124 Pen Court Lot 5Davie County, NC Tax Parcel Report Monday, December 19, 2016
218_,123
WARNING: TIHS IS NOT A SURVEY
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Parcel Information
!
___126
D301OA0005
Township:
Q
�'
17
Municipality:
Account Number.
8306415
Census Tract
37059-801
Listed Owner 1:
t
0
200 124
Mailing Address 1:
124 PEN COURT
O
Davie County
193
Zoning Class:
W
State:
LL
Zoning Overlay:
Zip Code:
W
Voluntary Ag. District:
---- W
188
181
Fire Response District:
WILLIAM R. DAVIE
176
r r
[all
Ali data is provided as Is elMoutvntrerdy or guarantee aany Idnd etherespressed or implied Including but net tanned to the
Davie County, Impriadmi.m. asof merchantabghywfltneas fora particular use. Ml users of Davie County's GIS website harmlessshell hold hadess the
County ofUavle, WorthCarolina, Its agents, consubards, contractors oremployees from any and all dalms oruuses ofadlon due to
NC or arising out of the use or Inability to use the GIS data provided by this uebdle.
WARNING: TIHS IS NOT A SURVEY
Parcel Information
!
Parcel Number.
D301OA0005
Township:
Clarksville
NCPIN Number:
5822250404
Municipality:
Account Number.
8306415
Census Tract
37059-801
Listed Owner 1:
MORRISON WILLIAM ROBERT
Voting Precinct
CLARKSVILLE
Mailing Address 1:
124 PEN COURT
Planning Jurisdiction:
Davie County
City: MOCKSVILLE
Zoning Class:
DAVIE COUNTY R -A
State:
NC
Zoning Overlay:
Zip Code:
27028
Voluntary Ag. District:
No
Legal Description:
LOT 5 DUTCHMAN HILLS
Fire Response District:
WILLIAM R. DAVIE
Assessed Acreage:
3.34 Elementary School Zone:
WILLIAM R DAVIE
Deed Date:
6/2016
Middle School Zone:
NORTH DAVIE
Deed Book / Page:
010200163
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:
[all
Ali data is provided as Is elMoutvntrerdy or guarantee aany Idnd etherespressed or implied Including but net tanned to the
Davie County, Impriadmi.m. asof merchantabghywfltneas fora particular use. Ml users of Davie County's GIS website harmlessshell hold hadess the
County ofUavle, WorthCarolina, Its agents, consubards, contractors oremployees from any and all dalms oruuses ofadlon due to
NC or arising out of the use or Inability to use the GIS data provided by this uebdle.
Account #: 990002706
Billed To: Jeff Hayes
Reference Name:
-roposeo racniry Kesioence
ATC Number: 3927
DAVIE COUNTY HEALTH DEPARTMENT y]�
Environmental Health Section !/
P. O. Boz 848/210 Hospital Street
Mocksville, NC 27028
(336)751-8760
Tax PIN/EH #: 5822-25-0404
Subdivision Info: Dutchman Hills Lot #
Location/Address: Pen Court -27028 4
oize: see
\Yll Y: [�] CZ�A•ti_Y_C�]i•� Cf�7 Carer/_�.'4 Y �rir/_U yI1(�'SY.`ll Y flu C��]r�I.i MS��MS��I
**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 CONST VAKD FOR A PERIOD OF FIVE YEARS.
Health Specialist's Signature:
A014111112113".19[i7y
**NOTE** The issuance of this Certificate of Completion
has been installed in compliance with Article4
Disposal Systems," but shall in NO WAYAbet
given period of time.
Septic System Installed By: _
Health Specialist's Signature:
DCHD 05/99 (Revised)
I- e
�oJf oF r>aD Feu
system described on Improvement/Operation Permit
13 4 Sxhon .1900 "Sewage Treatment and
e tha a system will function satisfactorily for any
Q0%C,1� U
Int
Account #: 990002706
Billed To: Jeff Hayes
Reference Name:
Proposed Facility Residence
DAVIE COUNTY HEALTH DEPARTMENT
Environmental Health Section
P. O. Boa 848/210 Hospital Street
Mockwille, NC 27028
(336)751-8760
IMPROVEMENT/OPERATION PERMIT
Tax PIN/EH #: 5822-25-0404
Subdivision Info: Dutchman Hills Lot # 05
Location/Address: Pen Court -27028
Property Size: see map
Z --,6D
ATC Number: 3927
**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 IN'T'ENDED USE CHANGE. YOUR
WASTEWATER SYSTEM CONTRACTOR MUST SEE THIS PERMIT BEFORE INSTALLING SYSTEM.
