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1583 Liberty Church RdDavie County, NC Tax Parcel Report A LW Monday, October 3, 2016 EelAll data is provided 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 �'+County 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. WARNING: THIS IS NOT A SURVEY Parcel Information _ Parcel Number: C200000034 Township: Clarksville NCPIN Number: 5812192036 Municipality: Account Number: 13277500 Census Tract: 37059-801 Listed Owner 1: CARTER ELIZABETH JOSEPHINE Voting Precinct: CLARKSVILLE Mailing Address 1: 2621 LOCKWOOD DRIVE Planning Jurisdiction: Davie County City: WINSTON SALEM Zoning Class: DAVIE COUNTY R-A,R-20 State: NC Zoning Overlay: Zip Code: 27103-0000 Voluntary Ag. District: No Legal Description: 73 AC LIBERTY CHURCH RD Fire Response District: WILLIAM R. DAVIE Assessed Acreage: 59.26 Elementary School Zone: WILLIAM R DAVIE Deed Date: 12/1997 Middle School Zone: NORTH DAVIE Deed Book / Page: 1998EO080 Soil Types: MnC2,MnB2,ChA,WATER,MdE Plat Book: 12 Flood Zone: Plat Page: 108 Watershed Overlay: DAVIE COUNTY Building Value: 42940.00 Outbuilding & Extra Freatures Value: 290.00 Land Value: 321270.00 Total Market Value: 364500.00 Total Assessed Value: 364500.00 EelAll data is provided 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 �'+County 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. DAVIE COMITY 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 130A, Wastewater Systems, Section .1900 Sewage Treatment and Disposal Systems) NAME A PROPERTY ADDRESS 1 � t� �i'11 % i� . i?ci� � '70 % DAA LOCATION SUBDIVISION NAME 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'7 Li�?L TYPE WATER SUPPLY DESIGN WASTEWATER FLOW (GPD) NEW SITE ,s / REPAIR SITE SYSTEM SPECIFICATIONS: TANK SIIE 4LL GAL. PUMP TANK GAL. TRENCH WIDTH . r; ROCK DEPTH" LINEAR L 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. I- ' I—P 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 1:80-1:30 P.M. ON THE DAY OF INSTALLATION. TELEPHONE # IS (704) 534-8760. OPERATION PERMIT SYSTEM INSTALLED BY �/°1• r�`_1r.�r.�.�. AUTHORIZATION N0. OPERATION PERMIT BY DATE 5?li **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 FRICTION SATISFACTORILY FOR ANY GIVEN PERIOD OF TIME. DCHD 10/95 APPLICATION FOR SITE EVALUATIONAMPROVEMENT PERMIT & ATC Davie County Health Department Environmental Health Section P.O. Box 8481 Mocksville, NC 27028 (704) 634-8760 ****IMPORTANT****. THIS APPLICATION CANNOT BE PROCESSED UNLESS ALL THE REQUIRED INFORMATION IS PROVIDED. 1. Name to be Billed `�� r 6/Cl;, Contact Person Mailing Address �aql C QiQ0Ur(.LbC'Z>.%die Home Phone 9/0 ?63'1,660 City/State/Zip%/NSTO�/ w IVC 97/D3 Business Phone 2. Name on Permit/ATC if Different than Above Mailing Address 3. Application For: [ ] Site Evaluation City/State/Zip improvement Permit & ATC 4. System to Serve: [House [ ] Mobile Home [ ] Business [ ] Industry [ ] Other [ ] Both 5. If Residence: # People --2— # Bedrooms # Bathrooms—/— [ ] Dishwasher [ ] Garbage Disposal [ ] Washing Machine [ ] Basement/Plumbing [ ] Basement/No Plumbing 6. If Business/Other: Specify type # People #Sinks # Commodes - # Showers # Urinals # Water Coolers If Foodservice: # Seats Estimated Water Usage (gallons per day) 7. Type of water supply: [ ] County/City V<ell [ ] Community 8. Do you anticipate additions or