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132 Highland Road Lot 19Davie Countv. NC Tax Parcel Report Monday, December 19, 2016 14 144 0 131 0 132 Z '� Q — t Z 118 r 117 [0011 Ali dm Is provided as Is a oltwamrdy or guarantee of any Idnd ebhereapressed or Implied Including butnotNmlted to the Davie County, Impliedunnaiesofinerchantabilriyaridnessforaparticularuse.ANusersofDavieCounty'sGISwebsbeshallholdharmleuthe l�Coadyof Davie, North Carolina, lts agents, consultants, eonbactors ar employees fmm any and all dalms or causes of action due to NC - or arising out of the use or lnabURyto use the GIS data provided by this wehstte - WARNING: THIS IS NOT A SURVEY Parcel Information Parcel Number: D301OA0019 Township: Clarksville NCPIN Number: 5822240182 Municipality: Account Number. 82522574 Census Tract 37059-801 Listed Owner 1: STEPHENS NATHAN Voting Precinct: CLARKSVILLE Mailing Address 1: 132 HIGHLAND ROAD Planning Jurisdiction: Davie County City: MOCKSVILLE Zoning Class: DAVIE COUNTY R-20 State: NC Zoning Overlay: Zip Code: 27028-4766 Voluntary Ag. District: No . Legal Description: LOT 19 DUTCHMAN HILLS Fire Response District: WILLIAM R. DAVIE Assessed Acreage: 0.83 Elementary School Zone: WILLIAM R DAME Deed Date: 912006 Middle School Zone: NORTH DAVIE Deed Book/Page: 006800176 Soil Types: MnB2 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: [0011 Ali dm Is provided as Is a oltwamrdy or guarantee of any Idnd ebhereapressed or Implied Including butnotNmlted to the Davie County, Impliedunnaiesofinerchantabilriyaridnessforaparticularuse.ANusersofDavieCounty'sGISwebsbeshallholdharmleuthe l�Coadyof Davie, North Carolina, lts agents, consultants, eonbactors ar employees fmm any and all dalms or causes of action due to NC - or arising out of the use or lnabURyto use the GIS data provided by this wehstte - Account M 990001825 Billed To: Mike Hester Reference Name: Proposed Facility: Residence DAVIE COUNTY HEALTH DEPARTMENT Environmental Health Section P. O. Boa 848/210 Hospital Street Mocksville, NC 27028 (336)7518760 IMPROVEMENT/OPERATION PERMIT Il� Tax PIN/EH #: 5822-24-0182MH Subdivision Info: Dutchman Hills Lot # 19 Location/Address: Highland Rd -27028 Property Size: see map �TC,N'flub& 3429 **N E* s provement/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 D sa #People #Bedrooms _ #Baths 3 Dishwasher: g Garbage Disposal: ❑ Washing Machine: 011-� Basement w/Plumbing: B--�Basement/No Plumbing: ❑ Commercial Specification: Facility Type #People #People/Shift #Seats Industrial Waste: ❑ Lot Size'6-%Sj I`�Type Water Supply�%ilry Design Wastewater Flow (GPD) � Site: New L4 Repair ❑ System Specifications: Tank Size1000GAL. Pump Tank GAL. Trench Width . 3U' Rock Depth t 2 Linear Ftp_ Other: 2- �3f�1P-?0T10r3 ' C ,INSSrALL UTAOS Q'o.c.rn,Ty. Required Site Modifications/Conditions: ' of(- )VEMENT/OPERATION PERMIT LAYOUT - APPROVED EFFLUENT FILTER RISER(S) IF 6 "BELOW 3ED GRADE. ****NOTICE: Contact a representative of the Davie County Health Department for final inspection of this 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.**** z 57' DCHD 05/99 (Revised) :�' VLOMNA0 MJSr ti'- AaP IAIW rto A'Vvlb SFmoto a fvtv`P Q; QeaQ 01 Lk - & QJ w.P 10 MUd• I - Date: �/ /j -f Account M 990001825 Billed To: Mike Hester Reference Name: Proposed Facility: Residence DAVIE COUNTY HEALTH DEPARTMENT Environmental Health Section P. O. Boa 848/210 Hospital Street Mocksville, NC 27028 (336)7518760 IMPROVEMENT/OPERATION PERMIT Il� Tax PIN/EH #: 5822-24-0182MH Subdivision Info: Dutchman Hills Lot # 19 Location/Address: Highland Rd -27028 Property Size: see map �TC,N'flub& 3429 **N E* s provement/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 D sa #People #Bedrooms _ #Baths 3 Dishwasher: g Garbage Disposal: ❑ Washing Machine: 011-� Basement w/Plumbing: B--�Basement/No Plumbing: ❑ Commercial Specification: Facility Type #People #People/Shift #Seats Industrial Waste: ❑ Lot Size'6-%Sj I`�Type Water Supply�%ilry Design Wastewater Flow (GPD) � Site: New L4 Repair ❑ System Specifications: Tank Size1000GAL. Pump Tank GAL. Trench Width . 