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191 Redwood Drive Y-Lot 10Davie Countv.'NC - Tax Parcel Report Wednesday. January 4. 2017 All data is provided as is without warranty or guarantee of any kind 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 NC or arising out of the use or Inability to use the GIS data provided by this website. WARNING: THIS IS NOT A SURVEY __ ....... Parcel Information Parcel Number: _ K507OA0010 Township: Mocksville NCPIN Number: 5747238505 Municipality: Account Number: - _ 8302570 Census Tract: 37059-805 Listed Owner 1: - - WRIGHT ANITA H . Voting Precinct: SOUTH MOCKSVILLE Mailing Address 1: - 191 REDWOOD DRIVE ' Planning Jurisdiction: Davie County City: MOCKSVILLE Zoning Class: DAVIE COUNTY R -A State: NC Zoning Overlay: Zip Code: 27028 Voluntary Ag. District: No Legal Description: LOT 10 SOUTHWOOD ACRES Fire Response District: JERUSALEM _ Assessed Acreage: 0.99 Elementary School Zone: CORNATZER Deed Date: 9/2013 . Middle School Zone: WILLIAM ELLIS Deed Book / Page: 009370937 Soil Types: PcC2,RnD Plat Book: 0008 Flood Zone: Plat Page: 205 Watershed Overlay: DAVIE COUNTY Outbuilding & Extra Building Value: Freatures Value: Land Value: Total Market Value: Total Assessed Value: All data is provided as is without warranty or guarantee of any kind 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 NC or arising out of the use or Inability to use the GIS data provided by this website. DAVIE COUNTY ENVIRONMENTAL HEALTH P.O. Box 848/210 Hospital Street Mocksville, NC 27028 (336)751-8760 Fax # (336)751-8786 OPERATION PERMIT Account #: 990004364 Billed To: Timothy & Christine Nelson Reference Name: Proposed Facility: Residence ATC Number: 4696 Tax PIN/EH #: 5747-23-8505 Subdivision Info: Redwood/Southwood off Deadmon R Location/Address: Redwood Drive -27028 Property Size: 1 acre Jyo pl� 141 **NOTE** The issuance of this Operation Permit shall indicate the system des on the ATC has been installed in compliance with Article 11 of G.S. Chapter 130A, Section .1900 "Sewage Treatment a isposal Systems," but shall in NO WAY be taken as a guarantee that the system will fuyion Satisfactorilyoyny gi n pexiod of time. System Type: y� . S.T. Ma ufacturer ate Ta VV Size I� Pump Tank Size�y P System Installed By: Y-� T (��� E.H. Spe Date: I FQ'sN-iT— DCHD 11/06 (Revised) DAVIE COUNTY ENVIRONMENTAL HEALTH P.O. Box 848/210 Hospital Street Mocksville, NC 27028 (336)751-8760 Fax # (336)751-8786 AUTHORIZATION FOR WASTEWATER SYSTEM CONSTRUCTION Account #: 990004364 Billed To: Timothy & Christine Nelson Reference Name: ' Proposed Facility: Residence ATC Number: 4696 Tax PIN/EH #: 5747-23-8505 Subdivision Info: Redwood/Southwood off Deadmon R Location/Address: Redwood Drive -27028 Lo -f41 10 Property Size: 1 acre Site Type.,;?Mew ❑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 3 # Bathrooms Z # People Z Basement Basement plumbing Non=Residential Specifications: Facility Type # People # Seats Square Footage(or Dimensions of Facility) Lot Size Type of Water Supply: ounty/City ❑Well ❑Community Well System Specifications: Design Wastewater Flow (GPD) � Tank Size jo��GAL. Pump Tank O©IDiAL. is I/ Trench Width_ Max. Trench Depth 24 Rock Depth N A Linear Ft. 3('00 Site Modifications/Conditions/Other: �LT� 2e-06 o --*S la' c'c Map_ l,)l�-- Contact the Davie County Environmental Health Section for final inspection of this system between 8:30 — 9:30a.m. on the day of installation. Telephone # (336)751-8760. Orr- A4 rr d Ak'nk C, 05 s 9 .. r. Li's 2?s Environmental Health Specialist Date: DCHD 11/06 (Revised) - -- • run MLfir_ r r r T t.;Q1 7/2" ' - J~IEi Fact , Jsk fits -Control Corner l � � '' • {�Flr' ��r • E4r , 1/2" Ear Fnd 120; 41 C90- E. r �'� .4,A � ,,,,_..,fit `'�,' o • i,� �C•`•; . W ` J 1 n+•. an a-. _._ h+: , Z` t.S �` r,,,.•'` Section 2—R' a lxf3 'Fa FG ,65 - 53 "'666 1 Cd M1���.. �j• y,{ r. fix r TSX. 1 n GaiTsm e' Mrn D,-Jte' ( S 85°52.'0'3" . t.�13.{r3- Tota as.7,5'� (67.M j 6R Frt \ T/2" FiR F,-, gs,_-.LLC_ "IL' ^a4a iRS Control Corner (0 a J1�1�11 1/2" EiR Fnd Block "Y ',FOOD ACRES AMMON Section 2-B p 5 to PIG 65 lax Lot 4 Tai; Map f-5 n/f Binghcrrt LL RB- 578 Q PSA.. -2.1 i 1 /;fix �ifz 'lid •�""" "-' �. __.,-..