178 Northbrook Dr Lot 21 Davie County,NC Tax Parcel Report Tuesday, February 7, 2017
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WARNING: THIS IS NOT A SURVEY
Parcel Information
Parcel Number: G306OA0021 Township: Mocksville
NCPIN Number: 5820328109 Municipality:
Account Number: 19560000 Census Tract: 37059-801
Listed Owner 1: DALTON LENORA A Voting Precinct: NORTH MOCKSVILLE COUNTY
Mailing Address 1: PO BOX 712 Planning Jurisdiction: Davie County
City: MOCKSVILLE Zoning Class: DAVIE COUNTY R-A
State: NC Zoning Overlay:
Zip Code: 27028-0712 Voluntary Ag.District: No
Legal Description: LOT 21 NORTHBROOK PHASE TWO Fire Response District: CENTER
Assessed Acreage: 0.68 Elementary School Zone: WILLIAM R DAVIE
Deed Date: 11/1998 Middle School Zone: NORTH DAVIE
Deed Book/Page: 002070355 Soil Types: PcC2,CeB2
Plat Book: 0007 Flood Zone:
Plat Page: 003 Watershed Overlay: DAVIE COUNTY
Building Value: 105750.00 Outbuilding&Extra 960.00
Freatures Value:
Land Value: 22000.00 Total Market Value: 128710.00
Total Assessed Value: 128710.00
9 t y�A All data Is provided as is without warranty or guarantee of any kind either expressed or implied Including but not limited to t]dueto
Davie County, Implied warranties of merchantability or fitness for a particular use.All users of Davie County's GIS website shall hold harmlr County of Davie,North Carolina,Its agents,consultants,contractors or employees from any and all claims or causes of actio
�OCN4 NC or arising out of the use or inability to use the GIS data provided by this website.
AUTHOR ATION NO: DAME COUNTY HEALTH DEPARTMENT
1373
Environmental Health Section PROPERTY INFORMATION
Pemtittee's ��� �+ P.O.Box 848 `
Name: V'!J ��W� Mocksville,NC 27028 Subdivision Name:
Phone#:704634-8760
Directions to property: rt:1 h� �1 ,> I;A n��4 Section: Lot: i
AUTHORIZATION FOR i �(
r241 LP ILS 4 r O*J tic i t�iC- '�.,� WASTEWATER Tax Office PIN:#SSZt,>
SYSTEM CONSTRUCTION
c P,1 ) t Road Name: t�_C7,+G-�'.>_v+L��p: 7-i v'..�, # ry Q t
**NOTE**This Authorization for Wastewater System Construction MUST BE ISSUED by the Davie County Environmental Health Section prior I r
to issuance of any Building Permits.This Form/Authorization Number should be presented to the Davie County Building Inspections k
Office when applying for Building Permits. f
(In compliance with Article I1 of G.S.Chapter 130A,Wastewater Systems,Section.1900 Sewage Treatment and Disposal Systems) i
�Af , ***NOTICE***THIS AUTHORIZATION FOR WASTEWATER CONSTRUCTION
1S IS VALID FOR A PERIOD OF FIVE YEARS.
ENVIRONVE7 ALE�I ALTH SPECIALIST DATE ISSUED
RESIDENTIAL SPECIFICATION.BUILDING TYPE NOVA #BEDROOMS 3 #BATHS 2 #OCCUPANTS GARBAGE DISPOSAL:Yes or�. ,
COMMERCIAL SPECIFICATION:FACILITY TYPE #PEOPLE #PEOPLE/SHIFT #SEATS INDUSTRIAL WASTE:Yes or No
LOT SIZE«{ TYPE WATER SUPPLY`sx?IJTy DESIGN WASTEWATER FLOW(GPD) NEW SrrE—::!:::L REPAIR SITE
ii I
SYSTEM SPECIFICATIONS: TANK SIZE t? GAL PUMP TANK j�j GAL TRENCH WIDTH ROCK DEPTH IZ LINEAR Fr. C
OTHER I 'n�eAbJ'h0� " �1 <
REQUIRED SITE MODIRCATIONSICONDTTIONS: l�6i LL GN �N izV 2 i K—aI' 5' d� rl d J5e.VtEl D er
IMPROVEMENT PERMIT LAYOUT J
�eV.-=-eCN: i
-
2�
- 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:
-Ij
1 )'1 r� hrtS 176 6�<k r
qa l �e
�r
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 NO WAY BE TAKEN AS A
GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORILY FOR ANY GIVEN PERIOD OF TIME.
DCHD 05/96(Revised)
r .t�e5 K -�>e(e,^'^ -x:a' y.a•ti4`"Cr 4a `p'w 7� i",".1{.G a.yYc r'::a'.,.w !r"1'.;< "' '�:r l -. _ �... 'ui'.s,:-. r . ,i^. ,.. ---' ,...
