142 Oakshire Court Lot 49Davie Countv. NC
Tuesday. January 10. 2017
♦1 Li1V\11\V: 11110 10114"X t1 0U1XV j0 1
Parcel Information
Parcel Number:
J7080B0049
Township:
Fulton
NCPIN Number:
5768202218
Municipality:
Account Number:
82526471
Census Tract:
37059-804
Listed Owner 1:
RAYBOULD MARK E
Voting Precinct:
FULTON
Mailing Address 1:
142 OAKSHIRE COURT
Planning Jurisdiction:
Davie County
City: MOCKSVILLE
Zoning Class: DAVIE
COUNTY R-20
State:
NC
Zoning Overlay:
Zip Code:
27028-0000
Voluntary Ag. District:
No
Legal Description:
LOT 49 HERITAGE OAKS PHASE TWO
Fire Response District:
FORK
Assessed Acreage:
0.68
Elementary School Zone:
CORNATZER
Deed Date:
5/2006
Middle School Zone:
WILLIAM ELLIS
Deed Book / Page:
006630289
Soil Types:
Gn132
Plat Book:
0008
Flood Zone:
Plat Page:
139
Watershed Overlay:
DAVIE COUNTY
Building Value:
Outbuilding & Extra
Freatures Value:
Land Value:
Total Market Value:
Total Assessed Value:
Davie County,
�T
1\ C
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 of the use or Inability to use the GIS data provided by this webshe.
F
DAVIE COUNTY HEALTH DEPARTMENT
Environmental Health Section
P. O. Boa 848/210 Hospital Street
Mockcsville, NC 27028
(336)751-8760
Account #: 990003632 Tax PIN/EH #: 5768-20-3337.49
Billed To: Raynor Investments
Reference Name:
ATC Number: 4094
Subdivision Info: Heritage Oaks Lot # 49
Location/Address: 142 Oakshire Court -27028
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: / /�✓ Dater l�
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. 1 b ��
Septic System Installed By:
Environmental Health Specialist's Signature: ��� Date:
DCHD 05/99 (Revised)
' DAVIE COUNTY HEALTH DEPARTMENT
Environmental Health Section
` P. O. Boz 848/210 Hospital Street i
Mocksville, NC 27028 �� / — a
(336)751-8760
IMPROVEMENT/OPERATION PERMIT
Account #: 990003632 Tax PIN/EH #: 5768-20-3337.49
Billed To: Raynor Investments Subdivision Info: Heritage Oaks Lot # 49
Reference Name: Location/Address: 142 Oakshire Court -27028
Proposed Facility Residence Property Size: see map
**NAP mbpr: 4094
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 CONTRALTO MUST SEE THIS PERMIT BEFORE INSTALLING SYSTEM.
Residential Specification: Building Type #People #Bedrooms_ #Baths
Dishwashers Garbage Disposal: ❑ Washing Machine Basement w/Plumbing: ❑ Basement/No Plumbing: ❑
Commercial Specification: Facility Type #People #People/Shift # 13Seaats Industrial Waste:
Lot Size Type Water Supply Design Wastewater Flow (GPD)y#SO d Site: New Repair ❑
System Specifications: Tank Size SAL. Pump Tank GAL. Trench Widths Rock Depth Linear FtC,064
Other:
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.m. to 1:30 p.m. on the day of installation. Telephone # is (336)751-8760.****
4
oil
t
Environmental Health Specialist's Signature: Date: S ��
DCHD 05/99 (Revised)
. EC EO V l5
D APPLIC i FOR SITE EVALUATION/IMPROVEMENT PERMIT & ATC
�.�QY 2 Q �� Davie County Health Department
EnvironmentaiHeaith Section
P. Box 848/210 Hospital Street
ENVIROiJ11ENTALHEAITlI Mocksville, NC 27028
DAVIECOUNTY (336) 751-8760
I ***IMPORTANT*** THIS APPLICATION CANNOT BE PROCESSED UNLESS ALL THE REQUIRED I
INFORMATION IS PRROVIDED. Refer to the INFORMATION BULLETIN for ,in^^structions.
