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300 Cornatzer RdDavie County, NC Tax Parcel Report 3144 729 i j: r 7307 Tuesday, September 27, 2016 7656 101 Davie County, NC WARNING: THIS IS 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. r Parcel Number: J60000005406 Township: Shady Grove NCPIN Number: 5758717307 Municipality: Account Number: 8301589 Census Tract: 37059-804 Listed Owner 1: RABON RONALD G Voting Precinct: WEST SHADY GROVE Mailing Address 1: 300 CORNATZER ROAD Planning Jurisdiction: Davie County City: MOCKSVILLE Zoning Class: DAVIE COUNTY R-20 State: NC Zoning Overlay: Zip Code: 27028 Voluntary Ag. District No Legal Description: 5.00 AC CORNATZER RD Fire Response District: CORNATZER - DULIN Assessed Acreage: 4.78 Elementary School Zone: CORNATZER Deed Date: 1112012 Middle School Zone: WILLIAM ELLIS Deed Book f Page: 009080138 Soil Types: GnB2,GnC2,WATER Plat Book: Flood Zone: AE,X Plat Page: Watershed Overlay:. - Building Value: 278040.00 Outbuilding & Extra 0.00 Freatures Value: Land Value: 68840.00 Total Market Value: 346880.00 Total Assessed Value: 346880.00 101 Davie County, NC All 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. Account #: Billed To: Reference Name: Proposed Facility DAVIE COUNTY HEALTH DEPARTMENT Environmental Health Section P. O. Boa 848/210 Hospital Street Mocksville, NC 27028 (336)751-8760 990003469 Tax PIN/EH #: 5758-71-7307 Dwight & Luann Prater Subdivision Info: 300 &Ndv I�"I Location/Address: Cornatzer Rd -27028 Residence Property Size: See map ATC Number: 3164 AUTHORIZATION FOR WASTEWATER SYSTEM CONSTRUCTION **NOTE** This Authorization for Wastewater System Construction MUST BE ISSUED by the Davie County Environmental Health Section prior to issuance of any building permit(s). This Form/Authorization Number should be presented to the Davie County Building Inspections Office when applying for building permit(s) (in compliance with Article 11 of G.S. Chapter 130A, Wastewater Systems, Section .1900 Sewage Treatment and Disposal Systems). THIS AUTHORIZATION FOR WASTE R TION S V FOR A PERIOD OF FIVE YEARS. Environmental Health Specialist's Signature Date: Ila LOJ CERTIFICATE OF COMPLETION **NOTE** The issuance of this Certificate of Completion shall indicate the system described on Improvement/Operation Permit 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. 3Lt �� s Q 1 Septic System Installed By: T e(2— Environmental Health Specialist's Signature:. Date: 1 2 LQ�c DCHD 05/99 (Revised) DAVIE COUNTY HEALTH DEPARTMENT Environmental Health Section ` P. O. Boz 848/210 Hospital Street Mocksville, NC 27028 (336)751-8760 IMPROVEMENT/OPERATION PERMIT Account #: 990003469 Tax PIN/EH #: 5758-71-7307 Billed To: Dwight & Luann Prater Subdivision Info: Reference Name: Location/Address: Cornatzer Rd -27028 Proposed Facility Residence Property Size: See map ATC Number: 3164 **NOTE** This Improvement/Operation Permit DOES NOT authorize the construction of a septic tank system or any wastewater system. An AUTHORIZATION FOR WASTEWATER SYSTEM CONSTRUCTION must be obtained from this Department prior to the construction/installation of a system or the issuance of a building permit (in compliance with Article 11 of G.S. Chapter 130A, Wastewater Systems, Section .1900 Sewage .Treatment and Disposal Systems). THIS PERMIT IS SUBJECT TO REVOCATION IF SITE PLANS OR THE INTENDED USE CHANGE. YOUR WASTEWATER SYSTEM CONTRACTOR MUST SEE THIS PERMIT BEFORE INSTALLING SYSTEM. Residential Specification: Building Type Hounc #People 2 #Bedrooms 3 #Baths •� Dishwasher: C" Garbage Disposal: Washing Machine: 0"" Basement w/Plumbing: d Basement/No Plumbing: ❑ Commercial Specification: Facility Type #People #People/Shift #Seats Industrial Waste: ❑ Lot Size �'�:�Ae�+-S Type Water Supply C001� Design Wastewater Flow (GPD) 3h0 Site: New [�' Repair ❑ System Specifications: Tank Size loco GAL. Pump Tank GAL. Trench Width :31; Rock Depth 12 Linear Ft. 4C& Other: '�15TR► L30i'��1X Required Site Modifications/Conditions: VA ---a 15� OFF �p� V,-- Q 1 (:� OeF PaOP L•,Z . IMPROVEMENT/OPi RATION PERMIT LAYOUT - APPROVED EFFLUENT FILTER RISER(S) IF 6 " BELOW FINISHED GRADE. * **NOTICE: Contact a representative of the Davie County Health Department for final inspection of this system between 8:30 a.m. to 9:30 a.m. or 1:00 p.m. to 1:30 p.m. on the day of installation. Telephone # is (336)751-8760.**** Environmental Health DCHD 05/99 (Revised) ialist's Signature: 134..M�a.►5' I 33' Iss 133' x3i"„ xt2" �R)"P Date: //.3/, Q: 7987 (4.88A) 7656 s. s J60000005406 i (4.79A)...� 73071 l\ 3110 tb r 4570 0 25� 5309/ �\ ^N (1.58A) 89- 1993 9 1993 3942 4825 M s n ��. 5706 r 2: APP TI SITE EVALUATION/IAIPROVUENT PERMIT & ATC JAN 2 2b�� D vie County Health Department vironmentaiHealth Section ) ENVIRON&ENTP� i00 P.O. ox 848/210 Hospital Street ocksville, NC 27028 pAV;_�Oi1NjY ` 5 (336) 751-8760 ***IMPORTANT*** THIS APPLICATION CANNOT BE PROCESSED UNLESS ALL THE REQUIRED INFORMATION IS PROVIDED. Refer to the INFORMATION BULLETIN for instructions. 1. N=o to be Billed L/QN//GAT 4 L-JAVN i��%�2 Contact Person a Mailing Address 6,14 D-misee)k/ c -r Home Phone 33G -q4 -s-0/13¢ City/State/ZIP Z-90SU/1-46M LY - Z7 -6Z3 Business Phone 3. Name on Permit/ATC if Different than Above Mailing Address 7 City/State/Zip rL /L 3. Application For:Site Evaluation Improvement Permit/ATC E3Both 4. System to Service: House ❑ Mobile Home /❑ Business ❑ Industry ❑ Other 5. ,Type system requested: 14 Conventional ❑ conventional modified ❑ innovative 6. If Residence: # People 2 # Bedrooms 3 # Bathrooms 3yz- 1ADishwashor Garbage Disposal Washing Machine IkBasement/Plumbing ❑Basement/No Plumbing 7. If Business/Industry /other: verify type # People # Sinks # Commodes # Showers # Urinals # Water Coolers IF FOODSERVICE: # Seats Estimated Water Usage (gallons per day) s. Type of water supply: ll County/City ❑ Well ❑ Community 9. Do you anticipate additions or cxpausions of tlic facility this system is intended to serve? ❑ Yes )1 No If yes, what type? *IMPORTANT*** CLIENTS AtUST COAIPLL•TE TILE REQUIRED PROPERTY INI,ORMATION REQUESTED BELOW. Eitlur a PLAT or SITE PLAN AIUST 6E• SUBAfITTED by the client ivith THIS APPLICATION. Properly Dimensions: J`tJ d /62)(269 )( 696 WRITE DIRECTIONS (froju Alocksvilic) to PROPERTY: Tax Office PIN: iE 27513-7/- 730 7 64E -r6 ('(jP-NA•?zE2 Property Address: Road Name _260 CO+QJtloff-zzaz OD City/Zip MOCLIS 1 I LLE. NC Azar.- 6V piety , Z70Z8 If in a Subdivision provide information, as follows: Name: Section: Block: Lot: Date ]ionic corners flagged: S This is to certify that the information provided is correct to the best of my luiotivledge. I understaud that any permit(s) issued hereafter arc 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 ain responsible for all charges hicarred frog this application. I, hereby, give consent to the Autliorized Representative of the Dav' County IIe. lil) Dcpartmen to enter upon above described property located in Davie County and o}} ned byti/lGf{T LUffNN297k to conduct all testfag procedures as necessary to determine tic site suilabilit DATES Q D .ZOOS SIGNATURECT �7IZ TRIS AREA MAYBE USED FOR DRAWING YOUR SITE PLAN (Include all of the following: Existing and proposed property lines and dimensions, structures, setbacks, and septic locations). Sign given �c \C-� Account No.