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124 Pennington Dowell LnDavie County, NC Tax Parcel Report �� Wednesday, October 5, 2016 / 149 fIX,i�V 148 Ix 716 710 - r .724-, 736 177 124 \ �'- �J� 750 758 ti`C 1 187 138 ` 135 - - -_195 WARNING: THIS IS NOT A SURVEY Parcel Information Parcel Number: H608OA000105 Township: Mocksville NCPIN Number: 5749937780 Municipality: Account Number: 43577120 Census Tract: 37059-805 Listed Owner 1: KOWALSKI LEONARD C Voting Precinct: NORTH MOCKSVILLE COUNTY Mailing Address 1: 124 PENNINGTON DOWELL LANE Planning Jurisdiction: Davie County City: MOCKSVILLE Zoning Class: DAVIE COUNTY R -A State: NC Zoning Overlay: Zip Code: 27028-4314 Voluntary Ag. District: No Legal Description: 1.148 AC OFF SAIN RD Fire Response District: MOCKSVILLE Assessed Acreage: 1.15 Elementary School Zone: MOCKSVILLE Deed Date: 11/1995 Middle School Zone: SOUTH DAVIE Deed Book / Page: 001830885 Soil Types: Gn132 Plat Book: Flood Zone: Plat Page: Watershed Overlay: DAVIE COUNTY Building Value: 112240.00 Outbuilding & Extra 10990.00 Freatures Value: Land Value: 26070.00 Total Market Value: 149300.00 Total Assessed Value: 149300.00 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 warrantles 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 ag daims or causes of action due to pUpS NC or arising out of the use or Inability to use the GIS data provided by this website. Phone: (336) - 753 - 6780 IN Davie County Health Department C -c -10P Environmental Health Section (6 �Ico P.O. Box 848 210 Hospital Street Courier # : 09-40-06 Mocksville, NC 27028 Fax: (336) - 753-1680 ON-SITE WASTEWATER CERTIFICATION (Check One) Replacement Remodeling Reconnection Name: C(,1 l Phone Number 6ql2q ak 4 (Home) Mailing Address: -!m' �5r1 %�{S� (Work) Detailed Directions To Site: *V l'§Y t' VdAl Say AJ Property Address:. Email Address: Ak/2 0 (d ets five ® li re X om AccP,t/ Please Fill In The Following Information /About The EXISTING Facility: Name System Installed Under: �"��rn''`aN 4410 Type Of Facility: 14V-5-e— Date System Installed (Month/Date/Year):4/ Number Of Bedrooms: Number Of People: . V- Is The Facility Currently Vacant? Yes ` No If Yes, For How LongZ Any Known Problems? YesQDf Yes, Explain: Please Fill In The Following Information About The NEW Qcog,Type Of Facility: 0,�OC,� i edro ms: Number of People Pool Size: Garage Size: Other: uestedBy: ,��jj Date-744/2615—Requested: (Signatuy) For Environmental Health Office Use Only Disapproved aonts-&?wdd,,'Ivt,-_ _eX i 11ALfi d( 6 Environmental Health Specialist y ,-?�, Date: --? — *The signing of this form by the Environmental Health Staff is in no way intended, nor should be taken as a guarantee (extended or limited) that the on-site wastewater system will function properly for any given period of time. Payment: Cash Check Money Order #. Paid By:_ Account #: Amount:$ Date: Received By: voice #: • 'HEALTH DEPARTMENT RELEASE Davie County Health Department 210 Hospital Street r . P.O. Box 848 Mocksville NC 27028 Phone: 336-753-6780 Fax: 336-753-1680 Applicant: Tammy Kowalski Address: 124 Pennington Dowell Lane City: Mocksville State2ip: NC 27028 Phone #: (336) 409-4412 For Office Use Only 'CDP File Number 161161 - 1 H6 -080 -AO -05 County ID Number: valuated For: HDRMWC PERMIT VALID 1 0/ 1 6/ 2 0 1 9 UNTIL: Property Owner: Tammy Kowalski Address: 124 Pennington Dowell Lane City: Mocksville State/Zip: NC 27028 Phone #: (336) 409-4412 _Property Location & Site Inforrnation Address 124 Pennington Dowell Lane Subdivision: Phase: Lot: Road # Mocksville NC 97n9R 'Structure: SINGLE FAMILY # of Bedrooms: 3 'Water Supply: N/A Basement: [-� Yes FjNo 'Proposed Improvement: Deck 27x14 # of People: Township: Directions Hwy 158 tum right on Sain Rd Turn right onto Pennington Dowell Lane Type of Business: Total sq. Footage: No. Of Employees: This release in no way expresses or implies that the existing subsurface sewage treatment and disposal system serving the site will continue to function for any period of time. Applicant/Legal Reps. Signature Required? Oyes ONO Applicant/Legal Reps. Signature; 'Date: / 'Issued By, 2140 -Nations, Robert *Date of Issue: 1 0 / 1 6 / .2 0 1 4 Authorized State Agent: **Site Plan/Drawing attached.