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1901 Cornatzer Rd (2)Davie C�unty, NC Tax Parcel Report Tuesday, October 11, 2016 201 �3�.,< <� , � � i E" II il !i �� � �. s.��_ a�i. ,........�.,i ' �'.. Ci�l� . , 1 3� ..... .� 1 � _..�,.� ; . , .' ..........�_ ; _. .......-...._....._ � �- mmm ...... �� � �� � � ::i �- — ___ ��� 1."���i � ., � Y �. �i."�i J =� � /. .li?t� � -.. � .:� .: f 1�,� � i, i ���-'� I .r �€ Y��� s� >19� � 75�N y rg � � ` '~^� 109 _.. � � ......-. __ i WARNING: T'IIIS IS NOT A SURV�Y _ __...__ Parcel Information Parcel Number: G700000039 Township: Shady Grove NCPIN Number: 5769598367 Municipality: Account Number: 34932000 Census Tract: 37059-803 Listed Owner 1: HENDRIX GRAHAM Voting Precinct: WEST SHADY GROVE Mailing Address 1: 1901 CORNATZER ROAD Planning Jurisdiction: Davie County City: MOCKSVILLE Zoning Class: DAVIE COUNTY R-A,R-20 State: NC Zoning Overlay: Zip Code: 27028-7143 Voluntary Ag. District: No Legal Description: LOT 1 HENDRIX S/D Fire Response District: CORNATZER - DULIN Assessed Acreage: 2.88 Elementary School Zone: CORNATZER Deed Date: 5/1966 Middle School Zone: WILLIAM ELLIS Deed Book I Page: 000760056 Soil Types: WeB,Gn62,Pc62,RnD Plat Book: 10 Flood Zone: Plat Page: 251 Watershed Overlay: DAVIE COUNTY Building Value: 164750.00 Outbuilding 8� Extra 810.00 Freatures Value: Land Value: 47250.00 Total Market Value: 212810.00 Total Assessed Value: 212810.00 °�;'°'�' Davie County, �o�,x�� NC : .. ; _. , ._ _ - .:, . : , , i F..r,i.. . o , � � . .. . _ ,. ,.oiZ�,. .. , ,. ,. . . -_+ , � .. . . � . . � . . . . , . - � �- , . , r _.1:..�..� -.. „ . „�,...� .,... _ .. ..�:. ......c,..,,,,., .. �-.. �� ,,.�.�',. .�.-. �:�. �'.�... �Q._.. , AUTHORIZATION NO: O 6 2 g DAVIE COUNTY HEALTH DEPARTMENT `�� '� `� Environmental Heatth Section PROPERTY INFORMATION Permittee's , �f� P.O. Box 848 Name: !���� ,�l��/;I�! Mocksville, NC 27028 Subdivision Name: � � " � Phone #: 704-634-8760 Directions to property: ;y:���� ,���. %�>•; Section: Lot: AUTHORIZATION FOR r/ �!' / SYSTEM CO STRUCTION Tax Office PIN:# �r/ �i' ��� - 0�+U � RoadName: ZI��G ���• Zip: ��O **NOTE** This Authorization for Wastewater System Construction MUST BE ISSLTED by the Davie County Environmental Health Section priar to issuance of any Building Pernuts. This Form/Authorization Number should be presented to the Davie County Building Inspections � Office when applying for Building Pernuts. ' (In compliance with Article 11 of G.S. Chapter 130A, Wastewater Systems, Section .1900 Sewage Treatment and Disposal Systems) ,�`� � -r, ,, , �,.- ***NOTICE*** THIS AUTHORIZATION FOR WASTEWATER CONSTRUCTION G�% .�� �: i' �: ��'� � Y; �,r;,� %- /�`- `:;,1�' IS VALID FOR A PERIOD OF FIVE YEARS. � ENVIRO MENTN AL HE�SPECIALIST DATE ISSUED . •. �F.. . . . . . . ... � � � . � � � . ' . . � . . : . � . _.: , . � ,..: .r-- .,---i, , � . .,, . . _.. ._ y , , , � � - � .. . . . : .. . . :.., . --... ; -. .. . . .. . . ,.. ,_ � ... . -. .., .:._. . . . .. . �.. .� ...... ,.., .,-... �,���' �r: .. . . _ . .. . ...... .. ... .. . ... �. . . -. . - , . �y,�„'l���, % `�� ,, ,. , DAVIE COUNTY HEALTH DEPARTMENT ��� a b '�-�`�� "' IMPROVEMENT AND OPERATION PERMITS PROPERTY INFORMATION � ;� ' Pe`ri�ittee' � / � ,� / Nam�; � ��� � ;"�;i�� •!'[;fl� /1�G✓/"i;y Subdivision Name: � � - f Direcdon's to property: Section: Lot: � �r � IlVIPROVEMENT // �r � �, i� PERNIIT Tax Office PIN:#� `! G� �` `f ;� �� t-; ti� �r`=�- .,.- �rr! Road Name: ��l r 1 2ip: u !��;'� **NOTE** This Improvement Pemut DOFS NOT authorize the construction or installation of a sepdc tank system or any wastewater system. An AUTHORIZATION FOR WASTEWATER SYSTEM CONSTRUCTION must be obtained from this Department prior to the consiruction/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) ..