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234 Pollard Ln � Davie County,NC Tax Parcel Report � �� Wednesday, October 5,2016 c� a ��-�'G� SAM ALLENS I `� SHAGGY f�'`�AY � BARK-LN ,� �I V�G � � a i ,�0�''�'L�,� � A� � O�� Q� � 1 �4s U � '��Q ���� ` ff� ���N 1 r / 1( � � WARNING: TffiS IS NOT A SURVEY ,__, . __ . _.. . __ .. , ,.. _, - -_,,. . ,. _ _ _ , , _ Parcel Information Parcel Number: F600000100 A Township: Farmington NCPIN Number: 5850980583 Municipality: Account Number: 57444000 Census Tract: 37059-803 Listed Owner 1: POLLARD J D Voting Precinct: SMITH GROVE Mailing Address 1: 234 POLLARD LANE Planning Jurisdiction: Davie County City: MOCKSVILLE Zoning Class: DAVIE COUNTY R-A State: NC Zoning Overlay: DAVIE COUNTY QD Zip Code: 2702&7755 Voluntary Ag.District: No Legal Description: 121.583 AC OFF HOWARDTOWN Fire Response District: SMITH GROVE Assessed Acreage: 110.36 Elementary School Zone: PINEBROOK Deed Date: 6/1961 Middle School2one: NORTH DAVIE Deed Book/Page: 000640168 Soil Types: MrC2,MrB2,RnC,EnB,ChA,RwA,MsD,WATER Plat Book: Flood Zone: Plat Page: Watershed Overlay: DAVIE COUNTY Buiiding Value: 64590.00 Outbuilding 8 Extra 11310.00 Freatures Value: Land Value: 423070.00 Total Market Value: 498970.00 Total Assessed Value: 146180.00 9�,��, All drta Is provided as is wkhout warraMy or guarantee of any Idnd eitha expressed or Imptied Including but not Iimlted to the Davie Counly� Implled warraMles of inerchaMa6111ty or fltness for a pardcular usa All users of Davie CouMy's GIS rvebsite ahatl hold hartnless the Cowky ot Davlq Nortl�Carolina,lts�gmts,conwltaMs,coMrac[ors w employees hvm any and a9 clalms or wuses of actlon due to np�N.�� NC or arising out of tha uu or inab(Iity to use the GIS data proNded 6y this website. !�, ., - ��y r', e��,�.. _ . .,- ,...y.v.�y�..-�:-..._�. •'•Y.,f" '" �._�Y::�. `�.,'����, _ . ;� ... � .� , , . . , � . . AUTHbRIZATION NO•` ,� ! �� E�l j�+ �o'!.J ,��,�4 �,, : ,4 • D V COUNTY HEALTH DEPARTMENT : - � Environmental Health Section PROPERTY INFORMATION `�Pezr'nittee's � a ; P.O.Box 848 . Mame`�' /�/� ` � GZ' Mocksville,NG27028 : Subdivision Name: ,� Phone#:704-634-8760 . Directions to property: /'O�/t��� !'?,:c'" Section: Lot: � . AUTHORIZATION FOR , �0�I� l � _ ��Q.� WASTEWATER Tax Office PIN:# ' SYSTEM CONSTRUCTTON ��� ,� / � o �' � Road Name: /0 f i Gt r� ��1 Zip:'_� **NOTE**This Autl:orization for Wastewater System Construction MUST BE ISSLJED by the Davie County Environmental Health Section prior to issuance of any Building Pernuts:This Form/Authorization Number should be presented to the Davie Counry Building Inspections O�ce when applying for Building Permits. (In compliance with Article 11 of G.S.Chapter 130A;Wastewater Systems,Section:1900 Sewage Treatment and Disposal Systems) , , _ � `a� ' `%� ' � ***NOTICE***THIS AUTHORIZATTON FOR WASTEWATER CONSTRUCTION .�c.•-;�"C.a' ` � .. .. ��Q!J��i"`,�'"�, . : IS VALID FOR A PERIOD OF FIVE YEARS. \ ENVIRONMENTAL`'HEALTH SPECIALISI',� DATE ISSUED . � , > _ , . . . ,. , , . . _., .. , . _ . , ,..- � -: � . �� ;.- r --, ' ' , � -;. ' .� r .c . 'tir�.� .. , .�r _ �: .ti. +� . ,.. `` y � . � ' . -r,. .: ;...,� .+ i ,.-ft-'a�_. , _ , � ..q�;� ., ,.... r. .. . -- . ' . _ ..'��:.�. �.�— . . ., ..., � � �. � ��: ��XU � ,�- �.. '� ��� DAVIE COUNTY HEALTH DEPAR ��� T~� ---_._.