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137 Landis Court Lot 29Davie County, NC Tax Parcel Report Wednesday, October 12, 201( qr;v f6, 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, Norm Carolina, its agents, consultants, contractors or employees from any and all claims or "uses of action due to �OUN't4 NC or arising out of the use or Inability to use the GIS data provided by this website. WARNING: THIS IS NOT A SURVEY Earcel Information ` Parcel Number: D301OA0029 Township: Clarksville NCPIN Number: -: 5822145232 Municipality: . Account Number:: 8303262 Census Tract: 37059-801 Listed Owner 1:: MARTINEZ DAVID - Voting Precinct: CLARKSVILLE Mailing Address 1: __ 137 LANDIS COURT - Planning Jurisdiction: Davie County City: _ - - MOCKVILLE= `- Zoning Class: DAVIE COUNTY R-20 State: NC Zoning Overlay: Zip Code: 27028 Voluntary Ag. District: No Legal Description: - LOT 29 DUTCHMAN HILLS Fire Response District: WILLIAM R. DAVIE Assessed Acreage: 0.79 Elementary School Zone: WILLIAM R DAVIE Deed Date: 3/2014 Middle School Zone: NORTH DAVIE Deed Book/ Page: 009520771 Soil Types: MnB2 Plat Book: 0007 Flood Zone: Plat Page: 190 Watershed Overlay: DAVIE COUNTY Building Value: 145290.00 Outbuilding & Extra .Freatures Value: 4360.00 Land Value: 30000.00 Total Market Value: 179650.00 Total Assessed Value: 179650.00 qr;v f6, 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, Norm Carolina, its agents, consultants, contractors or employees from any and all claims or "uses of action due to �OUN't4 NC or arising out of the use or Inability to use the GIS data provided by this website. 0 Davie Colnity Health Department 9 1836 Environmental Health Section P:O. Box 848 SCE 210 Hospital Street 0 ifVk er # i 09-40-06 1911 v3oDaw Rocksville, NC 27028 �n. Phone: (336) - 753-6780 - Fax: (336) - 753-1680 ON-SITE WASTEWATER CERTIFICATION ck (Check One) 1 Replacement Remodeling Reconnection Name:--�Ulj I � CA/ +kVVC-`l- - Phone Number3J% S7Sj D(Home) Mailing Address: 151 laVic( IS CT - (Work)' - MOC96ville- NC- 2-70Zf Property Address: fi Please Fill In The Following `I,n/formation About The EXISTING Facility: ����Jj� Name System Installed Under: Wood (rl Type Of Facility:=/1jasp— _ Date System Installed (Iylont6/DateJYear)/' /��Q Z Number Of Bedrooms: Number Of People ------ Js - =Is The Facility Currently Vacant? Yes (N0 If Yes, For How Lone? Any Known Problems? Yes1 fo If Yes, Explain: Please Fill In Type Of Facilit Pool Sizer Requested By:_ Approved Disapproved Environmental Health Information About The NEIVFacility: Number Of Bedrooms: Number of People For Environmental Health Office Use Only ,�y *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 Mo&4AQrarer # J"'I'S(o Amount:$ .400-00 Date: Paid By: Received By: r �,t Account #: 1 Invoice #: �j 3Cp -I 9/20/2016 * III Parcels - . ;i- ILI i Zoo Buffer Card Property Zoom Buffer +Card httpJ/maps2.roktech.net/DaVienc_gm4l# GoMaps 4.0 125 • (D Environmental Health Section P. O. Boa 848/210 Hospital Street Mocksville, NC 27028 (336)751-8760 Account #: 990002147 Tax PIN/EH #: 5822-14-5232.29 Billed To: The Ward Group of NC, LLC Reference Name: ?roposed Facility: Resiaence ATC Number. 