242 Hidden Valley Lane Lot 10Davie County, NC t Tax Parcel Report Tuesday, January 31, 2017
WAKNIING: TH1,151VU'1' A SURVEY
Parcel Information
Parcel Number:
G3140A0010
Township:
Mocksville
NCPIN Number:
5729183736
Municipality:
Account Number:
82515595
Census Tract:
37059-806
Listed Owner 1:
PRIESTLEY JAMES M
Voting Precinct: NORTH
MOCKSVILLE COUNTY
Mailing Address 1:
242 HIDDEN VALLEY 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:
TRACT 10 HIDDEN VALLEY SECTION TWO
Fire Response District:
WILLIAM R. DAVIE
Assessed Acreage:
4.67
Elementary School Zone:
WILLIAM R DAVIE
Deed Date:
9/2000
Middle School Zone:
NORTH DAVIE
Deed Book / Page:
003440882
Soil Types: WeC,PcC2,ChA,CeB2
Plat Book:
0006
Flood Zone:
Plat Page:
118
Watershed Overlay:
DAVIE COUNTY
Outbuilding & Extra
Building Value: Freatures Value:
Land Value: Total Market Value:
Total Assessed Value:
F-01-
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 or fitness for a particular use. All users of Davie County's GIS website shag 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
NCor arising out of the use or Inability to use the GIS data provided by this website.
DAVIE COUNTY HEALTH DEPARTMENT 46"
Environmental Health Section
P. O. Boz 848/210 Hospital Street
Mocksville, NC 27028
(336)751-8760
IMPROVEMENT/OPERATION PERMIT
Account #:
990001266
Tax PIN/EH #:
5728-18-3736.10
Billed To:
James Priestley
Subdivision Info:
Hidden Valley Lot # Tract 10
Reference Name:
James Priestley
Location/Address:
Hidden Valley Lane -27028
Proposed Facility:
Residence
Property Size:
5.133 Acres
ATC Nu�pb?r: 2479
**NOTE** This mprovement/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 SITE PLANS OR THE INTENDED USE CHANGE. YOUR
WASTEWATER SYSTEM CONTRACTOR MUST SEE THIS PERMIT BEFORE INSTALLING SYSTEM.
Residential Specification: Building Type 1 �• (1� #1People J� #Bedrooms #Baths �-
Dishwasher: 6711" Garbage Disposal: ❑ Washing Machine: ® Basement w/Plumbing: ❑ Basement/No Plumbing: ❑
Commercial Specification: Facility Type #People #People/Shift #Seats Industrial Waste: ❑
Lot Size 5 + ACVJEn�,Type Water Supply� `�' Design Wastewater Flow (GPD) Site: New 0'/ Repair C3
System Specifications: Tank Size VDO GAL. Pump Tank 1 C00GAL. Trench Width Rock Depth
Other: to.,-) —16-C>V
Required Site Modifications/Conditions:
01.
" r
1 $ Linear Ft. 2y0
a�
W
IMPROVEMENT/OPERATION PERMIT LAYOUT - APPROVED EFFLUENT FILTER RISER(S) IF 6 k 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.****
M o;V2
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Environmental Health Specialist's Signature:Date: /
DCHD 05/99 (Revised)
DAVIE COUNTY HEALTH DEPARTMENT
Environmental Health Section
P. O. Boa 848/210 Hospital Street
Mocksville, NC 27028
(336)751-8760
Account #:
990001266
Tax PIN/EH #:
5728-18-3736.10
Billed To:
James Priestley
Subdivision Info:
Hidden Valley Lot # Tract 10
Reference Name:
James Priestley
Location/Address:
Hidden Valley Lane -27028
Proposed Facility:
Residence
Property Size:
5.133 Acres
ATC Number: 2479
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 11 of
G.S. Chapter 130A, Wastewater Systems, Section .1900 Sewage Treatment and Disposal Systems). THIS
AUTHORIZATION FOR WASTEWATER COT CTIO IS VALID FOR A PERIOD OF FIVE YEARS.
