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2957 US Highway 601 South Lot 30-31Davie County, NC t Tax Parcel Report Thursday, November 3, 2016 WAK1 MG: 1111-tb 11b NV"1' A bUKV N:Y Parcel Information Parcel Number: M512OA0001 Township: Jerusalem NCPIN Number: 5745874421 Municipality: Account Number. 73297620 Census Tract: 37059-807 Listed Owner 1: THOMPSON PAMELA L Voting Precinct: JERUSALEM Mailing Address 1: C/O PAMELA L EVERHART Planning Jurisdiction: Davie County City: MOCKSVILLE Zoning Class: DAVIE COUNTY R -20,R-8 State: NC Zoning Overlay: DAVIE COUNTY CZOD Zip Code: 27028-1935 Voluntary Ag. District: No Legal Description: LOTS 30-31 HWY 601 Fin: Response District: JERUSALEM Assessed Acreage: 0.48 Elementary School Zone: COOLEEMEE Deed Date: 10/1992 Middle School Zone: SOUTH DAVIE Deed Book / Page: 001650739 Soil Types: CeB2 Plat Book: 0006 Flood Zone: Plat Page: 011 Watershed Overlay: DAVIE COUNTY Building Value: 78910.00 Outbuilding & Extra 0.00 Freatures Value: Land Value: 15000.00 Total Market Value: 93910.00 Total Assessed Value: 93910.00 All data Is provided as is without warranty or guarantee of any Idnd 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, consultands, contractors or employees from any and all claims or causes of action due to no U t1� NC or arising out of the use or Inability to use the GIS data provided by this website. 02/16/2815 23:19 Phone; (F)8f)r - 7,.53- 6780 9989773 RDGB Davie County Healtlx Department Environmental Health. Section P.O. Box 848 210 Hospital Street Courier # : 09-4M6 Mocksvilk, NC 27028 ON-SITE W,ASTEWATEP, CERTINCATION (Check One) Replacement Remodeling econnection PAGE 01 Fax: (336) - 753-1680 Name: �, L� Phone Number 34 -'1`O `�7 (homey Mailing Address: e ox �+ ` /" %' (Work Please Fill Ina The Failowing Information ,About The E)USUNG Facility: 6b)(,°ao0t PC/r L4490,15 Name System Installed Underle",gp�v,� � t e ��c f ,- Type Of Facility: Date System installed (Manth/Date/"Year):� J G Q a Number Of Bedroom&: 2 Number Of People:_ , Is The Facility Cunvatly Vacant?as) No If Yes, For How Long? to tq,,,► 41 Any Known Problem? Yes0-0-) If Yes, F-vlaw:_ - Please Fill In The Following Information About The Type Pool Requ Number Of Bedrooms: '3 Number of Pcople--?--- Requested: - For Environmental H Ath Office Use Only Disapproved In w -A -hi) -m 34 Envitonmental Health Specialist sighing of this form by the Aj L is in iso v y n ei`nded, not should be tak4m as a guarantee (extended or limited) that the on-site wastewater system will £unction properly for any given period of time. Payment: Cash Check laloney Order # Amount:$ Date: Paid BY -........Received By: Account #: Invoice #: AUTHORIZATION NO: 0641 DAVIE COUNTY HEALTH DEPARTMENT Environmental Health Section PROPERTY INFORMATION Permittie's- ,j� P.O. Box 848 ,�J Name: Qlil OhI"Oft Y� Mocksville, NC 27028 Subdivision Name: ,1�/ 'OyegES Phone #: 704-634-8760 ,- Directions to propertySection: i Lot: AUTHORIZATION FOR �!] WASTEWATER Tax Office PIN:# - r //'' /� / SYSTEM CONSTRUCTION a� uS r! �� 601-SRoa�Na�� 10d��• Zip: **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) ***NOTICE*** THIS AUTHORIZATION FOR WASTEWATER CONSTRUCTION .' ` IS VALID FOR A PERIOD OF FIVE YEARS. ENVIRONMENTAL HEALTH S ECIALIST DATE ISSUED �'i'{'�*;s b�,�,'i'�kJ'"a krnA'1P` hlii>r•'°'-r+� �r:;,t'"+ "y '4"nd'tf°"`r�''��i`-+yi'�tuy�:+f'+lN'r�%'�A``tW"t'1*�k'W.d,.ji'f3'�5 "i'j�r wt°'ty�"t��'iiir.��!Y=�'...,ya.q +pf,e. �,Y „ r STN i .yw.J:: DAVIE COUNTY HEALTH DEPARTMENT IMPROVEMENT AND OPERATION PERMITS PROPERTY INFORMATION r Permfft'sf^ Name: Subdivision Name: Directions to property: Section: Lot: IMPROVEMENT PERMIT Tax Office PIN:# R G Roa�i�b 1ya�•-g Zip: **NOTE** T1uhmprovement Peirnit ]FOBS NOT authorize the construction or installation of a septic tank system or any wastewater system. An AUTHORIZATION.PORWASTEWATER 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. Chapte'r 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 # PEOPLEISHIFT # SEATS INDUSTRIAL WASTE: Yes or No LOT SIZE TYPE WATER SUPPLY _ DESIGN WASTEWATER FLOW (GPD).. NEW SITE REPAIR SITE SYSTEM SPECIFICATIONS: TANK SIZE GAL. PUMP TANK GAL. TRENCH WIDTH ROCK DEPTH —IZ�LINEAR FT. /D t) OTHER REQUIRED SITE MODIFICATIONS/CONDITIONS: "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. V AUTHORIZATION NO. OPERATION PERMIT BY: /C / 61 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) w�""'7+"'��i .