161 Deacon Way Lot 17 1 �
Davie County,NC Tax Parcel Report Monday,December 19, 2016
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WARNING: THIS IS NOT A SURVEY
Parcel Information
Parcel Number: K5030A0017 Township: Mocksville
NCPIN Number: 5747652329 Municipality:
Account Number: 82515150 Census Tract: 37059-805
Listed Owner 1: SYKES JOHN RICHARD Voting Precinct: SOUTH MOCKSVILLE
Mailing Address 1: 161 DEACONS WAY Planning Jurisdiction: Davie County
City: MOCKSVILLE Zoning Class: DAVIE COUNTY R-A,R-12
State: NC Zoning Overlay:
Zip Code: 27028-0000 Voluntary Ag.District: No
Legal Description: LOT 17 DEACONS RIDGE Fire Response District: JERUSALEM
Assessed Acreage: 3.16 Elementary School Zone: CORNATZER
Deed Date: 7/2000 Middle School Zone: WILLIAM ELLIS
Deed Book/Page: 003410348 Soil Types: PcC2,CeI32
Plat Book: 0006 Flood Zone:
Plat Page: 060 Watershed Overlay: DAVIE COUNTY
Building Value: Outbuilding&Extra
Freatures Value:
Land Value: Total Market Value:
Total Assessed Value:
101
All data is provided as is without warranty or guarantee of any kind either expressed or Implied Including but not limited to the
warrantiesDavie County, implied warrdies of merchantability or fitness for a particular use.All users of Davie County's GIS website shall hold harmless the
County of Davie,NorthCarolina,Its agents,consultants,contractors o►employees from any and all claims or causes of action due to
NCor arising out of the use or Inability to use the GIS data provided by this website.
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DAVIE COUNTY HEALTH DEPARTMENT
IMPROVEMENT:PERMIT and OPERATION PERMIT
IMPROVEMENT PERMIT
**NOTE** This improvement permit DOES NOT authorize the constructionor installation of a septic tank system or any wastewater
systema. AN AUTHORIIATION 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.
p (In compliance with Article 11 of G.S. Chapter 130A, Wastewater Systems, Section .1900 Sewage Treatment and Disposal Systems)
NAMEl// PROPERTY ADDRESS DATE
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LOCATIDN/ /��f�,�7Y1Ol.J ��• ! �A�O/vS �� / � . �O O'Z�:..
SUBDIVISION NAME {� P,f�''%��>s` ,�/J,o LOT NUMBER / SEC./BLOCK NUMBER
RESIDENTAL SPECIFICATION: BUILDING,TYPE # BEDROOMS # BATHS # OCCUPANTS GARBAGE DISPOSAL: Yes/No
COMMERCIAL SPECIFICATION: FACILITY TYPE # PEOPLE # PEOPLE/SHIFT # SEATS INDUSTRIAL WASTE: Yes/No
LOT SIZE R ' _ TYPE WATER SUPPLY DESIGN WASTEWATER FLOW {GPD) NEW SITE ZZ REPAIR SITE
SYSTEM SPECIFICATIONS: TANK SIZE ,0. GAL.' PUMP TANK GAL., TRENCH WIDTH,-T/"' ROCK DEPTH A— LINEAR FT.?d d
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.
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: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.
OPERATION PERMIT SYSTEM INSTALLED BY �`'�►.
146 Us
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AUTHORIZATION NO. 0 31AL\ OPERATION PERMIT BY 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.FlNCTIDN SATISFACTORILY FOR ANY GIVEN PERIOD OF TIME.
