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1924 Junction RdDAVIE COUNTY HEALTH DEPARTMENT Environmental Health Section d/ P. O. Boa 848/210 Hospital Street Mocksville, NC 27028 (336)751-8760 IMPROVEMENT/OPERATION PERMIT Account M 989900149 Billed To: Home Improvement Services Reference Name: Proposed Facility: Residence Tax PIN/EH #: 5735-45-8944 Subdivision Info: Location/Address: Junction Road -27028 Property Size: 15 acres **NOTES* This-Improv%ent/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 _ Dishwasher: Garbage Disposal: ❑ Commercial Specification: Facility Type .--X!/ #People .2 #Bedrooms _ Washing Machine: 00"Basement w/Plumbing: ❑ S #Baths Q' Basement/No Plumbing: ❑ #People #People/Shift #Seats Industrial Waste: ❑ Lot Size ,4 G Type Water Supply n Design Wastewater Flow (GPD) Site: New;2'0"'Repair ❑ System Specifications: Tank Size./" GAL. Pump Tank [all Ii1;10,F Required Site Modifications/Conditions: IMPROVEMENT FINISHED GRAI system between 8:3 GAL. Trench WidthL 1_� Rock Depth / Linear Ft. Od 1T LAYOUT - APPROVED EFFLUENT FILTER RISER(S) IF 6 " BELOW ntact a representative of the Davie County Health Department for final inspection of this :00 P. p.m. on t e tallation. Telephone # is (336)751-8760.**** Environmental Health Specialists Signature: 4aaa�4 r � Date: DCHD 05/99 (Revised) DAVIE COUNTY HEALTH DEPARTMENT Environmental Health Section P. O. Boz 848/210 Hospital Street Mocksville, NC 27028 (336)751-8760 Account #: 989900149 Billed To: Home Improvement Services Reference Name: Proposed Facility: Residence ATC Number: 2961 Tax PIN/EH #: 5735-45-8944 Subdivision Info: Location/Address: Junction Road -27028 Property Size: 15 acres AUTHORIZATION FOR WASTEWATER SYSTEM CONSTRUCTION e -- **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 WASTE W CONSTR TION IS VALID FOR A PERIOD OF FIVE YEARS. Environmental Health Specialist's Signature: s Date: 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. IV -'r Septic System Installed By: Environmental Health Specialist's Signature: DCHD 05/99 (Revised) Date: /Yl %r1 -� TION FOR SITE EVALUATION/IMPROVEMENT PERMIT & ATC Davie County Health Department Environmental Health Section P.O. Box 848/210 Hospital Street Mocksville, NC 27028 (336) 751-8760 p""- 1"'�'Oe 8. Do you anticipate additions or expansions of the facility this system is intended to serve? ❑ Yes PMVo If yes, what type? ***IMPORTANT*** CLIENTS MUSTCOMPLETETHE REQUIRED PROPERTY INFORMATION REQUESTED BELOW. Either a PLAT or SITE PLAN MUSTBESUBMITTED by the client with THIS APPLICATION. Property Dimensions: # 5`73r - #.5-U*4- Tax Office PIN: Property Address: Road Name nnldipa j&d City/Zip If in a Subdivision provide information, as follows: Name: Section: Block: Lot: WRITE DIRECTIONS (from Mocksville) to PROPERTY: n I S.,A J,. C21 aJ at Rd Date Property Flagged: slzi OI This is to certify that the information provided is correct to the best of my knowledge. I understand that any permit(s) 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 ant responsible for all charges incurred front this application. 