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216 Dixie Way Davie County,NC Tax Parcel Report Jo` Monday, September 26, 2016 X, L73 � 5 �1 5 I) 5 t—f r 5 WARNING: THIS IS NOT A SURVEY f �'' � ParcelInformahon Parcel Number: N600000041 Township: Jerusalem NCPIN Number: 5745837815 Municipality: Account Number: 82524253 Census Tract: 37059-807 Listed Owner 1: FALLER DIXIE MAE TRUSTEE Voting Precinct: JERUSALEM Mailing Address 1: DIXIE MAE FALLER REV TRUST Planning Jurisdiction: Davie County City: MOCKSVILLE Zoning Class: DAVIE COUNTY R-20 State: NC Zoning Overlay: DAVIE COUNTY CZOD Zip Code: 27028-6940 Voluntary Ag.District: No Legal Description: 108.450 HWY 601 Fire Response District: JERUSALEM Assessed Acreage: 108.45 Elementary School Zone: COOLEEMEE Deed Date: 4/2005 Middle School Zone: SOUTH DAVIE Deed Book I Page: 006020912 Soil Types: SeB,PaD,WeC,WeB,PcB2,RnC,PcC2,RnD,ChA Plat Book: 11 Flood Zone: Plat Page: 57 Watershed Overlay: DAVIE COUNTY Building Value: 85570.00 Outbuilding&Extra 0.00 Freatures Value: Land Value: 304310.00 Total Market Value: 389880.00 Total Assessed Value: 269140.00 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 Nr, C or arising out of the use or inability to use the GIS data provided by this website. 1, DAVIE COUNTY ENVIRONMENTAL HEALTH P.O.Box 848/210 Hospital Street Mocksville,NC 27028 ' (336)753-6780/Fax#(336)753-1680 OPERATION PERMIT Account #: 990005211 Tax PIN,EH#: 5745-83-7815 Billed To: Clayton Homes of Statesville Subdivision"€nfo: :> �&1� Reference Name: Vinnie Nathaniel Location!Addr2ss:,<< 27028 Proposed Facility: Residence .,'i " Properly Size: 100 Acres ATC Number: 5732 **NOTE**The issuance of this Operation Permit shall indicate the system described on the ATC 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. 7— ,% — orQ System Type:S.T.Manufacturer Tank Date Tank Size _�_�d� Pump Tank Size _ h System Installed By:'A E -5 E.H.Speciali : Date: GPS Coordinate: Aoc}. s*vd G � a-0�t � ya ��M44 . 5.l � ��V G 4 o0 love a3 as 3 ' D PC t DCHD 11/06(Revised) DAVIE COUNTY ENVIRONMENTAL HEALTH P.O.Box 848/210 Hospital Street Mocksville,NC 27028 (336)753-6780/Fax#(336)753-1680 AUTHORIZATION FOR WASTEWATER SYSTEM CONSTRUCTION Account #: 990005211 Tax PIN:EH#: 5745-83-7815 Billed To: Clayton Homes of Statesville Subdivisiop,Inalp D!�C/�� Reference Name: Vinnie Nathaniel Jm r' //M LocationiAddress: 7028 Proposed Facility: Residence Property Size: 10qAcres Site Type: DNew ❑Repair ❑Expansion ATC Number: 5732 **NOTE**This Authorization to Construct(ATC)MUST BE ISSUED by the Davie County Environmental Health Section prior to issuance of any building permit(s),(in compliance with Article 11 of G.S.Chapter 130A Wastewater Systems,Section.1900 Sewage Treatment and Disposal Systems). THIS AUTHORIZATION TO . CONSTRUCT IS VALID FOR A PERIOD OF FIVE YEARS. This ATC is subject to revocation if site plans,plat or the intended use change. Residential Specifications: #Bedrooms 3 #Bathrooms a- #People Basement❑ Basement plumbing❑ Non-Residential Specifications: Facility Type #People #Seats Square Footage(or Dimensions of Facility) . Lot SizeO-CX 5 Type of Water Supply: C3eounty/City ❑Well ❑CommunityWell System Specifications: Design Wastewater Flow(GPD)3CQ 0 Tank Size 600 AL.Pump Tank_AGAL. AL. \4 Trench Width- 3*LP 1 Max.Trench Depth, Rock Depth Linear Ft.S3 3 v Site Modifications/Conditions/Other: !.