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760 Duke Whitaker RdDavie County, NC Tax Parcel Report cD 0— Thursday, September 29, 2016 775 784 766 129 -122 ,L 1C/y OJT .1 51 -760 1 701 109+0 it 5 758 720 r 712 l�J�� �•• 752 � 704 [Oil All data Is provided as is without warranty or guarantee of any Idnd either expressed or Implied Including but not limited to the Davie County, Impliedwamntlas of merchantability or fitness for a particular use. All users of Davie County's GIS website shall hold harmless the N`' County of Davie, North Carolina, Its agents, consultants, contractors or employees from any and all claims or causes of action due to 1. or arising out of the use or Inability to use the GIS data provided by this website. WARNING: THIS IS NOT A SURVEY Parcel Information Parcel Number E200000047 Township: Clarksville NCPIN Number. 5801945563 Municipality: Account Number: 82530962 Census Tract: 37059-801 Listed Owner 1: GROCE MONICA P Voting Precinct: CLARKSVILLE Mailing Address 1: 760 DUKE WHITAKER ROAD Planning Jurisdiction: Davie County City: MOCKSVILLE Zoning Class: DAVIE COUNTY R -A State: NC Zoning Overlay: Zip Code: 27028-0000 Voluntary Ag. District: No Legal Description: 1.972 AC DUKE WHITAKER RD Fire Response District: SHEFFIELD - CALAHALN Assessed Acreage: 2.02 Elementary School Zone: WILLIAM R DAVIE Deed Date: 7/2009 Middle School Zone: NORTH DAME Deed Book / Page: 008000740 Soil Types: MnC2,MnB2,ChA Plat Book: Flood Zone: Plat Page: Watershed Overlay: DAVIE COUNTY Building Value: 134820.00 Outbuilding 8r Extra Freatures Value: 0.00 Land Value: 22540.00 Total Market Value: 157360.00 Total Assessed Value: 157360.00 [Oil All data Is provided as is without warranty or guarantee of any Idnd either expressed or Implied Including but not limited to the Davie County, Impliedwamntlas of merchantability or fitness for a particular use. All users of Davie County's GIS website shall hold harmless the N`' County of Davie, North Carolina, Its agents, consultants, contractors or employees from any and all claims or causes of action due to 1. or arising out of the use or Inability to use the GIS data provided by this website. : - = e .yr„•i �,�, 1 r.y, '::.i n:.,,.t•• '.':.-w^"y-.I.:.�e r ,. - %-�n^�.-r.. Y'f�>..-.._ .,, Pennittee's f % . DAVIE COUNTY HEALTH DEPARTMENT ey /711 C) S Name: r'l. `AGI tf'- l ` - Environmental Health Section PROPERTY INFORMATION r-, r t " P.O. Box 848;' Directions to property: �J . t /` + �' �;' rp ocksville, NC 27028 Subdivision Name: Phone #: 336-751-8760 Section: Lot: AUTHORIZATION. FOR WASTEWATER Tax Office PIN:# SYSTEM CONSTRUCTION AUTHORIZATION NO: 45- A _ /7&�N met K„'" p **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 l~orm/Authorization Number should be presented to the Davie County Building Inspections Office when applying for Building Permits: (In compliance with Article I 1 of G.S. Chapter 130A; Wastewater Systems, Section .1900 Sewage Treatment and Disposal Systems) ***NOTICE*** THIS AUTHORIZATION FOR VALID FOR A PERIOD WASTEWATER CONSTRUCTION OF.FIVE YEARS. , ENVIRONMENTAL HEAL H SPECIALIST. DATE ISSUED RESIDENTIAL SPECIFICATION: BUILDING "TYPE, # BEDROOMS # BATHS Q # OCCUPANTS GARBAGE DISPOSAL: Yes or No COMMERCIAL SPECIFICATION: FACILITY TYPE/ # PEOPLE # PEOPLE/SHIFT # SEATS INDUSTRIAL WASTE: Yes orNo LOT SIZE TYPE WATER SUPPLY C DESIGN WASTEWATER FLOW (GPD) NEW SITE REPAIR SITE SYSTEM SPECIFICATIONS: TANK SIZE GAL. PUMP TANK GAL. 