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108 Oakshire Court Lot 52Davie County, NC Tax Parcel Report Tuesday, January 10, 2017 S HAIL LV;'OOD DR -- - �—�— S I IAZ[: L%^FOOD DR ; I 186 ~------- ---109 ' 10 8 V c Uj U U� p 120 __._ - 121 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: MOCKSVILLE Building Value: Land Value: Total Assessed Value: WARNING: THIS IS NOT A SURVEY Parcel Information J7080B0052 Township: Fulton 5768201782 Municipality: 8302125 Census Tract: 37059-804 DEZARN DAVID M Voting Precinct: FULTON 108 OAKSHIRE COURT Planning Jurisdiction: Davie County NC 27028 LOT 52 HERITAGE OAKS PHASE TWO 0.82 4/2013 009230526 0008 139 Zoning Class: DAVIE COUNTY R-20 Zoning Overlay: 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 harmlessthe County of Davie, North Carolina, its agents, consultants, contractors or employees from any and all claims or causes of action due to or arising out of the use or Inability to use the GIS data provided by this website. i 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: W-1 Davie County, NC 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 harmlessthe County of Davie, North Carolina, its agents, consultants, contractors or employees from any and all claims or causes of action due to or arising out of the use or Inability to use the GIS data provided by this website. i 'HEALTH DEPARTMENT RELEASE Davie County Health Department 210 Hospital Street r ` - P.O. Box 848 Mocksville NC 27028 Phone: 336-753-6780 Fax: 336-753-1680 Applicant: David M. Dezam Address: 108 Oakshire Court City: Mocksville State2ip: NC 27028 Phone #: (336) 816-2076 For Office Use Only *CDP File Number 137234-1 i7-08MO-052 County ID Number. valuated For. HDRIMC PERMIT VALID 0 4/ 1 5/ 2 0 1 9 IIMTII rd ope rty Owner. David M. Dezarn ess: 108 Oakshire Court City: Mocksville State2ip: NC 27028 Phone #: (336) 816-2076 Property Location & Site Information Add res s108 Oakshire Court Subdivision: Heritage Oaks Phase: Lot 52 Road # Mocksville NC 27028 — SINGLE FAMILY Township: *Structure: Directions # of Bedrooms: 3 # of People: Hwy 64 E. Past Lake Louise, Heritage Oaks on left *Water Supply: PUBLIC Basement: R Yes ❑ No *Proposed Improvement: Storage Bldg 14x24 Type of Business: Total sq. Footage: No. Of Employees: Storage building may be placed as drawn on second submital where building is to be behind pool and inside of fenced area. Building must be no closer than 5 foot from septic system. This release in no way expresses or implies that the existing subsurface sewage treatment and disposal system serving the site will continue to function for any period of time. Applicant/Legal Reps. Signature Required? Oyes ONO Applicant/Legal Reps. Signature:. *Issued By: 21140 -Nations, Robert Authorized State Agent:— 11 *Date: *Date of Issue: 0 4/ 1 5/.1 0 1 4 **Site Plan/Drawing attached.** (�) Hand Drawing O ImportDrawing C!i R!! 5; Drawing Tyde: HEALTH DEPARTMENT RELEASE Davie county Health DepartmentCDP File Number: 137234 - 1 210 Hospital Street j7-080-130-052 P.O. Box 848 County File Number: Mocksville NC 27028 Date: 04/ 15/ 2 0 1 4 Olnch Scale: O Block '--.ft. Health Department Release O N/A 41� 5 h re 1q, rs-�►; t k UA ,fY4 •�ww4�i 1 o S OAIf:6h;rc Ci., %1�p61 rYiik. AK X17829 wAnim r t Irive WAY r + t k UA ,fY4 •�ww4�i 1 o S OAIf:6h;rc Ci., %1�p61 rYiik. AK X17829 wAnim r t Irive WAY s ' hiV Phone: (336) - 753 - 6780 Davie County Health Department