428 Farmland Road Lot 22Davie County, NC ` c Tax Parcel Report Wednesday. December 28. 2016
WARNING: THIS IS NOT A SURVEY
Parcel Information
Parcel Number:
G500000150
Township:
Mocksville
NCPIN Number:
5749083044
Municipality:
Account Number:
2428250
Census Tract:
37059-806
Listed Owner 1:
APPELT WILLIAM DAVID
Voting Precinct: NORTH MOCKSVILLE COUNTY
Mailing Address 1:
428 FARMLAND ROAD
Planning Jurisdiction:
Davie County
City: MOCKSVILLE
Zoning Class: DAVIE COUNTY R -A
State:
NC
Zoning Overlay:
DAVIE COUNTY QD
Zip Code:
27028-4148
Voluntary Ag. District:
No
Legal Description: LOT 22 FARMLAND ACRES SECTION FOUR
Fire Response District:
MOCKSVILLE
Assessed Acreage:
1.07
Elementary School Zone:
MOCKSVILLE
Deed Date:
11/1989
Middle School Zone:
SOUTH DAVIE
Deed Book / Page:
001510445
Soil Types:
SeB,MsC
Plat Book:
0005
Flood Zone:
Plat Page:
201
Watershed Overlay:
DAVIE COUNTY
Building Value:
Outbuilding & Extra
Freatures Value:
Land Value:
Total Market Value:
Total Assessed Value:
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 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
NC or arising out of the use or Inability to use the GIS data provided by this website.
• DAVIE COUNTY HEALTH DEPARTMENT
IMPROVEMENTS PERMIT AND CERTIFICATE OF COMPLETION
NOTE: Issued in Compliance With Article 11 of G.S. Chapter 130a
Sanitary Sewage System4 _ Permit Number
Name, Date S "�l NO
7077
Location —
Subdivision Name ^"" �``r~`' / �Lot No. Sec. or Block No.
Lot Size House Mobile Home _T Business _— Speculation
No. Bedrooms No. Baths No. in Family
Garbage Disposal YES ❑ NO p Specifications for System:
Auto Dish Washer YES NO ❑ �7� /
Auto Wash Ma thine YES NO ❑ --� /1��
Type Water Supply __—
`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.
t
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
'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.
DAVIE COUNTY HEALTH DEPARTMENT
:IMPROVEMENTS PERMIT AND CERTIFICATE OF COMPLETION
*NOTE: Issued in Compliance with G.S. of North Carolina Chapter 130 Article 13c r
Sewage Treatment and Disposal Rules (10 NCAC 10A .1934-.1968) Permit Nbmber
t � ,
Name /, ,• _ A/ r .^�� j,, ,, ;- Z , /Y' �� /%,.� 7 . ! ; Date r `, % ',! r r' Q "' i ,
T , ♦, �.l
Location / . Z/2-1,1
Subdivision Name�l''� Lot No. -%�- Sec. or Block No.
Lot Size ! �' House Mobile Home _ Business Speculation
No. Bedrooms No. Baths i No. in Family
Garbage Disposal YES p NO Q-- Specifications for System:
Auto Dish Washer YES NO p
Auto Wash Machine YES NO ❑ '�`" '� t t /
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
:a
Certificate of Completion( Date'R
*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.
sj ..y..•i ,r`r �.EiAi'`f
y :Y •'R tt'
. AUTHORISATION NO ,i 3 9- DAVIE COUNTY. HEALTH DEPARTMENT
Environmental Health Section PROPERTY INFORMATION
Permittee's P.O. Box 848 �
Name: Aa �'k Mocksville, NC 27028 Subdivision Name: f� ny 1-• ��.� f�t�
4. Phone # 336-751-8760
s
! Directions to property: / -�� Section: Lot:
AUTHORIZATION FOR
WASTEWATER Tax Office PIN:# -
SYSTEM CONSTRUCTION
Road Name: Zip.
