117 North Hazelwood Drive Lot 9Davie County. NC
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Tuesdav, 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:
WAK1VMU: -IMN 1J PIU1 A JUKV1' Y
Parcel Information
J7080B0009
Township:
Fulton
5768105950
Municipality:
CORNATZER
82522426
Census Tract:
37059-804
MOORE SHAWN M
Voting Precinct:
FULTON
117 NORTH HAZELWOOD DRIVE
Planning Jurisdiction:
Davie County
MOCKSVILLE
Zoning Class: DAVIE
COUNTY R-20
Land Value:
Total Assessed Value:
NC
27028-7164
LOT 9 HERITAGE OAKS PHASE ONE
0.69
4/2004
005430551
0007
005
Zoning Overlay:
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 8r Extra
Freatures Value:
Total Market Value:
9[lF All 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 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
r'p C N.t NC or arising out of the use or Inability to use the GIS data provided by this webs@e.
DAVIE COUNTY HEALTH DEPARTMENT
Environmental Health Section
P. O. Boa 848/210 Hospital Street �74
Mocksville, NC 27028 e7 -3a -v3
(336)751-8760
IMPROVEMENT/OPERATION PERMIT
Account #: 990002859 Tax PIN/EH #: 5768-10-5950
Billed To: Titan Homes Subdivision Info: Heritage Oaks Lot # 9
Reference Name: Location/Address: Hazelwood Drive -27028
Proposed Facility: Residence Property Size: see map
ATC Ny&Pfr: 3522
**NOTE** is mprovement/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 Type #People 'L #Bedrooms #Baths
Dishwasher: Il"Garbage Disposal: ❑ Washing Machine Basement w/Plumbing: ❑ Basement/No Plumbing: ❑
Commercial Specification: Facility Type #People #People/Shift #Seats Industrial Waste: ❑
Lot Size Type Water Supply Design Wastewater Flow (GPD) Site: New;!r Repair ❑
System Specifications: Tank SizeA2 GAL. Pump Tank
Other:
Required Site Modifications/Conditions:
GAL. Trench Width zl:� Rock Depth 451— Linear Ft._—w
IMPROVEMENT/OPERATION PERMIT LAYOUT - APPROVED EFFLUENT FILTER. RISER(S) IF 6 " BELOW
FINISIIED 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 1.3 on the day of installation. Telephone # is (336)751-8760.****
Environmental Health Specialist's Signature: 4 Date:
DCHD 05/99 (Reyi'
i
DAVIE COUNTY HEALTH DEPARTMENT
Environmental Health Section
P. O. Boa 848/210 Hospital Street
Mocksville, NC 27028
(336)751-8760
Account #: 990002859 Tax PIN/EH #: 5768-10-5950
Billed To: Titan Homes Subdivision Info: Heritage Oaks Lot # 9
Reference Name: Location/Address: Hazelwood Drive -27028
pro
ATC Number: 3522
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 WASTEWATER CO TRUCTION IS VALID FOR A PERIOD OF FIVE YEARS.
Environmental Health Specialist's Signature: Date:
CERTIFICATE
**NOTE** The issuance of this Certificate of Completion
has been installed in compliance with Arti e 1
Disposal Systems," but shall in NO WAYY t2
given period of time.
Septic System Installed By:
Environmental Health Specialist's Signature:
DCHD 05/99 (Revised)
COMPLETION
rdicate the system described on Improvement/Operation Permit
S. Chapter 130A, Section .1900 "Sewage Treatment and
a guarantee that the system will function satisfactorily for any
Date: / / d J
t '
APPLICATION FOR SITE EVALUATION/iMP110VEAIENT PEIi
Davie County Health Department
E7yironmel7ta/118,71t1i Section
P.O. Box 848/210 Hospital Street
Mocksville, NC 27028
(336)751-8760
JUL282003
EIN5RZ0V NTALyEALTM
***IMPORTANT*** TRIS APPLICATION CANNOT BE PROCESSED UNLESS .A1b�"R1;QUIRLD
INFORMATION IS PROVIDED. Refer to the INFORMATION BULLETIN for instructions
c
1. Name to be Billed I1'1 N� 1 UMC 7 Contact Person a, k J (n rd 1 s
�l y C n` Q -- cI 1
Mailing Address 43 I !I 5`t yer5 "tri 1`d Home Phone /2� t ei 1
City/State/ZIPyj1r�pn S�1,e W�- �L' ai 1� 1 Business Phone 33�, 3``( 1
2. Name on Permit/ATC if Different than Above
Mailing Address
City/State/Zip
3. Application For: ❑ Site Evaluation Improvement Permit/ATC ❑ Both
P
4. System to Service: 0( House ❑ Mobile Home ❑ Business ❑ Indust-ry ❑ Other
5. Type system requested: 0( Conventional ❑ conventional modified ❑ innovative
6. If Residence: it People 7 It Bedrooms it Bathroom,
MDishwasher []Garbage DisposalLlYWashing Machine ❑Basement/Plumbing pc�Basement/No Plumbing
IV 7. If Business/Industry /Other: verify type ## People It Sinks
It Commodes ## Showers ## Urinals It Water Coolers
IF FOODSERVICE: # Seats Estimated Water Usage (gallons par day)
8. Type of water supply: County/City ❑ Well ❑ Colmnunityppp,,,{{{
9. Do you anticipate additions or CXpa11SiO115 Of the facility this systeill is intended t0 serve? ❑ Yes � No
i
If yes, what type?
