125 Landis Court Lot 28Davie County, NC
Tax Parcel Report Monday, December 19, 2016
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Ali data is provided as Iswghoutwarardy or guarantee of any Idnd ehherexpressed or Implied Including but not limited to the
Davie County, Implied wanrMes of merchardabllNy"Itnessfor a parthularuse.AH userso/Davie CouWs GIS website shall hold harmlessihe
County of Davie, North Carolina, Its agents, consultants, wrwaaors oremployeea here any and all claims or causes of allon due to
NC - or arising outlet the use or Inability to use Me MS data provided by this vrebsite. _
WARNING: TMS IS NOT A SURVEY
Parcel Information
Parcel Number:
D301OA0028
Township:
Clarksville
NCPIN Number.
5822145346
Municipality:
Account Number.
82523368
Census Tract:
37059-801 `
Listed Owner 1:
HALL VIRGIL RJR
Voting Precinct:
CLARKSVILLE
Mailing Address 1:
125 LANDIS COURT
Planning Jurisdiction:
Davie County
City: MOCKSVILLE
Zoning Class: DAVIE
COUNTY R -A R-20
State:
NC
Zoning Overlay:
Zip Code:
27028-4768
Voluntary Ag. District:
No
Legal Description:
LOT 28 DUTCHMAN HILLS
Fire Response District:
WILLIAM R. DAVIE
Assessed Acreage:
0.73 Elementary School Zone:
WILLIAM R DAVIE
Deed Date:
9/2004
Middle School Zone:
NORTH DAVIE
Deed Book/Page:
005730095
Soil Types:
MnB2
Plat Book:
0007
Flood Zone:
Plat Page:
0190
Watershed Overlay:
DAVIE COUNTY
Building Value:
Outbuilding & Extra'
Freatures Value:
Land Value:
Total Market Value:
Total Assessed Value:
[611
Ali data is provided as Iswghoutwarardy or guarantee of any Idnd ehherexpressed or Implied Including but not limited to the
Davie County, Implied wanrMes of merchardabllNy"Itnessfor a parthularuse.AH userso/Davie CouWs GIS website shall hold harmlessihe
County of Davie, North Carolina, Its agents, consultants, wrwaaors oremployeea here any and all claims or causes of allon due to
NC - or arising outlet the use or Inability to use Me MS data provided by this vrebsite. _
• DAVIE COUNTY HEALTH DEPARTMENT�Q ) w
Environmental Health Section
" P. O. Boa 848/210 Hospital Street
Mocksville, NC 27028
(336)751-8760'
IMPROVEMENT/OPERATION PERMIT
Account #: 989900204. Tax PIN/EH #: 5822-14-5346
Billed To: J. D. Crews Homebuilder Subdivision Info: Dutchman Hills Lot # 28
Reference Name: Location/Address: Landis Court -27028
Proposed Facility: Residence Property Size: see map
ATC Number: 3538
**NOTE** This Improvement/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 #People #Bedrooms 3 #Baths 2—
Dishwasher: u Garbage Disposal: 121 Washing Machine: Basement w/Plumbing: ❑ Basement/No Plumbing: ❑
Commercial Specification: Facility Type (1 #�P,,eoople #People/Shift #Seats Industrial13 Waste:
Lot Size • 14 `�-%- Type Water Supply�--t 0010 Design Wastewater Flow (GPD) '3' LOD Site: New 91
1Repair Cl
n n
System Specifications: Tank Size 1CC(7'AL. Pump Tank GAL. Trench Width 26 Rock Depth 12- Linear Ft.3CIED
Other: —00X- /
Required Site Modifications/Conditions:
�� pFF 1 IOJS,1�` k=p ltd PUFF. u..I
IMPROVEMENT/OPERATION PERMIT LAYOUT - APPROVED EFFLUENT FILTER. RISER(S) IF 6 " BELOW
FINISHEDGRADE. ****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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EnVVironmental Health Specialist's Signature: Dat . /1
DCHD 05/99 (Revised)
DAVIE COUNTY HEALTH DEPARTMENT
Environmental Health Section
P. O. Boa 848/210 Hospital Street
Mocksville, NC 27028
(336)751-8760
Account #: 989900204 Tax PIN/EH #: 5822-14-5346
Billed To: J. D. Crews Homebuilder Subdivision Info: Dutchman Hills Lot # 28
Reference Name: Location/Address: Landis Court -27028
riupuseu racuuy. rcesiuenue - rruperiy Size: see map -
ATC Number: 3538
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 Treatment and Disposal Systems). THIS
AUTHORIZATION FOR WASTEWA S VA14D FOR A PERIOD O7117,03 YEARS.
