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110 Pine Valley Road Section 1 Lot 18Davie County, NC , Tax Parcel Report Tuesday, January 24, 2017 - ��- yII r v 122 157-------- I m, "T_ Z.y w y ' - `tom __-- ------ 113 C 110 2239 -n i i i r Parcel Number: NCPIN Number: Account Number: Listed Owner 1: Mailing Address 1: City: State: Zip Code: Legal Description: Assessed Acreage: Deed Date: Deed Book / Page: Plat Book: Plat Page: Building Value: WARNING: THIS IS NOT A SURVEY Voluntary Ag. District: Parcel Information LOT 18 HICKORY HILL SECTION 1 J605OA0013 Township: Fulton 5757997952 Municipality: Elementary School Zone: 82531376 Census Tract: 37059-804 SHORE TAMMIE L Voting Precinct: FULTON 110 PINE VALLEY RD Planning Jurisdiction: Davie County MOCKSVILLE Zoning Class: DAVIE COUNTY R-20 NC Zoning Overlay: Land Value: Total Assessed Value: 27028-0000 Voluntary Ag. District: No LOT 18 HICKORY HILL SECTION 1 Fire Response District: FORK 0.58 Elementary School Zone: CORNATZER 2/2016 Middle School Zone: WILLIAM ELLIS 010110895 Soil Types: GnI32 0004 Flood Zone: 105 Watershed Overlay: DAVIE COUNTY Outbuilding & Extra Freatures Value: Total Market Value: F(P] Ag 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 County's GIS webske shall hold harmless the County of Davie, North Carolina, its agents, consultants, contractors or employees from any and alt 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. 1 DAVIE COUNTY HEALTH DEPARTMENT IMPROVEMENT PERMIT and OPERATION PERMIT //0 IMPROVEMENT PERMIT (1 1 F� -e G L �% " **NOTE** This improvement permit DOES NOT authorize the construction or installation of a septic tank system or any wastewater system. AN AUTHORIZATION FOR WASTEWATER SYSTEM CONSTRUCTION must be obtained from this Department prior to the I' construction/installation of a system or the issuance of a building permit, (In compliance with Article 11 of G.S. Chapter 136A, Wastewater Systems, Section .1900 Sewage Treatment and Disposal Systems) NAME /) � PROPERTY ADDRESS Vldno JL f" I V a 7-0 2V PATE ,., a LOCATION i�// ,��% SUBDIVISION NAME ��'� �! /7 - LOT NUMBER SEC./BLOCK NUMBER _;?7Pl )W RESIDENTAL SPECIFICATION: BUILDING TYPE &17 G # BEDROOMS # BATHS # OCCUPANTS GARBAGE DISPOSAL: Yes/No COMMERCIAL SPECIFICATION: FACILITY TYPE # PEOPLE # PEOPLE/SHIFT # SEATS INDUSTRIAL WASTE: Yes/No LOT SIZE TYPE WATER SUPPLY e"o DESIGN WASTEWATER FLOW (GPD) ( NEW SITE P" REPAIR SITE SYSTEM SPECIFICATIONS: TANK SIZE ,�dL GAL. PUMP TANK GAL. TRENCH WIDTH" ROCK DEPTH �� LINEAR FT..�jJO OTHER REQUIRED SITE MODIFICATIONS/CONDITIONS: ***THIS PERMIT IS SUBJECT TO REVOCATION IF SITE PIANS OR THE INTENDED USE CHANGE. YOUR WASTERWATER SYSTEM CONTRACTOR MUST SEE THIS PERMIT BEFORE INSTALLING THE SYSTEM. r IMPROVEMENT PERMIT BY **CONTACT A REPRESENTATIVE OF THE DAVIE COUNTY HEALTH DEPARTMENT FOR FINAL INSPECTION OF THIS SYSTEM BETWEEN 8:30-9:30 A.M. OR 1:N-1:30 P.M. ON THE DAY OF INSTALLATION. TELEPHONE # IS (704) 634-8760. OPERATION PERMIT SYSTEM INSTALLED BY 1\ �sJ rviw T� C►1 �V F �+ AUTHORIZATION NO. OPERATION PERMIT BY �- DATE **THE ISSUANCE OF THIS OPERATION PERMIT SHALL INDICATE THAT THE SYSTEM DESCRIBED ABOVE HAS BEEN INSTALLED IN COMPLIANCE WITH ARTICLE 11 OF G.S. CHAPTER 130A, SECTION .1900 -SERE TREAMT 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. DCHD 10/95 �.Y why ,..r".• .t Davie County Health Department f ENVIRONMENTAL HEALTH SECTION P.O. Box 665 Mocksville, N.C. 27028 I �',� U 1 `AUTHORIZATION FOR WASTEWATER SYSTEM CONSTRUCTION _ (Issued in compliance with Article 11 of G.S. Chapter 130A, Wastewater Systems) ***This Authorization For Wastewater System Construction must be issued by the Davie County Environmental Health Section prior to issuance of any Building Permits. This Form/Authorization Number should be presented to the Davie County Building Inspections Office when applying for Building Permits.