108 Oakshire Court Lot 52Davie County, NC Tax Parcel Report Tuesday, January 10, 2017
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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:
MOCKSVILLE
Building Value:
Land Value:
Total Assessed Value:
WARNING: THIS IS NOT A SURVEY
Parcel Information
J7080B0052 Township: Fulton
5768201782 Municipality:
8302125 Census Tract: 37059-804
DEZARN DAVID M Voting Precinct: FULTON
108 OAKSHIRE COURT Planning Jurisdiction: Davie County
NC
27028
LOT 52 HERITAGE OAKS PHASE TWO
0.82
4/2013
009230526
0008
139
Zoning Class: DAVIE COUNTY R-20
Zoning Overlay:
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 harmlessthe
County of Davie, North Carolina, its agents, consultants, contractors or employees from any and all claims or causes of action due to
or arising out of the use or Inability to use the GIS data provided by this website.
i
Voluntary Ag. District:
No
Fire Response District:
FORK
Elementary School Zone:
CORNATZER
Middle School Zone:
WILLIAM ELLIS
Soil Types:
Gn132
Flood Zone:
Watershed Overlay:
DAVIE COUNTY
Outbuilding & Extra
Freatures Value:
Total Market Value:
W-1
Davie County,
NC
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 harmlessthe
County of Davie, North Carolina, its agents, consultants, contractors or employees from any and all claims or causes of action due to
or arising out of the use or Inability to use the GIS data provided by this website.
i
'HEALTH DEPARTMENT RELEASE
Davie County Health Department
210 Hospital Street
r ` - P.O. Box 848
Mocksville NC 27028
Phone: 336-753-6780 Fax: 336-753-1680
Applicant: David M. Dezam
Address: 108 Oakshire Court
City: Mocksville
State2ip: NC 27028
Phone #: (336) 816-2076
For Office Use Only
*CDP File Number 137234-1
i7-08MO-052
County ID Number.
valuated For. HDRIMC
PERMIT VALID 0 4/ 1 5/ 2 0 1 9
IIMTII
rd
ope
rty Owner. David M. Dezarn
ess: 108 Oakshire Court
City: Mocksville
State2ip: NC 27028
Phone #: (336) 816-2076
Property Location & Site Information
Add res s108 Oakshire Court Subdivision: Heritage Oaks Phase: Lot 52
Road # Mocksville NC 27028 —
SINGLE FAMILY Township:
*Structure: Directions
# of Bedrooms: 3 # of People: Hwy 64 E. Past Lake Louise, Heritage Oaks on left
*Water Supply: PUBLIC
Basement: R Yes ❑ No
*Proposed Improvement:
Storage Bldg 14x24
Type of Business:
Total sq. Footage: No. Of Employees:
Storage building may be placed as drawn on second submital where building is to be behind pool and inside of fenced area. Building must
be no closer than 5 foot from septic system.
This release in no way expresses or implies that the existing subsurface sewage treatment and disposal
system serving the site will continue to function for any period of time.
Applicant/Legal Reps. Signature Required? Oyes ONO
Applicant/Legal Reps. Signature:.
*Issued By: 21140 -Nations, Robert
Authorized State Agent:— 11
*Date:
*Date of Issue: 0 4/ 1 5/.1 0 1 4
**Site Plan/Drawing attached.**
(�) Hand Drawing O ImportDrawing
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Drawing Tyde:
HEALTH DEPARTMENT RELEASE
Davie county Health DepartmentCDP File Number: 137234 - 1
210 Hospital Street j7-080-130-052
P.O. Box 848
County File Number:
Mocksville NC 27028 Date: 04/ 15/ 2 0 1 4
Olnch
Scale: O Block '--.ft.
