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563 Buck Seaford RdDavie C�untv. NC a Tax Parcel Renort Tuesdav. October 11. 2016 WAK1V11V(J: '1'llla l� 1VU1' A �UKVLY _ __ Parcel Information Parcel Number: K40000004303 Township: Jerusalem NCPIN Number: 5736191147 Municipality: Account Number: 5080750 Census Tract: 37059-807 Listed Owner 1: BARONE JOSEPH J JR Voting Precinct: SOUTH MOCKSVILLE Mailing Address 1: 563 BUCK SEAFORD ROAD Planning Jurisdiction: Davie County City: MOCKSVILLE Zoning Class: DAVIE COUNTY R-A State: NC Zoning Overlay: Zip Code: 27028-4171 Voluntary Ag. District: No Legal Description: 52.716 AC BUCK SEAFORD RD Fire Response District: JERUSALEM,MOCKSVILLE Assessed Acreage: 51.89 Elementary School Zone: MOCKSVILLE Deed Date: 11/1988 Middle School Zone: SOUTH DAVIE Deed Book / Page: 001460207 Soil Types: PaD,Gn62,PcC2,GnC2,ChA,WATER Plat Book: Flood Zone: Plat Page: Watershed Overlay: DAVIE COUNTY Building Value: 245160.00 Outbuilding & Extra 37140.00 Freatures Value: Land Value: 363320.00 Total Market Value: 645620.00 Total Assessed Value: 318070.00 9�°:'F Davie County, �o�,N�� NC ..._. ;,:.. , ,... .,,. ; ��,�,AUTHORJ�ATION NO. � O � J DA � . . . , � . ; . . , ��.� . � .-. ao , o c� z,�Xd�� �. � VIE COUNTY HEALTH DEPARTMENT I .. `°.'� ,�'' � • Environmental Health Section PROPERTY INFORMATION -Permittee' P.O. Box 848 ���� r"""_" Name: ,�t Mocksville, NC 27028 Subdivision Name: ' Phone #: 704-634-8760 Directionstoproperty: �'�`'*_r7,��..T�, �. sr-.�L1' Section: Lot: """' 'S AUTHORIZATION FOR i .. 1 �y ti C��. �� C; � WASTEWATER �{ "^ � ` ��` �� '"�`�`" "}"' �'` "`�'-`�'�'�� ��'� SYSTEM CONSTRUCTTON Tax Office PIN:# � �"�b - i '-� _ �.�_ \ � �` L� � � I ��. � T� _�.cti� �.,• �,,r�;�±,�. ��.. c�,^�3;.:a- Road Name: � lp;�� **NOTE** This Authorization for Wastewater System Construction MUST BE ISSLJED by the Davie Counry Environmental Health Section prior to issuance of any Building Pernuts: This Form/Authorization Number should be presented to the Davie County Building Inspections Office when applying for Building Permits. (In compliance with Article 11 of G.S. Chapter 130A, Wastewater Systems, Section .1900 Sewage Treatment and Disposal Systems) ' �"��� �, ***NOTICE*** THIS AUTHORIZATION FOR WASTEWATER CONSTRUCTION �,...y�.��'�,�=.���>���""`�,. ` �'.,,� IS VALm FOR A PERIOD OF FIVE YEARS. ENVIRONMENTAL HEALTH SPECIALIST DATE ISSUED f , �" ;' , . ,..., , . . . . . . . . . . . . . . . . _ _ . •� �.�� M� aa�., i c ��:'' 4 � � .,-� .,,. , . . (�. , � �� , - � � , � : � � � � � DAVIE COUNTY HEALTH DEPARTMENT � ' t} ' �' t� � `� IMPROVEMENT AND OPERATION PERMITS PROPERTY INFORMATION � Permittee�s» ' ..-�---� : ;'N�me`:``�.!