1211 Junction Rd, 187 Delanos Ln Lot 11Davie County, NC Tax Parcel Report Tuesday, January 3, 2017
Parcel Number:
NCPIN Number:
Account Number:
Listed Owner 1:
Mailing Address 1:
WAKLV11Vli: *ffflJ 1J 1VU'1 A JUKV.LY
Parcel Information
M401 OA0011 Township: Mocksville
5726-91-1130 Municipality:
69870000 Census Tract: 37059-801
SPILLMAN CLARENCE Voting Precinct: SOUTH CALAHALN
1949 JUNCTION ROAD Planning Jurisdiction: Davie County
Zoning Class: DAVIE COUNTY R -A R-20
NC Zoning Overlay: DAVIE COUNTY CZOD
City: MOCKSVILLE
State:
Zip Code:
Legal Description:
Assessed Acreage:
Deed Date:
Deed Book / Page:
Plat Book:
Plat Page:
Building Value:
Land Value:
Total Assessed Value:
27028-0000 Voluntary Ag. Dlstri :
LOT 11 GRANT HEIGHTS 1.72 ac Fire Response District:
COOLEEMEE
1.72 Elementary School Zone:
COOLEEMEE
8/2011 Middle School Zone:
SOUTH DAVIE
008660454 Soil Types:
GnE32
10 Flood Zone:
371 Watershed Overlay:
DAVIE COUNTY
Outbuilding & Extra
Freatures Value:
Total Market Value:
22
9Dt� ( All data Is provided ..is without warranty or guarantee of any Idnd either expressed or Implied Including but not limited to the
Davie County, i Implied warranties of merchantability or fitness for a particular use. All users of Davie CouWs GIS websHe shall hold harmless the ,
rmu I County of Davie, North Carolina, its agents, consultants, contractors or employees from any and all claims or causes of action due to
I �pU N� NC or arising out of the use or Inability to use the GIS data provided by this website.
P
AtiTHt5Ri+2.ATION NO: '� �� � � DAME COUNTY HEALTH DEPARTMENT
zEnvironmental Health Section PROPERTY INFORMATION
Permittee Is
// 'j P.O. Box 848
Name: ' �T Mocksville, NC 27028 Subdivision Name: f/✓.� �/'
Phone # 336-751-8760
Directions to property: \/�f ft;:' / c% r �' Section: f Lot:
AUTHORIZATION FOR
WASTEWATER Tax Office PIN:#
SYSTEM CONSTRUCTION
....
Road Name: a I /Z p �a
**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)
/ i ***NOTICE*** THIS AUTHORIZATION FOR WASTEWATER CONSTRUCTION
'ill'
% IS VALID FOR A PERIOD OF FIVE YEARS.
ENVIRONMENTAL HEALTH SPECIALIST DATE ISSUED
5 2 5 DAVIE BOUNTY HEALTH DEPARTMENT
IMPROVEMENT AND OPERATION PERMITS PROPERTY INFORMATION
Permittee: s C, .
Name:- Subdivision Name:1421
i - %r .
• ^ .Directions to property: '°�.-' �� � Section: Lot:
IMPROVEMENT
PERMIT Tax Office PIN:#
Road Name: .-'� �' Z P..�...,
**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 1,21 # BEDROOMS # BATHS ,� # OCCUPANTS � GARBAGE DISPOSAL: Yes or No
COMMERCIAL SPECIFICATION: FACILITY TYPE # PEOPLE # PEOPLE/SHIFT # SEATS INDUSTRIAL WASTE: Yes or No ,
LOT SIZE h � TYPE WATER SUPPLY DESIGN WASTEWATER FLOW (GPD) �NEWSITE. REPAIR SITE
SYSTEM SPECIFICATIONS: TANK SIZE GAL. PUMP TANK GAL. TRENCH WIDTH `. , _ ROCK DEPTH __2L LINEAR FT. l�
REQUIRED SITE MODIFICATIONS/CONDITIONS:
IMPROVEMENT PERMIT LAYOUT
"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 (336)751-8760.