Environmental Health Section 'VF'D P:O. Box 848 D PAID C 210 Hospital Street ourier # : 09-40-06 Receivedb Mocksville, NC 27028 Fax: (336) - 751 - 8786 ON-SITE WASTEWATER CERTIFICATION FOR DWELLING (Check One) Replacement Remodeling Reconnection Name: V/ ! , l - ��ZA ) Phone Number 3 b �� b ;?07f,—(Home) Mailing Address: /Of 0/¢<S17 d`2 &% (Work) 1111 C- 4rV 1 d*-- AL 270 4 � Email "n', 6S-6- 5.! r/ D tailed Directions To Site: G . L.1�7 � / /U/c7(Ja-�S Dw S4 We- Laurse-� 5z Property Address: Please Fill In The Following Information.About The EXISTING Facility: Ile // ale, (,tet s Name System Installed Under: Type Of Facility: f (S Date System Installed (Month/Date/Year): t (1 Number Of Bedrooms: Number Of People: Is The Facility Currently Vacant? Yes 1�D If Yes, For How Long? Any Known Problems? Yes No If Yes, Explain: Please Fill In The Following Information About The NEW Facility: Type Of Facility: I X Z Number Of Bedrooms: N be of People p� Requested By- Date Requested: ,11/ ' \ ignature). �—� For Environmental Health Office Use Only .Environmental Health Specialist Date: qlltl *The signing of this form by the Environments ealth 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: Money Order # Paid By: R4 Ai L., Received By:_ Account #: 3 Invoice #: 0 d Date: 203 53 1 52 CO1011 i CD s`t V 203 U-1 2 C CO O All data Is provided as is without warranty or guarantee of any kind 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 County of Davie, North Carolina, its agents, consultants, contractors or employees from any and all claims or causes of action due to or arising out Printed : Mar 31, 2014 of the use or inability to use the GIS data provided by this website. : A � VIE COUNTY HEALTH DEPARTMENT Environmental Health Section PO Box 848/210 Hospital Street Mocksville, NC 27028 Phone: (336)751-8760 S•PI'E WASTEWATER CERTIFICATION FOR DWELLING REPLACEMENT o REMODELING ❑ RECONNECTION ❑ Narne:_ � In"yeJ si ; ' 119ew f } Phone Number: (Home) Mailing Address: r� % ����`G'sr� 14 Ae"?IN OJf (Work) v c As �ff, //�% fit., C Detailed Directions To Site: 'X /7 2 ti, Z2%4s i 9-C d -,/L- ('!C h Property Address: r Please Fill In The Following Information About The Existing Dwelling: Name System Installed Under: 0r 6N,Type Of Dwelling: - buse Date System InstaRed(Month/Day/Year): L ci D� Number Of Bedrooms:_Z.Number Of People: Is TIie Dwelling Currently Vacant? Yes ❑ N05- If Yes, For How Long? Any Known Problems? Yes ❑ No g--' If Yes, Explain: Please Fill In The Following Information About The New Dwelling: Type Of }(Requested By:. 11 xDu For Environmental Health Office Use Only ber Of People: Requested? 5 ^ r'' . Approved i( Disapproved O Comments: 1,01Vl 5 ' &c OWL % L )VJ r in I'l I'll . Environmental Health I*The signing of.this.form by the Environmental Health Staff is in no way intended, nor should be taken as a euarantee(extended or limited) that the on-site wastewater system will function Droverly for anv given veriod of time. Payment: Cash VCheck ❑ Money Order ❑ # Amount: $ 00, 00 Date: Paid By: /'� �z 12 �f Received By: Account #:Z7� Invoice #: ibl%q Davie County Development Services tvf� 298 E. Depot Street, Suite 100 Mocksville, NC 27028 Coo 202009-96 Ph:336-753-6050 Fx:336-751-7689 uta Permit Number Zoning Permit Approval Date: 5/14/2009 Applicant Name: HUGHES CONST. CO., GLENN A. Phone: 336-764-1752 Address: 339 SHADY LANE WINSTON-SALEM, NC 27107 Total Fees: $30.00 Total