� �. ***NOTICE*** THIS PERMIT IS SUBJECT TO REVOCATION IF S1TE '�" ,". ,�',:: ' PLANS OR Tf� INT'ENDED USE CHANGE. YOUR WASTEWATER ENVIRONMENTAL HEALTH SPECIALIST DATE ISSUED SYSTEM CONTRACTOR MUST SEE TfII.S PERMIT BEFORE INSTALLING THE SYSTEM. RFSIDENTIAL SPECIFICATION: BUILDING TYPE �# BEDROOMS �T # BATHS �� # OCCUPANTS � GARBAGE DISPOSAL: Yes or No COM ERCIAL SPECIFICATION: FACILITY TYPE # PEOPLE # PEOPLFISHIF'I' # SEATS INDUSTRIAL WASTE: Yes or No L SIZE� TYPE WATER SUPPLY l� DESIGN WASTEWATER FLOW (GPD) -.��d NEW SITE � REPAIR SITE �� � %�1� �Oc.r S7t�5TEM SPECIFICATIONS: TANK SIZE ��o GAL. PUMP TANK GAL. TRENCH WIDTH �..�� ROCK DEPTH��"t�2 LINEAR Ff. �—`�'�''! ,.t ` . OTF�R -- C-'�,"'-ay'�� \ . �. � **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 SYSTEM INSTA 'F'u,� �, � �� � ° u-�� � ;D Y: D �i.9� 1�-c� F �'R N lld S�. �ep�Q`J a i��.�c — - l5 -�( AUTHORIZATION NO. OPERATION PERMIT BY: Cik�� _ DATE:� 1� . **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) C���� . �� Environmental Health Section D I � ('� P. O. Box 848 �,�` +� L�� J Mocksville, NC 27028 �OV 2 �!J� j ., j Z �,� ��J (704) 634-8760 � a � ��' �i ****IMPORTANT**** THIS APPLICATION CANNOT BE PROC SSED UNLESS ��' ALL THE REQUIRED INFORMATION IS PROVIDED. C✓l r t 1'a"'^ i-� o{ 1. Name to be Billed v_ j"Gt h �t ��7 . C7 � X Contact Person �''�A �'�- �'�X Mailing Address � 9Q 1 C �''n °�� Z � '' '� G1 • Home Phone / � �� � 3 � / � City/State/Zip �b �`� SV � �1 �/" C. 2 7 0 Z� Business Phone << f/ � 2. Name on PermidATC if Different than Above l7'i' � �•�. �� [� e-'24�'//r �' I APPLICATION FOR SITE EVALUATION/IMPROVEMENT PERMIT & ATC ' Davie County Health Department ( � � (� � n /� � L5 L5 V Mailing Address 3. Application For: 4. System to Serve: 5. If Residence: O�Dishwasher 6. If Business/Other: # Commodes If Foodservice: -------- � Site Evaluation City/State/Zip L�d Improvement Permit & ATC ❑ House �Mobile Home ❑ Business ❑ Industry ❑ Other # People � ❑ Gazbage Disposal Specify type _ _ # Showers # Seats a :. # Bedrooms 3 # Bathrooms Z- C�Washing Machine ❑ Basement/Plumbing ❑ Basement/No Plumbing # People # Sinks # Urinals Estimated Water Usage (gallons per day) # Water Coolers 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 Q� No If yes, what type? PROPERTY INFORMATION REQUIRED: *** IMPORTANT *** A PLAT OF THE PROPERTY MUST BE SUBMITTED WITH THIS APPLICATION. Property Dimensions: �X 2 Cc. (' /' eJ � WRITE DIRECTIONS (from � ' ? Mocksville) TO PROPERTY: , Tax Office PIN: # �7 �� - s 9 _ � J d 7 j / � ! 7- / � l ���,�i�a� d _G., Property Address: Road Name u�ol �. ! r� �! � / ^/ � T �•� le�f �nr' City/Zip �n ��'1v;%!� /VC 27�7ZCp � /� �J � I .O/'�l �i�LL� � a!- If in Subdivision provide information, as follows: 1 / � � /QO/ ^/ � !F, � a r < (�o � Name: � if, �o u Section: Lot #: � 1 1 This is to certify that the information provided is correct to the best of my knowledge. I understand that any permit(s) issued hereafter are 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 �i� �..�..1-� ��-�c�-.�_ to conduct all testing procedures as necessary to determine the site suitability. DATE � � — � � ` �� SIGNATURE '�?`%/1% Revised DCHD (06-96) �� � � / � . y�Lq.y �� �1'� t : ; � � �/+, � � �e= � O� � � � �; y 1�� �4t - 7 � . r'f �� � � 1 � SF,�F � qs�� 3 [ , s tiy cb,J� ._,.��,tt4Rb � !rj t � 1- ;:� r' 't , � ~ ,,n '� � r _ g � � d t / r� �i��.� � � �;�..� t .:.�i . � t f 4'� � `' � �,! :..y � �r .�l �_I a"G �.�:. �. tu��'!T"T �?�p' � �F ta � i� . '� � .. � �':�. 