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121 Oakshire Court Lot 38Davie Countv. NC I f Tax ParrPl R Pr�nrt Tuesday, January 10, 2017 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: WAKNING: TH15151VUT A SURVEY Parcel Information J7080B0038 Township: Fulton 5768204519 Municipality: 8305561 Census Tract: 37059-804 MITCHELL WILLIAM THOMAS Voting Precinct: FULTON 121 OAKSHIRE COURT Planning Jurisdiction: Davie Countv MOCKVSILLE Land Value: Total Assessed Value: NC 27028 LOT 38 HERITAGE OAKS PHASE TWO 0.68 9/2015 010010325 0008 139 Zoning Class: DAVIE COUNTY R-20 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 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 np NC or arising out of the use or inability to use the GIS data provided by this website. N.t'ti DAVIE COUNTY HEALTH DEPARTMENT Environmental Health Section P. O. Boa 848/210 Hospital Street Mocksville, NC 27028 (336)751-8760 Account #: 990003441 Tax PIN/EH #: 5768-10-9560.38 MS Billed To: Micah Stauffer Subdivision Info: Heritage Oaks Lot # 38 Reference Name: Location/Address: Oakshire Court -27028 Proposed Facility Residence Property Size: see map ATC Number: 4233 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 WASTEWATRU VAL FOR A PERIOD OF FIVE YEARS. Environmental Health Specialist's Signature: ate: /ID// % 0 e 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. R. J `to QV IC !C LPSTO C446 -4A ' TN0V_ `t7ATi� i - l 1p Septic System Installed By: Environmental Health Specialist's Signature: DCHD 05/99 (Revised) r1 a r a�•KP�T G I„ tSAXXI cel �Coag Alza pipe 0/ 5c" Ho DAVIE COUNTY HEALTH DEPARTMENT I�r3 Environmental Health Section P. O. Boz 848/210 Hospital Street /0 o s Mocksville, NC 27028 (336)751-8760 IMPROVEMENT/OPERATION PERMIT Account #: 990003441 Tax PIN/EH #: 5768-10-9560.38 MS Billed To: Micah Stauffer Subdivision Info: 1 Heritage Oaks Lot # 38 Reference Name: Location/Address: Oakshire Court -27028 Proposed Facility Residence Property Size: see map (Ib�r: 4233 * * N * is mprovement/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 i #People #Bedrooms 3 #Baths -?— Dishwasher: Dishwasher: 13"�- Garbage Disposal: ❑ Washing Machine: C'�- Basement w/Plumbing: ❑' Basement/No Plumbing: ❑ Commercial Specification: Facility Type #People #People/Shift #Seats Industrial Waste: ❑ Lot Size ,D�4 }� Type Water Supply cvo r� Design Wastewater Flow (GPD) Site: New Ey�' Repair ❑ System Specifications: Tank Size l Goo GAL. Pump Tank GAL. Trench Width 3�, Rock Depth ►`I A. Linear Ft. S Other: 2 NST -A & "n <JJ Required Site Modifications/Conditions: I t)EOL -- act C 8A ow 9,.j 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 s`yStem between ;30 a.m. to9:30 a.m. or 1:00 p.m. to 1:30 p.m. on the�dary of installation. Telephone # is (336)751-8760.**** C�' MPJ, rt; J1 Mir,' DCHD 05/99 (Revised) 4V'�-D t , a�-' l� '+Ud'k-C�p sz�Te"" >+ L , "L�R- CjM-T1'(9 A Ptd *�� F�6-C'Tjo'' We- �,1T- Date: 1.011-2 01 APPLICATION FOR SITE EVALUATION/lAIPROVEMENT PERMIT &Davie County Health DepartmentRD ,;,----�... EnvironmentaiHealth Section E Q V E P.O. Box 848/210 Hospital Street Mocksville, NC 27028 (336) 751-8760 OCT 1 •2 b05 * * *IFIPORTANT * * * TRIS APPLICATION CANNOT BE PROCESSED UNLESS ALL THE �P`p--r- INFORtIATION IS PROVIDED. Refer to