'TRENCH WIDTH--J t7' ROCK DEPTH�� (r LINEAR FT./06 OTHER /f TCS PC' Z tJ' rL� REQUIRED SITE MODIFICATIONS/CONDITIONS: **CONTACT A REPRESENTATIVE OF THE DAVIE COUNTY HEALTH DEPARTMENT FOR FINAL INSPECTION OF THIS SYSTEM BETWEEN, 8:30 - 9:30 A.M. OR 1:00 .1:30 P.M. ON THE DAY OF INSTALLATION. TELEPHONE # IS (336)751-8760. DAVIE COUNTY HEALTH DEPARTMENT Environmental Health Section PO Box 848/210 Hospital Street Mocksville, NC 27028 Phone: (336)751-8760 ON-SITE WASTEWATER CERTIFICATION FOR DWELLING ' (Check One) REPLACEMENT ❑ REMODELING ❑ RECONNECTION ❑ Name: ~�cj c. Zit Phone Number: _L(Home) Mailing Address: -� ; o �, ��_ r r '7 f.l 1��f< �i.6 low ' �O �s (Work) FLe P f Do71oS Detailed Directions To Site: Property Please Fill In The Following Information About The Existing Dwelling. Name System Installed Under: L- )4. L_ L-,& °,.� Type Of Dwelling: S Cj Date System Installed(Month/Day/Year): C� �' Number Of Bedrooms: � Number Of People: Is The Dwelling Currently Vacant? Yes G-' No ❑ If Yes, For How Long? Any Known Problems? Yes ❑ No V,-- If Yes, Explain: Please Fill In The Following Information About The New Dwelling. Type Of Dwelling: Number Of Bedrooms: L Number Of People. C/ Requested By: Date Requested: (Signature) For Environmental Health Office Use Only Approved ❑ Disapproved ❑ Comments: � A f4 i:. j`�( i' T (; %..� , a /'�✓�y �:� ,�. �1 Environmental Health .y '"The signing of this form by the Environmental Health Staff is in no way intended, nor should be taken as a euarantee(extended or limited) that the on-site wastewater system will function properly for any given period of time. V Payment: Cash B' Check ❑ Money Order ❑ # t $ U Date: Paid By: �7 a S Received By: r� L � q Account #: -3'45-7 Invoice #:-4-1 7 � I DAVIE COUNTY HEALTH DEPARTMENT IMPROVEMENT PERMIT and OPERATION PERMIT ;'A IMPROVEMENT PERMIT **NOTE** This improvement permit DOES NOT authorize the construction or installation 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) NAME PROPERTY ADDRESS h'W k(" 71011 . / lI' ZI � r�D� /`'/` C_ DATE LOCATION SUBDIVISION NAME LOT NUMBER SEC./BLOCK NUMBER RESIDENTAL SPECIFICATION: BUILDING TYPE eV t # BEDROOMS # BATHS _a7-# OCCVANTS GARBAGE DISPOSAL: Ye COMMERCIAL SPECIFICATION: FACILITY TYPE # PEOPLE # PEOPLE/SHIFT # SEATS IN�DUSSTRI�AL WASTE: Yes/No LOT SIZE TYPE WATER SUPPLY DESIGN WASTEWATER FLOW (GPD) %� NEW SITE �'' REPAIR SITE SYSTEM SPECIFICATIONS: TANK SIZE %1'� GAL. ,PUMP TRMI GAL. TRENCH WIDTH! ROCK DEPTH LINEAR FT.� OTHER REQUIRED SITE MODIFICATIONS/CONDITIONS: ***THIS PERMIT IS SUBJECT TO REVOCATION IF SITE PLANS OR THE INTENDED USE CHANGE. YOUR WASTERWATER SYSTEM CONTRACTOR MUST SEE THIS PERMIT BEFORE INSTALLING THE SYSTEM. ti. IMPROVEMENT PERMIT BY/ **CONTACT A REPRESENTATIVE OF THE DAVIE COUNTY HEALTH DEPARTMENT FOR FINAL INSPECTION OF THIS SYSTEM BETWEEN 8:30-9:30 A.M. OR 1:00-1:30 P.M. ON THE DAY OF INSTALLATION. TELEPHONE # IS (704) 634-8760. i OPERATION PERMIT SYSTEM INSTALLED BY A ►J cel:: 1�.