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108 Landis Court Lot 36(- Davie Countv. NC Tax Parcel Report Monday. December 19.2016 �2T 145 O� cR` FFNF�F<0 RD 01 V ,off` -----111 ----- [all WARNING: THIS IS NOT A SURVEY All data to provided uisrimoulwemanly or guarantee of any hind elthereapeaaed or implied including butnutlimited to Me impliedmrrantiu fdof merchantability or nessfor a partise. cularuAll uaero of Davie CounlysGlSwebsife shall hold harmlessMe County of Davie, Novi Carolina,gaagent% consultands, contractors oremplaye shun anywriaidaimsorcausesofactiondueto or arising out of the use or inability to use the GIS data provided by this webche. Information Parcel Number: D301OA0036 Township: Clarksville NCPIN Number: 5822142599 Municipality: Account Number: 6303644 Census Tract: 37059-801 Listed Owner 1: HEAFNER ALEX LEE Voting Precinct: CLARKSVILLE Mailing Address 1: 108 LANDIS COURT Planning Jurisdiction: Davie County City: MOCKSVILLE Zoning Class: DAVIE COUNTY R-20 State: NC Zoning Overlay: Zip Code: 27028 Voluntary Ag. District: No Legal Description: LOT 36 DUTCHMAN HILLS Fire Response District: WILLIAM R. DAVIE Assessed Acreage: 0.99 Elementary School Zone: WILLIAM R DAVIE Deed Date: 6/2014 Middle School Zone: NORTH DAVIE Deed Book/Page: 009610267 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: [all Davie County, NC All data to provided uisrimoulwemanly or guarantee of any hind elthereapeaaed or implied including butnutlimited to Me impliedmrrantiu fdof merchantability or nessfor a partise. cularuAll uaero of Davie CounlysGlSwebsife shall hold harmlessMe County of Davie, Novi Carolina,gaagent% consultands, contractors oremplaye shun anywriaidaimsorcausesofactiondueto or arising out of the use or inability to use the GIS data provided by this webche. DAVIE COUNTY HEALTH DEPARTMENT e Environmental Health Section P. O. Boa 848/210 Hospital Street Mocksville, NC 27028 II / (336)751-8760 Ipc6 -4f)d) S t �3-010-�O-03(r Account #: 989900111 Tax PIN/EH #: 5822-14-6855.36 Billed To: Gray Potts Subdivision Info: Dutchman Hills Lot # 36 Reference Name: Gray Botts b 1 wa.- CRAWS Location/Address: Eatons Church Road -27028 ATC Number: 3712 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 CON N IS ALID FOR A PERIOD OFF YEARS. ital Health Specialist's Signatur . Date: 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. �%�lz-DAl`iZ 10 -17 Septic System Installed By: Health Specialist's Signature DCHD 05/99 (Revised) DAVIE COUNTY HEALTH DEPARTMENT Environmental Health Section P. O. Boa 848/210 Hospital Street Mocksville, NC 27028 (336)751-8760 IMPROVEMENT/OPERATION PERMIT �3-0(b-A(�-C31 Account #: 989900111 Tax PIN/EH #: -5822-14-6855.36 - -- - Billed To: Gray Potts Subdivision Info: Dutchman Hills Lot # 36 Reference Name: Gray -Potts Wrtirew.dk=u3S Location/Address: Eatons Church Road -27028 Proposed Facility: Residence Property Size: 51 Acres ATC Number. " 3712 **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 �WSE #People #Bedrooms 3 #Baths _ Dishwasher: 13' Garbage Disposal: ETf Washing Machine: Basement w/Plumbing: Basement/No Plumbing: ❑ Commercial Specification: FacilityType #People— #People/Shift #Seats Industrial Waste: ❑ Lot Size ^ QCaV- Type Water Supply t3 Ji7 Design Wastewater Flow (GPD) 3(00 Site: New Repair ❑ System Specifications: Tank Size 1 O� GAL. Pump Tank GAL. Trench Width � Rock Depth 12 �� ft�fil� Linear Ft. Other: 4 �t�7�� Required Site Modifications/Conditions:LLi , to& ,O 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.