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113 Rod Court Lot 15Dav a r to County, NC ; Tax Parcel Report Monday, December 19, 2016 121 I t 64 r I I k � 154 I I i i i I 132„ 108 r-105. 1131 GREENFIELD RD I t RO I 111 156 gs�tp WARNING: THIS IS NOT A SURVEY Ali data Is provided as Is whissAmmanty orguarantee of any Idnd either expressed orimplled Including but not limled to the Implied mmandes of merchantability or Mness for a parlcularuse. All users of Davie Coumys GIS means shall hold hannlesathe �p�ta•t4 NC Parcel Information._._____ Parcel Number. D301OA0015 Township: Clarksville NCPIN Number. 5822241773 Municipality: Account Number: 82521261 Census Tract: 37059-801 Listed Owner 1: ROBERTS STEVEN LLOYD Voting Precinct: CLARKSVILLE Mailing Address 1: 113 ROD COURT Planning Jurisdiction: Davie County City: MOCKSVILLE Zoning Class: DAVIE COUNTY R -A ' State: NC Zoning Overlay: Zip Code: 27006-0000 Voluntary Ag. District No Legal Description: . LOT 15 DUTCHMAN HILLS Fire Response District: WILLIAM R. DAVIE Assessed Acreage: 0.89 Elementary School Zone: WILLIAM R DAVIE Deed Date: 7/2003 Middle School Zone: ` NORTH DAVIE Deed Book/Page: 005020179 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: gs�tp Davie County, Ali data Is provided as Is whissAmmanty orguarantee of any Idnd either expressed orimplled Including but not limled to the Implied mmandes of merchantability or Mness for a parlcularuse. All users of Davie Coumys GIS means shall hold hannlesathe �p�ta•t4 NC county of Davis, North Camgna, Its agents, comullnRs, contractors or employees from any and all claims orcausm of anion due to bythis - or arising out ofthe use or lnablllyto use Me GIS data provided umbels. DAVIE COUNTY HEALTH DEPARTMENT ^ Environmental Health Section �. P. O. Boa 848/210 Hospital Street Mocksville, NC 27028 (336)751-8760Z— IMPROVEMENT/OPERATION PERMIT / Account #: 990001825 Tax PIN/EH #: 5822-14-6855.15 Billed To: Mike Hester Reference Name: Gray Potts Proposed Facility: Residence Subdivision Info: Dutchman Hills Lot # 15 Location/Address: Rod Lane -27028 Property Size: 0.909 acres ATC Number: 3334 **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 PERMHH BEFORE INSTALLING SYSTEM. Residential Specification: Building Type #People #Bedrooms 3 #Baths Dishwasher: 17/Garbage Disposal: 0 Washing Machine: Er Basement w/Plumbing: El Basement/No Plumbing: El Commercial Specification: Facility Type ,� "##P-�e/ople #People/Shift #Seats Industrial Waste: 13 Lot Size 0 101 //�W Type Water Supply I%ry 1 1 Design Wastewater Flow (GPD) 'CAQ Site: New �Repav � ) t n qco I System Specifications: Tank Sizelo) GAL. Pump Tank GAL. Trench Width Rock Depth Linear Linear Ft. Other: 14 lI tSTQI�tNn� �7tia�. 1Algmu- L1rJES 03Ito.C. A'.w. Required Site Mndifications/Conditions: 0,3 'CCW -j=, rT 0(r Id ©PF U 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.**** z7' I i .� 8 8 0 0 t Environmental Health Specialist's Signature: Iti ai DCHD 05/99 (Revised) Account #: 990001825 Billed To: Mike Hester Reference Name: Gray Potts DAVIE COUNTY HEALTH DEPARTMENT Environmental Health Section P. O. Boa 848/210 Hospital Street Mocksville, NC 27028 (336)751-8760 Tax PIN/EH #: 5822-14-6855.15 Subdivision Info: Dutchman Hills Lot # 15 Location/Address: Rod Lane -27028 W Proposed Facility: Residence Property Size: 0.909 acres ATC Number: 3334 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 1 I of. G.S. Chapter 130A, Wastewater Systems, Section . 0 Sewage Trea ent and Disposal Systems). THIS AUTHORIZATION FOR WASTEWA T IS V PERIOD OF FIVE YEARS. Environmental Health Specialist's Signalise: 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 fimction satisfactorily for any given period of time. tpo Op' l ►t)01 T . l8' Noor k -r FQaA T- Septic System Installed By:,� Environmental. Health Specialist's Signature : te: t- DCHD 05199 (Revised) APPLICATION FOR SITE EVALUATION/IMPROVEMENT PERMIT & Davie County Health Department EnvironmentaiHeaithSection : P.O. Box 848/210 Hospital Street Mocksville, NC 27028 - (336)751-8760 Q�'i 12 2032 ***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/ Nt 1 t3 C,1j I C 0l�T C�:' Contact Person Mailing Address d- / y, S 4 d�Q (yl ✓tee /L �'1, Home - Phone City/State/ZIP A-!