146 Landis Court Lot 32Day.
016
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WARNING: TIHS IS NOT A SURVEY
All data Is provided as la withadwamldy, or guarantee of any Idnd ekha expressed or Implied Inducting but not Ilmked to the
Implied wamantles of memhardabilky or fitness for a parkcularuse. AU users of Davie county's GISwebsite shell held harmless the
County a Davis, Nath Carolina, Its agents, wnwhada, mrntradas or employees from any and all dalms or causes aaction due to
or adsing od ofthe use or lnabifdy, to use the GIS data provided by this websth, --
Parcel Information��.
Parcel Number.
D301OA0032
Township:
Clarksville
NCPIN Number:
5822133906
Municipality:
Account Number.
6302310
Census Tract:
37059-801
Listed Owner 1:
SHULAR STANLEY
Voting Precinct:
CLARKSVILLE
Mailing Address 1:
146 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 32 DUTCHMAN HILLS
Fire Response District:
WILLIAM R. DAVIE
Assessed Acreage:
0.89
Elementary School Zone:
WILLIAM R DAVIE
Deed Date:
6/2013
Middle School Zone:
NORTH DAVIE
Deed Book / Page:
009280938
Soil Types:
MnB2
Plat Book:
0007
Flood Zone:
Plat Page:
0190
Watershed Overlay:
DAVIE COUNTY
Outbuilding & Extra
Building Value:
Freatures Value:
Land Value:
Total Market Value:
Total Assessed Value:
9aate
nUUN't�
Davie County,
NC
All data Is provided as la withadwamldy, or guarantee of any Idnd ekha expressed or Implied Inducting but not Ilmked to the
Implied wamantles of memhardabilky or fitness for a parkcularuse. AU users of Davie county's GISwebsite shell held harmless the
County a Davis, Nath Carolina, Its agents, wnwhada, mrntradas or employees from any and all dalms or causes aaction due to
or adsing od ofthe use or lnabifdy, to use the GIS data provided by this websth, --
ATC Number: 3769
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 Treatipent and Disposal Systems). THIS
AUTHORIZATION FOR WASTEWATER CONS IS V4LID FOR A PERIOD OF FIVE YEARS.
Environmental Health Specialist's Signature: Date:
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.
Septic System Installed By:
Environmental Health Specialist's Signature
DCHD 05/99 (Revised)
Date:
/
DAVIE COUNTY HEALTH DEPARTMENT
`
Environmental Health Section
P. O. Boa 848/210 Hospital Street
Mocksville, NC 27028
(336)751-8760
Account #: 990003176
Tax PIN/EH #:
5822-13-3906
Billed To: Jeff Hayes
Subdivision Info:
Dutchman Hills Lot # 32
Reference Name:
Location/Address:
Landis Court -27028
Proposed Facility Residence
Property Size:
see map
ATC Number: 3769
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 Treatipent and Disposal Systems). THIS
AUTHORIZATION FOR WASTEWATER CONS IS V4LID FOR A PERIOD OF FIVE YEARS.
Environmental Health Specialist's Signature: Date:
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.
Septic System Installed By:
Environmental Health Specialist's Signature
DCHD 05/99 (Revised)
Date:
DAVIE COUNTY HEALTH DEPARTMENT
Environmental Health Section —2,
P. O. Boa 848/210 Hospital Street
Mocksville, NC 27028
(336)751-8760
r'
IMPROVEMENT/OPERATION PERMIT
Account #: 990003176 Tax PIN/EH #: 5822-13-3906
Billed To: Jeff Hayes Subdivision Info: Dutchman Hills Lot # 32
Reference Name: Location/Address: Landis Court -27028
Proposed Facility Residence Property Size: see map
ATC Number: 3769
**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 1 I 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 fl ` >_ #People #Bedrooms --f:> #Baths �—
Dishwasher: Garbage Disposal: ❑ Washing Machine: 13"� Basement w/Plumbing: ❑ Basement/No Plumbing: ❑
Commercial Specification: Facility Type #People _ #People/Shift #Seats Industrial13JWaste:
Lot Size �.�� Q`"LE \ Type Water Supply�� Design Wastewater Flow (GPD) ZUV Site: New Repair ❑
System Specifications: Tank SizeL0CY'AL. Pump Tank _ GAL. Trench Width 3to C Rock Depth 1Z' LinearFt.
