127 Meadowview Road Section 1 Lot 18Davie County, NC , I Tax Parcel Report Thursday, January 26, 2017
WARNING: THIS 1S NOT A SURVEY
Parcel Information
Parcel Number:
J6050D0002
Township:
Fulton
NCPIN Number:
5757899915
Municipality:
Account Number:
82519807
Census Tract:
37059-804
Listed Owner 1:
SINGLETON DEBBIE L
Voting Precinct:
FULTON
Mailing Address 1:
127 MEADOWVIEW ROAD
Planning Jurisdiction:
Davie County
City: MOCKSVILLE
Zoning Class: DAVIE COUNTY R-20
State:
NC
Zoning Overlay:
Zip Code:
27028-0000
Voluntary Ag. District:
No
Legal Description:
LOT 18 HICKORY HILL SECTION 1
Fire Response District:
FORK
Assessed Acreage:
0.45
Elementary School Zone:
CORNATZER
Deed Date:
11/2002
Middle School Zone:
WILLIAM ELLIS
Deed Book / Page:
004500448
Soil Types:
GnB2
Plat Book:
0004
Flood Zone:
Plat Page:
105
Watershed Overlay:
DAVIE COUNTY
Building Value:
Outbuilding & Extra
Freatures Value:
Land Value:
Total Market Value:
Total Assessed Value:
9 AAll
Davie County,
data Is provided as 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
�pUt3't4
NC
County of Davie, North Carolina, 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
r P. O. Boz 848/210 Hospital Street
Mocksville, NC 27028
(336)751-8760 J
IMPROVEMENT/OPERATION PERMIT
Account #: 989900093 Tax PIN/EH #: 5757-89-9915SC
Billed To: Shelton Construction Services Subdivision Info: Hickory Hill 1 Lot # 18
Reference Name: Location/Address: Pine Valley Road -27028
Proposed Facility: Residence Property Size: see map
ATC Number: 3357
**NOTE** This Improvement/Operation Permit DOES NOT authorize the construction of 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 #People #Bedrooms_ #Baths
Dishwasher 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) (YKy Site: NewoRepair ❑
System Specifications: Tank Size,% GAL. Pump Tank
Other:
Required Site Modifications/Conditions:
u
,GAL. Trench Width'' Rock Depth c'vl d/ Linear Ftjo
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.****
5- j01
Environmental Health Specialists Signature: Date:
DCHD 05/99 (Revised)
APP
��\ROPMEC00��
FOR SITE EVALUATION/IMPROVEMENT PERMIT &
Davie County Health Department
Environmental Health Section
0. Box 848/210 Hospital Street
Mocksville, NC 27028
(336)751-8760
* *IMP T*** THIS APPLICATION CANNOT BE PROCESSED UNLESS ALL THE REQUIRED V
INk NATION IS PROVIDED. Refer to theINFORMATIONINFORMATION BULLETIN for instructions.)
1. Name to be Billed ' k c 1 � - 11 1� „ �-j „ _ Contact Person r7 2-
�+ -_ Ste //w w
/
Mailing Address t Z S (/ S �+ J �p IIID c� Home Phone / s 2- 6
City/State/ZIP �o (G I_, � �� rJ. C, 2 7 0 Z b Business Phone 3 e o to
2. Name on Permit/ATC if Different than Above
Mailing Address City/State/Zip
3. Application For: site Evaluation ❑ Improvement Permit/ATC ❑ Both
4. System to Service: &,, ouse ❑ Mobile Home ❑ Business ❑ Industry ❑ Other
5. If Residence: # People 3 # Bedrooms 3 # Bathrooms Z
k-ishwasher �arbage Disposal 14-Wa�shing 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 Iof water supply: R—Cbun ty/City ❑ Well ❑ Community
e. Do you anticipate additions or expansions of the facility this system is intended to serve? ❑ Yes Z>6
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.
If e
Property Dimensions: / O 0 -!- Zy WRITE DIRECTIONS (from Mocksville) to PROPERTY:
Tax Office PIN: # S' -7 —7.8'1,911 S d: I Z
Property Address: Road Name L o f Ig
City/Zip i?4p. ,�L 1•.2-7 v2 -P �' 1� : t-- 3
If in a Subdivision provide information, as follows:
Name: 7 f • �'� ,� ���
Section: Block: Lot: 19
Date Property Flagged: / / .Z D / 0 -S
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 Depart ent
to enter upon above described property located in Davie County and owned by lJc �6 b', e S : TO
to conduct all testing procedures as necessary to determine the site suitability.
