175 Doby Rd Davie County,NC Tax Parcel Report Monday, September 26, 2016
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WARNING: THIS IS NOT A SURVEY
.Parcel Information
Parcel Number: H10000000302 Township: Calahaln
NCPIN Number: 4799657513 Municipality:
Account Number: 82518802 Census Tract: 37059-801
Listed Owner 1: CAMPBELL MICHAEL TODD Voting Precinct: NORTH CALAHALN
Mailing Address 1: 175 DOBY ROAD Planning Jurisdiction: Davie County
City: HARMONY Zoning Class: DAVIE COUNTY R-A
State: NC Zoning Overlay:
Zip Code: 28634-8911 Voluntary Ag.District: No
Legal:Description: 2.787AC TRACT 1 DOBY RD Fire Response District: COUNTY LINE
Assessed Acreage: 2.30 Elementary School Zone: WILLIAM R DAVIE
Deed Date: 7/2009 Middle School Zone: NORTH DAVIE
Deed Book/Page: 008020086 Soil Types: PcC2,CeB2
Plat Book: 0010 Flood Zone:
Plat Page: 101 Watershed Overlay: DAVIE COUNTY
Building Value: 89330.00 Outbuilding&Extra 4650.00
Freatures Value:
Land Value: 25460.00 Total Market Value: 119440.00
Total Assessed Value: 119440.00
l v All data Is provided as is without warranty or guarantee of any kind either expressed or implied Including but not limited to the
9 ine F 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
r'p DN'�4 NC or arising out of the use or inability to use the GIS data provided by this website.
Permittee' s{ DAVIE COUNTY HEALTH DEPARTMENT
Name: t!�t� �L►� O U M 'F 21:S\C%,k_F,nvironmental Health Secti PROPERTY INFORMATION
/ } U` lir P.O.Box 848 �I
Directions to property: {.� y �� rr�/ Mocksville,NC 27028 'r Sub 'vision Name:
Phone#:336-751-8760
ect'on: Lot:
,� / AUTHORIZATION FOR
WASTEWATER x Office PIN:#
SYSTEM CONSTRUCTIO
/ 5.. ! a� `� � t) 3
AUTHORIZATION NO: 002970 A Road Name:: Zip: ,l ��►
**NOTE**This Authorization for Wastewater System Construction MUST BE ISSUED by the Davie County Environmental Health Section prior
to issuance of any Building Permits.This Form/Authorization Number should be presented to the Davie County Building Inspections
Office when applying for Building Permits.
(In compliance with Article 1 I of G.S.Chapter 130A,Wastewater Systems,Section.1900 Sewage Treatment and Disposal Systems)
***NOTICE***THIS AUTHORIZATION FOR WASTEWATER CONSTRUCTION
IS VALID FOR A PERIOD OF FIVE YEARS.
ENVIRONMENTAL HEALTH SPECIALIST DATE ISSUED pp f
5MU J
RESIDENTIAL SPECIFICATION:BUILDING TYPE l#BEDROOMS #BATHS #OCCUPANTS GARBAGE DISPOSAL:Yes or No
COMMERCIAL SPECIFICATION: FACILITY TYPE / #PEOPLE #PEOPLE/SHIFT ( F
#SEATS INDUSTRIAL WASTE:Yes or No
a. l'3 ccLd r`7 t U X�0N
1-1U
LOT SIZE TYPE WATER SUPPLY '`�` DESIGN WASTEWATER FLOW(GPD) NEW SITE REPAIR SITE /
SYSTEM SPECIFICATIONS: TANK SIZE J 64' GAL. PUMP TANK GAL. TRENCH WIDTH 3b ROCK DEPTH 0 LINEAR FT.