the INFORbIATION BULLETIN for instructiA#ii ,� 1 1. Name to be Billed _ ILAR J-TAVF-(, S Contact Person Mailing Address �D� SA•I•v'1 Home Phone City/State/ZIP —rfloft,AS�it t.G_ AIC 7-,736 0 Business Phone 2. ldamo on Permit/ATC if Different than Above Mailing Address 3. Application For: ❑ Site Evaluation City/State/Zip S—rm—p—rovement Permit/ATC ❑ Both A. System to Servico: luso ❑ Mobile Iiome ❑ Business ❑ Industry ❑ Other S. Typo system requostod: 2 --Conventional ❑ conventional modified? ❑ innovative pacCepted 6. If ;Residence: it People ff Bedrooms 3 it Bathrooms Z llldf�ahwashor ❑Garbago Disposal Dashing Machine 8 asement/Plumbing ❑Basement/Ito Plumbing 7. If Business/Industry /Other: verify type # People # Sinks _ # Commodes # Showers # Urinals # Water Coolers IF FOODSERVICE: # Seats Estimated Water Usage (gallons per day) 8. Typo of water supply: L9' County/City ❑ well ❑ Community 9. Do you anticipate additions or expansions of the facility this system is intended to serve? ❑ Yes ( - If yes, what type? ***1A1P0R7�iN7*** CLIENTS MUST COMPLETE THE REQUIRED PROPERTY INFORMATION REQUESTED BEL01V. Etcher a PLAT or SITE PLAN MUST BE SUBMIT= by the client with T111S APPLICATION. Property Dimensions: 'rax Ofticc PIN: #,�7�, & - l o - 9 �5c-v- 3 8 Property Address: Road Na /me 6,,-r3 8 .©,ot�Nra CT in City/Zip / r`oc6w",1vc If in a Subdivision provide information, as follows: qNarne: 9VATA(nE ©It -ISS Section: Block: Lot: '36 WRITE DIRECTIONS (from Mocksvilic) to PROPERTY: coq , //w7a �1E/Lr%A9EI)Ar5. K,T oNiv H,-11-(wtoD0,,%;—/,o ©A4g.9ou Ci , Z.o /o i L-E�. Date hone corners !lagged: IO /Z a, This is to certify that the information provided is correct to the best of my knowledge. I understand that any perndt(s) issued Ilercafter arc subject to suspension or revocation, if the site plans or intended use change, or if the inforination submitted in IIIis 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 uecessary to determine the site suitabil'ty. DA'Z'E l'. I ,,�ys SIGNATURE TRIS AREA MAY BE USED FOIZ DIZAIVING YOUR SITE PLAN (Include all o the following: Existing and proposed property lines and dimensions, structures, setbacks, and septic locations). DAVIE CO. ENVIRONMENTAL, HEALTH Li 0 Sign given r" o � Revised DCIID (05/03 Site Wv1sit Charge Date(s): Client Notification Date: EI•IS: ,Account No./ Invoice No. �S// ' DAVIE COUNTY HEALTH DEPARTMENT Environmental Health Section Soil/Site Evaluation NAME ADDRESS PROPOSED FACIILTY DATE EVALUATED 2 _// PROPERTY SIZE "//1/Af LOCATION OF SITE f�''�� Water Supply: On -Site Well _ Community Public / Evaluation By: Auger Boring Pit Cut FACTORS 1 2 3 4 Landscape position Slope Z HORIZON I DEPTH Texture group Consistence Structure MineralogX HORIZON II DEPTH -L1 Texture group Consistence Structure 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 /I� EHE SITE CLASSIFICATION: EVALUATED BY: &/,/ LONG-TERM ACCEPTANCE RATE: OTHER(S) PRESENT: REMARKS: LEGEND Landscape Position R -Ridge S -Shoulder L -Linear slope FS -Foot slope N -Nose slope CC -Concave- sione 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- Vc-.-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 Mi neraloey 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 L OT 6 LO 17 3 LO 1- L T' 14 0'4*54*,I-r Vv 2