**NOTE** This Authorization for Wastewater System Construction MUST BE ISSUED by the Davie County Environmental Health Section prior
to issuance of any Building-Pennmts. This Form/Authorization Number should be presented to the Davie County Building Inspections
Office when applying for Building Permits: ,
(1n c pliance with Article Il of G.S. Chapter 130A, Wastewater Systems, Section .1900 Sewage Treatment and Disposal Systems)
***NOTICE*** THIS AUTHORIZATION FOR WASTEWATER CONSTRUCTION
IS VALID FOR A PERIOD OF FIVE YEARS.
ENVIRONMENTAL H TH SPEALIST DATE ISSUED
t r� ,.-,• ..—..:y -.A ,.-.. _�,.�,.,..<1,�..�-.}wY..�o.;t,;..e-t'. ,,.-_, .y.r«.+..,.-mak -' . ...� ^. -. i J
DAVIE COUNTY HEALTH DEPARTMENT t
IMPROVEMENT AND OPERATION PERMITS PROPERTY INFORMATION
v Permittee's ,r,*
Name:( ` f t Subdivision Name: j.' L • �'
Directions to property: °def>�`"_�' / Section: - Lot:`
IMPROVEMENT
PERMIT Tax Office PIN:# -
Road Name: 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.
a (In compliance with Article 11 of G.S. Chapter 130A, Wastewater Systems, Section .1900 Sewage Treatment and Disposal Systems)
***NOTICE*** THUS PERMIT IS SUBJECT TO REVOCATION IF SITE
' f PLANS OR THIN INTENDED USE CHANGE. YOUR WASTEWATER
ENVIRONMENTAL H TH SPECIALIST DATE ISSUED SYSTEM CONTRACTOR MUST SEE TIUS 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 • - TYPE WATER SUPPLY %�N DESIGN WASTEWATER FLOW (GPD) NEW SITE - REPAIR SITE
SYSTEM SPECIFICATIONS: TANK SIZE GAL. •/PUMP TANK GAL. TRENCH WIDTH ROCK DEPTH LINEAR FT.
OTHER_ 08 J2�[LLJ /Ia �t
r
REQUIRED SITE MODIFICATIONS/CONDITIONS:
IMPROVEMENT PERMIT
FFLUENT FILTER' *RISER(8) IF 6" BELOW FINISHED GRADE*
r
"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) 6349M10 X X X X
(336)751-876
OPERATION PERMIT
SYSTEM INSTALLED BY:
AUTHORIZATION NO. 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)
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� ,'.�'' �� +? f � .SII ,. tl.,., �� � j•' S
J 911 DAVIE COUNTY HEALTH DEPARTMENT
C IMPROVEMENT AND OPERATION PERMITS PROPERTY INFORMATION
Subdivision Name: '
Directions to property: *r; Section: Lot:
IMPROVEMENT
PERMIT Tax Office PIN:#
Road Name: 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 TYPE WATER SUPPLY ` ' i DESIGN WASTEWATER FLOW (GPD) NEW SITE REPAIR SITE )
I
SYSTEM SPECIFICATIONS: TANK SIZE GAAL. PUMP TANK GA/L. TRENCH�WIIDTHH ROCK DEPTH LINEAR FT.
