105 South Hazelwood Drive Lot 23Davie County, NC Tax Parcel Report Tuesday, January 10, 2017
131
117
- - t
Parcel Number:
NCPIN Number:
Account Number:
Listed Owner 1:
Mailing Address 1:
City:
State:
Zip Code:
Legal Description:
Assessed Acreage:
Deed Date:
Deed Book / Page:
Plat Book:
Plat Page:
Building Value:
i�
107
112
-----105 115, 125 133 14
0
S HALED"JOOD DR w
CI—
WARNING: THIS IS NOT A SURVEY
Parcel Information
J7080B0023 Township: Fulton
5768119050 Municipality:
8300412 Census Tract: 37059-804
SMITH JOHNATHAN K Voting Precinct: FULTON
105 SOUTH HAZELWOOD DRIVE Planning Jurisdiction: Davie County
MOCKSVILLE Zoning Class: DAVIE COUNTY R-20
Land Value:
Total Assessed Value:
NC
27028-0000
LOT 23 HERITAGE OAKS PHASE ONE
0.73
6/2011
008610578
0007
005
Zoning Overlay:
Voluntary Ag. District:
No
T
139
Elementary School Zone:
136
I
WILLIAM ELLIS
Soil Types:
Gn132
Flood Zone:
Watershed Overlay:
DAVIE COUNTY
Outbuilding & Extra
131
117
- - t
Parcel Number:
NCPIN Number:
Account Number:
Listed Owner 1:
Mailing Address 1:
City:
State:
Zip Code:
Legal Description:
Assessed Acreage:
Deed Date:
Deed Book / Page:
Plat Book:
Plat Page:
Building Value:
i�
107
112
-----105 115, 125 133 14
0
S HALED"JOOD DR w
CI—
WARNING: THIS IS NOT A SURVEY
Parcel Information
J7080B0023 Township: Fulton
5768119050 Municipality:
8300412 Census Tract: 37059-804
SMITH JOHNATHAN K Voting Precinct: FULTON
105 SOUTH HAZELWOOD DRIVE Planning Jurisdiction: Davie County
MOCKSVILLE Zoning Class: DAVIE COUNTY R-20
Land Value:
Total Assessed Value:
NC
27028-0000
LOT 23 HERITAGE OAKS PHASE ONE
0.73
6/2011
008610578
0007
005
Zoning Overlay:
Voluntary Ag. District:
No
Fire Response District:
FORK
Elementary School Zone:
CORNATZER
Middle School Zone:
WILLIAM ELLIS
Soil Types:
Gn132
Flood Zone:
Watershed Overlay:
DAVIE COUNTY
Outbuilding & Extra
Freatures Value:
Total Market 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 i
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, North Carolina, its agents, consultants, contractors or employees from any and all claims or causes of action due to
NC
or arising out of the use or Inability to use the GIS data provided by this website.
7-
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ri
DAME COUNTY HEALTH DEPARTMENT
Environmental Health Section
P. O. Boz 848/210 Hospital Street
Mocksville, NC 27028
(336)751-8760
IMPROVEMENT/OPERATION PERMIT
Account #: 990001178 Tax PIN/EH M 5768-11-9050.23
Billed To: Brad McCullough Subdivision Info: Heritage Oaks Lot # 23
Reference Name: Brad McCullough Location/Address: Hazelwood Drive -27028
Proposed Facility: Residence Property Size: 161x240x100x
**NOT1*iis gmpro4em2ent/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 oos #People 2 #Bedrooms __:� #Baths 7:2—
Dishwasher:
ZDishwasher: IT"" Garbage Disposal: ❑ Washing Machine: e Basement w/Plumbing: ❑ Basement/No Plumbing: ❑
Commercial Specification: Facility Type #People #People/Shift #Seats Industrial Waste: ❑
2
Lot Size 30�COU�t �= Type Water Suppl3CCg2tJTY Design Wastewater Flow (GPD;?1,00 Site: New at Repair ❑
System Specifications: Tank Sizeb—COGAL. Pump Tank GAL. Trench Width RockkDepth 17— Linear Ft3CO
Other: I -I;hSTe,, ic, J'b6�C, I0r>Tku %-IrJGS 1410.6, 60%1.J.
