105 Rod Court Lot 14Davie County, NC
Tax Parcel Report Monday, December 19; 2016
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WARNING: THIS IS NOT A SURVEY
AU data Isprovided as Is withoutwamnty, or guarantee of any kind either expressed or Implied Including but not ilmited to the
Implied mpardles of mwchartability"Illness for a palloularuse. All users of Davie County's GIS website shall hold harmless the
NC
Parcel Information
or arising out of use or use provided website. -
Parcel Number.
D301OA0014
Township:
Clarksville
NCPIN Number:
5822240724
Municipality:
Account Number.
82521225
Census Tract:
37059-B01
Listed Owner 1:
RUFF SHAWN R
Voting Precinct:
CLARKSVILLE
Mailing Address 1:
105 ROD COURT
Planning Jurisdiction:
Davie County
City: MOCKSVILLE
Zoning Class:
DAVIE COUNTY R -A
State:
NC
Zoning Overlay:
Zip Code:
27028-4770
Voluntary Ag. District:
No
Legal Description:
LOT 14 DUTCHMAN HILLS
Fire Response District:
WILLIAM R. DAVIE
Assessed Acreage:
1.16 Elementary School Zone:
WILLIAM R DAVIE
Deed Date:
7/2003,
( Middle School Zone:
NORTH DAVIE
Deed Book/Page:
004990545
Soil Types:
MnB2,MdE
Plat Book:
0007
Flood Zone:
Plat Page:
0190
Watershed Overlay:
DAVIE COUNTY
Building Value:
Outbuilding & Extra
Freatures Value:
Land Value:
Total Market Value:
Total Assessed Value:
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Davie County,
AU data Isprovided as Is withoutwamnty, or guarantee of any kind either expressed or Implied Including but not ilmited to the
Implied mpardles of mwchartability"Illness for a palloularuse. All users of Davie County's GIS website shall hold harmless the
NC
County of Davie, North Carollna, its agents, consuparoa, contractors orenoployees Inn any and all do]=or causes of action due to
the Inability to the GIS data by this
or arising out of use or use provided website. -
Account #: 990002600
Billed To: William Crews
Reference Name:
rupuseu raum y. rtebruence
ATC Number: 3362
DAVIE COUNTY HEALTH DEPARTMENT
Environmental Health Section mat/
P. O. Boa 848/210 Hospital Street r`
Mocksville, NC 27028
(336)751-8760 ,
Tax PIN/EH #: 5822-24-0724.WC
Subdivision Info: Dutchman Hills Lot # 14
Location/Address: 105 Rod Court -27028
014e: r.irwdUUS
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 -C N TWJOXV IS VALID FOR A PERIOD OF FIVE YEARS.
Date:
CERTIFICATE OF COMPLETION
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 betaken as a guarantee that the cyst will function satisfactorily for any
given period of time.
10
2-12_ /
Septic System Installed By:
Health Specialist's Signature: _
DCHD 05/99 (Revised)
- DAVIE COUNTY HEALTH DEPARTMENT
Environmental Health Section
P. O. Box 848/210 Hospital Street
Mocksville, NC 27028 �/_ j, 2.0`-'3
(336)751-8760
IMPROVEMENT/OPERATION PERMIT
Account #: 990002600
Tax PIN/EH #:
5822-24-0724.WC
Billed To: William Crews
Subdivision Info:
Dutchman Hills Lot # 14
Reference Name:
Location/Address:
'105 Rod Court -27028
Proposed Facility: Residence
Property Size:
1.174 acres
ATC Number: 3362
**NOTE** This ImprovemenUOperation 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 ##Pe/ople #Bedrooms" J #Baths S
Dishwasher: Cy� Garbage Disposal: Washing Machine: Er Basement w/Plumbing: LTJ Basement/No Plumbing: ❑
Commercial Specification: Facility Type #People #People/Shift #Seats Industrial Waste: ❑
