648 Fred Lanier Rd lot 4 Davie County,NC' Tax Parcel Report Friday, December 30, 2016
615'x} 499,
FRED LANIER RD
i, 1-620 630 642, 648
610 !-' I'' 'ct�y' ~y
658 �`
1038
477
O 1
1602 457
I i
1
i
I
1
5
s
� I
I
I
590
WARNING: THIS IS NOT A SURVEY
Parcel Information
Parcel Number: G200000084 Township: Calahaln
NCPIN Number: 5719391105 Municipality:
Account Number: 8305768 Census Tract: 37059-801
Listed Owner 1: KILLIAN GOLDIE CAMILLE Voting Precinct: NORTH CALAHALN
Mailing Address 1: 185 GRANNAMAN DRIVE Planning Jurisdiction: Davie County
City: MOCKSVILLE Zoning Class: DAVIE COUNTY R-20
State: NC Zoning Overlay:
Zip Code: 27028 Voluntary Ag.District: No
Legal Description: LOT 4 JOE GOBBLE S/D Fire Response District: CENTER
Assessed Acreage: 1.05 Elementary School Zone: WILLIAM R DAVIE
Deed Date: 11/2015 Middle School Zone: NORTH DAVIE
Deed Book/Page: 010060141 Soil Types: MnC2,MdD
Plat Book: 0009 Flood Zone:
Plat Page: 050 Watershed Overlay: DAVIE COUNTY
Building Value: Outbuilding 8r Extra
Freatures Value:
Land Value: Total Market Value:
Total Assessed Value:
pt'nVut�` 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
County of Davie,North Carolina,its agents,consultants,contractors or employees from any and an claims or causes of action due to
DUN�� NC or arising out of the use or Inability to use the GIS data provided by this website.
Pd
DAVIE COUNTY ENVIRONMENTAL HEALTH '310
P.O. Box 848/210 Hospital Street f
Mocksville,NC 27028
(336)751-8760 Fax#(336)751-8786
AUTHORIZATION FOR WASTEWATER SYSTEM CONSTRUCTION
Account #: 990003257 Tax PIN/EH M 5719-29-9196.04
Billed To: Joe Gobble Subdivision Info: Joe Gobble Division Lot#4
Reference Name: Location/Address: Fred Lanier Road-27028
Proposed Facility: Residence Property Size: 1 ac
ATC Number: 4630
Site Type�w ❑Repair ❑Expansion
**NOTE**This Authorization to Constrict(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 3 #Bathrooms#People Basement❑ Basement plumbing❑
Non-Residential Specifications: Facility Type #People #Seats
Square Footage(or Dimensions of Facility)
Lot Size Type of Water Supply: P<ounty/City ❑Well ❑Community Well
System Specifications: Design Wastewater Flow(GPD) � �L'Xank Size i GAL.Pump Tank GAL.
Trench Width 5V Max.Trench Depth Rock Depth 17-1' Linear Ft. yep
Site Modilcatio, s/Conditions/Other: `/yell_ 0 a ��
'5: ' C-FE 1400—qF—
Contact the Davie County Environmental Health Section for final inspection of this system between
8:30—9:30a.m.on the day of installation. Telephone#(336)751-8760.
f 1po{) Lt._li=
1 q 73'
b
41
As steted In 15A NCAC 18A.3969(5)
accepted Systems may also be usegd
Environmental Health Speciali / Date: 7
DAVIE COUNTY ENVIRONMENTAL HEALTH
P.O.Box 848/210 Hospital Street
Mocksville,NC 27028
(336)751-8760 Fax#(336)751-8786
OPERATION PERMIT
Account #: 990003257 Tax PIN/EH#: 5719-29-9196.04
Billed To: Joe Gobble Subdivision Info: Joe Gobble Division Lot#4
Reference Name: Location/Address: Fred Lanier Road-27028
Proposed Facility: Residence Property Size: 1 ac
ATC Number: 4630
**NOTE**The issuance of this Operation Permit shall indicate the system described on the ATC 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.