-� " Revised DCIiD (05/03 Invoice Na �I U,d Account #: 990001296 Billed To: Michael Myers Reference Name: Proposed Facility: Residence DAVIE COUNTY HEALTH DEPARTMENT Environmental Health Section P. O. Boz 848/210 Hospital Street Mocksville, NC 27028 (336)751-8760 IMPROVEMENT/OPERATION PERMIT Tax PIN/EH M 5758-71-7307 Subdivision Info: Location/Address: 260 Cornatzer Rd -27028 Property Size: see map **NO4lTi9* l q6prXkent/Operation Permit DOES NOT authorize the construction of a septic tank system or any wastewater system. An AUTHORIZATION FOR WASTEWATER SYSTEM CONSTRUCTION must be obtained from this Department prior to the construction/installation of a system or the issuance of a building permit (in compliance with Article 11 of G.S. Chapter 130A, Wastewater Systems, Section .1900 Sewage Treatment and Disposal Systems). THIS PERMIT IS SUBJECT TO REVOCATION IF SITE PLANS OR THE INTENDED USE CHANGE. YOUR WASTEWATER SYSTEM CONTRACTOR MUST SEE THIS PERMIT BEFORE INSTALLING SYSTEM. Residential Specification: Building Type H �t #People -S #Bedrooms #Baths 2 , S Dishwasher: fid" Garbage Disposal: 7*' Washing Machine: Basement w/Plumbing: 011, Basement/No Plumbing: 13 Commercial Specification: Facility Type /� _ #People #People/Shift 4SSeats Industrial Waste: � Lot Size .1-1 Q�� ype Water Supply l-�J�Design Wastewater Flow (GPD) q?c) Site: New 12/ Repair t�,. l System Specifications: Tank Size IDD�GAL. Pump Tank GAL. Trench Width Rock Depth �2 �Linear Ft. S� Other:t !71 sT21 bl) Tl 0�?C tJSTAIL UnkS 9' Required Site Modifications/Conditions: � is` F,(:(7 �c, Zt�`r C:`k.G Id,J Pump � IMPROVEMENT/OPER ION PE IT LAYOUT - APP OV ENT FILTER RISERS) IF 6 "BELOW FINISHED GRA E. **** OTiCE: Contact a representativ of the Davie County alth Department for final inspection of this system between 8. 0 a.m. to r 1:00 p.m. o 1:30 p.mon the Py of installat' n. Telephone # is (336)751-8760.**** r'17- .1 q- Zr P Environmental Health Specialist's Signa e: Date: DCHD 05/99 Cjp(wzea `7 Account #: 990001296 Billed To: Michael Myers Reference Name: ATC Number: 3164 DAVIE COUNTY HEALTH DEPARTMENT Environmental Health Section P. O. Boa 848/210 Hospital Street Mocksville, NC 27028 (336)751-8760 Tax PIN/EH #: 5758-71-7307 Subdivision Info: Location/Address: 260 Cornatzer Rd -27028 AUTHORIZATION FOR WASTEWATER SYSTEM CONSTRUCTION **NOTE** This Authorization for Wastewater System Construction MUST BE ISSUED by the Davie County Environmental Health Section prior to issuance of any building permit(s). This Form/Authorization Number should be presented to the Davie County Building Inspections Office when applying for building permit(s) (in compliance with Article 11 of G.S. Chapter 130A, Wastewater Systems, Section .1909 Sewage Treatment and Disposal Systems). THIS AUTHORIZATION FOR WASTEW NS CIS V ID FOR A PERIOD OFF FIVE YEARS. Environmental Health Specialist's Signa Date: 0 CERTIFICATE OF COMPLETION **NOTE** The issuance of this Certificate of Completion shall indicate the system described on Improvement/Operation Permit 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. Septic System Installed By: Environmental Health Specialist's Signature: DCHD 05/99 (Revised) Date: -' n �AON FOR SITE EVALUATION/IMPROVEMENT PERMIT & ATC Davie County Health Department Env/tdnntenfb/ Heys/th S&Non MAY 3 0' P.O. Box 868/210 Hospital Street — Mocksville, HC 27028 (336)751-8760 *.