Other: 3 S eV 77fJ I�7i9,/�s
Required Site Modifications/Conditions: )rSrALL GO.JTO> eFF FI.`tx
IMPROVEMENT/OPERATION PERMIT LAYOUT - APPROVED EFFLUENT FILTER. RISER(S) IF 6 - 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.****
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Environmental Health�peciah 's Signature: Date: 5
DCHD 05/99 (Revised)
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APPLICATION P011 SITZ• EVALUATION/Ih111110 hIENT PLlilli11•
Davie County Health Department
ED vi�onmenta/Hen/ih Section
P.O. Bole 848/210 Hospital. Street.
Mockaville,.NC 27028. i
(336)751-87d0
UUN l7
***IOIPORTANT*** THIS APPLICATION CANNOT Dl PROCESSED U21LESS ALL THE REQUIRED
-INFORMATION IS PROVIDED. Refer be the INFORMATION BULLETIN for instructions
1. Time to be Billed Contac L Person _
Mailing Address Zotl4/1� T�vN me Phone
City/State/ZIP awl 0"nosa Phone
2. Name on Permit/LTC if .Different than Above
Mailing Address e— City/Stata/Zip -r-- -
3. Application For; ite Evaluation - ❑ Improvement Permit/ATC ❑ Both
9. Spstem to Service: ,av House ❑ -Mobile Home ❑ Dusineaa ❑ Industry ❑ Otller
5. Type system requested:/1l/Conventional ❑ conventional modified ❑ innova Live -
_ 6. If Residence: .S people 9 Bedrooms �. 11 Bathroom:; v _
�Vishwanher ❑Garbage DisposalWashing Machine ❑Basement/Plusbing ❑Basement/No l+lumbing
7. If Busiaoss/Industry /Other: verify type 6 People USinls - �—
II Commodes 6 Showers - i( Urinals ---_-� It Wa L•or Coolaru
IF FOODSERVICE: 1{ Sesta Estimated Water Usage (gallons par. day)
S. Type of water supply:County/City ❑ Well - ❑ Colmnunity
9. Do you aatieipato additions or CxpallSions of the flcinty this Sys tell, Is le(elldell to sel•ve? ❑ yes OIVn
if yes, }that type?
***IDIPOIfliINLx**CLIENTS AIUSTCOAII'LETETHE IU,QUIItEDI'ItOPllt'1'YINU'Olth•IA'l'10NItLQIJIiS'1-1iD
BEL01Y.. Either a PLLATT-oorSIT�'E PLAN 51USTEESUMVITTEclient D by the client u•illl'I'IIIS APPLICATION.
Property DimJ
ensions: '7�) /�6 jC 2z kECPIONS (from hluel6ville) to
Tax orrfe i'iN: iE/,/2.2�
ProperlyAddress: Road Name- 0_r
City/Zip llft'-'�Lfyi��Q
If in a Subdivision provide inrornlalion, as folloWS:
Nano: _ //!�3-�CGi /Yr /2 di/ �i ��
Section:�3 b /Block: 2 Lot: j�
Date llomccorllcrsllaggcd:
This Is to certify that the information provided is correct to the best of Illy l(noivledgc. I understand (hat any 11crildI($)
issued hereafter are subject to suspension or revocation, itthe site plans or intended use change, or if the infornlaliall
subl(litted in this application is falsified or changed. 1,, also, «tlderstand that I «al responsiblefor all charges iucllrri�d.%rnnl
this iyiplicdtfull. I, hereby, give consent to the Authorized Representative of the Davic County Ii.iiil Dcpar(IucMt
to cuter upon above described property located in Davie County and olvncd by
to conduct all testing procedures as necessary to determine (lie site suitability.
I)ATl - 6 CF SIGNATURE
T"IS AREA MAY BI's US1 D TOR DRAWING YOUR SITE PLAtlxi ludo 11 u the following: Lxisting and proposed
properly lines and dimensions, structures, setbacks, and Septic locations).
Site Revisit Charge
Sign given
Revitori nr l -TT) reC/n1
Client Notification Date:
EIiS:
Account'No.
APPLICATION FOR SITE EVALUATION/IMPROVEMENT PER MR & ATC rIF
�, P.
Davie County Health Department
' /q;� Envllvnmenfa/ Health Section
4 ' `� P.O. Bo: 868/210 Hospital Street Z-� 7
�IPG�J C F��_ Mocksville, NC 27028
,ay, f�P (336)751-8760
***XWCRTANT***
THIS APPLICATION
.",
CANNOT BS PROCESSED UNLESS ALL TRIC REQUIRED
INIM MRTI011 I8
PROVIDED. Refer
to the INr0R91TI0H BULLETIN for
instructions.
