County Line Road Lot 4Davie Countv, NC Tax Parcel Renort Tuesday Novemher R_ 2016
WARNIN is lMh 1S 140'1' A SURVEY
Parcel Information
Parcel Number: H10000000804 Township: Calahain
NCPIN Number:
4799864915
Municipality:
Account Number:
8305446
Census Tract:
37059-801
Listed Owner 1:
WHITE ROBIN LYNN BRACKEN
Voting Precinct:
NORTH CALAHALN
Mailing Address 1:
332 PLEASANT HILL DRIVE
Planning Jurisdiction:
Davie County
City:
ELKIN
Zoning Class:
DAVIE COUNTY R -A
State:
NC
Zoning Overlay:
Zip Code:
28621.
Voluntary Ag. District:
No
Legal Description:
LOT 4 BRACKEN DOWNS
Fire Response District:
SHEFFIELD - CALAHALN
Assessed Acreage:
1.74
Elementary School Zone:
WILLIAM R DAVIE
Deed Date:
6/2013
Middle School Zone:
NORTH DAVIE
Deed Book / Page:
2013E0612
Soil Types:
PaD,GnB2,PcC2
Plat Book:
0008
Flood Zone:
Plat Page:
152
Watershed Overlay:
DAVIE COUNTY
Building Value:
0.00
Outbuilding 8r Extra
Freatures Value:
0.00
Land Value:
26120.00
Total Market Value:
26120.00
Total Assessed Value: 26120.00
E61All
Davie County,
NC
data is provided as Is without warranty or guarantee of any Idnd either expressed or Implied Including but not limited to the
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County of Davie, North Carolina, Its agents, consultants, contractors or employees hon any and all claims or causes of action due to
or arising out of the use or InabgRy to use the GIS data provided by this website.
t a V�
LiCATION FOR SITE EVALUATIO•N/IMPROVEMENT PERMIT & ATC
Davie County Health Department
r - Environmental Health Section
? P.O. Box 848/210 Hospital Street
Mocksville, NC 27028
{ (336) 751-8760
***IM *** THIS APPLICATION CANNOT BE PROCESSED UNLESS ALL THE REQUIRED
RMATION IS PROVIDED. Refer to the INFORMATION BULLETIN for instructions.
1.
Name to' be Billed .')bna R. 1Ba KEIV
Contact Person JoAd R. BcIZIn AS -9
Mailing Address 00.2 5 mes 5T.
110
Home Phone 704 Z 79 `,2562
City/State/ZIP _Roei�uu��� N,C,
Z813� Business Phone
2.
Name on Permit/ATC if Different than Above
Mailing Address
City/State/Zip
3.
Application For: Evaluation
❑ Improvement Permit/ATC El Both
/
4.
WSite
System to Service: i!�'House ❑ Mobile
IIome ❑ Business ❑ Industry ❑ Other
5.
Type system requested: Ponventional
❑ conventional modified ❑ innovative
6.
If Residence: # People
# Bedrooms _c� # Bathrooms 1_
I3rbage Washing ❑Basement/Plumbing ❑Basement/No
ishwasher
L7DGa Disposal
Machine Plumbing
7.
If Business/Industry /Other: verify type
# People It Sinks
# Commodes tt Showers
# Urinals # Water Coolers
IF FOODSERVICE: It Seats
Estimated Water Usage (gallons per day)
8.
Type of water supply: County/City
❑ Well ❑ Community
9.
Do you anticipate additions or expansions of the facility this system is intended to serve? ❑ Yes [DINO
If ycs, what type?
***IMPORTANT*** CLIENTS MUST COMPLETE THE REQUIRED PROPERTY INFORMATION REQUESTED
BELOW. Ether a PLAT or SITE PLAN MUST BE SUBMITTED by the client with THIS APPLICATION.
Property Dimensions: ..300 1 X 1100 1
Tax Office PIN: # 47998 907 Oq
Property Address: Road Name Coygii I. WE Zn.
city/zip kffouY. u.C• 2604 -
If in a Subdivision provide information, as follows:
WRITE DIRECTIONS (from Mocksvillc) to PROPERTY:
�uJY_
CA- wr-s7 t o N, C.%I
7o Olywy LIgr 210.
INTJJJISEGTU OF ALL 0ODGON I`()
Name: —30r -K 1W EST l
Section: 1 Block: Lot: 0 S Date home corners flagged: ) / =S O
This is to certify that the information provided is correct to the best of my knowledge. I understand that any permits)
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 frau
this application. I, hereby, give consent to the Authorized Representative of the Davie County IIealth Department
to enter upon above described property located in Davie County and owned by
to conduct all testing procedures as necessary to determine the site su' ability
DATE X — �Z ? _ z;'cam: SIGNATURE
THIS AREA MAY BE USED FOR DRANVING.YOUR SITE PLAN (Include all of the following: Existing and proposed
property lines and dimensions, structures, setbacks, and septic Iocations).
i
Sign given
Revised DCIID (05/03
Site Revisit Charge
I Datc(s):
Client Notification Date:
J EHS:
Account No. -�
Invoice No.07
5
-1
DAVIE COUNTY HEALTH DEPARTMENT
Environmental Health Section
Soil/Site Evaluation
APPLICANT INFORMATION PROPERTY INFORMATION
Account #: 990003389 Tax PIN/EH #: 4799-86-9137.04
Billed To: John Bracken Subdivision Info: Bracken Est Lot # 04
Reference Name: Location/Address: County Line Road -28634
Proposed Facility: Residence Property Size: see map Date Evaluated: S
Water Supply: On -Site Well Community_
Evaluation By: Auger Boring Pit
Public
Cut
FACTORS
1 2
3
4 5 6 7
Landscape position
L
CW
Slope %
U
HORIZON I DEPTH
1 !
d "
Texture groupC
Consistence
S
S S
Structure
Mineralogy
HORIZON II DEPTH
3 -
3
Texture group
C
Consistence
! S
/
Structure
55t
Mineralogy
HORIZON III DEPTH
31 ^ Lkls-
q 1
3 43
Texture group
C.N:
Ke OO
Consistence
Irr S
C
Structure
S
Mineralogys
HORIZON IV DEPTH
Texture group
Consistence
Structure
Mineralogy
SOIL WETNESS
RESTRICTIVE HORIZON
SAPROLITE
CLASSIFICATION
U $
S S►►at_
LONG-TERM ACCEPTANCE RATE
0.2
SITE CLASSIFICATION;
LONG-TERM ACCEPTANCE RATE:
REMARKS: tj 85 "1 �
Landscape Position
03 �r- &< Cl)'"t&ATION BY: .rl� K.Wa1 4�
OTHER(S) PRESENT:
,GEN
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
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 05/99 (Revised)