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239 Deacon Way Lot 14 Davie County,NC ` ' Tax Parcel Report Monday,December 19, 2016 246 265 - f' 226 259 _ 206 5t 247-'- .fJr fJ, 19 4 23 9_r 1' + ' i 1 1 217 ' -- 178 r"'193 ' 162 I 161 --. I WARNING: THIS IS NOT A SURVEY Parcel Information Parcel Number: K503OA0014 Township: Mocksville NCPIN Number: 5747555974 Municipality: Account Number: 82530757 Census Tract: 37059-805 Listed Owner 1: JENNINGS KEVIN D Voting Precinct: SOUTH MOCKSVILLE Mailing Address 1: 239 DEACONS WAY Planning Jurisdiction: Davie County City: MOCKSVILLE Zoning Class: DAME COUNTY R-A State: NC Zoning Overlay: Zip Code: 27028-0000 Voluntary Ag.District: No Legal Description: LOT 14 DEACONS RIDGE Fire Response District: JERUSALEM Assessed Acreage: 3.12 Elementary School Zone: CORNATZER Deed Date: 5/2009 Middle School Zone: WILLIAM ELLIS Deed Book/Page: 007910968 Soil Types: Ce132 Plat Book: 0006 Flood Zone: Plat Page: 061 Watershed Overlay: DAVIE COUNTY Outbuilding&Extra Building Value: Freatures Value: Land Value: Total Market Value: Total Assessed Value: Fo- 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, Implied warranties of merchantability or fitness for a particular use.All users of Davie County's GIS website shall hold harmless the NC 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. i-ri v ii-;,%,vviv 1 1 civ v m univim,4 i t11,nntit,i n P.O.Box 848/210 Hospital Street } Mocksville,NC 27028 (336)753-6780/Fax#(336)753-1680 REPAIR OPERATION PERMIT c Account #: 990005817 Tex PIN,EN#: K502OA0014 f Billed To: Kevin Jennings Subdivision Info: :��pOON S �jd8e, � Reference Name: SYSTEM EXPANSION Location/Address:' 239'Deecon Way-27028 Proposed Facility: Residential Expansion Properly Size — 112-'Acres **NOTE**The issuance of this Operation Permit shall indicate the system described on the ATC has been installed AT(3 WffWAPci5Sj i 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. System Type: S.T.Manufacturer h Tank Date `� Tank Size Pump Tank Size e:� 1 System Installed By: �(' LAyLA E.H.Specialist: CQbate: b/7 GPS Coordinate: SCJ 4 )Qew wS r z 4 i y S DCHD 11/06(Revised) 4S t DAVIE COUNTY ENVIRONMENTAL HEALTH P.O.Box 848/210 Hospital Street . Mocksville,NC 27028 (336)753-6780/Fax#(336)753-1680 AUTHORIZATION FOR WASTEWATER SYSTEM CONSTRUCTION Account #: 990005817 Tax.PIN,EH#: K502OA0014 Billed To: Kevin Jennings Subdivision Info: Reference Name: SYSTEM EXPANSION -LocatiortlAddress: 239 Deacon Way-27028 Proposed Facility: ❑ Residential Expansion Proper �$�� �Ft����air �xpansion Ale,: ATVgQHbbrThiS&?dhorization to Construct(ATC)MUST BE ISSUED.by the Davie County Environmental Health Section prior to.issuance of any building permit(s),(in compliance with Article 11 of G.S.Chapter 130A Wastewater Systems,Section.1900 Sewage Treatment and Disposal Systems). THIS AUTHORIZATION TO CONSTRUCT IS VALID FOR A PERIOD OF FIVE YEARS. ,This ATC is subject to revocation if site plans,plat or the intended use change. Residential Specifications: #Bedrooms #Bathrooms #People Basement❑ Basement plumbing❑ Non-Residential Specifications: Facility Type #People #Seats Square Footage(or Dimensions of Facility). Lot Sizel�a C. Type of Water Supply: ❑County/City ❑Well ❑Community