Receipts: $30.00 Parcel Number: J7080B0052 Zoning: Address: 108 OAKSHIRE CT MOCKSVILLE, NC 27028 Owner Name: HUGHES CONST. CO., GLENN A. Phone: 336.764.1752 Address: 339 SHADY LN. WINSTON-SALEM, NC 27107 SWIMMING POOL HARRIS POOL COMPANY Address: 277 PLEASANT ACRE DR MOCKSVILLE, NC 27028 Phone: 336.284.4817 Other Fields: Rear Setback: Health Dept. Rear Yard Proposed Use: INGROUND SWIMMING POOL Front Setback: Government County of Davie Side Setback: Corner Side Water No Sewage No Private: No Private: No Comments: 15X30 INGROUND POOL In support of this application, I have submitted one set of plans showing the dimensions and shape of the parcel to be built upon, the exact size, use and locations of the parcels or buildings already existing, if any, and the dimensions of all proposed buildings, alterations, additions or uses. This permit shall expire and be cancelled unless the work authorized by it shall have begun within one(1) year of its date of issue, or if the work authorized by it is suspended or abandoned for a period of one(1) year. Date Davie County Development Services 298 E. Depot Street, Suite 100 , Mocksville, NC 27028 'o BP2009-104 Ph:336-753-6050 Fx:336-751-7689 u Permit Number Building Permit Approval Date: 5/14/2009 Applicant Name: HUGHES CONST. CO., GLENN A. Phone: 336-764-1752 Address: 339 SHADY LANE WINSTON-SALEM, NC 27107 Total Fees: $75.00 Total Receipts: $75.00 Parcel Number: J7080B0052 Zoning: Address: 108 OAKSHIRE CT MOCKSVILLE, NC 27028 Owner Name: HUGHES CONST. CO., GLENN A. Phone: 336.764.1752 Address: 339 SHADY LN. WINSTON-SALEM, NC 27107 SWIMMING POOL HARRIS POOL COMPANY Address: 277 PLEASANT ACRE DR MOCKSVILLE, NC 27028 Phone: 336.284.4817 Description Structure Use: Residential Purpose: Swimming Pool Construction Value: $20,000.00 Other Fields: Finished 1st Modular No Finshed 0 Decks: 0 Total Finished 0 Finished 2nd 0 Finished 0 Unfinished 0 Unfinished 0 Garage: 0 Porches: 0 Comments: 15X30 INGROUND POOL This permit is hereby issued with the provision that the applicant will act in full compliance with all Federal, State and Local Laws, Rules, Regulations and Ordinances including but not limited to; the North Carolina State Building Code, Flood Damage Prevention Ordinance of Davie County and Zoning Ordiance as applicable. This permit expires 6 months from the date of issuance if the work has not begun, or if construction is suspended or abandoned for a period 1 year at anytime after construction has comenced. All inspection requests must be made at least 24 hours in advance. Date • DAVIE COUNTY ENVIRONMENTAL HEALTH P.O. Box 848/210 Hospital Street Mocksville, NC 27028 (336)751-8760 Fax # (336)751-8786 OPERATION PERMIT Account #: 990004086 Tax PIN/EH #: 5768-20-1782 Billed To: Glenn Hughes Subdivision Info: Heritage Oaks II Lot # 52 Reference Name: Location/Address: Suez-elwood-27028 Proposed Facility: Residence Property Size: .82 acres /Ug Qa&hi iG ATC Number: 4899 **NOTE** The issuance of this Operation Permit shall indicate the system described on the ATC 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. System Type: S.T. Manufacturer S 1� a Tank Date Tank Size `166 0 Pump Tank Size" �` System Installed By: E� �^ �G E.H. Specialist: 1kAIDate: DCHD 11/06 (Revised) DAVIE COUNTY ENVIRONMENTAL HEALTH P.O. Box 848/210 Hospital Street 6 Mocksville, NC 27028 (336)751-8760 Fax # (336)751=8786 11 AUTHORIZATION FOR WASTEWATER SYSTEM CONSTRUCTION Account #: 990004086 Tax PIN/EH #: 5768-20-1782 Billed To: Glenn Hughes Subdivision Info: Heritage Oaks II Lot # 52 Reference Name: Location/Address: S. Hazelwood -27028 Proposed Facility: Residence Property Size: .82 acres ATC Number: 4899 Site Type:New ❑Repair ❑Expansion **NOTE** This Authorization to Construct (ATC) MUST BE ISSUED by the Davie County Environmental Health Section prior to issuance of any building permit(s), (in compliance with Article 11 of G.S. Chapter 130A Wastewater Systems, Section .1900 Sewage Treatment and Disposal Systems). THIS AUTHORIZATION TO CONSTRUCT IS VALID FOR A PERIOD OF FIVE YEARS. This ATC is subject to revocation if site plans, plat or the intended use change. Residential Specifications: # Bedrooms # Bathrooms a#People Basement❑ Basement plumbing❑ Non:Residential Specifications: Facility Type # People # Seats Square Footage(or Dimensions of Facility) Lot Size V �Q�'�� Type of Water Supply: Rlnunty/City ❑Well ❑CommunityWell System Specifications: Design Wastewater Flow (GPD) 7 Tank Sized C GAL. Pump Tank —A A—AL. Trench Width 3(c� 'Max. Trench Depth_�61 Rock Depth Q `• Linear Ft. k 3V Ac stated in 15A NCAC 18A.1969(ra Site Modifications/Conditions/Other: h+-ce ted Systems may also be usLa Contact the Davie County Environmental Health Section for final inspection of this system between 8:30 — 900a.m. on the day of installation. Telephone # (336)751-8760. 'A%; A —ttv' 1 �" r 1 `G C.z ✓""� Environmental Health Specialist/�{'/'' _ Dat nr`HTl 1 1 /06 (Rrvi.aPr1) Davie County Environmental Health P.O. Box 848/210 Hospital Street Mocksville, NC 27028 (336)751-8760/ Fax (336)751-8786 Account #: 990004086 IMPROVEMENT PFAN/EH #: 5768-20-1782 Billed To: Glenn Hughes Subdivision Info: Heritage Oaks II Lot # 52 Address: 339 Shady Lane Location/Address: S. Hazelwood -27028 City: Winston-Salem Property Size: .82 acres Reference Name: Proposed Facility: Residence **NOTE**This Improvement Permit DOES NOT authorize the construction of a wastewater system. An Authorization To Construct a wastewater system must be obtained from this office prior to the construction/installation of a wastewater system or the issuance of a building permit(in compliance with Article 11 of G.S. Chapter 130A, Wastewater Systems). This Improvement Permit is subject to revocation if site plans, plat or the intended use change. Permit Type: E(New ❑Repair ❑Expansion Permit Valid for: [?5r Years ❑No Expiration Residential Specifications: # Bedrooms # Bathrooms # People Basement❑ Basement plumbing❑ Non -Residential Specifications: Facility Type # People # Seats Square Footage(or Dimensions of Facility) Design Flow(GPD): 3 Type of Water Supply: County/City 0 Well ❑ Community Well Site Modifications/Permit Conditions: As stated in 15A NCAC 1SA.19$9(5� S stem T)Te LTAR Initial e- g- .- -4 1 -e-CP 7 Re air . o e . tv 1 Site Plan t C Xc� 40 If � Y -71 1 Environmental Health APPLICATION FOR SITE EVALUATIONAMPR Davie County Environmental Health P.O. Box 848/210 Hospital Street Mocksville, NC 27028 (336)751-8760/ Fax (336)751-8786 8- 4NT PERM' ' l f�, 1 J f �Rno Application For: q, Sit Evaluation/Improvement Permit ❑Authorization To Construct(ATC) ITo 1--, Type of Application: New System ❑Repair to Existing System ❑Expansion/Modification of Existing System or Facility ***IMPORTANT*** THIS APPLICATION CANNOT BE PROCESSED UNLESS ALL OF THE REQUIRED INFORMATION IS PROVIDED. Refer to the INFORMATION BULLETIN