123 Cedarwood Place Lot 2Davie Countv. NC �
C
Tax Pnrrel R Pnnrt
Tuesday, January 10, 2017
Parcel Number:
NCPIN Number:
Account Number:
Listed Owner 1:
Mailing Address 1:
City:
State:
Zip Code:
Legal Description:
Assessed Acreage:
Deed Date:
Deed Book / Page:
Plat Book:
Plat Page:
Building Value:
Land Value:
Total Assessed Value:
WARNING: THIS IS NUT A SURVEY
Parcel Information
J7080B0002
Township:
Fulton
5768197941
Municipality:
CORNATZER
8304701
Census Tract:
37059-804
LEAVERS CHARLES A JR
Voting Precinct:
FULTON
123 CEDARWOOD PLACE
Planning Jurisdiction:
Davie County
Mocksville
Zoning Class: DAVIE
COUNTY R-20
NC
27028
LOT 2 HERITAGE OAKS PHASE ONE
0.68
1/2015
009781042
0007
005
Zoning Overlay:
Voluntary Ag. District:
No
Fire Response District:
FORK
Elementary School Zone:
CORNATZER
Middle School Zone:
WILLIAM ELLIS
Soil Types:
GnB2
Flood Zone:
Watershed Overlay:
DAVIE COUNTY
Outbuilding & Extra
Freatures Value:
Total Market Value:
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, consultants, contractors or employees from any and all claims or causes of action due to
�ooty�� NC or arising out of the use or Inability to use the GIS data provided by this website.
AUT:IORIZATION NO:, 1 2,8 2 DAVIE COUNTY HEALTH DEPARTMENT 'ri✓Xa
' Environmental Health Section PROPERTY INFORMATION
Permittee's - . 4- P.O. Box 848
Name:�1�` l� �" Mocksville, NC 27028 Subdivision Name: ��" �:' '� 'y
fir,,. �f ,� � i��._5�
Phone #: 704-634-8760
Directions to property: 1 C�' Section: l Lot:
AUTHORIZATION FOR
WASTEWATER Tax Office PIN:#Y-=,�
SYSTEM CONSTRUCTION
� �
- - Road Name: "�' r`' � z1P qw:
**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
/"� i - 't / r� '.,✓ %5��`<'� IS VALID FOR A PERIOD OF FIVE YEARS.
ENVIRONMENTAL HEALTH SPECIALIST DATE ISSUED
0 DAVIE COUNTY HEALTH DEPARTMENT�ko
IMPROVEMENT AND OPERATION PERMITS PROPERTY INFORMATION
�r.PCTkII#te� . S � ""'}... • i /s+
Name` -Arl7 LIU
Directions to property:
Subdivision Name:e''�
Section: Lot:
IMPROVEMENT � .. ~
PERMIT Tax Office PIN:#f X, -
Road Name.
**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
cons'truction/mstallation 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 3 # BATHS # OCCUPANTS _ GARBAGE DISPOSAL: Yes or No
COMMERCIALSPECIFICATION: FACILITY TYPES # PEOPLE # PEOPLE/SHIFT # SEATS INDUSTRIAL WASTE: Yes or No
LOT SIZE 17a' TYPE WATER SUPPLY r b DESIGN WASTEWATER FLOW (GPD) NEW SITE Z -f"' REPAIR SITE
SYSTEM SPECIFICATIONS: TANK SIZE �C� D GAL. PUMP TANK GAL. TRENCH WIDTH ROCK DEPTH /` y LINEAR FT.�-?O)
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 (704) 634-8760.
OPERATION PERMIT
SYSTEM INSTALLED BY:
AUTHORIZATION NO. _y�GZ OPERATION PERMIT BY: ez DATE: 7J
"THE ISSUANCE OF THIS OPERATION PERMIT SHALL INDICATE THAT THE SYSTEM DESCRIBED ABOVE HAS BEEN INSTALLED IN COMPLIANCE
WITH ARTICLE 1 I 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)
APPLICATION FOR SITE EVALUATIONAMIPROVEMENT
00gg� Davie County Health Department
�vN ?Z� 1 Environmental Health Section
t CN°MPS 0 P.O. Box 848
Mocksville, NC 27028
(704) 634-8760
****IMPORTANT****
THIS APPLICATION CANNOT BE PROCES
THE REQUIRED INFORMATION IS PROVIDED.
1. Name to be Billed Zrwi S
Mailing Address .'&6_,L
City/State/Zip .0 C
2. Name on Permit/ATC if Different than Above
Contact Person :5Z G u -e- -fin rr d 5
Home Phone -R3L - Zd
BusinessPhone
Mailing Address OZ 6 4) r�� r 7' t�/ �yt City/State/Zip I e-'Jc1&
3. Application For: [�] Site Evaluation KImprovement Permit & ATC [ ] Both
4. System to Serve: IVI House [ ] Mobile Home [ ] Business [ ] Industry [ J Other
5. If Residence: # Peopled_ # Bedrooms_ # Bathrooms [Dishwasher [ ] Garbage Disposal
] Washing Machine [ ] Basement/Plumbing [ ] 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: X County/City [ ] Well [ ] Community
8. Do you anticipate additions or expansions of the facility this system is intended to serve? [ ] Yes Pd No
If yes, what type?
EITHER A PLAT OR SITE PLAN
PROPERTY INFORMATION REQUIRED: *** IMPORTANT ***yAT4Ar OF THE PROPERTY MUST BE
SUBMITTED WITH THIS APPLICATION.
Property Dimensions: %710i. X /71 WRITE DIRECTIONS (from Mocksville) TO PROPERTY:
Tax Office PIN: #.3 7��' -1 q - n A� 6 Easy- 7 /—
Property Address: Road lame 1r2 3e=ej�r wtlll Lr4262/4U-2O0ri Y/d c -c .4 c'
City/Zip f g45y; Z& -27-0x?
If in Subdivision provide information, as follows:
Name:[ i 7�a u G ��k5 '
'
Section: / Lot #: 2 r,
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 . a ry i 5�'-4 to
DATE_J - AJ/ - 9 F SIGNATURE
Revised DCHD (06-96)
THIS AREA AIAlj $E USED FOR DRAWING YOUR SITE PLAN:
to determine the site suitability.
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DAVIE COUNTY HEALTH DEPARTMENT
Environmental Health Section
Soil/Site Evaluation
M
NAME z4J4
ADDRESS
PROPOSED FACIILTY
DATE EVALUATED ,
PROPERTY SIZE -�we-
LOCATION OF SITE CP 7,C'
Water Supply: On -Site Well _ Community Public
Evaluation By: Auger Boring Pit 0/ Cut
FACTORS 1 2 3 4
Landscape position
Sloe R 1-1
HORIZON I DEPTH
Texture group
Consistence
Structure
Mineralogy
HORIZON II DEPTH f �-
Texture group r
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 RATLI
/
SITE CLASSIFICATION: EVALUATED BY:
LONG-TERM ACCEPTANCE RATE: OTHER(S) PRESENT:
REMARKS:
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- Vc.-y 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
DCHD (01-901