Health Department Release O N/A
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Phone: (336) - 753 - 6780
Davie County Health Department
Environmental Health Section
'VF'D P:O. Box 848 D PAID C
210 Hospital Street ourier # : 09-40-06 Receivedb
Mocksville, NC 27028
Fax: (336) - 751 - 8786
ON-SITE WASTEWATER CERTIFICATION FOR DWELLING
(Check One) Replacement Remodeling Reconnection
Name: V/ ! , l - ��ZA ) Phone Number 3 b �� b ;?07f,—(Home)
Mailing Address: /Of 0/¢<S17 d`2 &% (Work)
1111 C- 4rV 1 d*-- AL 270 4 � Email "n', 6S-6- 5.! r/
D tailed Directions To Site: G . L.1�7 � / /U/c7(Ja-�S Dw S4
We- Laurse-�
5z
Property Address:
Please Fill In The Following Information.About The EXISTING Facility: Ile // ale, (,tet s
Name System Installed Under: Type Of Facility: f (S
Date System Installed (Month/Date/Year): t (1 Number Of Bedrooms: Number Of People:
Is The Facility Currently Vacant? Yes 1�D If Yes, For How Long?
Any Known Problems? Yes No If Yes, Explain:
Please Fill In The Following Information About The NEW Facility:
Type Of Facility: I X Z Number Of Bedrooms: N be of People
p� Requested By- Date Requested: ,11/
' \ ignature).
�—� For Environmental Health Office Use Only
.Environmental Health Specialist Date: qlltl
*The signing of this form by the Environments ealth Staff is in no way intended, nor should be taken as a guarantee
(extended or limited) that the on-site wastewater system will function properly for any given period of time.
Payment:
Money Order #
Paid By: R4 Ai L., Received By:_
Account #: 3 Invoice #:
0 d Date:
203
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All data Is provided as is without warranty or guarantee of any kind 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 County of
Davie, North Carolina, its agents, consultants, contractors or employees from any and all claims or causes of action due to or arising out Printed : Mar 31, 2014
of the use or inability to use the GIS data provided by this website.
: A
�
VIE COUNTY HEALTH DEPARTMENT
Environmental Health Section
PO Box 848/210 Hospital Street
Mocksville, NC 27028
Phone: (336)751-8760
S•PI'E WASTEWATER CERTIFICATION FOR DWELLING
REPLACEMENT o REMODELING ❑ RECONNECTION ❑
Narne:_ � In"yeJ si ; ' 119ew f } Phone Number: (Home)
Mailing Address: r� % ����`G'sr� 14 Ae"?IN OJf (Work)
v c As �ff, //�% fit., C
Detailed Directions To Site: 'X /7 2 ti, Z2%4s
i
9-C d -,/L- ('!C
h
Property Address:
r
Please Fill In The Following Information About The Existing Dwelling:
Name System Installed Under: 0r 6N,Type Of Dwelling: - buse
Date System InstaRed(Month/Day/Year): L ci D� Number Of Bedrooms:_Z.Number Of People:
Is TIie Dwelling Currently Vacant? Yes ❑ N05- If Yes, For How Long?
Any Known Problems? Yes ❑ No g--' If Yes, Explain:
Please Fill In The Following Information About The New Dwelling:
Type Of
}(Requested By:.
11
xDu
For Environmental Health Office Use Only
ber Of People:
Requested? 5 ^ r'' .
Approved i( Disapproved O
Comments: 1,01Vl 5 ' &c OWL % L )VJ r in I'l I'll .
Environmental Health
I*The signing of.this.form by the Environmental Health Staff is in no way intended, nor should be taken as a
euarantee(extended or limited) that the on-site wastewater system will function Droverly for anv given veriod of time.
Payment: Cash VCheck ❑ Money Order ❑ # Amount: $ 00,
00 Date:
Paid By: /'� �z 12 �f Received By:
Account #:Z7� Invoice #: ibl%q
Davie County Development Services tvf�
298 E. Depot Street, Suite 100
Mocksville, NC 27028 Coo
202009-96 Ph:336-753-6050 Fx:336-751-7689 uta
Permit Number Zoning Permit Approval Date: 5/14/2009
Applicant Name: HUGHES CONST. CO., GLENN A. Phone: 336-764-1752
Address: 339 SHADY LANE
WINSTON-SALEM, NC 27107
Total Fees: $30.00 Total Receipts: $30.00
Parcel Number: J7080B0052 Zoning:
Address: 108 OAKSHIRE CT MOCKSVILLE, NC 27028
Owner Name: HUGHES CONST. CO., GLENN A. Phone: 336.764.1752
Address: 339 SHADY LN.