3062 Subdivision Info: Dutchman Hills Lot #29 Location/Address: 137 Landis Church -27028 t-9,ANEWvza 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 Sewage Treatment and Disposal Systems). THIS AUTHORIZATION FOR WASTEWA CO STRUCTI IS VALID FO" PERIOD OF FIVE YEARS. Environmental Health Specialist's Signature:Akskl Date: OC /l7) Z CERTIFICATE OF COMPLETION 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�S; (guarantee that the system will function satisfactorily for any given period of time. I / 106 Septic System Installed By: . /�� 9: /G Environmental Health Specialist's Signature : DCHD 05199 (Revised) Date: DAVIE COUNTY HEALTH DEPARTMENT Environmental Health Section - _ P. O. Boa 848/210 Hospital Street Mocksville, NC 27028 (336)751-8760 IMPROVEMENT/OPERATION PERMIT Account M 990002147 Tax PIN/EH M 5822-145232.29 Billed To: The Ward Group of NO, LLC Subdivision Info: Dutchman Hills Lot # 29 Reference Name: Location/Address: 137 Landis Church -27028 Proposed Facility: Residence Property Size: see map ATC Number: 3082 **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 (m 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 #Baths .� Dishwasher Garbage Disposal: ❑ Washing Machine.' Basement w/Plumbing: ❑ Basement/No Plumbing: ❑ Commercial Specification: Facility Type #People . #People/Shift #Sfeats Industrial Waste: ❑ Lot Size Type Water Supply 4— Design Wastewater Flow (GPD) C?& D Site: N7;3'Repair ❑ System Specifications: Tank Size GAL. Pump Tank _GAL. Trench Width-�" Rock Depth/ Linear Ftr� Other: Required Site Modifications/Conditions: IMPROVEMENVOPERATION PERMIT LAYOUT - APPROVED EFFLUENT FILTER RISER(S) IF 6 k 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.**** Environmental Health Specialist's Signature: Date: [ - �/� 2 DCHD 05/99 (Revised) APPUCUM FOR WE EYB{(NUNVOU SOMM PEMW & AIC nddaCaaMrOdpednda d,Ymurddam)soc�rr P.D. so: 040/210 Hospital stmest wootsvLWA, He 27026 (336)7B1-6760 FEB 5 2002 '1L'OmMus 20 Hof==. HaZCHaCae f xwcor= RMUM f Zee la.lsno"i . I e...con:.umMie WozDGaouyofNC.PL"e -We 1?nd 1�1;15aG- !/ ammo 7(1W . AinLTN WLST B LV D . ""biai 7ebas 3 fe T- is at:/srt.isQ W��sFan o(n,wtt.J7�ol i..sa...aeo.(3307a7j8 ./� X. m sw=at/=.w mzroweac =Ms*. C'.Op QA- QMrZ44 d.14e9 aaua.. 5=.+e as above agleee./s� Sa.....e as eJovot tea, aPYll..tim Yoe+ ❑ sib ivalmtian �L(pzovanmt Yea3t/ATC 0 soth (,tee. ay.er m Hoaas a X*Lu Bose o sosiseas U ladastty a other ,�6: u a..saoo., . Y•epl. a . Hsdeeee,s 3 . Hnehtoms 2 (/z .� y(mmmm.e u om.ya tl,�l XTM� wm.. a a..00t/a7mst.6 i (9..�oua. meeasop 6. u 6msaesyU tom• 4 V"Pl. 6 ""a 6 ra•a3u 6 Bne..e.' 1 aeLat. 