1, hereby, give consent to the Authorized Representative of the Dayic County Health Dcp:►rtment to enter upon above described property located in Davie County and owned by stephetv &-rA Jr - to conduct all testing procedures as necessary to determine the site suitabjlity. DATE f4/ SIGNATURE THIS AREA MAY BE USED FOR DRAWING YOUR SITE PLA"n Ae all of the following: Existing and proposed property lines and dimensions, structures, setbacks, and septic locatiib s). Revised DCHD (07/99) Site Revisit Charge Datc(s): Client Notification Date: EHS: Account No. �7 Invoice No. I 1, ***IMPORTANT*** THIS APPLICATION CANNOT BE PROCESSED UNLESS'ALL INFORMATION IS PROVIDED. Refer to the INFORMATION BULLETIN for THE REQUIRED instructions. NO e 1. Name to be Billed tJ t'0/'d1Ce' Contact Person N % P�rK I -777 Mailing AddressA I Home Phone 7S �.3 / City/State/ZIP U4 �L/11l e L ��� ` Z� Business Phone ~ 77 2. Name on Permit/ATC if Different than Above Mailing AddressCity/ to/Zip 3. Application For: Site Evaluation Improvement Permit/ATC Il Both 4. System to Service: ❑ House Mobile Home ❑ Business ❑ Industry ❑ .Other 5. If Residence: # People _ # Bedrooms # Bathrooms Dishwasher U Garbage DisposalWSJ asking Machine L1 Basement/Plumbing 1.1 Basement/No Plumbing 6. If Business/Industry/other: Specify type # People # Sinks # Commodes # Showers # Urinals # Water Coolers IF FOODSERVICE: # Seats Estimated Water Usage (gallons per day) 7. Type of water supply: R County/City ❑ Well CI Community 8. Do you anticipate additions or expansions of the facility this system is intended to serve? ❑ Yes PMVo If yes, what type? ***IMPORTANT*** CLIENTS MUSTCOMPLETETHE REQUIRED PROPERTY INFORMATION REQUESTED BELOW. Either a PLAT or SITE PLAN MUSTBESUBMITTED by the client with THIS APPLICATION. Property Dimensions: # 5`73r - #.5-U*4- Tax Office PIN: Property Address: Road Name nnldipa j&d City/Zip If in a Subdivision provide information, as follows: Name: Section: Block: Lot: WRITE DIRECTIONS (from Mocksville) to PROPERTY: n I S.,A J,. C21 aJ at Rd Date Property Flagged: slzi OI This is to certify that the information provided is correct to the best of my knowledge. I understand that any permit(s) 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 ant responsible for all charges incurred front this application. 1, hereby, give consent to the Authorized Representative of the Dayic County Health Dcp:►rtment to enter upon above described property located in Davie County and owned by stephetv &-rA Jr - to conduct all testing procedures as necessary to determine the site suitabjlity. DATE f4/ SIGNATURE THIS AREA MAY BE USED FOR DRAWING YOUR SITE PLA"n Ae all of the following: Existing and proposed property lines and dimensions, structures, setbacks, and septic locatiib s). Revised DCHD (07/99) Site Revisit Charge Datc(s): Client Notification Date: EHS: Account No. �7 Invoice No. I 1, W Pc Nates* I. 7,,nl W R-20 1, aeerp. Robert !tom. ewflfy tact ibis plot wee how soder se s"Wvfe/w firm 44 441041 sees" ill• *Oder ea sspervl-slon rsarded 1• MN -a . ►spa 6 . off.) (other): fast fed �• L, �.