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137 Maple Knoll Dr Lot 4 Davie County, NC 4 Tax Parcel Report 0 (p Friday, September 23, 201 f 123 124 5 ti 5 5 J 0 -� z t ------ Yit Z ' W 137 p 136 i ccc 137 -------------- I;3 ' ry WARNING: THIS IS NOT A SURVEY Parcel Information Parcel Number: H518OA0004 Township: Mocksville NCPIN Number: 5749745634 Municipality: Account Number: 8303202 Census Tract: 37059-805 Listed Owner 1: HEPLER PETER W Voting Precinct: NORTH MOCKSVILLE COUNTY Mailing Address 1: 137 MAPLE KNOLL DRIVE Planning Jurisdiction: Davie County City: MOCKSVILLE Zoning Class: DAVIE COUNTY R-A,R-20 State: NC Zoning Overlay: Zip Code: 27028 Voluntary Ag.District: No Legal Description: LOT 4 MAPLE KNOLL Fire Response District: MOCKSVILLE Assessed Acreage: 0.70 Elementary School Zone: MOCKSVILLE Deed Date: 2/2014 Middle School Zone: SOUTH DAVIE Deed Book/Page: 009510668 Soil Types: GnB2,GnC2 Plat Book: 0008 Flood Zone: Plat Page: 079 Watershed Overlay: DAVIE COUNTY Building Value: 178580.00 Outbuilding 8r Extra 8600.00 Freatures Value: Land Value: 25000.00 Total Market Value: 212180.00 Total Assessed Value: 212180.00 by t All data Is provided as is without warranty or guarantee of any kind either expressed or Implied Including but not limited to the 9 vjF 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 uIrl1<1 NC or arising out of the use or inability to use the GIS data provided by this website. r DAVIE COUNTY HEALTH DEPARTMENT ,pmittee s cA kA 1.-r r Name: Environmental Health Section PROPERTY INFORMATION C P.O. Box 848 J?irections to property: Mocksville,NC 27028 Subdivision Name: Phone#:336-751-8760 4- AUTHORIZATION FOR Section: Lot: /6,., L WASTEWATER Tax Office PIN:# SYSTEM CONSTRUCTION 3 -14 ' 1 AUTHORIZATION NO: 002906 A Road N a mQ.9— r, "r f ZipD le.1 **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 applying0 for Building Pen-nits. (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 XJ' IS VALID FOR A PERIOD OF FIVE YEARS. ENVIRONMENTAL HEALTH SPECIALIST DATE ISSUED RESIDENTIAL SPECIFICATION:BUILDING TYPE #BEDROOMS-3 #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 AL. TRENCH WIDTH ROCK DEPTH LINEAR FF. OTHER REQUIRED SITE MODIFICATIONS/CONDITIONS: IMPROVE]4ENT PERMIT LAYOUT 'A T U%A L&37 1\ _59-SIrv , -k- I -)050iARA Z= A6,(21-r- kuell A, FOR FINAL INSPECTION OF THIS SYSTEM PLEASE CALL BETWEEN 8:30-9:30 A.M.ON THE DAY OF INSTALLATION.TELEPHONE#IS(336)751-8760. OPERATION PERMIT SYSTEM INSTi LLED BY: dullh. tA (C 4 -1 c, at A AUTHORIZATION NO.—C)6XCf01'C0-PERATION PERMIT BY: G r-L- &-aye z4o I 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. DMD 0=(Revised) 1)ec-r*r5Z Iq -7M V.W 6--70,V DAVIE COUNTY HEALTH DEPARTMENT Environmental Health Section Soil/Site Evaluation APPLICANT INFORMATION PROPERTY INFORMATION � � e A e���r 1� �� 6_ Gb J Y � 1 S� -t- dry S'a nit � _ 9' r�`�fi` r3 Water Supply: On-Site Well Community Public lir Evaluation By: Auger Boring Pit Cut e e - FACTORS 1 2 3 4 5 6 7 Landscape position Slope% HORIZON I DEPTH Texture group Consistence Structure MineralogyF HORIZON II DEPTH Texture group 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 SITE CLASSIFICATION: EVALUATION BY: LONG-TERM ACCEPTANCE RATE: -75 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 clay loam SIL-Silty loam CL-Clay loam SCL-Sandy clay loam SC-Sandy clay SIC-Silty clay C-Clay CONSISTENCF. I?'I41SI VFR-Very friable FR-Friable FI-Firm VFI-Very firm EFI-Extremely firm 3Y91 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 05/05(Revised) DAVIE COUNTY