2031 Liberty Church RdDavie County, NC
t
Tax Parcel Report 0 5 �t Monday, October 3, 2016
WARNING: THIS IS NOT A SURVEY
Parcel Information
Parcel Number: C200000021 Township: Clarksville
NCPIN Number: 5803846196 Municipality:
Account Number:
78191000
Census Tract:
37059-801
Listed Owner 1:
WHITAKER RUTH P
Voting Precinct:
CLARKSVILLE
Mailing Address 1:
2031 LIBERTY CHURCH ROAD
Planning Jurisdiction:
Davie County
City: MOCKSVILLE
Zoning Class:
DAVIE COUNTY R-A,R-20
State:
NC
Zoning Overlay:
Zip Code:
27028-0000
Voluntary Ag. District:
No
Legal Description:
8.07 AC LIBERTY CHURCH RD
Fire Response District:
LONE HICKORY,WILLIAM R. DAVIE
Assessed Acreage:
7.70
Elementary School Zone:
WILLIAM R DAVIE
Deed Date:
6/1987
Middle School Zone:
NORTH DAVIE
Deed Book / Page:
001380003
Soil Types:
MnC2,GrB
Plat Book: Flood Zone:
Plat Page: Watershed Overlay: DAVIE COUNTY
Building Value: 37140.00 Outbuilding & Extra 660.00
Freatures Value:
Land Value: 52690.00 Total Market Value: 90490.00
Total Assessed Value: 90490.00
Davie County,
All data isprovided 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
lei7n
/-�County
of Davie, North Carolina, its agents, consultants, contractors or employees from any and all claims or causes of action due toNC
or arising out of the use or Inability to use the GIS data provided by this website. _1
-AUTxuYzIZATION NO. 0 5 4 8 DAVIE COUNTY HEALTH DEPARTMENT t l X0
Environmental Health Section PROPERTY INFORMATION
Permittee' s ` P.O. Box 848
Name:Mocksville, NC 27028 Subdivision Name:
f i Phone #:704-634-8760
Directions to property: -S � /�' � .� A/ Section: Lot:
AUTHORIZATION FOR
WASTEWATER Tax Office PIN:#
SYSTEM CONSTRUCTION
Road Name: L• { ml y 4.0 Zip: 2'76a,r
**NOTE** 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.
(In compliance with Article 11 of G.S. Chapter 130A, Wastewater Systems, Section .1900 Sewage Treatment and Disposal Systems)
***NOTICE*** THIS AUTHORIZATION FOR WASTEWATER CONSTRUCTION
1 / �jV'f- r%✓.r `1= 6 f '%�% /:'� IS VALID FOR A PERIOD OF FIVE YEARS.
?NVIRONMENTAL HEALTH SPECIALIST DATE ISSUED
DAVIE COUNTY HEALTH DEPARTMENT
IMPROVEMENT AND OPERATION`PERMITS
,t,
;^�
Detections to property:.,-
r' IMPROVEMENT
PERMIT
PROPERTY INFORMATION
Subdivision Name:
Section: Lot:
Tax Office PIN:#
Road Name: L'. lwjj C). aj Zip: 2
**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)
ENVIRONMENTAL HEALTH SPECIALIST DATE ISSUED
***NOTICE*** THIS PERMIT IS SUBJECT TO REVOCATION IF SITE
PLANS OR THE INTENDED USE CHANGE. YOUR WASTEWATER
SYSTEM CONTRACTOR MUST SEE THIS PERMIT BEFORE
INSTALLING THE SYSTEM.
RESIDENTIAL SPECIFICATION: BUILDING TYPE Z # BEDROOMS 2— # BATHS 3 # OCCUPANTS GARBAGE DISPOSAL: Yes or No
COMMERCIAL SPECIFICATION: FACILITY TYPE # PEOPLE # PEOPLE/SHIFT # SEATS INDUSTRIAL WASTE: Yes or No
LOT SIZE TYPE WATER SUPPLY DESIGN WASTEWATER FLOW (GPD) NEW SITE REPAIR SITE A"' -
SYSTEM SPECIFICATIONS: TANK SIZE GAL. PUMP TANK GAL. TRENCH WIDTH (-� .� � ROCK DEPTH ZE/ LINEAR FT IZ -/) /
REQUIRED SITE MODIFICATIONS/CONDITIONS:
IMPROVEMENT PERMIT LAYOUT
i
"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:
n
1, i
�Xc L
4f*
AUTHORIZATION NO. �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 NOWAY BETAKEN ASA
GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORILY FOR ANY GIVEN PERIOD OF TIME.
