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128 Hawks Trail Lot 1Davie County, NC Tax Parcel Report Wednesday, January 11, 2017 256 _ s 218 rTl i m 180 - f 1_� ~ 294 I' 128 216--- ``-�r` 312 w `�. 19 6 230'..' _ f/��-------- - ; ���.9CALLIS +ER RC ' itiCALLISTER RQ Parcel Number: NCPIN Number: Account Number: Listed Owner 1: Mailing Address 1: City: MOCKSVILLE WARNING: THIS IS NOT A SURVEY NC Zoning Overlay: Parcel Information 27028 1301 OA0001 Township: Calahaln 5728158926 Municipality: 5.44 8301202 Census Tract: 37059-801 RETKO ERIC Voting Precinct: NORTH CALAHALN 128 HAWKS TRAIL Planning Jurisdiction: Davie County Flood Zone: Zoning Class: DAVIE COUNTY R-A,R-20 State: NC Zoning Overlay: Zip Code: 27028 Voluntary Ag. District: No Legal Description: LOT 1 HAWKS LANDING Fire Response District: CENTER Assessed Acreage: 5.44 Elementary School Zone: MOCKSVILLE Deed Date: 7/2012 Middle School Zone: SOUTH DAVIE Deed Book / Page: .008950891 Soil Types: MrC2,Gnl32,MsD,WATER Plat Book: 0008 Flood Zone: Plat Page: 009 Watershed Overlay: DAVIE COUNTY Building Value: Outbuilding & Extra Freatures Value: Land Value: Total Market Value: Total Assessed Value: Davie County, All data Is provided as is without warranty or guarantee of any Idnd either expressed or implied Including but not limited to the Implied warranties of merchantability or fitness for a particular use. All users of Davie County's GIS website shall hold harmless the rpC NC County of Davie, North Carolina, its agents, consultants, contractors or employees from any and all claims or causes of action due to �q� or arising out of the use or Inability to use the GIS data provided by this website. DAVIE COUNTY HEALTH DEPARTMENT \6v 3 U Environmental Health Sectional P. O. Bog 848/210 Hospital Street bbl Mocksville, NC 27028 (336)751-8760 Account #: 990003998 Billed To: Kent Shaw & Son Construction, Inc. Reference Name: Kent Shaw 'r000sed Facilitv: Residence ATC Number: 4422 Tax PIN/EH #: 5728-16-0119.01 Subdivision Info: Hawks Landing Lot # 1 Location/Address: McAllister Road -27028 ProDertv Size: 5.435 Acres As stated in 15A NCAC 18A.1969(5 accepted Systems may also be use 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 Sewag Treatment and Disposal Systems). THIS AUTHORIZATION FOR WASTEWATER CO IO IS V FOR A PERIOD OF FIVE YEARS. Environmental Health Specialist's Signatu Date: CERTIFICATE OF COMPLETION **NOTE** The issuance of this Certificate of Completion shall indicate the system described on has been installed in compliance with Article 11 of G.S. Chapter 130A, Section 190 Disposal Systems," but shall in NO WAY be taken as a guarantee that the syst Ove given period of time. ql_ (�u (tv 4 sTJ (+w6pabf� iN, CQ 4gr— Septic System Installed By: Environmental Health Specialist's Signature i � \a054--- v rpent/Operation Permit d 1040 is ac for any --Ab "7 P6PA I e z J� ate: I "—d 0�> I O-) DCHD 05/99 (Revised) DAVIE COUNTY HEALTH DEPARTMENT Environmental Health Section P. O. Boz 848/210 Hospital Street Mocksville, NC 27028 Pil (336)751-8760 6 IMPROVEMENT/OPERATION PERMIT Account #: 990003998 Tax PIN/EH M 5728-16-0119.01 Billed To: Kent Shaw & Son Construction, Inc. Subdivision Info: Hawks Landing Lot # 1 Reference Name: Kent Shaw Location/Address: McAllister Road -27028 Proposed Facility: Residence Property Size: 5.435 Acres ATC Number: 4422 **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 TypeON--Sc--#People 2— #Bedrooms 3 #Baths 2• S7 Dishwasher: ❑ Garbage Disposal: ❑ Washing Machine: ❑ Basement w/Plumbing: ❑ Basement/No Plumbing: ❑ Commercial Specification: Facility Type #People #People/Shift #Seats Industrial Waste: ❑ Lot Size Sq 40215-5 Type Water Supply Design Wastewater Flow (GPD) Site: New e Repair ❑ System Specifications: Tank Size IGUCUAL. Pump Tank GAL. Trench Width 3U' Rock Depth W/& Linear Ftj�b Other: Required Site Modifications/Conditions: kSTAI.L [j,J 0 A -Z 100 T:�- - 6.