WINSTON-SALEM, NC 27107
SWIMMING POOL HARRIS POOL COMPANY
Address: 277 PLEASANT ACRE DR
MOCKSVILLE, NC 27028
Phone: 336.284.4817
Other Fields:
Rear Setback:
Health Dept.
Rear Yard
Proposed Use: INGROUND SWIMMING POOL
Front Setback:
Government County of Davie
Side Setback:
Corner Side
Water No
Sewage No
Private: No
Private: No
Comments: 15X30 INGROUND POOL
In support of this application, I have submitted one set of plans showing the dimensions and shape of
the parcel to be built upon, the exact size, use and locations of the parcels or buildings already
existing, if any, and the dimensions of all proposed buildings, alterations, additions or uses. This
permit shall expire and be cancelled unless the work authorized by it shall have begun within one(1)
year of its date of issue, or if the work authorized by it is suspended or abandoned for a period of
one(1) year.
Date
Davie County Development Services
298 E. Depot Street, Suite 100 ,
Mocksville, NC 27028 'o
BP2009-104
Ph:336-753-6050 Fx:336-751-7689 u
Permit Number Building Permit Approval Date: 5/14/2009
Applicant Name: HUGHES CONST. CO., GLENN A. Phone: 336-764-1752
Address: 339 SHADY LANE
WINSTON-SALEM, NC 27107
Total Fees: $75.00 Total Receipts: $75.00
Parcel Number: J7080B0052 Zoning:
Address: 108 OAKSHIRE CT MOCKSVILLE, NC 27028
Owner Name: HUGHES CONST. CO., GLENN A. Phone: 336.764.1752
Address: 339 SHADY LN.
WINSTON-SALEM, NC 27107
SWIMMING POOL HARRIS POOL COMPANY
Address: 277 PLEASANT ACRE DR
MOCKSVILLE, NC 27028
Phone: 336.284.4817
Description
Structure Use: Residential Purpose: Swimming Pool
Construction Value: $20,000.00
Other Fields:
Finished 1st
Modular No
Finshed 0
Decks: 0
Total Finished 0
Finished 2nd 0
Finished 0
Unfinished 0
Unfinished 0
Garage: 0
Porches: 0
Comments: 15X30 INGROUND POOL
This permit is hereby issued with the provision that the applicant will act in full compliance with all
Federal, State and Local Laws, Rules, Regulations and Ordinances including but not limited to; the
North Carolina State Building Code, Flood Damage Prevention Ordinance of Davie County and
Zoning Ordiance as applicable. This permit expires 6 months from the date of issuance if the work
has not begun, or if construction is suspended or abandoned for a period 1 year at anytime after
construction has comenced. All inspection requests must be made at least 24 hours in advance.
Date
• DAVIE COUNTY ENVIRONMENTAL HEALTH
P.O. Box 848/210 Hospital Street
Mocksville, NC 27028
(336)751-8760 Fax # (336)751-8786
OPERATION PERMIT
Account #: 990004086 Tax PIN/EH #: 5768-20-1782
Billed To: Glenn Hughes Subdivision Info: Heritage Oaks II Lot # 52
Reference Name: Location/Address: Suez-elwood-27028
Proposed Facility: Residence Property Size: .82 acres /Ug Qa&hi iG
ATC Number: 4899
**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 taken as a guarantee that the system will function satisfactorily for any given period of
time.