AUTHORISATION NO: DAVIE COUNTY HEALTH DEPARTMENT
1373
Environmental Health Section PROPERTY INFORMATION
"PeiQi tee's �'� P.O.Box 848
Name: fJ IQ Mocksville,NC 27028 Subdivision Name: c' T Il nth
w Phone#:704-634-8760
Directions to property: U1 tJ � L Section: Lot:
r�,., AUTHORIZATION FOR c�
{5. tAT- V"� 00r--rtiiC k WASTEWATER Tax Office PIN:#
— SYSTEM CONSTRUCTION
Road Name:
**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
IS VALID FOR A PERIOD OF FIVE YEARS.
ENVIRbNIvtEIV�AL EALTH S ECLO ST DATE ISSUED
VVV
xv p�Y v� 3.� .,r ,": •".+ ">w-:..-aw...wr+'w.+•"M•''y'Y:.w+ yr. ..r.,.,—,- K :.:�.. .,;t_-� ,,,x::.. //JJ�.. ... .... ....
DAVIE COUNTY HEAL H DEPARTMENT
IMPROVEMENT AND OP RATION PERMITS " PROPERTY INFORMATION
:t _1 Subdivision Name: t:= 1t� {'t: ,t
Directions to property: fr't._l tM'' �-' 1,� , �, ""— Section: Lot.
i
IMPROVEMENT
f''Ai L17>_ �,' t t3� t�lti��'i t1 `ct`F� PERMIT
\ ,A f� // ((,,��yy ))�y{,( *i Tax Office ) £
t„N t'.::L4k k� J L1'�L.V_,j 4\ (I a �'��::i t�4aa J°a,q$� � `�R._.S»�.t4C�L-<.�� � r ;,_� ��•
Roadame: Yp: ti ....
t
**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***THIS PERMIT IS SUBJECT TO REVOCATION IF SITE
PLANS OR THE INTENDED USE CHANGE.YOUR WASTEWATER
ENVIRON AL HEALTH SPECIALIST DATE ISSUED SYSTEM CONTRACTOR MUST SEE THIS PERMIT BEFORE'
INSTALLING THE SYSTEM.
RESIDENTIAL SPECIFICATION:BUILDING TYPE NOV S #BEDROOMS 3 #BATHS +Z- #OCCUPANTS GARBAGE DISPOSAL:Yes or .,,
COMMERCIAL SPECIFICATION: FACILITY TYPE #PEOPLE #PEOPLE/SHIFT #SEATS INDUSTRIAL WASTE:Yes or No
LOT SIZE t E WATER SUPPLY C rJTY DESIGN WASTEWATER FLOW(GPD) :3(CC> NEW SITE REPAIR SITE
SYSTEM SPECIFICATIONS: TANK SIZE I GAL. PUMP TANK GAL. TRENCH WIDTH _7:�(o ROCK DEPTH 12LINEAR FT.
OTHER ` �P_Abur10�
REQUIRED SITE MODIFICATIONS/CONDITIONS: 02�iA LL CN UAY 0-1 �� cJr Hdjx. yFF YD •UJcS
6AboNYTA,,J Q'0,6.
IMPROVEMENT PERMIT LAYOUT
Rev,-sed
loo _
a j
*"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 L
SYSTEM INSTALLED BY:
-�1
AUTHORIZATION NO. OPERATION PERMIT BY:_- CSC./ 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)
i
�' �+► APPLICATION FOR SITE EVALUATIONAMPROVEMENT PERF
Davie County Health Department
Environmental'Health Section t
P.O.Box 848 APR 2 3 M
Mocksville NC 27028
"MMY7
X'(3 660 ENVIRONMENTAL HEALTH
****IMPORTANT**** THIS APPLICATION CANNOT BE PROCESSED fR& 8
VIE COUNTY
ALL THE REQUIRED INFORMATION IS PROVIDED.-T
1. Name to be BilledLiZE1l�$ Contact Person ./FRR4 CREW$
Mailing Address SOI E1-YhORE1Zd • Home Phone Y47-76/d?
City/State/Zip M0CA<5 �'J L 2-7JZ8 Business Phone �2-76l R
2. Name on Permit/ATC if Different than Above
Mailing Address City/State/Zip
3. Application For: ❑ Site Evaluation I9'tyImprovement Permit&ATC ❑ Both
4. System to Serve: B House ❑ Mobile Home ❑ Business ❑ Industry ❑ Other
5. If Residence: # People # Bedrooms 3 # Bathrooms Z
UY/Dishwasher ❑ Garbage Disposal 5r/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 ❑ Well ❑ Community
8. Do you anticipate additions or expansions of the facility this system is intended to serve? ❑ Yes ❑ No
If yes,what type?
