173 Cedarwood Place Lot 6t {
Davie County, NC 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 IS NOT A SURVEY
Parcel Information
J7080B0006
Township:
Fulton
5768107524
Municipality:
CORNATZER
82532483
Census Tract:
37059-804
WISECARVER JASON
Voting Precinct:
FULTON
173 CEDARWOOD PLACE
Planning Jurisdiction:
Davie County
MOCKSVILLE
Zoning Class: DAVIE
COUNTY R-20
Land Value:
Total Assessed Value:
NC
27028-0000
LOT 6 HERITAGE OAKS PHASE ONE
0.68
11/2010
008440174
0007
005
Zoning Overlay:
Voluntary Ag. District:
No
Fire Response District:
FORK
Elementary School Zone:
CORNATZER
Middle School Zone:
WILLIAM ELLIS
Soil Types:
Gn62
Flood Zone:
Watershed Overlay:
DAVIE COUNTY
Outbuilding & Extra
Freatures Value:
Total Market Value:
9hIA 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
7�T County of Davie, North Carolina, its agents, consultants, contractors or employees from any and all claims or causes of action due to
�o 1� C or arising out of the use or Inability to use the GIS data provided by this website.
F'�
DAVIE COUNTY HEALTH DEPARTMENT1��
Environmental Health Section
P. O. Boa 848/210 Hospital Street
Mocksville, NC 27028
(336)751-8760
IMPROVEMENT/OPERATION PERMIT
Account #: 990003400 Tax PIN/EH #: 5768-10-7524
Billed To: Charles & Pat Jones Subdivision Info: Heritage Oaks Lot # 06
Reference Name: Location/Address: Cedarwood Place -27028
Proposed Facility Residence Property Size: see map
ATC Number: 3517
**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 V1001E) V--- #People Z #Bedrooms #Baths —I
Dishwasher: Garbage Disposal: ❑ Washing Machine: Basement w/Plumbing: ❑ Basement/No Plumbing: ❑
Commercial Specification: Facility Type #People #People/Shift #Seats Industrial Waste: ❑
Lot Size f//4 kQ Q -'F Type Water Supply ' Design Wastewater Flow (GPD) c5 Site: New Repair ❑
System Specifications: Tank SizelCa) GAL. Pump Tank GAL. Trench Width Rock Depth )Z Linear Ft
Other:
Required Site Modifications/Conditions: — 1 1,1:P 1c &�F Oce. L'/")z
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.****
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Mr. ,fit
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Environmental Health Specialist's Signature: qCc L-mwL4
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DCHD 05/99 (Revised)
APPLICATION FOR SITE EVALUATION/IMPROVEMENT PERMIT
Davie County Health Department
EnvironmentaiHealth Section
P.O. Box 848/210 Hospital Street
Mocksville, NC 27028
(336)751-8760
EC E 0 9 E
LOCT 8 2004
NVIRONMENTAL HEALTH I
***IMPORTANT*** THIS APPLICATION CANNOT BE PROCESSED UNLESS ALL THE REQUIRED—"
INFORMATION IS PROVIDED.
" Refer to the INFORMATION BULLETIN for instructions.
1. Name to be Billed C.�nF/zyeS-''�r"'�`S /'fir—/"7,�5 Contact Person ��J�9�Z��S —,fC ,t -J
Mailing Address .2:5"J'A4'40rS 6i, -ye Home Phone
City/State/ZIP VeC' .27.2.3 9 Business Phone
2. Name on Permit/ATC if Different than Above
Mailing Address
City/State/Zip
3. Application For: ❑ Site Evaluation improvement Permit/ATC ❑ Both
4. System to service: douse ❑ Mobile Home ❑ Business ❑ Industry ❑ Other
S. Type system requested: Conventional ❑ conventional modified
6. If Residence: # People a # Bedrooms -3
7.
11261".4hwasher ❑Garbage Disposal asking Machine
If Business/industry /Other: verify type
# Commodes
# Showers
IF FOODSERVICE: # Seats
8. Type of water sup ly;,Z?'*Eounty/City
❑ innovative
# Bathrooms 3
❑Basement/Plumbing ❑Basement/No Plumbing
# Urinals
# People # Sinks
# Water Coolers
Estimated Water Usage (gallons per day)
❑ Well
❑ Community
9. Do you anticipate additions or expansions of the facility this system is intended to serve? ❑ Yes I.7 -Kr
If yes, what type?
***IMPORTANT*** CLIENTS MUST COMPLETE THE REQUIRED PROPERTY INFORMATION REQUESTED
BELOW. Either a PLAT or SITE PLAN MUST BE SUBMITTED by the client with TRIS APPLICATION.
Property Dimensions: X �/ 9 /
Tax Office PIN: #
Property Address: Road Name
City/Zip -2 70,2 S'
If in a Subdivision provide innfo—rmation, as follows:
Name:
Section: �_ Block: Lot: lv
WRITE DIRECTIONS (from Mocksville) to PROPERTY:
ewes
Date home corners flagged:
/!a - 7 =CJy
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. I, also, understand that I am 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 6/suitability.`
DATE ""5/264 SIGNATURE '�L5
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).
i�/d
Sign given
Revised DCHD (05/03
Site Revisit Charge
Date(s):
Client Notification Date:
EHS:
Account No.