System Type: S.T. Manufacturer S 1� a Tank Date Tank Size `166 0
Pump Tank Size" �`
System Installed By: E� �^ �G E.H. Specialist: 1kAIDate:
DCHD 11/06 (Revised)
DAVIE COUNTY ENVIRONMENTAL HEALTH
P.O. Box 848/210 Hospital Street 6
Mocksville, NC 27028
(336)751-8760 Fax # (336)751=8786 11
AUTHORIZATION FOR WASTEWATER SYSTEM CONSTRUCTION
Account #: 990004086 Tax PIN/EH #: 5768-20-1782
Billed To: Glenn Hughes Subdivision Info: Heritage Oaks II Lot # 52
Reference Name: Location/Address: S. Hazelwood -27028
Proposed Facility: Residence Property Size: .82 acres
ATC Number: 4899
Site Type:New ❑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 a#People Basement❑ Basement plumbing❑
Non:Residential Specifications: Facility Type # People # Seats
Square Footage(or Dimensions of Facility)
Lot Size V �Q�'�� Type of Water Supply: Rlnunty/City ❑Well ❑CommunityWell
System Specifications: Design Wastewater Flow (GPD) 7 Tank Sized C GAL. Pump Tank —A A—AL.
Trench Width 3(c� 'Max. Trench Depth_�61 Rock Depth Q `• Linear Ft. k 3V
Ac stated in 15A NCAC 18A.1969(ra
Site Modifications/Conditions/Other: h+-ce ted Systems may also be usLa
Contact the Davie County Environmental Health Section for final inspection of this system between
8:30 — 900a.m. on the day of installation. Telephone # (336)751-8760.
'A%; A
—ttv'
1 �" r 1 `G C.z ✓""�
Environmental Health Specialist/�{'/'' _ Dat
nr`HTl 1 1 /06 (Rrvi.aPr1)
Davie County Environmental Health
P.O. Box 848/210 Hospital Street
Mocksville, NC 27028
(336)751-8760/ Fax (336)751-8786
Account #:
990004086
IMPROVEMENT PFAN/EH #:
5768-20-1782
Billed To:
Glenn Hughes
Subdivision Info:
Heritage Oaks II Lot # 52
Address:
339 Shady Lane
Location/Address:
S. Hazelwood -27028
City:
Winston-Salem
Property Size:
.82 acres
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: E(New ❑Repair ❑Expansion Permit Valid for: [?5r Years ❑No Expiration
Residential Specifications: # Bedrooms # Bathrooms # People Basement❑ Basement plumbing❑
Non -Residential Specifications: Facility Type # People # Seats
Square Footage(or Dimensions of Facility)
Design Flow(GPD): 3 Type of Water Supply: County/City 0 Well ❑ Community Well
Site Modifications/Permit Conditions: As stated in 15A NCAC 1SA.19$9(5�
S stem T)Te LTAR
Initial e- g- .- -4 1 -e-CP 7
Re air . o e .
tv 1
Site Plan
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1
Environmental Health
APPLICATION FOR SITE EVALUATIONAMPR
Davie County Environmental Health
P.O. Box 848/210 Hospital Street
Mocksville, NC 27028
(336)751-8760/ Fax (336)751-8786
8-
4NT PERM' '
l f�, 1 J f
�Rno
Application For: q, Sit Evaluation/Improvement Permit ❑Authorization To Construct(ATC) ITo 1--,
Type of Application: New System ❑Repair to Existing System ❑Expansion/Modification of Existing System or Facility
***IMPORTANT*** THIS APPLICATION CANNOT BE PROCESSED UNLESS ALL OF THE REQUIRED
INFORMATION IS PROVIDED. Refer to the INFORMATION BULLETIN for instructions.
APPLICANT INFORMATION
Name to be Billed 45�( C&Al le 11-61 Contact Person —.5 A 11 F
Billing Address 1 Is Home Phone j Se - rey • 1A0,'3_
City/State/ZIP e; 2 2/6' Business Phone �; 3G l/� ' • ,> U
Name on Permit/ATC if Different than Above
Mailing Address
FKUFLK I Y 1N P UKMA l IUN
'Fllate House/facility Comers
NOTE: A survey plat or site plan must accompany this application. Included: K Site Plan ❑Plat(to scale)
(Permit is valid for 60 months with site plan, no expiration with complete plat.)
