164 Lakeview Road Lots 8-9Davie County, NC ' Tax Parcel Report Tuesday, January 17, 2017
CIR LItv kk
478 146` 171
115 185 f:
/} r
.4193 �203
J
117 '
j 454
C��� 178 192 _ s
`n 444
ry / 2D2
434 �/ 222 -_r
f .,
422 �-
WARNING: THIS IS NOT A SURVEY
Parcel Information
Aii 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 Coungrs GIS website shall hold harmless the
Parcel Number:
1614OA0041
Township:
Shady Grove
NCPIN Number:
5758731668
Municipality:
Account Number:
62675620
Census Tract:
37059-804
Listed Owner 1:
RUSH WINONA E
Voting Precinct: WEST SHADY GROVE
Mailing Address 1:
164 LAKEVIEW 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:
LOTS 8-9 HICKORY HILL LIFE ESTATE
Fire Response District:
CORNATZER - DULIN
Assessed Acreage:
1.96
Elementary School Zone:
CORNATZER
Deed Date:
10/2004
Middle School Zone:
WILLIAM ELLIS
Deed Book / Page:
005770676
Soil Types: GnC2,GaD,WATER
Plat Book:
0005
Flood Zone:
Plat Page:
026
Watershed Overlay:
DAVIE COUNTY
Building Value:
Outbuilding 8r Extra
Freatures Value:
Land Value:
Total Market Value:
Total Assessed Value:
Davie County,
Aii 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 Coungrs 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
SOU N'�4
NC
or arising out of the use or Inability to use the GIS data provided by this webshe.
[ DAVIE COUNTY HEALTH DEPARTMENT
1j. IMPROVEMENTS PERMIT AND CERTIFICATE OF COMPLETION
'NOTE: Issued in Compliance With Article II of G.S. Chapter 130a
Sa it Sew,a Systems r ;, .� ; Permit Number
Name
GLt or =� . moi'/ — d_ Date N2 % r'j 5 Q
Location
Lot Size /yfr� House 1-'� Mobile Home _ Business _ Industry
No. Bedrooms No. Baths :1 No. in Family_ Public Assembly Other
Garbage Disposal YES NO ❑ Specifications f r
Auto Dish Washer YES NO ❑
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.
i
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
System Installed by Do N N +e / K �4 I,
U¢ N
f. r)
73
Y
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.
0
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
Name�� r�'>.r r Jin it -,U Date . r'/ N2 7450
Location
—Z44 V1, pcJ
I// -r-�-
r4%
Subdivision
M 40 cors ��
Subdivision Name Ll �i �� ;!--�--- Lot No. y - Sec. or Block No.
Lot Size House Mobile Home — Business -- Industry
No. Bedrooms Jd . No. Baths-� — No. in Family 2__ Public Assembly Other
Garbage Disposal YES NO ❑ Specifications for System -'
Auto Dish Washer YES NO El
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.
U _
—WImp—
rovements 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: /System Installed by
/60 1 -Uk N
JOO �V fir,
z -A �f r
rp
--
8-
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 �0�
ADDRESS
PROPOSED FACIILTY
Water Supply: On -Site Well
Evaluation By: Auger Boring [i
DATE EVALUATED_znl/,a%/
PROPERTY SIZE
LOCATION OF SITE
Community
Pit
Public
Cut
FACTORS
1
2
3
4
Landscape position
L
L
Sloe %.
A/
HORIZON I DEPTH
Texture group
Consistence
Structure
Mineralogy
HORIZON II DEPTH'
-
Texture group
Consistence
.-
Structure
Mineralogy
/
/- `/
Al /
HORIZON III DEPTH
Texture group
Consistence
Structure
Mineralogy
HORIZON IV DEPTH
Texture group
Consistence
Structure
Mineralogy
SOIL WETNESS
RESTRICTIVE HORIZON
SAPROLITE
CLASSIFICATION
79TS
LONG-TERM ACCEPTANCE RATEI
I K
I,
SITE CLASSIFICATION:
LONG-TERM ACCEPT
REMARKS:
DCHD(01-90)
'E RATE: i 7
f7� SCJ/1J G ✓ G',fl D �i
EVALUATED BY: A4 //
OTHER(S) PRESENT:
END ell
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
iC-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
,q APPLICATION FOR SITE EVALUATION/IMPROVEMENTS PER",.;�,r'.::,,
t, 2'yt Davie County Health Department (�" Ij
Environmental Health Section FES 1 1994
P. O. Box 665
Mocksville, NC 27028 4��
1. Application/Permit Requested By f <_ �� a
R
Mailing Address / l a b ' 7 Home Phone 4T-
07441' a- Business Phone
2. Name on Permit if Different than Above R C C L -_T 4-A », Pd /" e_ C
3. Application for: ❑ General Evaluation 32fSeptic Tank Installation Permit
4. System to Serve: ouse ❑ Mobile Home ❑ Place of Public Assembly
❑ Business ❑ Industry l/ ❑ Other ❑ Unknown �o•»�u--✓
5. If house, mobile home: Subdivision L� -/C a r `� /7 l Section r,?-- Lot # 8
❑ Basement/Plumbing
No. of People C�
No. of BedroomsT�
No. of Bathrooms > /�
Dwelling Dimensions X
6. If business, industry, place of public assembly, other: Specify type
No. of People Served
No. of Commodes
No. of Lavatories
No. of Showers
No. of Sinks
No. of Urinals
No. of Water Coolers
Water Usage Figures
XBasement/No Plumbing
Washing Machine
Dishwasher
Garbage Disposal
7. Type of water supply: ❑ Public ❑ Private X Community
8. Property Dimensions�6'1S Sewage Disposal Contractor .% JAJti� ��PL-
9. Do you anticipate additions/expansion of the facility this sytem is intended to serve? ❑ Yes XNo
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:
This is to certify that the information provided is correct to
incurred from this application.
"2- 2:g - 9 y
DATE
my knowledge,
�and
II 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. 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 pe on authorized by the owner:
I hereby give consent to the authorized representative of the Davie County }iealth epartment to enter upon above described
property located in Davie County and owned by
to conduct all testing procedures as necessary to detelffnine said site's suitability for a ground absorption sewage treatment
and disposal system.
i -� �,
DATE SIGNATURE
DCHD (1193)