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124 Pen Court Lot 5Davie County, NC Tax Parcel Report Monday, December 19, 2016 218_,123 WARNING: TIHS IS NOT A SURVEY ti^ 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.**** ��/���p s�fL �Ft� �I�zs toCoa� �-7a,,d �I,.L I'b�lt. �MOT r^'"��, �\ T �OC7 pp7��0' CVS q0 / �s`nPC / 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 1 1 ', NN LOT #5 3, 346 AC. 1 1 ; 1 1 . 1 - 1 ME /1—NFOR04—AT 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)