**** �j Environmental Health Specialist's Signature: DCHD 05/99 (Revised) Date: 1 LOT #37 s N 6. 42 . S.E. nP. C> rr .� LOT #36 0 �- 0, 998 AC, i 10' uriurY EASEMENT 1 25359"� s• e �/ o ��° f ,� / LOT o QJ��CZ 0. 69: CD CI C:> #36 o j 0, 925 AC. v S 79. z / 020 s; .CR . � - v � 244. 35 �UUC� uu MAR (2 8 2004 O1 LIGATION 1`011 SITE CVALUATION/IAIPIIOVBIL•N'I' IIEIIA'Il7'�iU1L Davie County Health Department UUU MAS Envi,-DnoJenta/Hea/tb Section 2 200 ENVIROW ENTALHEAUH P.O.Dox 040/210 Hospital Street' 4 DA 1E COUNTY Mocksville, PIC 27020 fM/ROIyM (336)751-0700 VA41f AINfgt� ***IbIPOILTANT*** THIS APPLICATION CANNOT DL•' PROMSSL•'D U14LESS ALL TILE REQUIRED INFORMATION IS PROVIDED. Refor to. the INFORMATION BULLETIN for instructions. 1. Name to be Dilled r Con LacL Peraon Mailing hddreaa V D / Ilona Phone City/State/ZIP g e %d 1`j Duuincas Phone I. Name on Parmit/ATC if Different than Above /, ,(,/: 41, Mailing Address � Ciity��/StaLo/Zip 1. Application For. �& SSiite Evaluation C1-Improvemcu L• Penni L -/ATC ❑ Both 4. spatem to service: IK Aoune ❑ Mobile Home ❑ Business ❑ Industry ❑ Othcr-- ti S. Type aystem requested: ❑ Conventional ❑ conventional modified ❑ iunova Live 6. Iff /Residence:,,�/� 0 People �. a Bedrooms a Bathroonu J _ ZDiahwaaher �Garbago Disposal L�Washing Machina 17Danement/Plwnbing ❑Danement/No Plumbing 7. If Duainooz/Induatry /Other: verify type 11 People I1'Sinks Y Commodca !!,Showers- 0 Urinaln 11 (Yater Cooloru IF FOODSERVICE: It Seats Estimated Water Usage (gallono par day) a. Type of water supply: 8'County/City ❑ Well ❑ Colununil-y 9. Do you anticipate additions or expansions or the racilily this syslcul is Intended to serve? ❑ Yes u iryes, what type? ***IAIPORT,iIY2*** CLIENTS nlUST conirLBTZTIIE RGQu//(GU I'lioPlilrrY lNl oltnh1110(V ILL QuliS riiU BELOW. Eidler i PLAT' or S1TL•• PLAN dIUSTDGSU/ir17/TTr;D by the clicnl wiffi T dIS APPLICATION Property Dimensions: WRITE DIREC170NS (from Alucicsvilic) (Ij PIt019;1 I'1': Tax Office PIN: it �8 —) ; /,-It -6 rS 51:31 6 p G 1 pJ .ho Property Address: RoadNamc City/Zip If in a Subdi�div��isiooll provide fnforn z1ionj, as follows: Nan lc' _VG/1 /yl q i✓. i �/- Scclion: _L- Block: Lotp Date home corners flagged: par 6w, 3I 1(p This is to certify that the information provided is correct to the best of my knowledge. I understand that any permi((s) issued hereafter arc subject to suspension or revocation, if the site plans or intended use change, m• if the hirorniallon subliniticd' in this •application is L•dsificd ur changed. 1, also, understand Illar I [lilt responsible for all cluugas incurred.jranl skis allplicativa. I, hereby, give consent to the Authorized Representative of the Davie Cuunly 1I a1tll Dep:u•hucu( to enter upon above described property located in Davie County and owned by to conduct all tes(ing procedures as necessary to detcrnniue the site suit' ilio'. DA'1'l_�3— %6�'®V SIGNATUL�� A/� THIS AREA MAY BE USED TOR DRAWING YOUR SITE PLAN property lines and dimensions, structures, setbaclu, and septic loca Sign given all of the following: Existing and prop used Site Revisit Charge ll:llc(s): Client Nolificatiol Date: Account No. APPLICATION FOR SITE EVALUATION/IMPROVEMENT PERMIT & ATC r IVDavie County Health Department EnPlronmentaf Health SftWon P.O. Bo: 868/210 Hospital street Z'�7 Mocksville, HC 27028 (336) 751-8760 ***IWC7RTANT*** THIS APPLICATION CANNOT BE pROCEBBBD UNLESS ALL 1101 REQUIRED INFORIMION I8 PROVIDED. Refer to the