Environmental Health Specialist's Signator 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.
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koos
Septic System Installed B(
Environmental Health Specialist's Signature
DCHD 05/99 (Revised)
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APPLICATION FOR SIVE EVALUATION/IM1IPROVEhIENY PER&IR 3 AT D
Davie County Health Department' D /cam
Environmenta/Health Sectim 40G �S
P.O. Box 848/210 Hospital Street �_ D
Mocksville, NC' 27028 -
(336) 751-8760RpN
AghFa'Tq( y
***IMPORTANT*** THIS APPLICATION CANNOT BE PROCESSED UNLESS ALL THE REQUI
INFORMATION IS PROVIDED. Refer to the INFORMATION BULLETIN for instruction
Tb s.
1. Name to be Billed � cRElAS �Iwke-zt & LbestS Contact Person J—ERg4 CA. -Ws
Mailing Address oo I E_LyAoa l=d-.' .Home Phone Amt-`%ia/ti'
City/State/ZIP MOC(4SUZ\IE (✓G 2-702-P Business Phone
y .
2. Name on Permit/ATC if iiifferent t}ian Above
i,
Mailing Address City/State/Zip -
3. Application For: ❑ Site Evaluation Vmprovement Permit/ATC - ElBoth
4. System to service: WomSouse ❑ -Mobile Home ❑ Business ❑ Industry ❑ Other
5. If Residence: --// # People - # Bedrooms �3 # BathroomsZ
eaLshxasher W;CLrbage Disposal $Washing Machine ❑easement/Plumbing ❑Basement/No Plumbing
6. If Business/Industry/Other: Specify type -- - # People # sinks
# Commodes # Showers # Urinals # Water Coolers
IF.FOODSERVICE: . r# Seats - Estimated Water Usage (gallons per day)
7. Type of water supply: R�bounty/City ❑ Well ❑ Community
8. Do you anticipate additions or expansions of the facility this system is intended to serve? ❑ Yes amo
If yes, what type?
k**IMPORTANT*** CLIENTS MUSTCOMPLETETHE REQUIRED PROPERTY INFORMATION REQUESTED
BELOW. Either a PLAT or SITE PLAN MUSTBESUBMLTTED by the client with THIS APPLICATION.
Property Dimensions: I3%)C 7-q* K I ZSR)( 7 q .WRITE DIRECTIONS (from Mocksville) to PROPERTY:
Tax Office PIN: # S$22 191.5'3 Ylei 4,01 1Jetzt'L. to eyyy l C UJXA.,"
Property Address: Road Name :-fWd.S C?" "r"w LT -Kenj I-eyt" ) t4i-O •Iiudcithiwa
city/zip MOGKSdi ttS tic_ I), -Til (-tg1W ;✓A) •H,"J TWO tep �tC�Ns
If in a Subdivision provide information, as follows: Os1 -M LtMdts C r Lar M Seeo,✓g hrr
Name: DwrcatnAt 1';l uS 0-d Le6T - p
Section: Block: Lot: Z-9 Date Property 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 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 suite
DATE 9' S -1L3 SIGNATURE
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).
Revised
(_1rCda 5 �z
Site Revisit Charge
Client Notification Date:
EHS:
Account No. 9 ".f aQd --w
Invoice No. -'-7
r.
E ` _ APPLICATION FOR SITEEVALUATION/IMPROVEMENF PERMIT & ATC D I" ? f
Davie County Health Department IE
Environmental Health Section
P.O. Boz 868/210 Hospital Street
Mockoville, HC 27028
,flay + (336)751-8760
***ZI4PORTAHT*** THIS APPLICATION CANNOT BE PROCESSrD uNIESS ALL HZ REQUIRED
INTORIATiON IS PROVIDED. Refer to the INYORHXTION BULLETIN for instructions.
