134 Edgewood CircleDavie County, NC Tax Parcel Report ] 4'1 :�— Friday, September 30, 201 f
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WARNING: THIS IS NOT A SURVEY
All data is provided as is without warranty or guarantee of any kind either expressed or Implied including but not limited to the
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
or arising out of the use or inability to use the GIS data provided by this website.
Parcel Information
Parcel Number:
M5070A0021
Township:
Jerusalem
NCPIN Number:
5745385843
Municipality:
Account Number:
.82523094
Census Tract:
37059-807
Listed Owner 1:
SIMMONS CARL E
Voting Precinct:
COOLEEMEE
Mailing Address 1:
139 PINE MEADOW LN
Planning Jurisdiction:
Davie County
City: MOORESVILLE
Zoning Class: DAVIE
COUNTY R-20
State:
NC
Zoning Overlay: DAVIE COUNTY CZOD
Zip Code:
28117-0000
Voluntary Ag. District:
No
Legal Description:
LOTS 82-87 EDGEWOOD SECTION 1
Fire Response District:
JERUSALEM
Assessed Acreage:
0.61
Elementary School Zone:
COOLEEMEE
Deed Date:
7/2004
Middle School Zone:
SOUTH DAVIE
Deed Book / Page:
005620680
Soil Types:
Gn62
Plat Book:
0004
Flood Zone:
Plat Page:
030
Watershed Overlay:
DAVIE COUNTY
Building Value:
119130.00
Outbuilding & Extra
1910.00
Freatures Value:
Land Value:
21000.00
Total Market Value:
142040.00
Total Assessed Value:
142040.00
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Davie County,
�r
NC
All data is provided as is without warranty or guarantee of any kind either expressed or Implied including but not limited to the
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
or arising out of the use or inability to use the GIS data provided by this website.
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AUTHORIZATION NO:- 1472 -JPy ✓ X 6
DAVIE COUNTY HEALTH DEPARTMENT
w` Environmental Health Section PROPERTY INFORMATION
~ Permittee's '7 6 f"' P.O. Box 848
Name: ��'� i 70 li J Mocksville, NC 27028 Subdivision Name:
' Phone #: 704-634-8760
Directions to property: "%" 'r' :�l f;�f Section: Lot:
AUTHORIZATION FOR
WASTEWATER
SYSTEM CONSTRUCTION Tax Office PIN:#
Road Name: •9 iip: 7O
**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 11 of G.S. Chapter 130A, Wastewater Systems, Section .1900 Sewage Treatment and Disposal Systems)
***NOTICE*** THIS AUTHORIZATION FOR WASTEWATER CONSTRUCTION
r i" 11 ";f IS VALID FOR A PERIOD OF FIVE YEARS.
ENVIRONMENTAL HEALTH SPECIALIST DATE ISSUED
'114724. •DAVIE COUNTY HEALTH DEPARTMENT
_ %�, IMPROVEMENT AND OPERATION PER,, PROPERTY INFORMATION
Perriiite's;.
Name`: Subdivision Name:
Directions to property: , y�;;;`'', -�.� ' ? Section: Lot:
f IMPROVEMENT
PERMIT Tax Office PIN:# f '•''
Road Name:
**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 1 I of G.S. Chapter 130A, Wastewater Systems, Section .1900 Sewage Treatment and Disposal Systems)
i' ***NOTICE*** THIS PERMIT IS SUBJECT TO REVOCATION IF SITE
%` '(e / '~ i t`k t✓. f /' r` ' ,'' r i,1 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 A/ # BEDROOMS ? # BATHS 1 # OCCUPANTS ..f GARBAGE DISPOSAL: Yes or No
COMMERCIAL SPECIFICATION: FACILITY TYPE' # PEOPLE # PEOPLE/SHIFT / # SEATS INDUSTRIAL WASTE: Yes or No
LOT SIZE h' TYPE WATER SUPPLY (� DESIGN WASTEWATER FLOW (GPD) ScI d NEW SITE i— ""o REPAIR SITE
ir
SYSTEM SPECIFICATIONS: TANK SIZE �,/% GAL. PUMP TANK GAL. TRENCH WIDTH ROCK DEPTH _4L LINEAR FT.
