111 Pen Court Lot 2Davie County, NC ' t . Tax Parcel Report Monday, December 19, 2016
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WARNING: THIS IS NOT A SURVEY
All data is provided as is without vn mnty or guarantee of any kind either expressed or Implied including but not limited to the
Implledwamntlas of merchantability orMness for a particularuse. Ali users of Davie County's CIS vebstte shall hold harmless the
[all
County of Davie, North Carolina, he agents,eonmitants, eontraclurs oremployees fromany anti all Balms orcauses of action dueto
_ v
_ ___Parcel
Information
Parcel Number.
D301OA0002
Township:
Clarksville
NCPIN Number.
5822155648
Municipality:
Account Number.
82527009
Census Tract:
37059-801
Listed Owner 1.
DECANIO MELISSA D
Voting Precinct:
CLARKSVILLE
Mailing Address 1:
111 PENN COURT
Planning Jurisdiction:
Davie County
City: MOCKSVILLE
Zoning Class:
DAVIE COUNTY R-20
state:
NC
Zoning Overlay:
Zip Code:
27028-0000
Voluntary Ag. District:
No
Legal Description:
LOT 2 DUTCHMAN HILLS
Fire Response District:
WILLIAM R. DAVIE
Assessed Acreage:
0.81 Elementary School Zone:
WILLIAM R DAVIE
Deed Date:
9/2006
Middle School Zone:
NORTH DAME
Deed Book/Page:
006810724
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:
Davie County,
All data is provided as is without vn mnty or guarantee of any kind either expressed or Implied including but not limited to the
Implledwamntlas of merchantability orMness for a particularuse. Ali users of Davie County's CIS vebstte shall hold harmless the
[all
County of Davie, North Carolina, he agents,eonmitants, eontraclurs oremployees fromany anti all Balms orcauses of action dueto
NC
or arlskng out ofthe use or lnabirdyto use the GIS data provided by this mbske. - -
DAVIE COUNTY HEALTH DEPARTMENT
Environmental Health Section
P. O. Boa 848/210 Hospital Street
Mocksville, NC 27028
(336)751-8760
IMPROVEMENT/OPERATION PERMIT
Account #: 990002162 Tax PIN/EH #: 5822-14-6855.02BC
Billed To: Bob Cope & Son Construction Subdivision Info: Dutchman Hills Lot # 02
Reference Name: Location/Address: Pen Court -27028
Proposed Facility: Residence
Property Size: see map
A-<
ATC Number: 3485
**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 JAQQS' = #People #Bedrooms -]�> #Baths 2.
Dishwasher: Er Garbage Disposal: ❑ Washing Machine: Ca Basement w/Plumbing: M Basement/No Plumbing: ❑
Commercial SpeSpecification:Specification:Facility Type #People #People/Shift #Seats Industrial13 Waste:
Lot Size b •S NO `ype Water Supply 621:��Design Wastewater Flow (GPD) 3LOC) Site: New 63rRepair ❑
I I 7r
System Specifications: Tank Size 1000GAL. Pump Tank GAL. Trench Width J�(O Rock Depth J Z Linear Ft. —2J--)6
Other: ��tSjQI�JTtoJ
Required Site Modifications/Conditions: t'Asy_ prJ C I)IJIWOR�� 4 I!EJ gC4= RL>)SI
��Yd. Lci
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.****
1
Environmental Health Specialist's
DCHD 05/99
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DAVIE COUNTY HEALTH DEPARTMENT `7
Environmental Health Section
P. O. Boz 848/210 Hospital Street
Mocksville, NC 27028
(336)751-8760
IMPROVEMENT/OPERATION PERMIT
Account #: 990002162
Billed To: Bob Cope & Son Construction
Reference Name:
Proposed Facility: Residence
Tax PIN/EH #: 5822-14-6855.0213C
Subdivision Info: Dutchman Hills Lot # 02