DATE I I z I, O 3 SIGNATURE
THIS AREA MAY BE USED FOR DRAWING YOUR SITE PLAN (Include all of the following: Existing and proposed
DroDerty lines and dimeasiorls, structures, setbacks, and septic locations).
Revised DCHD (07/99)
Site Revisit Charge
Datc(s):
Client Notification Date:
EHS:
Account No.
Invoice No.
3 `�
,
,
,
,
,
t 11,
N
0
19765o
,
o
N
n87"72,0
DAVIE COUNTY HEALTH DEPARTMENT
Environmental Health Section
Soil/Site Evaluation
APPLICANT INFORMATION
Account #: 989900093
Billed To: Shelton Construction Services
Reference Name:
Proposed Facility: Residence Property Size
Water Supply:
Evaluation By:
On -Site Well
Auger Boring
PROPERTY INFORMATION
Tax PIN/EH #: 5757-89-9915SC
Subdivision Info: Hickory Hill 1 Lot # 18
Location/Address: Pine Valley Road -27028
see map Date Evaluated:
Community
Pit
Public
Cut
FACTORS 1 2 3 4 5 6 7
Landscape position
Sloe %
HORIZON I DEPTH
Texture group
Consistence
Structure
Mineralogy
HORIZON II DEPTH
Texture group
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:
LONG-TERM ACCEPTANCE RATE:
REMARKS:
EVALUATION BY:
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
DCHD 05/99 (Revised)
DAVIE COUNTY HEALTH DEPARTMENT
IMPROVEMENTS PERMIT AND CERTIFICATE OF COMPLETION
*NOTE: Issued. in Compliance With Article 11 of G.S. Chapter 130a
Saeitary Sewage Systems Permit /'; Permit Number
Name ---r? -/ ��i�%//�;✓ ✓p:Y�S = r'' Date d �_ N�
2
Location ,i'. /l ` rGic.,✓j/ _ -.
v j rl
Subdivision NameWill Lot No. Sec. or Block No.
Lot Size House Mobile Home ___,___ Business -- Speculation
No. Bedrooms No. Baths No. in Family ? _
Garbage Disposal YES ❑ NO p--
Specifications for System:
Auto ish Washer YES NO ❑ . - r .
Auto Wash Ma shine YES T NO ❑ ��
Type Water Supply 1176 ��D x �,X
*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.
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. or 1:00-1:30 P.M. on day of completion. Telephone Number 704-634-5985.
Final Installation Diagram:
'*4 --
System Installed 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
P. O. Box 665
Mocksville, N.C. 27028
SOIL/SITE EVALUATION
Name Date /"
Address Lot Size 2 Lois
CAf1-rnoc AREA I AREA 9 ARFA 3 AREA 4
Topography/ Landscape Position
SS_
S
PS
S
PS
U
U
U
U
!) Soil Texture (12-36 in.) Sandy,
Loamy, Clayey, (note 2:1 Clay)
S
<2M)
S
CE3)
S
PS
S
PS
U
U
U
U
1) Soil Structure (12-36 in.)
Clayey Soils
S
S
<D)
S
PS
S
PS
U
U
U
1) Soil Depth (inches)
—&
S
S
PS
PS
PS
PS
U
U
U
U
i) Soil Drainage: Internal
S
d f5
S
S
PS
S
PS
U
U
U
U
External
C�>
&
S
S
PS
PS
PS
PS
U
U
U
U
i) Restrictive Horizons
54i
') Available Space
S
AD
S
PS
S
PS
U
U
U
U
3) Other (Specify)
S
PS
PS
PS
PS
U
U
U
U
�) Site Classification
%
1 1-1 1K1 -Q1 11TAR1 F S—St 11TARLF -R—Provisionally
Suitable
Recommendations/Comments:
Described by 9Z-a� n'j-', Title NQ � �1M L Date
��,QIAf�RAM
Zcr-i
DCHD (6-82)
t DAVIE COUNTY HEALTH DEPARTMENT
.s.
