951 County Line Rd a
Davie County,NC Tax Parcel Report Thursday, February 23, 2017
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WARNING: THIS IS NOT A SURVEY
Parcel Information
Parcel Number: G100000036 Township: Calahaln
NCPIN Number: 4799980413 Municipality:
Account Number: 4156000 Census Tract: 37059-801
Listed Owner 1: BARKER PAULINE C Voting Precinct: NORTH CALAHALN
Mailing Address 1: 951 COUNTY LINE ROAD Planning Jurisdiction: Davie County
City: HARMONY Zoning Class: DAVIE COUNTY R-A
State: NC Zoning Overlay:
Zip Code: 28634-0000 Voluntary Ag.District: No
Legal Description: 2 AC COUNTY LINE RD Fire Response District: SHEFFIELD-CALAHALN
Assessed Acreage: 1.94 Elementary School Zone: WILLIAM R DAVIE
Deed Date: 5/1965 Middle School Zone: NORTH DAVIE
Deed Book/Page: 000720246 Soil Types: PaD,PcC2,CeB2
Plat Book: Flood Zone:
Plat Page: Watershed Overlay: DAVIE COUNTY
Building Value: 83710.00 Outbuilding&Extra 0.00
Freatures Value:
Land Value: 21670.00 Total Market Value: 105380.00
Total Assessed Value: 105380.00
161 AlldataIsprovided 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
rCounty of Davie,North Carolina,Its agents,consultants,contractors or employees from any and all claims or causes of action due to
NC or arising out of the use or Inability to use the GIS data provided by this website.
OPERATION PERMIT EEvaluated
ice Use n v
Davie County Health Department umber 232261 -1
210 Hospital Street
PA Box 848 mber,
Mocksville - NC 27028 REPAIR
Phone:336-753-6780 Fax:336-753-1684
C7 Applicant: - Pauline Foster Property Owner: Pauline Foster
_-Address: 951 County Line Rd Address: 951 County Line Rd
COY: Harmony, CRY: Harmony
_ State2ip: NC28634, State/Zip: NC 28634
Phone#: (336);:4927519 Phone#: (336)492-7519
Property Location & Site Information
Address/Road#: Subdivision: Phase: Lot:
951 County Line Road
»Harmony NC 28634 Directions
structure SINGLE FAMILY Hwy�64 West, right on Sheffield Rd. then turn on
#of Bedrooms: 3
County Line Rd
#of People: 3
"Water Supply: NIA
KIP,Issued by. -
*System Classification/Description:
_ - TYPE 111 G.OTHER NON-COW.TRENCH SYSTEMS
*CA issued by: 2140.Nations,Robert
" . Saprotite System? 0Yes No
Design Flow. _ _-3 6 0 GRAVITY-SERIAL Pump Required?
` '' Distribution Type: QYes rQNo
_.Soil Application Rate: 3 *Pre Treatment:
Drain field
- Sq. ft. *
Nitrification Field �-_ - � .__ _ __ System Type: INFILTRATOR QUICK 4 STANDARD
No. Drain Lines 1 . Installer: Sammy reavis
Total Trench Length: 1 0 0 ft. Certification#: 3001
Trench Spacing: _ 9 Inches O.C.
Feet O.C. ENS: 2140-Nations,Robert
Trench Width: 3 Qinches
Feet Date: 1 2 / 0 8 / 2 0 1 6
Aggregate Depth: inches
Minimum Trench Depth: 3 6 Inches
Minimum Soil Cover4 Inches Approval Status
,\"Maximum Trench Depth: 3 6 ® Approved Disapproved
Inches
Maximum Soil Cover: a 4 Inches j//A7 v
CDP File Number 232261 - 1 Septic Tank County ID Number: '
Lat.
Manufacturer. -
STB: - Long:
Gallons: Installer:
Date:
Certification#:
*EHS:
*Filter Brand:
ST Marker: ❑ Yes ❑ No Date:
Reinforced Tank: ❑ Yes ❑ NO
Approval Status
Piece Tank: p Yes Y❑ No ❑ Approved❑ Dlsapproved,
Pump Tank
Manufacturer. Installer.
:. PT: Certification 4:
`:Gallons: *EHS:
,Date: Date:
RiserSealed ❑ Yes ❑ No
RiserHeght '❑ Yes ❑ No (Min.6,in.)