1. Mess to be billed
V
S Content brawn
J
Mailing Address
nnnn''/�PQ
b eiA;90SS
/
�c' noir none
9911- kV09
eitp/state/ai?
_ //d//y Ale
97,9a6 Business shone
OPP- X `/OLO
p. Wase on peruit/ASC if Different than
Mailing Address
City/stat/Zip
3. Application ror: 0'Hite Evaluation O Improvement Permit/ATC 0 Both
*• systa to Service: ys Mouse 0 Mobile Home 0 Business O Industry 0 Other
S. If Residence: 1 People s Bedrooms a Bathrooms
n Dishwasher D -Garbage Disposal D Washing Machine D sasssant/dubbing a basesent/No plumbing
e. if Business/Industry/other: apsaify typo 6 people a links
a Co®odes / showers I Urinals
6 Water Coolers
Ir r00DSERVICE: t Seats Estimated Water Usage (gallon■ per day)
v. Type of water supply: bounty/City 0 well O Community
e. Do you anticipate additions or expansions of the facility this system is Intended to serve? ❑Yea ❑ No
If yes, what type?
***IMPORTANT'** CLIENTS MUST COMPLETETIE REQUIRED PROPERTY INFORMATION REQUESTED
BELOW. Either a PWT or SITE PLAN MUST BESUBMI77ED by the client with THIS APPLICATtnN_
v�,y
Property DimensloQ4 Rif
Ta: Office PBV:
Properly Address: Road Name
CIty21pl[i B 3/ii'LLe-
If In a Subdivision provide Information, as folfllo[ws: /
Name: Va71z //1V&4
Section: Block: Lot: 2z
WRITE DIRECTIONS (from Mocksvllle) to PROPERTY:
/o/ Nose 7e S,-ioti lti
rope Y
� 1
Date Property Flogged:
This Is to certify that the Information provided Is correct to the beat of my knowledge. 1 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. 1, hereby, give consent to the Authorized Representative of the Davie County Health Department
to ester upon above described property located in Davie County and owned by
to conduct all testing procedures as necessary to determine the site suits fly.
DATE_'�%�—��
THIS AREA MAY BE USED FOR DRAWING YOUR SITE PLAN
property line and dimensions, structures, setbacks, and septic too
Revised DCHD (07/99)
of the following: Existing and proposed
Date(s):
ENS:
Site Revisit Charge
Notification Date:
Account No. _ _/
Invoice No.
H # 32'
DAVIE COUNTY HEALTH DEPARTMENT
Environmental Health Section
Soil/Site Evaluation
APPLICANT INFORMATION PROPERTY INFORMATION .
Account #: 989900111 Tax PIN/EH #: '5822-146855.32
Billed To: Gray Potts Subdivision Info: Dutchman Hills Lot # 32.
Refe' ., y
renceName:-'Gra Potts Location/Address: EatonsChurch Road -27028
Proposed Facility: Residence Property Size:; j 51 Acres Date Evaluated:. 4713
Water Supply: On -Site Well Community Public
Evaluation By: Auger Boring Pit Cut
FACTORS 1 2- 3 4 5 -. 6, ;7 ..
Landscape position . - .. L
Slope % Wo
HORIZON I DEPTH
Texture groupG
Consistence r✓r $
Structure _
Mineralogy 1 7 v)
HORIZON II DEPTH. 12.Z7— 17,3
Texture group C G +
Consistence
Structure L 5
MineralogyI : 1
HORIZON III DEPTHlip3 -
Texture group _ � 0
Consistence
Structure' .. .
Mineralogy
HORIZON IV DEPTH
Texture group
Consistence
Structure
Mineralogy
SOIL WETNESS
RESTRICTIVE HORIZON
SAPROLITE : 5
CLASSIFICATION, PS
LONG-TERM ACCEPTANCE RATE O .
SITE CLASSIFICATION: EVALUATION BY:
NG -TERM ACCEPTANCE. .
I.o_ , 1
RATE: O� `[ OTHER(S) PRESENT:
REMARKS:
LEGEND
Landscape Position
R - Ridge - S - Shoulder L - Linear slope FS - Foot slope N - Nose slope
CC - Concave slope CV - Convex slope T,- TerraceFP Flood plain H = Head slope
Texture
S=Sand'. LS -Loam
y sand SL _ Sandy loam L - Loam .SI Silt
SICL - Silty clay loam SII.. - Silty loam - CL - Clay loam SCL - Sandy,clay loam
SC - Sandy clay SIC - Silty clay C- Clay
CONSISTENCE . .
VFR - Veryfriable FR - Friable FI -'
Firm VFI -Very fum 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)