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193 Greenfield Road Lot 41Davie Countv. NC Tax Parcel Report Tuesday, December 20, 2016 4179 200 J 601 lL LL 193 2 W W --- I i 188 l l 181 [Oil All data is provided as Is withoutwarra`dy or guarantee of any kind ebherexpresred or Implied including but rmIlmlted to the vaaDavie County, implied radies of merchantability or flmessfor a particular use. All users M Davie County's GIS webalte anal[ hold harmlessthe /'�CountyofDavie, North Carolina, b agentsconsultands, contractorsoremployees bora anyandaltclaimsorcausesaactiondueto NC or arising out ofthe use or[nablNlyto use the GIS data provided by this website. WARNING: TIHS IS NOT A SURVEY — Parcel Information Parcel Number: D301OA0041 Township: Clarksville NCPIN Number: 5822153323 Municipality: Account Number: 82525144 Census Tract: 37059-801 Listed Owner 1: MALLOY ROBERT H Voting Precinct: CLARKSVILLE Mailing Address 1: 193 GREENFIELD ROAD Planning Jurisdiction: Davie County City: MOCKSVILLE Zoning Class: DAVIE COUNTY R-20 state: NC Zoning Overlay: Zip Code: 27028-4769 Voluntary Ag. District: No Legal Description: LOT 41 DUTCHMAN HILLS Fire Response District: WILLIAM R. DAVIE Assessed Acreage: 0.97 Elementary School Zone: WILLIAM R DAVIE . Deed Date: 9/2005 Middle School Zone: NORTH DAVIE Deed Book/Page: 006260289 Soil Types: MnB2,MdE 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: [Oil All data is provided as Is withoutwarra`dy or guarantee of any kind ebherexpresred or Implied including but rmIlmlted to the vaaDavie County, implied radies of merchantability or flmessfor a particular use. All users M Davie County's GIS webalte anal[ hold harmlessthe /'�CountyofDavie, North Carolina, b agentsconsultands, contractorsoremployees bora anyandaltclaimsorcausesaactiondueto NC or arising out ofthe use or[nablNlyto use the GIS data provided by this website. I` c • DAVIE COUNTY HEALTH DEPARTMENT Environmental Health Section P. O. Boa 848/210 Hospital Street Mockwille, NC 27028 (336)751-8760 Account #: 989900204 Billed To: J. D. Crews Homebuilder Reference Name: P oL Tax PIN/EH #: 5822-15-3323 Subdivision Info: Dutchman Hills Lot # 41 Location/Address: Greenfield -27208 Proposed Facility Residence Property Size: see map ATC Number: 3967 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 I 1 of G.S. Chapter 130A, Wastewater Systems, Section .1900 Sewage Treatm and Disposal Systems). THIS AUTHORIZATION FOR WASTEW ST VAL FOR A PERIOD OF FIVE YEARS. Environmental Health Specialist's Signature Date: / b 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 I 1 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. 1,51 ree.rr Septic System Installed y ..9..7 t,.; - Environmental ,.;-Environmental Health Specialist's Signa e DCHD 05/99 (Revised) DAVIE COUNTY HEALTH DEPARTMENT 0� _ �S Environmental Health Section t- Vf P. O. Boa 848/210 Hospital Street Mocksville, NC 27028 (336)751-8760 IMPROVEMENT/OPERATION PERMIT Account #: 989900204 Tax PIN/EH #: 5822-15-3323 Billed To: J. D. Crews Homebuilder Subdivision Info: Dutchman Hills Lot # 41 Reference Name: Location/Address: Greenfield -27208 Proposed Facility Residence Property Size: see map ATC Number: 3967 **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 Z Dishwasher: Garbage Disposal: 0'_Washing Machine: 12"opBasement w/Plumbing: ❑ Basement/No Plumbing: ❑ Commercial Specification: Facility Type #People #People/Shift #Seats Industrial Waste: 13//�� Lot Size 0 �lI P ype Water Supply lr".tw Design Wastewater Flow (GPD) 7 Site: New '❑' Repair ❑ i System Specifications: Tank Size 1B�GAL. Pump Tank GAL. Trench Width ZL� Rock Depth44 Linear Ft. Other: �1gfQaP�7T).s+J gBj( !I Required Site Modifications/Conditions: IMPROVEMENT/OPERATION PERMIT LAYOUT- APPROVED EFFLUENT FILTER RISER(S) IF 6 - BELOW FINISHED GRADE. ****NOTICE: Contact a representative of the Davie County Health Department for final inspection of this tem 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.**** ::� ''I s>�°'�;a � J Max ��-►1 �P� Environmental Health Specialist's Si a Date:. O 1 DCHD 05/99 (Revised) El DAVIE COUNTY HEALTH DEPARTMENT Environmental Health Section �C-6 j P. O. Boa 848/210 Hospital Street O S Mocksville, NC 27028 (336)751-8760 IMPROVEMENT/OPERATION PERMIT Account #: 989900204 Tax PIN/EH #: 5822-15-3323 Billed To: J. D. Crews Homebuilder Subdivision Info: Dutchman Hills Lot # 41 Reference Name: Location/Address: Greenfield -27208 Proposed Facility Residence Property Size: see map ATC Number: 3967 **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 11D #People #Bedrooms #Baths �— Dishwasher: M"' Garbage Disposal: C?r Washing Machine: 19'� Basement w/Plumbing: ❑ Basement/No Plumbing: ❑ Commercial Specification: Facility Type #People #People/Shift #Seats Industrial Waste: ❑ Lot Size 0A -?6- AOS -S Type Water Supply C OW Design Wastewater Flow (GPD) 3� Site: New m alRepair ❑ System Specifications: Tank SizeGAL. Pump TanklGAL. Trench Width 3( Rock DepthIZ� Linear Ft. -350r Other: -3 b5TQA&)rI0a3 ZoVj:-:f'- Required Site Modifications/Conditions: WST-A-L, aa CA,JTWfL lid? toGP to 0(--F PAOR IMPROVEMENT/OPERATION 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 #his (336)751-8760.**** -ST M,�J•Iks - � 0 8. Cf 1 C' N x y Environmental Health Specialist's Signature: r Date:,�D ho IOt f DCHD 05/99 (Revised) - L. I 1 50' r I S. E. 'YP `7n42 LOT # h. 81 • jOeo`. 1 1,414 Al LAJ I .� o�cu s; a I LOT #41 Q 0.976 AC. 3< 1 N so• a 84'2C'50" E 0 270.00 -, LOT Q - ♦ 1 L V o LOT #40 :n I coCD 0.930 AC. cz� CD CD "3 I EAS EMFN1 S 84.20.50' E cy I 270 00 :> ,� rnT A APPLICATION FOR SITE EVALUATION/IMPROVEMENT PER IT & ATE C LS UU Davie County Health Department D Environmental Health Section " P.O. .Box 848/210 Hospital Street 6 2005 Mocksville, NC 27028 - (336)751-8760. ***IMPORTANT*** THIS APPLICATION CANNOT BE PROCESSED UNLESS ALL THE REQUIRED INFORMATION IS PROVIDED. Refer ,t/o the INFORMATION BULLETIN for instructions. - 1. Name to be Billed �J 0 C G7,,JS }11Jy�n/L &g6 W5 Contact Person Gl;f Rel Mailing Address 4to I 61...Ine2ac- ' RA - Ems Phone --—5e/Z,--7619 City/State/ZIP M 0CKS-,M US I✓G ;7-70Z? Business Phone Cl410- 799,5— Ctrty. 