expansions of the facility this system is intended to serve? [ ] Yes [ ] No If yes, what type? PROPERTY INFORMATION REQUIRED: *** IMPORTANT *** A PLAT OF THE PROPERTY MUST BE r�J, SUBMITTED WITH THIS APPLICATION. Property Dimensions: 30� Or / 7 %%r WRITE DIRECTIONS (from Mocksville) TO PROPERTY: Tax Office PIN: # -1�91_ Property Address: Road Name City/Zip E ' If in Subdivision provide information, as follows: Name: Section: Lot #: ; This is to certify that the information provided is correct to the best of my knowledge. I understand that any permit(s) issued hereafter are subject to suspension or revocation, if the site plans or intended use change, or if the information submitted in this application is falsified or changed. I, also, understand that I am responsible for all charges incurred from this application. 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 DATE -7L( 0 �6 SIGNATURE Revised DCHD (06-96) all testing procedures as necessary to determine the site suitability. DAVIE COUNTY HEALTH DEPARTMENT Environmental Health Section Soil/Site Evaluation NAME p//X/�/!7/%� DATE EVALUATED ADDRESS PROPERTY SIZE PROPOSED FACIILTYLOCATION OF SITE .C_/ �,✓ Water Supply: On -Site Well t/ _ Community Public, Evaluation By: Auger Boring Pit Cut FACTORS 1 2 3 4 Landscape position L L Slope Z HORIZON I DEPTH Texture group Consistence Structure Mineralogy HORIZON II DEPTH Texture group Consistence r Structure / :577/ /l Mineralogy el -'l 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: LONG-TERM ACCEPTANCE RATE: REMARKS: DCHD (01-901 EVALUATED BY: OTHER(S) PRESENT: 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-Silt,v .lay loam, SIL -Silty loam CL -Clay loam SCL-Sandy clay loam SC -Sandy clay SIC -Silty clay C -Clay CONSISTENCE Moist VFR- V�_.-y friable FR -Friable FI -Finn 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 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 ■�������/����/�����/�����/�����/��/����� \/ ���� ������� ��� ■�����■�����_���������N■����������n���� �__����� _����������ii��■ ■����������� ������������������� �������� ���u� ��u����������� ■����������������������������n���������i=�i�i �������u���u����� ■�����������������������n�����������u� �u ���■���������� ■����������i�.�/������������������N������/�����������v���������� ■�������������������������Uu������ �����u �������������u������ ...............•....................5....� C.. .... ......■...... .........................................��C.►.��...■�■.■.......... ■/■��■�������������►���������������� ����%��I�'%�0��= ������N�■��� ■�����������������������������v�N���/��I�lLw7i�/���� �■���uu����■ ����������������������r��������� � ������������ ��� �������������� ....................................... ......�...a ..=.s........ ■■■■■■■■■■■■■■■■■.■■■■■u �i■■.._.■■■■■ u■u■ ■■■ ■ ■u■■■■■ ■������■�����������������i=��������.�� � ■ ��� ■ ���� ■ ��■��� ■������ ������ ����������������� ���■���.����� ■ �� "�C� n �� ■�����o����■��_�����■�����=���u=����n��u-•= �ii�u��■��� �iiu ■���■�■���������■��������� ���u������u ��� �-:_■������n u��� ■������������������������������� ����■����� ■ii��in.i:..:_•������ ■�■���������������������������� ����v �■ �au������������v.� ���������������■��������������� ���������u��� �=�u���u���� ■��■���������\�■�����������������������%�� ■ ���� �������� ����/���e��������������������������� �.i��� �e��� ����� ���N� ■���������������■�������■�������� ��ir���r�=� �y �■�� _� �u�� � �������������N�������N�����■�������/.