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'
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LOT: 11
LOT 12
13
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LOT 16
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EUNICE STEWART
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JOT
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LOT 6 LOT 7
8
LOT 24
LOT 20
LOT 19
LOT - 18
LOT 17
r"
I 15c. 00.
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148.31' 167 LOT 28
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LOT
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7
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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 -
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EUNICE STEWART
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LOT 38
LOT 37 LOT 27
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LOT 36-" -
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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)