� Q Gv�91 t12 rbT �"„sem Q u AUTHORIZATION NO. (q 1 G b OPERATION PERMIT BY �^-►`$ ”' DATE0-2:2ZU **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 10/95 APPLICATION FOR SITE EVALUATION/IMPROVEMt Davie County Health Department Environmental Health Section 1996 P. O. Box 665 FEB ' 6 ,) Mocksville, NC 27028 1. Application/Permit Requested By G'AeDL /91 G ...�:-Al jHome Phone �•• : . �O� .�� j Mailing Address I iocksy i l l e- .A)O— a 7pa ? Business Phone:% -'103&- 2. Name on Permit if Different than Above e 3. Application for: a General Evaluation ZSeptic Tank Installation Permit 4. System to Serve: ❑ House EY obile Home ❑ Place of Public Assembly ❑ Business ❑ Industry ❑ Other ❑ Unknown 5. If house, mobile home: Subdivision Section Lot # ❑ Basement/Plumbing No. of People ❑ Basement/No Plumbing No. of Bedrooms 3 No. of Bathrooms Dwelling Dimensions /-%z X �� ---- ---- 6. If business, industry, place of public assembly, other: Specify type '.� No. of People Served No of Commodes No. of Sinks No. of Urinals No. of Lavatories No. of Water Coolers 1 No. of Showers Water Usage Figures 7. Type of water supply: public ❑ Private ❑ Community 8. Property Dimensions jf'�PLI tfn Cjosed Sewage Disposal Contractor RAndLl' m i e- 9. 9. Do you anticipate additions/expansion of the facility this sytem is intended to serve? ❑ Yes S -No If yes, what type? 5"Washing Machine ET -Dishwasher ❑ Garbage Disposal 'NOTE: Improvements Permits shall be valid from date issued. Improvements Permits are subject to revocation, if site plans or the intended use change. Effective October 1, 1989. Directions to Property: loD i/I/ wI Pops R 44 -- Tax Office PIN: # A7 ODA06O PROPERTY ADDRESS, as.follows: Road Name: pu,41. bi.I bi %t19 k'Pf 1 city: mocksu; 11�. lN( SUBMIT A PLAT WITH THIS APPLICATION. Revisions effective October 1, 1995. This is to certify that the information provided is correct to the best of my knowledge, and I understand I am responsible for all charges incurredfro this application. Z& & DATE SIGNATURE CONSENT FOR SITE EVALUATION TO BE DONE ON ABOVE DESCRIBED PROPERTY MUST CHECK ONE: �. 1 OWN the property. ❑ 2. 1 DO NOT OWN the property. If you checked Box #2, the rest of this form MUST be completed by the owner or a person authorized by the owner: 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 to conduct all testing procedures as necessary to determine said site's suitability for a ground absorption sewage treatment and disposal system. DATE SIGNATURE DCHD (1/93) 311' •••I,C:RAY C AT ES certify that on JUNE 2 8 , 19 94 • I surveyed the property shown on this plat; s thdt the property lines and location of all structures are accurately shown hereon; that no structure located on this property encroaches on any adjacent street or property; and that no structure on adjacent property encroaches on the premises z surveyed." a 77 ro MVRR Y,. `\ to OGS' y{ P 1 ,r �0 Z 4v, Q 0• � % =y f V pc -J ti w C i9 �V6 C11� 4. 