�6 L � 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 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.**** RZCP NDIP tJ - '7q' �,-�MIa 1o' leaazL r -�c-rpt' 1 - Environmental Health Specialist's Signature: Z DCHD 05/99 (Revised) TO. ��' nneUL) ST *POF-> Uzi I,, 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 #: 990003998 Tax PIN/EH #: 5728-16-0119.01 Billed To: Kent Shaw & Son Construction, Inc. Subdivision Info: Hawks Landing Lot # 1 Reference Name: Kent Shaw Location/Address: McAllister Road -27028 Proposed Facility: Residence Property Size: 5.435 Acres ** ffq Nymber: 4422 NO is 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 'UDLY #People 2- #Bedrooms #Baths 2, Dishwasher: ❑ Garbage Disposal: ❑ Washing Machine: ❑ Basement w/Plumbing: ❑ Basement/No Plumbing: ❑ Commercial Specification: Facility Type #People #People/Shift #Seats Industrial Waste: ❑ Lot Size 6A A(f g�$Type Water Supply Design Wastewater Flow (GPD) -_5(cQ Site: New e Repair ❑ I+ I I t System Specifications: Tank Size I 000GAL. Pump Tank GAL. Trench Widtlt_� Rock Depth 112- Linear Ft. ) Other: �1�Ti2��Tlo�1 �DXS accepted in 15A also be used Required Site Modifications/Conditions: FIRM- IMPROVEMENT/OPERATION . M IMPROVEMENT/OPERATION PERMIT LAYOUT - APPROVED EFFLUENT FILTER. RISER(S) IF 6;` BELOW FINISHED GRADE. ****NOTICE: Contact a representative of the Davie County Health Department for final inspection of this system between 8:30 a.m. to 9:30 a.m. or 1:00 p.m. to 1:30 p.m. t e d y of installation. Telephone # is (336)751-8760.**** o � PLI -' L Environmental Health Specialist's Signature: s 4 r�atP' A w led �3 277' DCHD 05/99 (Revised) WAU.t�)fij � �� Si, iy, ��+yt ✓ A Z � Y '�`e' 3 � 1 4 � Y� � +*`k � � �` ��` , {.'S-�c 'r rla '�' ^ .' { 6. Y,.• a r;F •4`.'w8i3 Cp _ �i,^ M. ro c T..'$'.aa� ..a lR w.. .�3`%. i �.4�1""'� ,�2 •.. w� c. :.E'!"ii' A." � :.#➢ .i C r3e�. j. 'fir '� , . E l- $ F am s��.waau w r •� Tw i , F- s'} �`" �A�. a.` 441,� . y y- p4 5- lit Ot VVI ya.' �'7l ,mow"t '` ay r't a `;3�. ti„`"@ 4 e 5 ga,-.mx r ;°. *�xi r -"S•"' < .d�fyw�u�` '� `,,.' ``..» + -,� *` I� ba x s x X acs A a h 77, 47 All t � xt � ^' w "u�». +`# '� "`--..,�� r�r:��,"°;,, `�° ""'` � '� °' ' .`.�. ��. z�r ��, � �. s<' �e g. • : acv, .��€«,�„r� i��•y m�`z-ii ;' a �' -' ; ''g� 1 rtI:7 R�"t �i� ���r.; I A'"�ka'�,y. _. •� �� a _ fir• i 44 t as • APPLICATIO OR SITE EVALUATION/IMPROVEMENT PERMIT & ATC D Davie County Health Department Environmental Health Section P.O. Box 848/210 Hospital Street Mocksville, NC 27028 '. (336)751-8760/ Fax 6)751-8786 plica i�jon (fl -16 ea mprovement Permit Authorization To Construct(ATC) Z I ith *I ANT*** THIS APPLICATION CANNOT BE PROCESSED UNLESS ALL OF THE REQUIRED ORMATION IS PROVIDED. Refer to the INFORMATION BULLETIN for instructions. APPLICANT INFORMATION Name to be Billed Contact f j �aiv f -_Sous Co.s/S f /�C Contact Person _ l�,eisl 5X1Y1L) Billing Address _ P. G, 80 'x lb 1, / Home Phone 41 City/State/ZIPj ry �i7�� iV. L ; Z f',/ L / Business Phone T�c,tg Name on Permit/ATC if Different than Above Mailing Address PROPERTY INFORMATION NOTE: A survey'plat or site plan must accompany this application. (Permit is y lid for 60 months with site plan, no