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203 Long Meadow Road Lot 40Davie County, NC, r Tax Parcel Report Wednesday, December 21, 2016 WARNING: THIS 1S NOT A SURVEY Parcel Information Parcel Number: H5010A0040 Township: Mocksville NCPIN Number: 5749068917 Municipality: Account Number: 63511650 Census Tract: 37059-806 Listed Owner 1: SCHROEDER GEORGE Voting Precinct: NORTH MOCKSVILLE COUNTY Mailing Address 1: 203 LONG MEADOW ROAD Planning Jurisdiction: Davie County City: MOCKSVILLE Zoning Class: DAVIE COUNTY R -A State: NC Zoning Overlay: DAVIE COUNTY QD Zip Code: 27028-4243 Voluntary Ag. District No Legal Description: LOT 40 FARMLAND ACRES SECTION FIVE Fire Response District: MOCKSVILLE Assessed Acreage: 4.98 Elementary School Zone: MOCKSVILLE Deed Date: 1011997 Middle School Zone: SOUTH DAVIE Deed Book / Page: 001980220 Soil Types: SeB,MsC,ChA,MsD Plat Book: 0006 Flood Zone: Plat Page: 021 Watershed Overlay: DAVIE COUNTY Building Value: Outbuilding 8r Extra Freatures Value: Land Value: Total Market Value: Total Assessed Value: F-0-1 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 nteess for a particular use. Ali users of Davie County's GIS website shall hold harmless theCounty of Davie, North Carolina, Its agents, consultants, contractors or employees from any and all claims or causes of action due to NC or arising out of the use or Inability to use the GIS data provided by this website. y,r7 a Q'`ki a`•�iv�` '�:-�'•f 4 >h.Jw„•.,;'��E'e'S.,"n.y%�:�''�,a•i'Sr "S c�yt �'�s: �}F° i i"x tiy. rr`r-i'. a',}� �,+�.�ls t'�r-�ti ._ �. i r -.. .}., -r i�:_ 1413 UTHORIZATIONs10 , , DAVIE CQUNTY HEALTH DEPARTMENT nvironmental Health Section PROPERTY INFORMATION Permitt€ s . P.O. Box 848 i.iri 'moi . Name: Mochsville, NC 27028 Subdivision Name: Phone #: 704-634-8760 Directions to property`. ' - Section: Lot: '7K"110 AUTHORIZATION FOR . ` �'' c/~ •C/T: fi. SYSTEM CONSTRUCTION WASTEWATER Tax Office PIN:#. -ate - -! Alter r Y"i i� Road Name: **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 11 of G.S. Chapter 130A, Wastewater Systems; -Section .1900 Sewage Treatment and Disposal Systems) ***NOT ICE*** THIS AUTHORIZATION FOR WASTEWATER CONSTRUCTION -�_ _ IS VALID FOR.A PERIOD OF FIVE YEARS. VI ENRONMENTAL HEALTH SPECIA IST DATE ISSUED 44, �.;!."""_y'F ' { �I t, X'y. 14.1 3;'DAVIE C U . TYHEALTH DEPARTMENT ti �+ . ,. IMPRO LENT AND OPERATION PERMITS PROPERTY INFORMATION Perm) Name owl Subdivision Name: Directions to propertSection: ` Lot: e IMPROVEMENT PERMIT Tax Office PIN:#r r - - / r oad Name: dY,p; **NOTE** This Improvement Permit DOES NOT authorize the construction or installation of a septic tapfc system or any wastewater system. An AUTHORIZATION FOR WASTEWATER SYSTEM CONSTRUCTION must be obtained i`n�is 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 Se�age Treatmeqtand D spousal Systems) ***NOTICE*** THIS PERMIT7S SUBJECT TO REVOCATION IF SITE PLANS OR THE INItNDED USF/C#IANGE. YOUR WASTEWATER ENV�IROiMENTAL HEALTH SPECIALi5TT_ DATE ISSUED SYSTEM CONTRACTOR MUST SEEM IS PERMIT BEFORE INSTALLING THE SYSTEM.) , RESIDENTIAL SPECIFICATION: BUILDING TYPE # BEDROOMS # BATHS —,47--# OCCUPANTS GARBAGE DISPOSAL: Yes or No COMMERCIAL SPECIFICATION: FACILITY TYPE # PEOPLE # PEOPLE/SHIFT # SEATS INDUSTRIAL WASTE: Yes or No LOT SIZE �� TYPE WATER SUPPLY DESIGN WASTEWATER FLOW (GPD) NEW SITE REPAIR SITE SYSTEM SPECIFICATIONS: TANK SIZE,%plS i GAL. PUMP TANK GAL. TRENCH WIDTH ,, 14, ROCK DEPTH 1� LINEAR FT. OTHER —:2 REQUIRED SITE MODIFICATIONS/CONDITIONS: IMPROVEMENT PERMIT LAYOUT 41 T Q.cx k r- i.J ?amu` • 0.0rj pot.: 2 cxiwIlIt 1 **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) 634-8760. OPERATION PERMIT /00 cam' n WE SLYSTEM INSTALLED BY: `_�lst SIVPco--z-4 Zoe I AUTHORIZATION NO. OPERATION PERMIT BY: DATE: v 1 **THE ISSUANCE OF THIS OPERATION PERMIT SHALL INDICATE THAT THE SYS ESCRIBED ABO AS 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 APPLICATION FOR SITE EVALUATIONAMPROVEMENT PERMIT & Davie County Health Department Environmental Health Section P. O. Box 848 Mocksville, NC 27028 (4VW= (336)751-8760 ""IMPORTANT"" THIS APPLICATION CANNOT BE PROCESSED U / ALL THE REQUIRED INFORMATION IS PROVIDE LName to be Billed Y'Y` ti Contact Person Mailing Address o Home Phone City/State/Zip /tel Y� 1 U)I 1 i' AJ L d— 1 Gd� Business Phone 2. Name on Permit/ATC if Different than Above Mailing Address City/State/Zip 3. Application For: 0 Site Evaluation ❑ Improvement Permit & ATC 4. System to Serve: House ❑ Mobile Home ❑ Business ❑ Industry 5. If Residence: # People �_ # Bedrooms t9' Dishwasher 0"Garbage Disposal LK"Washing Machine ❑ Basement/Plumbing 0' Both ❑ Other # Bathrooms ❑ 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) 7. Type of water supply: ❑' County/City ❑ Well ❑ Community 8. Do you anticipate additions or expansions of the facility this system is intended to serve? ❑ Yes 0� o If yes, what type? PROPERTY INFORMATION REQUIRED: *** IMPORTANT *** A Cff THE PROPERTY MUST BE SUBMITTED WITH THIS APPLICATION. Property Dimensions: n I �� x�+ T� �� +1 WRITE DIRECTIONS (from Mocksville) TO PROPERTY: Tax Office PIN: # - Property Address: Road Name City/Zip If in Subdivision provide information, as follows: Name: 1 Section: Lot #: 1 / LYw �1 j� k 1 -1%�A This is to certify that the information provided is correct to the best of my knowledge. I un3ei'stand that dh} 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 Representative of the Davie County Health Department to enter upon above described property located in Davie County and owned by l'� -, ±:,� r �`I 1 � LL— to conduct all testing procedures as necessary to determine the ite suitability. DATE — SIGNATURE ` Revised DCHD (06-96) YOU MAY USE THE 13ACK OF THIS FORM FOR DRAWING YOUR SITE PLAN. ict LONGMEAD0 W ROAD 60' Public R/W 20'+/— Pavement R/W R/W I t 1" EIP z Tie Line r S 20'37'15'E 1 76.54' I W/2" EIP aR�Cable 7V Pecesta Po.er 6a. •Te pwrl. Peaesa: I I258.94' N 20°37'15'V \ 1 1„` Tie line EIP N 35.08'40"E 65.65' ARC 61.82' CH Lot 39 FARMLAND ACRES Section Five Lot 41 FARMLAND ACRES Section Five PB 60 PG 21 N 69°20'20"E 630.38' Lot 40 5.010 Acres+/— A/ App—irnatle Lablition of aM=h1 \ 1 S 05°28'40" Y1 544.41' 7 1" EIP Beside Stone sczerosx—� 203.79' / r � r 1 1” EIP Tax Lot 24.04 Tax Map H-5 n/f Charles E Yates DB 184 0 PG 902 DB 191 0 PG 88 N 41°53'20"V. 29.69 ARC IRSVX 29.01' CH 40' RAD IRS + P 55' V 61.50' ARC Radius 58.35' CH r Cable