Residential Specification: Building Type #People #Bedrooms 3 #Baths 3
Dishwasher: 120'� Garbage Disposal: ❑ Washing Machine: d Basement w/Plumbing: Mr' Basement/No Plumbing: ❑
Commercial Specification: Facility Type #People #People/Shift #Seats Industrial Waste: ❑
Lot Size 3.3rHvDLD-,---S Type Water Supply Ceye Design Wastewater Flow (GPD) EA� Site: New 121 Repair ❑
System Specifications: Tank Size :CO GAL. Pump flank GAL. Trench Width mil Rock Depth Linear Ft. —
Other: 1>6TPAWT'ItAJ DXr i ARJra) 25%Q 2rl�Jcrla l 1r1r 1d/aTi � �
Required Site Modifications/Conditions: ?,TSTA L-0-3 CANJ1641 AFF N�
IMPROVEMENT/OPERATION PERMIT LAYOUT - APPROVED EFFLUENT FILTER RISER(S) IF 6 K BELOW
FINISHED GRADE. ****NOTICE: Contact a rep entative 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.rt11I on the day of installation. Telephone # is (336)751-8760.****
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Environmental Health Specialist's Signatur . Date: l�
DCHD 05/99 (Revised)
39, C1� S LOT #4
1 2. 284 AC,
N
S 76044�46a E
C14 / LJ c0. BARN
G�� OLD 1 013AC
To DF,tAOYED S HBc S
1 3g&. 2� ,
1
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3, 346 AC.
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DAVIE COUNTY HEALTH DEPARTMENT
Environmental Health Section
SoiV/Site Evaluation
ION PROPERTY INFORMATION
.count #: 989900111 Tax PIN/EH M 5822-14-6855.06
/Billed To: Gray Potts Subdivision Info: Dutchman Hills Lot # 6
,--ference Name: Gray Potts Location/Address: Eatons Church Road -27028
2roposed Facility: Residence Property Size: 51 Acres Date Evaluated: :h-5—Lo
later Supply: On -Site Well Community Public
valuation By: Auger Boring Pit f Cut
CLASSIFICATION: EVALUATION BY: ;t'3t�rtx�tl+P
-TERM ACCEPTANCE RATE: OTHER(S) PRESENT:
IRKS:
LEGENDSPuT > aFnLF-.co„ aj JY df
Landscape Position &1`16A w
R - Ridge S - Shoulder L - Linear slope FS - Foot slope N - Nose slope c -o7—,5
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 SII. - Silty loam CL - Clay loam SCL - Sandy clay loam
SC - Sandy clay SIC - Silty clay C - Clay
CONSISTENCE
of . -
VFR - Very friable FR - Friable F1- Finn VFI - Very fine EFI - Extremely firm
Wet
NR - Nnn stir_kv SS - Slioh9.. �.:^�-.• ^ " -
ti
insistence
MA
cralogy
UZON IV DEPTH
.ure group
sistence
!ralogy
MCTIVE HORIZON
•
G -TERM ACCEPTANCE RATE
CLASSIFICATION: EVALUATION BY: ;t'3t�rtx�tl+P
-TERM ACCEPTANCE RATE: OTHER(S) PRESENT:
IRKS:
LEGENDSPuT > aFnLF-.co„ aj JY df
Landscape Position &1`16A w
R - Ridge S - Shoulder L - Linear slope FS - Foot slope N - Nose slope c -o7—,5
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 SII. - Silty loam CL - Clay loam SCL - Sandy clay loam
SC - Sandy clay SIC - Silty clay C - Clay
CONSISTENCE
of . -
VFR - Very friable FR - Friable F1- Finn VFI - Very fine EFI - Extremely firm
Wet
NR - Nnn stir_kv SS - Slioh9.. �.:^�-.• ^ " -
ti
Aa
\VI APPLICATION FOR SUE EVALUI\TION/IMPROVG1ENf1'En111T& AfC
V Davie CountytrealthOeplIMent
j} �-��� F.nPvonmenra/H�a/fhSectlon
NO� 'lk P.O. nest e40/210 Hospital Street
���xttti Nockaville, NC 27028
„ s1FPau" (336)751-8760
e TMXUFQRTANTrrr TEXS APPLXC,ITION CANNOT DE PROCESSED UNLESS ALL THE REQUIRED -_ --•
IEFORNATXON XS PROVIDED. Refer tp blia XNFORNATION BULLETIN ror instrucLiona.
