169 Turrentine Church Rd Davie County, NC Tax Parcel Report Tuesday, October 18, 201 E
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WARNING: THIS IS NOT A SURVEY
Parcel Informationy �
Parcel Number: K500000030 Township: Mocksville
NCPIN Number: 5747644311 Municipality:
Account Number: _ :_ = 39820000 Census Tract: 37059-805
Listed Owner 1:-. JAMES STEVEN GRAY '� ' ''. Voting Precinct: SOUTH MOCKSVILLE
Mailing Address 1: " 169 TURRENTINE CHURCH ROAD Planning Jurisdiction: Davie County
City: MOCKSVILLE Zoning Class: DAVIE COUNTY R-12,H-B
State: NC Zoning Overlay:
-Zip Code: 27028-0000 Voluntary Ag.District: No
Legal Description: 5.66 AC TURRENTINE CHURCH Fire Response District: JERUSALEM
Assessed Acreage: 5.66 Elementary School Zone: CORNATZER
Deed Date: / Middle School Zone: WILLIAM ELLIS
Deed Book/Page: Soil Types: PaD,PcC2,CeB2
Plat Book: Flood Zone:
Plat Page: Watershed Overlay: DAVIE COUNTY
Building Value: 45470.00 Outbuilding&Extra 24210.00
Freatures Value:
Land Value: 71110.00 Total Market Value: 140790.00
Total Assessed Value: 140790.00
O[ /� 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 Davis,North Carolina,Its agents,consultants,contractors or employees from any and all claims or causes of action due to
cUUN�� NC or arising out of the use or Inability to use the GIS data provided by this website.
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AUTHORI7ATION NO: " 1 DAVIE gOUNTY.HEALTH DEPARTMENY
`
Environmental Health Section PROPERTY INFORMATION'
Permittee'~ j� P.O.Box 848'
Mocksville,NC 27028 Subdivision Name:
Phone# 336-751-8760
Directions to property: �fl �.:, rN Section Lot:
AUTHORIZATION FOR .
1 / - WASTEWATER
t:r,f -rs/�j/nit` Tax Office PIN.# ��
/—� SYSTEM CONSTRUCTION ,
flu-iG>� f'vlJ CA) Road Name ( l '.:n T.r�C ip:
**NOTE**This.Authorization for Wastewater System Construction MUST BE ISSUED by the Davie County.Environmental.Health Section prior ,
to issuance of any.BuildingPern-iits.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.1900Sewage Treatment and Disposal Systems)
✓ ***NOTICE***THIS
VAFOR AUTHORIZATION PERIOD FOR WASTEWATER CONSTRUCTION
F FIVE YEARS.'
ENVIRON ,- ALTH SPEC ALI DATE I SUE
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DAVIE OUNTY HEALTH DEPARTMENT .
IMPRO; EMENT AND OPERATION PERMITS PROPERTY INFORMATION
�eiiriittee's r ,n �
•�=Name: Subdivision Name:
Directions to property lltc 91C!ti , ItI^its d'' :
Section: "� Lot:
�'. IMPROVEMENT "7L�.I- �!
f, j ,/
-( t7'.' tF }( t �.� /,r1,t PERMTT 'I ,,//�I`�
Tax Office PIN:# `T-
Road Name �,{ 4•/4t1, Zip 217t,
**NO`TE**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 '
constructionTmstallation of a'system or the issuance of a building peirtut. '
(In compliance with Article 11 of G.S.Chapter 130A,Wastewater Systems,Section.1900 Sewage Treatrnent and Disposal Systems) ,
X
***NOTICE***THIS PERMIT IS SUBJECT TO REVOCATION IF SITE '
.. PLANS OR THE INTENDED USE CHANGE.YOUR WASTEWATER
ENVIRO ALTH SPECIAL DATE S SYSTEM CONTRACTOR MUST SEE THIS PERMIT BEFORE
INSTALLING THE SYSTEM.
RESIDENTIAL SPECIFICATION:BUILDING TYPE #BEDROOMS #BATHS 2— #OCCUPANTS GARBAGE DISPOSAL:Yes o .
