188 Greenfield Road Lot 8Dau
. . I
A16
WARNING: THIS IS NOT A SURVEY
All data Is provided as is without warranty or guarantee of any kind either expressed or implied Including but not limited to the
Implied vrarrandes of merchantability or gmessfor a pardcularuse Ali users of Davie County's GIS website shall hold harmless the
[all
NC
Parcel Information
Parcel Number.
D301OA0008
Township:
Clarksville
NCPIN Number:
5822156274
Municipality: -
Account Number.
8306763
Census Tract:
37059.801
Listed Owner 1:
BOLAND JOEL
Voting Precinct
CLARKSVILLE
Mailing Address 1:
188 GREENFIELD ROAD
Planning Jurisdiction:
Davie County
City: MOCKSVILLE
Zoning Class: DAVIE COUNTY R -A R-20
State:
NC
Zoning Overlay:
Zip Code:
27028
Voluntary Ag. District:
No
Legal Description:
LOT 8 DUTCHMAN HILLS
Fire Response District:
WILLIAM R. DAVIE
Assessed Acreage:
1.18 Elementary School Zone:
WILLIAM R DAVIE
Deed Date:
8/2016
Middle School Zone:
NORTH DAVIE
Deed Book/Page:
010270461
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:
Davie County,
All data Is provided as is without warranty or guarantee of any kind either expressed or implied Including but not limited to the
Implied vrarrandes of merchantability or gmessfor a pardcularuse Ali users of Davie County's GIS website shall hold harmless the
[all
NC
County ofDavie. Nath Carolina, Ns agentsconsuMzms, wnbactas or employeea from any and all chime oreauses ofacgon due to
or arising out of the use or lnabillty to use the GIS data provided by this website - ..
Account #: 990003176
Billed To: Jeff Hayes
Reference Name:
ATC Number. 3757
DAVIE COUNTY HEALTH DEPARTMENT 1 -°
Environmental Health Section
P. O. Boz 848/210 Hospital Street
Mocksville, NC 27028
(336)751-8760
Tax PIN/EH #:
5822-14-6855.08 JH
Subdivision Info:
Dutchman Hills Lot # 08
Location/Address:
601/Eaton Ch. Rd. -27028
AUTHORIZATION FOR WASTEWATER SYSTEM CONSTRUCTION
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 ONUC ION IS'VALID FORA PERIOD O FIVE YEARS.
ital Health Specialist's Signa e: Date:
r
CERTIFICATE OF COMPLETION
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.
l/Ot xsta,wlZ`�
e p
MQ$u`. IoQLAe
T4aL DA T& `i -J
Septic System Installed By: _
Environmental Health Specialist's Signature : _
DCHD 05/99 (Revised)
to y
It G
ell,
J
DAVIE COUNTY HEALTH DEPARTMENT
Environmental Health Section /%�
P. O. Boz 848!210 Hospital Street
Mocksville, NC 27028
(336)751-8760
IMPROVEMENT/OPERATION PERMIT
Account #:
990003176
Tax PIN/EH #:
5822-14-6855.08 JH
Billed To:
Jeff Hayes
Subdivision Info:
Dutchman Hills Lot # 08
Reference Name:
Location/Address:
601/Eaton Ch. Rd. -27028
Proposed Facility:
Residence
Property Size:
see map
**NO 1(;*'lhislmprovement/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 1I 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 PERMIT BEFORE INSTALLING SYSTEM.
Residential Specification: Building Type 6L✓#Peeople #Bedrooms 3 #Baths 3
Dishwasher: d Garbage Disposal: 12Washing Machine: Gr"
Basement w/Plumbing: Ga/ Basement/No Plumbing: ❑
Commercial Specification: Facility Type #People #People/Shift #Seats Industrial Waste: ❑
Lot Size /\Ckas Type Water Supply CW10TYDesign Wastewater Flow (GPD) Site: New 19 Repair ❑
Z&;'
„ �
System Specifications: Tank Size loco GAL. Pump Tank GAL. Trench Width 3fo Rock Depth 12 Linear Ft.3so
Other: 3 �11Sr(L6\7rlt�S t 1cS5VtL LI�JtS C1tp'C. �bJ.
- t
1:&
Required Site Modifications/Conditions:
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.****
4 1 •\ _/
15' ST`
Cn01 IS`
Environmental H th Specia e:
DCHD 05/99 (Revised)
t �'y-1211
Fj
0
Date: 11422 OAF
APPLICATION 1:011 SITE LVALVATION/Ih1P11011alEMf
Davie County Health Department
Env1r0flmenta/Hee/t/1 Section
-.P.O. Dox 848/210 Hospital Stre�
Mockaville, NC 27028
(336)751-8760
RSH 1 9-2004
***IFIPORTANT*** TRIS APPLICATION CANNOT,BE. PROCESSED UNLESS ALL THE REQUIRED
INFORMATION IS PROVIDED. Refer to the INFORMATION BULLETIN for instructions
1.