1. nu• to be Billed sa h /A -LI lq,jJ' f�9 (� contort person J
Mailing Address IS/7. Z//L�rr�ss lce� none Phone (40 '9
city/state/ntp _ A "Iyee_ Ale, e97Da6 Duainese Phone 99aU-
2. Mase on **fait/LSC it Different than Above
Mailing Address city/state/sip
3. Application Tort I9 Bite Zvaluation D Improvement Permit/ATC 0 Both
t. system to aervioes j!I-House O Mobile Rome 0 Business 0 Industry 0 Other
5. If Residences t People - s Bedrooms t Bathrooms
D Dishwaaher 0 Garbage Dlspoeal D Mashing Machine- D nesemant/Pltobing D Basement/Ho plumbing
S. If nueiness/rudustry/othert Specify type
t Cosaod•s
I showers
IT TOODSZRVICZ: # Seats
t people m sink,
e urinal, I Mater coolers
Estimated Nater Usage (gallons per day)
I- Type of Mater supply: 1S County/City
0 Well
e. Do you anticipate additions or expansions of the helllty this system is Intended to serve?
If yes, what type?
0 Community
0 Yes 0 No
***IMPORTANT*** CLIENTS MUSTCOMPIETETIIE REQUIRED PROPERTY INFORMATION REQUESTED
BELOW. Either a PWT or SITE PLAN MUST BE SUBMITTED by the client with THIS APPLICATION -
Property Dimeoslsm '�7 g 9,3 2f�5
Tax Office PBV: a�1-8pa-lU ?5
Property Address: Road Name %d/ 4-M
V41 eA
CltylZip_jy%bGigy� �JP,�7�{ll
If In a Subdivision ol
provide Information, as follows -
Name:. JacklZ 11"O', &.-//r
Section: Blocks Lot:
WRITE DIRECTIONS (from MockrAlle) to PROPERTY:
lo/ AliVA'A T El/ dv e, A
R/of�8/
Date Property Flagged: 70 /,1C -e 1 ScmC- rte 2% -IT -
This
% -I _
This Ise to certify that the Information provided b correct to the beat of my knowledge. I understand that any permit(s)
Issued hereafter are subject to suspension or revocation, if the mite plass or intended use change, or If the Information
submitted In this application Is falaiHed or changed. 1, also, understand that I am responsible for aU charges Incurred from
this application. 1, 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 getting procedures as necessary to determine the site suital�ilty.
DATE_ 0—r2r9—do()
THIS AREA MAY BE USED FOR DRAWUVG YOUR SITE PLAN
property lines and dimensions, structures, setbacks, and septic loo
of the following: Existing and proposed
ERS:
Site Revisit Charge
Notification Date:
Account No. ///_
Revised DCHD (07199) Invoice No.
DAVIE COUNTY HEALTH DEPARTMENT
Environmental Health Section
Soil/Site Evaluation
APPLICANT INFORMATION PROPERTY ]INFORMATION
Account #: 989900111' Tax PIN/EH #: ,5822-146855.28
Billed To Gray Potts Subdivision info: Dutchman Hills Lot # 28
Reference Name: Gray Potts Location/Address: Eatons Church Road -27 28
Proposed Facility: Residence Property Size: : 51 Acres Date Evaluated: Z7
Water Supply:; On -Site Well Community .Public -
Evaluation
By: Auger Boring Pit Cut _
FACTORS l 2 3, q 5 6 '7 .
Landscape position
Slo % T7,
HORIZON I DEPTH -Z-)
Texture group.
Consistence , $
Structure 1C
Mineralogy b
HORIZON II DEPTH / — tfj _ u
Texture group Gk
Consistence FrS 5
Structure Sg L
Mineralogy
HORIZON III DEPTH
Texturegroup
Consistence
Structure
Mineralogy
HORIZON IV DEPTH
Texture group
Consistence
:
Structure
Mineralogy
SOIL WETNESS .
RESTRICTIVE HORIZON
' SAPROLITE
CLASSIFICATION
LONG-TERM ACCEPTANCE RATE ¢t7 • n
SITE CLASSIFICATION: ✓ EVALUATION BY: r
LONG-TERM ACCEPTANCE RATEOTHERS) 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' „ sticky -'Slightly Y Y ry,
NS - Non stic SS stick S - Stick VS - Very Sticky '
NP - Non plastic SP - Slightly plastic P - Plastic VP - Very plastic
Structure
SC -Single grain M - Massive CR - Crumb OR - Granular ABK - Angular blocky .
SBK - Subangular blocky PL - Platy PR - Prismatic
Mineraloev
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)
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