ENVIRONMENTAL HEALTH SECTION • APPLICATION FOR IMPROVEMENT PERMIT(REPAIR) NAME PHONE NUMBER / ADDRESS �37 /�/�IDI�I�NGy�- &e&vule SUBDIVISION NAME A NO I LOT # DIRECTIONS TO SITE J� �U +� O�) :14i cJ U ��le Ki � 0A1 )U DATE SYSTEM INSTALLED NAME SYSTEM INSTALLED UNDER TYPE FACILITY� NUMBER BEDROOMS NUMBER PEOPLE SERVED TYPE WATER SUPPLY 1101ink SPECIFY PROBLEM OCCURRING ldhgyy INAeAo curt i alix DATE REQUESTED / INFORMATION TAKEN BY L14 This is to certify that the information provided is correct to the best of my knowledge,and that nd d I am respons' for all charges incurred from this application. SIGNATURE OF OWNER OR AUTHORIZED AGENT Rev.1/93 Zx DAVIE COUNTY HEALTH DEPARTMENT Environmental Health Section P.Ok.Boz 848/210 Hospital Street } Mocksville,NC 27028 ' (336)751-8760 Account #: 990000981 Tax PIN/EH#: 5749-74-3766.04 Billed To: San Filippo Companies Subdivision Info: Maple Knoll Lot#04 Reference Name: Location/Address: Sain Road-27028 Proposed Facility Residence Property Size: see map ATC Number: 3882 AUTHORIZATION FOR WASTEWATER SYSTEM CONSTRUCTION **NOTE** This Authorization for Wastewater System Construction MUST BE ISSUED by the Davie County Environmental Health Section prior to issuance of any building permit(s). This Form/Authorization Number should be presented to the Davie County Building Inspections Office when applying for building permit(s)(in compliance with Article 11 of G.S.Chapter 130A,Wastewater Systems,Section.1900 Sewage Treatment and Disposal Systems). THIS AUTHORIZATION FOR WASTEWATER CONSTRUCTION IS VALID FOR A PERIOD OF FIVE YEARS. Environmental Health Specialist's Signature: � Date: CERTIFICATE OF COMPLETION **NOTE** The issuance of this Certificate of Completion shall indicate the system described on Improvement/Operation Permit 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. S 12� 1b Septic System Installed By: 6,✓ i C Environmental Health Specialist's Signature: Date: DCHD 05/99(Revised) • DAVIE COUNTY HEALTH DEPARTMENT Environmental Health Section • P.O.Boa 848/210 Hospital Street Mocksvilte,NC 27028 (336)751-8760 IMPROVEMENT/OPERATION PERMIT Account #: 990000981 Tax PIN/EH #: 5749-74-3766.04 Billed To: San Filippo Companies Subdivision Info: Maple Knoll Lot#04 Reference Name: Location/Address: Sain Road-27028 Proposed Facility Residence Property Size: see map ATC Number: 3882 **NOTE** This Improvement/Operation Permit DOES NOT authorize the construction 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 1 l of G.S.Chapter 130A,Wastewater Systems, Section.1900 Sewage Treatment and Disposal Systems). THIS PERMIT IS SUBJECT TO REVOCATION IF SITE PLANS OR THE INTENDED USE CHANGE. YOUR WASTEWATER SYSTEM CONTRACTOR MUST SEE THIS PERMIT BEFORE INSTALLING SYSTEM. Residential Specification: Building Type .#People #Bedrooms �"f #Baths Dishwasher: Z Garbage Disposal:IQ Washing Machine: Basement w/Plumbing: Basement/No Plumbing: 0 Commercial Specification: Facility Type #People #People/Shift #Seats Industrial Waste: El Lot Size Type-Water Supply e _ Design Wastewater Flow(GPD) Site: New Repair 1 System Specifications: Tank SizeAa'iAL. Pump Tank GAL. Trench Width.�'Rock DepthLinear Ftja�. Other: Required Site Modifications/Conditions: IMPROVEMENT/OPERATION PERMIT LAYOUT- APPROVED EFFLUENT FILTER RISER(S) IF 6°°BELOW FINISHED GRADE. ****NOTICE: Contact a representative of the Davie County Health Department for final inspection of this system between 8:30 a.m.to 9:30 a.m.or 1:00 p.m.to 1:30 p.m.on the day of installation. Telephone#is(336)751-8760.