COMMERCIAL SPECIFICATION: FACILITY TYPE #PEOPLE #PEOPLE/SHIFT #SEATS INDUSTRIAL WASTE:Yes or No
LOT SIZE TYPE WATER SUPPLYO DESIGN WASTEWATER FLOW(GPD) NEW SITEPAIR SITE
SYSTEM SPECIFICATIONS: TANKS GAL. PUMP TANK GAL. TRENCH WIDTH ROCK DEPTH Z LINEAR FT.
OTHER 1 tS�T�LII0T/��`'7
REQUIRED SITE MODIFICATIONS/CONDITIONS: VE E1 `��� �1`� Drr C� �Val(
IMPROVEMENT PERMIT LAYOUT
co ,
�0, /Ca0 1,_3!,I�s�/2 �I �L►CPG S cS'�% —TO
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i,Qanl7" �,t���
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**CONTACT A REPRESENTATIVE OF THE DAVIE COUNTY HEALTH DEPARTMENT FOR FINAL INSPECTION OF THIS SYSTEM
BETWEEN 8:30-9:30 A.M.OR 1:00-4:30 P.M.ON THE DAY OF INSTALLATION.TELEPHONE#IS (336)751-8760.
OPERATION PERMIT
SYSTEM INSTALLED BY:
00
Nop• � 100' x
xi7
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Fu
AUTHORIZATION
NO._ �]��OPERATION PERMIT BY: � DATE: I►7 rL1
*'THE ISSUANCE OF THIS OPERATION PERMIT SHALL INDICATE THAT TH M DESCRIBED ABOVE HAS BEEN INSTALLED IN COMPLIANCE
WITH ARTICLE I I 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 051%(Revised)
14
1586 DAVIE OUNTY HEALTH DEPARTMENT t
IMPROi EM
AND OPERATION PERMITS PROPERTY INFORMATION
Termittee's
Name-' rr-- ` 'f: /� ? !7 _ Subdivision Name:
Directions to property;, ;,,It k'' "fir '�- `"" Section. Lot:
IMPROVEMENT
PERMIT Tax Office PIN:#`- y
f<l {' Road Name Ip. '
**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)
w; r ***NOTICE***THIS PERMIT IS SUBJECT TO REVOCATION IF SITE
PLANS OR THE INTENDED USE CHANGE.YOUR WASTEWATER
ENVIRONM9NTA LTH SPECIALI T�� DATE SUED SYSTEM CONTRACTOR MUST SEE THIS PERMIT,BEFORE.
INSTALLING THE SYSTEM.
RESIDENTIAL SPECIFICATION:BUILDING TYPE I 1): #BEDROOMS #BATHS ""#OCCUPANTS GARBAGE DISPOSAL:Yes o�
}
,COMMERCIAL SPECIFICATION: FACILITY TYPE - #PEOPLE #PEOPLE/SHIFr #SEATS INDUSTRIAL WASTE:Yes or No
`LOT SIZE,,(A0 Pr TYPE WATER SUPPLY DESIGN WASTEWATER FLOW(GPD) NEW SITE_ PAIR SITE
SYSTEM SPECIFICATIONS: TANK SIZE J t (`GAL. PUMP TANK GAL. TRENCH WIDTH ROCK DEPTH 17— LINEAR Fr. -�CO
OTHER
REQUIRED STI EMODIFICATIONS/CONDITIONS: �t 1 � rt �S !�' 1'C t� `'wit U C C 4�I" 1'7 �-IA)L5,
C�nJ70Id
IMPROVEMENT PERMIT LAYOUT ((FCti(
�i>v' A S
M � t
is
"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.
OPERATION PERMIT j D
SYSTEM INSTALLED BY: 11✓✓
Qvs QST
oma, x „
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A-J1� A b'�
Fug
AUTHORIZATION NO. I SISLO OPERATION PERMIT BY: DATE:
"THE ISSUANCE OF THIS OPERATION PERMIT SHALL INDICATE THAT TEM 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 051%(Revised)
PLICATION FOR SITE EVALUATION/IMPROVEMENT PERMIT&ATC D U U
n� Davie County Health Department AUG 1998
Environmenta: —Health Section 5
P.O. Box 848/210 Hospital Street
Mocksville, NC 27028 ENVIRONMENTAL HEALTH
(336)751-8760 DAVIE COUNTY
�— *"*IMPORTANT*** THIS APPLICATION CANNOT BE FRO=SSED UNLESS ALL THE REQUIRED
A i'NFORMATION IS PROVIDED. kkefer .to the INFORMATION BULLETIN for instruc ' s.