6.e Me te.1.e. lY Y00D9SMCB: p asap Satieabsd watos us"s (eau". D•• M) V7. Too of vuw apply.- - P�ematr/Clti o wall o MIMMiar -.. so7..s.dei)ate add"diseaoe e6pndotla(dk Bx)Yry ehY yNea+is Weededfoam? 0Yes levo - If M %int(ypei —off OdTdNI"- ab7( AMTC1110UMMmwvmmrwr R(vUVOMUTM tpQ(wmw . B8W(Y. H1ia.pLATr�MteYf6:EZSOAOY/BA 9.drae �i7ID8AY!)iCATIOw. v re6revHa..�ba� F'i35�5-143 B -pyo (�Woeswo8crtors(B..(.eHorBwrv, ` -t" ( TAke Gd -1-awae-As Ya, �l ,jAe vPnpedlAdiwe Rodman 137 Landis C -L Org_k{py_ !Aa oeer T--40 #4 -will Mo ��dlla IVC.�Zo2$ be L JN6se tm id apMdebd�eWitl ..wo.: CAToNS Churflti. AO:Q rk..: Du�-c1wY.osi 1�i��s I t�" Le� an {n fiio�_ --DWRWrOMMW: I2IZ _ aue ppUmOn I.iee6% sima•aW 6emeAwMm2SdH9Vr=WW eeratY McWMy Hum Uepaearctl )sedeaPMaitleieenied pespee(7ko0[d)e MleGasyadeadb'rte W.�rti1 C'�-o'^Q t.tved6dashsWgpeed.rtltltxeaor7Miele+aie6tailea$..b,Yp: - . , /TM ABU MAYIM UM SOBM&WMG YOURSQB PMMOaddess 6t6+e sdk LV M&ft=vdFVcW _ pnpeepE�adi4edm� afiadrtl, =owl , sadivalmotbo) SdOeseahi(CkSrV cocorkilsodwBaft nm - I AeaatNa � 1 � 1 _k..keft �wJ Dta� LOT 37 336. \ LOT 12 I N 82.11.57• y Nsl \ I P LOT ##36 0. 998 AC. �P\ — � ^0�` 5 -�a N FIEL, J 25mJC- �. �2, — SD 83'16'19' E LOT #27 v W — - 260. o(L _ / 0.691 AC. v - o LOT #35 o - LOT #26 0 0.925 AC. ` I Z 79.20"55' f 244.35 C3 Z 0.929 AC, Z u CO I 50' nI LOT #28 o W < N S 234.71 0.742 AC.cs 260.07 N 88'35'40' V N� ovoi O Y U O S 6 b 81-53,57, E LOT #25 o o LOT 34 o+ ti I —,C uill.rl 24 EASEMENT 0 0. 836 AC. n I 0.826 AC. N I I o o I° p o M LOT #29 Y o< S 81-5 7'1 3• 0 `D Pl 0.795 AC. io E 260.07 86'29'55' E 245.57 o F o 0 �'`]Z o 0 �N Ns LOT #24 221.39 / \ N 85.04'24• y 0.836 AC. LOT #33 N o _ 1.069 AC. j T pl'57'13' c LOT #30 ow `'� bo.e7 0.830 AC. c N u' -� EAST IJEM - u o LOT #23 z9 s C2z 0,836 AC, '. ��•F I LOT ##32 o S 91-57-13- 1.161 AC. < ^' LOT ##31 260.07 N 05'39'10' E N v o 0.923 AC. p o I / 83.13 V — ciJP uNnsc.,Pe 'LOT #22 —._ — — CtiSEMEM — 0.786 AC. N 87.30.23. ,a — 282 450 _-- - --- - _ N 87.39'23' M 5' N EGAME ` \ ACCESS FASEMCar MAq, %A,, _ 240.u0 - ._._ - N N 87.39'23' V__ 108.36--- N 81' 39.4 _ 8• , ,. y� 152.02 _ EATON CHURCH RD. MAc — - iS. R. 1415 _ d-79 WES TO INTX. u.S. 6: R APPLICATION FOR SHE tVAI 11ATI0N/IMPfl011EMENT PERMIT & ATC D MIFF? f Davie County Health Department - EnPltenmenfa/Healfb sftwon 'a P.O. Box B40/210 Hospital Street2�� 7 JP�`� ��� Mockaville, HC 27028 (336)751-8760 ***rJMPCRTANTA** THIS APPLICATION CANNOT BE PROCZSSZD UNLZSS LLL HZ REQUIRED IMMMSTION I8 PROVIDED. Refer to the INTOPMTIOH BULLETIN for instructions. 