/yrt -? C -e"/'z 4 Business Phone - 2. Name on Permit/ATC if Different than Above - Mailing Address City/State/Zip- 3. Application For: Ll site- Evaluation K/Improvement 'Permit/ATC ❑ Both 4. system to Service: ff-116use ❑ Mobile Home _ ❑ Business ❑ Industry ❑ Other° 5. If Residence: # People # Bedrooms # Bathrooms I O Dishwasher ❑ Garbage Disposal LT`Washifig Machine ❑ Basement/Plumbing ❑ Basement/No Plumbing, 6. If Business/Industry/Other: Specify type -- - # People # Sinks # Commodes -# Showers # Urinals # Water Coolers i. IF FOODSERVICE: # Seats 'Estimated Water Usage (gallons per day) . 7.;. Type of water, supply:❑-'County/City. ❑ Well ❑ Community a. Do you anticipate additions or expansions of the facility this system is intended to serve? ❑ Yes 3 --Pio If yes, what type? ***IMPORTANT*** CLIENTS MUSTCOMPLETETHE REQUIRED PROPERTY INFORMATION REQUESTED BELOW. Either a PLAT or SITE PLAN MUST RESUBMITTED by the client with THIS APPLICATION. Property Dimensions: rl 0 / x d 30, WRITE DIRECTIONS (from Mocksville) to PROPERTY: Tax Office PIN: 6 O ( Al Property Address: Road Name (7. o L Ci kP L.c/ 015 C_`1 , %t �. 7`G.? ✓ ) r LJ City/zip MOCf5l Ig4 _215P ShG,\�� 7�,a/- /0 If in a Subdivision provide information, as follows: I S-� Le T G ✓ LTJ Name: ��ITC(ij1119-✓ Il C� s Section: Block: Lot: I S Date Property Flagged: IJ - Id - 0j_ 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 to conduct all testing procedures as necessary to determine the site suitability., DATE I �' )'� OJ SIGNATURE "/i - 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 locations). 7T #9 171 AC. #'10 i AC. i IT #12 89 AC. LOT #13 1.136 AC. LOT #16 4.142 AC. CD M k'w 1. Chairman of the / ,O / Davie County Board of Commissoners hereby certify / 0that said Board of Commissioners has approved _ 4� this plat entitled: DUTCHMAN HILLS DATE CHAIRMAN, DAVIE COUNTY BOARD OF COMMISSIONER; DUTCHMAN HILLS 1' = 100' -155 0o— N e'•161g• "leo 100 50 0 100 200 300 RODN COURT SCALE IN FEET _EC WAGE 2 FOR NOTE: FILE NN•E, DRAWING NUNSM DUTCH -1 16001-3 e _ OWNER ------------------ DEVELOPER GRAY POTTS & JERRY McCULLOH 1870 UNDERPASS RD. 585 STATE RD. ADVANCE, N.C. 27006 CHINA GROVE, N.C. 28023 e O(336) 998-8409 (336) 750-5020�yCV� IZ � � 4 4 V CS V CLARKSVILLE TOWNSHIP LOT 14 # W � DAVIE COUNTY, NORTH CAROLINA z 1.174 AC. <a LOT #15 q M 0 0 0.909 AC. ' W of \oj i� [I� DATE: JUNE i, 2001 I C r'1 v z o ('O tJi M SURVEYED BY: f>y f>a Q TUTTEROW SURVEYING COMPANY 124 BURY STREET 2MCs O q I I V OLLE, N O I I (336) 751-5616 1' = 100' -155 0o— N e'•161g• "leo 100 50 0 100 200 300 RODN COURT SCALE IN FEET _EC WAGE 2 FOR NOTE: FILE NN•E, DRAWING NUNSM DUTCH -1 16001-3 APPUC4TION FOR SITE EVAWAT10N/IMPROVEMENT PERMIT & ATC r .^'7 Davie County Health Department ~� Envimnmenla/ HeB/th Sectlon c 'z � � � P.O.. Box 868/210 Hospital Street Mockeville, NO 27028 .Ey + (336)751-8760 ***IMPORTANT*** THIS APPLICATION CANNOT BE pROCESS&D UNLESS ALL THS REQUIRED IHIPORMATIOH IS PROVIDED. Refer to the INFORMATION BULLETIN for instructions. I- Name to M Billed QA contact Parson J Nailing Address /R;7,0 /1/ rt SS c./ _ cone Hww _ 99�+�- S('Gf o 9 City/state/exp /V P,0,/g_ Ale, o -77e06 Buainese Whom a. Naas on permit/ATC Jr Dieearant than Above Nailing Address city/:tato/sip 3. Application For: 19 Bite Evaluation ❑ Improvement Permit/ATC ❑ Both 6. By@tam to Service, Winona ❑ Mobile Home ❑ Business ❑ Industry ❑ Other S. If Residence: 1 People 1 Bedrooms i Bathrooms D Dishwasher O garbage Disposal D Hashing Machine O Baseman!