4
Required Site Modifications/Conditions:�
19a'
U aL
IVPROVEMENT/OPERATION PERMIT LAYOUT- APPROVED EFFLUENT FILTER RISERS) IF 6 -BELOW
F 1 ISHED ADE. ****NOTICE: Contact a representative of the Davie County Health Department for final inspection of this
system between 8:3 . 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.****
RAI NJ Lkj --->
i Specialist's Signature:
DCHD 05/99 (Revised)
St'
V7
Date: z44
rL
DAVIE COUNTY HEALTH DEPARTMENT
Environmental Health Section
P. O. Boa 848/210 Hospital Street
Mocksville, NC 27028
(336)751-8760
Account #: 990001178 Tax PIN/EH #: 5768-11-9050.23
Billed To: Brad McCullough
Reference Name: Brad McCullough
Proposed Facility: Residence
ATC Number: 2432
Subdivision Info: Heritage Oaks Lot # 23
Location/Address: Hazelwood Drive -27028
Property Size: 161x240x100x
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 ONS ZCTIO V ID FOR A PERIOD OF FIVE YEARS.
Environmental Health Specialist's Signatur : ate: O
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. I l
Li
Septic System Installed By: y�"� ��
Environmental Health Specialist's Signature: - Cyvvr/ Date:
DCHD 05/99 (Revised)
�. It"Y110
IP
APPLICATION FOR SITE EVALUATION/IMPROVEMENT PERMIT & ADavie County Health Department 14AY 1 0
Enl* vn/nenfa/ Health Section
P.O. Box 848/210 Hospital Street
Mocksville, NC 27028
!336!751-8760
Dishwasher (_1 Garbage Disposal H Washing Machine 11 Basement/Plumbing CI 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: e'County/City ❑ Well ❑ Community
a. Do you anticipate additions or expansions of the facility this system is intended to serve? ❑ Yes S -14o
If yes, what type?
***IMPORTANT*** CLIENTS MUSTCOMPLETETHE REQUIRED PROPERTY INFORMATION REOUESTED
BELOW. Either a PLAT or SITE PLAN MUST BE SUBMITTED by the client with THIS APPLICATION.
��x 2Yv. C7,jc vol
Property Dimensions: ��(a�Y WRITE DIRECTIONS (from Mocksville) to PROPERTY:
Tax Office PIN: # S-7G�'//- '10-1-0 (a,7)6 y
Property Address: Road Name /tk Z j w o b o r C14 -44/ 00
City/Zip f/2lyc �sv � l% z�oZfl
u in a aubdivisiou provide information, as follows:
Name:
Section: Block: Lot: Zj
Date Property Flagged: C3
This is to certify that the information provided is correct to the best of my knowledge. 3 understand that any permit(s)
issued hereafter are subject to suspension or revocation, if the site plans or intend use change, or if the information
submitted in this application is falsified or changed A, 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 lucaied in Davie County and owned by C- /K. t <
to conduct all testing procedures as necessary to determine the site suitability.
DATE -� 9 - "� SIGNATURE
THIS AREA MAY BE US R WING YOUR SITE PLAN (Include all of the following: Existing and proposed
property lines and dimensions, stru es, backs, and septic locations).
Q
Q
33
F
Revised DCHD (07/99)
3
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Q
1�
I Date(s):
I EHS•
Account No. Z 0
Invoice No. 5'DO
***IMPORTANT***
THIS APPLICATION CANNOT BE PROCESSED UNLESS ALL THE REQUIRED
INFORMATION IS
PROVIDED.Refer to
I
the INFORMATION BULLETIN for instructions.I
1.
Name to be Billed
2.--/ "/ t ul��+vq�/
' /
Contact Person
Mailing Address
3% Z 1/ /evil?
Home Phone 32,,6 `I rim'
City/State/ZIP
_Z )Oii2(- �C
07Z--i-L- Business Phone
2.
Name on Permit/ATC
it Different than Above
Mailing Address
City/ tate/Zip
3.
application For:
❑ Site Evaluation
Improvement Permit/ATC Bothl
4.
system to service:
0--hiouse ❑ Mobile Home ❑ Business ❑ Industry ❑ Other
5.
if Residence:
# People 2
# Bedrooms 3 # Bathrooms Z
Dishwasher (_1 Garbage Disposal H Washing Machine 11 Basement/Plumbing CI 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: e'County/City ❑ Well ❑ Community
a. Do you anticipate additions or expansions of the facility this system is intended to serve? ❑ Yes S -14o
If yes, what type?
***IMPORTANT*** CLIENTS MUSTCOMPLETETHE REQUIRED PROPERTY INFORMATION REOUESTED
BELOW. Either a PLAT or SITE PLAN MUST BE SUBMITTED by the client with THIS APPLICATION.
