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2573 Liberty Church Rd Davile County,NC Tax Parcel Report Wednesday, February 8, 2017 E 25441 LIgEa •(•,HURON RD ffr 2589 2601 k,�` ,.• `-2573 l 2496 X 2493 2479 2 471 _............................. __.............._..............................................__...._.__ _.._-__.___ ' ........._.........._....._...............................................-....._.........__................................... .._..__....._..................___.__._...__..... ,-..._ . . WARNING: THIS IS NOT A SURVEY Parcel Information Parcel Number: B20000000406 Township: Clarksville NCPIN Number: 5803594473 Municipality: Account Number: 82516707 Census Tract: 37059-801 Listed Owner 1: REAVIS SHERMAN BLEU Voting Precinct: CLARKSVILLE Mailing Address 1: 2573 LIBERTY CHURCH ROAD Planning Jurisdiction: Davie County City: YADKINVILLE Zoning Class: DAVIE COUNTY R-20 State: NC Zoning Overlay: Zip Code: 27055-0000 Voluntary Ag.District: No Legal Description: 6.369 AC LIBERTY CHURCH Fire Response District: LONE HICKORY Assessed Acreage: 5.66 Elementary School Zone: WILLIAM R DAVIE Deed Date: 4/2001 Middle School Zone: NORTH DAVIE Deed Book/Page: 003680030 Soil Types: MnB2,MdC Plat Book: Flood Zone: Plat Page: Watershed Overlay: DAVIE COUNTY Building Value: 259850.00 Outbuilding&Extra 0.00 Freatures Value: Land Value: 43520.00 Total Market Value: 303370.00 Total Assessed Value: 303370.00 All data Is provided as la 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 ��UN'� NC or arising out of the use or Inability to use the GIS data provided by this website. Da4ie County Health Department q16 � Environmental Health Section P.O.Box 848 . .� •�`•'�, ,� 210 Hospital Street 0 U Courier# : 09-40-06 n 1 Mocicsville,NC 27028 Phone:(336)-753-6780 Fax:(336)-753-1680 ON-SITE WASTEWATER CERTIFICATION (Check One) Replacement Remodeling Reconnection Name: e r�y n ��e_y/, "R-C.7AN_y L Phone Number '�?,G �7'D/S_5� (Home) Mailing Address: �5-7 , eeI.T «r C, (Work) (Z o a� L(aAlti)nv t (LP- Email Address: lln,,,ji� 1ti79,Q �4c3b ijn Detailed Directions To Site: f1l W PropertyAddress: Please Fill In The Following Information About The EXISTING Facility: [� Name System Installed Under: �7 r 3 l ex ,&V 5 Type Of Facility: Date System Installed(Month/Date/Year): �j l L -U Z- Number Of Bedrooms: Number Of People: f Is The Facility Currently Vacant? Yes No If Yes,For How Long? Any Known Problems? Yes No If Yes,Explain: Please Fill In The Following Information About The NEW Facility: Type OfFacility: Vo rag e Sh ed Number Of Bedrooms: Number of People 'Pool Size: Garage Size: ?0 y7 0 Other: ,(Requested By: Date Requested: (Signature) For Environmental Health Office Use Only ,:A:ppr ve Disapproved 7 Comments: -to 4 -e 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 p erl for any given period of time. Payment: Cash Check Money Order # Amount:$ Date: Paid By: Received By: Account#: Invoice#: ! v / M. ' yfa s c= T� h . Ij tt, 3544 y � � If 75 : r.rt. yam/ y 9 `Y l,'.'