*** ,/ i.S� SCJ DATE ��9 VaJRUTHDRIZAT0 4 R NAME ON IMPROVEMENT PERMIT (If different than above) SITE LOCATION COMENTS/CONDITIONS ON AUTHORIZATION TO CONSTRUCT WASTEWATER SYSTEM APPLICATION FOR SITE EVALUATIONAMPROVEMENT PERMIT & ATC Davie County Health Department 2 P a % Environmental Health Section FRNI L5 P.O. Box 848 2 5 1996 Mocksville, NC 27028 (704) 634-8760 ****IMPORTANT**** THIS APPLICATION CANNOT BE PROCESSED SS ALL THE REQUIRED INFORMATION IS PROVIDED. 1. Name to be Billed Contact Person Mailing Address �� Home Phone City/State/Zip P&Vi f Business Phone 2. Name on Permit/ATC if Different than Above Mailing Address 3. Application For: [ ] Site Evaluation 4. System to Serve: [vJ House [ ] Mobile Home [ ] Business [ ] Industry [ ] Other 5. If Residence: # People_ --L__ # Bedrooms 1, # Bathrooms /0— VrKishwasher [' ] Garbage Disposal City/State/Zip [improvement Permit & ATC [ ] Both [kT �4shing 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: 114-1county/City [ ] Well [ ] Community 8. Do you anticipate additions or expansions of the facility this system is intended to serve? [ ] Yes [ ] No If yes, what type? PROPERTY INFORMATION REQUIRED: *** IMPORTANT *** A PLAT OF THE PROPERTY MUST BE SUBMITTED WITH THIS APPLICATION. Property Dimensions: / 02 q Y ao WRITE DIRECTIONS (from Mocksville) TO PROPERTY: Tax Office PIN: # - - is y 7 • Lt F+ 'b 14 • %( t Property Address: Road Name 4A G 4 ta I pt t^t u w6,, 1 Ctn M ne U et L 6w4 City/Zip rAo LIL Z,17 o 2-r If in Subdivision provide information, as follows: Name: io4&nq H;i[ x ; Section: Lot #: b 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 i to co d pct all testin"roce4urs as necessary to determine the site suitability. � � 1 DATE (/ CP SIGNATURE L Revised D D (06'-96) - uuije Tjalmt�' Tax �kbraiuieitratvr DAVIE COUNTY ADMINISTRATIVE BUILDING MOCKSVILLE, NORTH CAROLINA 27028 APPLICATION FOR CERTIFICATION THAT A PROPERTY OWNER OWES NO Mary Nell Richie Tax A&nMisv,awr Telephone: (704) 634-3416 Fax: (704) 634-7408 DELINQUENT TAXES FOR THE PURPOSES OF OBTAINING A BUILDING PERMIT. 1 . PROPERTY OWNER: ----------------------- ACCOUNT #:---------- 2. PROPERTY OWNER ADDRESS: ------------------------------------- ------------ ------------------------ 3. MAP NUMBER (PARCEL IDENTIFICATION_�'12 4. DESCRIPTION OF IMPROVEMENT, NEW DWELLINGS ADDITION TO EXIST- ING DWELLING, GARAGE, SHOP, FARM BUILDING, ETC.) 5. 6. ------------------------------------------------------------ DIRECTIONS TO SITE __/ Y APPLICANT: /�2�2/`.�I �ll�J/L' DATE: APPLICATION FOR CERTIFICATION APPROVED: THE OFFICE OF THE DAVIE COUNT TAX ADMINISTRATOR CERTIFIES THAT THE PROPERTY OWNER, ( name )__�_�_ka _ �_f C -L ----- _-OWES NO DE- LINQUENT TAXES THIS- --DAY OF (month) --_-_(year)1q9, -- --------- TITLE- TITLE-A�fwi------------- APPLICATION FOR CERTIFICATION DENIED: ------------------------------------ THE OFFICE OF THE DAVIE COUNTY TAY. ADMINISTRATOR DENIES CERTIFICATION. THE REASON BEING THAT THE PROPERTY OWNER(name) ------------------------- OWES $--__---_---_IN DELINQUENT TAXES THIS ----- -__DAY OF (month) (year) : TITLE ----------------------- c�c • APPLICATION FOR SITE EVALUATION/IMPROVEMENTS PERMIT 0p Davie County Health Department 0 e Environmental Health Section rn� !R( P. O. Box 665 Mocksville, NC 27028 _ ... J 7U . 