Apprxvai Status
Reinforced Tank: ❑ Yes 13. No p Approved❑ atsappiroved,
1 Piece Tank; ❑ Yes _❑..No
Supply Line
Pipe Size: inch diameter Installer:
Pipe Length: feet Certification#:
*Schedule:
"EHS:
Pressure Rated ❑ Yes ❑ No Date:
Approved fittings ❑ -Yes ❑ NO Approval Status
❑ Approved❑ -Dlsapproved:
Pump Requirement
Pump Type: Installer.
Dosing Volume: — Gal Certification#:
Draw Down: Inches *EHS:
*Chain:
Date:
Valves Accessible ❑ Yes ❑ NO
Flow Adjustment Valve ❑ Yes ❑ No
Check-valve ❑ Yes ❑ No Approval Status z-
PVC unions ❑ Yes ❑ No ❑ Appraved❑ Disapproved
Vent Hole ❑ Yes ❑ No
Anti-siphon Hole ❑ YeS ❑ NO
CDP Fire Number 232261 - 1 County ID Number:
Electric Equipment
NEMA 4X Box or Equivalent' E] yes ❑ No Installer:
Box 12 inches Above Grade ❑ Yes ❑ No
Certification#:
Box Adj.To Pump Tank ❑ Yes ❑ No
Conduit Sealed ❑ Yes ❑ No 'EHS:
Pump Manually Operable
❑ Yes ❑ No
*Activation Method: _ __ Date:
Approval St atus
„
_ Alarm Audible ❑ Yes _.,. .._ ❑ No
❑ Approved El
Ala rm - •_ _
_ _
visible ❑ Yes ❑ No
2140•Nations,Robert
'Op-eration Permit completed by: r :. ...
..___. .Authorized State Agent: - Date of issue: 1 a / 0 8 2 0 1 6
Owner/Applicant Signature:
This system has been installed in with.applicable NC General Statutes:Article 11, Chapter 130A, Rulesfor y
_ -Sewage Treatment and Disposal,15A NCAC 18A:1900 ef. Seq.,and all conditions of the Improvement Permit and
Construction Authorization.-This property is served by a TYPE Ill G. sewage septic system.
Rule.:1961 requires that a Type--,1YPE 111 G. septic system meet the following criteria:
Minimum System Review ByThe Local Health Department: WA
__._.._....__.._Management Entity:
OWNER . . .
Minimum-System Inspection/Maintenance Frequency ByCertified Operator:
NIA
Reporting Frequency By Certified Operator: WA
Rule .1961 requires that a Type IV.and V septic systems designed fora home/business owner must maintain a valid contract.. _..
with a public management entity with a certified operator or a private certified operator for the life of the septic system.
Rule .1961 requires that Type VI septic systems designed for a homelbusiness owner must maintain a valid contract with a
_ public management entity with a certified operator for the life of the septic system.
Rule. 1961 (2)(e)requires a contract shall be executed between the system owner and a management entity prior to the
issuance of an Operation Permit for a system required to be maintained by a public or private management entity,unless the
system owner and certified operator are the same. The contract shall require specific requirements for maintenance and
operation, responsibilities of the owner and systems operator,provisions that the contract shall be in effect for as long as the
system is in use,and other requirements for the continued proper performance of the system. It shall also be a condition of
the Operation Permit that subsequent owners of the systems execute such a contract.