� •i T.. ._�' ,41..i.. �V.} 4� 1? �� .fit-`d<� a 1:. l � S 247 � 1 Fee. 0 20 fi0 120 v+ v y lyy/ �I�I,Q, L�I�s • Davie Caunry hss canpiled chis mvp Gom vuiaus wuaes aM makes nowmndes C/ or rtpruemuonc ezpmsed m implieq in fxr or in lau'.irclWingwrhwr liminrian µ 1. Ute implied wrevmes of merchanradliry aM fimess(orapacUMar purpose s Users art crcouuged m nods Utc GIS Depuvncmaf utcottasrettoev in rhe map Davie CowryDercbpmen15ecins w Urn corrtcnons can M made u,Ivmrt pnnUngc , Februvryt0,4916 ` • , • I • DAME COUNTY HEALTH DEPARTMENT Environmental Health Section P.O.Boa 848/210 Hospital Street Mocksville,NC 27028 (336)751-8760 Account #: 990001682 Tax PIN/EH#: 5803-59-7811 Billed To: S. Bleu Reavis Subdivision Info: Reference Name: Location/Address: Liberty Church Road-27028 Proposed Facility: Residence Property Size: 6.395 acres ATC Number: 2791 AUTHORIZATION FOR WASTEWATER SYSTEM CONSTRUCTION **NOTE** This Authorization for Wastewater System Construction MUST BE ISSUED by the Davie County Environmental Health Section prior to issuance of any building permit(s). This Form/Authorization Number should be presented to the Davie County Building Inspections Office when applying for building permit(s)(in compliance with Article 11 of G.S.Chapter 130A,Wastewater Systems,Section.1900 Sewage Treatment and Disposal Systems). THIS AUTHORIZATION FOR WASTEW N I D FOR A PERIOD OF FIVE YEARS. Environmental Health Specialist's Signatur : Date: CERTIFICATE OF COMPLETION **NOTE** The issuance of this Certificate of Completion shall indicate the system described on Improvement/Operation Permit 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 thetem�vill function satisfactorily for any given period of time. �� C-e©►,1 T INS I400 s` T X.5to "LIT l Septic System Installed By: Environmental Health Specialist's Signature- Date: i DCHD 05/99(Revised) DAVIE COUNTY HEALTH DEPARTMENT • Environmental Health Section P.O.Bog 848/210 Hospital Street Mocksville,NC 27028 (336)751-8760 IMPROVEMENT/OPERATION PERMIT Account #: 990001682 Tax PIN/EH#: 5803-59-7811 Billed To: S. Bleu Reavis Subdivision Info: Reference Name: Location/Address: Liberty Church Road-27028 Proposed Facility: Residence Property Size: 6.395 acres ATC Number: 2791 **NOTE** This Improvement/Operation Permit DOES NOT authorize the construction 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). THIS PERMIT IS SUBJECT TO REVOCATION IF SITE PLANS OR THE INTENDED USE CHANGE. YOUR WASTEWATER SYSTEM CONTRACTOR MUST SEE THIS