13 1994 1. Application/Permit Requested By �� '�'V -f S Mailing Address .2 / g P, rn e Vat /I -e x, d Home Phone 70 3 7— /VG Z'7DZx-, Business Phone y%Z"SS1Z% /VG 2. Name on Permit if Different than Above Z4 rvu Z , d L "tiCla n L LA0 h S 3. Application for: A(General Evaluation ❑ Septic Tank Installation Permit 4. System to Serve: House ❑ Mobile Home ❑ Place of Public Assembly ❑ Business ❑ Industry ❑ Other ❑ Unknown r 5. If house, mobile home: Subdivision A Section E104 f4 Lot # / ❑ Basement/Plumbing L No. of People T ❑ BasemenVNo Plumbing No. of Bedrooms 3 K Washing Machine No. of Bathrooms 2-3 ,5� Dishwasher Dwelling Dimensions (v0 X Z ,Garbage Disposal 6. If business, industry, place of public assembly, other: Specify type No. of People Served No. of Sinks No. of Commodes No. of Urinals No. of Lavatories No. of Water Coolers No. of Showers Water Usage Figures 7. Type of water supply: ,�i Public ❑ Private ❑ Community 8. Property Dimensions 29 ' X 20 8 Sewage Disposal Contractor 9. Do you anticipate additions/expansion of the facility this sytem is intended to serve? ❑ Yes ,K No If yes, what type? 'NOTE: Improvements Permits shall be valid for a period of 5 years from date issued. Improvements Permits are subject to revocation, if site plans or the intended use change. Effective October 1, 1989. Directions to Property: JA6 GSl ccd,/ 40 f1.��ory //,Y1 - Lam- ,,5 "41 dr 8,14 1412-c d Gnt /8-, acA /f , Src�.c>„ /� /�$ -�1. �S /o Sb►lo�J �'a" c /Na/, \J-11 Cf- i 3 This is to certify that the information provided is correct incurred from this application. 7-/3-9V 6 DATE best of my knowledge, and I understand I am responsible for all charges SIGNATURE CONSENT FOR SITE EVALUATION TO BE DONE ON ABOVE DESCRIBED PROPERTY MUST CHECK ONE: ❑ 1. 1 OWN the property. .-1<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 Davie Count Health Department to enter upon above described property located in Davie County and owned by0�2/�� to conduct all testing procedures as necessary to determine said site's suitability for a ground absorption sewage treatment and disposal system. /ted DF mac% DATE DCHD (1193) DAVIE COUNTY HEALTH DEPARTMENT Environmental Health Section Soil/Site Evaluation NAME S�he< ADDRESS PROPOSED FACIILTY ,41ei1_�( r DATE EVALUATED PROPERTY SIZE LOCATION OF SITE Water Supply: On -Site Well Community Public Evaluation By: Auger Boring i/ Pit Cut FACTORS 1 2 3 4 Landscape position Sloe % — — HORIZON I DEPTH Texture group Consistence Structure Mineralogy HORIZON II DEPTH ey Texture groupL' Consistence Structure S It / 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 , y , SITE CLASSIFICATION: r / EVALUATED BY: 4411 LONG-TERM ACCEPTANCE RATE: 7 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 Tt;xture S -Sand LS -Loamy sand SL -Sandy loam L -Loam SI -Silt SILL -Silty :lay loam, SIL -Silty loam CL -Clay loam SCL-Sandy clay loam SC -Sandy clay SIC -Silty clay C -Clay CONSISTENCE Moist VFR--Vcry 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 DCHD(01-901 Davie County Aealtif Department and Nome Yfealtl Ayency 210 HOSPITAL STREET/ P.O. BOX 665 MOCKSVILLE. N.C. 27028 PHONE: (704) 634.5985 July 20, 1994 Larry & Linda Jones 218 Pine Valley Rd. Mocksville, NC 27028 Re: Site Evaluation Hickory Hill I/Block A—Lot 18 Dear Mr. & Mrs. Jones: As requested, a representative from this office visited the aforementioned site on July 18, 1994. Based upon the information provided on the application for a site evaluation and after the evaluation was completed, the site was found to be provisionally suitable for the installation of an on—site sewage disposal system. If you have any questions, please feel free to contact this office. Sincerely, 100�u' -a- e; Robert B. Hall, Jr., R.S. Environmental Health Section RH/wd Enclosure