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132 Greenfield Road Lot 12Davie County, NC Tax Parcel Report Monday, December 19, 2016 [all AlidataisprovidedHIswithout warranty orguarantee of any idnd ether a p..ed.,implied Including but net limited to the Davie County, Impiledvar w sof merchantability pertness fora particular use. All users of Davie Coumys GIS webitesshall hold harmlessthe CountyofDawe, Novi Carolina,fh agentsconsuhaMa, eardraRonp employees tom anyand ail claimsor rousesofaction due to NC or arising out ofthe use orinabilhyto use the GIS data provided by this websha 154 Parcel Information �1 D301OA0012 Township: M' NCPIN Number. 5822146656 Z' Account Number: rt Census Tract: 37059-801 Listed Owner 1: JENKINS JUSTIN LEE Voting Precinct: O Mailing Address 1: 5 Q Davie County I 145 Zoning Class: DAVIE COUNTY R -AR -20 State: NC Zoning Overlay: Zip Code: l l Voluntary Ag. District: No j 108--1 `O GREENFIELD Rp Assessed Acreage: �O� O WILLIAM R DAVIE Deed Date: 312012 Middle School Zone: NORTH DAVIE i Q 008861025 Soil Types: J Plat Book: 0007 i? l Q Plat Page: I [all AlidataisprovidedHIswithout warranty orguarantee of any idnd ether a p..ed.,implied Including but net limited to the Davie County, Impiledvar w sof merchantability pertness fora particular use. All users of Davie Coumys GIS webitesshall hold harmlessthe CountyofDawe, Novi Carolina,fh agentsconsuhaMa, eardraRonp employees tom anyand ail claimsor rousesofaction due to NC or arising out ofthe use orinabilhyto use the GIS data provided by this websha WARNING: THIS IS NOT A SURVEY Parcel Information Parcel Number: D301OA0012 Township: Clarksville NCPIN Number. 5822146656 Municipality: Account Number: 8300875 Census Tract: 37059-801 Listed Owner 1: JENKINS JUSTIN LEE Voting Precinct: CLARKSVILLE Mailing Address 1: 132 GREENFIELD ROAD Planning Jurisdiction: Davie County City: MOCKSVILLE Zoning Class: DAVIE COUNTY R -AR -20 State: NC Zoning Overlay: Zip Code: 27028 Voluntary Ag. District: No Legal Description: LOT 12 DUTCHMAN HILLS Fire Response District: WILLIAM R. DAVIE Assessed Acreage: 0.88 Elementary School Zone: WILLIAM R DAVIE Deed Date: 312012 Middle School Zone: NORTH DAVIE Deed Book / Page: 008861025 Soil Types: Mn82,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 AlidataisprovidedHIswithout warranty orguarantee of any idnd ether a p..ed.,implied Including but net limited to the Davie County, Impiledvar w sof merchantability pertness fora particular use. All users of Davie Coumys GIS webitesshall hold harmlessthe CountyofDawe, Novi Carolina,fh agentsconsuhaMa, eardraRonp employees tom anyand ail claimsor rousesofaction due to NC or arising out ofthe use orinabilhyto use the GIS data provided by this websha Account #: 990002600 Billed To: William Crews Reference Name: DAVIE COUNTY HEALTH DEPARTMENT n lv Environmental Health Section I° P. O. Boa 848/210 Hospital Street Mocksville, NC 27028 (336)751-8760 Tax PIN/EH #: 5822-14-6656 Subdivision Info: Dutchman Hills Lot # 12 Location/Address: 132 Greenfield Road -27028 Proposed Facility: Residence Property Size: .0889 acre ATC Number: 3499 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 .19"ewareatment nd Disposal Systems). THIS AUTHORIZATION FOR WASTEW SVAL FOR A PERIOD OFF7ARS. Environmental Health Specialist's Signature ate: 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 function satisfactorily for any given period of time. 4 ! -D4-t7e,.S -S Septic System Installed By.