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200 Greenfield Road Lot 6Davie County, NC Tax Parcel Report Monday, December 19, 2016 , � 5 126 --01 p2T G� 217 "' , ti , 0 200 0 124 W 193 Z �. W LLl i 1 --- 188 181 --� Qh�v tB t'p DNR'L WARNING: THIS IS NOT SURVEY AlldamisprvWdedasl without warranty or guarantee of any turd either expressed or Implied including but not limited to Ne Implied warranties of=ntablltty orlit ess fora partieularuse. All users of Davle County's GIS vebaNe shall hold harmless the county of Davie. North Carolina, Its agent% mnssitards, contraclms oremployees from any and all claims or causes of action due to orarising out ofthe use orinabghyto use the GIS data provided by this website. Parcel Information Parcel Number. D301OA0006 Township: Clarksville NCPIN Number: 5822156472 Municipality: Account Number: 82522757 Census Tract: 37059-801 Listed Owner 1: LAGROTTERIA PETER A Voting Precinct CLARKSVILLE Mailing Address 1: 200 GREENFIELD ROAD Planning Jurisdiction: Davie County City: MOCKSVILLE Zoning Class: DAVIE COUNTY R -AR -20 State: NC Zoning Overlay: Zip Code: 27028-4771 Voluntary Ag. District: No Legal Description: LOT 6 DUTCHMAN HILLS Fire Response District: WILLIAM R. DAVIE Assessed Acreage: 1.41 Elementary School Zone: WILLIAM R DAVIE Deed Date: 5/2004 Middle School Zone: NORTH DAVIE Deed Book/Page: 005510807 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: Qh�v tB t'p DNR'L Davie County, NC AlldamisprvWdedasl without warranty or guarantee of any turd either expressed or Implied including but not limited to Ne Implied warranties of=ntablltty orlit ess fora partieularuse. All users of Davle County's GIS vebaNe shall hold harmless the county of Davie. North Carolina, Its agent% mnssitards, contraclms oremployees from any and all claims or causes of action due to orarising out ofthe use orinabghyto use the GIS data provided by this website. Account #: 990002780 Billed To: Blake Hope Reference Name: Proposed Facility: Residence DAVIE COUNTY HEALTH DEPARTMENT Environmental Health Section P. O. Boa 848/210 Hospital Street --Mocksville, NC -27028 - - - - - (336)751-8760 IMPROVEMENT/OPERATION PERMIT Tax PIN/EH #: Subdivision Info: Location/Address: Property Size: 5822-15-6472 Dutchman Hills Lot#6 Greenfield -27028 see map ATC Number: 3708 **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 INTENDED USE CHANGE. YOUR WASTEWATER SYSTEM CONTRACTOR MUST SEE THIS PERMIT BEFORE INSTALLING SYSTEM. Residential Specification: Building Type #People #Bedrooms _ #Baths 2 - Dishwasher: Dishwasher: [Er Garbage Disposal: ❑ Washing Machine: E Basement w/Plumbing: 1:3 / Basement/No Plumbing: El Commercial Specification: Facility Type #People #People/Shift #SSeats Industrial Waste: 0 Lot Size 1A QA-�S Type Water Supply CVtiDesign Wastewater Flow (GPD) 1480 Site: New d Repair �OOD n � -- t System Specifications: Tank Size _GAL. Pump Tank GAL. Trench Width � Rock Depth � Linear Ft.J7"tt�.' Other: Required Site Modifications/Conditions: IMPROVEMENT/OPERATION PERMIT LAYOUT - APPROVED EFFLUENT FILTER RISER(S) IF 6 " BELOW FINISHEDWDE. ****NOTICE: Contact a representative of the Davie County Health Department for final inspection of this system betty 8:30 a.m. to 9:30 a.m. or 1:00 p.m. to 1:30 p4n. on 1he day of installation. Telephone # is (336)751-8760.