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121 Shiloh Court Lot 5Davie Countv. NC Tax Parcel R ennrt Tuesday, November 29, 2016 City: MOCKSVILLE Zoning Class: DAVIE COUNTY R -A State: NC Zoning Overlay: DAVIE COUNTY QD Zip Code: 27028-0000 Voluntary Ag. District: Legal Description: LOT 5 COUNTRY MEADOWS Fin: Response District: Assessed Acreage: 0.72 Elementary School Zone: Deed Date: Deed Book / Page: Plat Book: Plat Page: Building Value: Land Value: Total Assessed Value: 5/2011 Middle School Zone: 008580874 Soil Types: 0009 Flood Zone: 306 Watershed Overlay: Outbuilding 8r Extra Freatures Value: Total Market Value: MOCKSVILLE MOCKSVILLE SOUTH DAVIE GnB2 DAVIE COUNTY No 9 �'iu�1AAll data is provided as Is without warranty or guarantee of any Idnd either expressed or Implied Including but not limited to the Davie County, implied warranties of merchantability or fkness for a particular use. All users of Davie County's GIS website shall hold harmless the County of Davie, North Carolina, its agents, consultants, contractors or employees from any and all claims or causes of action due to �O tyt NC or arlsirng out of the use or Inability to use the GIS data provided by this website. WAICINI G: TMS IS 1V0'1' A SUKV.LY Parcel Information Parcel Number: H420OA0005 Township: Mocksville NCPIN Number: 5739639472 Municipality: Account Number: 8300333 Census Tract: 37059-806 Listed Owner 1: EAGLE CHRISTOPHER Voting Precinct: NORTH MOCKSVILLE COUNTY Mailing Address 1: PO BOX 162 Planning Jurisdiction: Davie County City: MOCKSVILLE Zoning Class: DAVIE COUNTY R -A State: NC Zoning Overlay: DAVIE COUNTY QD Zip Code: 27028-0000 Voluntary Ag. District: Legal Description: LOT 5 COUNTRY MEADOWS Fin: Response District: Assessed Acreage: 0.72 Elementary School Zone: Deed Date: Deed Book / Page: Plat Book: Plat Page: Building Value: Land Value: Total Assessed Value: 5/2011 Middle School Zone: 008580874 Soil Types: 0009 Flood Zone: 306 Watershed Overlay: Outbuilding 8r Extra Freatures Value: Total Market Value: MOCKSVILLE MOCKSVILLE SOUTH DAVIE GnB2 DAVIE COUNTY No 9 �'iu�1AAll data is provided as Is without warranty or guarantee of any Idnd either expressed or Implied Including but not limited to the Davie County, implied warranties of merchantability or fkness for a particular use. All users of Davie County's GIS website shall hold harmless the County of Davie, North Carolina, its agents, consultants, contractors or employees from any and all claims or causes of action due to �O tyt NC or arlsirng out of the use or Inability to use the GIS data provided by this website. i ,r: W., DAVIE COUNTY ENVIRONMENTAL HEALTH P.O. Box 848/210 Hospital Street Mocksville, NC 27028 (336)751-8760 Fax # (336)751-8786 Account #: 990005110 OPERATION PER)'IAJ PIN/EH #: 5739-63-9472 Billed To: Jones and Jones Construction, LLC Subdivision Info: Country Meadows Lot # 5 Reference Name: Location/Address: 121 Shiloh Court -27028 Proposed Facility: Residence Property Size: 3/4 acre ATC Number: 4878 **NOTE** The issuance of this Operation Permit shall indicate the system described on the ATC 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 tkeln as a guarantee that the system will function satisfactorily for any given tperiod of time. r_c%atCJw System Type: � S.T. Manufacturer Tank Date �! ` Tank Size Pum Tank Size p System Installed By:L4(/' � E.H. Specialist:_0 Date: nr..HT) 11 /06 M f-.vigp.d) DAVIE COUNTY ENVIRONMENTAL HEALTH ' ' t P.O. Box 848/210 Hospital Street Mocksville, NC 27028 �c2 (336)751-8760 Fax # (336)751-8786 1�\ AUTHORIZATION FOR WASTEWATER SYSTEM CONSTRUCTION Account #: 990005110 Tax PIN/EH #: 5739-63-9472 Billed To: Jones and Jones Construction, LLC Subdivision Info: Country Meadows Lot # 5 Reference Name: Location/Address: 121 Shiloh Court -27028 Proposed Facility: Residence Property Size: 3//44 acre ATC Number: 4878 Site Type: C*7New ❑Repair ❑Expansion **NOTE** This Authorization to Construct (ATC) MUST BE ISSUED by the Davie County Environmental Health Section prior to issuance of any building permit(s), (in compliance with Article 11 of G.S. Chapter 130A Wastewater Systems, Section .1900 Sewage Treatment and Disposal Systems). THIS AUTHORIZATION TO CONSTRUCT IS VALID FOR A PERIOD OF FIVE YEARS. This ATC is subject to revocation if site plans, plat or the intended use change. Residential Specifications: # Bedrooms / # Bathrooms 3' # People Basement❑ Basement plumbing❑ Non -Residential Specifications: Facility Type # People # Seats_ Square Footage(or Dimensions of Facility) Lot Size 6.75 CLei'.rS Type of Water Supply: 91'-`ounty/City ❑Well ❑Community Well System Specifications: Design Wastewater Flow (GPD) 90 Tank Size1_d`1'AL. Pump Tank,�AL. f R L( �` Rock Depth Linear Ft. I 010Trench Width 36 Max. Trench Depth T1sstated in 15A NCAC 1t1A.1969(5) Site Modifications/Conditions/Other: accepted Systems may also be uses# Contact the Davie County Environmental Health Section for final inspection of this system between 8:30 — 9:30a.m. 2n the day of installation. Telephone # (336)751-8760. d f0%1 l6 r CPII�11X11/06 (Revised) . Date: �/ -coonfry -meQrj,,,jS or"c-s --cj ITOIW-S 60' Row 4- SkiiCA Cf-. I Proposed HousC OX63 ,303 04 my Environmenta 3367518756 p.1 SITE EVALUATION/34PROVEMEENT PERMIT & ATC Davie County Environmental Health P.O. Box 8481210 Hospital Street Mocks'v:ille, NC 27028 (336)751-87601 Fax (336)751-8786 Site valuatiorJlinprovetnent P=. it 1j, Authorization To Construct(ATC) -S- Boni : Wew System CRepair to Existing System aExpansion(Mcdification of Existing System or Facility ***I,'NPOR«!N'*** THIS APPLICATION CAMVT BEF'ROCESSED LWLESS ALL OF THE REQUIRED IlNTFOR-MATION LS PROVIDED, Refer to the INF'ORMA'.i'ION BULLETIN for instructions. APPLICAuNT Ii`tFOR2yIATIUN ru_ / ZV �%�Z�% Dame to be Billed sT/-L Co tact Person TOS kudL (Zhu Billing Address P17 P' r--5 emcee' K &CCA ��;a}f�t� Home Pnore 336- 7a S-9 x/00 CitylStatelZIP '1„};.. -clan _Sa l�w.i QIP x.710.3 Business Phone 334- WGA - 13 oil Nage on PermitrATC if Different than Above 'I' 4 - Mailing Address T City/StatelZip PROPERTY INFORMATION *Date House/Facility Comers Fl NOTE: A survey plat or site plan must accompany this appl: cation. Included: Site Plan 11 lat(to scale) (Petrut is'valid for 60 months withsite plan, no expiation with complete plat.) Owner's Name 6,Sr1rt,^S�LS Phone Number._.3 3&7A,S-9Hod O-wner's Address flj7 QG,}er-s ree K Parkwo jCity/State/Zip1.j nsFon Sale... NG a7/03 Property Addr s 00l, I C4 J City 606-<SV11e, zoo 8 Lot Size W of o.n hcrlc TaxPiN; ,739(03gg7a Subdivision Name(if applicable) CA 11 r rN j S—SecticrdLo'u�- $ Directions To Site: Z q0 fb GO1 { (ol +a C0LVI lane T/'r,n+o Loorxrfc,13 Or if the answer to tory of the :ollowing questions is "yes", supporting documentatiopp utast be attacht:d. evlfclo-scaA Are there any existing wastewater systems on the site? ZYes T-qc Does the site contaiajurisdictional wetlands? .Yes ie Are there any easements or right-of-ways on th-. site? E'Yes �: e Is the site subject to approval by another public agen:y? CYes Will wastewater ccther than domestic sewage be generated? CYes IF RESIDENCE FILL OUT THE B0X B 0 V &OS� 1pMd6 _ Itl # _ People '.�y� # Bedroorns Bathrooms ��Garden Tub/Whirlpooi Yes LNo� Basemcritr CYes Ao BasetnentPlutnbing: Oyes ONO i IF NON-' E SIDENCE FILL OUT THE BOX BELOW Type of Facility,Bttsiness Total Square Footage of Building _# People # SinIG # Commodes # Sho areas # Urinals Estimated Water Usage (gallons per day) _(Attach docum.entation of similar facility water consumption) FOODSERVICE ONLY: # Seat; Type systeaarequested: R!Conventionel CAccepted Mnnovative CAlternative Mother Water Supply Type: V County'City Water C New Well CExisting Writ G Communk- Well Do you anticipate additions or expansions of the facility this system is intended to serve? E Yes WNa If yes, what tepc? _ -_.