System Type: S.T.Manufacturer Tank Date Tank Size
Pump Tank Size
System Installed By: E.H. Specialist: Date:
DCHD 11106(Revised)
., 'APPLICATION FOR SITE EVALUATION/IMPROVEMENT PERMIT & ATC
L ; Davie County Health Department
Environmental Health Section
$ 2006-- L
P.O.Box 848/210 Hospital Street
ll _- . Mocksville,NC 27028
(336)751-8760/Fax(336)751-8786
MCONMENTAL HEALTH 3•t y o 7"
bpplirstinn Y' provement Permit CYAuthorization To Construct(ATC) /Both
***IMPORTANT***THIS APPLICATION CANNOT BE PROCESSED UNLESS ALL OF THE REQUIRED
INFORMATION IS PROVIDED. Refer to the INFORMATION BULLETIN for instructions.
APPLICANT INFORMATION
Name to be Billed 1 Contact Person
Billing Address V5 11 Home Phone 1 /2 -
. City/State/ZIP 2, Q Z g Business Phone 9f6 ` 3 it.f 2-2- 6cf
Name on Permit/ATC if Different than Above
Mailing Address City/State/Zip
PROPERTY INFORMATION
NOTE: A survey'plat or site plan must accompany this application
(Permit is valid for 6 mon with site plan,no expiration with com Tete pl ) Q /
Street Address y City�� � Va� IN# 5- 71q a, 9 cf ) 16
Subdivision Name c>G 01G15� 0+J)S)°tJSe tion/ ot# '1'S2- Lot Size l A G-}-
Directions To Site: ,� D L�'.t��' �,�.L
/ t7 /
Date House/Facility Corners Flagged '7- 2-
If
If the answer to any of the following questions is"yes",supporting documentation must be attached.
Are there any existing wastewater systems on the site? Dyes Rf' o oft-
Does the site contain jurisdictional wetlands? Dyes Rf4oG Po
Are there any easements or right-of-ways on the site? Dyes RNo � °�
t
Is the site subject to approval by another public agency? Dyes Qflo ¢/
Will wastewater-other than domestic sewage be generated? Dyes
IF RESIDENCE FILL OUT THE BOX BELOW
#People 3 . #Bedrooms 3' #Bathrooms_2 Garden Tub/Whirlpool ❑Yes PNo
Basement: Dyes RNo Basement Plumbing: ❑Yes Flo
IF NON-RESIDENCE FILL OUT THE B9LC BELOW
Type of FacilityBusiness�? �"`— otal Square Footage of Building' ,7 #People
#Sinks - #Commodes #Showers #Urinafd
Estimated Water Usage(gallons per day) (Attach documentation of similar facility water consumption)
FOODSERVICE ONLY: #Seats
Type system requested: VConventional ❑Accepted ❑Innovative ❑Alternative ❑Other
Water Supply Type: Vcounty/City Water ❑New Well ❑Existing Well ❑ Community Well
Do you anticipate additions or expansions of the facility this system is intended to serve? ❑ Yes P''Ro .
. If yes,what type?
This is to certify that the information provided on this application is true and correct to the best of my knowledge. I understand that
any permit(s)or ATC(s)issued hereafter are subject to suspension or revocation if the site is altered,the intended use changes,or if
the information submitted in this application is falsified or changed 1 understand that I am responsible for all charges incurred
from this application. I hereby grant right of entry to the Authorized Representative of the Davie County Health Department to
conduct necessary inspections to determine co m liance with applicable laws and rules on the above described property located in
"• Davie County and owned by
Site Revisit Charge
Property owner's or owner's legal representative signature
Date(s):
7- /q- y Client Notification Date:
Date EHS:
Sign given ❑Yes ❑No Account# (3l7
Revised 2/06 Invoice#
v
9�iese�it`
r2 f U(IA
0
5 r \
y •.
r.• L -
.
J 1
r
�3
Vicinity Map
0522
1 -
5590!
