139 Woodberry Trail Davie County, NC l ,i\ Parcel Report Tu�,tla� . \o%cmhcl 5, 2016
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Parcel Information
Parcel Number: G70000000401 Township: Shady Grove
NCPIN Number: 5860109404 Municipality:
Account Number: 82516691 Census Tract: 37059-803
Listed Owner 1: COFFEY JEFFERY W Voting Precinct: WEST SHADY GROVE
Mailing Address 1: 139 WOODBERRY TRAIL Planning Jurisdiction: Davie County
City: MOCKSVILLE Zoning Class: DAVfE COUNTY R-A
State: NC Zoning Overlay:
Zip Code: 27028-7370 Voluntary Ag. District: No
Legal Description: 4.783 AC HOWARDTOWN RD Fire Response District: CORNATZER-DULIN
Assessed Acreage: 4.63 Elementary School Zone: CORNATZER
Deed Date: 4/2001 Middle School Zone: WILLIAM ELLIS
Deed Book/Page: 003670664 Soil Types: EnB
Plat Book: Flood Zone:
Plat Page: Watershed Overlay: DAVIE COUNTY
Building Value: 319100.00 Outbuilding&Extra 10980.00
Freatures Value:
Land Value: 35920.00 Total Market Value: 366000.00
Total Assessed Value: 366000.00
OsyyPAll data is provided as Is without warranty or guarantee of any kind either expressed or Implied Including but not limited to the
Davie County, Implled 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
nD NC or arising out of the use or Inability to use the GIS data provided by this website.
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AUTHORIZATIONrNO: 0814 ' DAVIE COUNTY HEALTH DEPARTMENT
+ Environmental Health Section PROPERTY INFORMATION
Permitfee's / P.O.Box 848
Name: ' '"t ,/' Mocksville,NC 27028 Subdivision Name:
Phone#:7047634-V60
Directions to'property .� . �. Section: Lot:
AUTHORIZATION FOR
WASTEWATER Tax Office PIN:#
SYSTEM CONSTRUCTION
Road Name: q-pl e �77 zip:
**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 1 I of G.S.Chapter 130A,Wastewater Systems,Section.1900 Sewage Treatment and Disposal Systems)
*** *** CONSTRUCTION, :
IS VALID FOR A PERIOD OF FIVE YEARS:.
NOTICE, THIS AUTHORIZATION FOR WASTEWATER CONSTRUCTIO
ENVIRONMENTAL HEALTH SPECIALIST DATE ISSUED .
at r a+ }.r„A. a.•„x',v ` wr t� r. `` i•'Y,t l _ ' ' Si.r.r.-.c 2' `4"�,. Yat r,.'i`°r +t' F. } °s r.rti
,..�5.•y:..i w•r,-di+3 i t `� �'9,N,.1 .{y .p '^d' 7 t' *, 4 ' .r'i;'• r. Ya r' /Y p
"DAVIE COUNTY HEALTH DEPARTMENT
IMPROVEMENT AND OPERATION PERMITS PROPERTY INFORMATION
Subdivision Name:
Directions to property: e-Z-4 e Section: Lot:
IMPROVEMENT
PERMIT Tax Office PIN:#5 XUQ _ 0 ;2/3.5
Road Name: 71 Zip:
**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
ENVIRONMENTAL HEALTH SPECIALIST DATE ISSUED SYSTEM CONTRACTOR MUST SEE THIS PERMIT BEFORE
INSTALLING THE SYSTEM.
RESIDENTIAL SPECIFICATION:BUILDING TYPE '#BEDROOMS #BATHS #OCCUPANTS_�_GARBAGE DISPOSAL:Yes or No
COMMERCIAL SPECIFICATION: FACILITY TYPE #PEOPLE #PEOPLE/SHIFT #SEATS INDUSTRIAL WASTE:Yes or No
LOT SIZE S,49 TYPE WATER SUPPLY 1 DESIGN WASTEWATER FLOW(GPD) NEW SITE t/' REPAIR SITE
SYSTEM SPECIFICATIONS: TANK SIZE�GAL. PUMP TANK GAL. TRENCH WIDTH 1 fZ,' ROCK DEPTH LINEAR FT. G�
OTHER '�,lcl a��ti sem-- h lrA��S
REQUIRED SITE MODIFICATIONS/CONDITIONS:
IMPROVEMENT PERMIT LAYOUT
Vel
i
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)6348760.