**** Environmental Health Specialist's Signature: 7lGY'�� Date: DCHD 05/99(Revised) DAVIE COUNTY HEALTH DEPARTMENT Environmental Health Section } P.O.Boz 848/210 Hospital Street Mocksville,NC 27028 (336)751-8760 IMPROVEMENT/OPERATION PERMIT Account M 990000981 Tax PIN/EH M 5749-74-3766.04 Billed To: San Filippo Companies Subdivision Info: Maple Knoll Lot#04 Reference Name: Location/Address: Sain Road-27028 Proposed Facility Residence Property Size: see map ATC Number: 3882 **NOTE** This Improvement/Operation Permit DOES NOT authorize the construction 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). THIS PERMIT IS SUBJECT TO REVOCATION IF SITE PLANS OR THE INTENDED USE CHANGE. YOUR WASTEWATER SYSTEM CONTRACTOR MUST SEE THIS PERMIT BEFORE INSTALLING SYSTEM. Residential Specification: Building Type .#People #Bedrooms �Iy #Baths 2 Dishwasher: 1Zf Garbage Disposal:0 Washing Machine:H Basement w/Plumbing: 0`�" Basement/No Plumbing: 13 Commercial Specification: Facility Type #People #People/Shift #Seats Industrial Waste:13 Lot Size Type-Water Supply Design Wastewater Flow(GPD). Site: New La' Repair System Specifications: Tank Size�aiAL. Pump Tank GAL. Trench Width,,go �Rock Depth f Linear Ft�Go✓ Other: Required Site Modifications/Conditions: IMPROVEMENT/OPERATION PERMIT LAYOUT- APPROVED EFFLUENT FILTER RISERS) IF 6 u BELOW FINISIIED GRADE. ****NOTICE: Contact a representative of the Davie County Health Department for final inspection of this system between 8:30 a.m.to 9:30 a.m.or 1:00 p.m.to 1:30 p.m.on the day of installation. Telephone#is(336)751-8760.**** F Environmental Health Specialist's Signature: Date: DCHD 05/99(Revised) i DAVIE COUNTY HEALTH DEPARTMENT Environmental Health Section P.O.Boa 848/210 Hospital Street Mocksville,NC 27028 (336)751-8760 Account #: 990000981 Tax PIN/EH#: 5749-74-3766.04 Billed To: San Filippo Companies Subdivision Info: Maple Knoll Lot#04 Reference Name: Location/Address: Sain Road-27028 Proposed Facility Residence Property Size: see map ATC Number: 3882 AUTHORIZATION FOR WASTEWATER SYSTEM CONSTRUCTION **NOTE** This Authorization for Wastewater System Construction MUST BE ISSUED by the Davie County Environmental Health Section prior to issuance of any building permit(s). This Form/Authorization Number should be presented to the Davie County Building Inspections Office when applying for building permit(s)(in compliance with Article 11 of G.S.Chapter 130A,Wastewater Systems,Section.1900 Sewage Treatment and Disposal Systems). THIS AUTHORIZATION FOR WASTEWATER CONSTRUCTION IS VALID FOR A PERIOD OF FIVE YEARS. Environmental Health Specialist's Signature: � Date: CERTIFICATE OF COMPLETION **NOTE** The issuance of this Certificate of Completion shall indicate the system described on Improvement/Operation Permit 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. S 1210 1b Septic System Installed By: PA SCG✓ i C Environmental Health Specialist's Signature Date: 7�'6S� DCHD 05/99(Revised) 1PIPLICATION FOR SITE EVALUATION IMPROVEMENT PERMIT& Cy •n � � Davie County Health Department � �J 0[¢ Envii»nmenta/Hea/th Section C P.O. Box 848/210 Hospital Street Z Mocksville, NC 27028 ?0Q l " (336)751-8760 �NM 49RIP�A F ***IMPORTANT*** THIS APPLICATION CANNOT BE PROCESSED UNLESS ALL THE INFORMATION IS PROVIDED. Refer to the INFORMATION BULLETIN for instructio Ms.., _ n n 1. Name to be Billed �I'A l�-1 l-I P P 0 (:/01.1VWC rl 0 Nf 11)CContact Person.4 H-r14 DJJ SAT.,) )"I L i l°C'0 Mailing Address / IQ `/A�V�I-/`J VAl-Lt `� iL0 Home Phone I C City/state/ZIP ANJAW CZ' , 1y(� t:700,p ,,tet Business