Name to be Dilled
A7,/��y�,`S/J�� Contact• Pcraon
�/d
�/L�i�'y
Mailing Addross/A-�/,"//✓1 /G/ /'4'IJ liana Phone
—..
-t0
/
City/State/ZIP Agpy''"Iez /✓ (— `��4 DuaineaD Phone
......... -.
2.
Name on Permit/ATC if Different than Above
-
Mailing Addroas - City/State/zip
" J.
Application For: ❑ Site Evaluation XImprovement- Permit/ATC ❑ Both
4.
system to Service: ex House ❑ Mobile Home ❑ Businebn ❑ Industry ❑ Other
S.
U,
Type system requeated;� Conventional ❑ conventional modified ❑
.innovative
6.
It Residence. It People • - - 6 Bedrooms •
II BnLhr00111
XDishwasher ❑Garbage Dispoaal Washing Machino )1Bascinent/l+lunb1ng
❑Dazoment/No ". Pluwbing
7.'
'If Dusinoas/Induatry /other: verify type '4 People
6'Sinlcs '__
S Commodea tt Showers tt Urinals
Q IVa t'CL" COOL el'J
'IF
FOODSERVICE: 0 Seats - Estimated Water Usage (gallona par -day)
S.
Typeof water supply County/City - ❑ Well
❑ ,Colmnunity
9. Do you anticipate additions or expansions or the racaity this system is in(Cnded to serve?sa,yes ❑ No
Ifycs,ivhattypc? 6.45eln-e 7l Wi6L Qi40/+14jeD /) �r
C�4jN
*"IMPORTirMP"CLIENTS AIUSTCOAVILBTETIdii REQUl/fBOI'it0flslt'1'Y1N1tOKl1(A'ffON1t000liSCh:U TI
BELONV. Either PLAT orSITE PLAN AIUSTBESU11t1fn-FED by the clic tt n•ilh'111IS APPLICA'T'ION.
Ll"
yojtci•ly llitticnsions: - 1VRITL DIREC'T'IONS (rrum piud:sville) it, fIt(1PIiH'1'1':
1 u,OfGce PIN: - Il
3015crty Athlress: Road Name
City/Zip
If in i bdivisioll provide information, as follows:
Ni,,,e• /7»��hma%/ /�� //S n // '/
Section: Block Lot: 8 C h0121C COrllcrS flagged:
This is to certify that the information provided is correct to the best of my kilotivlcdge. I understand that any perwil(s)
issued hereafter are subject to suspension or revocation, if the site plans or intclidcd use change, or if the Enlornia(ion
submitted in this applicaliou is faBifled or changed. 1, also, uittldtstand thall alit respollsiblefat• all o1„nb ds I,lenrr,.11.j,-,;h, -
tklsapplicarion. I, hereby, give consent to the Authorized Representative of the Davie Cuill, ty I1ca1(111)cp:1•(tticu( -
to cuter upon above described liroperty located in Davie County and ulva b), _
to "conduct all testing procedures as necessary to detavlinc lllc site suite (y,
DATL lG SIGNATUI
TIiIS AREA MAY BE USED FOR DRAWING YOUR SITE; PL (Include all of the follolviug: Existing :old proposed
property lines and dimensions, structures, setbacks, and septic locations),
Site Revisit Charge
Sig„ given
Revised DCIIn M101
Datc(s):
ClicutNotification Date:
EIIS: `
Account No. 3i 7 G
13 5
:%
Davie County, North Carolina Spatial Data Explorer Pagel of 2
Spatial Data Emmpf@rer
QN(3Caralina
Click on the Map to: Map Li
0 zoomin 0 ZoomOut O Recenter Map 0Identify: PafCBIS ! Draw L
Zoom Factor.: O Radius Search (feet)'O F,3ndary
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F... 1
4
Parcel Data
Find Adjoining Parcels
• County to: D301OA0008
• Account Number.82515152 -
• PIN:5822156274 _
• Legal 1:LOT 8 DUTCHMAN HILLS -
• Owner Name: CANA GROUP LLC
• Owner/Address 1: CANA GROUP LLC
• Owner/Address 2:
• Owner/Address 3: 1870 UNDERPASS ROAD
• Cfty,State Zip: ADVANCE ,NC 27006 - 0000
• Land Value: $12,000.00 -
• Building Value: $0.00
•
Land Unit /Type: D301 OA0008 :1 LT
•
Deed BoolvPage: 00335 / 0341
•
Dead Date: 2000/05126
•
Sales Prim: $0.00
•
Pmperty Address:
000188 000188 RD
•
County Zoning: R-20
•
Census Code:
•
City Code:
•
Fire District.
•
Flood Zone: ZONE X .
