572 Danner Rd Davie County,NC Tax Parcel Report '3 Monday, September 26, 2016
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WARNING: THIS IS NOT A SURVEY
Parcel Information
Parcel Number: F40000000701 Township: Clarksville
NCPIN Number: 5820783846 Municipality:
Account Number: 8301338 Census Tract: 37059-801
Listed Owner 1: HARDIN JEREMY STEVEN Voting Precinct: CLARKSVILLE
Mailing Address 1: 572 DANNER ROAD Planning Jurisdiction: Davie County
City: MOCKSVILLE Zoning Class: DAVIE COUNTY R-A
State: NC Zoning Overlay:
Zip Code: 27028 Voluntary Ag.District: No
Legal Description: 1.000 AC DANNER RD Fire Response District: WILLIAM R.DAVIE
Assessed Acreage: 1.00 Elementary School Zone: WILLIAM R DAVIE
Deed Date: 8/2012 Middle School Zone: NORTH DAVIE
Deed Book/Page: 009000992 Soil Types: PcC2,Ce62
Plat Book: Flood Zone:
Plat Page: Watershed Overlay: DAVIE COUNTY
Building Value: 65070.00 Outbuilding&Extra 0.00
Freatures Value:
Land Value: 16420.00 Total Market Value: 81490.00
Total Assessed Value: 81490.00
I v 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
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rap UN{'y 1. or arising out of the use or Inability to use the GIS data provided by this website.
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DAVIE COUNTY HEALTH DEPARTMENT
Environmental Health Section
P.O.Boz 848/210 Hospital Street
Mocksville,NC 27028
(336)751-8760
990002118 - - = - 5820-79-6287
;,:;;r, Tr_.. Joyce Boger -ion 1^fo• 51Z
..
Danner Road-27028
r Irnn.r. Residence n", 1 acre
3052
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 WASTEWA NSTRUCTION IS VALID FOR A PERIOD OF FIVE YEARS.
Environmental Health Specialist's Signature: Date:
PetmWdAm .3 f39
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.
A6
8 C�
Septic System Installed By: , /
Environmental Health Specialist's Signature:: Date:
P gn — .–
DCHD 05199(Revised)
• DAVIE COUNTY HEALTH DEPARTMENT
Environmental Health Section C �"
P.O.Boz 848/210 Hospital Street
Mocksville,NC 27028
(336)751-8760
IMPROVEMENT/OPERATION PERMIT
Account #: 990002118 Tax PiWEH#: 5820-79-6287
Billed To: Joyce Boger Subdivision info:
Reference Name: Location/Address: Danner Road-27028
Proposed Facility: Residence Property Size: 1 acre
ATC Number: 3052
**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 #People #Bedrooms_ #Baths
Dishwasher:X- Garbage Disposal: ❑ Washing Machine: Basement w/Plumbing: ❑ Basement/No Plumbing: ❑
Commercial Specification: Facility Type #People #People/Shift #Seats Industrial Waste: ❑
Lot Size Type Water Supply Design Wastewater Flow(GPD) Site: NewZ'Repair❑
System Specifications: Tank Size/
26 GAL. Pump Tank GAL. Trench Width?,C' Rock Depth o,/j Linear Ft.c2U
Other:
Required Site Modifications/Conditions:
IMPROVEMENT/OPERATION 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 Specialist's Signature: Date:
DCHD 05/99(Revised)
• • 1
APPLICATION FOR SITE EVALUATION/IMPROVEMENT PERMIT&AFCENVIRONMENTAL
Davie County Health Department
EnvironmentalHealthSection 2 2P.O. Box 848/210 Hospital Street
Mocksville, NC 27028(336)751-8760 HEALTH
DAVIE COUNTY
***IMPORTANT*** THIS APPLICATION CANNOT BE PROCESSED UNLESS ALL THE REQUIRED
INFORMATION IS PROVIDED. Refer to the INFORMATION BULLETIN for instructions.
1. Name to be Billed- .17 aytolntact Person 11// /
Mailing Address Home Phone 414 %(p (�
i
City/State/ZIP Ali 4Business Phone
2. Name on Permit/ATC if Different than Above
Mailing Address City/State/Zip
3. Application For: Site Evaluation "Uprovement Permit/ATC ❑ Both
4. system to Service: ❑ House V?-.M'obile Home 0, Business ❑ Industry ❑ Other
S. If Residence: # People f # Bedrooms - # Bathrooms
❑ Dishwasher ❑ Garbage Disposal Washing Machine ❑ Basement/Plumbing ❑ Basement/No Plumbing
6. If Business/Industry/Other: Specify type # People # Sinks
# Commodes # Showers # Urinals # Water Coolers
IF FOODSERVICE: # Seats Estimated Water Usage (gallons per day)
7. Type of water supply: ❑ County/City ell ❑ Community
8. Do you anticipate additions or expansions of the facility this system is intended to serve? ❑Yes XNo
If yes,what type?
'IMPORTANT***CLIENTS MUST COMPLETE THE REQUIRED PROPERTY INFORMATION REQUESTED
BELOW. Either a PLAT or SITE PLAN MUST BE SUBMITTED by the client with THIS APPLICATION.
S
Property Dimensions: WRITE DIRECTIONS(from Mocksville)to PROPERTY:
Q
Tax Office PIN: # u- A/.00 �O aa"=x- SI`d v
Property Address: Road Name
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City/zip !n/7hS 1Z/ I—t—to D e r U41
If in a Subdivision provide information,as follows: `/ N�
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Name: G�� C.—d4
Section: Block: Lot: Date Property Flagged:
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. 1,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
to conduct all testing procedures as necessary to determine the site suitability.
DATE JAA l/ SIGNATURE
THIS AREA MAY BE USED FOR DRAWING YOUR SITE PL Include all of the following: Existing and proposed
property lines and dimensions, structures, setbacks, and septic locations).
Site Revisit Charge
r ,
1. Date(s):
1
Client Notification Date:
EHS:
Account No. I I
Revised DCHD(07/99) Invoice No. }
0
h
v
323
422
F400000007
• N
(36.26A)
0 6284
(275) r
DANNER RD -
363
396
507
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• , DAVIE COUNTY HEALTH DEPARTMENT
• - - Environmental Health Section
Soil/Site Evaluation
'APPLICANT INFORMATION PROPERTY INFORMATION
Account #: 990002118 Tax PIN/EH#: 5820-79-6287
Billed To: Joyce Boger Subdivision Info:
Reference Name: Location/Address: Danner Road-27028
Proposed Facility: Residence Property Size: 1 acre Date Evaluated:
Water Supply: On-Site Well t/ Community Public
Evaluation By: Auger Boring Pit Cut
FACTORS 1 2 3 4 5 6 7
Landscape position 4-1
Sloe%
HORIZON I DEPTH
Texture group
Consistence
Structure
Mineralogy
HORIZON II DEPTH G"
Texture group
Consistence �-
Structure 777
Mineralogy AI/
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: 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
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)
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