1028 Eatons Church Road Lot 2Davie County, NC Tax Parcel Report Tuesday. November 29. 2016
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Parcel Information
Parcel Number: D3120A0002 Township: Clarksville
NCPIN Number: 5822620583 Municipality:
Account Number. 71130000 Census Tract: 37059-801
Listed Owner 1: STEWART ROGER Voting Precinct: CLARKSVILLE
Mailing Address 1: 1028 EATONS CHURCH ROAD Planning Jurisdiction: Davie County
City: MOCKSVILLE Zoning Class: DAVIE COUNTY R-20
State:
NC
Zoning Overlay:
Zip Code:
27028-4741
Voluntary Ag. District:
No
Legal Description:
LOT 2 COUNTRYSHIRE WAY
Fire Response District:
WILLIAM R. DAVIE
Assessed Acreage:
1.05
Elementary School Zone:
WILLIAM R DAVIE
Deed Date:
2/1994
Middle School Zone:
NORTH DAVIE
Deed Book / Page:
001720710
Soil Types:
Mr132
Plat Book:
0006
Flood Zone:
Plat Page:
051
Watershed Overlay:
DAVIE COUNTY
Building Value:
Outbuilding 8r Extra
Freatures Value:
Land Value:
Total Market Value:
Total Assessed Value:
E@1
Davie County,
NC
All data Is provided a Is without warranty or guarantee of any Idnd either expressed or Implied Including but not limited to the
Implied warranties of merchantability or fitness for a particular use. All users of Davie County's GIS website shall hold harmless the
County of Davie, North Cardin, Its agents, consultants, contractors or employees from any and all claims or causes of action due to
or arising out of the use or Inability to use the GIS data provided by this website.
DAVIE COUNTY HEALTH DEPARTMENT
Environmental Health Section
P. O. Boz 848/210 Hospital Street
Moeksville, NC 27028
(336)751-8760
IMPROVEMENT/OPERATION PERMIT
Account #:
990001363
Tax PIN/EH #:
5822-62-0583
Billed To:
Roger Stewart
Subdivision Info:
Country Shire Way Lot # 2
Reference Name:
Randy Miller
Location/Address:
Eaton Church Road -27028
Proposed Facility:
Residence
Property Size:
1.2 acres
**NOT) * i�iIsgmpr2527 ei nt/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 0& #People -.2— #Bedrooms -2 #Baths .V -
Dishwasher: ;9 Garbage Disposal: ❑ Washing Machine Basement w/Plumbing: ❑ Basement/No Plumbing: ❑
Commercial Specification: Facility Type #People #People/Shift #Seats Industrial Waste: ❑
Lot Size (.' Type Water Supply_ Design Wastewater Flow (GPD) c� Site: New Repair ❑
System Specifications: Tank Size/ GAL. Pump Tank
Other:
Required Site Modifications/Conditions:
GAL. Trench Width��t Rock Depth � Linear Ft(_?Of)1
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 173-0`p. the day of installation. Telephone # is (336)751-8760.****
O
Environmental Health Specialist's Signature: Date:�� ZL 20 y
DCHD 05/99 (Revised)
DAVIE COUNTY HEALTH DEPARTMENT
Environmental Health Section
P. O. Boz 848/210 Hospital Street
Mocksville, NC 27028
(336)751-8760
Account #:
990001363
Tax PIN/EH #:
5822-62-0583
Billed To:
Roger Stewart
Subdivision Info:
Country Shire Way Lot # 2
Reference Name:
Randy Miller
Location/Address:
Eaton Church Road -27028
Proposed Facility:
Residence
Property Size:
1.2 acres
ATC Number: 2527
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 WASTEWA C NSTRUCTION IS VALID FOR A PERIOD OF FIVE YEARS.
Environmental Health Specialist's Signature: , 5�1 Date: X9'1,7'eb
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 1 of .S. Chapter 130A, Section .1900 "Sewage Treatment and
Disposal Systems," but shall in NO WAY t en a guarantee that the system will function satisfactorily for any
given period of time.
Sir �P
rn �o�Q
Septic System Installed By:
Environmental Health Specialist's Signature:
DCHD 05/99 (Revised)
Date:
If yes, what type?