IMPROVEMENTS PERMIT AND CERTIFICATE OF COMPLETION
!` *NOTE:'Issued in Compliance With Article II of G.S. Chapter 130a ?U W
Sanitary Sewage Systems � � �/ Permit .Number
Name �! n �.�,��i/>f/ �, if/Y�,S = Date o -
Location J�/, � ��s�:� �✓ // /� ���i'�r :rl"� zw
r --
Subdivision Name Lot No. Sec. or Block No.
Lot Size House Mobile Home —T Business -- Speculation
No. Bedrooms No. Baths— No. in Family 2 _
Garbage Disposal YES ❑ NO p� . Specifications for System:
Auto Dish Washer. YES NO ❑ _
Auto Wash Ma .hine YES Q NO E]«Ml _� �..Jtx/_
Type
jDo cwe 01
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.
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. or 1:00-1:30 P.M. on day of completion. Telephone Number 704-634-5985.
Final Installation Diagram:
System Installed 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.
_a DAVIE COUNTY HEALTH DEPARTMENT
'»
IMPROVEMENTS PERMIT AND CERTIFICATE OF COMPLETION
t *" NOTE: Issued in Compliance With Article 11 of G.S. Chapter 130a PC, go L'J
Sanitary Sewage Systems jPermit Number
Name / r .� r 'fll, r"7�i �'_� 5; !� Date �`"" / N2
Location
�..
Subdivision Name f/. Lot No. J^ 1
Sec. or Block No.
Lot Size
House
�� ~ Mobile Home
No. Bedrooms - ��
No. Baths
No. in Family.
Garbage Disposal
YES ❑ NO
per`
Auto Dish Washer.
YES [�] NO
❑
Auto Wash Ma :hive
YES p NO
❑
Type Water Supply
Business Speculation
Specifications for System:
tJjJ `-y�1'�1� �/ l v.r
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.
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. or 1:00-1:30 P.M. on day of completion. Telephone Number 704-634-5985.
Final Installation Diagram:
System Installed 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.
�- APPLICATION FOR SITE EVALUATION/IMPROVEMENTS PERMI
�- •. Davie County Health Department
Environmental Health Section
P. 0. Box 665 JUN
Mocksville, NC 27028 /
191
A 11
1. Application/Permit Requested By a / Tc
Mailing Address 1. lac, -,r,
Home Phone L -3 1) - /S Z % Business Phone -3 y -.2 2 S
2. Name on Permit if Different than Above
3. Property Owner if Different than Above
4. Application/Permit For: General Evaluation/Tank Installation
5. System to Serve: douse U Mobile Home 0 Business
L Industry u Other 0 Unknown
6. If house, mobile home: Subdivision V C - 4011V Sec. Lot#
No. of People Dwelling Dimensions s �k 'J
No. of Bedrooms _ Basement/Plumbing
No. of Bathrooms _�LJ ` Basement/No Plumbing
0 Washing MachineJ Dishwasher CJ Garbage Disposal
7. If business, industry, other: Specify type
No. of People Served
No. of Commodes
No. of Lavatories
No. of Showers
8. Type of water supply:ublic
No. of Sinks
No. of Urinals
No. of Water Coolers
CJ Private
/ Ca Community
9. Property Dimensions l O � 1C Z () O !
10. Sewage Disposal Contractor C- 4-211n rt
11. Do you anticipate additions/exp ions of the facility this system .is
intended to serve? 0 Yes
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.
I/ Effective October 1, 1989.
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.
6�//z /y/ e
Date Signature
Directions to Property: d
Jc. .1 0
DCHD (10-89)
I
DAVIE COUNTY HEALTH DEPARTMENT
Environmental Health Section
Soil/Site Evaluation r /%
NAME O� DATE EVALUATED
ADDRESS PROPERTY SIZE�(>2/i/�
PROPOSED FACIILTY 4VT r LOCATION OF SITE
Water Supply: On -Site Well Community _ Public
Evaluation By: Auger Boring iZ — Pit
Cut
FACTORS
1
2 3
4
Landscape position
I-
L L
L
Slope %
.Z
2
HORIZON I DEPTH
Texture group
Consistence
Structure
Mineralogy
HORIZON II DEPTH
Texture groupC
Consistence
i
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
jr
SITE CLASSIFICATION: ,. EVALUATED BY:/F
LONG-TERM ACCEPTANCE RATE:��
OTHER( RESENT:
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
'r—t. mss.
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
Motes
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