1006 Daniel Road Lot 5David County, NC- ; 1 " Tax Parcel Report Wednesday, December 14, 2016
i�
r
DAM&L
If
f
974--- ` i 99.2 Jj i it
f
982 994 i
1006--, I
1014 1024._-Jl
r^--�
i
tom«
r
582
yhiywt8Ali data Is provided as is vdthoutwarrmM1y or guarantee of any kind either expressed or Implied including but not limited to the
Davie County, Implied warrantlea of merchantability or illness for a paNeularuse. All users of Oahe County's GIS webshe shall hold harmless the
Countyor Davie,North Cma Rsagents,emmubzhds,mh then oremployeesfw anyandagdartsor"usesofactlondueto
NC
r'p ON•t; orarising out ofthe use arinabgityto use rhe GIS data pnvided bythlswebsRa
WARNING: THIS IS NOT A SURVEY
Parcel Information
Parcel Number
L40000004805
Township:
Jerusalem
NCPIN Number.
5736624861
Municipality:
Account Number:
8302784
Census Tract:
37059-807
Listed Owner 1:
JONES MICHAEL C
Voting Precinct
COOLEEMEE
Mailing Address 1:
142 CLOISTER DRIVE
Planning Jurisdiction:
Davie County
City: MOCKSVILLE
Zoning Class:
DAVIE COUNTY R -A
State:
NC
Zoning Overlay:
DAVIE COUNTY CZOD
Zip Code:
27028
Voluntary Ag. District:
No
Legal Description:
LOT 5 DANIEL WEST 0.477AC
Fire Response District:
JERUSALEM
Assessed Acreage:
0.48
Elementary School Zone: COOLEEMEE
Deed Date:
3/1997
Middle School Zone:
SOUTH DAVIE
Deed Book/Page:
1997E0009
Soil Types:
WeB,En13
Plat Book:
0005
Flood Zone:
Plat Page:
139
Watershed Overlay:
DAVIE COUNTY
Outbuilding & Extra
Building Value:
Freatures Value:
Land Value:
Total Market Value:
Total Assessed Value: '
yhiywt8Ali data Is provided as is vdthoutwarrmM1y or guarantee of any kind either expressed or Implied including but not limited to the
Davie County, Implied warrantlea of merchantability or illness for a paNeularuse. All users of Oahe County's GIS webshe shall hold harmless the
Countyor Davie,North Cma Rsagents,emmubzhds,mh then oremployeesfw anyandagdartsor"usesofactlondueto
NC
r'p ON•t; orarising out ofthe use arinabgityto use rhe GIS data pnvided bythlswebsRa
Lot Size/oo X 2c)6 House Mobile Home -e
No..Bedrooms— No. Baths 1 z No. in Family
Business Speculation
Garbage Disposal YES ❑ NO;p Specifications for System:
Auto Dish Washer YES i❑' NO ❑
Auto Wash Machine YES p NO ❑ (N ;
Type Water Supply
.This permit Void if sewage system described below is not installed within 36 months from date of issue.
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. or 1:00-1:30 P.M. on day of completion. Telephone Number: 704-634-5985.
Final Installation Diagram:,
System Installed by
Certificate of Completion Date 4L Q - ?
*The signing of this certificateshall 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.
a:
%
' DAVIE COUNTY HEALTH DEPARTMENT
??'
b
IMPROVEMENTS PERMIT AND CERTIFICATE OF COMPLETION'.'
*NOTE:
Issued in Compliance with G.S. of North Carolina Chapter 130 Article 13c
Sewage Treatment and Disposal Rules (10 NCAC 10A .1934-.1968]
Permit Number . '.
Name
�'�'-� ,.,y ^^JJ . H-77,
tisk n
Location
` LL w `.
I
Subdivision
Name Lot No. Sec. -or Block
No.
Lot Size/oo X 2c)6 House Mobile Home -e
No..Bedrooms— No. Baths 1 z No. in Family
Business Speculation
Garbage Disposal YES ❑ NO;p Specifications for System:
Auto Dish Washer YES i❑' NO ❑
Auto Wash Machine YES p NO ❑ (N ;
Type Water Supply
.This permit Void if sewage system described below is not installed within 36 months from date of issue.
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. or 1:00-1:30 P.M. on day of completion. Telephone Number: 704-634-5985.
Final Installation Diagram:,
System Installed by
Certificate of Completion Date 4L Q - ?
*The signing of this certificateshall 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.
DAVIE COUNTY HEALTH DEPARTMENT
Environmental Health Section
P. O. Box 665
Mocksville, N.C. 27028
SOIL/SITE EVALUATION
Name Date
Address Lot Size
FACTr1GR ARFA 1 ARFA 9 AREA:3 ARFA A
Topography/ Landscape Position
S
S
S
S
PS
PS
PS
PS
U
U
U
U
!) Soil Texture (12-36 in.) Sandy,
S
S
S
S
Loamy, Clayey, (note 2:1 Clay)
PS
PS
PS
PS
U
U
U
U
1) Soil Structure (12-36 in.)
S
S
S
S
Clayey Soils
PS
PS
PS
PS
U
U
U
U
g Soil Depth (inches)
S
S
S
S
PS
PS.