—. son 000
---tom
- s65 000,
RO
• t
--
O - \ \ass.00 ` (375)
ODO
6203
-'
----------
5116' ' r/' �, 1, 196"' LO, :. L-d \ � (1.46A
--
4018 mit6 17
-- Lo"
y.iD 1 LorZ ffi5.�0
� � , sas.000
sso.aoo
M.000 _
144
soeo,
,
3.210A �. -- _
4&17
' , 1
(35.19A)
5543-
/ /\/CountyLine
Streets
St4eets
J zRarlroad
i" i 1 t `f Ponds
\/
Contours
Parcels -5 ft
200 0 200 400 600 Feet
FM Printed: May 31,2005
t�
- Tree Line / _ t ------�
1 __ Tree Line-,-" y "
Existing _ - S
Double-Wide
It \ Proposed
Mobile Home Proposed
dHouse House
t
House y
Proposed } y
o X TH #75 72 House
X
tTH #76 X I t co
CO I Q t TH #71 TH #68 yt m
O of v
N Q-C9 S
C) o. \
M o \ U) 3
i J� t N y
QN % o T TH #77 o TH #74 0 TH# 73 X TH #H9
J Z LL t CO. c , X do X p TH #70 X
X 4p _ca
•Q O W
t - i C7►
Ch/
W / CO
C2 N
{' CO
0 0 0--O-_O _
}}a) Aerial Power Lines Aerial Power Lines O / 0 Tax Lot 53
.01 i� ________________ ---+- / - Aerial Power Lines- ---- Tax Ma G-2
_2 --a"- ----^------LL-=- ,,,.--�,---_.__ - -- ---- iiJt �ja�iS85 Cfo'aSrOaCjS �ia�'i�ia� C�iuiG�i
Tree Line Tree Line DB 107 ® PG 344
-. EbrigFt
PG 816 _
t Lot 1 LVt < Lot 3 Lot 4 Lot
1.994 Acres +f— 1,472 Acres +/- 1.117 Acres +f— 1.098 Acres +/— 1.696 Acres
J
231.78' 97.15' 100.13' 101.00
• � ' 206.30`
L—r Total
Draugnt6n
DAVIE COUNTY HEALTH DEPARTMENT
Environmental Health Section
Soil/Site Evaluation
APPLICANT INFORMATION PROPERTY INFORMATION
Account #: 990003257 Tax PIN/EH#: 5719-29-9196.04
Billed To: Joe Gobble Subdivision Info: Joe Gobble Division Lot#4
Reference*Name: Location/Address: Fred Lanier Road-27028 �l"'i
Proposed Facility: Residence Property Size: 1 ac Date Evaluated: Al'TAX
1tIZSlOt.'
Water Supply: On-Site Well Community Public
Evaluation By: Auger Boring Pit s Cut
FACTORS 1 2 3 4 5 6 7
Landscape position4-
Slope% /426 1 7-o Is
HORIZON I DEPTH el," ,
Texture group 1_ 03-
Consistence
Consistence i !/je;r cr $ F'
Structure
Mineralogy '/
HORIZON II DEPTH 55;vw y -
Texture group C
Consistence psrKslp
Structure bit- 4�
Mineralogy
HORIZON III DEPTH i
Texture group 0-4 S4 0
Consistence t,
Structure se k
MineralogyS.
HORIZON IV DEPTH :30 4
Texture group
Consistence
Structure
Mineralogy
SOIL WETNESS
RESTRICTIVE HORIZON 3q qC>
SAPROLITE -
CLASSIFICATION 195
LONG-TERM ACCEPTANCE RATE n. D
SITE CLASSIFICATION: AD EVALUATION BY:
LONG-TERM ACCEPTAN RATE: OTHER(S)PRESENT:
J
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
Tse
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
M41S1;
VFR-Very friable FR-Friable FI-Firm VFI-Very firm EFI-Extremely firm
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
]�tsS
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 05105(Revised)
�S�#4fi t`�.1i 2'�y�„k �F`..z.�'� �43,��,�j 3, ��'��..A .dAti,'S�"F K ..G.. .� °rSY =. �,'a^.�..f�.'` �ti` � i, 'e� -.,L� ..�Y 8�, �i 4 av �,7.. Y*ai•'k 7` .G'.,"'= 'y'.` 't.` �'yA 7. ` M''�'F,;
S.r ..w �' ,+. t»�,. :d "''x`3.,. r.a.��.�.H3+�' ..�cw\z.+ y,*i�: . R4'`#.i�.,. "r.K:h:'i fe:.�s.:.; '�'S& �'�y�;.�a• t�, R%.4�{( r...,.n.-�..k �.^�....fk _t:'A;��..A �. .�s,n t
�* .�. fi. :t�C-..Sy^3 ,.,r .a.. ,r;+TM .,r. `+ ui",. mss+`" mT�'.,., AT"z �,..ti'^b TJ'a". "�.v4 �•. k a?us�T ; `;N�..;. -
.S' ff°.