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TANCE RATEI .L/ I . SITE CLASSIFICATION: ,: EVALUATED BY: LDNG-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-Silt.Y �;lay loam SIL-Silty loam CL-Clay loam SCL-Sandy clay loam SC-Sandy clay SIC-Silty clay C-Clay CONSISTENCE Moist VFR- V�:-y friable FR-Friable FI-Firrn 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-Sin�le grain M-Massive CR-Crumb GR-Granular ABK-MQular blocky SBK-Subangular blocky PL-Platy PR-Prismatic Mineralaicy 1:1, 2:1, Mixed Notes liori2on depth - In inches Depth of fill - In inches Restrictive horizon - Thickness and inches from land surface Saprolite - S(suitable), U(unsuitable) Soil w etness - Inches from land surface to free wate�' 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(01-901 ■■���■��■�������■���������■■�����������■ ■���■�■����■�t�■ ■s ■�■■ ■�����������_��������■N�������■���n��■ ■������������■�������■�s■ ■����������� ■��■��������������■ ■������������■������������������ ■■■���■■�����■■��■��■�■�������������■��■ ������������■������■■ ■�■■���������■����■���■�■�����■���■��■���_�_��■■■����������������■ ■��■��■■■■�■����■■�������■■■���������■����■���■����■�■���■■������■ ■���■■����■������■���������������■�����■���■�������■■�����������■■ ...........................................�........�............. .......................................... ........ ............. .................................................... ............. ■�����■��■���������������������� N��������������� ��■�■������■�■ ■���■�����■������■�������������■��������������������■�■����■�■��� ■■���■���������■■�����■�■■����■�■■■����������/���■� �����������■■ ■����������■��������������� ■���������■ ■���■�■ ■�■ ���� �■��■■�■ ■��������■■■���������■�������������■���������� ����■ H���������■ ■����■■��■�■�■����������������������������������■ ��� ■■■��� ■■ ■■��■���■���■■���■���■���■�■�����������■ ��� ■ _■���■�����n�i�■ ■��■��������■■■�■■��■��■�����������������������������■�����������■ ■����■■������������■������������ ■���■�■���■��■��■�������■��■�■�■■ ■�■■■■�■■���������■����������■��■■�����N�G�i����■������■��■■��� ■���■��������■���������������■��������■■���Ni����■�����N�������� ■■■����������■��■■■■�������■�����■■■���■����■�■ ■ ����■�����■��■�� ■■��■■�■������\■���■������■���■��■.■��N������■�■■ ��■���■..■�■��� ■��������������■������■������■�►`:7�� ■ ������ ��■u����■■■ ■ ���■■ ■���■����������■���■■���5■■■■��11���...�......n...■.�.....�..�.. � ■■���������■■■�����������������■■■���■���������U��� ■������� �� ■����■�A��■■■■������■���������� ■����Nv ���N�u���������■��■� ■������■��■��������■����■■��■■����■��N���� u���■����■■���\�� ■■■����������������■�N������������M�������■� ���■ ������■��� ■��■�■��������������■�n��■���■���■�■��N■��■�■ ��� ��� ■����� ................................................. ....C......�� ::::::C:::::::::::::::C:::::C::::C:::::::'::::::C ��..�.........0 .........................................�....... .:C:::�::::::: ................................�.��...................._........ ■�N���■����������■■�������■���� ■��wN������ ��N���� ■������■ ■■■ v������H�h������������������f/�■��N��� �M�h C ��■��■■ ■�����������������■■��■�■�����������r���■������ ■ ����������� ���������������������������iiiiu � ■ � \��� ■ ■ ����������■ .................C....z'.�....:::■:.�:���CC� �.. _.... ■�����������■■����������n������ ■���i�■ � n■� ■ ��ii■����� ���������������������������������� �� �N� ����■� . ����� ���� ■ ■ �� ��■��■ ■���������N���■������vll����■��■����� ■ ��� ■��■�■� ■���������������■�■■����1/������������� ■N��� ■������� ■����■������N����������11��■�■������ �� ��■����� ■�■■�����■��������■=����r���■����������_ ■ �� �N�� ■■ �����������un���� ���■L�� .: ■��u ■� ■■�■���■ :::::::�::::::::::::::��::u:::' :CC=C::::�� ........■.......■■■...■■■.■■■■■■ ...■..�.�..■. ............�:u::'.::5�:::=::: .. . ..:: :.:.::: ........._.. ■����■��� �������Hu���u���Y� �� h� �����■� ■����������������u���■.■�����n�■ N �■ ■���■��� ■���������������������■��� a��� ■ ■ N�■���� ■�����\������N��������������■�� ■ �� ■ �u��u� ■�����■�������N���������■����■ ■ ■����■���������n���������� � uN�����■���N� ■����v� ���� ..._... 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