OTHER
REQUIRED SITE MODIFICATIONS/CONDITIONS:
IMPROVEMENT PERMIT LAYOUT
"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.
OPERATION PERMIT
SYSTEM INSTALLED BY:
/Goehc
0
AUTHORIZATION NO. �— OPERATION PERMIT BY: ,(XL� 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 05/96 (Revised)
APPLICATION FOR SITE EVALUATIONAMPROVEMENT PERMI �j "-
Davie County Health Departments t " "
Environmental Health Section
P. O. Box 848 JUN I 8190M
Mocksville, NC 27028
(6
ENVIR0t1�.'EIITAL F0ail
****IMPORTANT**** THIS APPLICATION CANNOT BE PROCESSE �ESSPAVIE COU;ITY
/i ALL THE REQUIRED INFORMATION IS PROVIDED. �`�
1. Name to be Billed CAP- AP- L- I VV' W� ONS Contact Person �� 4C
Mailing Address -1'306-7 Home Phone VW -6 SSS
City/State/Zip 11 ISe NG. 2_-7 072 8 Business Phone r�f�lo 7117
2. Name on Permit/ATC if Different than Above a4 r L ( N aa-i'i ►n, �t w. w� a �-� S
Mailing Address 73'9•7 hl�uj -c, i S City/State/Zip�N�cce k&;j i
3. Application For: -' Site Evaluation Improvement Permit & ATC ❑ Both
4. System to Serve: House ❑ Mobile Home ❑ Business ❑ Industry ❑ Other
5. If Residence
U Dishwasher
# People A
# Bedrooms 1— # Bathrooms ---)—
❑ Garbage Disposal Jed Washing Machine ❑ Basement/Plumbing ❑ Basement/No Plumbing
6. If Business/Other: Specify type
# Commodes
If Foodservice
# Showers
# Seats
# People # Sinks
# Urinals
Estimated Water Usage (gallons per day)
# Water Coolers
7. Type of water supply: A County/City ❑ Well ❑ Community
8. Do you anticipate additions or expansions of the facility this system is intended to serve? ❑ Yes No
If yes, what type?
EITHER A PLAT OR SITE PLAN
PROPERTY INFORMATION REQUIRED: *** IMPORTANT *** A PkTHE PROPERTY MUST BE
SUBMITTED WITH THIS APPLICATION.
f
Property Dimensions: /65' 4 /%G X /S5 �x /75 �
Tax Office PIN: # -.6-7 vs-
Property
sProperty Address: Road Name /•�1/ ��P Gc�oa� ellec./K
city/zip I-Acck5y/Ae . iC.
If in Subdivision provide information, as follows::r/y
Name:ala/D0?
Section:
Lot #:
WRITE DIRECTIONS (from
Mocksville) TO PROPERTY:
lo/ s :o goi
77o
64Pwa�� C2 li�e/�ToN
��G•,,Qweocll « �r?�'x
a - of M,'J',- 0 A GreUlei-
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. 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 ,4e d 5, kc o; S to conduct all testing procedures
as necessary to determine the site suitability.
DATE SIGNATU C?.�
Revised DCHD (06-96)
YOU MAY USE THE BACK Of THIS FORM FOR DRAWING YOUR SITE PLAN.
AP/1� 7
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APPLICATION FOR SITE EVALUATIONAMPROVEMENT PERMIT & ATC
91 Davie County Health Department a
Environmental Health Section
D
��✓ P.O. Box 848 APR 2 4 1997
Mocksville, NC 27028
(704)634-8760 !I
****IMPORTANT**** THIS APPLICATION CANNOT BE PROCESSED UNLESS ALL
THE REQUIRED INFORMATION IS PROVVIDED.