Owner's Name 61 C NN 4- t:1 n r2,: , Phone Number ?Se n-('/- la o' ,
Owner's AddressSri .( , 0 .. City/State/Zip LUl�✓�%n, N-�%�.l. M /�%; '� 7/�
Property Address 4 o- ' .15'Q ' �= , i -- 0.4 E Z61' City &bc k% r,/„1,1 F
Lot Size ,, Fa Art'ir5 Tax IN# .5-709, 2,0-:- I7?Z
Subdivision Name(if applicable)/,("�fl,�cf �!I,FtS Section/Lot#�_
Directions To Site: ioo ikrrle of V- (C911A &LII 0�'
4, 4 .h' e Y i?T_,� J Cit is c -r
f the answer to any o�the following questiofia is "yes", supporting documentation must be attached.
Are there any existing wastewater systems on the site? ❑Yes YNo
Does the site contain jurisdictional wetlands? ❑Yes PNo
Are there any easements or right-of-ways on the site? ❑Yes ®No
Is the site subject to approval by another public agency? ❑Yes R No
Will wastewater other than domestic sewage be generated? ❑Yes Klo
IF RESIDENCE FILL OUT THE BOX BELOW
# People # Bedrooms ' # Bathrooms " Garden Tub/Whirlpool FfYes ❑No
Basement:: ❑Y�o Basement Plumbing: ❑Yes ❑No '
IF NON -RESIDENCE FILL OUT THE BOX BELOW
Type of Facility/Business Total Square Footage of Building # People ”
# Sinks # Commodes # Showers # Urinals
Estimated Water Usage (gallons per day) (Attach documentation of similar facility water consumption)
FOODSERVICE ONLY: # Seats
Type system requested:. ❑Conventional ❑Accepted ❑Innovative ❑Alternative ❑Other.
Water Supply Type: County/City Water ❑ New Well ❑Existing Well ❑ Community Well
Do you anticipate additions or expansions of the facility this system is intended to serve? ❑ Yes C�"N0
If yes, what type?
This is to certify that the information provided on this application is true and correct to the best of my knowledge. I understand that
any permit(s) or ATC(s) issued hereafter are subject to suspension or revocation if the site is altered, the intended use changes, or if
the information submitted in this application is falsified or changed. I hereby grant right of entry to the Authorized Representative
of the Davie County Health Department to conduct necessary inspections to determine compliance with applicable laws and rules.
I understand that I am responsible for the proper identification and labeling of property lines and corners and locating and flagging
or staking the house/facility location, pro o well location and the location of any other amenities.
Site Revisit Charge
Property owner's or owner's leg Representative signature
Date
Date(s).
Client Notification Date:
EHS:
Sign given ❑Yes ❑No Account # DO
Revised 11/06 Invoice #9
DAVIE COUNTY HEALTH DEPARTMENT
' Environmental Health Section
Soil/Site Evaluation
NAME
ADDRESS
PROPOSED FACIILTY
'f'��
DATE EVALUATED %��� 14��
PROPERTY SIZE
LOCATION OF SITE
Water Supply: On -Site Well _ Community Public_
Evaluation By: Auger Boring Pit Cut
iS =d8
FACTORS 1
2
3 4
Landscape position
Slo e Z
HORIZON I DEPTH
—[-(e
Texture group
G
Consistence
Structure
Mineralogy
HORIZON II DEPTH 4
c/bi
Texture group
Consistence
-�
Structure 5
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 RATEI
I•a
SITE CLASSIFICATION: EVALUATED BY:
LONG-TERM ACCEPTANCE RATE: •OTHER(S) PRESEN
REMARKS: .17
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- V+ ---y friable FR -Friable FI -Finn 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
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(01-901
1 OC1931
aa—,
OwKt1,#Ke CaaRT
Piot PIAN
ENG�Nl�f SCALE IS 2O
o7vE 1f41
3 bat gm, Come Ypwg -A
Glsw 4 &Ity 9046 �S
l�� $ y &L if w tv A JiatON AS