** O Hand Drawing O ImportDrawing oL �5—% 4 6 (o 4�+g • 0 Davie County Health Department Environmental Health Section P.O. Box 848 ,j,, ,�A� 210 Hospital Street Courier # : 09-40-06 Mocksville, NC 27028 Phone: (336) - 753 - 6 IV 4 w aw�'40 (33� 3(eG-51,?�', ON-SITE WASTEWATER CERTIFICATION (Check One) Replacement Remodeling Reconnection Fax: (336) - 753-1680 Name:i )rnlrl IS tit Phone Number 3310 - y09 - L1t{1 a (Home) Mailing Address: OL `1 f {/ i j ki (Work) Mpl&s Vi I Lt Detailed Directions To Site:lQ NE 4a' S� +)WArylpr� ro� �q�4urnk onh Al" Please Fill In The Following Information About The EXISTING Facility: 146 -ONO -A0,001-00 Name System Installed Under: Y1hYl voakw Type Of Facility: 61/IRU- 4nm1 j N QWf f!G/2q Date System Installed (Month/Date/Year): R011 Number Of Bedrooms:_ Number Of People: 2 - Is Is The Facility Currently Vacant? Yes0 If Yes, For How Long? Any Known Problems? Yes (9 If Yes, Explain: Please Fill In The Following Information About The NEW Facility: s Type Of Facility: J5// Number Of Bedrooms: Number of People Pool Size: arage Size: Other: Requested By: Date Requested: �/ (Signature) For Environmental Health Office Use Only Approved Disapproved Environmental Health Specialist Date: *The signing of this form by the Environmental Health Staff is in no way intended, nor should be taken as a guarantee (extended or limited) that the on-site wastewater system will function properly for any given period of time. Payment: Cash Che Money Order # / `f' v{ Amount:$ A 0,-60 Date: /6 -'% 1 Paid By: XX) lj o/A14 getc' Received By: Account #: 1 jGli Invoice #: _'P 3 • f>EEA i900K UPAat, , / MLW FCR RCCISTRATION _ May 7, 1986 4:31 P.M. MA MEN . olronco In.e . 131;."", 227 .L k SMMK RCGMTCR CT CEaSOS nAVta COUNTY. N. C Deputy TaxLot No......................................................................................... Parcel Identifier No........................................................................... Verifiedby........................................................................ County on the ............. day of ....................................................,..., 18............ by Mail after recording to ....J..Jamar... o.r.............................................................................................. .....................................................................................I ................................................................................................................................ This instrument was prepared by ....... Wi XUAIA...G • ...I j Ames r...Jr.,................................. ....................................... Biief description f1lr the Index 2.328 acres off Sain Road NORTH CAROLINA GENERAL WARRANTY DEED THIS DEED made this ..... 1..,... day of ..................4 ........................ , 19 X'.. , by and between GRANTOR Richard Issac Shores► Jr. and wife, Judy Willard Shores GRANTEE Timothy Lloyd Pennington and wife. Debbie Shores Pennington Kim vo�lmr . Enter In appropriate block for each party: name, address, and. If appropriate, character of enlity, e.q. corporation or partnership. The designation Grantor sod Grantee as used herein shall include said parties, their heirs, successors, and assigns, and shall include singular, plural, maeculine, feminine or neuter as required by context. WITNESSETH, that the Grantor, for a valuable consideration paid by the Grantee, the receipt of which is hereby 'acknowledged, has and by these presents does grant, bargain, sell and convey unto the Grantee. In fee simple, all that certain lot or parcel of land situated in the City of . .... , PiDcksville.. Township, Davie County, North Carolina and more particularly described as follows: BEGINNING at an iron pin located at the end of a 50 foot easement off Sain Road (S.R. 1643); running thence South 19 degrees 19 minutes 48 seconds East 360.79 feet to an iron pin located at a new line of Von C. Shelton, et al (D.B. 126, Pg. 757)1 running thence South 37 degrees 34 minutes 