OTHER
REQUIRED SITE MODIFICATIONS/CONDITIONS:
IMPROVEMENT PERMIT LAYOUT *APRRO�t6 EFFLUENT FILTER* *RISER(S) IF 6” BELOW FINISHED GRPtDE*
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"066.X X X X X
(336)751-876
OPERATION PERMIT
SYSTEM INSTALLED BY:
AUTHORIZATION NO. 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)
Davie County, NC I I Tax Parcel Report Wednesday, December 28, 2016
Parcel Number:
NCPIN Number:
Account Number:
Listed Owner 1:
Mailing Address 1:
WARNING: THIS IS NOT A SURVEY
Parcel Information
G500000150 Township: Mocksville
5749083044 Municipality:
2428250 Census Tract: 37059-806
APPELT WILLIAM DAVID Voting Precinct: NORTH MOCKSVILLE COUNTY
428 FARMLAND ROAD Planning Jurisdiction: Davie County
Zoning Class: DAVIE COUNTY R -A
NC Zoning Overlay: DAVIE COUNTY QD
City: MOCKSVILLE
State:
Zip Code:
Legal Description:
Assessed Acreage:
Deed Date:
Deed Book / Page:
Plat Book:
Plat Page:
Building Value:
27028-4148 Voluntary Ag. District: No
LOT 22 FARMLAND ACRES SECTION FOUR Fire Response District: MOCKSVILLE
1.07 Elementary School Zone: MOCKSVILLE
Land Value:
Total Assessed Value:
11/1989 Middle School Zone: SOUTH DAVIE
001510445 Soil Types: SeB,MsC
0005 Flood Zone:
201 Watershed Overlay: DAVIE COUNTY
Outbuilding & Extra
Freatures Value:
Total Market Value:
Q� 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 fitness for a particular use. All users of Davie Courdy s GIS website shall hold harmless the
County of Davie, North Carolina, Its agents, consultands, contractors or employees from any and all claims or causes of action due to
noC ty C� NC or arising out of the use or Inability to use the GIS data provided by this website.
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DAVIE COUNTY HEALTH DEPARTMENT
IMPROVEMENTS PERMIT AND CERTIFICATE OF COMPLETION
*NOTE: Issued in Compliance With Article I I of G.S. Chapter 130a
S nitary Sewage System Permit Number
Name/% �,pe���� Date 36 NO 7 0.7 7.
Locationi9�ir��>1✓�.��
Subdivision Name ���''/'"Lot No. Sec. or Block No.
Lot Size House Mobile Home _�/ Business Speculation
No. Bedrooms No. Baths `� No. in Family
Garbage Disposal YES ❑ NO [' Specifications for System:
Auto Dish Washer YESNO ❑ / `` .�/
Auto Wash Ma shine YES T NO ❑ � _
Type Water Supply
*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.
Improvements permit by —! "X!/
*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
*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.
r
�.y DAVIE COUNTY HEALTH DEPARTMENT-
1U0RnVFMFNT_R PERMIT AND CERTIFICATE OF COMPLETION
' NOTE: Issued in Compliance With Article 11 of G.S. Chapter 130a
r Sanitary Sewage Sy tems; Permit .�1 bre
.� �.. %` i • Date cN�
Name / 2
/�.7�r1,�,1,; r,,r''�.r �''. �'�/ r`:+'✓r':'�' ,/�G%✓ � /%�`' _ � ,-�,�,' sem` �'
Location
Subdivision Name Lot No. Sec. or Block No.
Lot Size House T— Mobile Home _T Business Speculation
No. Bedrooms No. Baths No. in Family
Garbage Disposal YES ❑ NO ❑ Specifications for System:
Auto Dish Washer YES NO ❑/
Auto Wash Ma shine YES NO ❑
Type Water Supply __—
*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.
i
_.. Improvements permit by
Ater/
"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
'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.
r .�•" DAVIE COUNTY HEALTH DEPARTMENT
!IMPROVEMENTS PERMIT AND CERTIFICATE OF COMPLETION
*NOTE: Issued in Compliance with G.S. of North Carolina Chapter 130 Article 13c
ewage Treatment and Disposal Rules (10 NCAC 10A .1934-.1968) Permit Number
NameN S
. .�CL7 /all�r %� �Slht1i %rr�� 7`��% %>` Date l/���� .. 0
Location (..��`! ✓ i — �i�/i »�I--P'i' .^ii=�-" 1 �; /oil ✓�f��r� l;, y /r7`
i
Subdivision Name r',JL/P'ja_- Lot No. - —' Sec. or Block No. l�
Lot Size Zit' House Mobile Home _ Business Speculation
No. Bedrooms No. Baths � No. in Family �L
Garbage Disposal
Auto Dish Washer
Auto Wash Machine
Type Water Supply
YES :❑ NO p2''
YES NO C❑
YES �j NO C❑
r�
Specifications for System:
*This permit Void if sewage system described below is not installed within 36 months from date of issue
Improvements permit by Z<'
*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
A ((/
Certificate of Completion( Date iU
*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.