2. Name on Permit/ATC if Different than Above - y Mailing Address City/State/Zip 3. Application For: ❑ Site ,Evaluation l lmprovement Permit/ATC ❑ Both' 4., system to Service: @' House's. ❑ Mobile Home ❑.Business ❑ Industry ❑ Other 5. If Residence:,, / #People # Bedrooms 3 # Bathrooms Z 6✓Dishwasher LY Garbage DisposalM Washing Machine ❑ Basement/Plumbing ❑ 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: Vcounty/City ❑ Well ❑ Community 8. Do you anticipate additions or expansions of the facility this system is intended to serve? ❑ Yes ❑ No If yes, what type? `**IMPORTANT*** CLIENTS MUSTCOMPLETETHE REQUIRED PROPERTY INFORMATION REQUESTED BELOW. Either a PLAT or SITE PLAN MUST RESUBMITTED by the client with THIS APPLICATION. . Property Dimensions: _150AK 29D X /65 x Z70 Tax Office PIN: # SPZZ153 3 2 3 Property Address: Road Name Ra--,dHa$A Qa City/Zip mgk&y l,e NG zzaz- WR,I/TE DIRECTIONS (from Mocksville) to PROPERTY: Yr4/CI &Ol 740,e7U 1k7-0& EhTOO C((uaa4 R. - LE R- ©IJ 14iqhtmk4s 'PA. 1f in a Subdivision provide information, as follows: LO V 4 ( ©4 I -e -FT- Name: bu,'tztklrolt),/ W05 Section: Block: Lot: 4% Date Property Flagged: (- 7-O,] 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 suitabill DATE - 1— 7 " D t� SIGNATUREi.� 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).. �� I Site Revisit Charge Revised DCHD (07/9 Date(s): Client Notification Date: EHS: Account No. Invoice No. 1u l MSION PAT GERTIFATE OF APPROVAL 30' EASEMENT Z LOT`S r_ that the subdivision plat shown hereon has been UTfLRY &ACCESS C6 1 0816 C �� 0 0 ,g9' Cit f with the County Subdivision Regulation, with the I 20• S 83.53.30• S i ch variances, if any, as are noted in the minutes r f— _ E 1 69. �� y Board and that it has been approved for recording Register of Deeds. It is hereby noted that such 1 �~ :ordation does not includes appproval to install and n sE Tra a3 Facilities nor does it includes approval for the ^ o l ;QS- 'o py'39Ci4 occupancy of building or structures. - o i # �� '� ri� g R 44 _C SEt1C«ayL �o .: C l� ay of Jill, 2001 0 �' L062 AC. \ P 2 PAv�O. E� X39 1 COUNTY PL51NNING BOARD z 1 I? �N ro "�o that I am the owner of the property shown so arson, which located in the County of Davie s ]opt this plan of subdivision with my free consent, , S.E. TYP• 1 N -num building setback lines and dedicate all streetsi 27a42 LOT #S rN' c rks and- other sites and easement to public or 1 J M 81'10 02• p "' 1.414 AC. led. Furthermore, I hereby dedicate all sanitary r W A• t a, � I m � a cines to the County of Davie (if applicable). DATE �; 1 ► -- 1 v LOT OWNER ® 2 Ibz' 0.976 ACS sv d �.. j / {� __' —"�7G 344.92 Z- OWNER/ 1 S 84• 7�n2Cvo ' N 80.38143• W, 1 20.00 o i balw 1 LOT #8 o a , O f 1 m -! 1.181 AC. • o = LOT #40 0 CD in j 0.930 At C. ! �• z 10' Unum h y w ptTIFICATE +V 1 A7ENT Q 1 S EASEL 1,,, 4 Review officer of Davie County,`� I or plot to which this certlfleation S 84.20'50• p `�i statutory requm lreerde for recording. 270.00 i � 1 a W �. LOT J9 0,, 1.171 At -. DATE LOT #S9 M • � f c ^ 1 0.930 AC, �; •• r z $80.35 36 r I APPLICATION FOR SITE EVALUATION/IMPROVEMENT PERMIT & ATC 6 k• Davie County Health Department Env/ronmenfa/ HaPIM SeXon yj P.O. Box 848/210 Hospital Street q.UU? 2-c;? 7 Moakeville, HC 27026 (336)731-8760 *** THIS APPLICATION CAMMOT BE PROCESSED UNLESS ALL yBE REQUIRED IS PROVIDED. Refer to the INFORK&TIOH BULLETIN for instructions. 