1. aaee to be Dlllcd
Cmwat Dorom
Mailing Met".
Yhmt'
citrlswta/zxe rA G
/none
6gY mace Dwm 3�,' a afCif'-
1. Nana an Pemtt/axe if Dia."t Nm
naiiivs Addcaae
J. Applicatioa Fox- Svaluatiws
❑ Improvement Pm-Alit/ATC ❑ notil
iii{,d,,,[,,,/Site
`
/:
f. si twx to Service /V{/,Rouse ❑ Vokile Some
❑ Business (3 industry 17 Other
S. Type oyetm rc9utatad eaaventlonal 13 eonventieaal m.diLled ❑ imavativc
6. TlY Relidanee: { People 1
EediyOomn �� g Batiste0m:1 . ,_�,
}dmiabvaaaer Mxbago Diopooal ONmbing Naebino
00arment/no kl.x inu
/
7• rf amrama/r wtrf /other: Verify type
6 ample ` t make
A Cvmodea A Ybovece
6 Ui taalo t Nater Caalora ,
IF FOODSERVICE: V Seats Estimated Wa= Unage hallo. pec day) _„_
s. Type eY stator aepply Coarawcity ❑ Well ❑ C..Ly
y, w ym aaClcipnm edditimo oe eypatlsioss afllta LtCiiify this SyalGnlT lultudnl le SGNC? QYr; �o
Utes, nkat gTio? .
Property Dimcusiour- DDtBCTIOAsir nu dluakaridc)lu PllUl'lilfl'1':
Tu Men 11 IN; d
property Address: Road Nana -(s em— CL
Ilia a Subdivision provldablernsatiou, as follows:
Name / '✓ -Jl
t !!//• 6 '/
scetion:0 h DbJ:: 6� Lee Data UanwcaruG•s CaggGl;
Tills is to certify that the )ufornsatiun provided is correct to the hot ormy koon•Icdge. I understand that say pG•srdt(s)
Issued herofler are subject to suspension or revocation, if the site plans or inuaided use change, or if the iafannatfuu
submitted in this applicatiou ls falsinud or chaugGl I also, tmdrrstm�dN�of lm, rapomi0lefor npehmgrr incunrdfrem
Ihisapplicadoa, I,hereby, give cowwlto the AufharixediteprGcutalive oCNe llaric Cutwfy lle:dlh Utparhuc,d
to enter upon above described property located In Davie County and owned by ,
to conduct all testing proculures ass necessary to determine the sllesuitabllfty. O
DATE 7J~y- SICNAfURi���s�-C
property lines and dfucnsious, structures, setbacks, and septic
Sign given I -
I v Cocl nu
andprapascd
Sha Revisit Charge
099 inNtal AncomtxWfS:7 6AA7'6 'AnNL
C
APPLICATION FOR SITE EVALUATION/IMPROVEMENT PERMIT & ATC FP
Davie County Health Department D '- �•
EnNmnmenfa/HeathSectfon �,?
P.O. Box 818/210 Hospital Strr� SGihi'c 7-4
Mockeville, HC 27028 // '
ys (336) 751-8760 � —a)
IMPORTANT*** THIS APPLICATION CANNOT Br PROCESSED UNLESS ALL I!n REQUIRED
ORMIITIOH IS PROVIDED. Refer to the INI'ORMIITION BULLETIN for instructions.
