance MBL Minimum l Max Building Une
PLAT NORTHUTIL: Ugley .-n----nom Ovedtead Power Line
P.B.5, PO -195 ESMT. Easement Fence Line Location Map: Not To Scall
LOT 4
v, PLAT BOOK 5, PAGE 196
Lot 3
0.51 acres �' •.
22000.00 sq ft
� Lot 2
i 0.62 acres _ ^ —= - ;0r
26868.09 sq It
'• $80'S4'� W _ .
zs1,5g ---'tel' CHARLES MISE
DEED BOOK 91, PAGE 584
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on MOOPIDAnoN F'Ne name: l3 I e lane r w.
Plot Plan For.
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132 Linda Lane
DATE:01.17-2007 IICAUMJla aewew��tlYotaap �..„
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Lot 3, Section 1
Carolina Home Place
four points surveyors pIIC
Plat Book 5, Page 196
x professiaal IMW aneyors t
94w
Mocksville Township
407•F Partway Drve
Davie County, NC
P.O. Boz 13480, Greensboro N.C. 27415
' r 1t Phone 9 336.273-5758 Fax i 336.273-5759
Address
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FACTORS
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DAVIE COUNTY HEALTH DEPARTMENT
Environmental Health Section
P. O. Box 665
Mocksville, N.C. 27028
SOIL/SITE EVALUATION
Date
Lot Size /%lJ 1'o2lllh
ARFA 1 ARFA 9 ARFA A eoce n
1) Topography/ Landscape Position
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2) Soil Texture (12-36 in.) Sandy,
Loamy, Clayey, (note 2:1 Clay)[PS))
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3) Soil Structure (12-36 in.)�_
Clayey Soils
1) Soil Depth (inches)
i) Soil Drainage: InternalS
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External
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Restrictive Horizons
Available Space
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Other (Specify)
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Site Classification
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P4
U—UNSUITABLE
Recommendations/ Comments: 'Z
S—SUITABLE
Described by 2��z'/ Title
SITE DIAGRAM
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OCND V, 121
PS—Provisionally Suitable
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