����%��u����■��� �� � ������������������u�u��u����������r�■�a���uu ■�������i■ ■�����■���������������n�n��������►a�w���u�u�����uw ��� ■■������������������■��n�������� ��n� �� ���u�� ��u� �� ■�������������� ■����N��������■������i��=�u�ii�ii ��_����������i � ��������������� ■■����n�u��■������ ��r ����� ■ ��� ■����� ��■s��� N��iu� �������������������u���i u�■� ■ ���� ������� ....................................�...��. .... .E.......0 ............■...■.....■...........■.►...��. ...� ■':�. ■....■. �����H������n �����uu���/�����Wl l��v�� �� u���� ■����u�/��■�u ����W�u��v� �N�!� �� ��N■��� ■�H������������������������■��nl\ �� ■ ■ ������� ��� �����HH�H���..■���������v�l�������� ��� � ��■���� ���������■���n��������������������ll �■N���� ■ ����� ■���i����■���������■�������■�■u = u� ■�� ��v ��������/������� n q�� ■������������������ � ��� I ■ n�� ■�����n��■ ����������'lfc'����■ �� II ■ � � ■������ ��������������u■� ���� ■ul ����� ...... ...... .._.:.��C"C ' �'� . ...... � ����������H�/����� ■ ■ ■ �� ���� ��■�������������������H������� ��' ■ ���■■� ■ �����u����� ���■uU�� �■��� v ������� ��������■����pJ/,.... ���.�..�� �� ■ �� ���iii��■u��'■�"'�' � w"Qii ■ viii� ......:C...........'�.:��.... _.■■..�� ��������...�.�������u�������■■i� i ��y ■ ��� ������������ v�■�u�� ���=w � u�n ���i� ■ �.�����■■=���iu■w�� �i�u �u ■� u���� ��������� ��'/���H�� ■ v� ��� ■������■�����►u/�u���� ■ ���/ �� ■ n ���/� ������v�u��\������� �u ■ ■ ����� ���0���%�N����i���1����■■���� \ 0���� ����������r■� ■ a,���� ������� �un �■ ����n� iii ii■� �i�iu�i°3p'w�ui�� �i��� �u ����i��� �u�� U�i.u�►�ii�ii �'iri�""i� ����%������� ���.V�f���N��■ �����N�� ■��������HL!�I��I�Di i��1�� :■����� ■ �����u ����/l���l�/�������� ' � ��H� ����V���ql'/uI/��I�����v� � ��i/L�n��u ■�����������11V/'/�►�����u��u�� ■ �►. . ��������v'�����■■���nn� dU�H�� ■ ����1�?ri� �����►l��N�N���N ��■� v �/���( ' II �N��� ��1����.���� �� ��� �� �h��� ���� ����u���l����:v���� �� �1 � ���������0 ���� �������u��\����u��� �vl� �■■��/�����v��� ����������8����u��I ���u��N ���� ��I��W■�■�v��Nu�u��� ■���//���������v����/I����U�vn�■v����l■w����n��N�u����� /��������������������►���������v����//�i���l��������/�����0������ :::::�:::::::::::::::::::::'::::::::::n'::'::�:':::::::::::::::::: ■��� ������■���■������ri����=���������� =��tur�����u�u��u��■■� ■ ����������u�������u�����■�u��������■■�����uu�u�u�■����_� �1�����u����■�■����n��������u ����un�� ru�� �����u���■������ ..... .............................. . � .C................. 43.1 AC. /0 \0'h P U+V o O- 40 WATERSHED 0 6' AM . B X99 �6 33 P_9 Ac. ',c. 9g 924 r°D N (6.03 A c.) CO c� u, 1�(2.75 A c CO m� 0 �438e ' ("g0 t, 6 6 2� 4 73 Ac. 29-1 LO 998 2S MAP D -2 m 33 627 660 N c6 1320 Davie County Health Department _ ENVIRONMENTAL HEALTH SECTION P.O. Box 665 Mocksville, N.C. 27028 AUTHORIZATION FOR WASTEWATER SYSTEM CONSTRUCTION A (Issued ip 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.*** AUTHORIZATION NV3ER NAME ZI r / ��l; -'. NAME ON IMPROVEMENT PERMIT (If different than above) SITE LOCATION COMENTS/CONDITIONS ON AUTHORIZATION TD.CONSTRUCT WASTEWATER SYSTEM **WICE*** THIS AUTHORIZATION FD WASTEWATER SYSTEM CONSTRUCTION IS VALID FOR A PERIOD OF FIVE (5) YEARS. ENVIRONMENTAL HEALTH CIALIST DATE DCHD 10/95 t