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133 South Hazelwood Drive Lot 26Davie,County, NC Tax Parcel Report Tuesday, January 10, 20' I 33 I ' I L_. i 7 i lu5 I 11C 7 `C & 1.. � IZ13 i ICC 1631 1 I Building Value: g Freatures Value: Land Value: Total Market Value: Total Assessed Value: 9 AIS, All data is provided as Is without warranty or guarantee of any Idnd either expressed or Implied including but not limited to the Davie County, 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 �'pU xq� NC or arising out of the use or Inability to use the GIS data provided by this webstte. .7 WARNING: THIS IS NOT A SURVEY Parcel Information Parcel Number: J7080B0026 Township: Fulton NCPIN Number: 5768213011 Municipality: Account Number: 8306123 Census Tract: 37059-804 Listed Owner 1: SANDERS ANDREW LEE Voting Precinct: FULTON Mailing Address 1: 133 S HAZELWOOD DRIVE Planning Jurisdiction: Davie County City: MOCKSVILLE Zoning Class: DAVIE COUNTY R-20 State: NC Zoning Overlay: Zip Code: 27028 Voluntary Ag. District: No Legal Description: LOT 26 HERITAGE OAKS PHASE TWO Fire Response District: FORK Assessed Acreage: 0.68 Elementary School Zone: CORNATZER Deed Date: 3/2016 Middle School Zone: WILLIAM ELLIS Deed Book / Page: 010130627 Soil Types: GnB2,GnC2 Plat Book: 0008 Flood Zone: Plat Page: 139 Watershed Overlay: DAVIE COUNTY Outbuildin 8r Extra Building Value: g Freatures Value: Land Value: Total Market Value: Total Assessed Value: 9 AIS, All data is provided as Is without warranty or guarantee of any Idnd either expressed or Implied including but not limited to the Davie County, 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 �'pU xq� NC or arising out of the use or Inability to use the GIS data provided by this webstte. .7 Account #: Billed To: Reference Name: Proposed Facility 990003441 Micah Stauffer Residence ATC Number: 3947 DAVIE COUNTY HEALTH DEPARTMENT Environmental Health Section P. O. Bog 848/210 Hospital Street Mocksville, NC 27028 (336)751-8760 Tax PIN/EH #: Subdivision Info: Location/Address: Property Size: P� yazelwod .�,p. 5768-20-3337.26 MS Heritage Oaks Lot # 26 Hazelwood -27028 see map 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 WASTEWATER CONSTRUCTION IS VALID FOR A PERIOD OF FIVE YEARS. Environmental Health Specialist's Signature: �� ' CX�< l Date:10 l 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, .1900 "Sewage Treatment and Disposal Systems," but shall in NO WAY be taken as a guarant t the syst will function satisfactorily for any given period of time. Septic System Installed By: 7 Environmental Health Specialist's Signature: 1%'� Date: !/ Z,) -5- C-- DCHD 05/99 (Revised) DAVIE COUNTY HEALTH DEPARTMENT Environmental Health Section P. O. Boz 848/210 Hospital Street Mocksville, NC 27028 (336)751-8760 IMPROVEMENT/OPERATION PERMIT Account #: 990003441 Billed To: Micah Stauffer F-1--- I.)-- ---> 7-0 -/ 133 s, �l�Zelwd�l .D�. Tax PIN/EH #: 5768-20-3337.26 MS n Subdivision Info: Heritage Oaks Lot # 26 Reference Name: Location/Address: Hazelwood -27028 Proposed Facility Residence Property Size: see map ATC Number: 3947 **NOTE** This Improvement/Operation Permit DOES NOT authorize the construction of 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 l I 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 #Bedroomsll? #Baths Dishwasher:ee Garbage Disposal: ❑ Washing Machine; Basement w/Plumbing: ❑ Basement/No Plumbing: ❑ Commercial Specification: Facility Type #People #People/Shift #Seats Industrial Waste: ❑ Lot Size Type Water Supply L o Design Wastewater Flow (GPD) C,Site: New Repair ❑ J System Specifications: Tank Size/��AL. Pump Tank GAL. Trench Width�`Rock Depth,% Linear R2b Other: Required Site Modifications/Conditions: IMPROVEMENT/OPERATION PERMIT LAYOUT - APPROVED EFFLUENT FILTER. RISERS) 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 1:3��iy of installation. Telephone # is (336)751-8760.