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
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ate:
22 '�
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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
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22
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S.E. TVP.
LOT #S ;
N
N
1.414 AC.
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1
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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
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S 80•1
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3335 9 6
92 E
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L08 0
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6• E
336.66ry
1
1
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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
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/
114. c;o
ry
e by