***IA1I'ORT.OP" CLIENTS AIUST C011MLETETHE REQUIRED PROPERTY INFORMATION RLQIJES'1'BD
BELOW. Either a PLAT or SITE PLAN ill UST BESURiVITTED by the client ~villi THIS APPLICA'T'ION.
Property Dimensions: t q
< -` -7 x ZD--� -A Z-? 1 WRIITL DIRECTIONS (f -onii Alodisville) to P1t01'I:ILTY:
Tax Office PIN: # 5 '.5 q .-o
ffin
Prop efty Address: RoadNamc
City/zip VNA,0 6 1:�,/ Ld l e
If in a Subdivision provide information, as follows:
Name: 49
Section: Block: Lot:_
Date ]ionic corners flagged:
This is to certify that the information provided is correct to the best of my knowledge. I understand that any pernlit(s)
issued hereafter are subject to suspension or revocation, if the site plans or intended use change, or if 111e information
submitted in this application is falsified or changed. 1, also, understand that 1 um responsible for all charges incurred fi•ou1.
this application. I,1lcreby, give consent to the Authorized Representative of the Davie County Ilcalth Dep:u•tnleu(
to cuter upon above described property located in Davie County and owned by
to conduct all testing procedures as necessary to determine the site suitability.
DATE "712-g ,3/, SIGNATURE -�
THIS AREA MAY BE USED FOR DRANVING YOUR SITE PLAN (Include all /efollowing: Existing and proposed
property lines and dimensions, structures, setbacks, and septic locations).
Sign given,
Revised DCHD (05/03
Site Revisit Charge
Datc(s):
Client Notification Dale:
,EIIS:
Account No.
Invoice No. �P
DAVIE COUNTY HEALTH DEPARTMENT
Environmental Health Section
Soil/Site Evaluation
NAME /14
ADDRESS
PROPOSED FACIILTY
DATE EVALUATED
PROPERTY SIZE
LOCATION OF SITE
Water Supply: On -Site Well _ Community Public [/
Evaluation By: Auger Boring Pit Cut
FACTORS 1 2 3 4
Landscape position 4-
L.
Sloe Z 1-9
HORIZON I DEPTH
Texture group
Consistence
Structure
Mineralogy
HORIZON II DEPTH
Texture group
Consistence
Structure S
Mineralogy,l
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 i
SITE CLASSIFICATION: EVALUATED BY: Jla/
LONG-TERM ACCEPTANCE RATE: 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 -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 -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
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
N
a
I
A•
4� GRAPHIC SCALE %
,3 "0 .�
{ IN FEET
I Inch - 30 IL
NDTICE:
