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107 North Hazelwood Drive Lot 8Davie Countv. NC , Tax Parcel Rennrt Tuesday. January 10. 2017 Parcel Number: NCPIN Number: Account Number: Listed Owner 1: Mailing Address 1: City: State: Zip Code: Legal Description: Assessed Acreage: Deed Date: Deed Book / Page: Plat Book: Plat Page: Building Value: WARNING: THIS IS NOT A SURVEY Parcel Information J7080B0008 Township: Fulton 5768107813 Municipality: 82523176 Census Tract: 37059-804 PEAK ANNETTE B Voting Precinct: FULTON 107 NORTH HAZELWOOD DRIVE Planning Jurisdiction: Davie County MOCKSVILLE Zoning Class: DAVIE COUNTY R-20 Land Value: Total Assessed Value: into 27028-0000 LOT 8 HERITAGE OAKS PHASE ONE 0.69 8/2004 005650293 0007 005 Zoning Overlay: Voluntary Ag. District: No Fire Response District: FORK Elementary School Zone: CORNATZER Middle School Zone: WILLIAM ELLIS Soil Types: GnB2 Flood Zone: Watershed Overlay: DAVIE COUNTY Outbuilding & Extra Freatures Value: Total Market Value: Davie County, All data is provided as is without warranty or guarantee of any Idnd either expressed or Implied including but not limited to the Implied warranties of merchantability or fitness for a particular use. All users of Davie County's GIS website shall hold harmless the NCor of Davie, North Carolina, Its agents, consultants, contractors or employees from any and all claims or causes of action due to 1County arising out of the use or Inability to use the GIS data provided by this website. A DAVIE COUNTY HEALTH DEPARTMENT / - ( �_ j(— o Environmental Health Section 3 , c7 P. O. Boz 848/210 Hospital Street Mocksville, NC 27028 (336)751-8760 IMPROVEMENT/OPERATION PERMIT Account #: 990000969 Billed To: Cranfill & Sons Reference Name:�{- Proposed Facility: Residence Tax PIN/EH #: 5768-10-7813.08 Subdivision Info: Heritage Oaks Lot # 8 Location/Address: Property Size: see map ATC Number: 2528 **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 TypeS— #People _ #Bedrooms --�> #Baths 2 - Dishwasher: 03"' Garbage Disposal: ❑ Commercial Specification: Facility Type Washing Machine: 2r Basement w/Plumbing: ❑ Basement/No Plumbing: ❑ #People #People/Shift #Seats Industrial Waste: ❑ Lot Size Type Water Supply(?TV Design Wastewater Flow (GPD) Site: New Repair ❑ System Specifications: Tank SizeOQCb-AL. Pump Tank GAL. Trench Width Rock Depth Linear Ft,� Other: lD%Sx l60 -nor- Y—&CV- Required Site Modifications/Conditions: ��S'f"�,� L 0;�, C�•)Tw Q r S or IMPROVEMENT/OPERATION PERMIT LAYOUT - APPROVED EFFLUENT FILTER RISER(S) H7 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.**** Environmental Health Specialist's Signature: DCHD 05/99 (Revised) .rL Date: 4Vj1l0 AN DAVIE COUNTY HEALTH DEPARTMENT Environmental Health Section P. O. Boa 848/210 Hospital Street Mocksville, NC 27028 (336)751-8760 Account #: 990000969 Tax PIN/EH #: 5768-10-7813.08 Billed To: Cranfill & Sons Subdivision Info: Heritage Oaks Lot # 8 Reference Name: Location/Address: Proposed Facility: Residence Property Size: see map ATC Number: 2528 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 WAST ERC TION VALID FOR A PERIOD OF F^^IV��E YEARS. Environmental Health Specialist's Signatu e: 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 I 1 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. l70 k Vf\ 1 v 1 Z t4 Septic System Installed By:l�� Environmental Health Specialist's Signature: DCHD 05/99 (Revised) Date: n WILLIAM A. BURNE17E D8. 