-.._._ ...._ , Bi; FIE10SED\ SOUTH' NOD l Sect P6 5. Q \ Q O.S ^` Acrm-+/- 6' _ o 610 ` �\ 9, 76 cli r o LLJ 40' Date Cute signed tJa'r+ ! (w•c) hereby certify that I am (we arr.) t;:e oxner (s ct the Frt i/ .04 i dcscribed hereon, which is ;oceted in the subdivision ju+isd ct'or FJ t Prn t: Cavae County and that f ha eby adopt U Ss s 'ted J for sr10/1 v ca earl s .-trr"W r rr9r;irrvrr " ' ,< se -?,71nss an u "ca Y F{S.{?�.rw C^�FSY'3;•°-iFtRlw . ,.�}Q{MY'r—(6Rfj--At »+ ..WFk!9;9 Qs+xt1-H3°:!dxe a?�-1f.^j Date Cute signed tJa'r+ f DAVIE COUNTY HEALTH DEPARTMENT Environmental Health Section PO Box 848/210 Hospital Street Mocksville, NC 27028 Phone: (336)751-8760 / Fax: (336)751-8786 May 22, 2007 Hendrix and Corriher Rentals Attn: Jack Corriher 449 Park Ave Mocksville, NC 27028 Re: Site Evaluation - Southwood Acres Addition, Block Y, Lot 10 1 Acre Lot on Redwood Road Tax PIN: 5747238505 Dear Client(s): As requested, a representative from this office visited the above site to perform a site evaluation. Based on the information provided on the Application for Site Evaluation/Improvement Permit, the results of the evaluation and the relocation of the "Woodland Boulevard" road easement, the site is now classified provisionally suitable for the installation of an on-site sewage disposal system. Before a representative of this office will revisit the site to issue an Improvement Permit/Authorization to Construct, the appropriate application must be completed and submitted to this office. The location of the facility the system is to serve must be staked off. If you have any questions, feel free to contact this office at 751-8760. Sincerely, Jeff Beauchamp, R.S. Environmental Health Section DAVIE COUNTY HEALTH DEPARTMENT Environmental Health Section Soil/ Site Evaluation APPLICANT INFORMATION PROPERTY INFORMATION Account #: 990003495 Tax PIN/EH #: 5747-23-8505 Billed To: Hendrix & Corriher Rental Subdivision Info: Southwood Acres Lot # 10 Reference Name: Location/Address: Redwood Drive -2702 Proposed Facility: Residence Property Size: see map Date Evaluated: 22 - Water Supply: On -Site Well Community Evaluation By: Auger Boring Pit Public / Cut SITE CLASSIFICATION: �S r� 1'`)1 EVATLUATION BY: CZ)= LONG-TERM ACCEPTANCE RATE: REMARKS: JP.1r/ & 0, F&, f LEGEND OTHER(S) PRESENT: .'P� - t At - T, n s ape 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 clay loam SIL - Silty loam CL - Clay loam SCL - Sandy clay loam SC - Sandy clay SIC - Silty clay C - Clay Moist VFR - Very friable FR - Friable FI - Firm VFI - Very firm EFI - Extremely firm 3Y91 NS - Non sticky SS - Slightly sticky S - Sticky VS - Very Sticky NP - Non plastic SP - Slightly plastic P - Plastic VP - Very plastic Structure SC - Single grain M - Massive CR - Crumb GR - Granular ABK - Angular blocky SBK - Subangular blocky PL - Platy PR - Prismatic F z 9) a- 7z Mineralogy „ 1:1, 2:1, Mixe LYQtcs �` 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 05105 (Revised) Landscape position Texture group _J��W�m Consistence WENEMEMR0 Mineralogy MAIM WIM HORIZON H . Texture group ire■©■��r������ Consistence �ar��arar���� rWE groupMineralogy Texture •Mineralogy HORIZON IV DEPTH Texture group Consistence -SOILMineralogy CLASSIFICATION • WINE SITE CLASSIFICATION: �S r� 1'`)1 EVATLUATION BY: CZ)= LONG-TERM ACCEPTANCE RATE: REMARKS: JP.1r/ & 0, F&, f LEGEND OTHER(S) PRESENT: .'P� - t At - T, n s ape 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 clay loam SIL - Silty loam CL - Clay loam SCL - Sandy clay loam SC - Sandy clay SIC - Silty clay C - Clay Moist VFR - Very friable FR - Friable FI - Firm VFI - Very firm EFI - Extremely firm 3Y91 NS - Non sticky SS - Slightly sticky S - Sticky VS - Very Sticky NP - Non plastic SP - Slightly plastic P - Plastic VP - Very plastic Structure SC - Single grain M - Massive CR - Crumb GR - Granular ABK - Angular blocky SBK - Subangular blocky PL - Platy PR - Prismatic F z 9) a- 7z Mineralogy „ 1:1, 2:1, Mixe LYQtcs �` 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 05105 (Revised) A rC6fPO,94,, UIV r1L S rR . 