6
1. Name to be Bille 6,L/ -/ 1,1S/717% e J0iy77/I a19S Contact Person '676 ,�
Mailing Address `73 YZ f tYc� 5;? 6% <�V-tA Home Phone as'7 '6 s -'F
City/State/Zip Z)J� ?.C& e --:�74JVc? Business Phone %
2. Name on Permit/ATC if Different than Above
Mailing Address
City/State/Zip
3. Application For: [!.-Kite Evaluation [ ] Improvement Permit & ATC
4. System to Serve: 1,-4 Fouse [ ] Mobile Home [ ] Business [ ] Industry [ ] Other
[ ] Both
5. If Residence: # People- # Bedrooms3 # Bathrooms Z- [ ] Dishwasher [ ] Garbage Disposal
[t.,r<ashing Machine [ ] Basement/Plumbing [ 9-19-asement/No Plumbing
6. If Business/Other: Specify type # People #Sinks # Commodes
# Showers # Urinals # Water Coolers
If Foodservice: # Seats Estimated Water Usage (gallons per day)
7. Type of water supply: [C�unty/City [ ] Well [ ] Community
8. Do you anticipate additions or expansions of the facility this system is intended to serve? [ ] Yes PINo
If yes, what type?
EITHER A PLAT OR SITE PLAN
PROPERTY INFORMATION REQUIRED: *** IMPORTANT *** XEDM(OF THE PROPERTY MUST BE
SUBMITTED WITH ) S APPLICATION.
Property Dimensions: 5� x 17S X /SS ,c !y� WRITE DIRECTIONS (from ocksville) TO PROPERTY:
Tax Office PIN: # - /
Property Address: Road Name�,G7` ""#a�SGIk�'%
City/Zip &&k ZC.L.LC•
If in Subdivision provide information, as follows:
�
Name: 64:nz.E: el
<Ze/.2— l X 9.z-- aye
Section: Lot #:
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. 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
to conduct all tes�tinn rocedures as necessary to determine the site suitability.
l SIGNATURFA AZ,4
Revised DCHD (06-96)
THIS AREA MAY BE USED FOR DRAIVING YOUR SITE PLAN:
(2)( )
21 a
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22
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REVISIONS
DAVIE COUNTY HEALTH DEPARTMENT
r Environmental Health Section SECTION LOT
Soil/Site Evaluation
APPLICANT'S NAME� > NoY75 DATE EVALUATED
PROPOSED FACILITY PROPERTY SIZE
SUBDIVISION ROAD NAME
Water Supply: On -Site Well
Community
Evaluation By: Auger Boring Pit
Public C�
Cut
FACTORS
1 2 3 4 5 6 7
Landscape position
Sloe %
HORIZON I DEPTH
Texture group
Consistence
Structure
Mineralogy
HORIZON II DEPTH
P�
Texture groupCi
Consistence
r
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:
LONG-TERM ACCEPTANCE RATE: 4 Z
REMARKS:
LEGEND
DCHD (01-90)
Landscape Position
EVALUATION BY:
OTHER(S) PRESENT:
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
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
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Davie County Health Department
and.Come Health Agency
Environmenta(Heafth Section
P.O. BOX 848 / 210 HosPITAL STREET
COURIER 809-4-06
MOCKSVILLE, N.C. 27028
PRONE: (704) 634-8760
May S, 1997
Carl & Bonnie Simmons
7387 Hwy. 801 South
Mocksville, RC 27028
Re: Site Evaluation
Edgewood Circle/Lot 21
Dear Mr. & Mrs. Simmons:
As requested, a representative from this office visited the
aforementioned site on May 2, 1997. Based upon the information.
provided on the application for site evaluation and after the evaluatiQi,
was completed, the site was found to be provisionally suitable for the
installation of .an on-site sewage disposal system.
If you have any questions, please feel free to contact this office.
RH/wd
Enclosure(s)
Sincerely,
Robert B. Hall, Jr., R.S.
Environmental Health Section
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