OPERATION PERMIT
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 I 1 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)
. A 1
APPLICATION FOR SITE EVALUATION/IMPROVEMENT PERMITT ,
Davie County Health Department
Environmental Health Section
P. O. Box 848 JUN -31M
Mocksville, NC 27028
(704) 634-8760 ENVIRO'dIF4 NTAL HEALTH
DAVIE COUNTY
****IMPORTANT**** THIS APPLICATION CANNOT BE PROCESSED UNLESS
ALL THE REQUIRED INFORMATION IS PROVIDED.
1. Name to be Billed aaqo t I C moh Contact Person
Mailing Address a Oy / Home Phone d,�-7- 7�
City/State/Zip l i � 0 l�t/L � Cti k6 6 �'y I Business Phone
2. Name on Permit/ATC if Different than Above
Mailing Address
3. Application For:
4. System to Serve:
5. IIf Residence:
3/Dishwasher
City/State/Zip
❑ Site Evaluation 1/ Improvement Permit & ATC ❑ Both
❑ House t/Mobile Home ❑ Business ❑ Industry ❑ Other
# People # Bedrooms 3 # Bathrooms 6P
❑ Garbage Disposal Ul"Washing Machine ❑ Basement/Plumbing ❑ Basement/No Plumbing
6. If Business/Other:
# Commodes
If Foodservice:
7. Type of water supply:
Specify type
# Showers
# Seats
C/County/City
# People # Sinks
# Urinals
Estimated Water Usage (gallons per day)
❑ Well
# Water Coolers
8. Do you anticipate additions or expansions of the facility this system is intended to serve?
If yes, what type?
❑ Community
❑ Yes 3 -"'No
PROPERTY INFORMATION REQUIRED: *** IMPORTANT *** A PLAT OF THE PROPERTY MUST BE
SUBMITTED WITH THIS APPLICATION.
Property Dimensions:1 WRITE DIRECTIONS (from
G 1 Mocksville) TO PROPERTY.
Tax Office PIN: #� ` - / �✓z 1
Property Address: Road Name
city/zip / o t/►'� V)
1
If in Subdivision provide information, as follows: 1
Name:
Il 1
Section:
Lot #:
1
1
This is to certify that the information provided is correct to the best of my knowledge. I understand that any 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(.L rn' to conduct all testing procedures
as necessary to determine the site suitability.
DATE & • '� - q
SIGNATURE
Revised DCHD (06-96)
DAVIE COUNTY HEALTH DEPARTMENT
Environmental Health Section SECTION_ LOT-
Soil/Site Evaluation
APPLICANT'S NAME DATE EVALUATED
PROPOSED FACILITY `i�%9� PROPERTY SIZE �,qC
SUBDIVISIONl� f ROAD NAME
Water Supply: On -Site Well Community Public ✓
Evaluation By: Auger Boring Pit Cut
FACTORS 1 2 3 4 5 6 7
Landscape position
Sloe %
HORIZON I DEPTH
Texture group
Consistence
Structure
Mineralogy
HORIZON II DEPTH
Texture group
Consistence
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
LONG-TERM ACCEPTANCE RATE
SITE CLASSIFICATION: ��
LONG-TERM ACCEPTANCE RATE: A
REMARKS:
LEGEND
Landscape Position
EVALUATION BY:
OTHER(S) PRESENT:
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 - 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 (01-90)
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Davie County, NC Tax Parcel Report Wednesday, January 4, 2017
L168�;�---198_
WARNING: THIS IS NOT A SURVEY
1175
203
Parcel Information
Parcel Number:
M401OA0011
�•� ` a� _�'
195
NCPIN Number:
5726-91-1130
.' 1185
187
Account Number:
69870000
1
'--179
1199
On
Voting Precinct:
SOUTH CALAHALN
12111
171 r'
�%
Davie County
�• 12 213
Zoning Class: DAVIE COUNTY R -A R-20
State:
NC
1229
-1 9 /
27028-0000
Voluntary Ag. District:
No
Legal Description:
OUN�
WARNING: THIS IS NOT A SURVEY
All data is provided as Is without warranty or guarantee of any Idnd either expressed or Implied Including but not limited to the
Implied warranties of merchantability or fitness for a particular use. All users of Davie County s GIS webslte 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
or arising out of the use or Inability to use the GIS data provided by this webslte. f
Parcel Information
Parcel Number:
M401OA0011
Township:
Mocksville
NCPIN Number:
5726-91-1130
Municipality:
Account Number:
69870000
Census Tract:
37059-801
Listed Owner 1:
SPILLMAN CLARENCE
Voting Precinct:
SOUTH CALAHALN
Mailing Address 1:
1949 JUNCTION ROAD
Planning Jurisdiction:
Davie County
City: MOCKSVILLE
Zoning Class: DAVIE COUNTY R -A R-20
State:
NC
Zoning Overlay: DAVIE COUNTY CZOD
Zip Code:
27028-0000
Voluntary Ag. District:
No
Legal Description:
LOT 11 GRANT HEIGHTS 1.72 ac
Fin: Response District:
COOLEEMEE
Assessed Acreage:
1.72
Elementary School Zone:
COOLEEMEE
Deed Date:
8/2011
Middle School Zone:
SOUTH DAVIE
Deed Book / Page:
008660454
Soil Types:
Gn82
Plat Book:
10
Flood Zone:
Plat Page:
371
Watershed Overlay:
DAVIE COUNTY
Building Value:
Outbuilding 8r Extra
Freatures Value:
Land Value:
Total Market Value:
Total Assessed Value:
OUN�
Davie County,
NC !
