302 Lakeview Road Section 2 Lots 24-25Davie County, NC I I Tax Parcel Report Tuesday, January 17, 2017
WARNING: THIS IS NOT A SURVEY
Parcel Information
Parcel Number:
1614OA0026
Township:
Shady Grove
NCPIN Number:
5758844111
Municipality:
-
Account Number:
82532886
Census Tract:
37059-804
Listed Owner 1:
WOOLDRIDGE DAVID M
Voting Precinct:
WEST SHADY GROVE
Mailing Address 1:
302 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 24-25 HICKORY HILL SECTION 2
Fire Response District: CORNATZER - DULIN
Assessed Acreage: 1.47
Elementary School Zone: CORNATZER
Deed Date: 9/2011
Middle School Zone: WILLIAM ELLIS
Deed Book / Page: 008680585
Soil Types: GnC2,GaD,WATER
Plat Book: 0005
Flood Zone:
Plat Page: 027
Watershed Overlay: DAVIE COUNTY
Building Value:
Outbuilding & Extra
Freatures Value:
Land Value:
Total Market Value:
Total Assessed Value:
O 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
�p
NC
County of Davie, North Carolina, Its agents, consultants, contractors or employees from any and all claims or causes of action due to
U l'3'C•�
or arising out of the use or inability to use the GIS data provided by this website.
DA�1IE COUNTY HEALADEP%AFBTMENT -
;.,� Y ..::y t.,:.- n. _
IMPR;OAVEMENT$� PER°MIT AN,D:CER�TIFI�CATE OF CO.MPLaETI:O;N
` *NOTE Issued in Complian0"W,.*A`rticle 1l of G.S. Chapter 130a £
Sbnitary'-Sewage Systems r
J Name ,%i Date_ Nk
Location/,'r���! r'L ('.a.>, /. .'.��
Sub:divis o,, Name�'_ '- _ '- / Lot NO.lSec. or B ock No
Lot Size House Mobile Home Business __ Speculation
No. Bedroom's No, Baths No. inl,Family
Garbage .Disposal YES 0 NO Specifications for System:
Auto Dish Washer YES NO E]
Auto Wash Machine YES Q NO ❑ '��`
Type Water Supply
*This permit Void'if sewage system described below isnot installed wifahi'n:5, years from date of iss.u.e
This.,permi,, is subject to revocation its, te-plans, or'the�in,tended>use, clian.ge.
3
,f r4 I -e4
11
Improvement"& ;permit by
*Contacta, representative of the Davie County H'ealthrep�artment for, final, inspection .o:f this system between
9:30 A.M. or 1:00-1:30 P.M. on day of completion. T,.elephoneyNmbPr704-634 5985:
Final Installation Diagram: System -Installed by R
1
* TL
ti
.rJ
10
,o p
a,
Certificoi Cgmpletion Date cy-
satistactoruytor any.given period ;of tite:
r^
APPLICATION FOR SITE EVALUATION/IMPROVEMENTS PERMIT
Davie County Health Department
Environmental Health Section
P. O. Box 665
Mocksville, NC 27028
Application/Permit Requested By. D e-:- J /'"` - 4-P cey"
Mailing Address /f T �� �/ ?/ /00 V, 6Z &
Home Phone Business Phone
2. Name on Permit if Different than Above
3. Application/Permit for:
4. System to Serve: M19ouse
❑ General Evaluation
❑ Mobile Home
❑ Septic Tank Installation
❑ Place of Public Assembly
❑ Business ❑ Industry� ❑ Other ❑ Unknown
5. If house, mobile home: Subdivision l) �C��•/ �Ct /� Section Lot # 2V-2 S
D-8asement/Plumbing
No. of People
No. of Bedrooms -�
No. of Bathrooms _
Dwelling Dimensions
491-1
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
No. of Showers Water Usage Figures _
7. Type of water supply: ❑' PublicI ❑ Private
,,�8. Property Dimensions - — / / /'116— Sewage Disposal Contractor
9. Do you anticipate additions/expansion of the facility this sytem is intended to serve? ❑ Yes
If yes, what type?
❑ Basement/No Plumbing
❑ Washing Machine
❑ Dishwasher
❑ Garbage Disposal
❑ No
❑ 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:
This is to certify that the information provided is correct to the best of my
incurred from this application.
DA'TE
and I understand I am responsible for all charges
,TUBE
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 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
and disposal system.