expiration with co leteF�'lat.) Street Address ��� 3� "yZ /� City S ✓, /'e Tax PIN# All Z Subdivision Name • Section/Lot# Lot Size Directions To Site: CS hill tnI-Wt Date House/Facility Corners Flagged If the answer to any of the following questions is "yes", supporting documentaho ,must be attached. Are there any existing wastewater systems on the site? El Yes RNo Does the site contain jurisdictional wetlands? ❑Yes Ao Are there any easements or right-of-ways on the site? ❑Yes P<0 Is the site subject to approval by another public agency? ❑Yes B'ilo Will wastewater other than domestic sewage be generated? []Yes Pf4o TV DT:CTT%TTkJ1'Tr 'CTT T 11TTT TT-Trr DLIV UTIT !1147 11- 1\L LJ1V1ilV Vli 1'1LL V V 1 1111..1 LV11 1)liLV YY # People # Bedrooms # Bathrooms Z Z Garden Tub/Whirlpool es ❑No Basement: ❑Ye Ko IJ o Basement Plumbing: ❑Yes �lo IF NON -RESIDENCE FILL OUT THE BOX BELOW Type of Facility/Business Total Square Footage of Building # People # Sinks # Commodes # Showers # Urinals Estimated Water Usage (gallons per day) (Attach documentation of similar facility water consumption) FOODSERVICE ONLY: # Seats Type system requested: VC/Onventional ❑Accepted ❑Innovative ❑Alternative ❑Other Water Supply Type: ❑ County/City Water VNew Well ❑Existing Well ❑ Community Well Do you anticipate additions or expansions of the facility this system is intended to serve? ❑ Yes V No If yes, what type? This is to certify that the information provided on this application is true and correct to the best of my knowledge. I understand that any permit(s) or ATC(s) issued hereafter are subject to suspension or revocation if the site is altered, the intended use changes, or if the information submitted in this application is falsified or changed. I understand that I am responsible for all charges incurred from this application. I hereby grant right of entry to the Authorized Representative of the Davie County Health Department to conduct necessary inspections toetermine compliance with applicable laws and rules on the above described property located in Davie County and owned by e Lek nZ L . 5e&) ,g li eke! Property owner's or owner's Date Sign given ❑Yes ❑No Revised 2/06 ve signature � �� `I Site Revisit Charge Date(s): Client Notification Date: EHS: Account # ­ L�gq? Invoice # dm_ 2- NS ( Yd"A;j Y ---- LV—. i bok- w v Kz ':tL -,)4 :u 14 'jv 90 9; �Tlmv ay CJI'FZ -Y-imy LO7 ... . ...... APPLICATION FOR SITE EVALUATION/IMPROVEMENT PERMIT & ATCli i Davie County Health Department Environmental Health Section 9 t P.O. Box 848/210 Hospital Street Mocksville, NC 27028 I (336) 751-8760 ENVI TIA%9EPJTAL HEALTH ... ehmv ***IMPORTANT*** THIS APPLICATION CANNOT BE PROCESSED UNLESS ALL THE REQUIRED INFORMATION IS PROVIDED. Refer to the INFORMATION BULLETIN for instructions. 1. Name to be Billed/Oyi� , Mailing Address126 /�C�(16.1 AG City/State/ZIP ^ /X%lfll/1 -270 2,,1- 2. Name on Permit/ATC if Different than Mailing Address Contact Person 4// Home Phone �90? -. y N Business Phone yIo - 0 7Q s City/State/Zip 3. Application For: Site Evaluation ❑ Improvement Permit/ATC ❑ Both 4. System to Service: Ag/House ❑ Mobile Home ❑ Business ❑ Industry ❑ Other 5. If Residence: # People # Bedrooms --� # Bathrooms ►dishwasher O Garbage Disposal Lq-washing Machine Basement/Plumbing U Basement/No Plumbing 6. If Business/Industry/Other: Specify type # Commodes # Showers # Urinals # People # Sinks # Water Coolers IF FOODSERVICE: # Seats Estimated Water Usage (gallons per day) 7. Type of water supply: ❑ County/City IR"Well ❑ Community 8. Do you anticipate additions or expansions of the facility this system is intended to serve? ❑ Yes 49- o If yes, what type? 