1. Nam, to he Billed
Melling Address
City/state/BIP
2. Naw on Permit/ATC it Different than
Mailing Address
Contact Parson
Name Phone 99k- 5?t/0
Business Phone 99 f'- Fled 0
City/state/Zip
x. Application Fort 19 ite Evaluation ❑ Improv--Gnt Permit/ATC ❑ Both
e. Brat" to seaeiws RAH'ouse ❑ Mobile Home ❑ Business ❑ Industry ❑ other
N. If Residence: I People IT Bedrooms I Bathrooms
O Dishwasher 13 garbage Disposal O Washing Machina O Basaaaut/Plumbing O Bwamant/No Plumbing
6. It Bualnees/Industry/other: "city type
e Commodes
11 showers
I people 11 sinks
I Urinals a Water Coolers
IF FOODSERVICE: # Seats Estimated hater Usage (gallons per day)
7.- Type of water supply: t7 l:ounty/City ❑ Well ❑ Community
e. Do you anticipate additions or expansions of the facllity this system Is Intended to serve? ❑ Yes ❑ No
If yes, what type?
***IMPORTANT***CLIENTS MUSTCOMPLETETHE REWRED PROPERTY INFORMATION REQUESTED
BELOW. Either a PLAT or SITE PLAN MUST BESUBMITTED by the client with THIS APPLICATION.
Property Dimensloni:" •fFl. of q 3 lal,405
Tax Office PIN: tea
Property Address: Road Name 661 i irh ion/ 2A
If in a Subdivision provide Information, as follows:
Name: 1�/� �/11U�/ _./1l< -I'
Sections Block: Lot:
WRITE DIRECTIONS (from MoekrA le) to PROPERTY:
Rrvpe4 a/rr
Date Property Flaggeds
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 plane or Intended we change, or If the Information
submitted to this application is falslRed or changed 1, also, understand that I am responsible for all charges incurred from
this appllcadom 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 aB testing procedures as Necessary to determine the site sullabRlty.
DATE 0-„iro-46)
THIS AREA MAY BE USED FOR DRAWING YOUR SITE PLAN
property lines and dimensions, stractures, setbacks, and septic loci
Revised DCHD (07/99)
of the following: Existing and proposed
Site Revisit Charge
Datc(s):
Client Notification Date:
Account No. ///—
Invoice No O
i DAVIE COUNTY HEALTH DEPARTMENT
Environmental Health Section
'Soil/Site Evaluation ..:
APPLICANT INFORMATION PROPERTY INFORMATION
Account #:'989900111 Tax PIN/EH #: 5822-146855.05
Billed To: ': Gray Potts Subdivision Info: Dutchman Hills Lot # 5 '
Reference Name: Gray Potts `Location/Address: Eaton Church Road -27P28
Proposed Facility: Residence Property Size: 51 Acres Date. Evaluated:'
Water Supply: On -Site Well Community Public -
Evaluation By: Auger Boring ' Pit Cut
FACTORS 1 2 3 4 S 6,_; 7.
Landscapeposition -
Slope % 3
HORIZON I DEPTH
Texture group
Consistence 55 nF
Structure
Mineralogy1
HORIZON II DEPTH - 3
Texture group
Consistence
Structure
A, -
..Mineralogy.
HORIZON III DEPTH
Texture group
Consistence -
Swcture .
Mineralogy
HORIZON IV DEPTH
Texture group
Consistence
Structure
Mineralogy
SOIL WETNESS. _
RESTRICTIVE HORIZON
SAPROLITE
CLASSIFICATION
LONG-TERM ACCEPTANCE RATE n G
SITE CLASSIFICATION: JS .I YS �' ✓z 1oT Co EVALUATION BY:
LONG-TERM ACCEPTANCE RATE: OTHER(S) PRESENT:
REMARKS: tel( �r l tiMIL�XD W� l Cwel�Cb7Li� '��hB�J� 1J� .. �Z .eF,r �D 1 rvs rt':
LEGEND P�ogtRs?o r'
Landscape Position
R - Ridge S - Shoulder : - L - Linear slope FS - Foot slope N Nose slope
CC - Concave slope CV - Convexslope 'T - Terrace FP =Flood plain H - Head slope
Texture
S - Sand LS - Loam sand . SL - Sandy loam „ L - Loam SI - Silt
SICL -SiltY clay loam SII-SiltY loam CL - Clay loam SCL -Sandyclay loam. '
-
SC -Sandy clay SIC - Silty clay C -'Clay
CONSISTENCE. `
Moi
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 L CR - Crumb GR - Granular ABK - Angular blocky
SBK - Subangular blocky, PL - Platy PR - Prismatic
Mineraloev
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)