•1(e1 4' _ .. • . ` .. v `r". y IAF r'l. 1 Pew -----L that The .4110 at pr441s144 44 441e01eted Is Id'Moee7 fast tble plot am proposed Is 44seedoeoa vita 6.8. 47-30 44 ao•ded. +l sle"two. regfstraflea *mbw ssd seal splen wee repel; p..+ a land. � This -t w/ at M43Y . s.0. 2000. • W Pc Nates* I. 7,,nl W R-20 1, aeerp. Robert !tom. ewflfy tact ibis plot wee how soder se s"Wvfe/w firm 44 441041 sees" ill• *Oder ea sspervl-slon rsarded 1• MN -a . ►spa 6 . off.) (other): fast fed (do" des*f 1pf144 ►000der Iso, not o.rreyed Ore slowly INleatod as drew frm IOlw"Otlea feved Is seek Pew -----L that The .4110 at pr441s144 44 441e01eted Is Id'Moee7 fast tble plot am proposed Is 44seedoeoa vita 6.8. 47-30 44 ao•ded. Wit"se to or Ipleal sle"two. regfstraflea *mbw ssd seal splen wee repel; p..+ a land. � This -t w/ at M43Y . s.0. 2000. ± 3441 or stamp C4or+ge R. Stoner PLS f Surveyor V ealaPill an L 3169 Plat Revisions: 7 -Or •-•2000 DO 197 ria J00 see l s tr of l oo Resew 1. Deed References Do 3X PC 40 2. Zoning Clo"fication S I V53'37"E 3. Ownen; ���I! • 044. Na urneft. "Jockey AZ MK" fid; ,,�fr.SSb . 4 % 5. Drainage & Utility Easement Dt 6. Subdivision Certificate • SEAL 7. Title Block 0 L-3162 J W Tax Lot 35 �►�; .,su••tt�'..�''g Tax Map M-4 ROGER M. M. Wagner D8 103 • PG 76 1.M C&Wob 1� arm K W �► Ik 231>012.Oe/ w 0 Z C 007401.000 w Sets F40br. 0.0014103 R Nt7► \ Z o -�► N °_ �o �'• tl \ we OW" COMMON, o. 0,401 A~ M O J ane■ A MID Tax of 38.04 T M-4 11i la d O.,r4.s J O N f. SS L e►w v n <o 0o ..x�:.`.'Fl+)....zW..r.r_�_sA+t1�.�.a._bT .._..+.a.w �..� _.....,n rwu.--..[__..4'�i.•..�i1L. ...rr� 0,X , Z wlatsr, Shed Clo■■ificntli' 05 -IV Protected bar A.w. +/- �✓ I Illy Acts to be served by public wooer and sewer � \� r 3lunch,vn Woad ,tS1P LIM 4. AN uWdm to be kietoNed Underground I Three (3) prgpo«d late (Public 60' R\ W) a Told subdlvfeion ar■a 1.488 Acres�4 s0, 7. Average lot crew 0.489 Acres 00831.1 cot,.. 8. N=fnofwrnwfts found wdMe 2000• of project \. \ - Tax mop ax IM 4-13 8sari'fg rsf►erwwe PA 7 • P10 13 for sii+e consistency � $ o+l•T. Deadman a 1 \ E. Qo \• Tax Lot 38.04 * D8 59 O PG 21 91. Nundbs► 4 Arbars set d ane now property cartes r N 1 1Q Setb■cllsr rrw* 4d'. 9aclr 30', Sides 15' , ,�4 dab^ i� \` Tax Map M-4 11. No new ■best cons&ucdon proposed meq, ``bTax lot 1 ` 1 12. The following drninoge and/or utility\\\'p7* ty so, \` Tax map easefttsrtb ane dedkoted; �� 'o'e \ M-4- 13 A. 10' a"exterior lines ��j x ` O� �Area in gquestionion�p (OverloP) 8. 10r each side of interior lines 223.38' \ � 62.58' Tax Lot 38.04 \9`f ,•1 i�-ftp .cool,. S. 87043'50'•E d . Tax Map M-4 �J\ found s 011 30n _ n/f John Grose- t�� f n ! •rivet sc SLJY 1/2" UK J .vifr .w. :Y).,) •vv. / rload 'I \ �- 98.59'* 010, DB 197 O PG 384 N 57 40'20'W o,,� DB 197 O PG 386 1 I 1 \ rot ` \ too HAWKNEST, Phse ne Ofg I PB7@PG I� 164.38' ons ' - t \ N 60.59'00"W °r b 0 120.46' end te ,.