***IMPORTANT*** CLIENTS MUSTCOMPLETETHE REQUIRED PROPERTY INFORMATION REQUESTED
BELOW. Either a PLAT or SITE PLAN MUST BESUBMI77ED by the client with THIS APPLICATION.
Property Dimensions: f , I GG rt S
Tax Office PIN: # S V%, l 2— duyc-L
0523
Property Address: Road Name _ &A �o ti'
City/zip i i IOc 1) 14
If in a Subdivision provide information, as follows:
Name: C'0041`4 S � f
Section: Block: Lot:
WRITE DIRECTIONS (from Mocksville) to PROPERTY:
0 i u R, oi, G4, qkirl
5 L paj
R-.,
r --
Date Property Flagged: S " 0
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 s ' ability.
DATE O^ (� " SIGNATURE 00,0'." qzdl.
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).
Site Revisit Charge
Date(s):
Client Notification Date:
EHS:
Account No.
Revised DCHD (07/99) Invoice No.
APPLICATION FOR SITE EVALUATION/IMPROVEMENT PERMIT & ATC
Davie County Health Department
Environmental Hea/Ifi Section
P.O. Box 848/210 Hospital Street
Mocksville, NC 27028
(336) 751-8760
***IMPORTANT*** THIS APPLICATION CANNOT HE PROCESSED UNLESS ALL THE REQUIRED
INFORMATION IS PROVIDED. Refer to the INFORMATION BULLETIN for instructions.
1.
Name to be Billed O 5 'tic - Contact Person
j
S�1GJ ISL
Mailing Address �J ICp�IIl L O- Home Phone
City/State/ZIP Y rSLA W— 'Z]2 -q'4 Business Phone
p U��c'
A 1 all&
2.
Name on Permit/ATC if Different than Above J (J)A
Mailing Address City/state/Zip
3.
Application For: ❑ Site Evaluation Improvement Permit/ATC
❑ Both
4.
system to service: A House ❑ Mobile Home ❑ Business ❑ Industry
❑ Other
Bathrooms
S.
If Residence: # People # Bedrooms_ #
V Dishwasher ❑ Garbage Disposal 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 ❑ Well
❑ community
e.
Do you anticipate additions or expansions of the facility this system is intended to serve?
❑ Yes )(No
If yes, what type?
***IMPORTANT*** CLIENTS MUSTCOMPLETETHE REQUIRED PROPERTY INFORMATION REQUESTED
BELOW. Either a PLAT or SITE PLAN MUST BESUBMI77ED by the client with THIS APPLICATION.
Property Dimensions: f , I GG rt S
Tax Office PIN: # S V%, l 2— duyc-L
0523
Property Address: Road Name _ &A �o ti'
City/zip i i IOc 1) 14
If in a Subdivision provide information, as follows:
Name: C'0041`4 S � f
Section: Block: Lot:
WRITE DIRECTIONS (from Mocksville) to PROPERTY:
0 i u R, oi, G4, qkirl
5 L paj
R-.,
r --
Date Property Flagged: S " 0
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 s ' ability.
DATE O^ (� " SIGNATURE 00,0'." qzdl.
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).
Site Revisit Charge
Date(s):
Client Notification Date:
EHS:
Account No.
Revised DCHD (07/99) Invoice No.
JSPORTATIO FINAL SUBDIVISION PLAT APPROVAL I Prgdy I.... TiAterow _ .... _ _ ..... ce{
HWAYS This s to certuty that this plat meets the recording requirements of the Subdivision this map was drawn from (an actual survey made by me) (deed descnpnon rec
ION AD Davie County and, if applicable, that a ceruh-
Book . .166 ............. ......: Page ......770 ... ..... . Book... . ... .......... . I
Page ..... .. ...... .etc.) (other); that the error of closure as calculated by latrtu
CERTIFICATION cafe of approval has been issued by the Division of Highways pursuant to Article departures s 1: ................20,000......... .
..... .. _ ........ ..... , that the bound
7, Chapter 136 of the General Statutes, State of North Carolina. surveyed are shown as broken lines plotted from information found in Book........