Invoice No.
7(01-3— !7 4-/a'' 0'°�
153•
Account #: 990002849
Billed To: Rickie Crowe
Reference Name:
DAME COUNTY HEALTH DEPARTMENT '
Environmental Health Section
P. O. Boz 848/210 Hospital Street
Mocksville, NC 27028
(336)751-8760
Tax PIN/EH #: 5768-10-7524
Subdivision Info: Heritage Oaks Lot # 06
Location/Address: 173 Cedarwood Place -27028
Pro osed Facility: Residence Pro ert Size: see ma
ATC Number: 3517
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 Sewa a eatment and Disposal Systems). THIS
AUTHORIZATION FOR WASTEWA JUE1 IS D F A PERIOD OF FIVE YE S.
Environmental Health Specialist's Signatur : a Z� b
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 guarant that the -ystem will function satisfactorily for any
given period of time.T,�Qj
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Septic System Installed By:��%�
Environmental Health Specialist's Signature: 14 WDate-
DCHD
05/99 (Revised)
DAVIE COUNTY HEALTH DEPARTMENT
Environmental Health Section
P. O. Boz 848/210 Hospital Street
Mocksville, NC 27028
(336)751-8760
IMPROVEMENT/OPERATION PERMIT
Account #: 990002849 Tax PIN/EH #: 5768-10-7524
Billed To: Rickie Crowe Subdivision Info: Heritage Oaks Lot # 06
Reference Name: Location/Address: 173 Cedarwood Place -27028
Proposed Facility: Residence Property Size: see map
* *NOTES*� T'hrisTmprovement/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 _H Ql)Sc-_- #People 2 #Bedrooms 4 #Baths 2 -
Dishwasher:
Dishwasher: 17 Garbage Disposal: ❑ Washing Machine: d Basement w/Plumbing: ❑ Basement/No Plumbing: ❑
Commercial Specification: Facility Type #People #People/Shift #Seats Industrial Waste: ❑
3 �1,�
Lot Size /4 ACS=– Type Water Supply^'`, — Design Wastewater Flow (GPD) LAD Site: New l�J 1
Repair ❑
System Specifications: Tank Sizel=GAL. Pump Tank
Other: 3 ��Si1�toJ
Required Site Modifications/Conditions: �f
GAL. Trench Width 3(, Rock Depth `2Q Linear Ft. Lit`%
gl>t�Ss.,1�-n ► o' 04-- pp"CP t-'1..
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.****
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Env9ronmental Health Sp list's Si ature:
DCHD 05/99 (Revised)
EC
�.� Al 1 TION FOR SITE EVALUATION/IMPIiOVEAIENT PEIINIIT & ATC
Davie County Health Department
16'`L 1.'� J3 Environmenta/Bea/th Section
—J P.O. Box 848/210 Hospital Street
NMENTAL HEALTH Mocksville, NC 27028
��pCAVIECOUN Y (336) 751-8760
***IMPORTANT*** THIS APPLICATION CANNOT BE PROCESSED UNLESS ALL THE REQUIRED
INFORMATION IS PROVIDED. Refer to the INFORMATION BULLETIN for instructions.
1. Name to be Billed Contact Person S4Me
Mailing Address 226, Home Phone 3310 7k7 -el go,/
City/State/ZIP e , „, ,, -11-C- .2 7.295 Business Phone
2. Name on Permit/ATC if Different than Above _
Mailing Address
3. Application For: E Site Evaluation
0
4. System to Service: House ❑ Mobile Home
City/S to/Zip
Improvement Permit/ATC
,�
13 Business
5. Type system requested: L?' Conventional ❑ conventional modified
❑ Industry ❑ Other
❑ innovative
❑ Both
6. If Residence: # People
a2
# Bedrooms
II Bathrooms .2
C7 Dishwasher []Garbage Disposal B��Washing
Machine ❑Basement/Plumbing
❑Dasement/No Plumbing
7. If Business/Industry /Other:
verify type
It People
It Sinks
It Commodes
It Showers
IF FOODSERVICE: ## Seats
# Urinals
# Water Coolers
Estimated Water Usage (gallons per day)
8. Type of water supply: Er—County/City ❑ Well ❑ Community
9. Do you anticipate additions or expansions of the facility this system is intended to serve? ❑ Yes 0
If yes, what type? i
***IMPORTANT'`** CLIENTS MUST COBIPLETETHE REQUIRED PROPERTY 1N FORMATION (REQUESTED
BELOW. Either a PLAT or SITE PLAN MUST BESUBMITTED by the client with THIS APPLICATION.