� `°°oma / ' 1 N 59.23'55"W a I j 1 ' , HAWKNEST, P ase ns ! 1 A� OR 7 @ Pr; 10% i 1 1 (we) lmehy awtlfq Rat I am (we am) the ow l r(s) \ Y�y �-N 54056�50"W of the pfopsrl�i dseaAsd Ifereen. wh10o! is booked h .\ Y�2 ' 45.47 /( •, 0 I Q 1 1 I the subdivision Jlrlsdlation of Dore Courtly and that I Honbhr adopt this eubd hileel plan w11h "W free \ ~- N 57 53 35"W ; 4 salbeok lif■s � • I I D � $ I I'I I I oen■wlf, est,abldied ""nurn buMn 2 p a Tax Lot oetsr ails' and easeents ego public ads use andi\ ���e �N 45'61205"W D mi I Tax Map M- 65.49' , I f o 3 I 4+m �-.-- ` N 36'50'55"W �liI �' I I 1 ansA- N I ., % 7 - ow.stl 66.95' o v 36603'40"104 � � , 0 - - ..- ftba &. is-&" ■ Of hereby certify the# the s6Nlvlsles Piet sham heroes hes been fount to 60*17 with the Covell sebdivlslee Roselotioos. with the easptios of seek ver loess■, if any. were noted is the 01116106 of the ploos1Rs 9~4 sed that It hes ►ase oderwed for recordist to the eff lee of the Resister of 000446 it Is here" MIN tkot doss not 1041640 psrsvel to Instell sed 6111120 soeitery fesliltlie Ref does It Inslv40 oNrovsl for the eenstrestlee w eeevraesy of kolldinp er streetwes.' ,P The Dols C=* Fhmft sood hsrsiv gpwmed to fhd pot for one A&iui�-�� � L ardaweR. odu Cllalft t� cm ft plo r State of North Carolina County of Davie /,John Gallimore , Review officer of Davis County, certify that the map or plat to which this certification is affix' meets all statutory requiements for recording. 'view Officer Date: Za=o f��il�'1Y"fAI.StT PCOM it" Being a Portion of Tax Lot 38.04 LEGEND -calor Lr» \ 92.33. , HAWKNEST, Phase Ore I Tax Map M-4 ' "tower- -'"'e► - C~ Line N 21040'00'V I PB 7 L2 PG 15 Er - E3111111111111 rb" Film er _ p a f Deed Book 197 •Page 384 -no�of �► last. \ �i / I Deed Book 197 O Page 386 Merle - add t +-►(�..' 65.76' , y ' do -PA - -+a N 02525'= I i 1 Being a Portion of Tax Lot 37 no 0,r► - c/. �na.g�e d� %Ad _ SIM� s 1 r Y I Sanitary Sewer Tax Map M-4 -r- 100 year nsN eslydaty - :�; own I Deed Book 339 • Page 458 �". ;.*"d fie` iio��oi'a,rs 12" Water Main ■■■■■■■■■■ ■■ass■■■■e Total Subdivision -Phase Two Area 1.468 Acres +/- SCME TOWHO4r COLMY sWE tali 1 " - 100' Jerusalem Davis North Carolina 5-01-21 Owners: John Grose, Ann M. Morison, Stone Land Surveying Company ,on N, 331 Paris Avenue MT.BLGeorgeRsbort slws, pts L-3142 � Mocksville, NC 27028 wwpm 113 Drum Lan. Phone (336) 996-4733 1UI 110 (336) 751-3323 GR4 Mock•vlie, N.C. 27028 Sam filed for registration at 2�.�.5 s'slaae 1, enew Robert 1✓y /f4AOetlfrtl LoW Sa%fir ► L -310L cW* ort lay !ea Y at • "- IV and er"sft; • "ralddse BEAF&C of Wad eetb do ove r O OwO; or nYd;"1144 so a" rsew M" splen wee repel; p..