Environmental Health Specialist's Signatur 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.
WELL. tJc7c � ,�S�til►.�
t d
Q0 `j
CA
rvto,�
sot►�'r
QPP O.E7Y�
Septic System Installed By: r N1l9
Environmental Health Specialist's Signature Date: /
14)ID
DCHD 05/99 (Revised)
APPUCATION FOR SITE EVALUATION/IMPROVEMENT PERMIT &
Davie County Health Department
Env/ronmenta/Hea/ffiS;e i do
P.O. Box 848/210 Hospital Street
Mocksville, NC 27028
(336)7k-8-160
ID L -M R 0 V F
A
3 2000
",.� „"•. .illi
***XBPORTANT*** THIS APPLICATION CANNOT BE PROCESSED UNLESS ALL THE REQUIRED
INFORMATION IS PROVIDED. Refer t e INFORMATION BULLETIN for instructions.
1. Name to be Bill 1 \ \ Contact Person
Mailing Address �p Home Phone _ VU
City/state/ZIP y Business Phone
2. Name on Permit/ATC if Differ nt than Above
Mailing Address :Zrovement
/Zip
3. Application For: ❑ Site Evaluation Permit/ATC ❑ Both
4. system to Service: ❑ House B/Mobile Home ❑ Business ❑ Industry ❑ Other
S. Zf Residence: # People _..� # Bedrooms_ # Bathrooms_
Dishwasher ❑ Garbage Disposal L9'Washing Machine ❑ Basement/Plumbing ❑ Basement/No Plumbing
6. If Business/Industry/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 211 ell ❑ Community
e. Do you anticipate additions or expansions of the facility this system is intended to serve? ❑ Yes 91,
If yes, what type?
***IMPORTANT*** CLIENTS MUST COMPLETETHE REQUIRED PROPERTY INFORMATION REQ!JESTED
BELOW. Either a PLAT or SITE PLAN MUSTBESUBMI17ED by the client with THIS APPLICATION.
Property Dimensions: �� 13 3 flat WRITE DIRECTIONS (from Mocksville) to PROPERTY:
Tax Office PIN: # C�
Property Address: Road Name v t C Zq4 E
Ci /Zip C ki V SIe
�►� .T.
If in a Subdivision provide information, as follows:
Name: C0114t'
7�
Ila
Section: Block: \ b 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. 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 the site suitability.
DATE ���'�CIO SIGNATUR ,-A
THIS AREA MAY BE USED FOR DRAWING YOUR STTE PLAN (Include all of the following: Existing and pri6posed
property lines and dimensions, structures, setbacks, and septic locations).
Revised DCHD (07/99)
Site Revisit Charge
Date(s):
Client Notification Date:
EHS•
Account No. LC21 19;;
Invoice No. t1 06
APPLICATION FOR SITE EVALUATIONAMPROVEMENT PERMIT &
Davie County Health Department u„,
Environmental Health Section 1�1Hf 12000
P. O. Box 848
Mocksville, NC 27028 ENVIRON10VJTAL HEALTH
It"=
DAVIE COUNTY
****IMPORTANT**** THIS APPLICATION CANNOT BE PROCESSED UNLESS
ALL THE REQUIRED INFORMATION IS PROVIDED.
1. Name to be Billed ,mss: lye uexe -r-r' Contact Person '5'a M E
Mailing Address / 0 r/ g i / 4a, N P Home Phone C/ 9,9# 7 17
City/State0p OG S Vi 11 e C 'I go va Business Phone
2. Name on Permit/ATC if Different than Above Ya M 6'
Mailing Address S %M 0, City/State/Zip
3. Application For: )2( Site Evaluation ❑ Improvement Permit & ATC ❑ Both
4. System to Serve: ❑ House Mobile Home ❑ Business ❑ Industry ❑ Other.
5. If Residence: # People A # Bedrooms 3 # Bathroomsoe
19 Dishwasher ❑ Garbage Disposal Qg 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 W/Well ❑ Community
8. Do you anticipate additions or expansions of the facility this system is intended to serve? ❑ Yes CR' No
If yes, what type?