**** L irJ 6f O -1S \ -101 �z y \ Nom, c Environmental Health Specialist's Signature: • Date: e/ F- DCHD 05/99 (Revised) C � S %6• !A UN I u.T 50' 1 j S, E. "YP. I LOT ##6 i ✓Np 1,414 AC, ► �s _co I N I C^ N . I r 344. 91 145. W In - .� -- LOT #8 ° I 1.161 AC. a� I � 342.1 0 I I r C5 0 LJ can LOT #9 _ .' APPLICATION FOR SITE EVALUATION/IMPROVEMENT PERMIT & ATC nn Davie County Health Department Dr�U Environmentnt Health Section P.O. Box 848/210 Hospital Street MAR 10 2004 Dfoalc (336) 7, -0 27028 (336)781-8760 EN it TH ***XWORTANT*** THIS APPLICATION CANNOT BE PROCESMW UNLESS ALL TRS DAVIECOUNTY INFORMATION IS PROVIDED. Refer to the INFORMATION BULLETIN for instructions. 1. Name to be Billed_ - Contact parson (� Nailing Address - 5/r+r,/� //r // Some Phone �p97 -Q City/stab/SIP ,A L,r/�.• 4' /'� x%700( ,Sinews Mesa .7! f r d If - 2. Name on Permit/ATC if Different than Above - - Nailing Address - City/state/zip - 9. AppllcetionFor: it:e'Evaluatioa ❑ Improvement Permit/ATC ❑ Both 4. system to Service: )k�9ouse ❑ Mobile Rome ❑ Business ❑ Industry ❑ Other a. If Residence: # People # Bedrows # Bathrooms dishwasher ❑ Garbage Disposal`' PeWa*bing O nasement/No Plumbing I S. If 8usinses/Industry/Other: opacify, type' #People # sinks # Commodes # Showers # Urinals # Water Coolers IF FOODSERVICE: # Seats Estimated (tater usage (gallons per day) y. Type of water supply: *County/City ❑ wall ❑ Community e. no you anticipate additions or eipanslons of the facility this system is intended to servo? ❑ Yes Avo If yes, what type? ***IMPORTANT***CLIENTS MUSTCOMPLETETHE REQVIREDPROPERTYINFORMATIONREQUESTED BELOW. Either a PLAT or SITE PLAN MUST BESUBIIIITIED by the client with THIS APPLICATION. Property Dimensions: �%k ZZ,�LX3/� k 3 �S� WRITE DIRECTIONS (from Moeh_s/v_llle) to PROPERTY: Ts:Offiice PIN: # Sr2 -7-/SP 5472- 661 A) T� Property Address: Road Name G/Cl/ &I citylzip 2-4 If If In s Subdivision provide Informstios,:as follows:. Name: /JGL�+G�t%11 �✓ /1)`//S Section: Block: 1b 3616 A - Lot: 0 ° Date Property Flagged: 3 // b 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, ifthe site pians or intended use change, or if the Information submitted in this application Is falslfled or changed I, also, understand that I an responsible jar 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 couduct all testing procedures as necessary to determine the site suitability. DATE ( D — a SIGNATURE THIS AREA MAY BE USED FOR DRAWING YOUR SITE PLAN (Include ell of the followingsdug and proposed property lines and dimensions, structures, setbacks, and septic locations). 1 gyp' ti $ #� 0 4 , s `Id APPLICATION FOR SITE EVALUATION/IMPROVEMENT PERMIT 81 ATC Davie County Health Department i r Env/ronmenfa/Hea/fhSectfon V 101,nm5 � .C���4- � P.O. Bo: 868/210 Hospital Street Z- 717 7 l - e�cJ C / �Mockeville, HC 21026 / r (336)751-8760 �-Af/ d rt: ***IM1?ORTANT*** THIS APPLICATION CRNNOT BE PROCESSED UWASS ALL HE REQUIRED IHrORMLTIOH IS PROVIDED. )q. Contact the INyDRMATIOH BULLETIN for instructiona. 1. Nage to be Milled _Cr" ry, Jf'�[S �] Contact ior.on f/ '/ ,� Mailing address n1?7.0 4ss e/ Mose show _ y 9d - .