1165 Daniel Road Lot 5Davie Countv. NC ,
Tax Parcel Report
Tuesday. December 13. 2016
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All datais provided as is adMoutwertamy or guarantee aany ldnd etiherexpressed or Implied Including but not gmNed to the
Davie County, Implied wamntles of merchantability or flness for a partleularuss. All users of Davie Counlys GIS websge shall hold harmless Me
County of Minds, North Carolina, Ns agents, consuhants, ooritraeton or employees from any and all clalms or causes of action due to
NC oradsing not of Me use orinablMyW use Me GIS data provided by this webslle.
WARNING: THIS IS NOT A SURVEY
Parcel Information
.
Parcel Number:
L50000001805
Township:
Jerusalem
NCPIN Number:
5736825641
Municipality:
Account Number:
82518367
Census Tract
37059-807
Listed Owner 1:
WAGNER RAY LAMAR
Voting Precinct:
COOLEEMEE
Mailing Address 1:
C/O LORRAINE WAGNER
Planning Jurisdiction:
Davie County
City: HARMONY.
Zoning Class:
DAVIE COUNTY R -A
State:
NC
Zoning Overlay:
DAVIE COUNTY CZOD
Zip Code:
28634-0000
Voluntary Ag. District
No
Legal Description:
LOT 5 DANIEL EAST
Fire Response District:
JERUSALEM
Assessed Acreage:
0.50
Elementary School Zone: COOLEEMEE
Deed Date:
3/2002
Middle School Zone:
SOUTH DAVIE
+
Deed Book/Page:
004120638
Soil Types:
PcC2
Plat Book:
0005
Flood Zone:
Plat Page:
125.
Watershed Overlay:
DAVIE COUNTY
Building Value:
Outbuilding & Extra
Freatures Value:
Land Value:
Total Market Value:
Total Assessed Value:
[all
All datais provided as is adMoutwertamy or guarantee aany ldnd etiherexpressed or Implied Including but not gmNed to the
Davie County, Implied wamntles of merchantability or flness for a partleularuss. All users of Davie Counlys GIS websge shall hold harmless Me
County of Minds, North Carolina, Ns agents, consuhants, ooritraeton or employees from any and all clalms or causes of action due to
NC oradsing not of Me use orinablMyW use Me GIS data provided by this webslle.
DAVIE COUNTY HEALTH DEPARTMENT �µN
IMPROVEMENTS PERMIT AND CERTIFICATE OF COMPLETION �N
'NOTE: Issued in Compliance With Article II of G.S. Chapter 130a p
Sanitary Sewage Systems \\ Permit Number �-q,
NameL[aL��/lG%�Jir /s!�Z 1, nt/on'�Date �� o� �/ N2 7785 Ir�091
Location lam/ �� ✓l `
Subdivision Name //-Zv/e/S Lot No. Sec. or Block No.
Lot Size —/L— House Mobile Home i� Business _-- Industry
No. Bedrooms .No. Baths 1 �2 No. in Family — Public Assembly Other
Garbage Disposal YES ❑ NO E],"' Specifications for Syste
Auto Dish Washer YES p NO,❑
Auto Wash Ma:hine YES 4l NO ❑
Type Water Supply
i
'This permit Void if sewage system described below is not installed within 5 years from date of issue.
This permit is subject to revocation if site plans or the intended use change.
Z w
O
Improvements permit by
'Contact a representative of the Davie County Health Department for final Inspection of this system' between 8:30-9:30 A.M.,
1:00-1:30 P.M. or 4:30-5:00 P.M. on day of completion. Telephone Number: 704-634.5985.
Final Installation Diagram: System Installed by
A, S' � p w N
Certificate of Completion \ � Date 1 k -E
'The signing of this certificate shall indicate that the system described above has been installed in compliance with
the standards set forth in the above regulation, but shall in NO way be taken as a guarantee that the system will function
satisfactorily for any given period of time.
`NOTE: Improvements Permits shall be valid for a period of 5 years from date issued. Improvements Permits are subject to
revocation, if site plans or the intended use change. Effective October 1, 1989.
Directions to Property:
SJ2J2_k#,Lr 17,eCf -W l af
This is to certify that the information provided is correct to the best of my knowledge, and I
Incurred from this application.
DATE SIGI
I am responsible for all charges
CONSENT FOR SITE EVALUATION TO BE DONE ON ABOVE DESCRIBED PROPERTY
MUST CHECK ONE: ❑ 1. 1 OWN the property. X 2. 1 DO NOT OWN the property.
If you checked Box #2, the rest of this form MUST be completed by the owner or a person authorized by the owner:
I hereby give consent to the authorized representative of the�ou ty Health D�gartrrent to ear ter upon above described
property located in Davie County and owned by %//a • �2,� h) ,f/f1N/�/—�
to conduct all testing procedures as necessary to determine saip site's suitability fora ound absorption sewage treatment
and disposal lssystem.
//--p
DATE SIGNATU E
DCHD (1(83)
APPLICATION FOR SITE EVALUATION/IMPROVEMENTS PERMIT
Davie County Health Department
I� pe0
W� FE®
EC FD
EC
Environmental Health Section
U"" U
o. Box sss
AUG 2 4 1994
Mocksville, NC 27028
`
1.