30 seconds West 145.36 feet to an iron pin, located in the line of Lester M. Bowles'(D.B. 93, Pg. 006)1 running thence North 86 degrees 41 minutes 37 seconds West 270.76 feet to a 32. inch Black Oak; running thence North 20 degrees 14 minutes 36 seconds East 452.09 feet to an iron pin; running thence North 42 degrees 57 minutes 15 seconds East 68.25 feet to an iron pin located at the 50 foot easement; running thence South 47 degrees 02 minutes 45 seconds West 50 feet to the POINT AND PIACE OF BEGINNING Containing 2.328 acres, as surveyed by Sam P. Hall, Registered Land Surveyor, dated April 16, 1986. Also conveyed is the use of a 50 foot easement of ingress, egress and regress Beginning at the southeastern corner of this 2.328 tract; running thence .North. 42 degrees 57 minutes 15 seconds East 200 feet with the line of Int # 3 of Sain Road Estates to an iron pin at the right of way of Bain Road (SR 1643)1 running thence South 47 degrees 02 minutes 45 seconds East 50 feet to an iron pin a N. C. sae M.ne, r'or,n rho.) ID 1 ole. ReYl,ed 9 1777 -,...,.waw... • o.. Iw., s.. n,, vwr.x+i.,. w. t eras 1✓IJl 9 f �, . . - DAVIE COUNTY HEALTH DEPARTMENT IMPROVEMENTS PERMIT AND CERTIFICATE OF COMPLETION *NOTEASsued in Compliance With Article 11 of G.S. Chapter 130a Sanitary Sewage Systems 4� Tfs Permit Number Name._ Date S� i' `'/ NO_ R , a ; Location _4.r y),2 %< - �' ; / 4'1 I Y�`-q-�!<'2 f ► O (.c )_ `N Subdivision Name Lot No. Sec. or Block No. Lot Size fiJ House I --"� Mobile Home _ Business —_ Speculation No. Bedrooms No. Baths !'7 No. in Family — Garbage Disposal YES p NO' p'' Specifications for System: Auto Dish Washer YESNO Auto Wash Ma thine YES p p NO p Type Water Supply *This,permit Void if sewage system described below is not installed within 5 years from date of issue. This permit is subject to revocation if site plans or the intended use change. F i� Improvements permit by -- *Contact a representative of the Davie County Health Department for final inspection of this system between 8:30- 9:30 A.M. or 1:00-1:30 P.M. on day of completion. Telephone Number 704-634-5985. Final Installation Diagram: System Installed by % %� 4 r I' Certificate of Completion �� Date 'The signing of this certificate shall indicate that the system described above has been installed in compliance with the standards set forth in the above regulation, but shall in NO way be taken as a guarantee that the system will function satisfactorily for any given period of time. +APPLICATION FOR SITE EVALUATION/IMPROVEMENTS PERMIT Davie County Health Department ' Environmental Health Section O P • 0 • 8RECD M40 A`! Mockoville, NC 27028 1. Application/Permit Requested By ny n �J V\ f'�Cne-S �� C- Mailing Address X oZ y 11 c�� 5C`� ►� .0 $ �y� '�� Home Phone Business Phone 770L-1-437- 63a 2. Name on Permit if Different than Above B. Property Owner if Different than Above K.�VNv r)e-CAA 4. Application/Permit For: 0 General Evaluation p(S/Tank Installation 5. System to Serve: r,,'House n Mobile Home 0 Business Industry u Other 0 Unknown 6. If house, mobile home: Subdivision en\C�To 0— E -OV -Sec Lot-# No. of People Dwelling Dimensions I Ll T h e-a� J No. of Bedrooms Basement/Plumbing No. of Bathrooms1\/' Basement/No Plumbing Washing Machine �`� Dishwasher 0 Garbage Disposai 7. If business, industry, other: Specify type No. of People Served No. of Commodes No. of Lavatories No. of Showers No. of Sinks No. of Urinals No. of Water Coolers 8. Type of water supply: 0 Public 0 Private 0 Community 9. Property Dimensions _Lt O b t -I q9 ACLS 10. Sewage Disposal Contractor 11. Do you anticipate additions/expansions of the facility this system is intended to serve? 0 Yes /Z No If yes, what type? *NOTE: Improvements Permits shall be valid for a period of 5 years from date issued. Improvements Permits are subject to revocation, if site plans or the intended use change. Effective October 1, 1989. This is to certify that the information provided is correct to tree best of my knowledge, and I understand I am responsible for all charges incurred from this application. Date ig atu Directions to Property: G�e�� a.