213 Childrens Home RdDavie County, NC
Tax Parcel Report q G3 I
Tuesday, September 27, 2016
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101
Davie County, NC
WARNING: THIS 13 NOT A SURVEY
causes of action due to or arising out of the use or inability to use the GIS data provided by this website.
P atatInfoD atl---�
arcel Ali—
Parcel Number:
B30000003109
Township:
Clarksville
NCPIN Number:
5813875817
Municipality:
Account Number.
29778700
Census Tract:
37059-801
Listed Owner 1:
GOMEZ JOSE DOLORES
Voting Precinct:
CLARKSVILLE
Mailing Address 1:
213 CHILDRENS HOME ROAD
Planning Jurisdiction:
Davie County
City:
MOCKSVILLE
Zoning Class:
DAVIE COUNTY R -A
State:
NC
Zoning Overlay:
Zip Code:
27028-4701
Voluntary Ag. District:
No
Legal Description:
1.978 AC CHILDRENS HOME
Fire Response District:
COURTNEY
Assessed Acreage:
1.74
Elementary School Zone:
WILLIAM R DAVIE
Deed Date:
8/1994
Middle School Zone:
NORTH DAVIE
Deed Book I Page:
001760008
Soil Types:
MnB2
Plat Book:
Flood Zone:
x
Plat Page:
Watershed Overlay:
Building Value:
0.00
Outbuilding & Extra
4940.00
Freatures Value:
Land Value:
20000.00
Total Market Value:
24940.00
Total Assessed Value:
24940.00
101
Davie County, NC
I data is provided as is without warranty or guarantee of any kind 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 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.
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a
DAVIE COUNTY HEALTH DEPARTMENT
IMPROVEMENTS PERMIT AND CERTIFICATE OF COMPLETION
NOTE: Issued in Compliance With Article 11 of G.S. Chapter 130a –
Sanitary Sewage Systems Permit Number
Name _Z�,�21'! ra .��, S�.�iGl. rur� Date S'�y N
r ' ° 7-63.7
Location /�'��
Subdivision Name �gE 3 r�81 % Lot No. Sec or Block No.
Lot Size
House Mobile HomeLk''� Business _Industry
No. Bedrooms + .No. Baths — No. in Family Public Assembly Other ` -
Garbage Disposal YES NO p Specifications for System:
Auto Dish Washer YES NO ❑ (D ,�'�y
Auto Wash Ma.hine YES NO ❑ �</� s ��1 �/ ,,.
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.
114 4o'S
"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
Certificate of Completion A 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 PERMIT
- Davie County Health Department �� _
' Jr Environmental Health Section f
P. O. Box 665 JUP�i
Mocksville, NC 27028 Q jQ�
1. Application/Permit Requested By
Mailing Address _193 d`1PL:sJ-J A Q c-GiM_Q `tel' ()Home Phone q I (J q&,5 `Li7'7U
4-n60-M1'i U -L DL AMA b Business Phone
A
2. Name on Permit if Different than Above
3. Application for:
❑ General Evaluation — (ZSeptic Tank Installation Permit
4. System to Serve: ❑ House (Mobile Home
❑ Business ❑ Industry ❑ Other
5. If house, mobile home: Subdivision
No. of People ,
No. of Bedrooms �S
No. of Bathrooms CJS V_XX l..fl.7
Dwelling Dimensions l JLbl D .a!_ (J -k
6. If business, industry, place of public assembly, other: Specify type
No. of People Served
No. of Commodes
No. of Lavatories
No. of Showers
7. Type of water supply: ❑ Public
No. of Sinks
No. of Urinals
No. of Water Coolers
Water sage Figures
Private
8. Property Dimensions a anus Sewage Disposal Contractor
9. Do you anticipate additions/expansion of the facility this sytem is intended to serve?
If yes, what type?
❑ Place of Public Assembly
❑ Unknown
Section Lot #
❑ Yes
❑ Basement/Plumbing
Vsement/No Plumbing
ing Machine
Dishwasher
Garbage Disposal
❑ 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:
"4ff4 .0 ),/, , �VA t --V? /" 0 ?,%-
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.
'D '3)"� - l�t�
DATE SIGNATURE
CONSENT FOR SITE EVALUATION TO BE DONE ON ABOVE DESCRIBED PROPERTY
MUST CHECK ONE: ❑ 1. 1 OWN the property. 192. I 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 thp Davie C unty Iealth 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 (1193)
y
DAVIE COUNTY HEALTH DEPARTMENT
Environmental Health Section
Soil/Site Evaluation
NAME DATE EVALUATED
ADDRESS PROPERTY SIZE
PROPOSED FACIILTY LOCATION OF SITE i
Water Supply: On -Site Well Community Public
Evaluation By: Auger Boring N Pit Cut
FACTORS 1
2
3
4
Landscape position
-1
L
s—
Slope %
,�.
HORIZON I DEPTH
Texture group
-.L
Consistence
Structure
Mineralogy
HORIZON II DEPTH
Texture group
Consistence
�-
Structure 767
L7b,r
/
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: 7
REMARKS:
DCHD(01-901
EVALUATED BY: 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 slay 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
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