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269 Drum LnDavie C�untv, NC Tax Parcel Report Wednesday, October 12, 2016 WAK1V11V1T: 1ri1J 1J 1VV1 A�UKVLY . : ParcelInformation Parcel Number: K700000079 Township: NCPIN Number: 5767645422 Municipality: Account Number: 82522775 Census Tract: Listed Owner 1: KING WILLIAM H SR Voting Precinct: Mailing Address 1: 269 DRUM LANE Planning Jurisdiction: City: MOCKSVILLE Zoning Class: State: NC Zoning Overlay: Zip Code: 27028-7160 Voluntary Ag. District: Legal Description: 3.001AC OFF DRUM LANE Fire Response District: Assessed Acreage: 3.00 Elementary School Zone Deed Date: 5/2004 Middle School Zone: Deed Book / Page: 005520305 Soil Types: Plat Book: Flood Zone: Plat Page: Watershed Overlay: Building Value: Land Value: Total Assessed Value: 9��°'�' Davie County, `'o�,N�j NC 79680.00 Outbuilding & Extra Freatures Value: 19560.00 Total Market Value: Fulton 37059-804 FULTON Davie County DAVIE COUNTY R-A No FORK CORNATZER WILLIAM ELLIS Pc62,PcC2 DAVIE COUNTY 750.00 99990.00 ... ,_� . _ . ,_ .,.... ,-_ ..., . . . _ . ..� y�o AUTxoFu�A'riON No: O 6 Z 3 DAVIE COUNTY HEALTH DEPARTMENT '' , Environmental Health Section PROPERTY INFORMATION Permittee's , P.O. Box 848 Naffie: �/`„�Q�'Y! �� Mocksville, NC 27028 Subdivision Name: ' Phone #: 704-634-8760 ' Directions to property: �.t�:��r� ni .�i;•.•, � Section: Lot: ', AUTHORIZATION FOR �// WASTEWATER Tax Office PIN:#�7� 7- l�7 � -(� `T6�� SYSTEM CONSTRUCTION Road Name: �,�I�'���ij �. i;t. Zip: v� r%o�i c� **NOT`E** This Authorization for Wastewater System Construction MUST BE ISSLTED by the Davie County Environmental Health Section prior 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) ��� ��� ,, /�,� j'r'� �f„ ***NOTICE*** THIS AUTHORIZATION FOR WASTEWATER CONSTRUCTION �'�' %�� �_!, ..,;��:'i�t` ,�--t <``°''1. �r" 7 �• IS VALID FOR A PERIOD OF FIVE YEARS. ENVIRONMENTAL HEAL�'fH SPECIALIST DATE ISSUED ., ; F�, , . ,, ,, , ,, . , , . v �, . . ,. �� . � , . . .. . , . : . , . `"'�eF , . ,. . . ,. � ' � � a: O z._,��.;� ' DAVIE COUNTY HEALTH DEPARTMENT �..-;�- . ;, �-:;�' -� IMPROVEMENT AND OPERATION PERMITS PROPERTY INFORMATION q Permittee's` �—� � -' / Nari9e:' -� � �'<.�"„�i' f,t�ii!�S� ,�"���,�'r� �i Direcdons to property: �' Subdivision Name: Section: Lot: �PERNII'rME� Tax Office PIN:# .� i �f - � '� - � r�� � � Road Name: ��'`7 � �, � �'�.