187. PG. 426 tiro N 0728'52" W 1028 39' N ��66 ��O N 12 L 0 T 52 "-: LOT: 11 LOT 12 13 LOT. ,.,l 4 'LOT 15 LOT 16 r" b LOT 25 , ' LOT 10 „LOT CD N/F > 0 rrl LI C 230.0o, REMAINING AREA j LOT 9 _T SCOTT STEWART & wife -0 cr Un 9.382 ACRES z b LOT 26 EUNICE STEWART 14022' ai z 127-3f1' 127-5,4' c) 250.00, r m 0 u C N W43 -3e -P. 1 4J DB. 102, PG. 740 652.f 1 C? LOT 38 JOT ao 151 152.37- 153.20' ;u pr LOT 6 LOT 7 8 LOT 24 LOT 20 LOT 19 LOT - 18 LOT 17 r" I 15c. 00. 2 40 00 V, 148.31' 167 LOT 28 �'° = Ise'L-15&4,r L. 131-" 6.4 '75 LOT 22 LOT 36-" - vi C, 3903- 230.00• S O(Y37'14:' E S 0(719 W `347 STCINF 73. 1 3.75.00' o LOT 29 7 55-36' S 00*19*34 W LOT 54 LOT 53 LOT 23 =g z5,o00 29 56' I 124A)4* 23,12 182.31* LOT 24 250.0107 - LOT 51 12 L 0 T 52 "-: I I ;u r" b LOT 25 0 CD N/F > 0 rrl LI C 230.0o, cu j _T SCOTT STEWART & wife -0 rrl z b LOT 26 EUNICE STEWART Ln ai z 148-W 250.00, r m 0 u C 1 4J DB. 102, PG. 740 LOT 38 LOT 37 LOT 27 ao 0 ;u pr I 15c. 00. V) 00 148.31' 167 LOT 28 �'° = LOT 36-" - vi 230.00• 3.75.00' o LOT 29 LOT 35 2-V CIO. APPUCATION FOR SITE EVALUATION/IMPROVEMENT PERMIT & ATCFLAW Q Davie County Health Department Envit»nmental SWIM S&Uon i✓ k-%' P.O. Box 848/210 Hospital Street 17 2000 Mocksville, NC 27028 (336)751-8760 h"ENTAHEALTH iG C(11fNTY ***IMPORTANT*** THIS APPLICATION CANNOT BE PROCESSED UNLESS ALL THE REQUIRED INFORMATION IS PROVIDED. Refer to CtheAINFORMATION BULLETIN for instructions. 1. Name to be Billed (� — I L L,� C+ J6 N 5 Contact Person L&I L E /� JAnyy raj Hailing Address Mor, L f 1( �I 1 tlAuC RP Home Phone 23l'/J�� r -- 5'5-/ City/State/ZIP ► V/ t V r)��� V"1. 47 Business Phone 7Q "Jj) j 2. Name on Permit/ATC if Different than Above Mailing Address City/State/Zip 3. Application For: ❑ Site Evaluation Improvement Permit/ATC ❑ Both a. System to service: WI -House ❑ Mobile Home ❑ Business ❑ Industry ❑ Other 5. If Residence: # People # Bedrooms -- # Bathrooms �^ shwasher ❑ Garbage Disposalash:Lnrg AM`achine❑ Basement/Plumbing ❑ Basement/No Plumbing (JkM 6. If Business/Industry/Other: Specify type jZf�-}-y� L 91 A People # Sinks # Commodes _ %i # Showers # Urinals # Water Coolers IF FOODSERVICE: # Seats Estimated Water Usage (gallons per day) 7. Type of water supply: County/City ❑ Well ❑ Community e. Do you anticipate additions or expansions of the facility this system is intended to serve? ❑ Yes U40 If yes, what type? I***IMPORTANT*** CLIENTS MUST COMPLETETHE REQUIRED PROPERTY INFORMATION REQUESTED I BELOW. Either a PLAT or SITE PLAN MUST BESUBMITTED by the client with THIS APPLICATION. Property Dimensions: !3156 1n A T Tax Office PIN: # 5--76 S i o 78 W ; Property Address: Road Name D -- � fity/Zip — If in a Subdivision provide information, as follows: Name: Mek / 7—A (g-'5; WRITE DIRECTIONS (from Mocksville) to PROPERTY: Section: Block: Lot: 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 use change, or if the information submitted in this application is falsified or changed 1, also, understand that I ant 