� �t h� �� �?� ��4�: �-�:�- Subdivision Name: Y � .. . ' •.1.. f F. � . . . . � Directions to property: ' � �- `��-a '_�. : � - Section: ""'""` Lot: ' � �„ t y � ;� ' . IlVIPROVEMENT � j�� . y'.: �'�, � , `,, , * ..y .�:�, �'�.5 �';, PERNIIT Tax Office PIN:# `' � .;. �y _ � `� � _ i � E � ._ . '� � � ,\ t�l � ^ , . �� � f °,. :;, ; � ... -�'� ;� Road Name�"�! r� �.:�,.:r �� �.�. �ip: �� i�'�?.; � •a� � **NOTE** This Improvement Pernut DOFS NOT authorize the construction or installa6on of a septic tank system or any wastewater system. An "'� AUTHORIZATTON FOR WASTEWATER SYSTEM CONSTRUCTION must be obtained from this Department prior to the construction/installation of a system or the issuance of a building pernut. (In compliance with Article 11 of G.S. Chapter 130A, Wastewater Systems, Section .1900 Sewage Treatment and Disposal Systems) t'`_,, :•-�- � --- ***NOTICE*** TEII.S PERMIT IS SUBJECT TO REVOCATION IF SIT'E �.,__ `� �',� :' �-�:��, ��:.°j ��;� j PLANS OR Tf� INTENDED USE CHANGE. YOUR WASTEWATER ENVIRONMENTAL HEALTH SPECIALIST DATE ISSUED SYSTEM CONTRACTOR MUST SEE THIS PERMIT BEFORE INSTALLING Tf� SYSTEM. RESIDENTIAL SPECIFICATION: BUILDING TYPE' �� # BEDROOMS � # BATHS �. # OCCUPANTS �,1 GARBAGE DISPOS Ye or No COMMERCIAL SPECIFICATION: FACILII'Y TYPE # PEOPLE # PEOPLFJSHIFT # SEATS INDUSTRIAL WASTE: Yes or No `�?��� i�o� `` j�j'� � LOT SIZE TYPE WATER SUPPI,Y �.� DESIGN WASTEWATER FLOW (GPD) ��`� NEW SITE �•`'� REPAIR SITE � f� � SYSTEM SPECIFICATIONS: TANK SIZE ��� GAL. PUMP TANK GAL. TRENCH WIDTH � ROCK DEPTH �� LINEAR FT.�-3 � a f OTHER � � ' REQUIRED SITE MODIFICATIONS/CONDTfIONS: I IMPROVEMENT PERMIT � ��� � **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 THE DAY OF INSTALLATION. TELEPHONE # IS (704) 634-8760. i . , , OPERATION PERMIT ���' � P� ��5 �� � ��e� fl� �l %�fb �,'r�' �� � INSTALLED BY: AUTHORIZATION NO. �6.�3 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 "SEWAGE TREATMENT 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 OS/96 (Revised) � ,: � • APPLICATION FOR SITE EVALUATION/IMPROVEMENT • ' Davie County Health Department ' Environmental Health Section � P.O. Box 848 Mocksville, NC 27028 � (704) 634-8760 D � & ATC f �� d� �--�� L/ 15 auG 2 0 �9�7 --_ � ****IMPORTANT**** THIS APPLICATION CANNOT BE PROCESSED U LESS A ---J THE REQUIRED INFORMATION IS PROVIDED. ��/Ar'� ���s� �� 63 �/ Y�3 � (,� 1. Name to be Billed .�QS��� �A�c�n �� Contact Person ��`SP��r1 �IF�12.DY1� �� . Mailing Address �.0, ��x `?�S Home Phone l..'� O'�� �'1 I-�515 City/State/Zip ��r��4-p -s�t i 1��P_ , �l . C • ��,�� � Business Phon�`�� > �`1 � ' ��Ol n 2. Name on Permit/ATC if Different than Above �� Y� me _ Kl -5 A�ic-�� � e, Mailing Address 3. Application For: [] Site Evaluation City/State/Zip [ ] Improvement Permit & ATC [.