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125 South Hazelwood Drive Lot 25Davie County, NC t r Tax Parcel Report 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 1S NOTA SURVEY Parcel Information J7080B0025 Township: Fulton 5768212001 Municipality: CORNATZER 82526574 Census Tract: 37059-804 HOUSEHOLDER SANDRA L Voting Precinct: FULTON 125 SOUTH HAZELWOOD DRIVE Planning Jurisdiction: Davie County MOCKSVILLE Zoning Class: DAVIE COUNTY R-20 NC 27028-0000 LOT 25 HERITAGE OAKS PHASE TWO 0.68 6/2006 006660590 0008 139 Zoning Overlay: Voluntary Ag. District: No Fin: Response District: FORK Elementary School Zone: CORNATZER Middle School Zone: WILLIAM ELLIS Soil Types: GnB2,GnC2 Flood Zone: Watershed Overlay: DAVIE COUNTY Outbuilding & Extra Freatures Value: Land Value: Total Market Value: Total Assessed Value: O t dI� All data Is provided as Is without warranty or guarantee of any ldnd 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 �pUN'S4 NIC or arising out of the use or Inability to use the GIS data provided by this website. DAVIE COUNTY HEALTH DEPARTMENT Environmental Health Section P. O. Bog 848/210 Hospital Street Mocksville, NC 27028 (336)751-8760 Account #: 990003441 Tax PIN/EH #: 5768-21-2001 Billed To: Micah Stauffer Subdivision Info: Heritage Oaks Lot # 25 Reference Name: Location/Address: S.Hazelwood Drive -27006 Proposed Facility Residence Property Size: 125 x 250 ATC Number: 4154 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 CONSTRUCTION IS VALID FOR A PERIOD OF FIVE/YEARS. Environmental Health Specialist's Signature: _A / Date: L Z2 75 1 11, 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 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. T 41''F4t E 7--C At- fry T 1-7 Septic System Installed By: --- Environmental Health Specialist's Signature: DCHD 05/99 (Revised) a DAVIE COUNTY HEALTH DEPARTMENT Environmental Health Section P. O. Boz 848/210 Hospital Street l v� Mocksville, NC 27028 (336)751-8760 IMPROVEMENT/OPERATION PERMIT Account M 990003441 Tax PIN/EH #: 5768-21-2001 Billed To: Micah Stauffer Subdivision Info: Heritage Oaks Lot # 25 Reference Name: Location/Address: S.Hazelwood Drive -27006 Proposed Facility Residence Property Size: 125 x 250 ATC Number: 4154 **NOTE** This Improvement/Operation Permit DOES NOT authorize the construction of 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 #Bedrooms _�—? #Baths Dishwasher: tv, Garbage Disposal: ❑ Commercial Specification: Facility Type Washing Machine;, Basement w/Plumbing: ❑ Basement/No Plumbing: ❑ #People #People/Shift #Seats Industrial Waste: ❑ Lot Size Type Water Supply �- Design Wastewater Flow (GPD) c-� (2 Site: New 2r, Repair ❑ System Specifications: Tank Sizel000 GAL. Pump Tank GAL. Trench Width &.W Rock Depth � Linear Ft,2216 Other: Ata ctated in 15A tJ_T—j — Itz�1 - Required Site Modifications/Conditions: IMPROVEMENT/OPERATION PERMIT LAYOUT - APPROVED EFFLUENT FILTER. RISER(S) IF 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 p.m. o nstallation. Telephone # is (336)751-8760.**** �:�%i'// c� Environmental Health Specialist's Signature: Date: DCHD 05/99 (Revised) i APPLICATION FOR SITE EVALUATION/IhIPROVEMENT PERMIT A U Davie County Health Department Environmental Health Section. S�� 2 5 ZQQ�J P.O. Box 848/210 Hospital Street Mocksville, NC 27028 (336) 751-8760 84MMMEMALHEALiH DAVIE COUNTY ***IMPORTANT*** THIS APPLICATION CANNOT BE PROCESSED UNLESS ALL REQUIRED INFORMATION IS PROVIDED. Refer to the INFORMATION BULLETIN for instructions. V 1. Name to be Billed / n ` %CA STAq P�6,2 Contact Person Mailing Address 4M Home Phone 33 i!,—t(7 S%03 City/State/ZIP% %�OdylrtSutLl NL 2736 o Business Phone 336 't -(%g- 6$`914 2. Name on Permit/ATC if Different than Above Mailing Address city/state/zip 3. Application For: 13 Site Evaluation vi5provement Permit/ATC ❑ Both 4. System to service:II.ou/sem El Mobile Home [I Business 13 Industry ❑ Other 5. Type system requested: f- Conventional ❑ conventional modified ❑ innovative paccepted 6. If -Residence: # People # Bedrooms 3 # Bathrooms Z. 25i1hwasher ❑Garbage Disposal R<ashing Machine ❑Basement/Plumbing ❑Basement/No Plumbing 7. If Business/Industry /Other: verify type # People # Sinks _ # Commodes # Showers # Urinals # Water Coolers IF FOODSERVICE: #��Sea��ts Estimated Water Usage (gallons per day) B. Type of water supply: LrCounty/City ❑ Well ❑ Community 9. Do you anticipate additions or expansions of the facility this system is intended to serve? ❑ Yes R<0 If yes, what type? ***IMPORTANT*** CLIENTS MUST COMPLETE THE REQUIRED PROPERTY INFORMATION REQUESTED BEL01V. Either a PLAT or SITE PLAN MUST BE SUBMITTED by the client with THIS APPLICATION. Property Dimensions: (Z >< Z S © WRITE DIRECTIONS (from Nlocksville) to PROPERTY:,' Tax Office PIN: # J 2o'f 0/3 00 �-S e;q � G� 7 /NT6 %r-vT�Gf Property Address: Road Name�Z' n- Cv,o,D Pe. (C bio 7-o5 57i S, rj City/Zip o, -37T, S. IfAz1-Cwoon If in a Subdivision provide information, as follows: ZS 1.5 Name: 144ziT-ACh ✓ nA-145 Section: Block: Lot: 96 Date home cornets flagged: 7� s/ os - L 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. I, also, understand that I ann responsible for all charges incurred from this application. I, hereby, give consent to the Authorized Representative of the Davie County I-Ieallh Department to enter upon above described property located in Davie County and owned by to conduct all teslin procedures as necessary to determine the site suits i 'ty. DATE 7ZSR b SIGNATURE. THIS AREA MAY BE USED FOR DRAWING YOUR SITE PLAN (Include all of tite following: Existing and proposed property lines and dimensions, structures, setbacks, and septic locatiof." Sign given Revised DCI D (05/03 Client Notification Date: EHS: Account No. Invoice No. L� DAVIE COUNTY HEALTH DEPARTMENT Environmental Health Section - Soil/Site Evaluation NAME c Gv ADDRESS PROPOSED FACIILTY Water Supply: On -Site Well _ Evaluation By: Auger Boring ,v,2s' DATE EVALUATED /'���6,C1 PROPERTY SIZE 1�Ac LOCATION OF SITE _5 *lam Community Pit [� Public Cut FACTORS 1 2 3 4 Landscape position Sloe % 144� HORIZON I DEPTH Texture group Consistence Structure Mineralogy HORIZON II DEPTH Texture group Consistence l Structure ,r✓ r� /� 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 l 1 94 SITE CLASSIFICATION: Cf LONG-TERM ACCEPTANCE RATE: REMARKS: DCHD (01-901 Landscave Position EVALUATED BY: OTHER(S) PRESENT: LEGEND 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- Vl:-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 neraloiry 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