1. Name to be aillod Nailing address City/stat*/ZIP 2. Name on perch/ATC it Different than Nailing Address s. Application rows Era -its Evaluation contact Pesson city/state/sip D Improvement Permit/ATC O Both a. systu to service, grHouse 0 Mobile Home O Business 0 Industry D Other s. I! Residences I People I Bedrooms 4 Bathrooms D Dishwasher 0 garbage Dispoeal 0 Mashing Machina D sesarnt/plusbisg D fta me t/No Plumbing S. If nusiness/industry/Othert Specify two a people s pinks e Comode@ a showers a Urinals s Nater Coolers IT FOODSERVICE: ii Seats Estimated Water Usage (gallons per day) 7. Type of Nater supply: bounty/City 0 Well 0 Community e. Do you anticipate additions or expansions of the facility this system is Intended to serve? 0 Yes 0 No If yes, what type? ***IMPORTANT'** CLIENTS MUSTOOMPLETETHE REQWRED PROPERTY INFORMA71ON REQUESTED BELOW. Either aPLAT orSITE PLAN �MUSTBESVBM TYEDbythe ellcat w�ithTHIS APPLICATION. AGI Property Dimensld l - F r. / .3 It'�� 5 WRITE DIRECTIONS (from Mocluvllle) to PROPERTY: Tax ORice PDN: # 62Va - IU - In 95-5 0/ , � 0 / A10i �'A 72 9 (, V, 1�o.1i 6 Property Address: Road Name 0/ tf f,e YJoh/ ly00/ro'O�7 City/Zip 4:& If Is a Subdivision provide Information, as folioowst /d / Name: aG�11�I491J Sections Block: Lot: Date Properly Flogged: /v /Vee fSc-rnc-trt e � This M to certify that the Information provided Is correct to The best of my knowledge. I understand that any permll(s) Issued hereafter are subject to suspension or. revocation, If the site plans or Intended we 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 sultalility. DATE ( -r2,-9 — Q&) SIGNA THIS AREA MAY BE USED FOR DRAWING YOUR SITE PLAN property lines and dimensions, structures, setbacks, and septic loci Revised DCHD (07/99) 'all of the following: Existing and proposed L isit Charge ale: Account No. Invoice No. 4tyl DAVIE COUNTY HEALTH DEPARTMENT Environmental Health Section Soil/Site Evaluation APPLICANT INFORMATION PROPERTY INFO - Tax PIN/EH #: 582 - RMATION ; Billed To: Gray Potts Subdivision Info: Dutchman Hills Lot # 44 Reference Named. Gray Potts Location/Address: Eatons Church Road -27028 Proposed Facility:, Residence Property Size:: 51 Acres ,.. Date Evaluated: DD Water Supply: On -Site Well Community Public Evaluation By: Auger Boring Pit / Cut FACTORS 1 2 3 4 5 6 7 Landscape position Slope % 7A - HORIZON I DEPTH D - Z -L 12 Texture groupG . G Consistence C, V P. Structure Mineralogyh' HORIZON II DEPTH 0 1 - Z Texture group Consistence Structure < Mineralogy 'HORIZON III DEPTH - • S- 0 Texture groupWDrtt% Consistence ro Structure a - Mineralogy HORIZON IV DEPTH Texture group Consistence Structure Mineralogy SOIL WETNESS RESTRICTIVE HORIZON SAPROLITE CLASSIFICATION S LONG-TERM ACCEPTANCE RATE SITE CLASSIFICATION: P� ` EVALUATION BY: LONG-TERM ACCEPTANCE RATE. D• 3s OTHER(S) PRESENT: REMARKS: - P#I -_-�TACT'-1 _t>P40 5DNAP, SyNkaLL ft 1#2 LEGEND Landscape Position l 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 - Sand clay SIC = Silty clay '! C- Clay y y ty 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 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).