PERMIT BEFORE INSTALLING SYSTEM. Residential Specification: Building Type rl601EC #People Ll #Bedrooms—_ #Baths 2.1 Dishwasher: Cl Garbage Disposal: ❑ Washing Machine: Mr— Basement w/Plumbing: er Basement/No Plumbing: ❑ Commercial Specification: Facility Type 1 ' #People #People/Shift #Seats Industrial Waste: ❑ Lot Size&- ��ype Water Supply w Design Wastewater Flow(GPD Site: New Repair❑ System Specifications: Tank SizelDCOGAL. Pump Tank GAL. Trench WidthQt Rock Depth Linear Ftt Other: -1�` T1E 7�fy�( J ��5��1.�l.�r S i'�. 1�/l t , Required Site Modifications/Conditions: I t'y�TALL_ Oj cj> r -rtyj12 Vlela-P 1!�o4;:C- 4uynkz, IMPROVEMENT/OPERATION PERMIT LAYOUT- APPROVED EFFLUENT FILTER RISER(S)IF 6"BELOW FINISHED GRADE. ****NOTICE: Contact a representative of the Davie County Health Department for final inspection of this system between 8:30 a.m.to 9:30 a.m.or 1:00 p.m.to 1:30 p.m.on the day of installation. Telephone#is(336)751-8760.**** t F Pcx-�J'r TO L T H 00f�)r-2- +� a �Za Environmental Health Specialist's ture- Date: o� �l02 L�"� 0 6 DCHD 05/99(Revised) • RR ------------•�,41 ICATiON FOR SITE EVALUATION/IAIPROVEM1tENT PERMIT tf ATC D .L5 �• • Q Davie County Health Department Environmenta/Healtfi Secdw P.O. Box 848/210 Hospital Street 9+ Mocksville, NC 27028 (336)751-8760 ENVIRONMENTAL ** APPLICATION CANNOT BE PROCESSED UNLESS ALL THE REQUIRED INFORMATION IS PROVIDED. Refer to the INFORMATION BULLETIN for instrucc/�tions.. 1. Name to be Billed _ L I¢ e(�uV�l�j Q(� Contact Person ^�N QU. c[�eT✓17 Mailing Address ok!A )( L t d6 t t' A Gln` ` P` Home Phone ]X31 � I!2•^�1r9,2•3 City/State/ZIP �lr�1t�y IIC 0. C. .13 < Business Phone L Y- 7 v� 2. Name on Permit/ATC if Different than Above Mailing Address City/state/zip 3. Application For: Site Evaluation Improvement Permit/ATC ❑ Both 't 4. system to Service: (/House ❑ Mobile Home ❑ Business ❑ Industry ❑ Other 5. If Residence: # People -4 Bedrooms �_ 3 # Bathrooms � L1 Dishwasher ❑ Garbage Disposal /Washing Machine Basement/Plumbing ❑ Basement/No Plumbing 6. If Business/Industry/Other: Specify type # People # Sinks # Co— des # Showers # Urinals # Water Coolers IF FOODSERVICE: # Seats Estimated Water Usage (gallons per day) 7. Type of water supply: ❑ County/City Well ❑ Community a. Do you anticipate additions or expansions of the facility this system is intended to serve? ❑Yes d N0 If yes,what type? ***IMPORTANT***CLIENTS MUSTCOMPLETETHE REQUIRED PROPERTY INFORMATION REQUESTED BELOW. Either a PLATT or SITE PLAN MUSTBESUBMITTED by the client with THIS APPLICATION. Property Dimensions: w WRITE DIRECTIONS(from Mocksville)to PROPERTY: Tax Office PIN: SAO 5551 7 S/1 6� ( e. Property Address: Road Name L-1 GI+• �� Q city/zip to G�--� - If in a Subdivision provide information,as