------- This it to certify that the infon ation provided on this apphoa-aou is true and correct to the best of my knowledge. I understand that any p--rrnit;s) or ATC(s) issued hereafter are sub ect to suspersion or revocation if the site is altered, the intended use cl=ges. or if the iniomtation submitted in osis application is falsified or chtmged. I hereby grant right of entry to the Authorized Representative of the Davie County Health Department to conduct necessary inspections to deter mae compliance with applicable laws and rule -s. I understand that I am responsible for the proper identification and labeling of property lines and cornets and locating and flagging or stakine :he houseliacility location. nr000sed well location :md t1m lncatinn of flnv ntb" rmmnit4^.a roperty mpe-P or 01 :et` egg presentative signature 26-�, 'Date Sign_ given :,Yes CNo Revised 11/06 Site Revisit Charge nate(s): Client NotMcatior. Date: _ ERS: Account Invoice t - Jul 29, Ot; -1 1: Osa davie county env&tealtli 336 751 9796 p.2 PV -I JAgI JN t 1ITE EVALUATION/IMPROVEMENT PERMIT & ATC I p� 1 Davie County health Department V� Environmental Health ,'.rection AUG 2p06 P.O. Box 848/210 Hospital Street Mocksville, NC 2701.8 (336)751-8760/ Fax (336)751-8786 ALTH Applicati �i , tSfEvaluation/ln : ovement Permit 1 ❑ Autborizat.on To Construct(ATC) Ll Both *IMPORTi1N7`***THIS APPLICA"JON CANNOT BE PROCESSED UNLESS ALL OF THE" REQUIRED INFORMATION IS PROVIDED. Iteler to the INFORMATION BULLET]:N for instructions. APPLICANT INFORMATION �^ Name to be Billed r`r L 1, u _ �!' Contact Person Billing Address Hcme Phone 17,41-) •-- o, CJ City/State/ZIPA,Zi Z 7 � _ • Bus ness Phone - -7;J00 W>b 1-P51 Name on Permit/ATC if Different th:.n Above Mailing Address City/Stage/Zip TION NOTE: A survey *plat or site plan must accompany this application. (Pennit is valid for 60 onths ";.ith site plan, no expiration with Street Address A=A e City Subdivision Name_ Section/ of#_ Directions To Site: I3. (;d u ,� ✓ .,r /-P �T Tax l'IN#, 739'14j2-492- Date House/Facility Corners F geed. If the answer to any of the following que :tion. is s supporting document::tiorymust be attached. Are there any existing wasteNva•:er systems on the site? UYe, CaN Does the site contain jurisdictional wetlands? ❑Ye: Are there any easements or rigt.t-of-ways on the site? ❑Yef Is the site subject to approval by another public agency? ❑Ye: Will wastewater other than domestic sewage be generated? ❑Yer o IF RESIDENCE FILL OUT THE BOX BELOW # People # Bedroi--ms 14 # Bathrooms Garden Tub/Whirlpool ❑Yes UNo Basement: ❑Yes (]No Basement Plumbing: ❑Yes flNo IF NON -RESIDENCE FILL OUTTHE BOX BELOW Type of Facility/Business Total Square Footage of Buildings # People # Sinks # Commodes _ # Showers 1._ # Urinals Estimated Water Usage (gallons per day) (Attach documentation of similar facility water consumption) FOODSERVICE ONLY: # Seats Type system requested:` onventioual ❑Accepted ❑Innovative ❑Alternative UOther Water Supply Type: Its County/City Wa•.er ❑ New Well ❑Existing Well ❑ Community Well Do you anticipate additions or expansio ts of the facility this system is intendt:d to serve? ❑ Yes Llr<o If yes, what type? _. This is to certify that the information provided on this application is true and :.orrect to the best of my knowledge. I understancLthat any permit(s) or ATC(s) issued herea fter are subject to suspension or revocat.on if the site is altered, the intended use changes, or if the information submitted in this application is falsified or changed. I understand that t a»: responsiblefor all charges incurred from this application. I hereby grant ril:ltt of entry to the Authorized Represc ntative of the Davie County Health Department to conduct necessary inspections��,�555��� determine compli j�ce with applicable laws :nd rules on the above described property located in Davie ty and own. ed/ by ��% i},)-: e.