Well i • System Specifications: Design Wastewater Flow(GPD) Tank Size4 AL.Pump Tank GAL. Trench Width Max. Trench Depth�fE Rock Depth i Linear Ft._,6 M,( Site Modifications/Conditions/Other: As stEted In 15 &A , p r �y.4tCft1S ,iIc)y assn hf+ lei* Contact the Davie County Environmental Health Section for final inspection of this system between 8:30—J130a.m.on the day of installation. Telephone#(336)751-8760. i � ,l Environmental Health Specialist 012 Dater lJl Z DCHD 11106(Revised) /// Davie County Health Department 11� s 1 Environmental Health Section , P:o.Box 848 210 Hospital Street O �'C Courier# :09-40-06 1911 Mocksville,NC 27028 Phone:(336)-753-6780 ON-SITE WASTEWATER CERTIFICATION Fax:(336)-753-1680 (Check One) Replacement Remodeling Reconnection Name: I ZfylA leyj1l//lgf Phone Number l33% -Moine) 0 M :line /, / DQ Address: � QCO/1 qyy !alp ik� AOCXSV111,f /VC 2700 Email Address: Detailed Directions To Site: (lJV S. .r E e- W i 1y Property Address: Please Fill In The Following Informatioo�Jn About The EXISTING Facility: Name System Installed Under: ! (�f 1 L%UK. Type Of Facility: Gage' —S—;lv4 le r 7 InI/E ,r} Date System Installed(MonthMate/Year): Number Of Bedrooms: Number Of People: Is The Facility Currently Vacant? Yes 0 If Yes,For How Long? Any Known Problems? Yes If Yes,Explain: Please Fill In The Following Inf rmation About The NEW Facility:A ��'tmi•��t?Cf!•�pi✓� � gds Type Of Facility: J(p/�jU/O/t) Agn, / Number Of Bedrooms: / Number of People Pool Size: Garage Size: Other: , tequested By: i gate Requested: (Signatur For Environmental Health Office Use Only Approved Disapproved Comments: Environmental'Health Specialist Date: *The signing of this-form by the Environmental Health Staff is in no way intended,nor should be taken as a guarantee (extended or limited)that the on-site wastewater system will function properly for any given period of time. Payment: Cash heck oney Order # Amount:$ , Date: Paid By: Received By: Account#: :/ Invoice#: a a'-A DAVIE COUNTY HEALTH DEPARTMENT IMPROVEMENTS PERMIT AND CERTIFICATE OF COMPLETION )}` '•° D& *NOTE:Issued in Compliance With Article II of G.S.Chapter 130a � � Sanitary Sewage Systems ._ tr c Permit Number Name .- A Date NB 8148 Location — Subdivision Name l c c, r� � �� }. Lot No. 14 Sec. or Block No. t Lot ,Size ,- --_House — t f Mobile Home ---_ Business -- Industry No. Bedrooms No. Baths —=^-- No. in Family — Public Assembly Other Garbage Disposal YES p NO p' Specifications for System: Auto Dish Washer YES ;; NOJr Auto Wash Ma^hine YES Q` NO ❑ t� (7`0 Type Water Supply - 'This permit Void if sewage system described below is not installed within 5 years from date of issue. This permit is subject to revocation if site plans or the intended use change ATTENTION: YOUR SEPTIC SYSTEM CONTRACTOR MUST SEE THIS PERMIT/LAYOUT BEFORE INSTAW NG THIS SYSTEM. i`'f' ) /do� .1 Improvements permit by "Contact a representative of the Davie'County Health Department for final inspection of this system between 8:30-9:30 A.M., 1:00-1:30 P.M. or 4:30-5:00 P.M.on day of completion.Telephone Number: 704-634-5985. Final Installation Diagram: System Installed iy 1pN _ h v V 'Q 1 AA A Certificate of Completion _ r -- Date 'The signing of this certificate shall in