✓ /7T DCHD (10-89) I It t tot 0"' e f S¢ AL L-2930 {� SL�V� • LOT # I / SAIN ROAD ESTATES PLAT BK. 5 PG. 143 / / STATE OF NORTH CAROLINA, —P—AJIE _ COUNTY d, SAM P. HALL, CERTIFY THAT THIS MAP WAS DRAWN UNDER MY SUPERVISION FROM Ali ACTUAL FIELD SURVEY MADE UVPER MY SUPERVI'�EON. WITNESS PAY HAND AND SLAL THIS DAY OF _ FERRJAKY . _ 19 JO HALL'S LAND SURVEYING CO. P.O. BOX 294 MOCKSVILLE, N.C. 27028 (704) 634-1155 HY L. PENNIf_ ).8.141 PG. 23 SURVEY FOR : KIMBERLY D. SCALE: I" = 50' APPROVED BY DATE: 02/23/90 DEED REFERENCE: Deed Book 141 Page 233 TAX MAP REFERENCE: H - 6 - 8 , Parcel 1.02 MOCKSVILLF TOWNSHIP, DAVIE COUNTY. N.C. . DAVIE COUNTY HEALTH DEPARTMENT Environmental Health Section Soil/Site Evaluation % NAME J O/�%lii/ /i'p/.�'�S _ DATE EVALUATED ADDRESS / PROPERTY SIZE PROPOSED FACIILTY LOCATION OF SITE Water Supply: On -Site Well Community Public Evaluation By: Auger Boring Pit Cut FACTORS 1 2 3 4 Landscape position G Sloe % 2 HORIZON I DEPTH Texture group Consistence Structure Mineralogy HORIZON II DEPTH Texture groupC Consistence r � Structure .E' r✓ /C 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: 'A ' EVALUATED BY: A'// LONG-TERM ACCEPTANCE RATE: / OTHER(S) PRESENT: REMARKS: 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/fu DCHD(01-901 ■�� ■��■■��■o��■��■��■ ��0■ ■��■ ■��■��■�■■�■��n��■�i��■��■��■■ �s .....0.......................... ......�.....................�.. ...■■...........................�...............■................ ...■.............................................................. ■��■��■��a��■�■ ■��■��■�■■�t��■��■■��■��■��■��■��■ ■��e��■��■��t��■��■ ■��■�■■��w��■��■��■ ■�■��■■��e��■�■�� ■��■��■ ■��■��■ ■��■��■■��■■■��■��■ iiiiiiiiiiiiiiiiiiiiiiiiiiiiiii�iiiiiiiiiiiiiiiiiiiii��isi�iiiiiii ■■��■��■ ■��■��■��■��■��■��■ ■��■��■��o�■■��■��■��■��■ ■■��t■��■■��■■��■ ■��■��■��■��■ ■■��■ ■��■��■�■��■��i��■ ■�■��■��\��■��■��■��■��■��■ ■��■��a��■��t■��■�� ■��r��■��■��■��■�� ■��■��■��■��■�� ■■��■��e�i��s��t�■ ■��v��■��o�e��■��■��■��■��■�_��■ ■��n��■■��■�� ■��■�� ■��■��■■��■��■��■��o��■��■��■��■�� ■��■�t��N■��n�� ■��■��■��■��■ ■��■�■��■�� ■��■��■■��■��t��■��■ ■��r.��■�_��■��t��■■ ■■ss��■��■��e��■�i-.��r��■��■�■��■ ■��■��i�� ■��\�■/�i:i��■■ ■��\��\��0��■��■ ��■��\�■��■��■ ....................................�....................�........ ........................................�................ ........ ..........................��...................................... ■��■��■��ti��A��■■��■�■��w��■ ■��■��■��■��r��e��■��r��■ �i�iiii�iii��i�iiiiii�iiiiiii�iiii:i�oiiiii�iiiiii�iiiiii� ■��■■��■��r��■t��■��■��■ ■��■��■��■��■��■��■ ■��■��■�i�■��■��■�■��w��■�■ ■��■��c•_��■��i�■��■��■ ■��■■■��-.��■��r��■■��■��■ ■��t�� ■ ................................ -•..............�....C.... ....... ■��■1��1��■�■��!l��i.�1■��1��1��1�� ■��1��1��■ ��i■ ..............................►=-......._•�.........C...........�.... ::::::::::::::::::::::::::::::::::::::::::�::_::'�::::C:�:::�: ...............■..■..............................C................ ............................................... ........ ........ ...............................................��.......�........ ... ............................ .............. ................. ...�............................�3................................ ....................�..................................■.........■ ........ ........... ....................................... ..... .....■. ... .....■.�...■.....■■.■..■..■■.■.■■■.■.■....■.■.. ..■.. ........ ...0................................■.................... ........................................... ...................... ...........................................C................._... ................................ ........................... .... ................................�................................ .................................................................. ■��■��e��■��■�■��■��■ ■��■��e��■�� ■��N��■��N��\�� ■��■��■��■��■��\��■n��■ ■��■�■ ■��■��■��\■��\��■��■ v��■��■�� \��■��■ ■��/�■��■��/��■��■ ■��/��■��■��■��■��■��N��/■�■ ■��/��/��/�■ ■��■ ■■��■��/��■�� ■��s��a��■ ■��u��o��s��■ ■��■ ■��■��■��■ ■��i�a�s��■■ ■��s��■