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115 Citadel Road Lot 1Davie Countv, NC , T Tax Parcel Report Tuesdav, November 15, 2016 WARNING: TMS IS VUT A SURVEY Parcel Information Parcel Number: F3010A0001 Township: Clarksville NCPIN Number: 5811729049 Municipality: Account Number: 82531096 Census Tract: 37059-801 Listed Owner 1: LUCE BARBARA J Voting Precinct: CLARKSVILLE Mailing Address 1: 115 CITADEL ROAD Planning Jurisdiction: Davie County City: MOCKSVILLE Zoning Class: DAME COUNTY R -A State: NC Zoning Overlay: Zip Code: 27028-0000 Voluntary Ag. District: No Legal Description: LOT 1 CHARLESTOWNE GRANT Fire Response District: WILLIAM R. DAVIE Assessed Acreage: 1.39 Elementary School Zone: WILLIAM R DAVIE Deed Date: 10/2011 Middle School Zone: NORTH DAVIE Deed Book I Page: 008720288 Soil Types: MnB2 Plat Book: 0007 Flood Zone: Plat Page: 102 Watershed Overlay: DAVIE COUNTY Building Value: 171130.00 Outbuilding & Extra Freatures Value: 1600.00 Land Value: 28000.00 Total Market Value: 200730.00 Total Assessed Value: 200730.00 Eal 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, Implied warranties of merchantability or (ttness 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 NC or arising out of the use or Inability to use the GIS data provided by this website. DAVIE COUNTY HEALTH DEPARTMENT �� o✓� Environmental Health Section P. O. Boz 848/210 Hospital Street Mocksville, NC 27028 (336)751-8760 IMPROVEMENT/OPERATION PERMIT Account #: 989900247 Tax PIN/EH #: 5811-72-7635.01sc Billed To: Seats Construction Company Subdivision Info: Charleston Grant Lot # 1 Reference Name: Location/Address: Wagner Road -27028 Proposed Facility: Residence Property Size: 2 acres ATC Number: 2975 **NOTE** This Improvement/Operation Permit DOES NOT authorize the construction 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). THIS PERMIT IS SUBJECT TO REVOCATION IF STTE PLANS OR THE INTENDED USE CHANGE. YOUR WASTEWATER SYSTEM CONTRACTOR MUST SEE THIS PERMIT BEFORE INSTALLING SYSTEM. Residential Specification: Building Type #People --7— #Bedrooms 3 #Baths -,2— Dishwasher: 2 Garbage Disposal: 21"" Washing Machine: Mel" Basement w/Plumbing: ❑ Basement/No Plumbing: fid' Commercial Specification: Facility Type #People #People/Shift #Seats Industrial Waste: ❑ Lot Size 1 • !&-Z5'ype Water Supply Design Wastewater Flow (GPD) �Ak Site: New 2XRepair ❑ System Specifications: Tank Size /CCQAL. Pump Tank GAL. Trench Width vcD Rock Depth -� Linear Ft.350 ! Other:I�I) j Loa)C . NY--4fAl1✓ Required Site Modifications/Conditions: ',)(-) u-- Ot'.1 C-m.,moz, kZ019 W off- 00t)SZ, IMPROVEMENT/OPERATION PERMIT LAYOUT - APPROVED EFFLUENT FILTER RISER(S) IF 6 " BELOW FINISHED GRADE. ****NOTICE: Contact a representative of the Davie County Health Department for final inspection of this system between 8:30 a.m. to 9:30 a.m. or 1:00 p.m. to 1:30 p.m. on the day of installation. Telephone # is (336)751-8760.**** C r � � v qlqe Environmental H alth Specialist's Signa c ate: U DCHD 05/99 (Re ised) DAVIE COUNTY HEALTH DEPARTMENT Environmental Health Section P. O. Boz 848/210 Hospital street Mocksville, NC 27028 (336)751-8760 Account #: 989900247 Billed To: Seats Construction Company Reference Name: Tax PIN/EH #: 5811-72-7635.01sc Subdivision Info: Charleston Grant Lot # 1 Location/Address: Wagner Road -27028 Proposed Facility: Residence Property Size: 2 acres ATC Number: 2975 AUTHORIZATION FOR WASTEWATER SYSTEM CONSTRUCTION **NOTE** This Authorization for Wastewater System Construction MUST BE ISSUED by the Davie County Environmental Health Section prior to issuance of any building permit(s). This Form/Authorization Number should be