- Environmental y: Environmental Health Specialist's Signature: DCHD 05/99 (Revised) M IooI �P�a�.atJto l J46.J-- LI�LS P -R . T -F6-0 k ate: 22 '� __i z. Account #: 990002600 Billed To: William Crews Reference Name: DAVIE COUNTY HEALTH DEPARTMENT n lv Environmental Health Section I° P. O. Boa 848/210 Hospital Street Mocksville, NC 27028 (336)751-8760 Tax PIN/EH #: 5822-14-6656 Subdivision Info: Dutchman Hills Lot # 12 Location/Address: 132 Greenfield Road -27028 Proposed Facility: Residence Property Size: .0889 acre ATC Number: 3499 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 .19"ewareatment nd Disposal Systems). THIS AUTHORIZATION FOR WASTEW SVAL FOR A PERIOD OFF7ARS. Environmental Health Specialist's Signature ate: 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 function satisfactorily for any given period of time. 4 ! -D4-t7e,.S -S Septic System Installed By.- Environmental y: Environmental Health Specialist's Signature: DCHD 05/99 (Revised) M IooI �P�a�.atJto l J46.J-- LI�LS P -R . T -F6-0 k ate: 22 '� DAME COUNTY HEALTH DEPARTMENT I Environmental Health Section P. O. Box 848/210 Hospital Street Mocksville, NC 27028 C S 2 (336)751-8760 _ IMPROVEMENT/OPERATION PERMIT Account #:990002600 Tax PIN/EH #: 5822-14-6656 Billed To: William Crews Subdivision Info: Dutchman Hills Lot # 12 Reference Name: Location/Address: 132 Greenfield Road -27028 --Proposed Facility: Residence Property Size: .0889 acre ATC Number: 3499 **NOTE** This Improvement/Operation Permit DOES NOT authorize the construction of a septic tank system or any wastewater system. An AUTHORIZATION FOR WASTEWATEWSYSTEM 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 CONTRACCT�OR MUST SEE THIS PERMIT BEFORE INSTALLING SYSTEM. Residential Specification: Building Type 00x #People #Bedrooms #Baths 13 Dishwasher: M'� Garbage Disposal: 12" Washing Machine: 12'� Basement w/Plumbing: e Basement/No Plumbing: ❑ Commercial Specification: Facility Type /j � #,People #PeopletShift - #Seats IndustJriall Waste: 13 Lot Size D • eO I � Type Water Supply <� Design Wastewater Flow (GPD) _c� Site: New L� Repair 0 ' rr t System Specifications: Tank Size IC7GAL. Pump Tank GAL. Trench 1Width -3 Rock Depth �2 Linear Ft.� Other: aDjSQ1_��Tt� �iX�. kt�1��1 t _ 1a 1aS o.G k„Q J . Required Site Modifications/Conditions: v5 ov, IMPROVEMENT/OPERATION PERMIT LAYOUT - APPROVED EFFLUENT FILTER. RISER(S) IF 6 u BELOW FINISHEDGRADE. ****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.**** mental Health Specialist's Signature: DCHD 05/99 (Revised) LN ff I 9st „ uag ' ~ APPLICATION FOR SITE EVAIDAT10N/IMPROVEMFM PERMIT & ATC Davie County Health Department 2 EnvironmenfofHealf6SecHon D LS (� pn P.O. Box 848/210 Hospital Street U Mockeville, NC 27028 (336)751-8760 JUL 2 20()3 ***IIPORTAlM** THIS APPLICATION CANNOT BE PROCESSED UNLESS ALL AE INFORMATION -IS PROVIDED. Refer .:to the INSORMATION BULLETIN for i _7 �1MENfAL HUA 7. nae to no Dille Contact Person, 441 ��L Mailing Address .?//.S ll1O Fl 24,-- 1A% some ?hone 90"y —/7/3-57�/ I city/state/ZXP L,5, ge, ,7/05 Business vnone .7q?— MZ2 2.. Memo on Permit/ATC it Different than Above Meiling Address - City/state/sip S. Application For: ❑ Site Evaluation e. system to service: N House ❑ Mobile Rome a.