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 suitability. DATE Q SIGNATURE / THIS AREA MAY BE USED FOR DRAWING YOUR SITE PLAN (Include all of the following: Existing and proposed property lines and dimensions, structures, setbacks, and septic locations). Revised DCHD (0' Site Revisit Charge Date(s): Client Notification Date: EHS• Account No. / Invoice No. / ��T �� r DAVIE COUNTY HEALTH DEPARTMENT Environmental Health Section /J&`/ / / Soil/Site Evaluation NAME 4G ` /./, 1 ADDRESS PROPOSED FACIILTY l DATE EVALUATED PROPERTY SIZE LOCATION OF SITE Water Supply: On -Site Well _ Community_ Public !'I-1 Evaluation By: Auger Boring Pit Cut FACTORS 1 2 3 4 Landscape position Slope Z HORIZON I DEPTH Texture group Consistence Structure Mineralogy HORIZON II DEPTH o<' Texture group 4 Consistence Structure5Z4- Mineralogy HORIZON III DEPTH Texture group Consistence Structure Mineralogy HORIZON IV DEPTH Texture group Consistence Structure Mineralogy SOIL WETNESS RESTRICTIVE HORIZON SAPROLITE CLASSIFICATION LONG-TERM ACCEPTANCE RATE .� SITE CLASSIFICATION: LONG-TERM ACCEPTANCE RATE: REMARKS: DCHD(01-901 EVALUATED BY: T rz l OTHER(S) PRESENT: 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 :lay loam, SIL -Silty loam CL -Clay loam SCL-Sandy clay loam SC -Sandy clay SIC -Silty clay C -Clay CONSISTENCE Moist VFR- V1_ --Y 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 3C --Single grain M -Massive CR -Crumb GR -Granular ABK-Angular blocky SBK-Subangular blocky PL -Platy PR -Prismatic Mi neralo¢y 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 ■EM■ ■M■■ ■O■■ ` APPLICATION FOR SITE EVALUATION/IMPROVEMENTS PE �n�7 Davie County Health Department V 1� Environmental Health Section JUN ® P. O. Box 665 �V 2 8 ���j Mocksville, NC 27028 �� I �a,vts �lso0 1. Application/Permit Requested By Jerry McCullough or Jim Gobble Mailing Address 213 Hwy. 64 W. Home Phone Lexington, N.C. 27292 Business Phone 704-249-6672 2. Name on Permit if Different than Above :26"-6 — y-v"V ir 3. Application for: 0 General Evaluation ❑ Septic Tank Installation Permit 4. System to Serve: ® House 59 Lots ❑ Mobile Home ❑ Place of Public Assembly ❑ Business ❑ Industry ❑ Other ❑ Unknown 5. If house, mobile home: Subdivision Property of Jerry McCullough and Section 1 Lot # Jim Gobble No. of People No. of Bedrooms _ No. of Bathrooms Dwelling Dimensions 6. If business, industry, place of public assembly, other: Specify type No. of People Served No. of Commodes No. of Lavatories No. of Showers _ 7. Type of water supply: ® Public 8. Property Dimensions Min. Lot size 30,000 No. of Sinks No. of Urinals No. of Water Coolers _ Water Usage Figures _ ❑ Private . f t -Sewage Disposal Contractor 9. Do you anticipate additions/expansion of the facility this sytem is intended to serve? If yes, what type? ❑ Basement/Plumbing ❑ Basement/No Plumbing ❑ Washing Machine ❑ Dishwasher ❑ Garbage Disposal ❑ Yes El No ❑ Community 'NOTE: Improvements Permits shall be valid for a period of 5 years from date issued. Improvements Permits are subject to revocation, if site pans or the intended use change. Effective October 1, 1989. ZO E T_ . Directions to Property: From Mocksville go East on Hwy. 64, property (50 acre tract) on left immediately after Hickory