� Zip:/ '; '%l �T. **NOTE** This Improvement Pernrit DOFS NOT authorize the construction or installation of a septic tanlc system or any wastewater system. An AiTTHORIZATION FOR WASTEWATER SYSTEM CONSTRUCITON must be obtained from this Department prior to the construction/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 SITE � ,:',' r",.r,�- y >,;�'; f PLANS OR THE INTENDED USE CHANGE. YOUR WASTEWATER ENVIRONMENTAL HEALTH SpECIALIST DATE ISSUED SYSTEM CONTRACTOR MUST SEE THIS PERMIT BEFORE � INSTALLING THE SYSTEM. RESIDENTIAL SPECIFICATION: BUILDING TYPE �# BEDROOMS �# BATHS �� # OCCUPANTS � GARBAGE DISPOSAL: Yes or No COMMERCIAL SPECIFICATION: FACILTI'Y TYPE # PEOPLE _ # PEOPLFJSHIFT # SEATS INDUSTRIAL WASTE: Yes or No LOT SIZE �+' � TYPE WATER SUPPLY .�;%"!/•� DESIGN WASTEWATER FLOW (GPD) /�l' NEW SITE [/� REPAIR SITE SYSTEM SPECIFICATIONS: TANK SIZE J�� %�GAL. PUMP TANK GAL. TRENCH WIDTH �r • ROCK DEPTH _� LINEAR FT. ��r�) ' OTHER REQUIRED SITE MODIFICATIONS/CONDITIONS: IMPROVEMENT PERMIT LAYOUT d,. ...�—"_""—^--" ,�--�__-----�-----� ��._.�...,�.�....�-.- **CONTACT A REPRESENTATIVE OF THE DAVIE COUNTY HEALTH DEPARTMENT FOR FINAL INSPECTION OF THIS SYSTEM BETWEEN 830 - 9:30 A.M. OR 1:00 - 1:30 P.M. ON Tf� DAY OF INSTALLATION. TELEPHONE # IS (704) 634-8760. I OPERATION PERMTT � ^�... SYSTEM INSTALLED BY: ��� �K�''� `TL�►�1L j�A�TC 4�5 �� AUTHORIZATION NO. 6 6�� OPERATION PERMIT BY: ��'�% DATE: �` � Y� **THE ISSUANCE OF THIS OPERATION PERMIT SHALL INDICATE THAT THE SYSTEM DESCRIBED ABOVE HAS BEEN INSTALLED IN COMPLIANCE WITH ARTICLE 11 OF G.S. CHAP'fER 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 OSN6 (Revised) > , APPLICATION FOR SITE EVALUATION/IMPROVEMENT PERMIT & ATC Davie County Health Department Environmental Health Section P. O. Box 848 ��/����� Mocksville, NC 27028 � (704)634-8760 ****IMPORTANT**** THIS APPLICATION CANNOT BE PROCESSED UNLESS ALL THE REQUIRED INFORMATION IS PROVIDED. 1. Name to be Billed �i �-- ��' '�� �� ��J L. Contact Person � n g�l T ST"o+Jc? MailingAddress L�� � Q� ►�1 A L-A+JL City/state/Zip �' ��- � �►►-�-� , l�i C- 2 7 d Zc'3 Home Phone `1� � n " `3S t3 • �� �5 9�0- 958-�[733 Business Phone 70� '(0 3�l - y 7� S 2. Name on PemudATC if Different than Above Mailing Address City/State/Zip 3. Application For: ❑ Site Evaluation Ud Improvement Permit & ATC ❑ Both / �Jn v3u: 4. System to Serve: ❑ House ❑ Mobile Home ❑ Business ❑ Industry O" Other 1-1 � Q �? 