*It.�TANT**-*—THIS APPLICATION CANNOT BB PW=SSBD UNLESS ALL THE REQUIRED I INFORMATION IS /PROVIDED. /Refer to the INFORMATION BULLETIN for instructions. 1. Naso to be gilled / 11'6hCt' d W /ie— /i� (,/��,�- �L Contact Parson M,W 4 c /' � ef Nailing Address Po '&X doq-0 - soca Poon 97 City/state/LIP A&f + ce- A rC J'1DOG -. O clo wMiness Phone 170p -Z 4 PZ Mass 2. Mas on Perait/ATC if Different than Above 1114 I Nailing Address City/state/Zip 3. Application For: VSite Evaluation 0 Improvement Permit/ATC •Both e. systan to service: X House ❑ Mobile Homo 0 Business 0 Industry 0 Other s. If Residence: i People r e Bedrooms f BathroomsJoe d " Dishwasher )t garbage Disposal washing machine )(baseaent/Plumbing O Dasestent/mo Plashing 6. If sueiness/Industry/Other: specify type • People • Sinks i Coasades i showers i Urinals # water Coolers IT I=SERVICE: # Seats Estimated Hater Usage (gallone per day) 7. Type of Mater supply: County/City 0 Well 0 Community 0. Do yon anticipate additions or expansions of the facility this system Is intended to serve? 0 Yes )9(No If yes, what type? ***IMPORTANT*** CLIENTS MUST COMPLETETHE REQUIRED PROPERTY INFORMATION REQUESTED BELOW. Either a PLAT or SITE PLAN MUST BESUBMITIED by the client with THIS APPLICATION. Property Dimensions: - Qa 1�l Tax Office PIN: # Property Address: Road Named 6o 6 /'nwc-u.- City/up /1ock�r%//t d70�i If in a Subdivision provide Information, as follows: Name: Section: Block: Lot: WRITE DIRECTIONS (from Mocksvilie) to PROPERTY: ZqC5 40 Date Property Fla ed: 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 we change, or if the information submitted in this application Is falsified or changed I, also, understand that I ant 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 A;ehAd /✓style m y c.,j to conduct all testing procedures as necessary to determine the site suitability. DATE�/ 2f L SIGNATURE THIS AREA MAY BE USED FOR DRAWING YOUR SITE PLAN (Include all ofthe following: Existing and proposed property lines and dimensions, structures, setbacks, and septic locations). 5,� A-Pr4c W Revised DCHD (07/99) Date(s): I Client Notification Date: ERS: Account No. 9 Invoice No. 0-0 �� 11 / • J►II M .II 11. r,• .; Mu lcn • ' " ' ~ Environmental Health Section • Soil/Site Evaluation APPLICANT INFORMATION PROPERTY INFORMATION Account #: 990001296 Tax PIN/EH #: 5758-71-7307 Billed To: Michael Myers Subdivision Info: Texture group ra�r.MM: Reference Name: Location/Address: 260 Cornatzer Rd -270 Proposed Facility: Residence ` Property Size: see,map Date Evaluated: 99Z, 11 Water Supply: On -Site Well Community Public Consistence W.AWTAW�.N / Evaluation By: Auger Boring f Pit Cut Texture group •-®®--�® 'SITE CLASSIFICATION: EVALUATION BY.,A%7r =1 Xyl r LONG-TERM ACCEPTANCE RATE: C)• 3S OTHER(S) PRESENT: REMARKS: LEGEND Landscape Position j 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 f 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 DCHD 05/99 (Revised) Landscape position 12511.1.1 HORIZON I DEPTH r��ril►��-®�® Texture • ,Consistence Mineralogy HORIZON Texture group ra�r.MM: ����� �•-^rConsistence MOM MKIWIld, Mineralogy HORIZON III DEPTH Consistence W.AWTAW�.N Mineralogy Texture group •-®®--�® role 'SITE CLASSIFICATION: EVALUATION BY.,A%7r =1 Xyl r LONG-TERM ACCEPTANCE RATE: C)• 3S OTHER(S) PRESENT: REMARKS: LEGEND Landscape Position j 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 f 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. 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