MARK JARVIS HAS VERIFIED TO ALLIED LAND SURVEYING COMPANY,
P.A. THE EXTERIOR HOUSE DIMENSIONS FDR THIS EXISTING
/ HOUSE/STRUCTI.RE. HOUSE POINTS AND POSITION SHOVN ON THIS NAF
I REPRESENT THE POINTS TO n PLACED ON THE PROPERTY. THE
OWN1£R/CONTRACTOR HAS REVIEWED ALL HOUSE/STRUCTURE
f DIMENSIONS, SETBACKS FROM PROPERTY LINES, AND CON LIANCE WITH
RESTRICTIVE COVENANTS AND/OR LOCAL GOVERNHENTAL
REQUIREMENTS ON THIS DRAWING AND BY THEIR SIGNATURE
AUTHORIZES ALLIED LAND SIiZVEYING COHPANY, P.A. TO PLACE THE
1 J POINTS AS ACCURATELY AS IS REASONABLE (TYPICALLY OVE'l).
r (IWNER/CONTRAC7OR TO VERIFY 7HE PLACEMENT OF POINITS SET 114
F f /
NOTE -
SURVEYOR HAS HAVE NO INVESTIGATIUN OR INDEPENDENT SEARCH FOR
EASEMENTS OF RECORD, ENCUHFRANCES. RESTRICTIVE COVENANTS,
OVNERSHIP, TITLE EVIDENCE, OR ANY OTHER FACTS THAT AN ACCURATE
AND CURRENT TITLE SEARCH MAY DISCLOSE. THIS SURVEY IS PERFURHED
WITHOUT THE BEKIEFOT OF A TITLE SEARCH
FIELD PRIOR TD AUTHORlZATlON OF OOT NGS BRTCK MASONS/
CONSTRUCTIOM TO PROCEED. BY SIGNING THIS STATEMENT OVHER/
CONTRACTOR FULLY ACCEPTS THEIR RESPONSIBILITY"TO VERIFY
POINTS INFIELD, THE HOUSE POINTS DENOTED BY SOLID FILLED
CIRCLES ARE THE ONLY POINTS TO ?E LOCATED IN THF. FIELA ALL
OTHER BUILDING CORNER LOCATIONS ARE TO BE THE RESPONSIBILITY
EIF THE UNDERSIGNED CONTRACTOR/DEVELUPER.
ACKNOYLEDGHENTP -------- _ - -____ DATE, JIA
OVwDNITRACTcR
FIELD REVISION- --------------------------DATE- --------
OVNER/CO4ITRACTOR/ALLIED STAFF
PRELIMINARY LAYQUT
LOT 9
HERITAGE OAKS
PHASE ONE
Plat fors Mark Jarvis
ALS PROJECT NOl 9399
110TE:
THIS PLAT DOES NOT REPRESENT A CURRENT FIELD SURVEY. ALL LOT
DIMENSICHS HAVE BEEN TAKEN FROM THE PIAT OF HERITAGE OAKS,
PHASE 1, LOCATED IN PLAT BOC( 7 PACE 6, AS REOdIOED JULY 1497.
NO TITLE RESEARCH HAS BEEN PIRFCRMED OR REQUESTED FOR THE
BENETIT OF THUS PLAT.
Allied Land Surveying Co., P.A.
47IO K;ESTER I. 0.4D S„rvr/rd by.
WINS1'01TSAI.Ehl,EAl, II0h711 CAROLRta 27103 cro+n By. xN
PLine: (136)765.2377 0 Fax: (316)960.8886 rro,ivct No. 935
cOaik: ]afixt?ylllinL[gySwv.Nm ooee. 1/25/2003
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} .4' CH DIST-25.20
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i
NOTE -
SURVEYOR HAS HAVE NO INVESTIGATIUN OR INDEPENDENT SEARCH FOR
EASEMENTS OF RECORD, ENCUHFRANCES. RESTRICTIVE COVENANTS,
OVNERSHIP, TITLE EVIDENCE, OR ANY OTHER FACTS THAT AN ACCURATE
AND CURRENT TITLE SEARCH MAY DISCLOSE. THIS SURVEY IS PERFURHED
WITHOUT THE BEKIEFOT OF A TITLE SEARCH
FIELD PRIOR TD AUTHORlZATlON OF OOT NGS BRTCK MASONS/
CONSTRUCTIOM TO PROCEED. BY SIGNING THIS STATEMENT OVHER/
CONTRACTOR FULLY ACCEPTS THEIR RESPONSIBILITY"TO VERIFY
POINTS INFIELD, THE HOUSE POINTS DENOTED BY SOLID FILLED
CIRCLES ARE THE ONLY POINTS TO ?E LOCATED IN THF. FIELA ALL
OTHER BUILDING CORNER LOCATIONS ARE TO BE THE RESPONSIBILITY
EIF THE UNDERSIGNED CONTRACTOR/DEVELUPER.
ACKNOYLEDGHENTP -------- _ - -____ DATE, JIA
OVwDNITRACTcR
FIELD REVISION- --------------------------DATE- --------
OVNER/CO4ITRACTOR/ALLIED STAFF
PRELIMINARY LAYQUT
LOT 9
HERITAGE OAKS
PHASE ONE
Plat fors Mark Jarvis
ALS PROJECT NOl 9399
110TE:
THIS PLAT DOES NOT REPRESENT A CURRENT FIELD SURVEY. ALL LOT
DIMENSICHS HAVE BEEN TAKEN FROM THE PIAT OF HERITAGE OAKS,
PHASE 1, LOCATED IN PLAT BOC( 7 PACE 6, AS REOdIOED JULY 1497.
NO TITLE RESEARCH HAS BEEN PIRFCRMED OR REQUESTED FOR THE
BENETIT OF THUS PLAT.
Allied Land Surveying Co., P.A.
47IO K;ESTER I. 0.4D S„rvr/rd by.
WINS1'01TSAI.Ehl,EAl, II0h711 CAROLRta 27103 cro+n By. xN
PLine: (136)765.2377 0 Fax: (316)960.8886 rro,ivct No. 935
cOaik: ]afixt?ylllinL[gySwv.Nm ooee. 1/25/2003