545 Jack Booe RdDavie Countv. NC
Tax Parcel Report b V:?) °I Thursday. September 29. 2016
WAK1V11NU: lri1J 16 1VU1 A NUKVhY
Parcel Information
Parcel Number:
C30000010703
Township:
Clarksville
NCPIN Number:
5812672842
Municipality:
Account Number:
8304354
Census Tract:
37059-801
Listed Owner 1:
MCBRIDE TABITHA S
Voting Precinct:
CLARKSVILLE
Mailing Address 1:
545 JACK BOOE ROAD
Planning Jurisdiction:
Davie County
City: MOCKSVILLE
Zoning Class:
DAVIE COUNTY R -A
State:
NC
Zoning Overlay:
Zip Code:
27028
Voluntary Ag. District:
No
Legal Description:
7.336 AC JACK BOOE RD
Fire Response District:
WILLIAM R. DAVIE
Assessed Acreage:
6.79
Elementary School Zone:
WILLIAM R DAVIE
Deed Date:
11/2014
Middle School Zone:
NORTH DAVIE
Deed Book / Page:
009730533
Soil Types:
MnC2,MnB2
Plat Book:
Flood Zone:
Plat Page:
Watershed Overlay:
DAVIE COUNTY
Building Value:
14200.00
Outbuilding & Extra
Freatures Value:
0.00
Land Value:
61130.00
Total Market Value:
75330.00
Total Assessed Value:
75330.00
r'pU N�4
Davie County,
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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DAVIE COUNTY HEALTH DEPARTMENT
IMPROVEMENT PERMIT and OPERATION PERMIT
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 13OA, Wastewater Systems, Section .1900 Sewage Treatment and Disposal Systems)
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NAME N �. �Q�e` iJ
LOCATION Ci
PROPERTY ADDRESS
v
DOF�,O . a IMF
DATE
SUBDIVISION NAME LOT NUMBER
SEC./BLOCK NUMBER
RESIDENTAL SPECIFICATION: BUILDING TYPE�\. 1�0 Amo-# BEDROOMS D. # BATHS tL # OCCUPANTS GARBAGE DISPOSAL: Ves No
n
COMMERCIAL SPECIFICATION:FACILITY TYPE # PEOPLE # PEOPLE/SHIFT # SEATS INDUSTRIAL. WASTE: Yes/No'" •
LOT SIZE c a TYPE`WATER SUPPLY DESIGN WASTEWATER FLOW (GPD) NEW SITE t -f REPAIR SITE
SYSTEM SPECIFICATIONS: TANK SIZE Prit Ski,yS PUMP TANK GAL. TRENCH WIDTH ROCK DEPTH ,��4 LINEAR FT.
OTHER ':•L t s.
REQUIRED SITE MODIFICATIONS/CONDITIONS:
***THIS PERMIT IS SUBJECT TO REVOCATION IF SITE PLANS OR THE INTENDED USE CHANGE. YOUR 14ASTERWATER SYSTEM CONTRACTOR MUST
SEE THIS PERMIT BEFORE INSTALLING THE SYSTEM.
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IMPROVEMENV 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
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AUTHORIZATION NO. 0) 3 OPERATION PERMIT BY Q� TZ�Z-&— DATE TIE _
**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 13OA, SECTION .1900 "SEWAGE TREATMENT AND DISPOSAL SYSTEMS', BUT SHALL IN NO WAY BE TAKEN AS A ,
GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTOFILY FOR ANY GIVEN PERIOD OF TIME.
DCHD 10/95
V4 r -.>aGt `.., a; a» t `.t'.i+.+.%'�ti rw w -,C PR ,i tiy,) ,w• if " w e ' z...N t .. .. r -:^ ., './�
ie County Health DepartmO'gj
ENVIRONMENTAL HEALTH SECTIbN �a
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)
***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.***
Q AUTHORIZATION NUMBER
NAME 11 �_ , '' N to �� �� A N DATE 1 I L c� '
NAME,ON-IMPROVEMENT PERMIT (If different than above) \
SITE LOCRTION A c.