•.;,;t�*�t-,�ar,�,r ,rv•`tf^'aa• v' ,y,, xs:e,:rl,.M'r r''4.{t: m w'wv s...yyt�._tilyi .v '�•'aY';,��'��r" — tk•� .: :,, ty-- f .> DAVIE COUNTY HEALTH DEPARTMENT PROPERTY INFORMATION IMPROVEMENT AND OPERATION PERMITS Pennnu'it s t Name: Subdivision SubdivisionName: Directions to property: f.� Section: r'' Lot: IMPROVEMENT PERMIT Tax Office PIN:# a Road lab 1vQ�.�. Zip: ` 4� **NOTE** Thi; -improvement Permit DOES NOT authorize the construction or installation of a septic tank system or any wastewater system. An AUTHORIZATION,POR 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 DESIGN WASTEWATER FLOW (GPD) NEW SITE % REPAIR SITE SYSTEM SPECIFICATIONS: TANK SIZE GAL. PUMP TANK GAL. TRENCH WIDTH .74' ROCK DEPTH —A2!��LINEAR Fr. AQ e? 1 OTHER ~ REQUIRED SITE MODIFICATIONS/CONDITIONS: IMPROVEMENT PERMIT LAYOUT � 7 "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) 6348760. OPERATION PERMIT SYSTEM INSTALLED BY: u AUTHORIZATION NO.� y/ OPERATION PERMIT BY: �/t t/l2il' DATE: �J *"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) • /�'?� g -. ,a'..6L'. s2 a, �' � .:. C,�, �.}-11 et:�7 r2. .9Sy4 .r- t�: .-'S. • '� 5�•J /% .. � .S r i . _ Y . DAVIE COUNTY HEALTH DEPARTMENT IMPROVEMENTS PERMIT AND . CERTIFICATE OF COMPLETION *NOTE: Issued in Compliance With Article I I of G.S. Chapter 130a Sanitary Sewage SystemsPermit Number Name `�= ���7-/9Y�/%Fr ,_ ; /f Date —f' N2 C,691 Location ar�/�/?/ /l. i�t7 fes, K- �. %l'r�/�: . %y,�t/ /J,• 30 -31 Subdivision Name A&,,4nr✓A,1-" Lot No. _Z Sec. or Block No. Lot Size House L -f Mobile Home _— Business __ Speculation No. Bedrooms_.No. Baths— No. in Family/fI Garbage Disposal YES ❑ NO Specifications for System: Auto Dish Washer YES NO ❑` Auto Wash Ma^hine YES NO ❑ /�o�, Type Water Supply _ C�10 X -fA-d r *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. 0 Gr fT X/%1/"/j" 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 byCo- *The signing of this certificate shall indicate the standards set forth in the above regulatic satisfactorily for any given period of time. I V Z 4 te 'icate of Cori letion Date hat the systgim described above has been installed in compliance with but shall iniNO way be taken as a guarantee that the system will function 44 �� Q APPLICATIONF/OR SITE EVALUATION/IMPROVEMENTS PERMIT ' 1y QrV Davie County Health Department MAR if 1992 Environmental Health Section 1 � P. O. Box 665 _ r Mocksville, NC 27028 1. Application/Permit Requested By 54 1"/ 4foA' Mailing Address /1 g Lf %z D Business Phone /,ZHome Phone ..; 2. Name on Permit if Different than Above 3. Application/Permit for: ❑ General Evaluation ❑ Septic Tank Installation 4. System to Serve: C -House ❑ Mobile Home ❑ Place of Public Assembly ❑ Business ❑ Industry ❑ Other ❑ Unknown 5. If house, mobile home: Subdivision 1,3 O X -Izi oe Y-- A _ Section Lot # — No. of People No. of Bedrooms 3 No. of Bathrooms Dwelling Dimensions 6. If business, industry, place of public assembly, other: Specify type No. of People Served No. of Commodes No. of Lavatories No. of Showers 7. Type of water supply: ❑ Public No. of Sinks No. of Urinals No. of Water Coolers Water Usage Figures ❑ Private 8. Property Dimensions Sewage Disposal Contractor 9. Do you anticipate additions/expansion of the facility this sytem is intended to serve? ❑ Yes If yes, what type? ❑ Basement/Plumbing ❑ Basement/No Plumbing 2 -Washing Machine ❑ Dishwasher ❑ Garbage Disposal ❑ No ❑ 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: 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. yy�� DATE SIGNATURE CONSENT FOR SITE EVALUATION TO BE DONE ON ABOVE DESCRIBED PROPERTY MUST CHECK ONE: M 1. I OWN the property. ❑ 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 Davie County Health Department to enter upon above described property located in Davie County and owned by to conduct all testing procedures as necessary to determine said site's suitability for a ground