�Y Q 9 City/.tate/s1P _Lal Ub1Ne¢_ ase, .0!.;706 Business rho" 99F- �ydD s. Maw on perch/ATC it Ditterent than Above Meiling Address City/State/tip 3. Application tort t9 Site Evaluation ❑ Improvement Permit/LTC ❑ Both e. syst" to service, w6ouse ❑ Mobile Home ❑ Business ❑ Industry ❑ Other 5. If Residence: s People s Bedrooms s Bathrooms D Dishwasher O Garbage Disposal D Washing Machine D Massaaxt/plumbing D Saseaent/No pl robing S. It Business/Industry/other: specify type a People s Sinks 11 Commode- a Showers 6 urinals Nater Coolers it rOODSERVICE: # Seats Estimated Nater Usage (gallons per day) 7. Type of water supply: IS County/City ❑ well ❑ Community 5. Do you anticipate additions or expansions of the facility this system is Intended to serve? ❑ Yea ❑ No If yes, what type? 1i*IMPOR7ANT***CLIEMMUSTCIOMPLETETHE REQUIRED PROPERTY INFORMATION REQUESTED BELOW. Either a PLAT er SITE PLAN MUST BBSVBMITIED by the client with THIS APPLICATION. Property Dlmeosi65:/ ";<g g 9.3 Tax Office PIN: 06-3 Aa - fU - � 95-5, t2EJ Property Address: Road Name %d / ri tic Yo?/ 1h City/Zip_%%GEgyiL_ n/P„JWe It In a Subdivisionprovide Information, as follows: Name. '�/GGT�/�l17712 Section: Blockt Lot: WRITE DIRECTIONS (from MockrAlle) to PROPERTY: to/ A//of �-�, T /I El.� �o.� A y0Pv, e4 Date Property Flagged: 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 I, also, understand Mat 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 site suitst�lity. I , �- DATE 0^ri10-Q() THIS AREA MAY BE USED FOR DRAWING YOUR SITE PLAN property Imes and dimensions, structures, setbacks, and septic loa Revised DCHD (07/99) of the following: Existing and proposed Site Revisit Charge Client Notification Date: EHS• Account No. Invoice Na o l 'ti , SLP DAVIE COUNTY HEALTH DEPARTMENT Environmental Health Section Soil/Site Evaluation APPLICANT INFORMATION PROPERTY INFORMATION Account #: 989900111 _' Tax PIN/EH #:'5822-14-6856.06: Billed To: Gray Potts Subdivision Info: Dutchman Hills Lot # 6 Reference Name: Gray Potts Location/Address: Eatons Church Road -27028' Proposed Facility:. Residence Property Size: 51 Acres Date Evaluated: j o0 Water Supply: On -Site Well Community Public Evaluation By: Auger Boring Pit ' Cut FACTORS 1 2 3 q. -5 6 7. Landscape position Slope % HIFRIZIFN I L)EY1 Hr groupTexture Consistence Structure ®®®®®® Mineralaw---®-® • • Texture group� ConsistenceMineralogy ®®®®®® Structure ®®®®®® III DEPTH groupHORIZON Texture �►I�®®®®®® Consistence StructureMineralogy HORIZON IV DEPTH Texture group ®®®®®®® Consistence --®�®�- Structure ®®®®®®® Mineralogy LONG=PERM ACCEYI•ANCE RATE I' D.35 I SIT ECLASSIFICATIONEVALUATION BY:�K%tl� +P LONG-TERM ACCEPTANCE RATE: OTHER(S) PRESENT: �;�" .: REMARKS: ot_t4 L1.o t� Qt . . W7� (iC SCO P6 , iJ l CQL'L''ICCS) LEGEND Landscape Position R - Ridge S - Shoulder . L - Linear slope FS - Foot slope N - Nose slope C-07 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 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 - Firm VFI - Very firm EFI - Extremely firm Ib 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 OR - 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)