PROPERTY INFORMATION REQUIRED: *** IMPORTANT *** A Pk*ftW THE PROPERTY MUST BE
SUBMITTED WITH THIS APPLICATION.
Property Dimensions: Z3 A 1 WRITE DIRECTIONS (from
Tax Office PIN: # ��%'�. is t - 3 736 _ 1 Mocksville) TO PROPERTY:
i 60/ N_ �-.anl Cc He
Property Address: Road Name i' d d d N �& rr 1 !/ L Ct ly e 1
Citymp /Inc -s Lei %1P X 7018 1
1 '
If in Subdivision provide information, as follows: 1
Name: kid r4 e )y 11a /I&%/1 1
LoG 1 ” 1/g/ i -
Section: t #: / 0 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 j�UT e IVIV P_ f r a 611 to conduct all testing procedures
as necessary to determine the site suitability.
DATE _5 • /— 0 O SIGNATURE
v L�
Revised DCHD (06-96) �.� C•`� Mv, ycG.v� G�u�t .�•%LI/L✓ � � i� cei
YOU MAY USE THE BACK OF THIS FORM FOR DRAWING YOUR SITE PLAN.64
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DAVIE COUNTY HEALTH DEPARTMENT
Environmental Health Section
Soil/Site Evaluation
APPLICANT INFORMATION
Account #:
989900214
Billed To:
Eugene Bennett
Reference Name:
Eugene Bennett
Proposed Facility:
Residence
PROPERTY INFORMATION
Tax PIN/EH #: 5728-18-3736
Subdivision Info: Hidden Valley Sec.2 Lot # 1
Location/Address: Hidden Valley Lane- 028
Property Size: 5.133 Acres Date Evaluated:
Water Supply: On -Site Well Community Public
Evaluation By: Auger Boring Pit Cut
SITE CLASSIFICATION: C52 EVALUATION BY:
LONG-TERM ACCEPTANCE RATE: OTHER(S) PRESENT: S�
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
W.
VFR - Very friable
FR - Friable FI - Firm VFI - Very firm EFI - Extremely firm i
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
HORIZON I DEPT
Consistence
���Il�il�
/
Ill��r�•
.I
HORIZON II DEPTH
-�•11'
r
Texture group
Consistence
eAM
5��M
HORIZON III DEPTH
fll• nilI
12MiZMI
-M
Omn, SM
Z
=142-4 owl U ISE
OEMWINi_XNAR
]�
...i
nmfflw
�1i7
Consistenceri..�ff
IINK
'L��
ffy�MOM
MUM-
IV DEPTH
Texture -
ConsistenceHORIZON
SAPROLITElarectime
SITE CLASSIFICATION: C52 EVALUATION BY:
LONG-TERM ACCEPTANCE RATE: OTHER(S) PRESENT: S�
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 i
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 05/99 (Revised)
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Davie County Nealth Department
Environmental )Yealth Section
PO Box 848 / 210 Hospital Street
Mocksville, NC 27028
Phone: (336)751-8760
May 18, 2000
Mr. Eugene Bennett
107 Nail Lane
Mocksville, NC 27028
Re: 2 Site Evaluations -Hidden Valley
Lot #10-5.130 Acre Tract
Lot #11-5.130 Acre Tract
Tax PIN #: 5723-18-3736
5729-28-3456
Dear Mr. Bennett:
As requested, a representative from this office visited the above site(s) on May 17,
2000. Based on the information provided on the Application for Site Evaluation(s) and
after the evaluations were completed, the sites were found to be provisionally suitable for
the installation of on-site sewage disposal systems.
Before a representative of this office will revisit the site to issue an Improvement
Permit/Authorization to Construct the appropriate application must be completed in full
and submitted to this office. The location of the facility the system is to serve must be
staked off.
If you have any questions, feel free to contact this office at (336)751-8760.
!4Sincerely,
L; ��
Jeff G. Beauchamp, R.S.
Environmental Health Section
enc(s)