Lot Size Type Water Supply Design Wastewater Flow (GPD) Site: New 135" Repair ❑
System Specifications: Tank Size GAL. Pump Tank GAL. Trench Width Rock Depth 2 Linear Ft.3�'
Other:
Required Site Modifications/Conditions:
IMPROVEMENT/OPERATION PERMIT LAYOUT- APPROVED EFFLUENT FILTER RISER(S) IF6"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.****
4cw, G apaa Flip ' s
Health
�r
Date:
DCHD 05199 (Revised)
APPLICATION FOR SITE EVALUATION/IMPROVEMENT PERMIT & ATC
Davie County Health Department D
EnvImnmentof Heath Section
P.O. Box 868/210 Hospital Street
Mockeville, HC 27028
(336) 751-8760 / FEB s 4
***IMPORTANT*** THIS APPLICATION CANNOT BE PROCESSED UNLESS ALL REQS U
INTOMATION IS PROVIDED. Refer to the INrORFATION BULLETIN for is ti MENTgt
f / / P
1. name to be Billed _ (c�i i Am �he%ls contact person ; �if:r+ rr '/ ,� tfE ry r �� m
Mailing address 36/S Afi A.L?Gl /l i e bi - soma whom 7q g - /9 i
city/stat./seaW S, N.L', tel' 7/OS' amines. phone
2. name on Permit/ATC if Different than above "
Mailing address - City/state/Sip .. _
3. Application ror: ❑ Site Evaluation ❑ improvement Permit/ATC IBoth
e. Slates to service, FY House ❑ Mobile Home ❑ Business ❑ Industry ❑ Other
5. If Residence: l People ! Bedrooms _ ! Bathrooms
91)ishmasher O-falisbage Disposal li'xuhing Machin. D -9"a ement/wlumbing 17 Bamenant/no Plumbing
6. It Busimss/Induetrr/Other, specify type ! people ! sinks
! Commodes ! Showers ! Urinals ! later Coolers
it "rOODSERViCE: A "Seats Estimated Hater Usage "tgailons per day)
7. Type of water supply: Dusty/City a Well - ❑ Community
s. Do you anticipate additions or expansions of the facility this system Is Intended to serve? ❑ Yes Cd No
If yes, what type?
***1MP0RTANT"** CLIENTS MUST COMPLETB THE REQUIRED PROPERTY INFORMATION REQUESTED
BELOW. Either a PLAT or SITE PLAN MUSTBESUBMITTED by the client with THIS APPIdCATION.
Properly Dbnensions: __ �e / 71 AP,
Tax Office PIN:
Property Address: Road Name A05- /2n /o rf�-
CltyiZip X760
WRITE DIRECTIONS (from Mocksville) to PROPERTY:
SDI'04y X:4-441
12� LOW
x�al
If in a Subdivision provide Information, as follows:.
Name: _ kUY(/ 'm i9R/
Section: _L Block: LOt: Date Property Flagged: Y-03
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 1 am responsible for all charges incurred frost
this application. I, hereby, give consent to the Authorized Representative of the Davie Co�raty Health Department
to enter upon above described property located in Davie County, and owned by 71 e L a4W 6LV4Q 4
to conduct all testing procedures as necessary to determine the t♦ to sultab,111ty.
/ '0-3
DATE a -_ `i —'0-3_ _ SIGNATURE 1JA1,
TIDS AREA MAY BE USED FOR DRAWING YOUR STTE PLAN
property lines and dimensions, structures, setbacks, and septic loo
all of the following: Existing and proposed
Site Revisit Charge
Notification Date:
Account No. �� O C
Invoice No.
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.. APPLICATION FOR SITE EVALUATION/IMPROVEMENT PERMIT A ATCD [13 F1
. r. .: Davis County Health Department
EnVimnmental Hca/0 Smdon
�- � P.O. Boz 878/210 Hospital Street "� 7-6
Mockoville, HC 27028
+ (336)751-8760
***nWCRTANT*** THIS APPLICATION CRNNOT BE PROCESSED UW=MZss ALL TBE
REQUIRED
INIMSIM2I011 IS PROVIDED, Refer to the IMMMTION BULLETIN for instructions.