Page .... .. _.. that this map was prepared in accordance with G.S 47 30 as a
R Trns the - day of _ 19 Witness my hand and seal this _......4.... .... day of. FEBRUARY... A.D.,tg
(Surveyor's Seal) .._................ ... ........... __ ._ __. _... ...
SURVEYOR
l y DIRECTOR OF PLANNING NORTH CAROLINA - DAVIE COUNTY
W. A. BECK
' PAVED DB, 47 PG, 271
DB. 112 PG, 73
trol
nor
351.64
S 85° 35' 02'• E 676.51 TOTAL
nip 196.60 nip
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control
corner
nip 185.65
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PAA pq4YwA -4 7196
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AREA =1.250 ACRES �Mti G? 2O o
\ \ v AREA =1.234 ACRES 4
(� ctiU 2s/se \ �° /AREA =1.520 ACRES o ° AREA =1.821 ACRES
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2300
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ILLIAM R. CUNNINGHAM o °' `� S°, go• AQ
DB. 167 PG. 118 M �4p. ° P.K. A
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Al
niP
3 13-C), ^i/V Sq. �vF AY
P.K. \ 30
S 85'
AR
ai lye /6S \w
� AREA = L295 ACRES ,,� \�, a3 ,olw oO o° nip
A -1ag3 CO
N 9193 h \ /r
\ N� AREA =1.513 ACRES \
79103
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181.93 eip 170.52ti
S 83° 09' 21" E- n� 486.10 a
656.62 TOTAL N 83° 09' 21" W nipl-
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1. Application/Perm
Mailing Address
APPLICATION FOR SITE EVALUATION/IMPROVEMENTS PERMIT
Davie County Health Department�(�
W
Environmental Health Section 6 W3
P. O. Box 665 MAR 1
Mocksville, NC 27028
Home Phone Y11 1� 7 2 T Business Phone
A&- -I- 00- i 0 _
2. Name on Permit if Different than Above
3. Application/Permit for: LZ General EvaluatiorN ❑ Septic Tank Installation
4. System to Serve: ❑ House ❑ Mobile Home ❑ Place of Public Assembly
❑ Business ❑ Industry ❑ Other ❑ Unknown
r
e
5. If house, mobile home: Subdivision ,L! Section Z Lot # 2
No. of People _
No. of Bedrooms
No. of Bathrooms
Dwelling Dimensions
6. If business, industry, place of public assembly, other: Specify type
No. of People Served
No. of Commodes
No. of Lavatories
No. of Sinks
No. of Urinals
No. of Water Coolers
❑ Basement/Plumbing
❑ Basement/No Plumbing
❑ Washing Machine
❑ Dishwasher
❑ Garbage Disposal
No. of Showers Water Usage Figures
7. Type of water supply: Vllpl'ublic ❑ Private ❑ Community
8. Property Dimensions 1-2 G Sewage Disposal Contractor
9. Do you anticipate additions/expansion of the facility this sytem is intended to serve? ❑ Yes ❑ No
If yes, what type?
'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: � •
6 a/ /plain - a w
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. ,
DAf E" ' SIGNATURE
CONSENT EQ@ SITE EVA6UATION TO BE DONE QN ABOVE DESCRIBED PROPERTY
MUST CHECK ONE: 1, I 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
If
disposal system.
DATE SIGNATURE
bcHD (12.90)
r
' DAVIE COUNTY HEALTH DEPARTMENT
Environmental Health Section
Soil/Site Evaluation
NAME DATE EVALUATED
ADDRESS PROPERTY SIZE
PROPOSED FACIILTY ,�` �s e ���/ ` LOCATION OF SITE ✓� � ��i �
Water Supply: On -Site Well
Evaluation By: Auger Boring
Community Public
Pit Cut
FACTORS
1
2 3 4
Landscape position
G
,L
Sloe
HORIZON I DEPTH
"
Texture groupL
Consistence
Structure
Mineralogy
HORIZON II DEPTH
Texture groupG
Consistence
Structure
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
SITE CLASSIFICATION: EVALUATED BY: 21al
LONG-TERM ACCEPTANCE RATE: 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