___ "�"'��.-� �� s� ° IMPROVEMENT AND OPERATION PE�I�� PROPERTY INFORMATION Pe`�m`itfe�'�s � - , ' ' j Name: ",�� �,;�Q'/^" Subdivision Name: � w "rf� �:� ". - .,� �E E �� Directions to property: ��='%f�'%.'�r"r` �r'� : ` Section: Lot: ' II1�II'ROVEMENT r''��J� c�1�r C�.�Y.� PERMIT Tax Office PIN:#�y � � , . � .... *�'�`�� i ,r. �� ',��s' Road Name: �[3�C� ,�'�'! ��i,Zip: � G�,= **NOTE**This Improvement Pernut DOFS NOT authorize the construction or installation of a septic tank system or any wastewater system.An AUTHORIZATION FOR WASTEWATER SYSTEM CONSTRUCTION must be obtained fmm this Department prior to the construction/installa6on of a system or the issuance of a building permit. (In compliance with Article 11 of G.S.Chapter 130A,Wastewater Systems,SecUon.1900 Sewage Treatment and Disposal Systems) � :' ,� '" �' .s; �� ***NOTICE***TEIIS PERMIT IS SUBJECT TO REVOCATION IF SITE �''`'(��t�'^ .�'"�.�c:`�r:%r'"��"'r;i��r� �+:�:..�'�s'�i---J��"f,��.' PLANS OR TI�INTENDED USE CHANGE.YOUR WASTEWATER ENVIRONMENTAL HEALTH SPECIALIST nA�tssuED SYSTEM CONTRACTOR MUST SEE TEIIS PERIVIIT BEFORE INSTALLING TI�SYSTEM. ,RESIDENTIAL SPECIFICATION:BUILDING TYPE � #BEDROOMS �l #BATHS r�sl #OCCUPANfS � GARBAGE DISPOSAL:Yes or No COMMERCIAL SPECIFICAT'ION: FACILITY TYPE #PEOPLE #PEOPLFJSHIFI' #SEATS INDUSTRIAL WASTE:Yes or No sLOT SIZE /Yl TYPE WATER SUPPLY �f'// DESIGN WASTEWATER FLOW(GPD)� NEW SITE � REPAIR SITE SYSTEM SPECIFICATIONS: TANK SIZE/aD� GAL. PUMP TANK GAL. TRENCH WIDTH-��'� /�ROCK DEPTH �� LINEAR Ff. . 0O/ 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 1:00-130 P.M.ON THE DAY OF INSTALLATION.TELEPHONE#IS(704)6348760. i OPERATION PERMIT Q� � �l14 I—� �Z v 0� SYSTEM INSTALLED BY:__�rLJ1,r'Y�d�.-�., �G(Mn�.� Lc1ic�- 3 0�� a �� . o� -� ,�,��'„' � ^,,�_-��, AUTHORIZATION NO.���5 OPERATION PERMIT BY: ��""�'' DATE: G��'� �� **THE ISSUANCE OF THIS OPERATION PERMTT 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 OS/96(Revised) � • _ i r , • APP�ICATYON FOR SITE EVALUATION/IMPROVEMENT PERMIT�i ATC �``i � -==�� ' ~N Davie County Health Department � � Y ��� � v � � �Environmental�Health Section; r��, ,r' ' D :�_.. ; P.O. Box 848 . : . : - .�y�.. . ...�..,.._ - �F� � � µ._..,..�._...._.__._ , L�•. Mocksville,NC 27028=.�. ' � . `' � 1�9 f ) _,. � - - ` " � (704) 634-8760 ' � f ,.� ****IMPORTANT'�*�* THIS APPLICATIC)N CANNOT BE PROCESSED ,, THE REQUIRED INFORMATIQN IS PROVIDED. �"-��' ., � , , , ,Q �� > �` 1. Name to be Billed ,/�c.c✓�r �� �l�d�� � Contact Person � ��/l� �/i�! �iti dc�C- � r� Mailing Address �,�� ,�'�I�/�{,(��!/l��c/ Tfa/�� �/' Home Phone �`'�U � �� � 3 City/State/Zip �i�.��2'/r`/t'�', ,�. .�i. , —��i Business Phone �-���,�� -` 2. Name on PermidATC if Different than Above i � .,. ..� Mailing Address City/State/Zip 3. Application For: [ ] Site Evaluation [']Improvement Permit&,ATC , �"� (�i}'Both 4. System to Serve: [�jf House (fiJ�Mobile Home [ ]Business [ ]Industry [ ]Other 5. If Residence: #People� #Bedrooms�_ #Bathro�s� �L [/��Dishwasher[ ]Gazbage Disposal ` (/]Washing Machine [�]Basement/Plumbing [U]Basement/No Plumbing 1 6. If Business/Other:Specify type #�People �l#Sinks #Commodes #Showers #Urinals #Water Coolers -( � If Foodservice:#Seats Estimated Water Usage(gallons per day) � , �� 7. Type of water supply: [ ]County/City [J]Well [ ]Community ,� 8. Do you anticipate additions or expansions of the facility this system is intended to serve?