DATE SIGNATURE
DCHD (12.90)
NAME _
ADDRESS
PROPOSED FACIILTY
DAVIE COUNTY HEALTH DEPARTMENT
Environmental Health Section
Soil/Site Evaluation
DATE EVALUATED
PROPERTY SIZE
LOCATION OF SITE
Water Supply: On -Site Well Community Public
Evaluation By: Auger Boring Pit Cut
FACTORS 1 2 3 4
Landscape position
Slope %
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:
DCHD(01-901
EVALUATED 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
D�ANfE CO"U,NTRY � 4J. A H DEPA�R�TM,EIVY : 1
IMYPR';OV�EMLE"NTS 'PERMIT AND 'CER�TIFI'CA�TE''OF s'C"O`M�PLE�TI N
r
`NOTE: Issued in Compliance-t'with G S. of North Carolina Chapter 130 Article 13c
t
Sewage Treatment and Di
g Disposal Rules (10 NCAC 10A .1934-:1968) P�,ermtmber
Name'r`t'''k€c�t/T:-'r.�fr — Date
Location i ! Ir f 17 ? Z
satisfactorily for any given-,,04—o=d
skof time: ""
" DAVIE COUNTY HEALTH DEPARTMENT
IMPROVEMENTS PERMIT AND CERTIFICATE OF COMPLETION
*NOTE: Issued in Compliance with G.S. of North Carolina Chapter 130 Article 13c
Sewage Treatment and Disposal Rules (10 NCAC 10A .1934-.1968) Permit Number
„Name# �' '° — Dates%'"
Location 6 Z_<
Subdivision Name Lot No. Sec. or Block No.
Lot Size — House Mobile Home — — Business — Speculation
No. Bedrooms �— No. Baths f — No. in Family —
Garbage Disposal YES NO 2-'
Specifications for System,
Auto Dish Washer YES [] NO 0 I
Auto Wash Machine YES Ep NO .0 � �-
Type Water Supply
*This permit Void 'if sewage system' -described below is not installed within 36 months from date of issue.
41
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.
DAVIE COUNTY HEALTH DEPARTMENT
Environmental Health Section
P. O. Box 665
Mocksville, N.C. 27028
SOIL/SITE EVALUATION
Name Date
Address Lot Size�(2C�
F
I
FACTORS AREA 1 ARFA ? ARFA 3 APPA A
1) Topography/ Landscape Position
�S
U
P
U
S
PS
U
S
PS
U
!) Soil Texture (12-36 in.) Sandy,
Loamy, Clayey, (note 2:1 Clay),.�
S
S
U
S
PS
U
S
PS
U
l) Soil Structure (12-36 in.)
Clayey Soils
S
S
er�p
U
S
PS
U
S
PS
U
G) Soil Depth (inches)
S
S
PS
U
S
PS
U
) Soil Drainage: Internal
S
U
_S�?
CI%Y_�
!U
S
PS
U
S
PS
U
External
S
U
S
PS
U
U
S
PS
U
�) Restrictive Horizons
Available Space�
�
U
U
S
PS
U
S
PS
U
I) Other (Specify)
S
PS
U
S
PS
U
S
PS
U
S
PS
U
1) Site Classification
U—UNSUITABLE S—SUITABLE / PS—Provisionally Suitable
Recommendations/Comments:
Described by`Title !y Date l
SITE DIAGRAMS
DCHD (6-82)
APPLICATION FOR SITE EVALUATION/ IMPROVEMENTS PERMIT
Davie County Health Department
Environmental Health Section
P. 0. Box 665
Mocksville, N.C. 27028
CONSTRUCTION SHALL NOT BEGIN UNTIL IMPROVEMENTS PERMIT HAS BEEN ISSUED.
Home Phone
1. Permit Requested By ` C l� y `L - Business Phone 9 9 s-- - kk `71
2. Address Abe--eaky k, /-,t V1,16,u 47'43 /�6 4-K&'uvLCe Al
3. Property Owner if Different than Above
Address
4. Permit To: a) Install �er Repair 1 p ,Zw— ?�(S
b) Privy Conventional -L -1 -Other Type Z -G 7,'0 AJ- 4W
Ground Absorption
c) Sub -Division Sec. Lot No.
5. System used to serve what type facility: House Mobile Home Business
Industry Other
b) Number of people 'A
6. a) If house or mobile home, state size of home and number of rooms.
House Dimensions
Bed Rooms_ Bath Rooms— Den w/Closet
b) If Business, Industry or Other, State: Number of persons served
What type business, etc.
Estimate amount of waste daily (24 hours)
7. Number and type of water -using fixtures:
commodes
urinals_
lavatory
showers
dishwasher
sinks —
8. a) Type water supply: Public Private Community.
b) Has the water supply system been approved? Yes
9. a) Property Dimensions
b) Land area designated to building site
garbage disposal
washing machine
c) Sewage Disposal Contractor
10. Do you anticipate any additions or expansions of the facility this sewage system is intended to serve?
What type?
This is to certify that the information is correct to the best of my knowledge.
z4z
Date Owner Signatufe
OWNER IS SOLELY RESPONSIBLE FOR COMPLIANCE WITH ALL STATE AND LOCAL LAWS
Allow 5 days for processing
Directions to property:
DCHD (6-82)