OPERATION PERMIT
�6 t} SYSTEM INSTALLED BY:
V0
AUTHORIZATION NO. b l 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).
i
R� -XPPLICATION FOR SITE EVALUATIONAMPROVEMENT P
r Davie County Health Department D
Environmental Health Section
P.O. Box 848 ApR
Mocksville,NC 27028
3 (704) 634-8760 t
****IMPORTANT**** THIS APPLICATION CANNOT BE PROCESSED UNLESS ALL
THE REQUIRED INFORMATION IS PROVIDED.
i
1. Name to be Billed Contact Person 1411��
Mailing Address Home Phone �c9
City/State/Zip Business Phone 9Z7
l zo— 9 d
2. Name on Permit/ATC if Different than Above
Mailing Address City/State/Zip
3. Application For: M Site Evaluation [ ]Improvement Permit&ATC 4CJ Both
4. System to Serve: W House [ ]Mobile Home [ J Business [ ]Industry [ J Other
5. If Residence: #People #Bedrooms _ #Bathrooms Q(j Dishwasher rJ Garbage Disposal
[4 Washing Machine [ J 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)
j 7. Type of water supply: [ ]County/City Y]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***AZED&WOF THE PROPERTY MUST BE
SUBMITTED WITH TIS APPLICATION.
Property Dimensions: 7-2 42 WRITE DIRECTIONS(fro Ccksville)TO PROPERTY:
Tax Office PIN: # � d - :2-� -- Z.'/- .'
Property Address: Road Name—,S//a , / /�%�h( t e� _ 7`�lJ�7Z/✓fix- ! !� • /17= _"r
City/Zip o2'k4l1za
If in Subdivision provide information,as follows:
Name: ;
Section: Lot#:
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
i
Representative of the Davie County Health Department to enter upon above described property located in Davie County and owned
by �,(L�' Jl�t/Y� to and ct all testing pro �ures anecessarygdetermine the sit suitability.
DATE 7 ;�Y' SIGNATURE
Revised DCHD(06-96)
THIS AREA MAY BE USEiD FOR DRAIVINC7 YOUR SITE PLAN:
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EAGLE��TRAYEL�SE N.C�"
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- � - RVICES OF n
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- 16�-EASEMENT-=ALONG=EXISTING _ws--r , � - - - AL ) ,7F
� ,. pRIVE,TQ SR =1637 (HOWARDTOWN RD ) r4 AREA BL270 "
SEE D8.83 P•G 388 - -
-
ting kon
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western pe o1 drWe r
721.25 (total) <354.94 '.TOT_AL
S•.;8e:31'09" E N 88°31,09°W
new Iron
ran. T RACT;
713 75
new ( UNE)
S 20 21- 42" E
97 90 384;94 TOTAL' '
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AREA _ --A. 476 ACRES
\ TAKEN _FROM: .DB; 171 PG.459 . to
' S 23. 50' 25" E - x
NEW PROPOSED . EAGLE TRAVEL SERVICES OF N.C., INC. �' ' m
\ \ 30'
EASEMENT-D.B.171 PG.459 n �'
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294,94 new
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new iron
_N 25•.59. 26" W 445.20
\ 2,56.70 t � p 84.13'27"
�..�\ EAGLE TRAVEL" SERVICES OF. N.C. INC.
DB_ (71 ' 'PG 459
,
DAVIE COUNTY HEALTH DEPARTMENT
Environmental Health Section SECTION LOT
Soil/Site Evaluation
APPLICANT'S NAME ,�r�� DATEEVALUATED
PROPOSED FACILITY PROPERTY SIZE C-5
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 L L
Slope% 2_
HORIZON I DEPTH
Texture group
Consistence
Structure
Mineralogy
HORIZON II DEPTH /• i� �j��
Texture group
Consistence
Structure
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 /
SITE CLASSIFICATION: v /q EVALUATION BY: G/
LONG-TERM ACCEPTANCE RATE:: OTHER(S)PRESENT:
REMARKS: /'/W��✓ r�-
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)
LIAR-Long-term acceptance rate-gal/day/ft2
DCHD(01.90)
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