+ a land. S 20'3243"E George R. Stone In Plot MM _i_. pew llelsumteal L later s1 0a4M 8.38' Ch pllla$ tea paid L-3 S 20"2307'E 104.53' Ch MMTt -AN i STAIR 0,X , Z wlatsr, Shed Clo■■ificntli' 05 -IV Protected bar A.w. +/- �✓ I Illy Acts to be served by public wooer and sewer � \� r 3lunch,vn Woad ,tS1P LIM 4. AN uWdm to be kietoNed Underground I Three (3) prgpo«d late (Public 60' R\ W) a Told subdlvfeion ar■a 1.488 Acres�4 s0, 7. Average lot crew 0.489 Acres 00831.1 cot,.. 8. N=fnofwrnwfts found wdMe 2000• of project \. \ - Tax mop ax IM 4-13 8sari'fg rsf►erwwe PA 7 • P10 13 for sii+e consistency � $ o+l•T. Deadman a 1 \ E. Qo \• Tax Lot 38.04 * D8 59 O PG 21 91. Nundbs► 4 Arbars set d ane now property cartes r N 1 1Q Setb■cllsr rrw* 4d'. 9aclr 30', Sides 15' , ,�4 dab^ i� \` Tax Map M-4 11. No new ■best cons&ucdon proposed meq, ``bTax lot 1 ` 1 12. The following drninoge and/or utility\\\'p7* ty so, \` Tax map easefttsrtb ane dedkoted; �� 'o'e \ M-4- 13 A. 10' a"exterior lines ��j x ` O� �Area in gquestionion�p (OverloP) 8. 10r each side of interior lines 223.38' \ � 62.58' Tax Lot 38.04 \9`f ,•1 i�-ftp .cool,. S. 87043'50'•E d . Tax Map M-4 �J\ found s 011 30n _ n/f John Grose- t�� f n ! •rivet sc SLJY 1/2" UK J .vifr .w. :Y).,) •vv. / rload 'I \ �- 98.59'* 010, DB 197 O PG 384 N 57 40'20'W o,,� DB 197 O PG 386 1 I 1 \ rot ` \ too HAWKNEST, Phse ne Ofg I PB7@PG I� 164.38' ons ' - t \ N 60.59'00"W °r b 0 120.46' end te ,.� `°°oma / ' 1 N 59.23'55"W a I j 1 ' , HAWKNEST, P ase ns ! 1 A� OR 7 @ Pr; 10% i 1 1 (we) lmehy awtlfq Rat I am (we am) the ow l r(s) \ Y�y �-N 54056�50"W of the pfopsrl�i dseaAsd Ifereen. wh10o! is booked h .\ Y�2 ' 45.47 /( •, 0 I Q 1 1 I the subdivision Jlrlsdlation of Dore Courtly and that I Honbhr adopt this eubd hileel plan w11h "W free \ ~- N 57 53 35"W ; 4 salbeok lif■s � • I I D � $ I I'I I I oen■wlf, est,abldied ""nurn buMn 2 p a Tax Lot oetsr ails' and easeents ego public ads use andi\ ���e �N 45'61205"W D mi I Tax Map M- 65.49' , I f o 3 I 4+m �-.-- ` N 36'50'55"W �liI �' I I 1 ansA- N I ., % 7 - ow.stl 66.95' o v 36603'40"104 � � , 0 - - ..- ftba &. is-&" ■ Of hereby certify the# the s6Nlvlsles Piet sham heroes hes been fount to 60*17 with the Covell sebdivlslee Roselotioos. with the easptios of seek ver loess■, if any. were noted is the 01116106 of the ploos1Rs 9~4 sed that It hes ►ase oderwed for recordist to the eff lee of the Resister of 000446 it Is here" MIN tkot doss not 1041640 psrsvel to Instell sed 6111120 soeitery fesliltlie Ref does It Inslv40 oNrovsl for the eenstrestlee w eeevraesy of kolldinp er streetwes.' ,P The Dols C=* Fhmft sood hsrsiv gpwmed to fhd pot for one A&iui�-�� � L ardaweR. odu Cllalft t� cm ft plo r State of North Carolina County of Davie /,John Gallimore , Review officer of Davis County, certify that the map or plat to which this certification is affix' meets all statutory requiements for recording. 