follows: S T"l�S 6 ^' s a Name: Section: Block: Lot: Date Property Flagged: v 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 frons 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 conduct all testing procedures as necessary to determine the site suitability. DATE Aigri/ SIGNATURE -2Z& n2, dZ, 'C._�___.Q. THIS AREA MAY BE USED FOR DRAWING YOUR SITE PLAN(Include all of the following: Existing and proposed property lines and dimensions, structures, setbacks, and septic locations). Site Revisit Charge 1 S DV(qs): Ilient Notification Date: EHS: p Account No. l0 0 Z Revised DCHD(07/99) Invoice No. r DAVIE COUNTY HEALTH DEPARTMENT • Environmental Health Section Soil/Site Evaluation APPLICANT INFORMATION PROPERTY INFORMATION Account #: 990001682 Tax PIN/EH#: 5803-59-7811 Billed To: S. Bleu Reavis Subdivision Info: Reference Name: Location/Address: Liberty Church R d-270 8 Proposed Facility: Residence Property Size: 6.395 acres Date Evaluated: I ! Water Supply: On-Site Well %-1/ Community Public Evaluation By: Auger Boring ✓� Pit Cut FACTORS 1 2 3 4 5 6 7 Landscape positionL Slope% S o HORIZON I DEPTH - to — 0—('0 Texture group 0_'Uf!A' Consistence Structure c-a C91 (1142- Mineralogy !.` l: 1 I i HORIZON II DEPTH Ca - Texture group Consistence Q Structure AS14 S10k ell 6 k Mineralo M, 1 HORIZON III DEPTH - Z- Texture groupkS f Consistence frS Structure < g)~ Mineralogy t t 1 HORIZON IV DEPTH -F 4- Texture groupSO Consistence Structure Mineralogy SOIL WETNESS RESTRICTIVE HORIZON SAPROLITE CLASSIFICATION S S LONG-TERM ACCEPTANCE RATE _3 _ 3 S D - E� SITE CLASSIFICATION: EVALUATION BY: LONG-TERM ACCEPTANCE RATE: OTHER(S)PRESENT: 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 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/fU DCHD 05/99(Revised) f. ■■■■■■■■■■■■11■■■■■■■■■■■■■■■■■■■■■■■■■■■■■ell■■■■/■■■■■■■■■■■■■■■■■ ■■■■■■■■■■■■11■■■■■■■■■■■■■■■■■■■ ■■■■■■■■■11■■■■■■■■■■■■■■■■ MEMOS ■■■■■■■■■■■■11/■■■■Idia■■■■Mr■■■1.7■EM■■11.7■■■■■■11/E■M/■■eE■e■■■■■■N/■■■ ■■■■■■■■■■■■11■■■■■■■/■■e■■E■�■■■ ■Iii■■ME■■11■E■■■■■e■M■■■■/■■■■■■■ ■■■■■■■■■■■■Ire■■■■■■■■■■Ee■■�s,■■■E■c��■■■.�.e►�i//M/■■■■■■/■■M■■■nr■■■■ ■■■■■■■■■■■■r1■■■■■■■■rn■■■■■■■■u■■■I`r���l►��a�`a►M�11■■■■■■■■■■e■■e■■■err■■■ ■■■■■■■E■■■■r■■■■ME■■■Mlce■■■■■■■■■■■r,■■■ri��►��►�a1■E/E/■■■■■■M■■■■■■i EMO ■■■■■■■■/■■■u■■■■■■■tM■■■■■■■■■■1�■Ira■■■I,1���►��1■/M■■■■■e■■■■■■■■■I.1■■■ SIMONSENEMINEMiMEMEMEERMEMEl MEMMEMEmmonsMEMMEMME NNEN ■/■■■■■■■■■■I■■■■■■■■■■s/■■■■Ira■le■■■■M■■■■/■■■■■■■■■■/■■■■EM■r-•aM■■ ■■■■■■EE■■E■I■■■■■■■■■■■/■■■■\r■■1i■■■■■M■■■■■M■■■■■■■■■■■■■■■■fel\M■■ ■■■■■■■■■■■■�■■■■■■■■■■■/■■■■■■M■■■■■■■■■■■■■■■■■MMM/■■eMMe■■e■■■■■ ■■■■■■■■■■■■■■r�■■■■■■■■■■■��■■■■■■■■■■E■■■■■■■■■■■■■■■■■■Err■■■■■■■ • YADKIN COUNTY DAV ICC I I y hur�h �a j SITE Centerline Curve lable CURVE RADIUS_ LENGTH CHORD T BEARING C-1650A0' 76.55' 76.505' S 89' '16' E Narµ¢1 C-2 2138.60' 156.86' 156.83' S 89'25'20' E v�.e Rd C-3 538.53' 1 246.21' 244.07' S 75'40'07' E 'topP Location Map Not To Scale LlBhRTY ChrbrRChr ROMP PUBLIC RIGHT 17F WAY - — - — ------- ---- N 88.05 ab• E I �.