1. None to be Killed Ceetaot PersonJ
Hailing beer... �'% /y Yt Ss c/ goes Phan. 9o9p9�J'-
sr4 9
/nj
city/state/KIP /d_ddJe_ A14, o: 7ed6 Business Phone
2. Nene on Permit/ATC i! Different than Above
Walling Address City/state/alp
3. Application Por: t9 Hite Evaluation ❑ Improvement Permit/ATC
❑ Both
e. system, to service, House ❑ Mobile Rome ❑ Business O Industry
❑ Other
5. If Residence: s People s Bedrooms s
Bathrooms
D Dishwasher D Oarbage Disposal D Washing Waohiae D Basemu,t/Plumbins
D Baeement/No Plumbing
6. If Business/Industry/oth&rs specify type / people
s Bink@
I Commodes a showers f Urinals / K@Gr coolers
IP FOODSERVICE: # Seats Estimated Water Usage (gallons
per day)
7. Type of water supply: 8County/City ❑ Well
❑ Community
e. Do you anticipate additions or expansions or the beility this system Is Intended to Serve?
❑ Yea ❑ No
If yea, 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
R
Property DimensioeCl: •+(' r . g 23 /e�i� 5 / WRITE DIRECTIONS (from Mocksvllle) to PROPERTY:
Tax Office PIN: 0t"0 - lU - �?5-5�
Properly Address: Road Name flod / 4 fie Yoh/ 1%
city/zip M *,Lie_
If in a Subdivision provide information, as fol
lows:
Name: �GC kl/yi7ee�1 17111 r
Section: Blocks Lot: 141�
j�0/ ltlyAli 72 -
Date
Date Property Flagged:: �U i!c"c fcSern�orte�i`C
This b to certify that the lorormation provided Is correct to the best of my knowledge. I understand that any permit(s)
Issued hereailer are subject to suspension or revocation, If the elle plans or Intended we change, or if the Information
submitted in this application Is falslRed or changed 1, also, understand that I am responsible for all charges Incurredfrom
this application. 1, 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 ss necessary to determine the site suitarity. n
DATE_ 'r%1;V-4()
THIS AREA MAY BE USED FOR DRAWING YOUR SITE PLAN (loci eiR of the following: Existing and proposed
property lines and dimensions, structures, setbacks, and septic load
Ibb
Revised DCHD (07/99)
Date(s):
IEHS:'
Site Revisit Charge
Dale:
Account No.
Invoice No.
tt 1
DAVIE.COUNTYHEALTHDEPARTMENT
Environmental Health Section
il/ ite Evaluation
'<S ,
APPLICANT INFORMATION 8o PROPERTY "INFORMATION
Account'* 989900111 Tax PIN/EH #: " 5822-14-6855.14
Billa i
d To:' Gray Potts'.. Subdivision Info: "Dutchman Hills Lot # 14
Reference Name: 'Gray Potts Location/Address: Eaton Church Road -27028
Proposed Facility: Residence Property Size: 51 Acres - Date Evaluatedr
Wates Supply: Ori -Site Well Community /' 'Public
Evaluation B y Aug et Boring: Pit ✓ Cut
i
FACTORS.'' 1 2 3 4 5 6 7
Landscape position .. '
Sloe %
HORIZON I DEPTH
Texture group 'lap L,
Consistence
. ,Structure
Mineralogy
HORIZON II DEPTH 1
Texture groupG
r.. Consistence
Structure
"Mineralogy
HORIZON III DEPTH 1
Texture groupF Si
Consistence P
- Structure
Mineralogy
HORIZON IV DEPTH .. $
Texture group
Consistence
Structure
Mineralogy
SOIL WETNESS
RESTRICTIVE HORIZON
SAPROLITE
CLASSIFICATION
LONG-TERM ACCEPTANCE RATE 0:
SITE CLASSIFICATION. \\ n
pS' EVALUATION BY: �'k� ' �UGN�"'t'
i "
LONG-TERM ACCEPTANCE RATE 0.3, `0.
OTHER(S) PRESENT:
REMARKS:
LEGEND
Landscape Position .
e N
R -Ridge - S -,Shoulder L - Linear slope : FS Foot slop - 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 EFT - Extremely firm
. .Wet...
NS -Non SS - Sli htl stick
sticky' g Y y 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)
S 83° 16' 19 E `
S 83' 16' 1 ,q' E'
155: 00 120. 00 a :
W
CO
Li
3 M
LOT # 4
75 .
z 1 , 174 AC; o .LOQ'. #
o o v f
.� 0 0.909 AC. o M
o 14-
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0
2 �•��q,NAr4
1_ 1' iASr'HENT
1 SS. OQ —
u N 83. 16` N 8-1- 16'. 1 <33 ' W
ROD COURT
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