..:;*e�&s�d*U '��f .y;r,.- ..�: ,:W.. a+'' ,.r .: 1EEK ;#"Zw�. � .. C ,�ps�.. �zn epi µ •. ...1'�..�'d;,A"�'
.,.:,�5 E.-+ M...^`��'3.S �: cys. a�w t 3.-.. ZtlU� "%'1��'f§' :3.,.x1. ,,LOM .'E;;',:� :k ^A✓in r.�X. � i't .tiz�u�lgg^.;" � .�'%1Y"rA tY .. �•
_...,. ..r. � a.„.,7;' & t '�',..E .. �i�•' U:��. ...r :;;.,,.,� ¢:�:,-. � .:�n� ,k.1;;,, trofi .,.:,.ry,.Ce,,,, •..3,��.ds. �, ..?t �%-+� .v,., .a *�.....;. <?.., s
..�.. �: "�'R .�..,;.?..., 2. ..�x.,i,..m� �.�-:.r,�`L . ....:kr" � ,>fiz::;�t k� ':�.... � .x..}�uso;.��'x�E,..�f..7} .+,T"� �•,« rs k' �;�;j, 'Fr.,a:'.e , � #='Sts"?:.;;s��X>``r sr�; ��S f
u+ -
y
t�T[rt%�Y X`Y c �1321�1t Q4%_ �'h✓5 +� r�'^ .y;+5,.`::
}
1
5543
1 K,X4,
s
{ !i ;; 'SC r,hrta k, S'
y x
$yrs
r i
nP a? sa
�pm Il
t d
y.� Y q d!a✓�r,� e ;�r : Q x,I' i"u' '; a ,��! i Tt a1, � � ,;,R 5 x>� � ((� ��$ �fir» ,`�
x<;c x4e t r"✓w4 ` r� £�{ '' .+
t t- `r, v" f r'44 R1v} aS Y tf...d .i{•':
r a
�yA
Qi
' Davie County Environmental Health
P.O.Boa 848/210 Hospital Street
.Mocksville,NC 27028
(336)751-8760/Fax(336)751-8786
IMPROVEMENT PERMIT
Account #: 990003257 Tax PIN/EH#: 5719-29-9196.04
Billed To: Joe Gobble Subdivision Info: Joe Gobble Division Lot#4
Address: 911 Sheffield Road Location/Address: Fred Lanier Road-27028
City: Mocksville Property Size: 1 ac
Reference Name:
Proposed Facility: Residence
**NOTE**This Improvement Permit DOES NOT authorize the construction of a wastewater system. An
Authorization To Construct a wastewater system must be obtained from this office prior to the
construction/installation of a wastewater system or the issuance of a building permit(in compliance with
Article 11 of G.S. Chapter 130A,Wastewater Systems). This Improvement Permit is subject to
revocation if site plans,plat or the intended use change.
Permit Type: Xw ❑Repair ❑Expansion Permit Valid for: 0 Years Expiration
Residential Specifications: #Bedrooms 3 #Bathrooms 2 #People Basement❑Basement plumbing❑
Non-Residential Specifications: Facility Type #People #Seats
Square Footage(or Dimensions of Facility)
Design Flow(GPD):a Type of Water Supply:.ET6unty/City ❑Well ❑Community Well
Site Modifications/Permit Conditions:
S stem e LTAR
Initialr�14L
Repair A
Site Plan
l
CBP
coo' JIB
022
Environmental Health Speciali<::::� Date (/
i.p.l l-06