1. Name to be Billed i L �M' ,�"` tact Person -7 \� —
Mailing Address /194 LI t) 1�f,L G' Home Phone (3 3 CO ) 3 5`7 " 2 $19
L
City/State/ZIP L V n&TD 4, A/C' �i,��Z Business Phone �33(p )/ Z 4,;
2. Name on Permit/ATC if Different than Above
?failing Address City/State/Zip
3. Application For: 11 Site Evaluation 11Improvement Permit/ATC fXBoth
4. System to Service: Y"House ❑ Mobile Home ❑ Business ❑ Industry ❑ Other
5. If Residence: # People �^ # Bedrooms -� # Bathrooms
$ Dishwasher ❑ Garbage Disposal Aashing Machine ❑ Basement/Plumbing Aasement/No Plumbing
TZ Ris1..,Pass/Indlstry/0ther: Specify type Ar # People 4651:: # sinks — —
# Ccmmocke,a # Showers _N( # Urinals --� # 1-7ater Coolers IV 4
?'" FOV::?SRVICE: # Seats _� Estimated Water Usage (gallons per day) A'A
7. Type of water supply: 1/County/City ❑ Well ❑ C"'Zvw'aity
a. Do you antiripale additions or expansions of the facility this system is intended to serve? ❑Yes AO
***LVPORTANT***CLIENTS AIUST COAIPLETE THE REQUIRED PROPERTY INFORMATION REQUESTED
BELOW. Either a PLAT or SITE PLAN MUST BESUBMITTED by the client with THIS APPLICATION. Z
Property Dimensions: A e iL t, o P T A arcs
I I WRITE DIRECTIONS(from Mocksville)to PROPERTY:
Tax Office?t"N: #
TtirA) L
Property Address: Road Name
(Z`0, on )f'-Dr on 1 814'9 .
city/zip__(vti Dc,k,s vit Nr Go 2 r,\r U F-7
lk in a'-'i!Wdivisiin provide information,as follows: GG11 �
hw:ae:
� Q,,Ok, /40 woe,
Block:
Th'Z EA tc cr-Aify that the information provided is correci to the best of my knowledge. I understand that any permit(s)
issued Lei eafter 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 responsiblefor all charges incurred from
this application. 1,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 •5 --r�—;V . J�/. W,5
to conduct all testing procedures as necessary to determine the site suitability.
DATE a I 03 l C(0 SIGNATURE
THIS AREA MAY BE USED FOR DRAWING YOUR SITE PLAN:
p*plpftatmu No.
Invoice No. ��d
Revised DCHD(07/98)
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• •DAVIE COUNTY HEALTH DEPARTMENT
Environmental Health Section SECTION LOT
Soil/Site Evaluation
APPLICANT'S NAME i C- w 11A DATE EVALUATED
PROPOSED FACILITY �S ` PROPERTY SIZE
SUBDIVISION ROAD NAME �!'� filn�G Cil
Water Supply: On-Site Well Community Public
Evaluation By: Auger Boring Pit Cut
FACTORS 1 2 3 4 5 6 7
Landscape position L_
Sloe% `Zs
HORIZON I DEPTH -2 0
Texture group C Z_ el-
Consistence r 55 5
Structure G2 2
Mineralogy1 i • f
HORIZON II DEPTH
Texture group G
Consistence P l5
Structure
Mineralogy t=1
HORIZON III DEPTH.
Texture group
Consistence
Structure C2
Mineralogy
HORIZON IV DEPTH
Texture group
Consistence
Structure r
Mineralogy
SOIL WETNESS
RESTRICTIVE HORIZON
SAPROLITE
CLASSIFICATION VS
LONG-TERM ACCEPTANCE RATE O.5kb,cF
SITE CLASSIFICATION: X S EVALUATION BY:
LONG-TERM ACCEPTANCE RATE: "� OTHER(S)PRESENT:
REMARKS: CAY ,, M2 S-y.Jc-7 1)e,
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
DCHD(01-90)
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