��x 2Yv. C7,jc vol
Property Dimensions: ��(a�Y WRITE DIRECTIONS (from Mocksville) to PROPERTY:
Tax Office PIN: # S-7G�'//- '10-1-0 (a,7)6 y
Property Address: Road Name /tk Z j w o b o r C14 -44/ 00
City/Zip f/2lyc �sv � l% z�oZfl
u in a aubdivisiou provide information, as follows:
Name:
Section: Block: Lot: Zj
Date Property Flagged: C3
This is to certify that the information provided is correct to the best of my knowledge. 3 understand that any permit(s)
issued hereafter are subject to suspension or revocation, if the site plans or intend use change, or if the information
submitted in this application is falsified or changed A, 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 lucaied in Davie County and owned by C- /K. t <
to conduct all testing procedures as necessary to determine the site suitability.
DATE -� 9 - "� SIGNATURE
THIS AREA MAY BE US R WING YOUR SITE PLAN (Include all of the following: Existing and proposed
property lines and dimensions, stru es, backs, and septic locations).
Q
Q
33
F
Revised DCHD (07/99)
3
n
Q
1�
I Date(s):
I EHS•
Account No. Z 0
Invoice No. 5'DO
S%oyV
N/F
WILLIAM A BURNErTE
DB. 187, PG. 426
170.55' 141.05'
SEDIMENT BASIN Z \ \ 38.22' 63.28' _
DRAINAGE AREA 5.23 ACS. \ °_
DISTURBED AREA 1.85
REQUIRED STORAGE 9,414 cf \ o N
USE 4' X 30' X 80' BASIN \ 'r` N `O LOT 11 LOT 12
ROCK DAM WEIR LENGTH 12'
-' LOT 10 �r
(DETAIL E-11) \ ��
6 RIP -RAP APRON (DETAIL E-5) LOT 9
12'WX 101X9'D \ D -
�O 1 116' 140.82'
-'ION BERM (DETAIL E-7) � 7 3g�' tk� \ - � �� -= "- '-
t.
140-74' 54.19' ¢ � <� % �. - --•-
153.28' �i B �y
c~
L 0 T
\ LOT 5 LOT E co
i LOTtA
�J
PUBLIC, R/W / �\ ��
r
'
1_418" FES % ./b�tK \9� LOT �° oma, LOT .
158 - - -- 1142•
75.45
ldpb i�1A'-`LOT 22
T ;\///
Our-
--o -- -
3B �-07.05' t 50.75
...160 - �~�'` - 24Q27• x
s -- 226.52' /` N
R = 1600.00'
T = 139 x
I
_ SEDIMENT B
.93' o I LOT
0 m 23
L - 279.16' ` o
,aJ+ LI
55 LOT 54 a �o DRAINAGE AREA
LOT 53 ; I ,24 FES DISTURBED ARF
<,.
250.00' REQUIRED STOT
� t 58.36' 160.45' 205.43' -� - - -- � � � _ '
USE. 5' X 40' X
�Q i-� LOT 24 ROCK DAM WEIR
DAVIE COUNTY HEALTH DEPARTMENT
Environmental Health Section
Soil/Site Evaluation J�
NAME z/ DATE EVALUATED
ADDRESS PROPERTY SIZE %mac
PROPOSED FACIILTY
LOCATION OF SITE G1��
Water Supply:
On -Site Well _
Community
Public G�
Evaluation By:
Auger Boring
Pit 1 /
Cut
FACTORS
1
2 3 4
Landsca a position
Sloe %
HORIZON I DEPTH
Texture group
Consistence
Structure
Mineralogy
HORIZON II DEPTH
Texture group
G
Consistence
Structure
S.
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
L
SITE CLASSIFICATION: A— EVALUATED BY: 11-46- `!
LONG-TERM ACCEPTANCE RATE: i 7 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
S -Sand LS -Loamy sand SL -Sandy loam L -Loam SI -Silt
SICL-Silty :lay loam- SIL -Silty loam CL -Clay loam SCL-Sandy clay loam
SC -Sandy clay SIC -Silty clay C -Clay
CONSISTENCE
Moist
VFR- V+:. -y 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
,3C --Single grain M -Massive CR -Crumb GR -Granular ABK-Angular blocky
SBK-Subangular blocky PL -Platy PR -Prismatic
Mineralotty
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(01-901