All data is provided as Is without warranty or guarantee of any Idnd either expressed or Implied Including but not limited to the
Implied warranties of merchantability or fitness for a particular use. All users of Davie County s GIS webslte 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
or arising out of the use or Inability to use the GIS data provided by this webslte. f
DAVIE COUNTY HEALTH DEPARTMENT
IMPROVEMENT PERMIT and OPERATION PERMIT
IMPROVEMENT PERMIT
**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)
NAME ZF/ �/� ice:'\ PROPERTY ADDRESS t1V 714 • h LL .-A �IeAa DATE
LOCATION
/Al/
SUBDIVISION NAME l i� /% �j'i� �� �f i� LOT NUMBER ,Z% SEC. /BLOCK NUMBER /
RESIDENTAL SPECIFICATION: BUILDING TYPE`) } # BEDROOMS '�? # BATHS 1. # OCCUPANTS GARBAGE DISPOSAL: Yes/
COMMERCIAL SPECIFICATION: FACILITY TYPE # PEOPLE # PEOPLE/SHIFT # SEATS INDUSTRIAL WASTE: Yes/No
LOT SIZE 1296 %�, y r TYPE WATER SUPPLY '� , DESIGN WASTEWATER FLOW (GPD) _?X1,,4) NEW SITE ,�` REPAIR SITE
SYSTEM SPECIFICATIONS: TANK SIZE /G'Dt7 GAL. PUMP TAW
OTHER
REQUIRED SITE MODIFICATIONS/CONDITIONS:
GAL. TRENCH WIDTH .3l ROCK DEPTH A) LINEAR FT. UU
***THIS PERMIT IS SUBJECT TO REVOCATION IF SITE PLANS OR THE INTENDED USE CHANGE. YOUR WASTERWATER SYSTEM CONTRACTOR MUST
SEE THIS PERMIT BEFORE INSTALLING THE SYSTEM.
IMPROVEMENT PERMIT BY ZI
**CONTACT A REPRESENTATIVE OF THE DAVIE COUNTY HEALTH DEPARTMENT FOR FINAL INSPECTION OF THIS SYSTEM BETWEEN
8:30-9:38 A.M. OR 1:00-1:30 P.M. ON THE DAY OF INSTALLATION. TELEPHONE # IS (704) 634-8760.
OPERATION PERMIT SYSTEM INSTALLED BY
F
b
C G
AUTHORIZATION NO. � J OPERATION PERMFM BY �h� DATE
**THE ISSUANCE OF THIS OPERATION PERMIT SHALL INDICATE THAT THEISYSTEM 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 10/95
Davie County Health Department
ENVIRONMENTAL HEALTH SECTION
P.O. Box 665
Mocksville, N.C. 27028
AUTHORIZATION FOR WASTEWATER SYSTEM CONSTRUCTION
(Issued in compliance with Article 11 of
G.S. Chapter 130A, Wastewater Systems)
2:0-t
***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.***
NAME /� i
f%h�
DATE/� !��
AUTHORIZATION NLIVBER
`�` 0 0.)!�
NAME ON IMPROVEhENT PERMIT (If different than above)