M stated in 15A NCAC 164.19&9(5)
OTHER zct:'IgV4 .rsy3tams may also by LISM'
REQUIRED SITE MODIFICATIONS/CONDITIONS: '
IMPROVEMENT PERMIT LAYOU Ll
Apa W
W �
I \ 1
31 — K
o
3;•J
I �
1
- -
FOR FINAL INSPECTION OF THIS SYSTEM PLEASE CALL BETWEEN 8:30-9:30 A.M.ON THE DAY OF INSTALLATION.TELEPHONE#IS(336)751-8760. C
OPERATION PERMIT V.,K 5 R SYSTEM INSTALLED BY:
A.f c, 3
AUTHORIZATION NO._�_ PERATION PERMIT BY: tzw IAfel DATE:
**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 02102(Revised)
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PeItte . DAVIE COUNTY HEALTH DEPARTME T
' N Te' ty� ��'' `�`` �, Environmental Health Sect]''-; �` {
' I I PROPERTY INFORMATION
P.O. Box 848 t ��
(Directions to property: %j �� /f_•-' �7/ Mocksville,NC 27028 f Subdivision Name:
Phone#:336-751-8760 1
r ; AUTHORIZATION FOR ect'bn: Lot:
i i' r,r ' "1 WASTEWATER f % �"° 7 �' a �.
r' r , r 4_.. . x Office PIN:# _ -__75" 3
SYSTEM CONSTRUCTIO
AUTHORIZATION NO: 002978 A Road Name / `c- zip s Ct
**NOTE**This Authorization for Wastewater System Construction MUST BE ISSAD by the Davie County Environmental Health Section prior
to issuance of any Building Permits.This Form/Authorization Number&uld be presented to the Davie County Building Inspections
Office when applying for Building Permits.
(In compliance with Article 11 of G.S.Chapter 130A,Wastewater Systems,Section':1900 Sewage Treatment and Disposal Systems)
***NOTICE***THIS AUTHORIZATION FOR WASTEWATER CONSTRUCTION
IS VALID FOR A PERIOD OF FIVE YEARS.
ENVIRONMENTAL HEALTH SPECIALIST DATE ISSUED'
RESIDENTIAL SPECIFICATION:BUILDING TYPE 5F ,#BEDROOMS #BATHS #OCCUPANTS GARBAGE DISPOSAL:Yes or No
COMMERCIAL SPECIFICATION: FACILITY TYPE #PEOPLE #PEOPLE/SHIFT #SEATS INDUSTRIAL WASTE:Yes or No
ff
LOT SIZE TYPE WATER SUPPLY /{�-t' DESIGN WASTEWATER FLOW(GPD) NEW SITE REPkR SITE 1/(fir
SYSTEM SPECIFICATIONS: TANK SIZE (�GG GAL. PUMP TANK GAL. TRENCH WIDTH 311 ROCK DEPTH LINEAR FT.
OTHER
c ,
- i
REQUIRED SITE MODIFICATIONS/CONDITIONS:
IMPROVEMENT PERMIT LAYOU ,�L!�
71
ell
�r1P ` n
w ,
a _ ` L.,
31-' ' K
40/i G G CUA'
FOR FINAL INSPECTION OF THIS SYSTEM PLEASE CALL BETWEEN 8:30-9:30 A.M.ON THE DAY OF INSTALLATION.TELEPHONE#IS(336)751-8760.