•If Residence: S People 9 provemant Permit/ATC ❑ Both' ❑ Business ❑ Industry O Other i Bedrooms '_3_ s Bathrooms 3 0Sshwasher Lruasaage Disposal (Hashing Machine li'lasemant/plumbing 6. If Business/zndustrr/other: specify two - I people 13 Basesent/no Plumbing / Sinks Commodes t 8hovero # urinals • water Coolers IF FOODSERVICE: A Seats i Estimated Nater Usage (gallons per day) 7. Type of water supply: Q-County/City ❑ well ❑ Community s. Do you anticipate additions or expansions of the facWty this system 1s intended to serve? O Yes 9wo- If yes, what type? ***IMPORTANT***CLIENTS MUSTCOMPLEINTHE REQUIRED PROPERTY INFORMATION REQUESTED BELOW. Either a PLAT or SITE PLAN MUST RESUBMITTED by the client with THIS APPLICATION. Property Dimensions: to, Tax Office PIN: # Property Address: Road Name 132 (o reeve City/Zip mprISaJ14bje p�o If in a Subdivision provide Information, as f0110M. Name: tO U is h m M /L A 1. 6 Section:. Block: Lot: _ WRITE DIRECTIONS (from Mocksville) to PROPERTY: 0. Date Property Fumed: 7—/-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 we change, or If the information submitted In this application Is falsified or changed. 1,, 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 s e sulfa ty. DATE SIGNATURE THIS AREA MAYBE USED FOR DRAWING YOUR SITE PLAN (Includ all of the following: Existing and proposed property lines and dimensions, structures, setbacks, and septic locations). R BE • TROVE0 S 2 E LOT #5 3.346 AC. 455 75 _ 4 N 80 8 5 N LOT #10 4,142 AC, 19' E _. 1_0.0 LOT #13 M 1.136 AC. z LOT 1 �d 1.174 RC. a LOT 7_ 0 0.909 AC r� b o I I 1 �O' OF t o – 20 p7AINA0E 1 < EASEMENT cLDN 8D3 16'19' N _ N'155. •a i�fJ, -- ..._ 83' 16't 9• N u \G/ 2C 39. C �p 04,0 PVg1 i N 22 I I Sp• l� U - S.E. TVP. LOT #S ; N N 1.414 AC. I 1 ' N 1 � 1 o 1 _N N 8o•3g 415 E I 1 3 _2 01 x an LOT #8 b '0 1 1.181 AC. N OD 0 0 ccl C) 1 10 I!TILITV EASEMENTS80.31 .N. j 342, J O 0 N I ^ 1 0 0 0 8 W ; 1 LOT d9 1.171 AC. M I o •D Q � 1 Ai Z1 1 ''OM1 S 80•1 I 3335 9 6 92 E i w o L08 0 C. A . 1 S 80.3 o 6• E 336.66ry 1 1 I LOT #11 1.049 AC. I m 1 I 324.15 N 81'1508' ' 1 N 10• ;TILIT� 1 �—EASEMENT j LOT #1,2 c� 0.889 AC. \ 1 �\ tS83• �/rrQ��� LOT #27 CFF PdGF 9 FnP InTC 17 TunllPw 74 R BE • TROVE0 S 2 E LOT #5 3.346 AC. 455 75 _ 4 N 80 8 5 N LOT #10 4,142 AC, 19' E _. 1_0.0 LOT #13 M 1.136 AC. z LOT 1 �d 1.174 RC. a LOT 7_ 0 0.909 AC r� b o I I 1 �O' OF t o – 20 p7AINA0E 1 < EASEMENT cLDN 8D3 16'19' N _ N'155. •a i�fJ, -- ..._ 83' 16't 9• N ,. APPLICATION FOR SHE EYALUATION/IMPROYEMFNT PERMIT & ATC [Ni—� Davie County Health Department D EnOmnmentB/ Hen/M Swffon 10/�a5e .Galt' R.O. Box 868/210 Hospital Street ys /eacJ � Mockaville, HC 27028 J (336)751-8760 ***rMPORTANTe** THIS APPLICATION CANNOT BE PROCESSED UNLESS AIM TSS REQUIRED IHfORMATIOH IS PROVIDED.//��Ref�err to the IHyORMATION BULLETIN for instructions. 1. Hama to be billed _Sa_L%�-�/ n, [[j contact Parson A944 UVS Hailing address 7J /j �t®Ss lose Phone 99�'- S'GV o 9 city/state/alP AAPRrre- Ale, :?;W6 business Phone /aye,- �7eo 2. Hems on Permit/ATC It Different than Above Hailing address city/state/sip 3. Application For: lite Evaluation ❑ Improvement Permit/ATC ❑ Both s. system to services Viouse ❑ Mobile Home ❑ Business O Industry ❑ Other s. If Residence: i People I Bedrooms I Bathrooms 0 Dishwasher O Garbage Disposal O Hashing machine 0 basement/plumbing D saaemant/No Plumbing 6. if business/Industrytother, specify type I commodes e showers UcLnals I people I sink@ I water coolers Ir YWDSERVICE: (i Seats Estimated Nater Usage (gallon@ per day) 7. Type of water supply: bounty/City ❑ Well ❑ Community s. Do you anticipate additions or expansions of the facility this system Is Intended to serve? ❑ Yes ❑ No If yes, what type? ***IMPORTANT'** CLIENTS MUST tbAIPLETETHE REQUIRED PROPERTY INFORMATION REQUESTED BELOW. Either a PLAT or SITE PLAN MUST BESUBAATTED by the