766 Al • S by d.m.d.17) , r • . , •rly,� MQ� ,��•'. :. ter rh:.. i(. )V IJ'S ` V �• J t axle O� 4, Q found O 4W %44; . f� O p QQ•. �r PARCEL 15.01 rco _ O' JIMMY GRAY KEATON .uw" o QJ D.B. 113-653 0. m a 'k/ o'�• rV6 s 3 / o 1V1 tv.O co f 1 R/ claimed f as C. 007 0.8 mile to by N• }:; CfeeV. Rd. Iron Jam. C $eof found . found Pi c' S F2 1320Iron.: C p 17J1�j.... ........ . ___... _._ .. T AK R r E� 0 KE HST _---- PROPERTY OF . CAROL L. ALLEN 'e 15.02 DAVIE COUNTY TAX MAP E-2 } LOT NO. MAP OF BLOCK NO. CLARKSVI LLE TOWNSHIP, 1, DEED BOOK 133 PAGE 169 - DAV I E COUNTY, N. C. SCALE: 1 INCH= 100 FEET Joe rlo 3270 r f I1IOYTH9IIN PHOTO PRINT • SUPPLY CO.—WINYTOM•YALIIM N50"9 .. ,• 4! rl t �`_ �`y{ - i ' DAVIE COUNTY HEALTH DEPARTMENT f Environmental Health Section Soil/Site Evaluation NAME '" f ADDRESS PROPOSED FACIILTY DATE EVALUATED PROPERTY SIZE LOCATION OF SITE Water Supply: On -Site Well _ Community Public f Evaluation By: Auger Boring jam_ Pit Cut FACTORS 1 2 3 4 Landscape position Sloe Z -L HORIZON I DEPTH Texture group Consistence Structure 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 / G SITE CLASSIFICATION: -( LDNG-TERM ACCEPTANCE RATE: l REMARKS: DCHD(01-901 EVALUATED BY: i � 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 :lay loam- SIL -Silty loam CL -Clay loam SCL-Sandy clay loam SC -Sandy clay SIC -Silty clay C -Clay Moist VFR- Vc.-y 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 3C --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 watet' 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 ■.■■■■■■■■■■.■/■EM■■■■■■■MM■.■■■�■■■e...■.■M■.E■E.M■■M■■MON■■■■■■ ■■■■■.■.M.M.■■■.M■■E■■ENMM■■■.■. 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Box 524 Mocksville, IVC 27028 Re:� 2 Site Evaluations Dike Whitaker Road/Sites 1 & 2 Dear Ms. Allen: As requested, a representative from this office visited the aforementioned sites on June 24, 1994. Based upon the information provided on the application for a site evaluation and after the evaluations were completed, two sites were found to be provisionally suitable for the installation of an on—site sewage disposal system on each site. If you have any questions, please feel free to contact this office. s Sincerely, Robert B. Hall, Jr., R.S. Environmental Health Section RH/wd Enclosure cc: Jesse Boyce Davie County Health Department ENVIRONMENTAL HEALTH SECTION P.O. Box 665 Mocksville, N.C. 27028 AUTHORIZATION FOR WASTEWATER SYSTEM CONSTRUCTION (Issued in compliance with Article 11 of G.S. Chapter 130A, Wastewater Systems) JD Lf(O ***This Authorization For Wastewater System Construction must be issued by the Davie County Environmental Health Section prior to issuance of any Building Permits. This Fore/Authorization Number should be presented to the Davie County Building Inspections Office when applying for Building Permits.*** AUTHORIZATION NUMBER NAME / />f�t'7'//f'i'i/ DATE C7� (� N2 phi 15 5 NAME ON IMPROVEMENT PERMIT (If different than above) SITE LOCATION COMMFMS/CUNDITIONS ON AUTHORIZATION TO CONSTRUCT WASTEWATER SYSTEM