'view Officer Date: Za=o f��il�'1Y"fAI.StT PCOM it" Being a Portion of Tax Lot 38.04 LEGEND -calor Lr» \ 92.33. , HAWKNEST, Phase Ore I Tax Map M-4 ' "tower- -'"'e► - C~ Line N 21040'00'V I PB 7 L2 PG 15 Er - E3111111111111 rb" Film er _ p a f Deed Book 197 •Page 384 -no�of �► last. \ �i / I Deed Book 197 O Page 386 Merle - add t +-►(�..' 65.76' , y ' do -PA - -+a N 02525'= I i 1 Being a Portion of Tax Lot 37 no 0,r► - c/. �na.g�e d� %Ad _ SIM� s 1 r Y I Sanitary Sewer Tax Map M-4 -r- 100 year nsN eslydaty - :�; own I Deed Book 339 • Page 458 �". ;.*"d fie` iio��oi'a,rs 12" Water Main ■■■■■■■■■■ ■■ass■■■■e Total Subdivision -Phase Two Area 1.468 Acres +/- SCME TOWHO4r COLMY sWE tali 1 " - 100' Jerusalem Davis North Carolina 5-01-21 Owners: John Grose, Ann M. Morison, Stone Land Surveying Company ,on N, 331 Paris Avenue MT.BLGeorgeRsbort slws, pts L-3142 � Mocksville, NC 27028 wwpm 113 Drum Lan. Phone (336) 996-4733 1UI 110 (336) 751-3323 GR4 Mock•vlie, N.C. 27028 Sam GILL TABLE COLRX BEAF&C DISTANCE L-1 S 20'3243"E 96.10' L-2 S 20e36'29E 8.38' Ch Rod; 13.700.85' L-3 S 20"2307'E 104.53' Ch Rad; 13.70085' L-4 S I V53'37"E 130.06' Ch Rat 13.700.85' L-5 S 75019'13"w 83.13• L-6 S 5r39'23" yf 150.00' L-7 N 06"00'2VV 107.5®" L-8 N 20'25' 13"w 104.53' L-9 N 20.30'43" w 104.46' 0,X , Z wlatsr, Shed Clo■■ificntli' 05 -IV Protected bar A.w. +/- �✓ I Illy Acts to be served by public wooer and sewer � \� r 3lunch,vn Woad ,tS1P LIM 4. AN uWdm to be kietoNed Underground I Three (3) prgpo«d late (Public 60' R\ W) a Told subdlvfeion ar■a 1.488 Acres�4 s0, 7. Average lot crew 0.489 Acres 00831.1 cot,.. 8. N=fnofwrnwfts found wdMe 2000• of project \. \ - Tax mop ax IM 4-13 8sari'fg rsf►erwwe PA 7 • P10 13 for sii+e consistency � $ o+l•T. Deadman a 1 \ E. Qo \• Tax Lot 38.04 * D8 59 O PG 21 91. Nundbs► 4 Arbars set d ane now property cartes r N 1 1Q Setb■cllsr rrw* 4d'. 9aclr 30', Sides 15' , ,�4 dab^ i� \` Tax Map M-4 11. No new ■best cons&ucdon proposed meq, ``bTax lot 1 ` 1 12. The following drninoge and/or utility\\\'p7* ty so, \` Tax map easefttsrtb ane dedkoted; �� 'o'e \ M-4- 13 A. 10' a"exterior lines ��j x ` O� �Area in gquestionion�p (OverloP) 8. 10r each side of interior lines 223.38' \ � 62.58' Tax Lot 38.04 \9`f ,•1 i�-ftp .cool,. S. 87043'50'•E d . Tax Map M-4 �J\ found s 011 30n _ n/f John Grose- t�� f n ! •rivet sc SLJY 1/2" UK J .vifr .w. :Y).,) •vv. / rload 'I \ �- 98.59'* 010, DB 197 O PG 384 N 57 40'20'W o,,� DB 197 O PG 386 1 I 1 \ rot ` \ too HAWKNEST, Phse ne Ofg I PB7@PG I� 164.38' ons ' - t \ N 60.59'00"W °r b 0 120.46' end te ,.� `°°oma / ' 1 N 59.23'55"W a I j 1 ' , HAWKNEST, P ase ns ! 1 A� OR 7 @ Pr; 10% i 1 1 (we) lmehy awtlfq Rat I am (we am) the ow l r(s) \ Y�y �-N 54056�50"W of the pfopsrl�i dseaAsd Ifereen. wh10o! is booked h .\ Y�2 ' 45.47 /( •, 0 I Q 1 1 I the subdivision Jlrlsdlation of Dore Courtly and that I Honbhr adopt this eubd hileel plan w11h "W free \ ~- N 57 53 35"W ; 4 salbeok lif■s � • I I D � $ I I'I I I oen■wlf, est,abldied ""nurn buMn 2 p a Tax Lot oetsr ails' and easeents ego public ads use andi\ ���e �N 45'61205"W D mi I Tax Map M- 65.49' , I f o 3 I 4+m �-.