947 Calahaln Rd Davie County, NC Tax Parcel Report b63ba.� Friday, September 23, 201E
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WARNING: THIS IS NOT A SURVEY
_� �_ Parcel Information
Parcel Number: G200000004 Township: Calahaln
NCPIN Number: 5800434144 Municipality:
Account Number: -6251630 Census Tract: 37059-801
Listed Owner 1: BELTON LARRY D Voting Precinct: NORTH CALAHALN
Mailing Address 1: 947 CALAHALN ROAD Planning Jurisdiction: Davie County
City: MOCKSVILLE Zoning Class: DAVIE COUNTY R-A,R-20
State: NC Zoning Overlay:
Zip Code: 27028-0000 Voluntary Ag.District: No
Legal Description: 11 AC CALAHALN RD Fire Response District: SHEFFIELD-CALAHALN
Assessed Acreage: 10.83 Elementary School Zone: WILLIAM R DAVIE
Deed Date: 1/2002 Middle School Zone: NORTH DAVIE
Deed Book/Page: 2002EO024 Soil Types: PaD,ApB,PCC2,CeB2
Plat Book: Flood Zone:
Plat Page: Watershed Overlay: DAVIE COUNTY
Building Value: 47150.00 Outbuilding&Extra 13840.00
Freatures Value:
Land Value: 99950.00 Total Market Value: 160940.00
Total Assessed Value: 160940.00
All data Is provided as is without warranty or guarantee of any kind 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 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
�pCNq� NC or arising out of the use or inability to use the GIS data provided by this website.
Pemlittee's �Y e� DAVIE WUNTY HEALTH DEPARTMENT
m
Nae: B rGhd-p. '+cDt1 Environmental Health Section PROPERTY INFORMATION
P.O. Box 848
Directions to property: (o4
1 W Ip�10 Mocksville,NC 27028 Subdivision Name:
LbQ Phone#:336-751-8760 Section: Lot:
AUTHORIZATION FOR
ho l If 7 onSYSTEM CONSTRUCTION WASTEWATER Tax Office PIN:#�
AUTHORIZATION NO: 003027 A �q 7RoaaddffamePtaAaln Q%` a7d p
Zrp.
**NOTE**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.
(In compliance •th Article I 1 of G.S.Chapter 130A.Wastewater Systems,Section.1900 Sewage Treatment and Disposal Systems)
/•/ q� ***NOTICE***THIS AUTHORIZATION FOR WASTEWATER CONSTRUCTION l tee" IS VALID FOR A PERIOD OF FIVE YEARS.
ENVIRONMENTAL HEALTH SPECIALIST DATE ISSUED
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cte� s GK' DAVIE COUNTY HEALTH DEPARTMENT,
f{cn a �-p yY� Environmental Health Section,
PROPERTY INFORMATION
,Name:
•
P.O.Box 848
Directions to property:, Mocksville,NC 27028 Subdivision Name:
5 h l CGI Phone#:336-751-8760
C
p t-40 Section: Lot:
G� AUTHORIZATION FOR
G 1 N O / 7 oil WASTEWATER Tax ),1 Ice PIN:#�� - 7 Gli/(y4(
SYSTEM CONSTRUCTIONUy 7 �Cr ` � ! ��
AUTHORIZATION NO: 003027 A Road Name: U/a a Jn Q C/ Zip: a t
**NOTE**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.
(In com liance ith Article I I of G.S.Chapter 130A,Wastewater Systems,Section.1900 Sewage Treatment and Disposal Systems)
} _***NOTICE***THIS AUTHORIZATION FOR WASTEWATER CONSTRUCTION
IS VALID FOR A PERIOD OF FIVE YEARS.
ENVIRONMENTAL HEALTH SPECIALIST DATE ISSSSUED�
RESIDENTIAL SPECIFICATION:BUILDING TYPE J ' #BEllROOMS #BATHSCUPANTSARBAGE DISPOSAL:Yes or No
COMMERCIAL SPECIFICATION: FACILITY TYPE #PEOPLE #PEOPLE/SHIFT #SEATS INDUSTRIAL WASTE:Yes or No
Q TYPE WATER SUPPLY DYI N WASTEWATER FLOW(GPD)
LOT SIZE '' 1 a i�NEW SITE REPAIR SITE
SYSTEM SPECIFICATIONS: TANK SIZE 90 GAL. PUMP TANK GAL. TRENCH WIDTH 3 ROCK DEPTH 3 G LINEAR FT. D
OTHER
REQUIRED SITE MODIFICATIONS/CONDITIONS:
IMPROVEMENT PERMIT LAYOUT nr'
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FOR FINAL INSPECTION OF THIS SYSTEM PLEASE CALL BETWEEN 8:30-9:30 A.M.ON THE DAY OF INSTALLATION.TELEPHONE#IS(336)751-8760.