GHand Drawing Olmport Drawing
**Site Plan/Drawing attached.**
OPERATION PERMIT
Davie County Health Department CDP File Number: 232261 - 1
210 Hospital Street
P:o.Box 848 County File Number:
Mocksville NC 27028 Date:
Q Inch
Drawing 'Drawing Type:-Operation Permit Scale: . pNtock
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s� -AL
CONSTRUCTION For Office Use Only
AUTHORIZATION *CDP File Number 232261 - 1:
Davie County Health Department County ID Number: "
t -210 Hospital Street Evaluated For: REPAIR
•�; ;,,• P.O. Box 848 Township:
Mocksville NC 27028 PERMIT VALID UNTIL:
-- Phone: 336-753-6780 Fax:336-753-1680 1 1 3 0 2 0 .1 1
Applicant: Pauline Foster Property Owner: Pauline Foster
Address: 951 County Line Rd Address: 951 County Line Rd
City: Harmony City: Harmony
State/Zip: NC 28634 State/Zip: NC 28634
Phone#: (336)492-7519 Phone M (336)492-7519
- Property Location & Site Information
Address/Road#: Subdivision: ` Phase: Lot:
951 County Line Road
i
-Harmony NC 28634 Directions
Structure '- "SINGLE FAMILY Hwy 64 West, right on Sheffield Rd. then turn on County
- -- re Rd
#of Bedrooms: 3 LiI
#of People: 3 I
*Water Supply: NSA
System Specifications
Minimum Trench Depth: a 4
Site Classification. Provisionally suitable Inches
Minimum Soil Cover:
Saprolite System? O Yes (&No 3 6 Inches
Design Flow: 3 6 0 Maximum Trench Depth: a 4 Inches
Soil Application Rate: 0 3 Maximum Soil Cover: 3 6 Inches `
*System Classification/Description: *Distribution Type: GRAVITY-SERIAL
TYPE III G.OTHER NON-CONY.TRENCH SYSTEMS
Septic Tank:
Gallons
*Proposed System:'25%REDUCTION 1-Piece: O Yes O No
Pump Required: O Yes O No O May Be Required
Nitrification Field
Sq.ft. Pump Tank: Gallons
No. Drain Lines 1-Piece: OYes ONo
Total Trench Length: .2 0 0 ft GPM--vs— ft. TDH
Trench Spacing: _ O Inches O.C.
O Feet O.C. Dosing Volume: Gallons
Trench Width: _ O Inches
O Feet Grease Trap: Gallons
Aggregate Depth: inches
Pre-Treatment: O NSF OTS-1 O TS-11
Septic Tank Installer Grade Level Required: 01011 O III 01V
Page 1 of 3
CDP File Number 232261 - 1 County ID Number:
❑ Open Pump System Sheet
Repair System Required:0 Yes ONO ONO, but has Available Space
rDesignFlow:
System
Trench Spacing: Inches O. .
ification: — Feet O.C.
Trench Width: _ 8 Fe tInches
Soil Application Rate: Aggregate Depth: inches
Minimum Trench Depth: Inches
*System Classification/Description:
= Minimum Soil Cover:
Inches
Maximum Trench Depth:
*Proposed System: Inches
Maximum Soil Cover:
Nitrification Field Inches
Sq.ft.
No. Drain Lines *Distribution Type:
No
Total Trench Length: -- - ft -- �� !Pump Required: OYes O O Ma YBeRe qulred
Pre-Treatment: O NSF OTS-I OTS-II
_ *Site Modifications
No grading or construction activity is allowed in areas.designated for system and repair without approval of Health Department. R��w
750
*Permit Conditions
The issuance of this permit by the Health Department in no way guarantees the issuance of other permits.The permit holder
is responsible for checking with appropriate governing bodies in.meeting their requirements. R 9
2000
This Authorization for Wastewater System Construction shall be valid for a person equal to the period of validity of the Improvement Permit,not
to exceed five years,and may be issued at the same time the Improvement Permit issued(NCGS 130A-336(b)).If the installation has not been
completed during the period of validity of the Construction Permit,the information submitted in the application for a permit or Construction
Authorization is found to have been Incorrect,falsified or changed,or the site is altered,the permit or Construction Authorization shall become
invalid,and may be suspended or revoked(.1937(8)).The person owning or controlling the system shall be responsible for assuring compliance
with the laws,rules,and permit conditions regarding system location,installation,operation,maintenance,monitoring,reporting and repair
(1938(b)).
Applicant/Legal Reps. Signature Required? O Yes O NO
Applicant/Legal Reps. Signature- Date: /
*Issued By: 2140-Nations,Robe Date of Issue: 1 1 / 3 0 / a 0 1 6
Authorized State Agent: Malfunction Log Oyes
Hand Drawing O Import Drawing
**Site Plan/Drawing attached.**
Page 2of3
CONSTRUCTION AUTHORIZATION
Davie County Health Department CDP File Number: 232261 - 1
210 Hospital Street
P.O.Box 848 County File Number:
- _Mocksville NC 27028 Date: 11 / 30 / 2016
Q Inch
Scale: . . Q Block
=: Drawing Drawing Type: Construction Authorization ON/A
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Page 3 of 3
CONSTRUCTION AUTHORIZATION
Davie County Health Department
210 Hospital street CDP File Number: 232261 - 1
P.O.Box 848
Mocksville NC 27028 County File Number:
--
Date: .1.1) 3.0 /.a.0.1.6.
Click below to import an image from an external location: Drawing Type:Construction Authorization
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