EITHER A PLAT OR SITE PLAN
PROPERTY INFORMATION REQUIRED: ***IMPORTANT***A B1:VM!!31<'THE PROPERTY MUST BE
SUBMITTED WITH THIS APPLICATION.
i
Property Dimensions: 235' 1C /,TS' 235� X /Co, 1 WRITE DIRECTIONS(from
Mocksville)TO PROPERTY:
Tax Office PIN: # sS$aO - 31 - G 9 01 1
601 A109M TO -TJMZ!S
Property Address: Road Name N0CyT\J118R00VC1 'D-IAZ•`tz I
Clht
City/Zip M OC.KS J 11 t OC— 2--7o4? '
' -s -ra l✓ozrr� �
If in Subdivision provide information,as follows: 1
Pi LT LoT ow R'i &T-
Name: lvyk t 2eOfllt 1
� 1
Section: P ,45,C TWO Lot #: o2I �
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 E� Cr'C�w to conduct all testing procedures
as necessary to determine the site suitability.
DATE 7- 23-!Q 00 SIGNATURE
Revised DCHD(06-96)
YOU MAY USE THE BACK OF THIS FORM FOR DRAWING YOUR SITE PLAN.
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NOTES:
OF LAND wnwN THE AREA A
rmSE ONE OF IIORrNlMOOIc .�`'� �, Ry'aI"m side found
p OF j -e Maks sit
PEAT OL 6 PAGE 124 . r•�� r:
S LOT �1 1 r L,Di f2 �:0 un nddlod Paint In co4w d eroncb
Mo KM" nwnunGmt WWI% 2000•
r L-25" c.r �anawt t uonl - 4W
ROW' t, 7ttT 1t1101r, c� IFY Tw uS[at — 3fl
An Mwmnx , MIS mp _ . - t s•
APPLICATION FOR SITE EVALLIATIOWIMPROVEMENTS PERM
Davie County Health Department
Environmental Health Section SEP ( 8 1995
P. O. Box 665
Mocksville, NC 27028 i
ENVIRONMENTAL
DAVIE COU
1. Application/Permit Requested By
{
Mailing Address
' `ala cs
Home Phone q9,9#rf 1 7 Business Phone
2. Name on Permit if Different than Above
3. Applidation/Permit for: V�/General Evaluation ❑ Septic Tank Installation
4. System to Serve: (P/House ❑ Mobile Home ❑ Place of Public Assembly
❑ Business ❑ Indust f Other ❑ Unknown a) yy
5. If house, mobile home:Subdivision wo � vRaa�Section Lot#, '�iL
❑ Basement/Plumbing
No. of People ❑ Basement/No Plumbing
No. of Bedrooms ❑ Washing Machine
No. of Bathrooms ❑ Dishwasher
Dwelling Dimensions ❑ Garbage Disposal
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: ErPublic 7 ❑ Private ❑ Community
8. Property Dimensions ( �&,t�tC, G fgezuQL Sewage Disposal Contractor 7
9. Do you anticipate additions/expansion of the facility this sytem is intended to serve? ❑ Yes ❑ No
If yes,what type?
'NOTE: Improvements Permits shall be valid for a period of 5 years from date issued. Improvements Permits are subject to
revocation, if site plans or the intended use change. Effective October 1, 1989.
Directions to Property: d a411
This is to certify that the information provided is correct to the best of my knowledge, and I understand I am responsible for all charges
incurred from this application.
DAT SIGNATURE
CONSENT FOR SITE EVALUATION TO BE DONE ON ABOVE DESCRIBED PROPERTY
MUST CHECK ONE: 1. I OWN the property. ❑ 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 Health Department to enter upon above described
property located in Davie County and owned by
to conduct all testing procedures as necessary to determine said site's suitability for a ground absorption sewage treatment
If
disposal system.
DATE SIGNATURE
DCHD(12.90)
- DAVIE COUNTY HEALTH DEPARTMENT
Environmental Health Section F�
Soil/Site Evaluation p
NAME ��5 DATE EVALUATED 9
ADDRESS 'l) E.', . Q PROPERTY SIZE no '' GyU
PROPOSED FACIILTY \X o v SQ- LOCATION OF SITE
Water Supply: On-Site Well _ Community Public
Evaluation By. Auger Boring Pit_ _ Cut
FACTORS 1 2 3 4
Landscape position
Sloe Z
HORIZON I DEPTH
Texture groupC
Consistence
Structure
Mineralogy '.�
HORIZON II DEPTH
Texture group
Consistence
Structure B
Mineralogy
HORIZON III DEPTH
Texture group
Consistence
Structure
Mineralogy
HORIZON IV DEPTH
Texture group
Consistence
Structure
Mineralogy
SOIL WETNESS S
RESTRICTIVE HORIZON
SAPROLITE
CLASSIFICATION
LONG-TERM ACCEPTANCE RATE
SITE CLASSIFICATION: _ "S - EVALUATED BY:
LONG-TERM ACCEPTANCE RATE: �� OTHER(S) PRESENT:
REMARKS: �ts►�. Im '�'
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 Aay loam• SIL-Silty loam CL-Clay loam SCL-Sandy clay loam
SC-Sandy clay SIC-Silty clay C-Clay
CONSISTENCE
Moist
VFR-Vc.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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