N Pedesto7 1„` Tie line EIP N 35.08'40"E 65.65' ARC 61.82' CH Lot 39 FARMLAND ACRES Section Five Lot 41 FARMLAND ACRES Section Five PB 60 PG 21 N 69°20'20"E 630.38' Lot 40 5.010 Acres+/— A/ App—irnatle Lablition of aM=h1 \ 1 S 05°28'40" Y1 544.41' 7 1" EIP Beside Stone sczerosx—� 203.79' / r � r 1 1” EIP Tax Lot 24.04 Tax Map H-5 n/f Charles E Yates DB 184 0 PG 902 DB 191 0 PG 88 ore APPLICATION FOR SITE EVALUATION/IMPROVEMENTS PERM v Davie County Health Department n Z l Environmental Health Section V P. O. Box 665 NOV 2 7 M Mocksville, NC 27028 1. Application/Permit Requested By 0 0 c Mailing Address��M Home Phone� 1 I hf7 IJV VI I e. I �J rZ � � Business Phone %3q— aZ i & 7 2. Name on Permit if Different than Above 3. Application for: General Evaluation ❑ Septic Tank Installation Permit 4. System to Serve: [/House ❑ Mobile Home ❑ Place of Public Assembly ❑ Business ❑ Industry ❑ Other ❑ Unknown 5. If house, mobile home: Subdivision PSection Lot # y0 Basement/Plumbing �j L Oti�mEAOo[r> J2G•�0 No. of People v ❑ Basement/No Plumbing No. of Bedrooms leWashing Machine No. of Bathrooms u Dwelling Dimensions SS"'(eV�J 6. If business, industry, place of public assembly, other: Specify type No. of People Served No. of Sinks No. of Commodes No. of Lavatories No. of Showers 7. Type of water supply: ,Public 8. Property Dimensions No. of Urinals No. of Water Coolers Water Usage Figures ❑ Private Sewage Disposal Contractor Dishwasher Garbage Disposal 9. Do you anticipate additions/expansion of the facility this sytem is intended to serve? ❑ Yes JZNo If yes, what type? ❑ Community "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: QL�L. — /�/Gh�f1/1tj �9•vG-EL Tax Office PIN # Road Name LOA)(' 12,0.441 Box # (if available) City /" Cr C k S VJ1- 4-0 , N. C This is to certify that the information provided is correct to the best of my knowledge, and I understand I am responsible for all charges incurred from this application. T DATE T SIGNATURE CONSENT FOR SITE EVALUATION TO BE DONE ONBA OVE DESCRIBED PROPERTY MUST CHECK ONE: ❑ 1. 1 OWN the property. 0-1. 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 Davi Coun Health Department to enter upon above described property located in Davie County and owned by _ 11 to conduct all testing procedures as necessary to determine said site's s ability for a ground ab"sorptidn sewage treetfnent and disposal system. //- 2 3 -�Ls— DATE SIGNATURE DCHD (1193) ~ DAVIE COUNTY HEALTH DEPARTMENT �o"�' Environmental Health Section Soil/Site Evaluation NAME 1D6C DATE EVALUATED ADDRESS PROPERTY SIZE ,p / PROPOSED FACIILTY _�/V1/41/S"P LOCATION OF SITE 15G��I.UC Water Supply: On -Site Well _ Community Public L,- Evaluation /Evaluation By: Auger Boring Pit Cut FACTORS 1 2 3 4 Landscape position L Slope HORIZON I DEPTH Texture group S° tnL ft°L Consistence Structure Mineralogy HORIZON II DEPTH Texture groupG Consistence r- i Structure i Mineralogy HORIZON III DEPTH Texture group Consistence Structure Mineralogy HORIZON IV DEPTH Texture group Consistence Structure Mineralogy SOIL WETNESS RESTRICTIVE HORIZON SAPROLITE CLASSIFICATION f LONG-TERM ACCEPTANCE RATE , SITE CLASSIFICATION: LONG-TERM ACCEPTANCE RATE: 1 - REMARKS: DCHD(01-901 EVALUATED BY: '&' GI/ OTHER(S) PRESENT: 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 ;lay loam• SIL -Silty loam CL -Clay loam SCL-Sandy clay loam SC -Sandy clay SIC -Silty clay C -Clay CONSISTENCE Moist VFR- Vl--ry 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 3C --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 ■■■■■■■■■■■■/■■■■/■/■■/■■■■■■■■■■■■■■■■■■■■■■■■■■�■■■■■■■■ ■■/NOON ■■■■■■■■■■■■�■■■NOON■■u■■■■/NOON■■N/■■■///NOON■ ■■■■■■■■■■■■■■■■ ...........................................■■.■■.■........■.■..■■■ ■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■�NNOON■■/NOON■/NOON■/■■■■■■■■■■■ ■■■■■■■■■■■■■■■■■■■■■■■■■■■:■■■■■■■■N■E■■EE■■N■:■■■■:■■■■':■■■■■■■■ ■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■.■■■■m:' ■■ ■■■■■■■ ■■ ■■■■■■■/■■■■■■//■■■■■■■■■■■■■■■■■■/■■■■■■ ■■■ 111111011111111111111111 NOON■■ ■■ ■■■■■■■■■■■■■■■■■■■■■■S■E■■■■■N■■■■■■■■■ ■■■ ■ ■■■■■■■■■■■■■■■■■■■■■■■■■■■■■N■■■■N■E■■■■■■■■■■■■ ■■■■■■■■■■■■■■■■ ■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■mm■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■ ■■■■NN■N■NNS■■■E■■■■■■E■■■■■■■N ■E■■■■■u■■■■■■■■■■S■■■■■■■■■■■■ ■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■E■■■NE■i■�■■■■■■N■■■■■■■■ ::::::::::::::::::::::::::::::::::::':N:mE':::■:■::::::'::m■::: ■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■i■�■■■■■■:■■■u■■■■■■■:■■■■■■■I: ::::::::::::::::::::::::::::::mE'N:■:'■:■mm:Emm::':::::::::::::�:':■: ■■■■■■■NE■N■NEN■NN■■■N■E■■N■■■■uE■■■■■NN�N:■N■u■■■■■■■■■■:■/■ ■■■■■■■■■■■■NN■NN■■■■■■■■■E■■EE■ NOON■■/■ ■SOON■■■E■■■■■■N■N■III ■ ::::::::::::::::::mmmmm:::::::�:::::::::::::"::::::I:::::m: ■■■■■■■■NE■N■■E■■■N■NNN■■■EEEE■NEN■N■N■■■■■■N■■S NOON ■■/■■■ ■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■E■■■■■N■■■■■■■■■ ■ ■N■■■■■■ ::::::::::::::::::::::::::::�::::::::::::::::::: :C::::':::::::: ■■■■■■NE■EEE■N■N■■N■■N■■N■E■■N/ vP.q■■■uNN■NNNu■■■■■■:■■■■■■■■ '::�:::::M■::H:'u':::::M■M■M■::■■� 't■■ ■""omIII NOON■■■: ■■/■:■■N■■N■■■■■■■EE■E■■■■■■■■■■■■■■■■ ■■■■■■■■ ■i=i'■ ::::::: ■■■■■■■■■EN■E■NNE■N■■■■■■■■■N■■N■ ■� /■■■ ■ //.�, ■■■�■■■■■■: ■■■■■NE■■■E■NNNNNiNE■Nim■■E■SS■E:I' :' ' �il�� ■■■ ■■■■■ :::::::::::::::::■::::■■mmm:::::■■: ■: ' ■■ � 71M"�r�■ M: ■■■::::: IS::::::M::::::"::M■:M�':::OE="" EY ■■■: NOON■■ . ■ ■■■ ■ ■■■�■■■■■■ ■■G'■■■■■■■■■■■■■■■■■■/v�irmi�■■■■■��/ �"�� ■■■ NOON■■ ■■(/I■■■■m■■N■N■NN■■O/2■■EN■S■■■■■■■■■ N�`.�■■�■■■■■■■■ ■■■1■Ns%■m■■/_i%Saii/■■■N■■NNNN■EEE■■N mm ■■■■■■■■ :::::::::M:::::::::•■■■■.■■..■._._ . . ■■ rN■■�■■ ■■■■■■■■ NE ■ ■ ■■ NOON■ ■■ :::::IIII MM=MMM:::::: ::m:::" ■ ::C:::::::: ■■■■■■■■/■■■■■NN■■NNNE■E■E■EN■N ■NNN:'::::: ■NNN■EE■NN■■ EN■NNN ■■e ■■■ NOON ■ ■ ■■N■EEE■N ■NMMu■NNEE■M0■■■:■■■ ■■ /■ NNSNS ■ ::::::::'■i:::::::uMMMM ii '■::::::iIII ::::::::::::::v:I■::::::::::::■�� ■■MM u:u: ■■■■■NN■■■■■mm ■■■■■■E■■ON-0 ■N ■ ■■■■■■■■/■■■/ E■■ E■■■E■E■■1■ N■■■■■■■■■■ ■■■■■N■ ■■■■�■■:u■■■■■■�/■\'�■ ■■■:■■::S■N� ■■E�■NN ::t:::::mommm : .. 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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 a modified, oversized on—site sewage disposal system. If you have any questions, please feel free to contact this office. Sincerely, Robert B. Hal 1, Jr., R.S. Environmental Health Section RH/wd Enclosure