5. If Residence: # People �O # Bedrooms `� # Bathrooms 2 0 Dishwasher ❑ Gazbage Disposal C� Washing Machine ❑ Basement/Plumbing ❑ BasementlNo Plumbing 6. If Business/Other: # Commodes If Foodservice: Specify type # Showers # Seats # People # Sinks # Urinals Estimated Water Usage (gallons per day) # Water Coolers 7. Type of water supply: ❑ County/City G� Well ❑ Community 8. Do you anticipate additions or expansions of the facility this system is intended to serve? ❑ Yes G�No If yes, what type? PROPERTY INFORMATION REQUIRED: *** IMPORTANT *** A PLAT OF THE PROPERTY MUST BE SUBMITTED WITH THIS APPLICATION. Property Dimensions: S �t �- � B�= l� � i a�CYi� Jt� Tax Office PIN: # � % �P � - � - � �% � � Property Address: Road Name � 2-v ✓1� �—�'' N �_ LoT 34.or ,ry�P iL-.-1 City/Zip /1�0 �x.s�� L�� , 1J C- 2702� If in Subdivision provide information, as follows: Name: Section: Lot #: This is to certify that the information provided is correct to the best of my WRITE DIRECTIONS (from Mocksville) TO PROPERTY: 5��� a:�a,c�'�c� 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 b /l1 �1 `,� 2� ���� to conduct all testing procedures Y --,��_ as necessary to determine the site suitability. DATE I Z' Z7 '�7 L SIGNATURE Revised DCHD (06-96) , �= DAVIE COUNTY HEALTH DEPARTMENT Environmental Health Section SECTION LOT Soil/Site Evaluation APPLICANT'S NAME �'l v DATE EVALUATED �� g� PROPOSED FACILITY PROPERTY SIZE _'��9� SUBDIVISION ��,� ROAD NAME �/`u� .C�t-ii,� Water Supply: Evaluation By: FACTORS Slope % � HORIZON I DEPTH Texture group Consistence Structure HORIZON II DEPTH Texture group Consistence Structure HORIZON III DEPTH Texture group Consistence Structure HORIZON IV DEPTH Texture group Consistence On-Site Well Community Auger Boring Pit SOIL WETNESS RESTRICTIVE HORIZON SAPROLITE LONG-TERM ACCEPTANCE RATE 1 /,' SITE CLASSIFICATION: LONG-TERM ACCEPTANCE RATE: � �1 REMARKS: DCHD (O1-90) Public Cut 3 4 5 6 7 r EVALUATION BY: OTHER(S) PRESENT: 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 Wet NS - Non sticky NP - Non plastic FR - Friable FI - Firm VFI - Very firm EFI - Extremely firm SS - Slightly sticky S- Sticky VS - Very Sticky 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 Mineraloev 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 - gaUday/ft2 ■■ ■■ �� ■■ ■■ ■■ ■■ ■�■�■■ ■■�■■■■�■■����■■��■■���■■��■■■■■��■■■�■■ ■■�■�■�����■■■■■�■■■■��■����������■����■ ■����■�����■����■■��■■■■■■■■■■■��■����■ ■■■■�■�■■■�■■■■�■■■�■�■■��■�■■■■ ■��■�■ ■�������■�������\\����■■��■��■���■■�■■�■ ■������������■��■■���■■■■■■�■■�■�■■����■ ■�■■���■■■■■■■■�■��■■■■■�■■���������■■�■ ■■■■■��■■�■■■■■�■■���■■■��■�■■�■■■�����■ ■����■■���������■��■�■���■■�■■■■■■����■■ ■■�■■�■�■■■■■�■■■�■■■■���������■���■■■■■ ■���������■����■��■���■■■■����■■�■���■■ ■��■■■■�■�e������������■■■■■■■■■ ■■■�■■ ■■�■�■��■■��■■■■��■■■■1�����■�����■■■■■■ ■■■■�■��■■�■■■■��■��■��■■��■■�■��■■��■�■ ■��■�■��■��■�■■��■■�■�■■��■■■�■��■■��■�■ ■■�■���■■��■■■■■■■■�■������������■■��■�■ ■�■■■�■����■�■���■�����■��■���i��■■��■�■ ■�■����■���■�■��■■��■�■■■G�■■■��■■■��■�■ ■�■■■■�■■��■�■��■�����■��■■��■�����■■�■ ■■■�■��■■■■■■■�����■■�Gr�������■ ■■■■■■ ■���������■��■■�■■�■��■■�■■�■��■■■�����■ ■■■�■■■■�■■�■���■���%■■��■■�■■�■■��■���■ ■��������������■��I.i�■��■■�■■�■■■�■■■�■I1 ■■■■■■■■■■��■����I■■�■■�■■�■■■■■■�■■�■■1� ■■���■������■��■I�■�����■��■■■■■��■■�■�1 ■■���■■�■■■�■■■I��■��������■��■■�■■��■II■ ■■���■��■■�������■■■■��■■��■■�■■�■��■11I� ■��■�■■�■�����1�■■��■�■■���■�■�■ �:1����II ■��■�■��■■t■■ri■■�■■�■t����������■■��■ri■� ■��■�■��■�■■��■■�■��■��■���■����■■■�■u�■ ■■���■��■��■�■��■■�■■�■■��■��■��■■��t��i■ ■�■■�■�■■�■r�■��■■����■■�■■■�■�■■■�■�i���■ ■�■����■■�■�■■■�■■�■�����■■����■■■�■��■��■ ■�■�■��■���■���■■�■■■����■■����■■��■��■��■ �iiiiii�i�iiiii�iiii:iii�iiiiiii '�iiii�iiiii ■�■��■��■r�■�■�■■������i�■�■■■■■■�■■■!����■ ■■■■■■■�■ri■�■�■■����i���■■■��■■����■■■ �■��■ ■■���■��■�■���■��i■ i�■��■��■■■■��n�■■��■►�■ ■����������■■■■���■�■�����■■�■��■■■�■��■ ■��■�■���1��■�■■�■■�■■■��i7■■■�■��■■���■r��■ ■■■■■■■��1��■����■��■■■�:�II.rJ�����■■��fl■/I■■ ■�■■���■1��■■■■��■��!!,\�i�L�i�■��■■■■ ■III�■■ ■�■■■�■■r�■■■■��■���r�������■■�■�■■�ii�� i■■■ ■■■■�■�■����■��■�■■��r����■���■�■����r■■�■ ■�■�■■■�■■■�■■■■�■����■■■�■■■■■��i�����■ ■���■■■�������■■�■■■■�■■■��■■■■��■i�■�■�■ ■■���■��■■��■�■��■��■��■��■■■■��u■u����■ ■■�■�■���■�������■■■�■■■■�■■������■i��■■■■ ■��■�����■��■�■■�■�����■��■■�����■■u�■�■■ ■■�■■�■�i■�������■��■■■■��■�����■ ��■■�■■ ■�■�■��n■�■■■■�■�����■■�■■■�■■■■►�i��■■■■ ■�■�■�■�t��■■���■■�■■�■��■���■�■■��■►������ ■■■���������■�■■��■■����■��■■■■��►�■►��■�■i ■■■■�■■��■■�■�■■�■■�■�■■��■■���������■��i ■������■�■■�■�������■�■■�����■���■►�������� ■■�■�■��t������■�■■■�■������■■■�■■■�'����■i ■��■�■■■i�■�■�■■��■�■■■■■�■■����■�■�i������i ■■�■■���������■■��■�■�����■■�■■■■ ■i���■i ■��■�■■����■�■��■■��■■■■■■�����■��■■�■■i ■■�■■ ■��■■ ■�■■■ ■■■�■ ■■■�■ ■■■■ ■ ■■■�■ ■�■�■ ■���■ ■�■�■ ■�■�■ ■���■ ■■■■■ ■ ■■ ■��■■ ■■■■■ ■■■■■�■ ■�■■■■■ ■■�■��■ ■��■��■ ■��■��■ ■■����■ ■��■ ■��■ ■■�■ ■��■ ■■■■ ■�■■ ■�■■�■■ ■����■■ ■�■■■�■ ■���■■■ ■■■�■■■ ■�■�■�■ ■■��■�■ ■��■��■ ■■■■��■ ■�■■��■ ■����■■ ■����■■ ■■■■■�■ ■���■■■ ■■■■■�■ ■�����■ ■ � � r : - ---- -- -- � 5 _ `` _ – _ �--�.'"__ T 1 �._.._�_. �� _ .L/�� ' 3't i .2 0 , � � C � L . . . 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