416, 50 �- LIC SITE EVALUATION/IMPROVEMENT PERMIT & ATC Davie County Environmental Health P.O. Box 848/210 Hospital Street Mocksville, NC 27028 (336)751-8760/ Fax (336)751-8786 �:�tE1lt4"1=k' A lica oiS tt it`'� ,5lif�z ion/Improvement Permit Authorization To Construct(ATC) ❑ Both T} e of Ap 1* t� :, f�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 % t1 "I �� '� ft e- 5 , Ac E' I V Q ( S 00tontact Person 1,5 1, , <k. Billing Address 5 3,;Z S t, J M c- ✓ k J- -,,- 74t. "�Ij Home Phone City/State/ZIP &f -2 7'l0 `% Business Phone Name on Permit/ATC if Different than Above Mailing Address PROPERTY INFORMATION *Date House/Facility Corners NOTE: A survey plat or site plan must accompany this application. Included: ❑ Site Plan ❑Plat(to scale) (Permit is valid for 60 months with site plan, no expiration with c mplete plat.) Owner's Name e �t i �` r ^ ✓ e ✓ f S Phone Number Owner's Address Li/ /�� K ✓ - City/State/Zip �-1 �_k s y,' ((e I G- 7p Property Address Irl/ t- City Lot Size / c;. e- ✓•,. Tax PIN# >"7`f 735 Subdivision Name(if applicable) _So �f l ,•��,iiCC �✓ e5 Section/Lot# Directions To Site: 4, o j S :�L- ::> 4,,-(4 � r__. (1 6_ oQ — I -f a �k_ %•� o�' ea � �"�C If the answer to any of the following questions is "yes", supporting documentation must be attached. Are there any existing wastewater systems on the site? ❑Yes RN6 Does the site contain jurisdictional wetlands? ❑Yes DNo Are there any easements or right-of-ways on the site? 2 -Yes ❑No Is the site subject to approval by another public agency? ❑Yes DNo Will wastewater other than domestic sewage be generated? ❑Yes 2No Ik RES1DEAUL P. LL UU 1 I riL 13UA 13tLU W # People ,2 # Bedrooms _3 # Bathrooms ®2 Garden Tub/Whirlpool VfYcs ❑No Basement: ❑Yes bio Basement Plumbing: ❑Yes Pff�o 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 If yes, what type? Cho 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, proposed well location and the location of any other amenities. Site Revisit Charge Property owner's or owner's legal representative signature Date Date(s): Client Notification Date: EHS: Sign given ❑Yes ❑No Account # Revised 11/06 Invoice # APPLICATION FOR SITE EVALUATION/IMPROVEMENT PERMIT & ATC Davie County Health Department EnvironmentaiHeaitii Section P.O. Box 848/210 Hospital Street Mocksville, NC 27028 (336) 751-8760 I k ***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 #J/%i)Pj x e04 M1 &A��/t��[ Contact Person JY�G Mailing Address y ¢AM AVE Home Phone M� z7Q x e+ City/State/ZIPAfAneS0 AAO. �. Z%O ZS— Business Phone 2. Name on Permit/ATC if Different than Above Mailing Address City/State/Zip �or'+wia 3. Application For: "j� Site Evaluation ❑.Improvement Permit/ATC ❑ Both / 4. System to Service: ouse ❑ Mobile Home ❑ Business ❑ Industry ❑ Other S. Typo system requested: ❑ Conventional ❑ conventional modified ❑ innovative C3acCepted Z- 6. If Residence: # People # Bedrooms # Bathrooms � 106ishwasher ❑garbage Disposal ZKashing Machine ❑Basement/Plumbing ❑Basement/No Plumbing 7. If Business/Industry /Other: verify type # People # Sinks # Commodes # Showers # Urinals 11 Water Coolers IF FOODSERVICE: # Seats Estimated Water Usage (gallons per day) 8. Type of water supply: Conn City ❑ Well ❑ Community /� 9. Do you anticipate additions or expansions of the facility this system is intended to serve? 11 Yes blzo If yes, what type? ***IMPORTANT'"** CLIENTS MUST COAiPLETETHE REQUIRED PROPERTY INFORMATION REQUESTED BELOW. Either a PLAT or SITE PLAN AfUST BESUBAf1TTED by the client with THIS APPLICATION. Property Dimensions: /$'9�2C !U ��,��j WRITE DIRECTIONS (froth Niocksville) to PROPERTY:' �a, its Sf Tax Office 1'IN: #� �D7d O /d 54",o Property Address: Road Name �ET%ll�l�l D RD Cityizip,/�O�sy�LL�� 074?,.�" If in a Subdivision provide information, as follows: Name: Section: Block:_ Lot: Date home corners flagged: 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 l ain responsible for all charges incurred front this application. I, hereby, give consent to the Authorized Representative of the Davie County IIealth 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. DATE 7— 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 (05103 Site Revisit Charge Datc(s): Client Notification Date: EHS: Account No. Invoice No. s f