OPERATION PERMITC
SYSTEM INSTALLED BY: MAY,
AUTHORIZATION NO.3V L� OPERATION PERMIT BY: DATE:
**THE ISSUANCE OF THIS OPERATION PERMIT SHALL INDICATE THAT THE SYSTEM DESCRIBED ABOVE HAS BEEN INSTALLED IN COMPLIANCE
WITH ARTICLE 1 I 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.
D=01!02(Revised) C 5-/,� -Lnv 'V9t
k P�rmittee's (' {{ f a `I� ` D`AVIE COUNTY HEALTH DEPARTMENT
Name: -` +�` l� Environmental Health Section PROPERTY INFORMATION
l( q V J /U P.O.Box 848
Directions tto(property: ` { Mocksville,NC 27028 Subdivision Name:
r,-I�1 � e fG1 (_ Phone#:336-751-8760
Section: Lot:
AUTHORIZATION FOR
7 O h
SYSTEM WASTEWATER
CONSTRUCTION
Tax Office PIN:#
AUTHORIZATION NO: 003027 A f y Ro�Name:�'r� �' Jn Zi 70.
r
**NOTE**This Authorization for Wastewater System Construction MUST BE ISSUED by the Davie County Environmental Health Section prior
to issuance of any Building Permits.This Fom-/Authorization Number should be presented to the Davie County Building Inspections
Office when applying for Building Permits.
(In com liance ith Article 11 of G.S.Chapter 130A,Wastewater Systems,Section.1900 Sewage Treatment and Disposal Systems)
***NOTICE***THIS AUTHORIZATION FOR WASTEWATER CONSTRUCTION
IS VALID FOR A PERIOD OF FIVE YEARS.
ENVIRONMENTAL HEALTH SPECIALIST DATE ISSUED
RESIDENTIAL SPECIFICATION:BUILDING TYPE � ' #BEDROOMS #BATHS I)--#OCCUPANTS -�,GARBAGE DISPOSAL:Yes or No
COMMERCIAL SPECIFICATION• FACILITY TYPE #PEOPLE #PEOPLE/SHIFT #SEATS INDUSTRIAL WASTE:Yes or No
LOT SIZE TYPE WATER SUPPLY Ca D$S19N WASTEWATER FLOW(GPD) l G NEW SITE REPAIR SITE l�
DO�cx
SYSTEM SPECIFICATIONS: TANK SIZE GAL. PUMP TANK GAL. TRENCH WIDTH J ROCK DEPTH 3 G LINEAR FT.� `y
OTHER
-- REQUIRED SITE MODIFICATIONS/CONDITIONS:
IMPROVEMENT PERMIT LAYOUT
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FOR FINAL INSPECTION OF THIS SYSTEM PLEASE CALL BETWEEN 8:30-9:30 A.M.ON THE DAY OF INSTALLATION.TELEPHONE#IS(336)751-8760.
OPERATION PERMIT
SYSTEM INSTALLED BY: kidtf ; , Iw
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AUTHORIZATION NO.3 on OPERATION PERMIT BY: , _ DATE: Q
**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.
XHD OW2(Revised) `,C * �5y Z()v ` �C O
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A` 'Perm tees 1 e^ DAVIE COUNTY HEALTH DEPARTMENT
.1 t1 a Environmental Health Section PROPERTY INFORMATION
Ll �,�� h/�r P.O. Box 848
Directions to property: Mocksville,NC 27028 Subdivision Name:
Phone#:336-751-8760 Section: Lot:
AUTHORIZATION FOR
7 vi WASTEWATERTax O ice PIN:#5 FfU- y �l!�i' 4/
SYSTEM CONSTRUCTION t ` x
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003027 t f 6+ luhol/, 0 ,'
AUTHORIZATION NO: A Road Name: Zip: t
**NOTE**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.
(In compliancewith Article 11 of G.S.Chapter 130A.Wastewater Systems,Section.1900 Sewage Treatment and Disposal Systems)
l-,r
***NOTICE***THIS AUTHORIZATION FOR WASTEWATER CONSTRUCTION
IS VALID FOR A PERIOD OF FIVE YEARS.
