187 Red Fern LnDavie Countv. NC Tax Parcel Report ji� a1 Thursday. October 6. 2016
C
WAR-NIAG: THIS 1S 1VU'1' A SURVEY
Parcel Information
Parcel Number:
K60000003303
Township:
Jerusalem
NCPIN Number:
5757602581
Municipality:
Account Number:
8304613
Census Tract:
37059-807
Listed Owner 1:
FELTS TINA C
Voting Precinct:
JERUSALEM
Mailing Address 1:
395 DEADMON ROAD
Planning Jurisdiction:
Davie County
City:
Mocksville
Zoning Class: DAVIE COUNTY R -A
State:
NC
Zoning Overlay:
Zip Code:
27028
Voluntary Ag. District:
No
Legal Description:
10 AC OFF DEADMON RD LOT 4
Fire Response District:
JERUSALEM
Assessed Acreage:
10.13
Elementary School Zone:
CORNATZER
Deed Date:
7/2014
Middle School Zone:
WILLIAM ELLIS
Deed Book / Page:
009620522
Soil Types: PaD,WeC,PcB2,PcC2,RnD,Ud
Plat Book:
Flood Zone:
Plat Page:
Watershed Overlay:
DAVIE COUNTY
Building Value:
0.00
Outbuilding & Extra
5100.00
Freatures Value:
Land Value:
58940.00
Total Market Value:
64040.00
Total Assessed Value:
7180.00
9 �d iF All 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.
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,/-47HORIZATION NO: "q j DAVIE BOUNTY HEALTH DEPARTMENT
Environmental Health Section PROPERTY INFORMATION
Pe 'Aoittee�s + 4 ,_ P.O. Box 848
Nam : r �rU/Nf C Mocksville, NC 2702E Subdivision Name:
Jf1
Phone # 336-751-8760
Directions to property: G� of /�`i �1 le"I' ' Section:
Lot;
AUTHORIZATION FOR
WASTEWATER
Tax Office PIN:#-5-7rel?
SYSTEM CONSTRUCTION
Road Name: f= +% 'Zip: CI
**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)
ENVIRONMENTAL HEALTH SPECIALIST
***NOTICE*** THIS AUTHORIZATION FOR WASTEWATER CONSTRUCTION
IS VALID FOR A PERIOD OF FIVE YEARS.
DATE ISSUED
t 4 �-„ T � lij+ `,.`1V a,{.,. ,`t.l 1Y,. -^''•it i.. Al :1.. . {. .. ^ .. . h, .,.. , 3 .. r ,. .,
DAVIE OUNTY HEALTH DEPAR,TMANT
4Y
' IMPROVEMENT AND OPERATION PERMITS PROPERTY INFORMATION
Nam Y ,'; �,i �'"f/'� Subdivision Name:
Directions to property: X ~' ;1 r Section: Lot:
IMPROVEMENT
PERMIT Tax Office PIN:# •y f r" - ,j�
Road Name:c°� i% ✓'Zip: ' r r?.
**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 pen -nit.
(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
ENVIRONMENTAL HEALTH Sl'$CIALIST DATE ISSUED SYSTEM CONTRACTOR MUST SEE THIS PERMIT BEFORE
INSTALLING THE SYSTEM.
RESIDENTIAL SPECIFICATION: BUILDING TYPE 17) # BEDROOMS Q # BATHS --/— # OCCUPANTS _..C— GARBAGE DISPOSAL: Yes or No
COMMERCIAL SPECIFICATION: FACILITY TYPE # PEOPLE # PEOPLE/SHIFT # SEATS INDUSTRIAL WASTE: Yes or No
LOT SIZE y` "1 ` L_ TYPE WATER SUPPLY /11 DESIGN WASTEWATER FLOW (GPD) NEW SITE /"� REPAIR SITE
SYSTEM SPECIFICATIONS: TANK SIZE GAL. PUMP TANK GAL. TRENCH WIDTH -� / ROCK DEPTH i>/, LINEAR FT.
OTHER
REQUIRED SITE MODIFICATIONS/CONDITIONS:
IMPROVEMENT PERMIT LAYOUT
Jo took/c l.�
*'"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 (336)751-8760.
I OPERATION PERMIT
SYSTEM INSTALLED BY:
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 03/96 (Revised)
APPUCAIION FOR SIZE EVALUAIION/IMPROVEMENT PERMIT & ATC -
Davie County Health Department 0
Envfivnmenta/Health SetWon
P.O. Box 848/210 Hospital street DEC — 2 19%
Mocksville, NC 27028
1336) 751-8760
***IMPORTANT*** THIS APPLICATION CANNOT SE PROCESSED UNLESS ALL
INFORMATION! Is PROVIDED. Refer to the INFORMATION BULLETIN for instructions.