SITE LOCATION V G���'lf /%i�r�
�C/�il v /!✓t'��ST/
COMMENTS/CONDITIONS ON AUTHORIZATION TO CONSTRUCT WASTEWATER SYSTEM
***NDTICE*** THIS AUTHORIZATION F WASTEWATER SYSTEM CONSTRUCTION IS VALID FOR A PERIOD OF FIVE (5) YEARS.
ENVIRONMENTAL HEALTH SPECIALIST DATE
DCHD 10/95
APPLICATION FOR SITE EVALUATION/IMPROVEMENTS PERMIT` --7 0 W IE
Davie County Health Department ; I �-
Environmental Health Section I IAY 1 4 19 J6
P. O. Box 665
Mocksville, NC 27028
1. Application/Permit Requested By ( T 'CyHIM n
Mailing Address P 0 &K r% b Home Phone��p4
O��'�mp ti✓. NC, ���� Business Phone b�'aSS I
2. Name on Permit if Different than Above
3. Application for: 0 General Evaluation U Septic Tank Installation Permit
4. System to Serve: ❑ House
F Mobile Home ❑ Place of Public Assembly
❑ Business ❑ Industry 1 L El Other El Unknown q
5. If house, mobile home: Subdivision G rQ,rtiT Section Lot # J1
No. of People
No. of Bedrooms
❑ Basement/Plumbing
❑ Basement/No Plumbing
❑ Washing Machine
No. of Bathrooms o2 ❑ Dishwasher
Dwelling Dimensions N ❑ Garbage Disposal
6. If business, industry, place of public assembly, other: Specify type YA
No. of People Served
No. of Commodes
No. of Lavatories
No. of Sinks
No. of Urinals
No. of Water Coolers
No. of Showers Water Usage Figures _
7. Type of water supply: Public ❑ Private
(
8. Property Dimensions ��� X ��� Sewage Disposal Contractor
9. Do you anticipate additions/expansion of the facility this sytem is intended to serve? ❑ Yes ❑ No
If yes, what type?
❑ Community
`NOTE: Improvements Permits shall be valid from date issued. Improvements Permits are subject to
revocation, if site plans or the intended use change. Effective October 1, 1989.
Directions to Property:
This is to certify that the information provided is correct to the
incurred from this application.
bAT
Tax Office PIN: #-r1ga-(Jr )o /1)APq
PROPERTY ADDRESS, as follows:
Road Name: )Ctme'`n bti.1 12b
City: MOCKSQT LLF, W
SU13MIT A PLAT WITH THIS APPLICATION.
Revisions effective October 1, 1995.
knowledge, and I
SIGNATWE
d I �Vsponsible for all charges
%
CONSENT FOR SITE EVALUATION TO BE DONE ON ABOVE DESCRIBED PROPERTY
MUST CHECK ONE: ❑ 1. 1 OWN the property. l� 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 representat' e of the Favie Cgunty a th �partm nt to enter upon above described
property located in Davie County and owned by
to conduct all testing procedures as necessary to d f rmin- said 1 su' i fora &und absorption sewage treatment
and disposal system.
1�-Jb
DATE SIGNATt OF,
DCHD (1193)
•DAVIE COUNTY HEALTH DEPARTMENT
Environmental Health Section
Soil/Site Evaluation
NAME /
ADDRESS
PROPOSED FACIILTY a, Az
DATE EVALUATED
PROPERTY SIZE rx
LOCATION OF SITE
Water Supply:
On -Site Well
_ Community
Public t�
Evaluation By:
Auger Boring
Pit
Cut
FACTORS 1 2 3 4
Landscape position
Sloe R
HORIZON I DEPTH
Texture group
Consistence
Structure
Mineralogy
HORIZON II DEPTH /
Texture group &G
Consistence
Structure
Mineralogy A • /
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: X �/
LONG-TERM ACCEPTANCE RATE: L� OTHER(S) PRESENT:
REMARKS:
LEGEND
Landscape Position
R -Ridge S -Shoulder L -Linear slope FS-Footslope 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- V". -y 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
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
DCHD(01-90)
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