1. Masa to be milled �] contort person J Meiling Addrsss?7, LSI ss IC� tone ehen.. %9�'- S'�09 City/state/a1P _) "Iree_ Ale, e2?;W6 Business Phone OFF- V97OLO s. uveae on Persdt/LTC if Different than Above Mailing Address City/state/aip s. Application Tor: l9 its Zvaluation ❑ Improvement Permit/ATC ❑ Both s. system to serrinel P16ouse ❑ Mobile Home ❑ Business ❑ Industry ❑Other a. If Residence: I People I Bedrooms I Bathrooms D Dishwasher - D Garbage Disposal D washing Machine D asseaent/Plumbing D Baseaent/No Plumbing a. xf Business/Industry/other: specify two I people / Rinke I commodes I showers I Urinals e were! coolers Ir rOODSERVICZ: N Seats Estimated Nater Usage (gallons per day) 7. Type of water supply: l9 County/City ❑ Well ❑ Community e. Do you anticipate addlHom or expansions of the facility this system Is Intended to serve? ❑ Yea ❑ No If yes, what type? *"IMPORTANTA11 CLIENTS MUST COMPLETETHE REQUIRED PROPERTY INFORMATION REQUESTED BELOW. Either • PLAT �or SATE PLyAA MUST BE SUBMITTED by the client with THIS APPLICATION PropertyDlmenslo / - /. /.3 WRITE DIRECTIONS (from MaWvllle)toPROPERTY: Tax Office PRH: to ,11RAa - iU -%/I In9SJS/�2l Property Address: Road Name % edit Yoe1 city/zip%✓/B v� Li�� Al e "217ae If las a Subdivision provide Information, as follows: Name- Al helh I a a /7i /l --T Section: Blockt Lot: '- 9 Date Property Flagged: _ lU /nc'e / 6cvxecW e mo/"I-- This `I-- 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 Ibis application Is folslled or changed. 1, 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 las Davie County and owned by to conduct AR testing procedures as necessary to determine the site suitalolty. THIS AREA MAY BE USED FOR DRAWING YOUR SrM PLAN property lines and dimensions, structures, setbacks, mud septic loo Revised DCHD (07/99) of the following: Existing and proposed Date(s): EHS• Site Revisit Charge Notification Date: Account No. invoice Na n� a � DAVIE COUNTY HEALTH DEPARTMENT Environmental Health Section Soil/Site Evaluation APPLICANT INFORMATION PROPERTY INFORMATION Account #: 989900111 Tax PIN/EH #: 5822-14-6855.29 Billed To: 'Gray Potts . Subdivision Info: Dutchman Hills Lot # 29 Reference Name: Gray Potts Location/Address: Eatons Church Road -27 28 Proposed Facility: 'Residence Property Size:' . 51 Acres Date Evaluated: x/11 va "•- .:Water Supplyi On -Site Well Community Public Evaluation By: Auger Boring - - Pit I Cut FACTORS 1 2 3 4 5 (> 7 Landscape position . ...-1. L l Slo % _. HORIZON I DEPTH - Texture group Consistence ..• : $ Structure 5612 - Mineralogy l t1-1 HORIZON H DEPTH . Z -4 30 _ Texture groupG Ck Consistence.:. Fr SSP -- Structure $IG Mineralogy. HORIZON III DEPTH - q8 Texture group Consistence Structure. Mineralogyl HORIZON IV DEPTH Texture group Consistence Stmcture . Mineralogy SOIL WETNESS RESTRICTIVE HORIZON SAPROLITE . CLASSIFICATION LONG-TERM ACCEPTANCE RATE' 3J SITE CLASSIFICATION: P S EVALUATION BY: °'Nurr- A" L) LONG -,TERM ACCEPTANCE RATE: D'� �•`� 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 - Loam y 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 VFR - Very friable FR - Friable FI - Finn 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 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)