Location/Address: Pen Court -27028
Property Size: see map
ATC Number: 3485
**NOTE** This ImprovementlOperation 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 SYS-TEENL
Residential Specification: Building Type #People #Bedrooms c -l' #Baths
Dishwasher:O"�Garbage Disposal: ❑ Washing Machin Basement w/Plumbing: 9! Basement/No Plumbing: ❑
Commercial Specification: Facility Type #People_ #People/Shift #Seats Industrial Waste: ❑
Lot Size 3� Type Water Supply Design Wastewater Flow (GPD) ��� Site: New ❑ Repair ❑
System Specifications: Tank Size`��GAL. Pump Tank _GAL. Trench Widthsl. Rock Depth Linear Ft.�l�
Other:
Required Site Modifications/Conditions:
IMPROVEMENT/OPERATION PERMIT LAYOUT - APPROVED EFFLUENT FILTER RISERS) 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: Date:
DCHD 05/99 (Revised)
DAVIE COUNTY HEALTH DEPARTMENT
Environmental Health Section
P. O. Boa 848/210 Hospital Street
Moclrsville, NC 27028
(336)751-8760
Account #: 990002162 Tax PIN/EH #: 5822-14-6855.02BC
Billed To: Bob Cope & Son Construction Subdivision Info: Dutchman Hills Lot # 02
Reference Name: Location/Address: Pen Court -27028
rroposed racmry: Residence rroperiy Size: see map
ATC Number: 3485
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: 1 Date: -'/
OF COMPLETION
**NOTE** The issuance of this Certificat of C;yf
n shall indicate the system described on Improvement/Operation Permit
has been installed in complian wi11 of G.S. Chapter 130A, Section .1900 "Sewage Treatment and
Disposal Systems," but shall' NOtaken as a guarantee that the system will function satisfactorily for any
given period of time.
Septic System Installed By:
Environmental Health Specialist's Signature :
DCHD 05/99 (Revised)
u
LICATION FOR SITE EVALUATION/IMPROVEAIENT PERMIT & Al
20 Davie County Health Department
Enviionmenta/ilea/th Section
�yIgONMENTALHFAl1H - ? P.O. Box 848/210 Hospital Street - - -
pANECAUNTY Mocksville, NC 27028
(336)751-8760
-***IMPORTANT***'THIS APPLICATION CANNOT BE .PROCESSED UNLESS, ALL THE REQUIRED
INFORMATION IS PROVIDED. Refer to the INFORMATION BULLETIN for instructions. -
1. Name to be Billed L,v/0l n6e / it �l Cd. /nCI Contact Person 40!0 rx
Mailing Address :/ v /�O 'trL, "/ ��0 nn Home'Phone'_
City/State/ZIP (pD �ee�ee - iyC. ?7y/V Business Phone ���y`�%Y7 -
2. Name on Permit/ATC if Different than Above
Mailing Address - ,City/State/Zip - -
3: Application For: ESite Evaluation ❑ Improvement Permit/ATC a Both '
4. system to Service: LEYFtouse - ❑ Mobile.'Home ❑ Business ❑ Industry ❑ Other. _
S.Type system requested: &�Conventional ❑ conventional modified ❑ innovative
6. IIff, Residence # People - ✓,A,�- # Bedrooms 9[ .TQT,/q,,p# Bathrooms 2ya
CJDishwasher h0arbage Disposal PWashing Machine EfBaf%em n Plumbing "/ ❑Basement/No Plumbing
-7. If Business//Industry /Other: verify type - # People # Sinks -
# Commodes J # Showers - oL - # Urinals It Water Coolers
IF FOODSERVICE: # SeatsEstimated Water Usage (gallons per day)
S. Type of water supply: 0County/City ❑ Well ❑ Community
S. Do you anticipate additions or, expansions of the facility this system is intended to serve? ❑ Yes'
If yes, what type?
- ***IMPORTANT*** CLIENTS MUST COMPLETE THE REQUIRED PROPERTY INFORMATION REQUESTED
BELOW. Either a PLAT or SITE PLAN MW RESUBMITTED by the client widi I'Ii1S APPLICATION.