r
1. Permit R
2. Address
' r
APPLICATION FOR SITE EVALUATION/ IMPROVEMENTS PEF100,
Davie County Health Department►
Environmental Health Section
R 0. Box 665 '�Gy
Mocksville, N.C. 27028
CONSTRUCTION SHALL NOT BEGIN UNTIL IMPROVEMENTS PERMIT HAS BEEN ISSUED470
3. Property Owner if Different than Above
Address
4. Permit To: a) Installer Alter Repair
b) Privy Conventional—,,L Other Type
Ground Absorption
C) Sub-Divisionf;,irsks.*,,`#t"AtlSecs Lot No. a"
5. System used to serve what type facility: Housed Mobile Home Business
Industry Other 11 ►{
b) Number of people 2 tti �c^t�
Up
6. a� If house or mobile home, state size of home and number of rooms. '7
House Dimensions oZ 41 X 3 7 � N.- 2•
Bed Rooms_ Bath RoomsAA 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: AA
commodes 3 urinals cJ garbage disposal
lavatory showers 4L washing machine
dishwasher sinks
8. a) Type water supply: Public. %Z Private Community
b) Has the water supply system been approved? Yeses No
9. a) Property Dimensions—
b)
imensions 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? IJ '0
What type?
This is to certify that the information is correct to the best pyy knowledge.
Date Owner Signatur
OWNER IS SOLELY RESPONSIBLE FOR COMPLIANCE WITH ALL STATE AND LOCAL LAWS
Allow 5 days for processing
Directions to property:
7rt,�� (Rk, S,; -t
DCHD (6-82)
(0 le
DAVIE COUNTY HEALTH DEPARTMENT
Environmental Health Section
R O. Box 665
Mocksville, N.C. 27028
SOIL/SITE EVALUATION
Name Date
Address Lot Size -- L
PArTnRR AREA 1 AREA 2 AREA 3 AREA 4
Topography/ Landscape Position
S
S
S
!) Soil Texture (12-36 in.) Sandy,
Loamy, Clayey, (note 2:1 Clay)
S
PS
S
S
U
{) Soil Structure (12-36 in.)
Clayey Solis
S
S
S
S
Soil Depth (inches)
S
S
S
S
i) Soil Drainage: Internal
�.
S
S
U
External
i PV
S
Is
i) Restrictive Horizons
z
Available Space
S��
��
S
/-Tss—
S
PS
S
U
U
1) Other (Specify)
S
PS
S
PS
S
PS
S
U
U
U
1) Site Classification
—
S,
U—UNSUITABLE S—SUITABLE PS—Provisionally Suitable
rfl
Ronmmontfanna/r"j-'q`/
nmmanta• . -?"/a .
'q 7"
Described by _
SITE DIAGRAM
DCHD (6.82)
G'7 Title _
Date
Address
FACTORS
DAVIE COUNTY HEALTH DEPARTMENT
Environmental Health Section
R 0. Box 665
Mocksville, N.C. 27028
SOIL/SITE EVALUATION
Date
Lot Size ,,14 C,
ARFA 1 ARFA 9 ARFA R AREA A
1) Topography/ Landscape Position
S
*S
S
P
S
?) Soil Texture (12-36 in.) Sandy,
Loamy, Clayey, (note 2:1 Clay)
S
S
S
U
3) Soil Structure (12-36 in.)
Clayey Soils
S
S
S
tu
S
1) Soil Depth (inches)
S
S
S
S
i) Soil Drainage: Internal
S
S
U
U
External
'CJ
S
SS
i) Restrictive Horizons
?
Available Space
S
(am'
S
S
PS
S
U
U
1) Other (Specify)
S
PS
S
PS
S
PS
S
U
UU
U
1) Site Classification
U—UNSUITABLE Y S- /—SUITABLE PS—Provisionally Suitable
.S ,
Recommendations/ Comments: .4 9k2, �r� l
Described by —
SITE DIAGRAM
DCHD (6-82)
Title
Date — f