DOHD 10/95
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Davie;,County Health Department
ENVIRONMENTAL HEALTH SECTION d�
P.O. Bax 665 I
ocksville, N.C. 27028 s
AUTHORIZATI FOR WASTEWATER SYSTEM CONSTRUCTION
(Issued in compliance with Article 11 of
r. G.S. Chapter 130A, Wastewater Systems)
***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#"Go-uid be presented to the Davie County Building Inspections
Office when applying for Building Permits.*** x '
AUTHORIZATION MP%. *R
NAME
DATE � .�!.��1� N2 0 3 g
NAME ON IMPROVEMENT PERMIT (If different than above) `
SITE LOCATION 47" 12Owlaar-
1
COMMENTS/CONDITIONS ON AUTHORIZATION TO CONSTRUCT WASTEWATER SYSTEM
*#*NOTICE*** THIS AUTHORIZATION FO ASTEWATER SYSTEM CONSTRUCTION IS VALID FOR A PERIOD OF FIVE (5) YEARS.
ENVIRONMENTAL SPECIALIST DATE
DCHD 10/95
4
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APPLICATION FOR SITE EVALUATION/IMPROVEMENTS PERMIT
Davie County Health Department
Environmental Health Section
P. O. Box 665
Mocksville, NC 27028
1. Application/Permit Requested By �ya471/,lGh� � l�'�tiJ�
Mailing Address ADD %7,I)f 511—,, Home Phone
11j �/��/2 t,� Business Phone
2. Name on Permit if Different than Above ����
3. Application for: El General Evaluation J&Septic Tank Installation Permit
4. System to Serve: UT House ❑ Mobile Home ❑ Place of Public Assembly
❑ Business ❑ Industry ❑ Other ❑ Unknown
5. If house, mobile home: Subdivision -Gae!nra!� /� 9 •P Section Lot #
❑ Basement/Plumbing
No. of People ❑ BasementlNo Plumbing
No. of Bedrooms _ W/Washing Machine
No. of Bathrooms 25"Dishwasher
Dwelling Dimensions 0 We, ❑ Garbage Disposal
6. If business, industry, place of public assembly, other: Specify type
No. of People Served No. of Sinks
No. of Commodes No. of Urinals
No. of Lavatories No. of Water Coolers
No. of Showers 11'
� Water Usage Figures
7. Type of water supply: LTJPublic ❑ Private ❑ Community
i
8. Property Dimensions ��/ Z( �OQ� Sewage Disposal Contractor
9. Do you anticipate additions/expansion of the facility this sytem is intended to serve? ❑ Yes C�'No
If yes, what type?
*NOTE: Improvements Permits shall be valid for a period of 5 years from date issued. Improvements Permits are subject to
revocation, if site plans or the intended use change. Effective October 1, 1989.
Directions to Property: Tax Office PIN: # �2 42 e�—„`13,99
�����1'1 L� PROPERTYADDRESS, as follows:
ze) Road Name:
City: '
' SUBMIT A PLAT WITH THIS APPLICATION.
Ida h / Revisions effective October 1 , 1995.
This is to certify that the information provided is correct tot best of my knowledge, and I un r tand I am responsible for all charges
incurred ffrom_ this application. r
DATE SIGNATURE
CONSENT FOR SITE EVALUATION TO BE DONE ON ABOVE DESCRIBED PROPERTY
MUST CHECK ONE: ❑ 1. I OWN the property. ❑ 2. I 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)
DAVIE COUNTY HEALTH DEPARTMENT
Environmental Health Section
Soil/Site Evaluation IA O/J_6 TIAGL
NAME ��i1/iC e e-2aD DATE EVALUATED
PROPERTY SIZE
ADDRESS
PROPOSED FACIILTY �zaa<Q_ LOCATION OF SITE �.�� i►Y �/-� � �1,�>
Water Supply: On-Site Well Community Public !/
Evaluation By: Auger Boring Pit 41f:::� Cut
FACTORS 1 2 3 4
Landscape position L
Sloe %
HORIZON I DEPTH
Texture group
Consistence
Structure
MineralogX
HORIZON II DEPTH
Texture group
Consistence r
Structure S--j"r-
Mineralogy A 'i
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: EVALUATED BY:
LONG-TERM ACCEPTANCE RATE: 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
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 watef 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(01-901
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