absorption sewage treatment and disposal system. DATE SIGNATURE DCHD (12-90) ,i DAVIE COUNTY HEALTH DEPARTMENT Environmental Health Section Soil/Site Evaluation NAME def ADDRESS PROPOSED FACIILTY Njw,S-e- Water Supply: On -Site Well DATE EVALUATED PROPERTY SIZE //%d.Y��D LOCATION OF SITE HOZ S7 Community Public L% Evaluation By: Auger Boring Z____ Pit Cut FACTORS 1 2 3 4 Landscape position L Sloe% HORIZON I DEPTH Texture group Consistence Structure Mineralogy HORIZON II DEPTH Texture group Consistence Structure a LZ 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: �D�Par %`0 C P ; �� �1�r 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 -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(01-901 ■ME■ OMEN ■EM■ ■on■ ■N■E■■M■■N■ ■EMM■MEMEM■ ■E■M■MEMME■ ■O■MMEMES■■ ■EMMEMEMEM■ ■EM■N■EME■■ ■■mm■■m■■o■ 0 oo by n \.. ,60a Ze.m I ' ire 9e 19fiS ���, ��I►or +, j l' � p�rEr"• 4'. r r - f •`r . c:e;; . meg.: , DAVIE COUNTY HEALTH DEPARTMENT V IMPROVEMENTS PERMIT AND CERTIFICATE OF COMPLETION *NOTE: Issued in Compliance With Article II of G.S. Chapter 130a Sanitary Sewage Systems w Permit Number Name. t✓� �( Namfi7'3 ri mer i ' ' .a% e L,- 'Date N2 J 6 9 a Location -33 Subdivision Name Lot No. -32 Sec. or Block No. Lot Size House _ ff_ Mobile Home _ Business Speculation No. Bedrooms No. Baths No. in Family Garbage Disposal YES ❑ NO g-- Specifications for System: Auto Dish Washer YES �NO E] Auto Wash Ma^hine YES NO ❑ Type Water Supply /'n ---�X� *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 0 I 1-� Q) U S iii Improvements permit by -- lI *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 D 1 *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 betaken as a guarantee that the system will function satisfactorily for any given period of time. I L 11�XO APPLICATION �OR SITE EVALUATION/IMPROVEMENTS PERMIT 0 .�R �Vk Davie County Health Department MAR 992 Environmental Health Section P. O. Box 665 Mocksville, NC 27028 01. t Application/Permit Requested By Mailing Address—/I Z,4 L,t Home Phone 2, 9 !;�: ' %Z D 2 Business Phone 8 go 2 ..- 2. Name on Permit if Different than Above 3. Application/Permit for: ❑ General Evaluation ❑ Septic Tank Installation 4. System to Serve: S -House ❑ Mobile Home ❑ Place of Public Assembly ❑ Business ❑ Industry ❑ Other ❑ Unknown S. If house, mobile home: Subdivision Section Lot # - No. of People No. of Bedrooms 3 No. of Bathrooms Dwelling Dimensions 6. If business, industry, place of public assembly, other: Specify type No. of People Served No. of Commodes No. of Lavatories No. of Showers 7. Type of water supply: ❑ Public No. of Sinks No. of Urinals No. of Water Coolers Water Usage Figures ❑ Private ❑ Basement/Plumbing ❑ Basement/No Plumbing @-Washing Machine ❑ Dishwasher ❑ Garbage Disposal 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? ❑ 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: x 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. 12 DATE SIGNATURE CONSENT FOR SITE EVALUATION TO ag DONE ON ABOVE DESCRIBED PROPERTY MUST CHECK ONE: P 1. I OWN the property. ❑ 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 Davie County Health Department to enter upon above described property located in Davie County and owned by to conduct all testing procedures as necessary to determine said site's suitability for a ground absorption sewage treatment and disposal system. DATE DCHD (12.90) SIGNATURE DAVIE COUNTY HEALTH DEPARTMENT Environmental Health Section Soil/Site Evaluation NAME �O DATE EVALUATED ADDRESS PROPERTY SIZE /0674� PROPOSED FACIILTY Water Supply: On -Site Well Evaluation By: Auger Boring LOCATION OF SITE Community Public Pit Cut FACTORS 1 2 3 4 Landscape position L -.4- Slope % HORIZON I DEPTH Texture group Consistence Structure Mineralogy HORIZON II DEPTH >' .es0 Texture group C Consistence Structure 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 o e SITE CLASSIFICATION: RJ� LONG-TERM ACCEPTANCE RATE: REMARKS: DCHD(01-901 EVALUATED BY: & 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 clay loam, SIL -Silty loam CL -Clay loam SCL-Sandy clay loam SC -Sandy clay SIC -Silty clay C -Clay 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