�/ or owner's legal repre:centative signature Sign given ,CLYds ❑ No Revised 2/06 Site Revisit Charge Date(s):� Client Notification Date: EHS: LIIAccount Yl Tv Invoice # DAVIE COUNTY HEALTH DEPARTMENT Environmental Health Section Soil/ Site Evaluation APPLICANT INFORMATION Water Supply: On -Site Well Community Evaluation By: Auger Boring Pit ' PROPERTY INFORMATION Public •� Cut 0 VAN • .31M HORIZON I DEPTH Texture group .Consistence HORIZO��aor•�■©���� .DEPX`. . • SOMo911wil MEMO ir-59M Mineralogy HORIZON III DEPTH group -Texture Consistence �®®���s■� HORIZON DEPrHTexture group Consistence Mineralogy SOIL WETNESS RESTRICTIVE HORIZON •• • CLASSIFICATION SITE CLASSIFICATION: P S EVALUATION BY.- - ,,f -P LONG-TERM ACCEPTANCE RATE: ©` 2 OTHER(S) PRESENT: REMARKS: �Fl! :�C (j ^'�-tFQU 2o- 2-0 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 VFR - Very friable FR - Friable FI - Firm VFI - Very firm EFI - Extremely firm 3Yet 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 lYutg.T 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 05105 (Revised) Reference Name: Proposed Facility: Residence **NOTE**This Improvement Permit DOES NOT authorize the construction of a wastewater system. An Authorization To Construct a wastewater system must be obtained from this office prior to the construction/installation of a wastewater system or the issuance of a building permit(in compliance with Article 11 of G.S. Chapter 130A, Wastewater Systems). This Improvement Permit is subject to revocation if site plans, plat or the intended use change. Permit Type: Zll�ew ❑Repair ❑Expansion Permit Valid for: 05 Years, 4B o Expiration Residential Specifications: # Bedrooms3 # Bathrooms 3 # People Basement❑ Basement plumbing❑ Non -Residential Specifications: Facility Type # People # Seats Square Footage(or Dimensions of Facility) Design Flow(GPD): 3LOO Type of Water Supply: E<-ounty/City []Well ❑CommunityWell Site Modifications/Permit Conditions: System Type LTAR Initial N✓ _ L' Q Z �. Repair - .rZ7 Environmental Health Specialist i.p. 11-06 Davie County Environmental Health P.O. Box 848/210 Hospital Street Mocksville NC 27028 (336)751-8760/Fax(336)751-8786 IMPROVEMENT PERMIT Account M 990004061 Tax PIN/EH M 5739-76-2682.05 Billed To: Terry Butler Subdivision Info: Country Downs Lot # 05 Address: 2480 NC HWY 801 North Location/Address: Country Lane -27028 City: Mocksville Property Size: see map Reference Name: Proposed Facility: Residence **NOTE**This Improvement Permit DOES NOT authorize the construction of a wastewater system. An Authorization To Construct a wastewater system must be obtained from this office prior to the construction/installation of a wastewater system or the issuance of a building permit(in compliance with Article 11 of G.S. Chapter 130A, Wastewater Systems). This Improvement Permit is subject to revocation if site plans, plat or the intended use change. Permit Type: Zll�ew ❑Repair ❑Expansion Permit Valid for: 05 Years, 4B o Expiration Residential Specifications: # Bedrooms3 # Bathrooms 3 # People Basement❑ Basement plumbing❑ Non -Residential Specifications: Facility Type # People # Seats Square Footage(or Dimensions of Facility) Design Flow(GPD): 3LOO Type of Water Supply: E<-ounty/City []Well ❑CommunityWell Site Modifications/Permit Conditions: System Type LTAR Initial N✓ _ L' Q Z �. Repair - .rZ7 Environmental Health Specialist i.p. 11-06