s
OPERATION PERMIT
t. to K 16()05 - SYSTEM INSTALLED BY:
.... 2
LV
Af
Lb
QI
(e,�01s '=
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AUTHORIZATION NO. ? r 7 PERATION PERMIT BY: v // DATE:
**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 02/02(Revised)
DAVIE COUNTY HEALTH DEPARTMENT
Environmental Health Section
Soil/Site Evaluation
APPLICANT INFORMATION PROPERTY INFORMATION
rr•
6
7
Water Supply: On-Site Well Community Public
Evaluation By: Auger Boring Pit Cut
FACTORS 1 2 3 4 5 6 7
Landscape position
Sloe %
HORIZON I DEPTH
Texture groupG
Consistence r
Structure r 4'
Mineralogy
HORIZON II 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
SITE CLASSIFICATION: J EVALUATION BY:
LONG-TERM ACCEPTANCE RATE: 3�- 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
A!Is2ist
VFR-Very friable FR-Friable FI-Firm 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
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
lYQtes
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 05105(Revised)
Davie County Health Dep envuL 1 5
zoos
� { ' Environmental Health S cti
4 P.O. Box 848 ENVIRONM TAL HEA
` OAV(ECOUNTY
O210 Hospital Street
rj ' Courier#: 09.40.06
Mocksville,NC 27028
St
Phone:(336)-751-8760 Fax:(336)-751.8786
ON-SITE WASTEWATER CERTIFICATION FOR DWELLING
(Check One)(] a lacement Remodeling Reconnection
1 ,
Name t/9 G ,•�� one Number &7_- Z.54-] (Home) ;
Mailing Address: ZD2(„ �a�a' S%�r �s oe- 7b4' g7 - LLL
fp (Work)
Detailed Directions To Site: !J O slsvl-
�
!-G .v o b — Pro toe r ,v.
Property Address: 1-715- n G g63q
Please Fill In The Following Information About The EXISTING Facility: -a
Name System Installed Under: Q m\ a n3 •, �A ���e�� Type Of Facility: 51 Y% U WL At
Date System Installed(Month/Date/Year): r610 -$7 Number Of Bedrooms: Number Of People:
Is The Facility Currently Vacant? Yes No If Yes,For How Long?
Any Known Problems? Yes e If Yes,Explain:
Please Fill In The Following Information About The NEW Facility:
Type Of Facility: F Er Q M ' Pr Number Of Bedrooms:_ Number of People
Requested By: Date Requested: 7 I S OS
ignat e)
/ For Environmental Health Office Use Only
Approved ✓ DiLsapproved ` 1 ^ p
Comments: `L%�J m• ! / /6 D�
Environmental Health Specialist •0017 —Date:
*The signing of this form by the Environmental Health Staff is in no way intended,nor should be taken as a guarantee
(extended or limited)that the on-site wastewater system will function properly for any given period of time.
Payment: Cash Check Money Order # Amount:$ Date:
Paid By: Received By:
Account#: Invoice#:
oun Health Department
010 � P
E vir nmental Health Section
�
lot P.O. Box 848ry
L 5
210 Hospital Street _ <_
Courier # : 09-40-06 °
Mocksville, NC 27028 .__ `
Phone: (336)-753-6780 Fax:(336) -753-1680
ON-SITE WASTEWATER CERTIFICATION FOR DWELLING
(Check One) Replacement Remodeling Reconnection
Name: i-j{'�E F,-.X>) AI Jb qPA S_612(5' Phone Number _7c5 ) '" -7 +t �� (Home)
Mailing Address: I Vs4,Dk1&) Ui`l (e !Zb ql— 616:5 (Work)
Detailed Directions To Site: �1 �� �"� - -��-� �-i ti' y i�•i
S �cYsC� l�e
.Property Address: , 5 S. �'y/
Please Fill In The Following In1114)Al
mation About The EXISTING Facility:
Name System Installed Under: T eOf Facility:
YP h'
Date System Installed(Month/Date/Year): Number Of Bedrooms: Number Of People:
Is The Facility Currently Vacant? Yes No If Yes,For How Long?
Any Known Problems? Yes No If Yes,Explain:
Please Fill In The Following Information About The NEW Facility:
Type Of Facility: Number Of Bedrooms: Number of People
.Pool Size: f!C ' f Garage Size: Other:
Requested By: .�°� <y� Date Requested: /'-�o `"J�
(Signature)
For Environmental Health Office Use Only
App" Disapproved
Disapproved
Comments:
Environmental Health Specialist Date:
*The signing of this form by the Environmental Health S e ff is in no way intended,nor should betaken as a guarantee
(extended or limited)that the on-site wastewater system will function properly for any given period of time.
Payment: Cash (Check) Money Order # Amount:$ 100,00 Date:
n_:a n 0 h! Received By: �' C