ENVIRONMENTAL HEALTH SPECIALIST DATE ISSUED
RESIDENTIAL SPECIFICATION:BUILDING TYPE #BEDROOMS #BATHS �#OCCUPANTS GARBAGE DISPOSAL:Yes or No
COMMERCIAL SPECIFICATION: FACILITY TYPE #PEOPLE #PEOPLE/SHIFT #SEATS INDUSTRIAL WASTE:Yes or No
`y f LOT_SIZE ' TYPE WATER SUPPLY l DESI,G/N WASTEWATER FLOW(GPD) G NEW SITE REPAIR SITE
0 C k ps/,%
SYSTEM SPECIFICATIONS: TANK SIZE 1 GG GAL. PUMP TANK GAL. TRENCH WIDTH 3 ROCK DEPTH G LINEAR FT. ?Q
OTHER
-. REQUIRED SITE MODIFICATIONS/CONDITIONS:
IMPROVEMENT PERMIT LAYOUT,
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FOR FINAL INSPECTION OF THIS SYSTEM PLEASE CALL BETWEEN 8:30-9:30 A.M.ON THE DAY OF INSTALLATION.TELEPHONE#IS(336)751-8760.
OPERATION PERMIT j t ,�
SYSTEM INSTALLED BY: k 1 ( f` 1 P
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w
AUTHORIZATION NO.3 OPERATION PERMIT BY: r 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.
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DAVIE COUNTY HEALTH DEPARTMENT
Environmental Health Section
Soil/Site Evaluation
APPLICANT INFORMATION PROPERTY INFORMATION
ZA
Water Supply: On-Site Well Community Public
Evaluation By: Auger Boring Pit- Cut
FACTORS 1 2 3 4 5 6 7
Landscape position
Slope %
HORIZON I DEPTH
Texture groupG
Consistence
Structure 5
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 RAT/E�/peF73:
SITE CLASSIFICATION: EVALUATION BY:
LONG-TERM ACCEPTANCE RATE: 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
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
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
Nato
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 05105(Revised)
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DAVIE COUNTY ENVIRONMENTAL HEALTH SECTION
APPLICATION FOR IMPROVEMENT PERMIT(REPAIR) DVriW3
NAME �y7rP,�'1PfQ. I��1ry PHONE NUMBER-�5 6--79—/Qb0 x/(p NIG
ADDRESS q`[ / 01Cjc.j'1 �►., x SUBDIVISION NAME
`` LOT#
DIRECTIONS TO SITE Zr 2-• 5
E<_cty ms 's
DATE SYSTEM INSTALLED NAME SYSTEM INSTALLED UNDER
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,3 �
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-
TYPE FACILITY NUMBER BEDROOMS of li4gd e-S NUMBER PEOPLE SERVED 3
TYPE WATER SUPPLY �u-h—� SPECIFY PROBLEM OCCURRING I XJArArLq
6�- 4 cc M. r S6k" Cay. w
DATE REQUESTED ('3' ID INFORMATION TAKEN BY
This is to certify that the information provided is correct to the best of my knowledge,and that I understand I am responsible for all charges incurred from this application.
SIGNATURE OF OWNER OR AUTHORIZED AGENT
Rev.1/93
Ti�� f I N = 51 b 0 - 3-y r qq3 G
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Davie County Health Department
Environmental Health Section Payment Due Now.
PO Box 848 (210 Hospital Street) Please Return a Copy of the Bill with Payment.
Mocksville, NC 27028 Your Check is Your Receipt.
(336)753-6780
Larry & Brenda Belton Account No: 990005488
947 Calahaln Rd Invoice No: 1 7288
Mocksville, NC 27028 Billing Date: 4/19/2010
Sry Date Service Code ID/ATC# Description Sry Cost Quan. Extended Cost
4/19/2010 SEPTIC-REP-R 3027A 947 Calahaln Rd-27028 $50.00 1 $50.00
4/20/2010 PAID-CK Check#2109- ($50.00) 1 ($50.00)
Balance Due Now: $0.00