151 Oakshire Drive Lot 41Davie County NC
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:
MOCKSVILLE
Land Value:
Total Assessed Value:
WARNING: THIS 1S NOT A SURVEY
Parcel Information
J7080B0041 Township: Fulton
5768204101 Municipality:
82531021 Census Tract: 3705&804
SCHNEIDER JOHN T Voting Precinct: FULTON
151 OAKSHIRE DRIVE Planning Jurisdiction: Davie County
NC
27028-0000
LOT 41 HERITAGE OAKS PHASE TWO
0.68
8/2009
008030275
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:
Gn62
Flood Zone:
Watershed Overlay:
DAVIE COUNTY
Outbuilding & Extra
Freatures Value:
Total Market Value:
O�a°.IFAll data is provided as is without warranty or guarantee of any kind either expressed or Implied Including but not limited to the
Davie County, implied warranties of merchantability or Illness for a particular use. All users of Davie County's GIS website shall hold harmless the
7 ��+ County of Davie, North Carolina, its agents, consultants, contractors or employees from any and all claims or causes of action due to
1\ C or arising out of the use or inability to use the GIS data provided by this website.
DAME COUNTY HEALTH DEPARTMENT
Environmental Health Section
P. O. Boz 848/210 Hospital Street
Mocksville, NC 27028
(336)751-8760
Account #: 990003561
Billed To: S& S Construction
Reference Name:
Proposed Facility Rsidence
ATC Number: 4035
Tax PIN/EH #: 5768-20-4101.41
Subdivision Info: Heritage Oaks Lot # 41
Location/Address: Highway 64 East -27028
Property Size: 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: Date: / �S
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 NOetaten � tee that the system will function satisfactorily for any
given period of time.
Septic System Installed By:
10�
0
F
Environmental Health Specialist's Signature :��0 Date:
DCHD 05/99 (Revised)
Environmental Health Section ":21 / ,P� . Us
P. O. Boz 848/210 Hospital Street 1j
Mocksville, NC 27028
(336)751-8760
IMPROVEMENT/OPERATION PERMIT
Account #: 990003561 Tax PIN/EH #: 5768-20-4101.41
Billed To: S& S Construction Subdivision Info: Heritage Oaks Lot # 41
Reference Name: Location/Address: Highway 64 East -27028
Proposed Facility Rsidence Property Size: see map
ATC Number: 4035
**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 Type #People #Bedrooms 1--i�l #Baths
Dishwasher Garbage Disposal: ❑ Washing Machine;ja-,*' Basement w/Plumbing: ❑ Basement/No Plumbing: ❑
Commercial Specification: Facility Type #People #People/Shift #Seats Industrial Waste: ❑
Lot Size Type Water Supply Al Design Wastewater Flow (GPD) s:� Site: New Repair ❑
System Specifications: Tank Siz� GAL. Pump Tank GAL. Trench Width Rock Depth Linear F
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 1:30 p.m. on the day of installation. Telephone # is (336)751-8760.****
r-
11
Environmental Health Specialist's Signature: 44�//Date: �/o
DCHD 05/99 (Revised)
APPLICATION FOR SITE EVALUATION/IMPROVEMENT PERMIT rS a
Davie County Health Department
Environmental Health Section APR
P.O. Box 848/210 Hospital Street ' 4 ?4z
Mocksville, NC 27028
(336) 751-8760 ��RONM
pA�I fflVTgl yfA[ru
***IMPORTANT*** THIS APPLICATION CANNOT BE PROCESSED UNLESS ALL THE REQUI
INFORMATION IS PROVI,jDED. Refer to the INFORMATION BULLETIN for instructions. J
1. Name to be Billed _ S �( 617 n'a f CA C f r O /n ` Contact Person � I 1-)-,
Mailing Address S -73 ,J e, ✓� ` �c Y S IL r (, Home Phone 3 j 6; 7'S / ` / 5-3 1
City/State/ZIP (Y\(�c V S V, lie 0 % ��GzO Business Phone
2. Name on Permit/ATC if Different than Above
Mailing Address City/State/Zip
3. Application For: ❑ Site Evaluation 0 Improvement Permit/ATC ❑ Both
4. System to Service: if House ❑ Mobile Home ❑ Business ❑ Industry ❑ Other
5. Type system requested: ® Conventional ❑ conventional modified ❑ innovative
6. If Residence: # People # Bedrooms - # Bathrooms
Dishwasher 130arbage Disposal OWashing Machine ❑Basement/Plumbing ❑Basement/No 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. Type of water supply: M County/City ❑ Well ❑ Community
9. Do you anticipate additions or expansions of the facility this system is intended to serve? ❑ Yes IM No
If yes, what type?
k"IMPORTANT*** CLIENTS d1UST CODIPLETETHE REQUIRED PROPERTY INFORMATION REQUESTED
BELOW. Either a PLAT or SITE PLAN d1UST BESUB/111TTED by the client with THIS APPLICATION.
Property Dimensions: 06" A- ,Zy c,. 7`t'
Tax Office PIN: # 7 (F
Property Addre S. Road Name
City/Zip
If in a Subdivision provide information, as follows:
Name: ae- :+tfse 061<5
Section: Block: Lot:
WRITE DIRECTIONS (from !Vlocksville) to PROPERTY:
S A,
S --ro e 7< '3 r to J- cin
Date home corners flagged:g A e r U' 5�
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 cliange, or if the information
submitted in this application is falsified or changed. I, also, understand that I am responsible for all charges incurred front
this application. I, hereby, give consent to the Authorized Representative of the Davie County IIealth 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 %� �A SIGNATURE �� _..!
TRIS AREA MAY BE USED FOR DRAWING YOUR SITE PLAN (Include all of the ollowing: Existing and proposed
property lines and dimensions, structures, setbacks, and septic locations).
L -r- —7,O s
Sign given
Revised DCIlD (05/03/03'
�rF"'�4C-
((raw .
,�74tt� �•-Y/
015
i- Cod y
Site Revisit Charge
Datc(s):
Client Notification Date:
EIIS:
Account No. 3 S ( J
Invoice No. / 7V5;
J DAVIE COUNTY HEALTH DEPARTMENT
Environmental Health Section
Soil/Site Evaluation
NAME �/U h
ADDRESS
PROPOSED FACIILTY
DATE EVALUATED
PROPERTY SIZE �G
LOCATION OF SITE
Water Supply:
On -Site Well
_ Community
Public
Evaluation By:
Auger Boring
Pit
Cut
FACTORS 1 2 3 4
Landscape position % ,U
Sloe %
HORIZON I DEPTH
Texture group
Consistence
Structure
Mineralogy
HORIZON I.I. DEPTH
Texture groupG
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 ,
SITE CLASSIFICATION:LIC
LONG-TERM ACCEPTANCE RATE:
REMARKS:
DCHD(01-901
EVALUATED BY: d //G l�
OTHER(S) PRESENT:
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 -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