presented to the Davie County Building Inspections Office when applying for building permit(s) (in compliance with Article I 1 of G.S. Chapter 130A, Wastewater Systems, Section .1900 Sewage Treatment and Disposal Systems). THIS AUTHORIZATION FOR WASTE CO NIS ALID FOR A PERIOD O FIVE YEARS. Environmental Health Specialist's Signa re: Date: CERTIFICATE OF COMPLETION **NOTE** The issuance of this Certificate of Completion shall indicate the system described on Improvement/Operation Permit 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. Ily Al -L L- s.1k DAW q I ;2 Septic System Installed By: bL)"� Environmental Health Specialist's Signature: Date: j D 2 DCHD 05/99 (Revised) 4 (50, CD f I AREA= 1. 189 ACRES CD co (INCLUDES S.R. 1310 R/W) X14 _ �d T Avy 10'x 10' UTIuTT EASEMENT 1 R;'R SPIk E O Q¢� P 'k 7L (d - , C%� ✓ • qZ L ! Q� AREA ACRES (INCLUDES S.R. 310 R/W) / Q�d o% v� 5.00 210#29 c A' nn• V � / • 0 PLICATION FOR SITE EVALUATION/IMPROVEMENT PERMIT & ATC Davie County Health Department C� `L 201 EnvilonmentaiHealth Section P.O. Box 848/210 Hospital Street ENZP����jN Mocksville, NC 27028 cNVIROJ;M c01}� (336) 751-8760 ***IMPORTANT*** THIS APPLICATION CANNOT BE PROCESSED UNLESS•ALL THE REQUIRED INFORMATION IS PROVIDED. Refer to the INFORMATION BULLETIN for instructions. 1. Name to be Billed Contact Person Mailing Address /xs-&/- d�j— Home Phone T 54; / City/State/ZIP �%�, ` Business Phone 3Z7.5- 3 2 p'LO 2. Name on Permit/ATC if Different than Above Mailing Address 3. Application For: ❑ Site Evaluation City/State/Zip improvement Permit/ATC ❑ Both 4. System to Service: ]K House ❑ Mobile Home ❑ Business ❑ Industry H Other 5. If Residence: # People # Bedrooms F # Bathrooms 0 Dishwasher W Garbage Disposal Nf Washing Machine U Basement/Plumbing V Basement/No Plumbing 6. If Business/Industry/Other: Specify type # Commodes # Showers # Urinals # People # Sinks # Water Coolers IF FOODSERVICE: # Seats Estimated Water Usage (gallons per day) 7. Type of water supply: ❑ County/City ❑ Well LI Community 8. Do you anticipate additions or expansions of the facility this system is intended to serve? ❑ Yes ❑ No If yes, what type? ***IMPORTANT*** CLIENTS MUST COMPLETETHE REQUIRED PROPERTY INFORMATION REQUESTED BELOW. Either a PLAT or SITE PLAN MUST BESUBMITTED by the client with THIS APPLICATION. Property Dimensions: Q e_0- -0-s WRITE DIRECTIONS (from Mocksville) to PROPER'1' '. Tax Office PIN: # ?c� _ �� 5 ° ! /„ O / x)—� �.G/� U—A Property Address: Road Name .L.)"., b rL 'I— • C ri City/Zip 2% p20 ,(✓e,� �- e r` c,., If in a Subdivision provide information, as follows: � �-, 7 L n� 62— ' Name: Section: Block: Lot: Date Property Flagged: 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. 1, 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 the site suitability. DATE S��—�% SIGNATURE THIS AREA MAY BE USED FOR DRAWING YOUR SITE PLAN (Include all of the following: Existing and proposed property lines and dimensions, structures, setbacks, and septic locations). U Revised DCHD (07/99) r- (,s-01%10 I Site Revisit Charge Date(s): Client Notification Date: EHS: o Account No. Invoice No. C" rD APPUtATION FOR SITE EVALUATION/IMPROVEMENT PERMIT & ATG Davie County Health Department B Environmental Health Section P.O. Box 848/210 Hospital Street Mocksville NC 27028 (336) 751-8760 ***D1P0RTANT*** THIS APPLICATION CANNOT BE PROCESSED UNLESS ALL THE REQUIRED INFORMATION IS PROVIDED. Refer to the INFORMATION BULLETIN for instructions. 