COMMENTSICONDITIONS ON AUTHORIZATION TO CONSTRUCT WASTEWATER SYSTEM
***NOTICE*** THIS AUTHORIZATION FOR WASTEWATER SYSTEM CONSTRUCTION IS VALID FOR A PERIOD OF FIVE (5) YEARS.
ENVIRONMENTAL HEALTH SPECIALIST DATE
DCHD . 10/95
APPLICATION FOR SITE EVALUATION/IMPROVEMENTS PE
Davie County Health Department
Environmental Health Section
P. O. Box 665
Mocksville, NC 27028
1. 'Application/Permit Requested By uv t)
Mailing Address 0 6 P n,P �(� Home Phone
Q 715a 6 Business Phone
2—Name on Permit if Different than Above
3. Application for: ❑ General Evaluation QrSeptic Tank Installation Permit
4: System to Serve: ❑ House Q'Mobile Home ❑ Place of Public Assembly
❑ Business ❑ Industry ❑ Other ❑ Unknown
5. If house, mobile home: Subdivision /A Section Lot #
❑ Basement/Plumbing
No..of People a ❑ Basement/No Plumbing
No. of Bedrooms a ET Washing Machine
No. of BathroomsaDishwasher
Dwelling Dimensions I Y k Q/Garbage Disposal
l:
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: r1 d Public ❑ Private
8. Property Dimensions I CLceCs Sewage Disposal Contractoi
9. Do you anticipate additions/expansion of the facility this sytem is intended to serve?
If yes, what type?
❑ Yes L'No
❑ Community
'NOTE: Improvements Permits shall be vali I gegaet4#8ayeefs from date issued. Improvements Permits are subject to
revocation, if site plans or the intended use change. Effective October 1, 1989.
Directions to Property:
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This is to certify that the information provided is correct to the best of my
incurred from this application.
12 -alo-qS
DATE
PROPERTY INFORMATION REQUIRED:
Tax Office PIN # aM62-61-1 � �–
Road Name -a, --V, .Qaae�
Box # (if available)
City M Z!� 1,-� I k1 I I P
SIGNA
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responsible for all charges
CONSENT FOR SITE EVALUATION TO BE DONE ON ABOVE DESCRIBED PROPERTY
MUST CHECK ONE: ❑ 1. 1 OWN the property. LF� 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 ; alth Department to enter upon above described
property located in Davie County and owned by eC'r
to conduct all testing procedures as necessary to. determ& said site's suitability for a gr n I absorpti sewage tre ent
and (disposal system.
DATE SIGNATURE
DCHD (193)
i DAVIE COUNTY HEALTH DEPARTMENT
Environmental Health Section
Soil/Site Evaluation q /
NAME V N EX 1R -,•N\;4 DATE EVALUATED
ADDRESS PROPERTY SIZE
PROPOSED FACIILTY X10 LOCATION OF SITE
Water Supply: On -Site Well _ Community Public -L,--,
Evaluation By:�L Auger Boring Pit Cut
FACTORS
1
2
3
4
Landscape position
-S
Slope
HORIZON I DEPTH
"
Texture group
QL
CI -
Consistence
L
Structure
Mineralogy
HORIZON II DEPTH
Texture group
Consistence
"
Structure
C,
�-
Mineralogy
I lk
HORIZON III DEPTH
Texture group
Consistence
Structure
Mineralogy
HORIZON IV DEPTH
Texture group
Consistence
Structure
Mineralogy
SOIL WETNESS
S J'
SS
RESTRICTIVE HORIZON
—
—
SAPROLITE
—
—
—
CLASSIFICATION
S.
S
S
S
LONG-TERM ACCEPTANCE RATE
. 3
SITE CLASSIFICATION: _� •S EVALUATED BY: Ft
LONG-TERM ACCEPTANCE RATE:`° � OTHER(S) PRESENT:
„�0 a
REMARKS: � 1,111 ,. � 1>1 i_ \1 co_�* �wt�S? <.•awr �i�Q
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
CONSISTENCE
Moist
VFR- V+..ry 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 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
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