-- stated in 15,E t4OAC 181VIS09(5) acceptSys erns may 5155 i use Contact the Davie County Environmental Health Section for final inspection of this system between 8:30—9:30a.m.on the day of installation. Telephone#(336)751-8760. �(V � J f!`U� Gr� I Environmental Health Specialist Date: _ 3 Ir DCHD 11/06(Revised) J-f W a �l 3 r c O Q to G �y • Davie County Environmental Health P.O.Box 848/210 Hospital Street Mocksville,NC 27028 (336)753-6780/Fax(336)753-1680 IMPROVEMENT PERMIT Account #: 990005211 Tax PIN/EH#: 5745-83-7815 Billed To: Clayton Homes of Statesville Subdivision Info: Address: 2026 North Side Drive Location/Address: Paradox Lane-27028 City: Statesville Property Size: 100 Acres Reference Name: Vinnie Nathaniel Proposed Facility: Residence **NOTE**This Improvement Permit DOES NOT authorize the construction of a wastewater system. An Authorization To Construct a wastewater system must be obtained from this office prior to the construction/installation of a wastewater system or the issuance of a building permit(in compliance with Article 11 of G.S. Chapter 130A,Wastewater Systems). This Improvement Permit is subject to revocation if site plans,plat or the intended use change. Permit Type: C�'New. ❑Repair ❑Expansion Permit Valid for: C'l5 Years ❑N-o--E-x--pi—r' Expiration _ I Residential Specifications: #Bedrooms a #Bathrooms #People-S Basement(] Basement plumbing❑ Non-Residential Specifications: Facility Type #People #Seats ?? Square Footage(or Dimensions of Facility) Design Flow(GPD): J &-o •Type of Water Supply: RC5unty/City ❑Well ❑Community Well Site Modifications/Permit Conditions: As stated in 15A NCAC 18A.19E9(5� eeeepted-Systems r-aay-also be use System T'Ype LTAR I Initial Cc © • 1 Repair cc-c 5 CS �] Site Plan I � l / J Environmental Health Specialist Date a -3 - / ( i.p.11-06 APPLICATI N.FOR SITE EVALUATION/IMPROVEMENT PERMIT & ATC V � Davie County.Environmental Health �� J.1`'} P.O.Box 848/210 Hospital Street t. N 3 2p11 Mocksville,NC 27028 loo}a.t�.c� ,A (336)753-6780/Fax(336)753-1680 App�e(ar: ❑ Site,�luition/Improvement Permit Authorization To Construct(ATC) ❑ Both Type of Application.:XVew System ❑Repair to Existing System ❑Expansion/Modification of Existing System or Facility *�*IMPORTANT****THIS APPLICATION CANNOT BE PROCESSED UNLESS ALL OF THE REQUIRED INFORMATION IS PROVIDED. Refer to the INFORMATION BULLETIN for instructions. APPLICANT INFORMATION Name D Contact Person Address .7 i' Home Phone 70� - 873-25"5 7 City/State/ZIPe a%/ ir/G Business Phone _�70 1�/- IVi. S -S07 Name on Permit/ATC if Different than Above Mailing Address City/State/Zip 49C PROPERTY INFORMATION *Date House/Facility Corners Flagged NOTE: A survey plat or site plan must accompany this application. Included: ❑ Site Plan ❑Plat(to scale) (Permit is valid for 60 months with site plan,no expiration with complete plat.) Owner's Name �/�/ Phone Number 33rd- W 9-9 StS Owner's Address P-14 ndJ o n City/State/ZipMX-Ag L/11/c /t-2_. Z-)OZ8 Property Address AC&q L qn City 0766&Su 14e Lot Size /Uri 4( . Tax PIN# 765-$341J Subdivision Name(if appl'c ble) Sec io Lot# Directions To Site: / ,r/ ,• If the answer to any of the following questions is"Yes",supporting documentation must be attached: Are there any existing wastewater systems on the site? Jle2o Does the site contain jurisdictional wetlands? _Ye�No Are there any easements or right-of-ways on the site? 