DCHD 05196 (Revised)
/ DAVIE COUNTY HEALTH
- . � , •_ DEPARTMENT
IMPROVEMENT AND OPERATION PERMITS PROPERTY INFORMATION
Permitee's
Name.4 erd„ r '�t.?J'° Subdivision Name:
Directions to property: Section: Lot:
IMPROVEMENT
PERMIT Tax Office PIN:#
Road Name: !. ;1; r . kV Zip:
**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)
***NOTICE*** TI -IIS PERMIT IS SUBJECT TO REVOCATION IF SITE
r.• PLANS OR THE INTENDED USE CHANGE. YOUR WASTEWATER
ENVIRONMENTAL HEALTH SPECIALIST DATE ISSUED SYSTEM CONTRACTOR MUST SEE THIS PERMIT BEFORE
INSTALLING THE SYSTEM.
RESIDENTIAL SPECIFICATION: BUILDING TYPE # BEDROOMS # BATHS -3 # OCCUPANTS GARBAGE DISPOSAL: Yes or No
COMMERCIAL SPECIFICATION: FACILITY TYPE # PEOPLE # PEOPLE/SHIFT # SEATS INDUSTRIAL WASTE: Yes or No
LOT SIZE TYPE WATER SUPPLY DESIGN WASTEWATER FLOW (GPD) NEW SITE REPAIR SITE
SYSTEM SPECIFICATIONS: TANK SIZE GAL. PUMP TANK GAL. TRENCH WIDTH ' ROCK DEPTH LINEAR FT S, -J?
REQUIRED SITE MODIFICATIONS/CONDITIONS:
IMPROVEMENT PERMIT LAYOUT
s
i
U' j,19 L7 ---
"CONTACT
�-
"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: \ % r l,. i �-�(�14-1
. f -
L
r
AUTHORIZATION NO. OPERATION PERMIT BY: DATE:
4/ T
"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 FUNCTION SATISFACTORILY FOR ANY GIVEN PERIOD OF TIME.
DCHD 05/96 (Revised)
k
,^
DAVIE COUNTY ENVIRONMENTAL HEALTH SECTION
APPLICATION FOR IMPROVEMENT PERMIT (REPAIR)
NAME D1A�(/� fGl�i'�l l•'/f, 41,0�i -PHONE NUMBER
ADDRESS-'� C �Q��.C,� 61 SUBDIVISION NAME
LOT #
DIRECTIONS TO SITE l �/
DATE SYSTEM INSTALLED NAME SYSTEM INSTALLED UNDER
TYPE FACILITY NUMBER BEDROOMS_ NUMBER PEOPLE SERVED
TYPE WATER SUPPLY GI6 SPECIFY PROBLEM OCCURRING
DATE REQUESTED ,�TS ��/ /G INFORMATION TAKEN BY_
This is to certify that the information provided is correct to the best of my knowledge, and that I understand I am responsible for all charges incurred from this application.
SIGNATURE OF OWNER OR AUTHORIZED AGENT.
Rev. 1/93
AU`TFORI7A/TION NO: 1039 DAVIE COUNTY HEALTH DEPARTMENT
' Environmental Health Section
Permittee's 1rf��:P.O. Box 848
PROPERTY INFORMATION
Name:.-� . , �y ' x s" A ,!� ;?
j Mocksville, NC 27028 Subdivision Name:
Phone #: 704-634-8760
Directions to property: ✓., / .l!
AUTHORIZATION FOR
WASTEWATER
SYSTEM CONSTRUCTION
Section:
Lot:
Tax Office PIN:#
Road Name:
**IiOTE** 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.
(In compliance with Article 11 of G.S. Chapter 130A, Wastewater Systems, Section .1900 Sewage Treatment and Disposal Systems)
` ***NOTICE*** THIS AUTHORIZATION FOR WASTEWATER CONSTRUCTION
IS VALID FOR A PERIOD OF FIVE YEARS.
ENVIRONMENTAL HEALTH SPECIALIST DATE ISSUED
DAVIE COUNTY HEALTH DEPARTMENT
r- -�--- r IMPROVEMENT AND OPERATION PERMITS PROPERTY INFORMATION
Permittee's �` �•,r� ; .�
�. Name: .1 �+ a'f• " �'� rr", �� " ^" Subdivision Name:
Directions to property: -' .� �'..' . Section: Lot:
IMPROVEMENT
PERMIT Tax Office PIN:#""
01
Road Name`' F` f r, ' .''�;^ zip
**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)
,fes ***NOTICE*** THIS PERMIT IS SUBJECT TO REVOCATION IF SITE
r ! I� PLANS OR THE INTENDED USE CHANGE. YOUR WASTEWATER
ENVIRONMENTAL HEALTH SPECIALIST DATE ISSUED SYSTEM CONTRACTOR MUST SEE TH ES PERMIT BEFORE
INSTALLING THE SYSTEM.