3U' Rock Depth t 2 Linear Ftp_ Other: 2- �3f�1P-?0T10r3 ' C ,INSSrALL UTAOS Q'o.c.rn,Ty. Required Site Modifications/Conditions: ' of(- )VEMENT/OPERATION PERMIT LAYOUT - APPROVED EFFLUENT FILTER RISER(S) IF 6 "BELOW 3ED GRADE. ****NOTICE: Contact a representative of the Davie County Health Department for final inspection of this 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.**** z 57' DCHD 05/99 (Revised) :�' VLOMNA0 MJSr ti'- AaP IAIW rto A'Vvlb SFmoto a fvtv`P Q; QeaQ 01 Lk - & QJ w.P 10 MUd• I - Date: �/ /j DAVIE COUNTY HEALTH DEPARTMENT Environmental Health Section P. O. Boa 848/210 Hospital Street Mocksville, NC 27028 (336)751-8760 Account #: 990001825 Tax PIN/EH #: 5822-24-0182MH Billed To: Mike Hester Subdivision Info: Dutchman Hills Lot # 19 Reference Name: Location/Address: Highland Rd -27028 Proposed Facility: Residence Property Size: see map ATC Number: 3429 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 .1900 Sewage Treatment and Disposal Systems). THIS AUTHORIZATION FOR WASTEWATER iNR VALID FOR A PERIOD OF FIVE YEARS. Environmental Health Specialist's Signature: D 6 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 guarant at the system will function satisfactorily for any given period of time. Ito 4 Y � I Septic System Installed By: Environmental Health Specialist's Signature: DCHD 05/99 (Revised) „ LIGATION FOR SITE EVALUATION/IMPROVEMENT PERMIT &ATC Davie County Health Department 2003 Environmental Health Section pp� P.O. Box 848/210 Hospital Street Mocksville, NC 27028 (336) 751-8760 ** RTANT*** THIS APPLICATION CANNOT BE PROCESSED UNLESS ALL THE REQUIRED INFORMATION IS PROVIDED. Refer to the INFORMATION BULLETIN for instructions. 1. Name to be Billed _ f11. 1` J 1LF 3 f/C/ 27W 6C /L t)l AI yLY; Contact Person r - , / 14 /�-7 h12PC/ Mailing Address rt/ L/ S L; G e% &.c,.e L,iSf Home Phone G - �/ ` / //D�� 'PA City/State/ZIP jfj-tl (/ e, J-7 C�-4 Business Phone / s7 2. Name on Permit/ATC if Different than Above Mailing Address 3. Application For: &'Site Evaluation 4. System to Service: ((Yt' Ouse S. If Residence: # People ❑ Mobile Home Dishwasher ❑ Garbage Disposal City/State/Zip Improvement Permit/ATC ❑ Business ❑ Industry # Bedrooms H Washing Machine RIB'ssement/Plumbing ❑ Both ❑ Other # Bathrooms 3 ❑ Basement/No Plumbing 6. If Business/industry/Other: Specify type - # People # Sinks # Commodes # Showers # Urinals # Water Coolers IF FOODSERVICE: # Seats Estimated Water Usage (gallons per day) 7. Type of water supply: iS <ounty/City ❑ Well ❑ Community a. Do you anticipate additions or expansions of the facility this system is intended to serve? ❑ Yes R -W If yes, what type? ***IMPORTANT*"* CLIENTS MUSTCOMPLETETHE REQUIRED PROPERTY INFORMATION REQUESTED BELOW. Either a PLAT or SITE PLAN MUSTBESUBMITTED by the client with THIS APPLICATION. Property Dimensions: 14140 k 314-0 Tax Office PIN: # S IrA4J Ile l �-J Property Address: Road Name 14 1 50 ciS d n er city/zip Ol'icdcrc. t(r�J? If in a Subdivision provide information, as follows: Name: 06f TCN M Ilvv wI LC S Section: Block: Lot: IL WRITE DIRECTIONS (from Mocksville) to PROPERTY: Date Property Flagged: Y —3 — 0 3 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 use 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 09 to conduct all atessting procedures as necessary to determine the site suitability. DATE SIGNATU THIS AREA MAY BE USED FOR DRAWING YOUR SITE PLAN property lines and dimensions, structures, setbacks, and septi_cIwA v Revised DCHD (07/99) S� all of the following: Existing and proposed EHS: Site Revisit Charge Notification Date: Account No. j 6 X57 Invoice No. � 0 �. APPLICATION FOR SITE EVALUATION/IMPHOVEMENi PERMIT &ATC D �S F1? f Davie County Health Department EnAmirmenea/HealthSectlon /�� _� P.O.p.0. Box 868/210 Hospital Street 7 fiAf? Z , Mocksville, HC 21026 (336)751-8760 ***IAII+ORTANT*** THIS APPLICATION CANNOT BE PROCESSED UNLE88 ALL HIE REQUIRED INFORMATION 18 PROVIDED. Refer to the INF =4=1011 BULLETIN for instructions. 