/plumbing O Bamement/No plumbing 6. I! Business/xndu@try/othes, "city type I Commodes I showers Usinsl■ I people I Sink@ I water Coolers IF FOODSERVICE: #i Seats Estimated Nater Usage (gallon. Pat day) 7. Type of water supply: E County/City ❑ Well ❑ Community a. Do you anticipate additions or expansions of the facllity this system R Intended to serve? ❑ Yes ❑ No If yes, what type? ***IMPORTANT*** CLIENTS MUST COMPLETETIIE REQUIRED PROPERTY INFORMATION REQUESTED BELOW. Either a PLAT or SITE PLAN MUST BESUBMITTED by the *hent with THIS APPLICATION. PropertyDlmenslovi:' •Sfl. d %•S Al2'V-5 ) Tax Office PIN: 0 6-10 - I U - I �JJ��1 — Property Address: Road Name /d / 44ot Yea/ 2 h city/zip 42fi l e- /Jf,dw1 U in a Subdivision rovidd/ Info matlon, as follows: / Name: ,r/LGTG�d // /////1 Section: Block: Lot: Af WRITE DIRECTIONS (from'MockrAlle) to PROPERTY: V boir'oe4 r Date Property Flagged:•_7U/77c'c'fScmClrte This h to certify that the Information provided M 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 we change, or If the Information submitted in this application M falslited or changed. 1, also, understand that 1 am responsible for all charger 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 to conduct all testing procedures as necessary to determine the site sultsWity. DATE l7^n9r!v-46) THIS AREA MAY BE USED FOR DRAWING YOUR SITE PLAN property lines and dimensions, structures, setbacks, and septic toe SID following: Existing and proposed Site Revisit Charge Client Notification Dale: Account No. Revised DCHD (07/99) Invoice No. txnuZ�vrN I unr In Texture group Consistence Structure JrtucLure� - Mineralogy HnRi70N 1 Consistence Structure Mineralogy- ' HORIZON IV DEPTH Texture group Consistence Structure . Mineralogy SOIL: WETNESS RESTRICTIVE HORIZON SAPROLITE CLASSIFICATION . LONG-TERM ACCEPTANCE RATE I 0.3 SITE CLASSIFICATION: T0.12�t7��2 EVALUATION BY: , 1— t�t)GB4wt ` LONG-TERM ACCEPTANCE RATE. ' • A-3� 1 0-'3 OTHER(S) PRESENT: - REMARKS:' ..J1yTb`Y�_:.1i.� 4Qe.�T,:M4P,: µA�IKTO PJa�Pr 'SACK DF fi �S UJI�"ut ToPO.' LEGEND 43 32✓',r 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 - Loam sand 'SL Sand loam • Y Y L -Loam' SI -Silt SICL-.Silt cla loam y y IoCL - Clay loam SCL - Sandy clay loam 'SC - Sandy clay SIC - Silty clay C - Clay CONSISTENCE Mid .. VFR - Very friable FR - Friable FI - Firrir . VFI - Very firm EFI - Extremely firm Wet NS - Non sticky SS c Slightly sticky, S - Sticky' VS - Very Sticky NP - Non plastic SP - Slightly plastic P - Plastic : VP - Very plastic tru tore 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) - DAVIE COUNTY HEALTH DEPARTMENT Environmental Health Section Soil/Site Evaluation . APPLICANT INFORMATION PROPERTY INFORMATION Account #: 989900111 • ., Tax PIN/EH #: 5822-14-6855.15 Billed To: Gray Potts,. Subdivision Info: ,Dutchman kills Lot#1$,.--, Reference Name: Gray Potts Location/Address: Eatons Church Road -27028 Proposed Facility: Residence Property Srz e: 51 Acres Date Evaluated:- s i 00 Water Supply:. On -Site Well Community Public / Evaluation By: Auger Boring Pit Cut ,JO 5 J s FACTORS.. 1. 2. 3 4 5 6 7..-. Landscane nosition - .. .. tom.:' .- txnuZ�vrN I unr In Texture group Consistence Structure JrtucLure� - Mineralogy HnRi70N 1 Consistence Structure Mineralogy- ' HORIZON IV DEPTH Texture group Consistence Structure . Mineralogy SOIL: WETNESS RESTRICTIVE HORIZON SAPROLITE CLASSIFICATION . LONG-TERM ACCEPTANCE RATE I 0.3 SITE CLASSIFICATION: T0.12�t7��2 EVALUATION BY: , 1— t�t)GB4wt ` LONG-TERM ACCEPTANCE RATE. ' • A-3� 1 0-'3 OTHER(S) PRESENT: - REMARKS:' ..J1yTb`Y�_:.1i.� 4Qe.�T,:M4P,: µA�IKTO PJa�Pr 'SACK DF fi �S UJI�"ut ToPO.' LEGEND 43 32✓',r 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 - Loam sand 'SL Sand loam • Y Y L -Loam' SI -Silt SICL-.Silt cla loam y y IoCL - Clay loam SCL - Sandy clay loam 'SC - Sandy clay SIC - Silty clay C - Clay CONSISTENCE Mid .. VFR - Very friable FR - Friable FI - Firrir . VFI - Very firm EFI - Extremely firm Wet NS - Non sticky SS c Slightly sticky, S - Sticky' VS - Very Sticky NP - Non plastic SP - Slightly plastic P - Plastic : VP - Very plastic tru tore 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)