RESIDENTIAL SPECIFICATION: BUILDING TYPE A/ # BEDROOMS 1,-7 # BATHS # OCCUPANTS GARBAGE DISPOSAL: Yes or No
COMMERCIAL SPECIFICATION: FACILITY TYPE # PEOPLE # PEOPLE/SHIFT # SEATS INDUSTRIAL WASTE: Yes or No
�N C
LOT SIZE TYPE WATER SUPPLY /Y/ /' DESIGN WASTEWATER FLOW (GPD) � / 4 NEW SITE !--' REPAIR SITE
SYSTEM SPECIFICATIONS: TANK SIZE ZLIf - GAL. PUMP TANK GAL. TRENCH WIDTH- f ROCK DEPTH e!�L LINEAR Fr.,5 21,0
OTHER
REQUIRED SITE MODIFICATIONS/CONDITIONS:
IMPROVEMENT PERMIT LAYOUT
"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:
J
is
bellj
AUTHORIZATION NO. / C/� 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 FUNCTION SATISFACTORILY FOR ANY GIVEN PERIOD OF TIME.
DCHD 05/96 (Revised)
goo APPLICATION FOR SITE EVALUATIONAMPROVEMEN
Davie County Health Department DEli-
Environmental Health Section
P.O. Box 848 SEP 2 9997
poo
Mocksville, NC 27028
(704) 634-8760
****IMPORTANT**** THIS APPLICATION CANNOT BE PROCESSED UNLESS ALL
THE REQUIRED INFORMATION IS PROVIDED.
1. Name to be Billed , lrlh it ��� kkk Contact Person �t5�i� �hkiake
Mailing Address 2031 418C,JTY CHORN Pof Home Phone 'lay x/'(2-732, nr 9/0 &79-VIY5-
City/State/Zip kS tJ Jie W-:- 27(».G Business Phone R 16 S'fR - 215 3
2. Name on Permit/ATC if Different than Above
Mailing Address N City/State/Zip
3. Application For: [„}'Site Evaluation [l l4 rovement Permit & ATC [iOoth
4. System to Serve: [ ] House [ ] Mobile Home [ ] Business [ ] Industry [ ] Other
5. If Residence: # People_ # Bedrooms 3 # Bathrooms 2 P rDishwasher.j,-J 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 [,i]' Well [ ] Community
8. Do you anticipate additions or expansions of the facility this system is intended to serve? [ ] Yes [ice] No
If yes, what type?
EITHER A PLAT OR SITE PLAN
PROPERTY INFORMATION REQUIRED: *** IMPORTANT ***�T OF THE PROPERTY MUST BE
Cr SUBMITTED WITH THIS APPLICATION.
Property Dimensions: WRITE DIRECTIONS (from Mocksville) TO PROPERTY:
Tax Office PIN: #5`i�3 -1_ - ID kq LP ; +t 1'1%/ Ip O l V 16 L16efk v C AOA CV K4
Property Address: RoadIf dame L i bP�+Q C A, IZA of co/ -A t r
City/Zip
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, D . i i ) ci+ o i4,e'r to conduct all testing procedures as necessary to determine the site suitability.
DATE— Q:7 SIGNA
Revised DCHD (06-96)
THIS AREA MAY $E USED )-0R DRAWINC7 YOUR SITE PLAN:
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DAVIE COUNTY HEALTH DEPARTMENT
Environmental Health Section SECTION
Soil/Site Evaluation
APPLICANT'S NAME
PROPOSED FACILITY
SUBDIVISION
Water Supply: On -Site Well d� Community
Evaluation By: Auger Boring Pit
DATE EVALUATED
PROPERTY SIZE �G
ROAD NAME
Public
Cut
LOT
FACTORS
1
2 3 4 5 6 7
Landscape position
.(1
Slope %
171,
HORIZON I DEPTH
Texture group
Consistence
Structure
Mineralogy
HORIZON II DEPTH
Texture group
C
C
Consistence
Structure
.4% /!
' re
Mineralogyj
HORIZON III DEPTH
Texture group
Consistence
Structure
Mineralogy
HORIZON IV DEPTH
Texture group
Consistence
Structure
Mineralogy
SOIL WETNESS
RESTRICTIVE HORIZON
SAPROLITE
CLASSIFICATION
S
LONG-TERM ACCEPTANCE RATE
SITE CLASSIFICATION:
LONG-TERM ACCEPTANCE RATE: 13
REMARKS:
DCHD (01-90)
LEGEND
Landscape Position
EVALUATION BY: l
OTHER(S) PRESENT:
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 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
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