1. Have, to be billed Contact ersn HilinAddress ?7 e/ forhonee 99-� Y�J _n _ .e City/atBusiness phone /OFF- c'1eo9 1. Har an permit/ATC it Different than Above Nailing Address City/State/lip 3. Application Por: Er1te Evaluation ❑ Improvement Permit/ATC 0 Both e. system to service, Viouse ❑ Mobile Home ❑ Business ❑ Industry ❑ other 5. xf Residences i People s Bedrooms a Bathrooms D Dishwasher D easbage Dispeeal D Hashing Machine D Easement/plumbing D ameament/No plumbing 6. I! Easiness/Industry/Others /plcity type I people a finks I Commodes a 8hovate a urinals a Mater Coolers IF FOODSERVICE: 1i Seats Estimated Water Usage lgallon■ per days 7. Type of Hater supply% 8 County/City ❑ Well ❑ Community e. Do you anticipate additions or expansions of the facility this system la intended to serve? ❑ Yes ❑ No If yes, what type? ***1MP0RTANT*** CLIENTS MUSTC10,11PLETETIIE REQUIRED PROPERTY INFORMATION REQUESTED BELOW. Either a PLAT or SITE PLAN MUST BE SUBMITTED by the client with THIS APPLICATION C.40 AV1 e Property Dlmensl0n{: / •�7 / . .3 d/L5 / WRITE DIRECTIONS (from Mockevllle) to PROPERTY: Tax Office PDN: q - ?S� PropertyAddress Rad Name I d / 4-%i YJon/ oil ;VPhvpe4 gy &%4 % 4 Clty/Zlp-%b_ GASyi �_ 10147ae H is a Subdivision provide Information, as followst / Name: /✓Gl rC �l /!% l/// Am/r, Section: Blocks Lot: /_ Date Property Flagged: _7o /W C -e IL6 +yxCC-n e This b to certify that the Information provided Is correct to the best of my knowledge. I understand that any permll(s) Issued hereafter are subject to suspension or revocation, If the site plane or Intended ase change, or If the Information submitted In this application is falsified or changed 1, also, understand that lam responsible for all charges Incurred frons this application. I, hereby, give consent to the Authorised 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 Euitshility. DATE 5�—r2A9-60() THIS AREA MAY BE USED FOR DRAWING YOUR SITE PLAN ([net sill of the following: Existing and proposed property lines and dimensions, structures, setbacks, and septic locstl Revised DCHD (07/99) Revisit Charge I Client Notification Date: EHS• Account No. Invoice No. .. •��,., arty DAVIE COUNTY HEALTH DEPARTMENT ` Environmental Health Section Soil/Site Evaluation.. APPLICANT INFORMATION PROPERTY INFORMATION Account #: 989900111 Tax PIN/EH #: 5822-146 _ 855.19... • Billed To:, Gray Potts • Subdivision Info: Dutchman Hills Lot # 19 Reference Name: 'Gray Potts Location/Address: Eatons Church Road -27028 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 q 5 6 7 Landscape position . Slo % HORIZON I DEPTH . • ... . Texture group Consistence Structure Mineralogy HORIZON II DEPTH - Texture groupL G' Consistence i - Structure Mineralogy 'HORIZON IH DEPTH . .Texture group Consistence Structure Mineralogy t' . HORIZON IV DEPTH Texture group- ..... Consistence -Structure. Mineralogy SOIL WETNESS .. . RESTRICTIVE HORIZON SAPROLITE CLASSIFICATION LONG-TERM ACCEPTANCE RATE/ SITECLASSIFICATION: EVALUATION BY: LONG-TERM ACCEPTANCE RATE:OTHER(S) PRESENT: REMARKS: LEGEND .._ Landscape Position : • on 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 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) ii■ MEN 07 5. 82 3 h 9'48 i 260. 00 1 � r25 ____ __ •w ' OT # e . /O� ► 836 ACI ' csLOT #18., 0.835 AC. d. M. 3' o 5 81 ' 39148• E . 00 A#24 33 AC. a cn o C LOT # 19 0 04835 AC. op� UTILITY a . . '1f CISvi Z EASEMENT � 3948 E ^ 2 UTILITY 60. 00 • EASEMENT ' I . ---- . _ W00 0 40' 23 j q TYP. BUILDING SET-BACKS a 09cs LOT :#20 -� 01835 AC:` I CD `* U . r . -