-•,,.� !-._ }� — _C-1 ______� ___----------- 293 59' __ --- -- - -------�----- - --+ �_'__.----_.!'_--.___,.�`�\ i Q4 �ltdin� \ Nlp Set Q4 4-1G r m u^ I ObaCCO L ` \ � Barn ISI - OV F u ti'ruposcq rtoa�e ds rt, rc �o f� To), Lot 0444 Map 5803 lacqupline jcmes N DB 78 PG 44. ¢i I v, i 6.36 Acres <dr�d �� ``` lux Lot 3546 Map b803 Sherman R Reovis z N a UH 114 P6' 819 Pond KENNETH L. FOSTER, PLS 2552 cERnFY THAT THIS MAP WAS DR*ff UNDER MY ,;UP£R17S`ON FROM AN E*tstmy ACTUAL FIELD SURVEY MODE UNDER MY SUPERRISION ON 1' I-'�•O \�� '-- _ _� / MFih't.ti 20 01 ! FURTHER CERT/FY THAT ACCLIRDIVO TO SAID FIELD SURVEY, THE PROPERTY LINES AND 10CATION OF ALL STRUCTURES ARE ACCURAT£L 1 SHOWN HfR£ON". Nip e t120 98' T -- F;n . CA k O e •�FESSID < \ I z S E A L � L-2552 PROPER r INE \ Tot Lot 5054 Map 803 �r�y��. Q•�` n F SUR pvSNT rr \,Av INf \ - ._�>MPC f' I-r'IC4 N �� ''• •••• — — -- — — LINE FPOk DEED OR PLAT 5 ^ ¢ •���i FTH L• F 0`0 D6 19.. r%• 7 j a "'Its I N/F NOW OR rORMERLv DB DEED BOOK \ I I PR£G'lS10N 1.•10,UIXI FEE7t PG PAU I DMD DOUBLE MERIDAN DISTANCE CL r_ENTERLINE v�, +� SURVEY FOR: Pt PROPERTY LINE 0a x R/W J RIF.HT OF WAV F F FINISHED FLOOR ELEVATION Lo 0 EI? EXISTING IRON FOUND O NIP NEW IRON SET c� 0 POINT < NO MONIIMENTATIpN SEI U REFERENCE DEED: DB t 14 PG 819 rJ NCG; CONTROL MCINUMENT r inlJttNla Nom „ + PORTION OF TAX LOT 3546 MAP 5803 (-Q40 LXI ALSO PART OF LUT 4 MAP 82 MAIL SET Exls^rr TOt1E CLARK-W111LE TOWNSHIP ; DAVIE COUNTY, N.C. c WATER METER �n CT-� ttTT1 TTY PO;f _ ' � 1'� LIGHT POLE I�_ SCALE a Lr, � \\ DATE: MARCH 2, 2001 SCALE: G R AY rI 1•' � 80' n SANITARY SEWER MANFI)LE TOTAL ACRES $Y DMD = 6.389 6' 6" _______-- ► tY�hrNh'?ff A'�S'�hR at .rs.S'OCLlT�.S, P� FIRE KYT)RANT - n rpTru [f SIt7 C- U YI < YARD INLET I FRBFE�;-iUNAL LAND SURI,'El't�, - PLANACR� an r' --- --'--`---------- Note, This ptot and any acco"ponyrip docunents 2200 SILAS CREEK PARKWAY SUITE 1-B 1. rn C CFVFR Cl FAN-NIT ; rt�r FE�.r, ort fur�tshed to the W, _ {I --34LE N!' CA Nfi 7! TELEPHONE POLL PLD person <si oo"ed thereon In�Ct u c t M tN Pl11 ► ? tR? _ Any nt teratbns or use by others �o.y be m V •� 1 inch = 60 ft. Y"utan of North Carokma copyright taw uaess TELEPHONE: 336 / 723-8850 y :r < per"tsston Ts obtamed fro" the Surveyor whose Ex+sting CC WATER VALVE Any tz ficial Seal "4cbstrure appears on this pint. A ' �• "�'� SHEAT 1 OF 1 JOB N0: 2535-0I C V y uauttwred dtstnbutton of this plat con constitute copyr ght riFrrigt"ent