1. Name to be Billed Y,¢�c/ CoC�EGG_ Contact Person 1//J�lJ Mailing Address X13 Z / Te.E T GE �t� �y Home Phone ` ,7 Z � c C� / City/State/ZIP /�OGI�Sd/LLLr� A/C- 2-70 Zia Business Phone 2. Name on Permit/ATC if Different than Above Mailing Address City/State/Zip 3. Application For: X Site Evaluation ❑ Improvement Permit/ATC ❑ Both 4. System to Service: XN House ❑ Mobile Home ❑ Business ❑ Industry ❑ Other 5. If Residence: # People # Bedrooms # Bathrooms N Dishwasher 11 Garbage Disposal IJ Washing Machine IJ Basement/Plumbing L) Basement/No Plumbing 6. If Business/Industry/Other: Specify type # Commodes # Showers # People # Sinks # Urinals # Water Coolers IF FOODSERVICE: # Seats Estimated Water Usage (gallons per day) 7. Type of Water supply: County/City ❑ Well IJ Community e. Do you anticipate additions or expansions of the facility this system is intended to serve? ❑ Yes 'KNo If yes, what type? ***IMPORTANT*** CLIENTS AIUST CO.41PLETE THE ,REQUIRED PROPERTY INFORMATION REQUESTED BELOW. Either a PLAT or SITE PLAN AIUST BE SUBMITTED by the client with THIS APPLICATION. Property Dimensions: Z ..^A e- _. dr// _ _ ! 2� R dd// VRITE DIRECTIONS (from Mocksville) to PROPERTY: Tax Office PIN: # d (O �+ �•J Property Address: Road Name to AGAIC 20,V> City/Zip OCICS✓1LC.-E Z%Ze �? GT o �l L/ 14E,eTN f'o 1=fM /cQ Tu,t?,J LEFT o� G✓/JG�Ie.� iCA_ If in a Subdivision provide information, as follows: Name:�F4i21�"sSTom) �QA,JT Section: Block: Lot: 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. 1, hereby, give consent to the Authorized Representative of the RJ� '� �Countl Health Department to enter upon above described property located in Davie County and owned by hb�.�vp�CD L• �R�f� . T�2 to conduct all testing procedures as necessary to determine the site suitability. DATE- / " 47K SIGNATURE DAVIE COUNTY HEALTH DEPARTMENT Environmental Health Section SECTION LOT Soil/Site Evaluation APPLICANT'S NAME ^DAn) �22�u. DATE EVALUATED / II PROPOSED FACILITY _ }�s� PROPERTY SIZE 700 1 2%'Y SUBDIVISION O Oti'J �`�'I% ROAD NAME 94A6VJCL9— Qin Water Supply: On -Site Well Community Evaluation By: Auger Boring Pit Public ✓ Cut FACTORS 1 2 3 4 5 6 7 Landscape position ` L Slope % o HORIZON I DEPTH D Texture groupL L Consistence Sig _ fSS Structure CAL as 0Z Mineralogy HORIZON II DEPTH .- Texture groupC Consistence _ Structure AR 14 Mineralogy 1, •`t 1 HORIZON III DEPTH 10 1k k Texture groupi Consistence Fr S Structure AAk Mineralogy1 I ; HORIZON IV DEPTH Texture group Consistence Structure Mineralogy SOIL WETNESS RESTRICTIVE HORIZON SAPROLITE CLASSIFICATION LONG-TERM ACCEPTANCE RATE Q• �. SITE CLASSIFICATION: LONG-TERM ACCEPTANCE RATE: ©• REMARKS: DCHD (OI -90) EVALUATION BY: 3i -,-A J AM:e 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 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 ■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■ ■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■ ■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■ ■■■■■■■■■■■■■■■ ■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■ ■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■ ■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■ ■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■ ■■■■■■■■■■■■■■■ ■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■ ■■■■■■■■■■■■■■■■■■■■r/1�;IBJ■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■ ■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■ ■■■■■tee■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■I■■■e■■■■■■e■ '"'��'����� l�iR!■■■HH�7f■■■H■■■■■■ ■■■■■■ ■■■■1e■ ■tee■■SEMMES ■■■■■■■■■■■■■■■■■■e■■■■■■tet■■t■e■■t■■■t■■■■■■i■■t■■■■■■■■■ ■■rig■�■�i■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■teal■■■■■■■■■■■■ ■■:siva■i■■■s■■■■■■■■■■■■■■■■■■a■■■■■■e■■■■■■■■■■■■■■■i■■■■■■■■■■■■ ■■■■■■■■■■■ll■����������������iiiiiiiiiiiiiiiiiiiiiiii�'iii::::s::::