[ ]Yes �;/�No If yes,what type? � % ; , - ' EZTHER A PLt1T OR SITE PLAN ' PRUPERTY INFORMATION REQUIRED:***IMPORTANT**'�CF.Y�4'OF THE PROPERTY MYJST BE u' ' SUBMITTED WITH THIS APPLICATION. Property Dimensions: �(�� ` ��0 � ��' � �WRITE DIRECTIONS(from Mocksville)TO PROPERTI': Tax Office PIN: # ��'—s�—-—1�3�� � ��� /��1=��.�/' .i.� �c�,i{_����TiY�t �� Property Address: Road l�ame Z 3 f ,�c7lli,��Cn. /�1/ � C4,..� ,t,cc,r�� �.-�it T/�r_ ��-, i t-/, Gv�r�-c._ I ' c�ty�z�P /1rf v�4.'s���%/�. �G���� � =�. 7 2 � ;/K ;�f°�R`L If in Subdivision provide information,as follows: � ��u- � � l� .� •.v �` . � r Name: � /�c� l����fi' �G.lJ .�e,�.�� Y.'�� .� � v c Section: Lot#: ; Tr.�r�--� �.�-�-- �uv'�� , v This is to certify that the information provided is correct to the best of my knowledge. I understand that any pertnit(s) issued hereafter aze 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 chazges incurred from this application. I, hereby, give consent to the Authorized Representative of the Davi o He th Department to enter upon above described property located in Davie County and owned .i' by GLl�I� to conduct a testin ocedu s sary etermine the site suitability. DATE �Z �O• � � SIGNATURE � Revised DCHD(06-96) � � . THIS ,4REA AIA� $E USE1� �OR bRttWZNC yDUR SITE P1�lN: �2,�3'y, � � D�! 11�►��� r"��� . " - ' � ._� � R � � / � . . . . . V 4 � �� � � . ,������. �. ' I .. I � � �� ��� : �� �- � ;..,�.�•- , . . . � • �� ` ._ r . �-- ' DAVIE COUNTY HEP�LTH DEPARTMENT '�� . �,; "` , - . Env'�nmental�Health Sectipn;-,�,_., ��' SECTION LOT �, � , �''y " � SoiUSite Evaluation � � ���' �_._ � APPLICANT'S NAME Df/�� ,�� , . r� - DATE_EVALUATED ���� �� PROPOSED FACILITY ��� PROPERTY SIZE ��-'' SUBDIVISION ROAD NAME ,��1l����✓�� Water Supply: On-Site Well Community Public Evaluation By: Auger Boring Pit Cut FACTORS 1 2 3 4 5 6 7 Landsca e osition Slo e% HORIZON I DEPTH Texture rou Consistence Structure Mineralo HORIZON II DEPTH ��� � Texture rou e �' Consistence � � Structure h�� /�:— Mineralo � �/t/ HORIZON III DEPTH Texture rou Consistence ' �+'- . Structure Mineralo HORIZON IV DEPTH Texture rou Consistence Structure Mineralo SOIL WETNESS RESTRICTIVE HORIZON SAPROLITE CLASSIFICATION LONG-TERM ACCEPTANCE RATE .3 SITE CLASSIFICATION: � EVALUATION BY: _ '� LONG-TERM ACCEPTANCE RATE: i� OTHER(S)PRESENT: REMARKS: LEGEND Landscane 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-Granulaz ABK-Angular blocky SBK-Subangular blocky PL-Platy PR-Prismatic MineraloEv 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-gaUday/ft2 DCHD(OI-90) - � � ■��■o�■�■��■�■s���■��d■■��■��■■���eo��■eo■���■�■■■■��■■■■■■�o■ e�■ a�■■���������o■■■�■o■�e�■��■��■�■�■■�■�■��o���t��■o������■�■��■��■ ■■������■��■��■�■�■�■���■■�■��■■ ■■�■■■�■�����■■��s����■■������■■ ■�■�■������■��■�■�■■■��■�■�■■■■■��■�■���■���■���■���■�■■■�����i■■ ■■■�■■�■��■■������■�■■���■���������■�■������00�������■��■■������■■ ■��■■��■�■�■�������■�■�■�■����■�■■.0�����■■��■■■��■�����■■������■■ ■�■��■��■�O�■■�■����e■■�■��■��■�■�A■�■�7����e�����■��■�■�����■��■■ ■��■�������■■■�■�■�■�\■����i��■�■�w■�■�■�■■��■����■�■■�■■■������■■ ■�■���■�■■���■■���■�■��■��■■��■���0������■���■���■■�■■■■■����■�■■■ 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