Hills Golf Course Tax Office PIN: #,676,$' a3- oNy11 PROPERTY AbbRESS, as follows: Road Name: N.C. Hwy. 64 City: Mocksville, N.C. SU13MIT A PLAT WITH THIS APPLICATION. Revisions effective October 1, 1995. This is to certify that the information provided is correct to the best of my knowledge, and I�underst, incurred fr m this appl'cation. D SIGNATURE I am responsible for all charges CONSENT FOR SITE EVALUATION TO BE DONE ON ABOVE DESCRIBED PROPERTY MUST CHECK ONE: G"1. I OWN the property. ❑ 2. 1 DO NOT OWN the property. If you checked Box #2, thl�rest of this form MUST be completed by the owner or a person authorized by the owner: 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 de ermine said site's suitabililey\Z_J a ground absorption sewage treatment and disposal system. DATE GNATURE DCHD (1193) /�'� ; 13GfGK kfil- APPLICATION FOR SITE EVALUATION/IMPROVEMENTS PERMIT Davie County Health Department Environmental Health Section P. O. Box aft s *9 Mocksville, NC 27028 1. Application/Permit Requested By Jerry McCullough or Jim Gobble Mailing Address 213 Hwy. 64 W. Home Phone Lexington, N.C. 27292 Business Phone 704-249-6672 2. Name on Permit if Different than Above 3. Application for: CS General Evaluation ❑ Septic Tank Installation Permit 4. System to Serve: ® House 59 Lots ❑ Mobile Home ❑ Place of Public Assembly ❑ Business ❑ Industry ❑ Other ❑ Unknown 5. If house, mobile home: Subdivision Property of Jerry McCullough and Section 1 Lot # Jim Gobble ' { Dr)�r ❑ Basement/Plumbing No. of People ❑ Basement/No Plumbing No. of Bedrooms No. of Bathrooms Dwelling Dimensions 6. If business, industry, place of public assembly, other: Specify type No. of People Served No. of Commodes No. of Lavatories No. of Showers No. of Sinks No. of Urinals No. of Water Coolers Water Usage Figures 7. Type of water supply: ® Public ❑ Private 8. Property Dimensions Min. Lot size 30,000 sq.ft-Sewage Disposal Contractor ❑ Washing Machine ❑ Dishwasher ❑ Garbage Disposal 9. Do you anticipate additions/expansion of the facility this sytem is intended to serve? ❑ Yes fl No If yes, what type? ❑ Community 'NOTE: Improvements Permits shall be valid for a period of 5 years from date issued. Improvements Permits are subject to revocation, if site plans or the intended use change. Effective October 1, 1989. PROPERTY . Directions to Property: From Mocksville go East on Hwy. 64, property (50 acre tract) on left immediately after Hickory Hills Golf Course Tax O,ff i ce PIN: # PROPERTY ADDRESS, as ,follows: Road Name: N.C. Hwy. 64 City: Mocksville, N.C. SUBMIT A PLAT WITH THIS APPLICATION. Revisions effective October 1, 1995. This is to certify that the information provided is correct to the best of my knowledge, and I understand I am responsible for all charges incurred from this application. DATE SIGNATURE CONSENT FOR SITE EVALUATION TO BE DONE ON ABOVE DESCRIBED PROPERTY MUST CHECK ONE: ❑ 1. 1 OWN the property. ❑ 2. 1 DO NOT OWN the property. If you checked Box #2, the rest of this form MUST be completed by the owner or a person authorized by the owner: 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 said site's suitability for a ground absorption sewage treatment and disposal system. DATE SIGNATURE DCHD (1193)