INFORMLTION BULLETIN for instruotions. Name 1. Hato D. Di11ed}9.),/ )9 / Content person Hailing Address �dled' ss d Ease phone ci.99p1 ty/state/izp _[�{ Ud1NGe- J�L %Ddne 6 Business Rho" 2. Hasa on vomit/ARC is Dieeerent than Above Hailing Address city/state/sip 3. Application Tors E9 H to Evaluation ❑ ImPVcV-meat Permit/ATC ❑ Both e. syst" to serape, P-Honse ❑ Mobile Rome ❑ Business - ❑ Industry ❑ Other a. If Residence: # People # Bedrooms # Bathrooms D Dishwasher D Garbage Disposal D Washing Machine D Basesent/slusbing. a Basesnnt/wo slushing 6. xe BuelMea/Industry/OWerl epeoiey type a people 6 Sinks # Coaaodea # showers # Urinals # Water Coolers IP I'OODSERVICE: # Seats Estimated Water Usage tgallons per day) 7. Type of water supply: bounty/City ❑ Well ❑ Community e. Do you anticipate additions or expansions of the facility this system 1s Intended to serve? ❑ Yes ❑ No If yes, what type? ++*IMPORTANT+++ CLIENTS MUSTCOMPLETETHE REQUIRED PROPERTY INFORMATION REQUESTED BELOW. Either a PLAT or SITE PLAN MUST BESUBMITMED by the client with THIS APPr.ICAT:nN_ Property DimemioBi- .'.;' .'g 9.3 Tax Office PIN: A_ - W -�50 Property Address: Road Name fo d 1 411J ,041 ?A I)-) Clty/Zip_%%D If In a Subdivision provide Information, as follows: Name: Vul—e 1 rntJ1j Section: Block: Lot: '740 WRITE DIRECTIONS (from MockWile) to PROPERTY: 40/ /1/EA' 77 -fl/.c-Mogi 64 IV ±4;/ LIN Date Properly 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 use change, or If the information submitted In this application Is falsified or changed [,also, Understand that I am responsible jar aN charges Incurred from this application. I, 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 saitsWity. DATE_ 2,9 THIS THIS AREA MAY HE USED FOR DRAVMG YOUR SITE PLAN (Inc a all of the following: Existing and proposed property Tina and dimensions, sirsct,res, setbacks, and septic locedo ; Revised DCHD (07/99) Site Revisit Charge I Client Notification Dale: EHS: Account No. //- /_ Invoice No. DAME COUNTY HEALTH DEPARTMENT #`3 Environmental Health Section .. Soil/Site Evaluation APPLICANT INFORMATION. PROPERTY INFORMATION .: 1 xP Account #: 989900111 Ta IN/EH #:.5822-14-6855.36 Billed To: Gray Potts Subdivision Info. Dutchman Hills Lot `Reference Name: Gray Potts Location/Address: Eatons Church Road 'i0 8 PropY• osed Facilit • Residence' Property Size: 51 Acres 'Date Evaluated: 3 Da Water Supply: On -Site Well Community Public Evaluation By Auger Boring Pit l Cut FACTORS .1 '. 2 g 4; S ( 7 Landscape position L Slope % .... S HORIZON I DEPTH _ L p Texture group Consistence C SS Structure Mineralogy. V.11 HORIZON II DEPTH Texture groupCi Consistence. S Structure �K Mineralogy HORIZON III DEPTH - 30 2 53 - Texture group Consistences5 of Structure: Mineralogy HORIZON IV DEPTH Texture'group Consistence Structure Mineralo SOIL WETNESS RESTRICTIVE HORIZON , SAPROLITE . CLASSIFICATION S LONG-TERM ACCEPTANCE RAT U. 3a SITE CLASSIETCATION:�S EVALUATION BY: 1��J r IIIC tQG^� LONG-TERM ACCEPTANCE RATE: © OTHER(S) PRESENT: REMARKS: LEGEND _ Landscape Position R - Ridge S - Shoulder. L - Linear slope FS - Foot slope N - Nose slope CV Convex sloe T -Terrace p p FP - Flood plain H - Head slope CC - Concave sloe - Texture S - Sand LS - Loam sand SL - Sand loam ., . Loamy y L -Loam SI -Silt • b 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 - Extreme[ firm Wet NS -Non sticky i 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 Mineraloev 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)