'IMPORTANT*** CLIENTS MUST COMPLETETHE REQUIRED PROPERTY INFORMATION REQUESTED BELOW. Either a�-P-LAT or SITE PLAN MUST BE SUBMITTED by the client with THIS APPLICATION. Property Dimensions: /0 WRITE JD IR/EC/TIONS (from Mocksville) to PROPERTY: b/I Tax Office PIN: 16 - oli Property Address: Road Name '' YC �LL r'l-d ' L'L-' City/zip Mourzw I Lw" "q If in a Subdivision provide information, as follows: y P� oYJ Name: Section: Block: Lot: Date Property Flagged: Inti (.,L CA Lk - 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 suitability. DATE V e/ e- QU, SIGNATURE THIS AREA MAY BE USED FOR DRAWING YOUR SITE PLAN (Include a theo ing: Existing and proposed property lines and dimensions, structures, setbacks, and septic locations). Revised DCHD (07/99) -�"Avcl Ic Site Revisit Charge Datc(s): Client Notification Date: EHS: Account No. of Invoice No.� APPLICANT INFORMATION Account #: 990002529 Billed To: Donald Boyd Reference Name: Proposed Facility: Residence DAVIE COUNTY HEALTH DEPARTMENT Environmental Health Section Soil/Site Evaluation PROPERTY INFORMATION Tax PIN/EH #: 5728-16-0119.01 Subdivision Info: Don Boyd Lot # 01 Location/Address: McCallister Road -27028 Property Size: 5+ acres Date Evaluated: 17—A, 0 Water Supply: On -Site Well / Community Public Evaluation By: Auger Boring Pit Cut SITE CLASSIFICATION: 41,t) LONG-TERM ACCEPTANCE RATE: REMARKS: Landscape Position ty C -•.F - SEND EVALUATION BY:h ) efiL Q� OTHER(S) PRESENT: &'DY� R - Ridge S - Shoulder L - Linear slope FS - Foot slope N - Nose slope iI 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) HORIZON I DEPTH Texture group Consistence 0LANMN0MMIIJ0 F A ,�3.�-AVA 9 UA' L HORIZON II DEPTH Texture • 160M 0WZE MAO I/MM-" tmi'1MFEE WA' 0 M -A MWA Texture group "RENW—Mo �_ Mineralogy HORIZON IV DEPTH Texture group •Mineralog--�--�- • ���mM,Mom -� elm-, SAPROLITE CLASSIFICATION • WIRMAE MMlNOMME wlw�NIN&M�� SITE CLASSIFICATION: 41,t) LONG-TERM ACCEPTANCE RATE: REMARKS: Landscape Position ty C -•.F - SEND EVALUATION BY:h ) efiL Q� OTHER(S) PRESENT: &'DY� R - Ridge S - Shoulder L - Linear slope FS - Foot slope N - Nose slope iI 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 - 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Box 848/210 Hospital Street Mocksville, NC 27028 Phone: (336) 751-8760 / Fax: (336) 751-8786 December 17, 2002 Don Boyd 196 McAllister Road Mocksville, NC 27028 Re: Site Evaluation(s)- 4 Tracts/McAllister Road Tax PIN#: 5728-16-0119 Dear Mr. Boyd: As requested, a representative from this office visited the above site(s) on December 16, 2002 to perform four site evaluations. Based on the information provided on the Application for Site Evaluation and after the evaluations were completed, all four sites were found to be provisionally suitable for the installation of on-site sewage disposal systems. It should be noted that the septic system for Tract #4 will be oversized due to soil characteristics. Additionally, house placement, soil conditions and topography may necessitate pump stations on any of the lots. Before a representative of this office will revisit the site(s) to issue an Improvement Permit/Authorization to Construct, the appropriate application must be completed in full and submitted to this office. The location of the facility the system is to serve must be staked off. Enc(s) If you have any questions, feel free to contact this office at 751-8760, Sincerely, JeffA1. .Buc amp, R.S. Environmental Health Section