**** i Environmental Health Specialist's Signature: Date: 'A" ry I DCHD 05/99 (Revised) 1 COOAP A ON FOR SITE EVALUATION/1&IPROVE&IENT PERMIT & ATC 0 % Davie County Health Department Environmental Health Section .0. Box 848/210 Hospital Street Mocksville, NC 27028 (336) 751-8760 ** I TANT*** THIS APPLICATION CANNOT BE PROCESSED UNLESS ALL THE REQUIRED INFORMATION IS PROVIDED. Refer to the INFORMATION BULLETIN for instructions. 1. Name to be Billed / V (. iGA l4 -�:5%fiU frec Contact Person /V I IGfF fI _�Ti9��FE� Mailing Address 7 �7 G�1 )Ll.)Le Y ,2. Home Phone 7j(�' / 76 Sbo 3� City/State/ZIP 12LAuSVILLE Business Phone 2. Name on Permit/ATC if Different than Above Mailing Address City/State/Zip 3. Application For: ❑ Site Evaluation Permit/ATC ❑ Both 4. system to Service: Clouse ❑ Mobile Home ❑ Business ❑ Industry ❑ Other 5. Type system requested: M Conventional ❑ conventional modified ❑ innovative 6. If Residence: # People # Bedrooms 3 # Bathrooms B15ishwasher ❑Garbage Disposal bashing Machine ❑Basement/Plumbing ❑Basement/No Plumbing 7. If Business/Industry /Other: verify type # People # Sinks # Commodes # Showers # Urinals 0 Water Coolers IF FOODSERVICE: #t Seats Estimated Water Usage (gallons per day) S. Typo of water supply: td' County/City ❑ Well ❑ Community 9. Do you anticipate additions or expansions of the facility this system is intended to serve? ❑ Yes If ycs, what type? ***I/l1P0RTANP** CLIENTS MUST COMPLETE THE REQUIRED PROPERTY INFORMATION REQUESTED BELOIV. Either a PLAT or SITE PLAN MUST BE SUBMITTED by the client ivith THIS APPLICATION. Property Dimensions: t Z.o x- Z;So x I Z -o >< 7—S—C> Tax Office PIN: # s"768 zo3S31 Property Address: Road Name jz� Ze LJV0 L City/Zip If in a Subdivision provide information, as follows: Name: _ 116 -41 -IT -A&E 04a Section: Block: Lot: 1VRITE DIRECTIONS �(from Mocks/vrille) to PROPERTY,: CqfvT o,� Date home corners flagged: / y This is to certify that the information provided is correct to the best of my luiovledge. I understand that any permits) 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, wrderstand that I am responsiblefor all charges facurred jron: this application. I, hereby, give consent to the Authorized Representative of the Davie County IIcalth 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 /Z/� Ole SIGNATURE TIIIS AREA MAY BE USED FOR DRANVING YOUR SITE PLAN (Include 211 of the foIlovtttg: Existing and proposed property lines and dimensions, structures, setbacks, and septic locations). Sign given W Revised DCIID (05103 Site Revisit Charge Datc(s): Client Notification Date: EIIS: Account No. ( �" Invoice No. 6oT Z5 I Za, la' Lc6TT ZG O� � S �PuS� S(Lf, T -c -l4 IZ,o.lo' Q H AZ.F(-L000p Dz, vE A 0 (- oT e,7 O O O _I / / - bJ / DAVIE COUNTY HEALTH DEPARTMENT Environmental Health Section Soil/Site Evaluation / NAME DATE EVALUATED PROPERTY SIZE��i�G LOCATION OF SITE ADDRESS PROPOSED FACIILTY Water Supply: On -Site Well _ Community Public Evaluation By: Auger Boring Pit ZZ Cut FACTORS 1 2 3 4 Landscape position Slope Z HORIZON I DEPTH Texture group Consistence Structure Mineralogy HORIZON II DEPTH �' Y Texture group Consistence r 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 , SITE CLASSIFICATION: EVALUATED BY: 41 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 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- Vl:.-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 iC--Single grain M -Massive Ctz_rr,1.,,t, SBK-Subangular blocky PL -Platy Mineralogy 1:1, 2:1, Mixed Notes Horizon depth - In inches Depth of fill - In inches Restrictive horizon - Thickness and inches Saprolite - S(suitable), U(unsuitable) Soil wetness - Inches from land surface to with chroma 2 or less Classification - S(suitable), PS(provisionall LTAR - Long-term acceptance rate - gal/d, DCHD(01-901 rp-RrantIlAf ABK-Angular bleckv ■/N ■■■■/■H■■.■■■ ■N■�N■HH■IM■N■/■m=HN.■■1 ■■ ■■■.MINIM■■ /H.HHN moommmommomommmmo /■■ ■■■■.■■1 ■■■1 ■■■H■■■■�UqMINIMMIN■'��' ■Ml MIS ONES .■.. ■.CMI■.■.■. ■.HC ■■. ■ .■■MINK..■IM/■IM■■■IMIM..IMIM■MI■MI■■!1 02-713 . ?wr; M 203? l I 20, 1 o' 120.1W 120.100 1 5 x ti 1� r 0