0
Property Dimensions: ` L ~% WRITE DIRECTIONS (from D'Iod:sville) to PROI'Islt'1'1':-
Tax Office PIN: # 2 tv r' -5� �0+� A0 -)6 1?d .
Property Address: Road Name PSN Con/ / /y/� L2i`1f �� %'� Tutu i.L
City/Zip rndCA Twrrl &4t' e,1).f, .c
If in a Subdivision provide information, as follows: �/tGL zo #e2
Name: _-A/a* 0N4 7`1713S LD
Section: / Block: Lot: Date lnonno corners flagged:
This is to certify that the information provided is correct to the best of my knowledge. 'I understand that :my 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 jar all Charges incurred from'_
this application. I, hereby, give consent to the Authorized Representative of the Davie County IIealth Deliartuunl
to enter upon above described property located in Davie County and owned by
to conduct all testing procedures as necessary to determine the site suite
DATE , t 9 �/ 3'� SIGNATURE _a
THIS AREA MAY BE USED FOR DRAWING YOUR SITE PLAN (Include all of the following: Existing and proposed
property lines and dimensions, structures, setbacks, and septic I'Kations).
-AT CERTIFATE OF APPROVAL
ubdiviston plot shown hereon has been
County Subdivision Regulation, with the
as, if any, as are noted in the minutes
that it `las been approved for recording
f Deeds. t is hereby noted that such
les no' rcludes appprovol to install and
^ does .i Includes approval for the
of building or structures.
)NE, 2001
NNING BOARD
he owner of the property shown
—, located in the County of Davie
n of subdivision with my free consent,
1 setback lines and dedicate all streets,
er sites and easement to public or
rmore. -ereby dedicate oil sanitary
> County of Davie (N applicable).
UNK
±r of Davie County,
h this certification
ants for recording.
DATE
3 plot was drawn
iI survey mode
.on recorded in
ler);thot the
indicated as drawn
Page that
led
dancea with 0.Sth S
genal signature. -......_
LOT #2
1816 AC.
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LOT #41
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-AT CERTIFATE OF APPROVAL
ubdiviston plot shown hereon has been
County Subdivision Regulation, with the
as, if any, as are noted in the minutes
that it `las been approved for recording
f Deeds. t is hereby noted that such
les no' rcludes appprovol to install and
^ does .i Includes approval for the
of building or structures.
)NE, 2001
NNING BOARD
he owner of the property shown
—, located in the County of Davie
n of subdivision with my free consent,
1 setback lines and dedicate all streets,
er sites and easement to public or
rmore. -ereby dedicate oil sanitary
> County of Davie (N applicable).
UNK
±r of Davie County,
h this certification
ants for recording.
DATE
3 plot was drawn
iI survey mode
.on recorded in
ler);thot the
indicated as drawn
Page that
led
dancea with 0.Sth S
genal signature. -......_
LOT #2
1816 AC.
LOT #39
0.930 AC.
Al
LOT #6
1.414 AC.
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LOT#10
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LOT #41
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LOT #40
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0.930 AC,
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LOT #39
0.930 AC.
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LOT #6
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"U^
APPLICATION FOR SIFE EVALUATION IMPROVEMENT PERMIT & ATC ^ r 2 �'
ti Davis County Health Department '
lea� /1 Envlronmenfa/Hee/p Sectfon
w5 G/ el P.O. Box 869/210 Hospital Street
,a/� J 2�cJ C / /i� Mookeville, He 27026
y (336)751-8760
***rMPORTANTe** THIS APPLICATION CANNOT BE PROCESSED UNLESS ALL HE
REQUIRED
IN1'ORIMIOH I8 PROVIDED. Refer to the INYOR1aTIOH BULLETIN for instructions.