Phone �3Ip 2. Name on Permit/ATC if Different than Above S7-\ \l AS A3 of Mailing Address �/� City/S�ta�/Zip 3. Application For: V Site Evaluation ;Impr-Sv�enftCPermit/ATC ❑ Both 4. System to Service: 69 House ❑ Mobile Home ❑ Business ❑ Industry ❑ Other S. If Residence: # People # Bedrooms ^a # Bathrooms NJ Dishwasher /Garbage Disposal f*7 Washing Machine f/Basement/Plumbing 11 Basement/No Plumbing 6. If Business/Industry/Other: Specify type # People # Sinks # Commodes # Showers # Urinals # Water Coolers IF FOODSERVICE: # Seats Estimated Water Usage (gallons per day) 7. Type of water supply: f/County/City ❑ Well CI Community e. Do you anticipate additions or expansions of the facility this system is intended to serve? ❑ Yes ❑ No If yes,what type? ***IMPORTANT***CLIENTS MUST COMPLETE THE REQUIRED PROPERTY INFORMATION REQUESTED BELOW. Either a PLAT or SITE PLAN MUST BE SUBMITTED by the client with THIS APPLICATION. Propert Dimensions: �L L LAI WRITE DIRECTIONS(from Mocksville)to PROPERTY: -rte �o a . Tax Office PIN: # 5-1q 9-l q-�P(o \j 5 Property Address: Road Name SAI N IZ. 4 tel?Lt=r0 �. �Yl t 1.� , City/Zip 010 C,V-4 41 lla 1 iJ C. P&D P,%:-A—(. A 1J 0 � �7®z� O S it�� �� If in a Subdivision provi11q information,as follows: SE L \e � Ir 6\110 W 6 l,-( S%) (b 0 1 \1 16 10%,� Name: L'elA10L- l/.l,.Nu LL h �L Section: Block: Lot: _ Date Property Flagged: This is to certify that the information provided is correct to the best of my knowledge. I understand that any permits) 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 ant responsible for all charges incurred front 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 Z51N 1-1 L_1 10 Co►.i SiNC is C,tV r I Iy C_ to conduct all t sting procedures as necessary to determine the sit+((Inc DATE ' �/ D�- SIGNATURES THIS AREA MAY BE USED FOR DRAWING YOUR SITE PLAe all of the following: Existing:Ind proposed property lines and dimensions, structures, setbacks, and septic locations). Site Revisit Charge C Datc(s): Client Notification Date., L � EHS• Account No. cV Revised DCHD(07/99) Invoice No Z_ . . DAVIE COUNTY HEALTH DEPARTMENT Environmental Health Section Soil/Site Evaluation APPLICANT INFORMATION PROPERTY INFORMATION Account #: 990000981 Tax PIN/EH#: 5749-74-3766.04 Billed To: San Filippo Companies Subdivision Info: Maple Knoll Lot#04 Reference Name: Location/Address: Sain Road-27028 Proposed Facility: Residence Property Size: see map Date Evaluated: Water Supply: On-Site Well Community Public Evaluation By: Auger Boring Pit .v� Cut FACTORS 1 2 3 4 5 6 7 Landscape position Slope% HORIZON I DEPTH .. Texture group Consistence Structure Mineralogy HORIZON II DEPTH � Texture group Consistence ,- l Structure fC Mineralogyl 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: EVALUATION BY: 2Z 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 clay loam SIL-Silty loam CL-Clay loam SCL-Sandy clay loam SC-Sandy clay SIC-Silty clay C-Clay CONSISTENCE Mois 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 05/99(Revised) ■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■ ■■■■■■■■■e■■■■■■■e■■■■tees■■■■e■�i■■■■eee■ee■■e■■ee■e■e■■tee■■eet■ ■■■■■■■e■■■■■■■■■■e■■■■■■■■ee■■■e■■■■■ee■e■t■e■■e■e■eee■eeeeee■et■ ■■■■■e■■■■■■■■■■ecce■■e■■e■■■■e■ee■■e■ea■eeee■e■■■■■eeeeeeeeeeeet■ ■■■■■■■■■■■■■s■■■e■■■■■■■■e■■■■■■■■■■■eee■■t■■e■■■■■■e■■eee■eeeee■ ■■■■■■■et■■■e■■t■■e■e■■e■■■e■■■■■■■■eeeeee■t■■■■e■ee■ee■eeeeeeeet■ ■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■ ■■■e■■■■ee■■■■eeee■eeteeeteeeet■ 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