for instructions. APPLICANT INFORMATION Name to be Billed 45�( C&Al le 11-61 Contact Person —.5 A 11 F Billing Address 1 Is Home Phone j Se - rey • 1A0,'3_ City/State/ZIP e; 2 2/6' Business Phone �; 3G l/� ' • ,> U Name on Permit/ATC if Different than Above Mailing Address FKUFLK I Y 1N P UKMA l IUN 'Fllate House/facility Comers NOTE: A survey plat or site plan must accompany this application. Included: K Site Plan ❑Plat(to scale) (Permit is valid for 60 months with site plan, no expiration with complete plat.) Owner's Name 61 C NN 4- t:1 n r2,: , Phone Number ?Se n-('/- la o' , Owner's AddressSri .( , 0 .. City/State/Zip LUl�✓�%n, N-�%�.l. M /�%; '� 7/� Property Address 4 o- ' .15'Q ' �= , i -- 0.4 E Z61' City &bc k% r,/„1,1 F Lot Size ,, Fa Art'ir5 Tax IN# .5-709, 2,0-:- I7?Z Subdivision Name(if applicable)/,("�fl,�cf �!I,FtS Section/Lot#�_ Directions To Site: ioo ikrrle of V- (C911A &LII 0�' 4, 4 .h' e Y i?T_,� J Cit is c -r f the answer to any o�the following questiofia is "yes", supporting documentation must be attached. Are there any existing wastewater systems on the site? ❑Yes YNo Does the site contain jurisdictional wetlands? ❑Yes PNo Are there any easements or right-of-ways on the site? ❑Yes ®No Is the site subject to approval by another public agency? ❑Yes R No Will wastewater other than domestic sewage be generated? ❑Yes Klo IF RESIDENCE FILL OUT THE BOX BELOW # People # Bedrooms ' # Bathrooms " Garden Tub/Whirlpool FfYes ❑No Basement:: ❑Y�o Basement Plumbing: ❑Yes ❑No ' 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:. ❑Conventional ❑Accepted ❑Innovative ❑Alternative ❑Other. Water Supply Type: County/City Water ❑ New Well ❑Existing Well ❑ Community Well Do you anticipate additions or expansions of the facility this system is intended to serve? ❑ Yes C�"N0 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 hereby grant right of entry to the Authorized Representative of the Davie County Health Department to conduct necessary inspections to determine compliance with applicable laws and rules. I understand that I am responsible for the proper identification and labeling of property lines and corners and locating and flagging or staking the house/facility location, pro o well location and the location of any other amenities. Site Revisit Charge Property owner's or owner's leg Representative signature Date Date(s). Client Notification Date: EHS: Sign given ❑Yes ❑No Account # DO Revised 11/06 Invoice #9 DAVIE COUNTY HEALTH DEPARTMENT ' Environmental Health Section Soil/Site Evaluation NAME ADDRESS PROPOSED FACIILTY 'f'�� DATE EVALUATED %��� 14�� PROPERTY SIZE LOCATION OF SITE Water Supply: On -Site Well _ Community Public_ Evaluation By: Auger Boring Pit Cut iS =d8 FACTORS 1 2 3 4 Landscape position Slo e Z HORIZON I DEPTH —[-(e Texture group G Consistence Structure Mineralogy HORIZON II DEPTH 4 c/bi Texture group Consistence -� Structure 5 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 RATEI I•a SITE CLASSIFICATION: EVALUATED BY: LONG-TERM ACCEPTANCE RATE: •OTHER(S) PRESEN REMARKS: .17 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 ;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 -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 3C --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(01-901 1 OC1931 aa—, OwKt1,#Ke CaaRT Piot PIAN ENG�Nl�f SCALE IS 2O o7vE 1f41 3 bat gm, Come Ypwg -A Glsw 4 &Ity 9046 �S l�� $ y &L if w tv A JiatON AS