•
Flood Community: 370308
- •
Flood Panel: 0025 C
- •
Flood Map Date: 12-17-1993 '
1
SE
Census Tra
City Bound
County Zor
M Syl
E911 Fire D
Flood Pane
F] Flood Zone
Qve Parcels
School Dial
MDltj Syi
Solis
Town Zonh
❑ Townships
Multi Syl
Q Voting Pre(
Driveways
❑ Rail Lines
❑ Street Cent
Q USINC Will
Multi Syl
L
h
Aerial Phot
❑ Creeks and
E911 Addrf
Fire Depart
E] Schools
Draw L
MAP Cl
i nis map is prep;
inventory of real I _
within this jurisdic
compiled from reg
plats, and other I:
and data. Users(
hereby notified th
http://66.208.132.254/servleticom.esri.esrimap.Esrimap?name=Davie&Cmd=sParcel2&N... 4/17/2004
'[ APPLICATION FOR SHE EVALUATION/IMPROVEMENT PERMIT A ATCr ^
Davie County Health Department D �'
Envlronmenfa/Nealtb Seallon
4 � P.O. Boz 849/210 Hospital Street ?—� %
A/ Mocksvills HC 27025
le`cJ (336) 751-8760
***ZMPCRTANT*** THIS APPLICATION CANNOT BE PROCESSVD UNLESS ALL INM REQUIRED
IHyOT4&TIOH IS PROVIDED. Refer to the IHMPMATION BULLETIN for instructions.
1. Nava to be billed Ck Contact Person J
Flailing Address Rose phone 9G9+S1- S'416'9G
_
City/state/zx i� "Iyee_ Ale, e27oaB business phone pl7eo
a. Nass on Permit/ATC i! Different than Above
Moiling address City/State/Rip
3. Application Tor: Er ite Evaluation ❑ Improvement Permit/ATC ❑ Both
a. system to Service, )House 0 Mobile Home ❑ Business 0 Industry ❑ Other
S. If Residence: a People s Bedrooms s Bathrooms
D Dishwasher D Garbage Dispaaal D Nothing Machine D Saeement/plumbing D basemant/No Plumbing
S. I! business/Industry/others Speoiry two
e Coamodea a Showers a urinals
e People a Sinks
e Nater Coolers
Ir TOODSERVICZ: II Seats Estimated Yater Usage (gallons per day)
7. Type of Nater supply: bounty/City D well 0 Community
e. Do you anticipate additions or expansions of the facility this system is Intended to serve? 0 Yes ❑ No
If yes, what type?
***IMPORTANT***CLIENTS MUSTCOAWLETETHE REQU/REDPROPERTY INFORMATION REQUESTED
BELOW. Either a PWT or SITE PLAN MUST BESVBMITTED by the client with THIS APPLICATION.
Property Dlmensioa. ' /6/e%! 5
Tax Office PBV: N ," N
Property Address: Road Name 11 d / :i %:t yn41
City/zip 4& svI r1C.'j70gV
If in a Subdivision
/provide Information, as follows:
Name•
Section: Block: Lot:
WRITE DIRECTIONS (from MockrAlle) to PROPERTY:
1,0/ A/0A'A T Etc iv e, A
� 1
Date Property Flagged:
This Is to certify that the Information provided IS correct to the beat of my knowledge. I understand that any permit(,)
Issued hereafter are subject to suspension or. revocation, If the site plans or intended as change, or If the Information
submitted In this application is felelfied or changed. 1, also, understand that I am responsible for 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 property located in Davie County and owned by
to conduct all testing procedures as necessary to determine the site sultak"Ity.
THIS AREA MAY BE USED FOR DRAWING YOUR SITE PLAN
property lines and dimensions, structures, setbacks, and septic loci
Revised DCHD (07/99)
0�- �`'
all of the following: Existing and proposed
0
Site Revisit Charge
Date(s):
I Client Notification Date:
EHS•
Account No.
Invoice No.
DAVIE COUNTY HEALTH DEPARTMENT
Environmental Health Section
Soil/Site Evaluation
APPLICANT` INFORMATION PROPERTY INFORMATION
Account #: 989900111 Tax,PIN/EH #: 5822-146855.08 .
Billed To: Gray Potts Subdivision Info: Dutchman Hills Lot # 8
Reference Name: Gray Potts Location/Address: Eatons Church Road -2 0
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 5 6 7-
Landscape
.Landsca a position
Slope % 470
HORIZON I DEPTH - Ito
D '
Texture rou +
Consistence .. S
Structure
Mineralogyl
HORIZON II DEPTH ..
Texture group
Consistence rS$
Structure
Mineralogy
1:
HORIZON III DEPTH -
Texture group
Consistence
Structure
Mineralogy
' . HORIZON IV DEPTH
Texture group
Consistence
Structure
Mineralogy1
SOIL WETNESS .
RESTRICTIVE HORIZON
SAPROLITE
CLASSIFICATION
LONG-TERM ACCEPTANCE RATE 3 O•
SITE CLASSIFICATION: S EVALUATION BY:
LONG-TERM ACCEPTA
NCE RATE: OTHERS) PRESENT:
REMARKS: Ufn) -in) WA.i��I�L t9F ..LOTS (iDMPL`)( TOFa Int W&OD-S
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
SC - Sandy clay SIC - Silty clay C - Clay
CONSISTENCE
Moist ''
VFR - Very friable FR - Friable FI - Finn 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)