1. Name to be Billed
Mailing Address
City/state/ZIP
2. Name on Permit/ATG if Different than Above
Contact Person
it
Berme Phone
Business Phone �1 � a5g i
Mailing Address City/state/Zip
3. Application For: 1�3ite Evalua on 0 Improvement Permit/ATC Ij1/Both
4. System to service: ❑ House Vubile Home ❑Business
❑Industry ❑Other
S. If Residence: # People_ # Bedrooms # Bathrooms
0 Dishwasher 0 Garbage Disposal OiWashing Machine 0 Basement/Plumbing ❑ Basement/No Plumbing
6. if Business/Industry/other: specify type
# Commodes # showers # Urinals
# People # sinks
# hater Coolers
IF FOODSERVICE: # Seats Estimated Water �Usaage (gallons per day)
7. Type of water supply: ❑ County/City (Yi%11 ❑ Community
S. Do you anticipate additions or expansions of the facility this system is intended to serve? 0 Yes `Y N
lo
U yes, what type'
***1MP0RTANT*** CLIENTS AIUST COMPLETETHE REQUIRED PROPERTY INFORMATION REQUESTED I
BELOW. Either a PLAT or SITE PLAN �1IUST BESUBM117ED by the client with THIS APPLICATION.
6h- !vtart.. cw� �,
Property Dimensions: DIRECPOt4S T2= rr -rZR 71i,
EJ
Tai Office 1PIN: #�/
Property Address: Road Name R On 2em/2V14 1
city/zip -L
If in a Subdivision provide information, as follows: i-el'!f 1 VL / dl
Name: 1-7erm Nn 1-e
Section: Block: Lot: Date Property Flagged: /a - A - 9d
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, understandthat I am responsiblefor all charges incurred from
this appU aadon. I, hereby, give consent to the Authorized Representative of the Davie County Health Dep rtment nn
to enter upon above described property located in Davie County and owned by 11.�'TL.�YlG P / . L behYy
to conduct all testing procedures as necessary to determine the site twittabiilih•.
DATE ` 1 -► U W '-'GNATURE _ ►�'l la"IYl
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).
Revised DCHD (07/98)
Account No.
Invoice No.
b
s j �✓
j`. 9
+ •�,
€ F'
'Z
�.
41 cR
3 v 62.58 1343
----4
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21.6A 226.96 135 135 267.08
4 _ I
R 642.84
312.8 � 1
T
174
S9r
2,64
® 1
332 33.03 33.04
oma( cv 1C?A 5 5 4Ac 11 52A6 -
31 3. Ac a 33,9 A c
;._ 5
r` z F27' =16C6ao r
1 'n ci I ca
G co di s3
1003 1`44
fi02.54 1
(13A c. o
30
7 A C v 169.7
676.5 1. ��
115,
) 1
95 135 (
267.69. 362.96
- -- 19
�g105
361.02
720.(-7
00342.3 236.2
032 Qe
3
M
m
35224
340 m
�0 2706
T
35.02 m
36 c
ss
4.14 Ac �
8.95Ac 3_
r �-3.01
1 �
N 12.33 Ac (11.29Ac)
N
o
45.0 AC N (8.42Ac) a m
m N / M
\ODCD
n'
/,-9 , cp 228 3�•� rs,
(IAc) 20
1 0 r -
al 737 2516.3
Al
_ oo ti 5.35Ac b, x57.6' !�
DAVIE COUNTY HEALTH DEPARTMENT
Environmental Health Section
Soil/Site Evaluation
SECTION LOT,
APPLICANT'S NAME C DATE EVALUATED o o - 2i"
PROPOSED FACILITY ��1� PROPERTY SIZE �%G'
SUBDIVISION ROAD NAME✓/
Water Supply: On -Site Well Community Public
Evaluation By: Auger Boring Pit Cut
FACTORS 1 2 3 4 5 6 7
Landscape position
Slope %
HORIZON I DEPTH
Texture group
Consistence
Structure
Mineralogy
HORIZON II DEPTH 3C
Texture group
Consistence r -
Structure /1 S
Mineralogy
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 i -,
SITE CLASSIFICATION:
LONG-TERM ACCEPTANCE RATE:
REMARKS:
DCHD (0I-90)
EVALUATION BY:�j
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 - 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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