�Both 4. System to Serve: [�House [] Mobile Home [] Business [] Industry [] Other 5. If Residence: # People `�_ # Bedrooms� # Bathrooms�_ �/f Dishwasher [�Gazbage Disposal E./rWashing Machine [] Basement/Plumbing [] BasemendNo Plumbing 6. If Business/Other: Specify type t�l �/� # People #Sinks # Commodes # Showers # Urinals # Water Coolers If Foodservice: # Seats Estimated Water Usage (gallons per day) 7. Type of water supply: [�County/City [] Well [] Community 8. Do you anticipate additions or expansions of the facility this system is intended to serve? [] Yes [✓J No If yes, what type? PROPERTY INFORMATION REQUIRED: *** IMPORTANT *** tY�T,�'4Y'OF THE PROPERTY MUST BE p'ep,�h cc�,d{�, SUBMITTED WITH T�I�S APPLICATION. Property Dimensions: �e�� �.� % Q� � � WRITE DIRECTIONS (from ocksville) TO PROPERTI': Ta�c Office PIN: # '% =` � - �� - � '� � ; �n.,n fY)�.E.;V; llf �.o.tF . F.c.r�n C/,u,«� PropertyAddress: RoadName�!/�'�..��f?�,P ��. � � �n ,��,�/cu�,a�'n2r� ,c'.� _ ��rr � /FF� � City/Zip j�()(' .SU//�i' � %�i�.P ; .�. ,a�=cF,9�I'aicsl � ��� � F F,��� d-f' � If in Subdivision provide information, as follows: � � i� ! , . Name: ��Xx,'� i� f�,�F�/9'" Fi,,� o� �Av�.�F�� � , - . Section: Lot#: � a� ;��rP �,•r2: ,,2,� n.�� / _-�'� This is to certify that the information provided is correct to the best of my knowledge. I understand that any permit(s) issued hereafter aze 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 SIGN testing procedures as necessary to determine the site suitability. Revised DCHD (06-96) V — THZS AItE�L �lftJ 13E USEb �OIz b1�tWZNC� JOU1t SITL- Pa�1N: ,�"c1. r;Cl. c�oPr�e,� p�' �3• D'� �.52 A�c '4U i o<. i 6.20 Ac ; 6.$ 9 A�c Ac 43 � � �� �C. # ... � �T7e.se � , : 34 � 9 8� .......�.� _ _ _ _ _ _ _ _ _ . _ _ � � - ---� ��- —',,�' � 2 �. 4 �.n7 -�" � .�..� � � �. ��� �' � � .., � �.�r, �, . 0 '�' - ,,c�3 � �. , -- } •.���f,.K ` - _ - - � t �,;: - � � - s :a � "�' � — - �, � ` `�' _,��Q•�� 5.f 2 i� `� !7 � �M1 - �d �' �� .�-- _._.,.,,,,,,__.�;;` ��r, # � 625.42 � �,. � ` .� 0 � .�5.5 ��' r + �' 323 �. 4� � - �..��� �� t�.S�Ac �' • � _ � �w ' �4,r �; d 7. 7Acj'a,a�' ��, � _�; y . -: � ,�i'M" ` , _ }' . „ �a +�.� - _ '� ,' '` :.� � �'. �� �f /' � � � ,:. �;: �: i "''�.... �, ; c� _ . ,�. _ - , t:: � '� �.��,'_. �',. ��i�'�y ` �;''` �� � 3`. - . � n � ,.� ' .� . �,3 :. • •9 , ; �, . `+Y�r4.9L _ r` m` ...9�.:,� . � � _ .. t, . O ,� 465 � � � .� •.'9+�' , � �' . 'k , h #; 4' -� - ��*. '4 1"�` y . _~ 30�. s ' > � � �,y � 4 :� � �%� �C S �'s� k �A s � �.) � � . � � � • ' �"�" � j� � � -----^_�.v < ...._.,,�;a {�'�� i+� _ ` �.