'Yes Is Is the site subject to approval by another public agency? _Yes o Will wastewater other than domestic sewage be generated? Yes1XNo IF RESIDENCE FILL OUT THE BOX BELOW r#People _ #Bedrooms _ #Bathrooms Z Garden Tub/Whirlpool ❑YesXNo Basement: ❑Yes_�Ko Basement Plumbing: ❑Yes,�Vo IF NON-RESIDENCE FILL OUT THE BOX BELOW Type of Facility/Business Total Square Footage of Building #People # Sinks #Commodes # Showers #Urinals Estimated Water Usage(gallons per day) (Attach documentation of similar facility water consumption) FOODSERVICE ONLY: # Seats Type system requested: gConventional ❑Accepted>novative ❑Alternative ❑Other Water Supply Type County/City Water ❑ New Well ❑Existing Well ❑ Community Well Do you anticipate additions or expansions of the facility this system is intended to serve? ❑ Yes XN"'o If yes,what type? This is to certify that the information provided on this application is true and correct to the best of my knowledge. I understand that any permit(s)or ATC(s)issued hereafter are subject to suspension or revocation if the site is altered,the intended use changes,or if the information submitted in this application is falsified or changed. I hereby grant right of entry to the Authorized Representative of the Davie Co Health Department to conduct necessary inspections to determine compliance with applicable laws and rules. I understand at am responsible for the proper identification and labeling of property lines and corners and locati nd a g sta ng a house/facility location,proposed well location and the location of any other amenities. P perry wne o er legal representative signature Site Revisit Charge Date(s): Client Notification Date: Date 4 EHS: Sign given ❑Yes ❑No Account# Z Revised 11/06 hrvoice# a 1 t0,g1-1)1;4 11577 • Map Frame Page 1 of 1 Davie County, NC - GIS/Mapping System r Click Here To Start Over VQuick Search:(County I❑ or Ot�aner Ni p .t ActiveLayer. 2Use "tap Trps C 4�P ® j PARCELS(Map Tips Available) ; Flddre [3ECKTOWN 1 t r• �ti 4x� 'ti 1 %L 7T==26( It http://maps.co.davie.nc.us/GoMaps/map/mapframe.cfm?CFID=4129&CFTOKEN=616408... 1/13/2011 DAVIE COUNTY HEALTH DEPARTMENT Environmental Health Section Soil/Site Evaluation APPLICANT INFORMATION PROPERTY INFORMATION Account #: 990005211 Tax PIN/EH#: 5745-83-7815 Billed To: Clayton Homes of Statesville Subdivision Info: Reference Name: Vinnie Nathaniel Location/Address: Paradox Lane-27028 Proposed Facility: Residence Property Size: 100 Acres Date Evaluated: Water Supply: On-Site Well Community Public Evaluation By: Auger Boring Pit Cut FACTORS 1 2 3 4 5 6 7 Landscape position L L_� Slope% 3 HORIZON I DEPTH Texture group G C S �- Consistence Structure Y 519k Y l`vS c tr Mineralogy HORIZON H 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 RATE! C)-12') CJ O J-3 7 SITE CLASSIFICATION: / EVALUATION BY:---�(a� � • 0'-)-- `) LONG-TERM ACCEPTANCE RATE: OTHER(S)PRESENT: u•it\N.12 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-Finn 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:I,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) TTAR -T.nna-tP.rm arrPntanrP ratp-nallr1aulft7 T— ^�'^"