PS
PS
U
U
U
U
Soil Drainage: Internal
S
S
S
S
PS
PS
PS
PS
U
U
U
U
External
S
S
S
S
PS
PS
PS
PS
U
U
U
U
1) Restrictive Horizons
Available Space
S
S
S
S
PS
PS
PS
PS
U
U
U
U
1) Other (Specify)
S
S
S
S
PS
PS
PS
PS
U
U
U
U
1) Site Classification
U—UNSUITABLE S—SUITABLE PS—Provisionally Suitable
Recommendations/ Comments:
Described by Title Date
SITE DIAGRAM
DCHD )6.82)
DAVIE COUNTY HEALTH DEPARTMENT
Environmental Health Section
P. O. Box 665
Mocksville, N.C. 27028
SOIL/SITE EVALUATION c�
Name (G /ey/��/% //�I,SY! —�r�� Date '1/5
Address �1,�Ls�v Lot Size
,
FACTORS AREA 1 AREA 2 AREA 3 AREA 4
)-Topography/ Landscape Position
2)
3)
d)
5)
6)
S
S
S
S
PS
PS
PS
U
U
U
Soil Texture (12-36 in.) Sandy,
S
S
S
Loamy, Clayey, (note 2:1 Clay)
PS
PS
PS
U
U
U
U
Soil Structure (12-36 in.)
S
S
S
Clayey Soils
S
PS
PS
PS
U
U
U
Soil Depth (inches)
S
S
S
S
PS
PS
PS
U
U
U
U
Soil Drainage: Internal
S
S
S
S
PS
PS
PS
U
U
U
U
External
S
S
S
S
Pj
PS
PS
PS
Restrictive Horizons
Available Space
S_
�jS�j
S
PS
S
PS
S
PS
U
U
U
1) Other (Specify)
S
S
S
S
PS
PS
PS
PS
U
U
U
U
3) Site Classification
P_S,
U—UNSUITABLE
Recommendations/ Comments:
Described by _
,SITE DIAGRAM
1
e
,
1
DCHD )8-62)
S—SUITABLE ( PS—Provisionally Suitable
Title .�9 / Date
Davie County Health Department
Environmental Health Section
P.O. Box 848
210 Hospital Street
Courier # : 09-40-06 y 911
Mocksville, NC 27028
Phone: (336) - 753 - 6780 ON-SITE WASTEWATER CERTIFICATION Fax: (336) - 753-1680
/ (Check One) Replacement Remodeling Reconnection
Name: ��/(� `'1� ` P l (9 �� '(' Phone Number 7 0 ;. Ov `/
D (Home)
Mailing Address: / �� !r 7L (Work)
i i /(,— Email Address:
Directions To
t) N/
Property
❑6
Please Fill In The Following Information About The EXISTING Facility:
Name System Installed Under: A161z' 94ee Type Of Facility:
Date System Installed (MonthMate/Year): Ig 81 Number Of Bedrooms: �3 Number Of People:
Is The Facility Currently Vacant? No
No If Yes, For How Long?
Any Known Problems? Yes o If Yes, Explain:
Please Fill In The Following Information About The NEW Facility: lIlp
Type Of Facility: NQ' It, t,. -pC/ c;l wP eel d art gr Number Of Bedrooms:_�t_Number of People �
11
For Environmental Health Office Use Only
Approve Disa proved
Comments: d Itool n
Environmental Health Specialist
*The signing of this form by the Environmental Health Staff is inVo way intended, nor should be taken as a guarantee
(extended or limited) that the on-site wastewater system will function properly for any given period of time.
Payment: Cash Check Money Order
Paid By:
Account #•
60cY)i)) D)m M"Pvo _T)A11V1n1').i4
0
�~ APPLICATION FOR SITE EVALUATION/ IMPROVEMENTS PERMIT
Davie County Health Department O MAQ `1
` Environmental Health Section VE
P. O. Box 665 ?05\
Mocksville, N.C. 27028
CONSTRUCTION SHALL NOT BEGIN UNTIL IMPROVEMENTS PERMIT HAS BEEN ISSUED.
Home Phone
1. Permit Requested By AQA Rhqp;Business Phone
2. Address 130 C ( '173 k i4Ad4* r_ L Mbbl
3. Property Owner if Different than Above
Address
4. Permit To: a) Install Alter— Repair
b) Privy_ Conventional Other Type—
Ground Absorption
c) Sub -Division 10k41Gt; (Jr 14: Sec. Lot No.
5. System used to serve what type facility: House_ Mobile Homed Business—
Industry— Other—
b) Number of people F_&LA
6. a) If house or mobile home, state size of home and number of rooms.
House Dimensions /q' V t n'
Bed Rooms:3Bath Rooms /f/i Den w/Closet
b) If Business, Industry or Other, State: Number of persons served
What type business, etc.
Estimate amount of waste daily (24 hours)
7. Number and type of water -using fixtures:
commodes urinals
lavatory
showers
garbage disposal
washing machine
dishwasher sinks
8. a) Type water supply: Public ✓ Private Community
b) Has the water supply system been approved? Yes_ZNo-
9. a) Property Dimensions
b) Land area designated to building site
c) Sewage Disposal Contractor
10. Do you anticipate any additions or expansions of the facility this sewage system Is intended to serve?
What type?
This is to certify that the information is correct to the best of my knowledge.
Date Owner Signatur
OWNER IS SOLELY RESPONSIBLE FOR COMPLIANCE WITH ALL STATE AND LOCAL LAWS
Allow 5 days for processing
Directions to property:
DCHD (6.82)