-,. � '� � � I . rj � , � �.y � � � - . I . * _ �t �� s . , �- +:;,, , � , - ;,;': _� aa e. ' :s • � �� g . � j� - P �.: _.:� _; ,� � � - y, \ � � . r a� �� rrr . .. � � , � � ��70. �7 � �� s� . � l� � � 4 � '_A t'���~ L � ., . T., 43.0 �3��' ,.. � � � _ « ;� � ,�.t; �, : , 54.7e Ac , � �`� �i , �;� , .��' _ e , 3 �- -_ s � � . �: - ;� �"�' ` rt „ , �� ?, o g� � � �-� ' i�f'� � ;:�'�'��: �:����i� r � '� � � � � N �_ ��� �� 4 3. 0 �4�� � - � 3.�.�. � � �� � �, � � :� � , �� . � � N�- �.Q r . ` � � - f i. s ' __ __ _ �r _ _ __ �`�.;-s,. : t - F�-: s. . -� , , � � DAVIE COUNTY HEALTH DEPARTMENT ., � Environmental Health Section SECTION LOT ' SoiUSite Evaluation APPLICANT'S NAME !�� � Gs�'�- ' DATE EVALUATED � �� � �� . �t� PROPOSED FACILITY � a�� PROPERTY SIZE I 9b � X�. `1�' SUBDIVISION ROAD NAME � � e��� � Water Supply: Evaluation B� �.1� FACTORS Slope % HORIZON I DEPTH Texture group Consistence Structure HORIZON II DEPTH Texture group Consistence Structure HORIZON III DEPTH Texture group Consistence Structure HORIZON IV DEPTH Texture group Consistence Structure SOIL WETNESS On-Site Well Community Auger Boring � Pit , 1 I 2 1 RESTRICTIVE HORIZON '—" � SAPROLITE -- CLASSIFICATION .� . � �, LONG-TERM ACCEPTANCE RATE ��} SITE CLASSIFICATION: `J 'S' LONG-TERM ACCEPTANCE RATE: • � REMARKS: ��� 19�.7` C�*., Y � � �—ti DCHD (OI-90) Public v Cut 3 4 5 6 7 EVALUATION BY: �J�� �a� 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 Wet NS - Non sticky NP - Non plastic FR - Friable FI - Firm VFI - Very firm EFI - Extremely firm SS - Slightly sticky S- Sticky VS - Very Sticky SP - Slightly plastic P- Plastic VP - Very plastic Structure SC - Single grain M- Massive CR - Crumb GR - Granular ABK - Angular blocky SBK - Subangulaz blocky PL - Platy PR - Prismatic Mineraloev 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 ■�����■ ■■�■��■ ■■�■�■■ ■■����■ ■■�■��■ ■■����■ ■�■■■■■ ■�����■ ■���■■■ ■■����■ ■�■���■ ■�����■ ■�■���■ ■■■■��■ ■�■■■■■ ■�■���■ ■■■■�■■ ■���iii ■�11■��■ ■�11���■ ■■I�■��■ ■�Il���■ ■■7■■■■ ■�����■ ■�I■■��■ ■����11■ ■���■11■ ■■■I■�11■ ■��I��11■ ■■�I��11■ ■��I■■11■ ■�11���1■ ■�11■��I■ ■�11��■I■ ■�II���I■ 7��1���1� C�\■!�\ ���:�9\11 r�������� ��:�uri���■ u�i���:r� ��■■�i■�� ■�■�n��� ■���[i�Y ■��■■■■ ■�����■ ■■■■■■■ ■�����■ ■���■ ■■�■■ ■�■■■ ■�■�■ ■�■�■ ■�■■■ ■�■�% �rr�■ ■��■■ ■��■�■ ■��■■■ ■����■ ■����■ ■����■ ■�■■��■ ■■■■■■■ ■��■��■ ■�■■��■ ■■■■��■ ■�����■ ■��■��■ ■��■��■ ■��■��■ ■■■■■■! ■��ii:iii ■���■■�■I ■��■�■�■i ■�������i ■�������i ■■�■�■�� ■ ■■■■ ■■■■ ■■■■ ■■■■ ■■■■ ■■■■ ■■■■ ■��■ ■■■■ ■■�■ ■■■■ ■��■ ■■■■ ■■■■ ■■■■ ■■�■ ■■�■ ■■■■ ■■�■ ■��■■ ■■■■■ ■■�■■ ■���■ ■��■■ ■��■■ ■���■ ■�■■■ ■�■�■ ■■■■■ ■■■�■ ■■�■■ ■■��■ ■���■ ■�■�■ ■�■�■ ■■■�■ ■■■�■ ■■�■■