Application/Permit Requested By
Mailing Address Home Phone g?;M ��Sg
• Business Phone
2.
Name on Permit if Different than Above
3.
Application for: XGeneral Evaluation ❑ Septic Tank
Installation Permit
4.
System to Serve: ❑ House Mobile Home
❑ Place of Public Assembly
❑ Business ❑ IndOther
rY
El Unknown
'�% t�t�2 4404-1 6'
5.
If house, mobile home: Subdivision
ection Lot #
❑ Basement/Plumbing
No. of People
❑ Basement/No Plumbing
No. of Bedrooms
❑ Washing Machine
/
No. of Bathrooms
❑ Dishwasher
`2 XS�5'
Dwelling Dimensions
❑ Garbage Disposal
6.
If business, industry, place of public assembly, other: Specify type
No. of People Served No. of Sinks
No. of Commodes No. of Urinals
No. of Lavatories No. of Water Coolers
No. of Showers Water Usage Figures
7.
Type of water supply: Public ❑ Private
❑ Community
?0 0 )� AQ 7
8.
Property Dimensions Sewage Disposal Contractor
9.
Do you anticipate additions/expansion of the facility this sytem is intended to serve? ❑
Yes No
If yes, what type?
`NOTE: Improvements Permits shall be valid for a period of 5 years from date issued. Improvements Permits are subject to
revocation, if site plans or the intended use change. Effective October 1, 1989.
Directions to Property:
SJ2J2_k#,Lr 17,eCf -W l af
This is to certify that the information provided is correct to the best of my knowledge, and I
Incurred from this application.
DATE SIGI
I am responsible for all charges
CONSENT FOR SITE EVALUATION TO BE DONE ON ABOVE DESCRIBED PROPERTY
MUST CHECK ONE: ❑ 1. 1 OWN the property. X 2. 1 DO NOT OWN the property.
If you checked Box #2, the rest of this form MUST be completed by the owner or a person authorized by the owner:
I hereby give consent to the authorized representative of the�ou ty Health D�gartrrent to ear ter upon above described
property located in Davie County and owned by %//a • �2,� h) ,f/f1N/�/—�
to conduct all testing procedures as necessary to determine saip site's suitability fora ound absorption sewage treatment
and disposal lssystem.
//--p
DATE SIGNATU E
DCHD (1(83)
- -- - STATE LAW
SAME IS F01
-� CONDITIONS
?S�3• ` 'pc 3o LjF - - EVALUATION
S FOR LIMITAT
AT.THE SA
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a,� O 630 N
Ne 0 2 6,c �
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IMPORTANT
CONSTITUTE
- - - LOTS IN SA'.
SEWAGE FA
F�q
\ .. DATE
/ \ - NORTH CA
f \ I. (WE) HER
OWNERS)
HEREON Al
I OF SUBDIV
ESTABLIS F
I l ROADS, AL
( I \ PUBLIC OF
CERTIFY T
- I \ PLATTING
I I -
I .. ( OWNER OF
I �
1 1
NOTES:
116/1
ZONED R
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COUNTY
• BEING.A
MORGAN
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SETBACK
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SIDE - 15'
FRONT
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DAVIE COUNTY HEALTH DEPARTMENT
Environmental Health Section
/ Soil/Site Evaluation
NAME ///�il�ll%�/ DATE EVALUATED
ADDRESS n ,[� PROPERTY SIZE
PROPOSED FACIILTY /r/ w • LOCATION OF SITE
Water Supply:
Evaluation By:
On -Site Well
-Auger Boring //
-Community
Pit -
Public
Cut
' tl�
HORIZON I DEPTH
Texture group
FACTORS 1
2 3 1 4
Landscape position L
L
Slope R
HORIZON I DEPTH
Texture group
Consistence
Structure .
Mineralogy
HORIZON II DEPTH F
`
Texture group
Consistence
i
Structuree
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: // EVALUATED BY:_
LONG-TERM ACCEPTANCE RATE: OTHER(S) PRESENT:
REMARKS:
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 -Finn 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(01-901
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Dade Counlv Nealtlf D17"ariffle it
and NoireNealtif ency
210 HOSPITAL STREET/ P.O. BOX 665
MOCKSVILLE. N.C. 27028
PHONE: (704) 634-5985
September, 71 1994
Mack Wagner
1864 Junction Road
Mocksyille, NC 27028
4"'X00�7 "S—
Robert B.' Hall, Jr., R.S.
Environmental Health Section
RH/wd
Enclosure
Re: Site Evaluation
Daniel East/Lot 5
Dear Mr. Wagner:
As requested,
a representative from this office visited the
aforementioned
site on August 26,
1994. Based upon the information provided on
the
application for a
site evaluation and after the evaluation was completed, the
site was found to
be provisionally suitable for the installation
of an on—site
iA
sewage disposal system.
If you have any
questions, please feel free to contact this
office.
Sincerely,
4"'X00�7 "S—
Robert B.' Hall, Jr., R.S.
Environmental Health Section
RH/wd
Enclosure