client with THIS APPWCATION. Property D(mensio / Rel g.5 S Tax Office PIN: A6-3�JS Property Address: Road Name �d / d !ii Yoe/ 2h ;a/ City/Zip _ Moe gyi� f P,,77ae If las a Subdivision provide Information, as follows: ,p Name: t�LL7G//// a /i /7i �IT Section: Block: Lot: WRITE DIRECTIONS (from Mocluvllle) to PROPERTY: l o/ NPs L T 9.4. iv e, A V 00tv "e Date Property Flogged: 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 plass or Intended we change, or If the Information submitted In this application Is falsified or changed I, afro, understand that I am responsiblefor all charges Incurred from this application. 1, hereby, give consent to the Authorized Representative of the Davie County Health Department to enter upon above described properly located In Davie County and owned by to conduct all testing procedures as necessary to determine the site suitsl�lity. r� THIS AREA MAY BE USED FOR DRAWING YOUR STTE PLAN (Insl96e all of The following: Existing and proposed property lines and dimensions, structures, setbacks, and septic locations), Revised DCHD (07/99) Site Revisit Charge Date('): Client Notification Date: Account No. Invoice No. - LONG-TERM ACCEPTANCE RATE 1 O• �• SITE CLASSIFICATION: ` S EVALUATION BY: LONG-TERM ACCEPTANCE RATE r)•'2;,S'O•� OTHERS) PRESENT: y REMARKS: :LEGEND 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 -Loamy sand SL'- Sandy loam. L - Loam SI - Silt SICL - Silty clay loam SIL - Silty loam CL - Clay loam SCL - Sandy clay loam Y Y Silty y . C - Clay SC -Sand clay , :SIC - Sil clay CONSISTENCE Moist _' 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 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) 1W.Tiff IT DAVIE COUNTY HEALTH DEPARTMENT '^ Environrrlental Health Section SoiVSite Evaluation APPLICANT INFORMATION PROPERTY INFORMATION Account #: 989900111. Tax PIN/EH #: 5822-14-6855.12 Billed To: Gray Potts Subdivision Info: Dutchman Hills Lot # 12 Reference Name: Gray Potts Location/Address: Eatons Church Road -27028 Proposed Facility: Residence. Property Size: 51 Acres Date Evaluated: o �' r : .. • ': -®-ems®® Water Supply: On -Site Well Community Public - Evaluation By: Auger Boring Pir Cut FACTORS 1 2 3 4 5 .' 6. 7' Landscape position Lw - Slope Slo % .. HORIZON I DEPTH 17 -1 l) - 2... .. - LONG-TERM ACCEPTANCE RATE 1 O• �• SITE CLASSIFICATION: ` S EVALUATION BY: LONG-TERM ACCEPTANCE RATE r)•'2;,S'O•� OTHERS) PRESENT: y REMARKS: :LEGEND 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 -Loamy sand SL'- Sandy loam. L - Loam SI - Silt SICL - Silty clay loam SIL - Silty loam CL - Clay loam SCL - Sandy clay loam Y Y Silty y . C - Clay SC -Sand clay , :SIC - Sil clay CONSISTENCE Moist _' 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 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) 1W.Tiff IT AM HORIZON IV DEPTH • ': -®-ems®® - LONG-TERM ACCEPTANCE RATE 1 O• �• SITE CLASSIFICATION: ` S EVALUATION BY: LONG-TERM ACCEPTANCE RATE r)•'2;,S'O•� OTHERS) PRESENT: y REMARKS: :LEGEND 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 -Loamy sand SL'- Sandy loam. L - Loam SI - Silt SICL - Silty clay loam SIL - Silty loam CL - Clay loam SCL - Sandy clay loam Y Y Silty y . C - Clay SC -Sand clay , :SIC - Sil clay CONSISTENCE Moist _' 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 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) '34/06 - � • , j g 33 06 " E ' o: 6. 66 til- E' j Z LOT # 11 s 1 . 049 AC, all NC, 324 Ir to 7Il11', t i EAS MEN t 42 1 L '57' ►� LOT ' # 12 0. 889 AC. " o d � t , / 114. c;o ry e by