Properly Dimensions:� ,
Tax Office PIN: # 5 7L —� O
Property Address: Road Name Z'73 C. '-de, ZL r
City/zip GCK4r1,11e
If in a Subdivision provide information, as follows:
Name:
Section: Block: Lot: le
WRITE DIRECTIONS (from Mocksville) to PROPERTY:
/e}A f,de cMl ,—,(
Date honic corners flagged: 7- z, - G3
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
subinitted in this application is falsified or changed. .1, also, understand that 1 ain responsible fur all charges incurredj•oin
this application. I, hereby, give consent to the Authorized Representative of the Davie County IIealth Department
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/—.?Z —l_3 SIGNATURE
TIIIS 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).
Sign given
Revised DCHD (05/03
Site Revisit Charge
Datc(s):
Client Notification Date:
EIIS:
Account No. ` �i
Invoice No. 2G
r<
'main
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CONNIE LEE HENDRIX JONES
NC HWY 64 ,�',�
PRELIMINARY SITE PLAN
TO MOCKSVILLE
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LOCATION MAP - NOT TO SCALE
GRAPHIC SCALE
0 20 40 so
( IN FEET )
I inch = 40 ft
5
LEGEND
PROPERTY. -UNE
BUIIDING FOOTPRINT
RIGHT 0 11AY LINE
LINE FROM DEED OR PLAT
------------ UTHlPY EASEMENT
O EIP EXISTIIdf1 ICON PIN
(#4 REBAR UNLESS OTHERWISE NOTED)
O NII' NEN IRON PW
(/4 REBAR UNLESS OTHERWISE NOTED)
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NOW OR PORMERLY
N NI
(60' PUBLIC R/W)
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TAX
LOT 64.14 TAX MAP J-6
DALLAS WAYNE JONES 6 WIPE
THIS WILL CERTIFY THAT THE SUBJECT PROPERTY ( ) IS
/ (X ) IS NOT LOCATED IN A SPECIAL FLOOD WIZARD AREA
CONNIE LEE HENDRIX JONES
OF HOUSING AND URBAN DEVELOPMENT.
PRELIMINARY SITE PLAN
D15.188 PG 486
_RICKIE CROWE
NO3'37'40" W
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GUPTON & ASSOCIATES, P.A.
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ENGINEERS -PLANNERS -SURVEYORS
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THIS IS NOT A FktD SURVEYI _ _ _
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CEDARWOOD PLACE
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(60' PUBLIC R/W)
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C-1 1630.00 148.86 148.81 S00'42 21 W
64.0' - 42.50'
PROPOSED
o HOUSE r>
gM�
5.08'
6.0' o o
_
----- _ _ 20.0' c6 'r `� 21.34'
30' BUILDING LINE _--- 45.00---` i - 11.58'---
-------------------------- ---- $;�-------------------------
Ct
4.56' j
901'54'37"E
C—
AR 7 FG Q
CEDARWOOD PLACE
PROPERTY CURVE DATA
(60' PUBLIC R/W)
CURVE I RADIUS I LENGTH I CHORD I BEARING
C-1 1630.00 148.86 148.81 S00'42 21 W
THIS WILL CERTIFY THAT THE SUBJECT PROPERTY ( ) IS
/ (X ) IS NOT LOCATED IN A SPECIAL FLOOD WIZARD AREA
AS DETERMINED BY THE DEPARTMENT
OF HOUSING AND URBAN DEVELOPMENT.
PRELIMINARY SITE PLAN
PROPM OF
_RICKIE CROWE
•I HARRIS B. GUPTON CERTIFY THAT
THIS PRELIMINARY SITE PLAN WAS PREPARED UNDER MY
GUPTON & ASSOCIATES, P.A.
SUPERVISION ON JULY 17, 2003, FROM
ENGINEERS -PLANNERS -SURVEYORS
EXISTING MAPS OF HERITAGE OAKS. P SE ONE
2200 SKAS CREEX PKWY' - SUITE 2B
WN90N-SAIFM NORTH CAROLINA
THIS IS NOT A FktD SURVEYI _ _ _
(33e)r -2459
MAP OF. HERITAGE OAKS
LOT NO.: G PHASE 1 P.B. 7 PG. 5-1 16
IBEAL D.B. PG. TwSP.
Nr L-1846 cr
9�f►O �� TAX LOT TAX BLK. MAP
P.I.N. DAVIE CouN1Y. N.C.
6q�A sem,
SCALE: 1 pp = 40' lim 11997-03A
g:\SDSKPR0J\i1997\SITE Thu Jul 17 16: 47: 50 2003 DBG
NAME
ADDRESS
PROPOSED FACIILTY
DAVIE COUNTY HEALTH DEPARTMENT fil�
Environmental Health Section
Soil/Site Evaluation
DATE EVALUATED
PROPERTY SIZE
LOCATION OF SITE 4��
Water Supply: On -Site Well _ Community/ Public C_--"
Evaluation By: Auger Boring Pit ,/ Cut
FACTORS
1 2 3 4
Landscape position
Sloe Z
HORIZON I DEPTH
Texture group
Consistence
Structure
Mineralogy
HORIZON II DEPTH
6 d-1Jf-
Texturegroup
�'. 0_1
Consistence
�-
Structure
Mineralogy,
-1
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: pl�
LONG-TERM ACCEPTANCE RATE:
REMARKS:
DCHD(01-901
EVALUATED BY: �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- 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
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