1. Name to be Billed PA Contact Contact Person IJirj%' 12yvar�
Mailing Address 2 0 NIR- asst hfhw 01L Home Phone 336
City/State/ZIP I-lAtti-ow A/C .2729X1 Business Phone x,)3!0' 2Y0'
2. Name on Permit/ATC if Different than Above
Mailing Address a/"" "' Cit/y/State/Zip
3. Application For: Site Evaluation W"IMprovement Permit/ATC ❑ Both
4. system to Service: Ie house ❑ Mobile Home ❑ Business ❑ Industry ❑ Other
S. Type system requested: t3 Conventional ❑ conventional modified ❑ innovative
6. If Residence: # People # Bedrooms _ # Bathrooms Z—
03Dishwasher ❑Garbage Disposal L7Washing Machine ❑Basement/Plumbing ❑Basemont/No Plumbing
7. If Business/industry /Other: verify typo # People Sinks
# Commodes' # Showers # Urinals Water Coolers
IF FOODSERVICE: ## Seats Estimated Water Usage (gallons per day)
8. Type of water supply: QSeCounty/City ❑ Well ❑ Community
9. Do you anticipate additions or expansions of the facility this system is intended to serve? ❑ Yes 8'No
If yes, What type?
***IMPORTANT*** CLIENTS AIUST COAIPLETET14E REQUIRED PROPERTY INFORMATION REQUESTED
BELOW. Eithera PLAT or SITE PLAN AfUST BESUBAIITTED by the client witl: THIS APPLICATION.
Property Dimensions: A1J.d x2P2•7--f flLlit o " Y2a-9vkITE DIRECTIONS (from Mocksville) to PROPERTY:
Tax Office PIN: It y �� 33 3 7 yy
Property Address: Road Name ��G� C?W/40;h6oc- a" f -1" L74 Go
City/Zip M041!J U %le- NL Ai Awr.'
If in a Subdivision provide information, as follows:
Name: I*01 f' mnr o/h'�S
Section: Block: Lot:
Date liome corners flagged: S -23 -
This
Z3 -
This is to certify that the information provided is correct to the best of my knowledge. I understand that any permits)
issued hereafter arc 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 am responsible for all charges incurred from
this application. I, hereby, give consent to the Authorized Represciitative of the Davie County I-Icalth 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.
�I
DATE SIGNATURE
TINS AREA MAY BE USED FOR DRAWING YOUR SITE PL ( nclude all of the following: Existing and proposed
property lines and dimensions, structures, setbacks, and septic locations).
7 •
C��-ee < C-
4
Sign given
Revised DCHD (05/03
Site Revisit Charge
Date(s):
Client Notification Date:
EHS:
Account No. 3
Invoice No. �� "
DAVIE COUNTY HEALTH DEPARTMENT 40
Environmental Health Section
Soil/Site Evaluation
NAME t4ZIz Al Z
ADDRESS
PROPOSED FACIILTY
DATE EVALUATED
PROPERTY SIZE
LOCATION OF SITE
Water Supply: On -Site Well _ Community Public
Evaluation By: Auger Boring Pit L.--- Cut
FACTORS 1 2 3 4
Landscape position
Slope Z
HORIZON I DEPTH
Texture group
Consistence
Structure
Mineralogy
HORIZON II DEPTH 9
Texture group
Consistence
Structure <be5 .0
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: �V
LONG-TERM ACCEPTANCE RATE:
REMARKS:
DCHD (01-901
EVALUATED BY:
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- V+2. -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 watet 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
t i
iBa.93'
771.79 166.94'
162.•{x'
158.36
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l
90.21,
201.57'
148.06'
5.06•
148.05'
148.06'
148.06'
182.31'
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2,
LOT 46
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LOT 47
LOT 48
LOT 49
LOT 50
LOT 51
lOT 52
-
o
Z
I N
LOT 45
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+0 VTUry EASEVEFC!
OAKSHIRE
COURT 60'
PUBLIC R/W
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40,
1
148-
,x.06'
1 ka 0S.
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ib2.66'
'
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PIIOP06tD 20' ASPM LT
5 CFS 1-34! L
1037.56'
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- — -
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—
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146.35:
148.33'
i 48.33•-
48.33'
148.33'
1 X8.56'
LOT 44
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O
O
O
.
N
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ainc
LOT 43
LOT 42
; LOT 41
N
�, LOT 40
N
O•
:, LOT 39 1.
N.„+,
LOT 38
LOT 37
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ry`
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1
1 !
1
I
100.06'
231.58'
148.33'
148.33'
148.33'
148.33'
148.33'
157.33'
30. 5'
199.92' i
199.84' 1 1
390-29'
1;
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1
I
820.10' TOTAL
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LOT
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LOT 35
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