1. Nuc to be Billed Cr"/I�( Contact "cam
Mailing Address gel Boca Phone _ 99p�-
'/
sr( Q 9
//� Ale,
City/state/a1P _ N�//yJ/1/G�= Ale, oL 7oa6 Business fhona
2. Naw on permit/ATC if Different than above
Mailing address city/State/Sip
S. Application Fors Elite Evaluation O Improvement Permit/ATC
❑ Both
e. system to Services pliouse ❑ Mobile Rome ❑ Business O Industry
❑ Other
B. If Residence: I People I Bedrooms I
Bathrooms
D Dishwasher D garbage Disposal D Washing Machine D Bassment/Plumbing
D Basemant/wo plumbing
a. xf Business/Imdustry/Other, Specify type / People
a Sinks
e Commodes I -Showers / Usinals I KtGr Coolers
IF FOODSERVICE: # Seats Estimated Nater Usage (gallons
per day)
7. Type of water supply: E County/City ❑ Well
O Community
e. Do you anticipate additions or expansions of the facility this system is Intended to serve?
❑ Yes D No
If yes, what type?
**AIMPORTANT***CLIENTS MUSTCOMPLETETHE REQUIRED PROPERTY INFORMATION REQUESTED
BELOW. Either a PLAT or SITE PLAN MUST BESVBMITIED by the client with THIS APP W CATInN_
Property Dimemioni: / n�'I . r� 9.3 ;0g'1° 5
Tax Office PIN: tl nAp - /U -
Properly Address: Road Name ae / d -1.i ,041 eh
If in a Subdivision provide Information, as follows:
Name: A( IZ-11unPi-ds-
Section:
i idsSections Block: Lot: 92—
WRITE DIRECTIONS (from MockrAlle) to PROPERTY:
/0/ Nos'A �G E.4 441 &
6'0
Date Properly Flagged(
This is to certify that the information provided Is correct to the best of my knowledge. I understand that any permit(,)
Issued hereafter are subject to suspension or revocation, If the site plana or Intended use change, or If the Information
submitted in this application Is falsliled or changed I, also, understand that I ani responsible for all charges Incurred frons
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
to conduct all testing procedures as necessary to determine the site suits ity.
DATE — IV 110 — D&?
THIS AREA MAY BE USED FOR DRAWING YOUR SITE PLAN
property Imes and dimensions, structures, setbacks, and septic too
Revised DCHD (07/99)
of the following: Existing and proposed
Date(s):
EHS•
Site Revisit Charge
Date:
Account No. �—
Ll
AAi�Invoice No. - ,
ek (P /Wo 0
Y
� � Z
t DAVIE COUNTY HEALTH DEPARTMENT
Environmental Health Section
Soil/Site Evaluation .
APPLICANT INFORMATION PROPERTY INFORMATION
Account #: 989900111 Tax PIN/EH #: 5822-14-8855.02 ...
Billed.To Gray Potts Subdivision Info: Dutchman Hills Lot # 2
Reference Name: Gray Potts Location/Address: Easton Church Road- 02 ,
y Property Size: 51 Acres Date Evaluated: 07
Proposed Facility: Proert Si
Water Supply: On -Site Well Community` Public t�
Evaluation By: Auger Boring Pit Cut
FACTORS 1 -.2 3 4 5 6 7
Landscape position
z
HORIZON I DEPTH.
Texture group
'Consistence
7
Structure
Mineralogy
HORIZON Il DEPTH
®®®®®
MWTexture
group
Consistence
Structure
HORIZON III DEPTH -e5oI-4
'Texture group
Consistence N
Structure
Mineralogy`t
HORIZON IV DEPTH, p'$p
Texture group
Consistence ..9
Structure
Mineralogy
SOIL WETNESS
RESTRICTIVE HORIZON
SAPROLITE
CLASSIFICATION
LONG-TERM ACCEPTANCE RATE
SITE CLASSIFICATION: EVALUATION BY: J61E:
LONG-TERM ACCEPTANCE ACCEPTANCE RATE. OTHER(S) PRESENT:
REMARKS:,..
LEGEND
Landscape RidgPoStion
Shoulder L - Linear sloe FS - Foot sloe N - Nose o
Ridge p p 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 '
Set 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)