hat the system deas been installed in compliance with the standards set forth in the above regul o 1. t s aif n FT0 way be take}ht as a guarantee that the system will function satisfactorily for any given period of time. t APPLICATION FOR SITE EVALUATION/IMPROVEMENTS PERMIT Davie County Health Department g�z/ -� Environmental Health Section P. O. Box 665 Mocksville, NC 27028 1. Application/Permit Requested By Mailing Address 30e) S / Home Phone ce l Business Phone ",;*)�2, 2. Name on Permit if Different than Above 24� 3. Application for: a General Evaluation IF-Septic Tank Installation Permit 4. System to Serve: 91H-ouse ❑ Mobile Home ❑ Place of Public Assembly ❑ Business ❑ Industry ❑ Other ❑ Unknown 5. If house, mobile home: Subdivision e-2C6 `e Section_L Lot # ❑ Basement/PlumbingNo. of People ❑ Basement/No Plumbing No. of Bedrooms 011washing Machine No. of Bathrooms / t!9 Dishwasher Dwelling Dimensions_3� ,k b ❑ 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 Water Usage Figures 7. Type of water supply: Public ❑ Private ❑ Community 8. Property Dimensions �, - 0G>eV-9 Sewage Disposal Contractor 9. Do you anticipate additions/expansion of the facility this sytem is intended to serve? ❑ Yes ya'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: SeA � c f t �This is to cerfy that the information provided is correct to the best f my knowledge, and I understand I am responsible for all charges incurred fromhis application.Au. d �h`DATE SIGNATURE CONSENT FOR SITE EVALUATION TO BE DONE ON ABOVE DESCRIBED PROPERTY MUST CECK ONE: ❑ 1. 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) DAVIE COUNTY HEALTH DEPARTMENT �� Environmental Health Section Soil/Site Evaluation NAME1!2fi0 Z— WQ1 \ q�� DATE EVALUATED 4": 95 ADDRESS S A t`M� PROPERTY SIZE 2 ��C 4• PROPOSED FACIILTY oV.5 LOCATION OF SITE �itii"l /,A b t Water Supply: On-Site Well Community Public /__� Evaluation By: Auger Boring Pit !/ Cut FACTORS 1 2 3 4 Landscape position ,L Sloe % G - 0- E- HORIZON I DEPTH Texture group C �^ Consistence Structure Mineralogy HORIZON II DEPTH /fit p f' L y Texture group Consistence #. Structure k,<, Mineralogy HORIZON III DEPTH Texture group Consistence Structure Mineralogy HORIZON IV DEPTH Texture group Consistence Structure Mineralogy SOIL WETNESS S --s-S RESTRICTIVE HORIZON SAPROLITE - CLASSIFICATION 7777 LONG-TERM ACCEPTANCE RATE L ,t 1� SITE CLASSIFICATION: � EVALUATED BY: A Zz LANG-TERM ACCEPTANCE RATE: OTHER(S) PRESENT: O NQ� REMARKS: S2 e 197Q�N EGEND 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 Mineralo" 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 DCHD(01-901 ■■■■■■■■■■■■.■■■■■■!■■■■■■.■.■Mfr ■■■.■..■■■.■■.■■■■■■■■■..■■■■■■■ O��OOOOOOOOOOOOOOO�0��1����O�A�OOOOOOO��OO■OI��OONOMINEES OOOOOOOOOOO ■■■■■■■■■■■■■.■■■■■■■.1■■■■■t•11■■■■■■■■■■.■�■It■■iii:.■ \.■■■■■.■■■■■■■ ■....■■.■■■■■...■■■■■tl■!!!■1lCJI■stns■z:J!!■.■.I�i�■:..1.►:1.1.■■■■■■■■■■■■■ ■■.■■■..■■■■■/.■■■■■.//■.■■■11.11■il.�■.■.■■■■■I�■■■ill■r■J■■■■■■■■■■■■■ ■■.■■■....■■■■.■!■■■.�■■■!■.■■■����■.��■..■./■■.biz■�■■■■■■....■■.■■ ■■■■....n..■..■.■■■w.■■■■!■.!■■■ .■■■.■■.._.��■.�nli�.r��■■.■..■.. ■■■ ■■■■■■.■■.1.■■■■.■■11...OEM■..!!!■:/�/..■.■....■11■11■■■■■■■..■■■.■... 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