160 Cardinal Land Lot 5+P/O 40
Davie County. NC
Tax Parcel R ennrt
Wednesday, November 23, 2016
WARNING: 11US IS N01' A SURVEY
Parcel Information
Parcel Number: H4100A0004 Township: Mocksville
NCPIN Number: 5739430092 Municipality:
Account Number: Census Tract: 37059-806
Listed Owner 1: Voting Precinct: NORTH MOCKSVILLE COUNTY
Mailing Address 1: Planning Jurisdiction: MOCKSVILLE
City: Zoning Class: MOCKSVILLE GR,OSR
State:
Zoning Overlay:
Zip Code:
Voluntary Ag. District:
Legal Description:
LOT 5 + P/O 4 COUNTRY LN
Fire Response District:
Assessed Acreage:
4.36
Elementary School Zone:
Deed Date:
12/1989
Middle School Zone:
Deed Book / Page:
001520137
Soil Types:
Plat Book:
0005
Flood Zone:
Plat Page:
068
Watershed Overlay:
MOCKSVILLE
MOCKSVILLE
SOUTH DAVIE
MsC,MsD
MOCKSVILLE
Building Value: 343020.00 Outbuilding & Extra 7850.00
Freatures Value:
Land Value: 28750.00 Total Market Value: 379620.00
Total Assessed Value: 379620.00
Im
pt aviul�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 fitness for a particular use. All users of Davie Courdy'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
rap p p C� NC or arising out of the use or Inability to use the GIS data provided by this website.
114 e: vX o
�'` DAVIE COUNTY HEALTH DEPARTMENT
IMPROVEMENTS PERMIT AND CERTIFICATE OF COMPLETION
'NOTE: Issued in Compliance With Article II of G.S. Chapter 130a
Sanitary Sewage Systems Permit Number
NameDate '^ -_ !' N2 8 005
Location
d (-'4�2di
'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
ATTENTION: YOUR SEPTIC SYSTEM CONTRACTOR MUST SEE THIS PERMIT/LAYOUT BEFORE INSTALLING THIS ��, 61
SYSTEM /
Z)og �y
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:
by —
Certificate of Completion __ Date
'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.
Subdivision Name
��`;11�3try
_ ��� ' Lot No.��� "'° �r�or Block No. �-
Lot Size —7_—
— House
— �� Mobile Home —
_ Business --
Industry
No. Bedrooms '
_.No, Baths
— _ No. in Family
_ Public Assembly
Other
Garbage Disposal
YESNO
C -)Q
Specifications for System:
Auto Dish Washer
YES NO
❑
_
/c 1��`� r
Auto Wash Ma^hine
YES NO
❑
Type Water Supply
'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
ATTENTION: YOUR SEPTIC SYSTEM CONTRACTOR MUST SEE THIS PERMIT/LAYOUT BEFORE INSTALLING THIS ��, 61
SYSTEM /
Z)og �y
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:
by —
Certificate of Completion __ Date
'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.
• DAVIE COUNTY HEALTH DEPARTMENT
Environmental Health Section
Soil/Site Evaluation
NAME �.4�/� &.'IV
ADDRESS
PROPOSED FACIILTY
Water Supply: On -Site Well _
Evaluation By: Auger Boring f
DATE EVALUATED
PROPERTY SIZE /pC
LOCATION OF SITE
Community
Pit
Public [/
Cut
FACTORS
1
2
3 4
Landscape position
L_
Slope %
HORIZON I DEPTH
Texture group
Consistence
Structure
Mineralogy
HORIZON II DEPTH
Texture group
C-
G
Consistence
a
77—
Structure
lr:e'r
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: t/Pif�Z t d
LONG-TERM ACCEPTANCE RATE:
REMARKS:
DCHD (01-901
EVALUATED BY: _- A& 1'2/
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 :lay loam SIL -Silty loam CL -Clay loam SCL-Sandy clay loam
SC -Sandy clay SIC -Silty clay C -Clay
CONSISTENCE
Moist
VFR- V ----y 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
3C --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
APPLICATION FOR SITE EVALUATION/IMPROVEMENTS PERMIT
Davie County Health Department
Environmental Health Section
P. O. Box 665
J Mocksville, NC 27028
1. Application/Permit Requested By .J-IC,VEx I l0 . 11(-UY`/
Mailing Address Nil
d I n r[ Home Phone % b 4 -gyp 3 -C)q IDS
I' QC -V5 Vi l 1,e,, NC Business Phone _71)q -IP314-57 3k/
2. Name on Permit if Different than Above
3. Application for: ❑ General Evaluation 1 eptic Tank Installation Permit
4. System to Serve: Ct74Hau—se . ❑ Mobile Home ❑ Place of Public Assembly
❑ Business ❑ Industry ❑ Other ❑ Unknown ,
5. If house, mobile home: Subdivision (JDUY)th,/els We5 Section Lot #
2-gaasement/Plumbing
No. of People —3 " ❑ Basement/No Plumbing
No. of Bedrooms J7 8 -Washing Machine
I
�
No. of'Bathrooms - B-BWwasher
Dwelling Dimensions, _ 0 00 X q'qf'l g) 216'arbage Disposal
6. If business, industry, place of public assembly, other: Specify type '
(� No. of People Served No. of Sinks "
No. of Commodes No. of Urinals
i
No. of Lavatories No. of Water Coolers
No. of Showers Water Usage Figures
7. Type of water supply: M -Public ❑ Private
8. Property Dimensions Sewage Disposal Contractor
0
9 Do you anticipate additions/expansion of the facility this sytem is intended to serve? ❑ Yes
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:
(p 01 N q-o�-
I s�
rs
'�� iY► �� �-jv �.a� i nab �l-ree.� I— �re��
- ,
art 2nd Cu I -d e -saw a�n -►-�I rtn-� "
t>
This is to certify that the information provided is correct to the best of my knowledge, and I understand.l am responsible for all charges
incurred frorp this application.
3 2
DATE SIGNAT
CONSENT FOR SITE EVALUATION TO BE DONE ON ABOVE DESCRIBED PROPERTY
MUST CHECK ONE: 1. 1 OWN the property. r7 0 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 thfl owners S.4
I hereby give consent to the authorized representative of the Davie County Health Department to enter upon above. dWribed� "
property located in Davie County and.owned by-*• I.
to conduct all testing procedures'as necessary `to determine said site's suitability for a ground absorption sewage treatment
and disposal system.
DATE SIGNATURE
., f
DCHD (1193)