-- ` N 36'50'55"W �liI �' I I 1 ansA- N I ., % 7 - ow.stl 66.95' o v 36603'40"104 � � , 0 - - ..- ftba &. is-&" ■ Of hereby certify the# the s6Nlvlsles Piet sham heroes hes been fount to 60*17 with the Covell sebdivlslee Roselotioos. with the easptios of seek ver loess■, if any. were noted is the 01116106 of the ploos1Rs 9~4 sed that It hes ►ase oderwed for recordist to the eff lee of the Resister of 000446 it Is here" MIN tkot doss not 1041640 psrsvel to Instell sed 6111120 soeitery fesliltlie Ref does It Inslv40 oNrovsl for the eenstrestlee w eeevraesy of kolldinp er streetwes.' ,P The Dols C=* Fhmft sood hsrsiv gpwmed to fhd pot for one A&iui�-�� � L ardaweR. odu Cllalft t� cm ft plo r State of North Carolina County of Davie /,John Gallimore , Review officer of Davis County, certify that the map or plat to which this certification is affix' meets all statutory requiements for recording. 'view Officer Date: Za=o f��il�'1Y"fAI.StT PCOM it" Being a Portion of Tax Lot 38.04 LEGEND -calor Lr» \ 92.33. , HAWKNEST, Phase Ore I Tax Map M-4 ' "tower- -'"'e► - C~ Line N 21040'00'V I PB 7 L2 PG 15 Er - E3111111111111 rb" Film er _ p a f Deed Book 197 •Page 384 -no�of �► last. \ �i / I Deed Book 197 O Page 386 Merle - add t +-►(�..' 65.76' , y ' do -PA - -+a N 02525'= I i 1 Being a Portion of Tax Lot 37 no 0,r► - c/. �na.g�e d� %Ad _ SIM� s 1 r Y I Sanitary Sewer Tax Map M-4 -r- 100 year nsN eslydaty - :�; own I Deed Book 339 • Page 458 �". ;.*"d fie` iio��oi'a,rs 12" Water Main ■■■■■■■■■■ ■■ass■■■■e Total Subdivision -Phase Two Area 1.468 Acres +/- SCME TOWHO4r COLMY sWE tali 1 " - 100' Jerusalem Davis North Carolina 5-01-21 Owners: John Grose, Ann M. Morison, Stone Land Surveying Company ,on N, 331 Paris Avenue MT.BLGeorgeRsbort slws, pts L-3142 � Mocksville, NC 27028 wwpm 113 Drum Lan. Phone (336) 996-4733 1UI 110 (336) 751-3323 GR4 Mock•vlie, N.C. 27028 Sam J • DAVIE COUNTY HEALTH DEPARTMENT Environmental Health Section Soil/Site Evaluation ' APPLICANT INFORMATION Account #: 989900149 Billed To: Home Improvement Services Reference Name: Proposed Facility: Residence Property Size: Water Supply: Evaluation By: PROPERTY INFORMATION Tax PIN/EH #: 5735-45-8944 Subdivision Info: Location/Address: Junction Road -27028 15 acres Date Evaluated: 3d P> On -Site Well Community Auger Boring Pit Public Cut iii FACTORS 1 2 3 4 5 6 7 Landscape position L 1 Sloe % �- HORIZON I DEPTH Texture group Consistence . Structure Mineralogy HORIZON II DEPTH Texture group(� Consistence Structure / 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 z SITE CLASSIFICATION: LONG-TERM ACCEPTANCE RATE: REMARKS: EVALUATION 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 clay loam SIL - Silty loam CL - Clay loam SCL - Sandy clay loam SC - Sandy clay SIC - Silty clay C - Clay CONSISTENCE Moist VFR - Very 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 SC - 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 05/99 (Revised)