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167 Oakshire Court Lot 42Davie Countv. NC ' t Tarr Pnri-Pl P r nr%rt Tuesday, January 10, 20117 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: WAKNIAG: TINS I5 NOT A SURVEY Parcel Information J7080B0042 Township: Fulton 5767294919 Municipality: 82525117 Census Tract: 37059-804 HOWELL KAREN KEY Voting Precinct: FULTON 167 OAKSHIRE COURT Planning Jurisdiction: Davie County find N2&W141:1 Land Value: Total Assessed Value: NC 27028-7171 LOT 42 HERITAGE OAKS PHASE TWO 0.68 9/2005 006240925 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: 9AIE, 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 humlea: 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. DAVIE COUNTY HEALTH DEPARTMENT Environmental Health Section P. O. Boz 848/210 Hospital Street MockvAlle, NC 27028 (336)751-8760 Account #: 990003628 Billed To: R.A .Freeman Construction Reference Name: Proposed Facility Residence ATC Number: 4092 Tax PIN/EH #: 5767-29-4919.42 RF Subdivision Info: Heritage Oaks Lot # 42 Location/Address: Oakshire Court -27028 Property Size: 148.33 x 202.4 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 WASTEWAT gCOMONLIA17_FOR A PERIOD OF FIVE YEARS. Environmental Health Specialist's Signature. Date: 2 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. GO' I- Dus LRt J% Septic System Installed By:-�L�4„rlo_3 Environmental Health Specialist's DCHD 05/99 (Revised) D� DAVIE COUNTY HEALTH DEPARTMENT /� 2 -o S Environmental Health Section P. O. Boa 848/210 Hospital Street Mocksville, NC 27028 (336)751-8760 IMPROVEMENT/OPERATION PERMIT Account #: 990003628 Tax PIN/EH #: 5767-29-4919.42 RF Billed To: R.A .Freeman Construction Subdivision Info: Heritage Oaks Lot # 42 Reference Name: Location/Address: Oakshire Court -27028 Proposed Facility Residence Property Size: 148.33 x 202.4 ATC Number: 4092 **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 OLX—c— #People s #Bedrooms 3 #Baths 2 Dishwasher:. C2"" Garbage Disposal: �� Washing Machine: Er Basement w/Plumbing: ❑ Basement/No Plumbing: Commercial Specification: Facility Type #People #People/Shift #Seats Industrial Waste: 171 Lot Size '3QOE70 -1�+2 Type Water Supply C-0LWTY Design Wastewater Flow (GPD) :5(ZD Site: New 2" -Repair 13 System Specifications: Tank Size GAL. Pump Tank GAL. Trench Width3(�' Rock Depth 1ZLinear Ft. 3CI:5 Other: 3 7h!-rej&)T,j 1caZ�' Required Site Modifications/Conditions: WSTZV-L ©nl 6ar4TWA, ki' Id OFF t� V�^��%� ILa IMPROVEMENT/OPERATION PERMIT LAYOUT - APPROVED EFFLUENT FILTER. RISER(S) IF 6 " BELOW FINISHED GRADE. ****NOTICE: Contact a representative of the Davie County Health Depent 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.**** I7 �� sZ A a )W�� u,�S l� .� 14171 N� 41" t'QerlT 1-E5 Environmental Health Specialist's Signature: Date: DCHD 05/99 (Revised) .t C) z •zo C) or�M .,...r..4 h •r�b� y� V Y/ r..rw�Y w 3 e .t C) z •zo C) or�M .,...r..4 h LOT 7.12! 48.� LOT LOT 4 1 10.24. LST 4 9 103 7,5i� $. �3' APPLICATION FOI1 SITE EVALUATION/IMPIiOVEAIENT PER511T i Davie County Health Department r q EnvironmentaiHeaith Section P.O. Box 848/210 Hospital Street Mocksville, NC 27028 (336)751-8760 ***IMPORTANT*** THIS APPLICATION CANNOT BE PROCESSED UNLESS ALL THE REQUIRED INFORMATION IS PROVIDED._ Refer to the INFORMATION BULLETIN for i>uatructions. 'Name to be Billed Mailing Address _� / S//m< Name on Pormit/ATC if Different than Above L- Contact Person /T19-6, .4 F Home Phone _'''!v/�/�(Q//^�Q�O 1 Business Phone 3 4Dishwasher KGarbage Disposal Owaahing Machine ❑Basement/Plumbing If Duainess/Industry /other: verify typo # Commodes' # Showers # Urinals # People ❑Basemont/No Plumbing # Sinks # Water Coolers IF FOODSERVICE: # Seats Estimated Water Usage (gallons per day) 8. Type of water supply: County/City El [I Community c Do you anticipate additions or expansions of the facility this system is intended to serve?i9Yes ❑ No If yes, what type? ***IAIPORTANT*** CLIENTS AIUST COAIPLETETHE REQUIRED PROPERTY INFORMATION REQUESTED BELOW. Either a PLAT or SITE PLAN AIUST BESUBAIITI'ED by (lie client wltli THIS APPLICATION. Property Dimensions: /1� 33 X 7� L/ 1vRITE DIRECTIONS (from Mocksville) to PROPERTY: Tax Office PIN: fl 5710 7 -;Z 1 4011 q i�1? le— Property Address: Road Namcak gh I re- e4• / N 16/ 0 el City/Zip Com' ` of - If in a Subdivision provide information, as follows: Nanic: Section: Block: Lot: LlDatc home corners flagged: This is to certify that the information provided is correct to the best of my knowledge. I understand that any perniil(s) issued hereafter arc 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, understand that I ani responsible for all charges incurred front this application. I, hereby, give consent to the Authorized Representative of the Davie County I callh Department to enter upon above described property located in Davie County and owned by to conduct all testing procedures as necessary to dctcrinine the site suita 1►ty. TE �SIGNATURE TIIIS AREA MAY BE USED FOR DRAWING YOUR SITE PLAN (Include all of the following: Existing and proposed property lines and dimensions, structures, setbacks, and septic locations). LA� w Sign given Revised DCHD (05/03 qqe q'31� EIIS: Account No. Invoice No. ��� 1V Mailing Address City/State/Zip Ci 3. Application For: ❑ Site Evaluation Improvement Permit/ATC ❑ Both -i/ System to Service: Al House ❑ Mobile Home ❑ Business ❑ Industry ❑ Other —45. Type system requested: Conventional ❑ conventional modified ❑ innovative If Residence: # People J # Bedrooms_ # Bathrooms_ 4Dishwasher KGarbage Disposal Owaahing Machine ❑Basement/Plumbing If Duainess/Industry /other: verify typo # Commodes' # Showers # Urinals # People ❑Basemont/No Plumbing # Sinks # Water Coolers IF FOODSERVICE: # Seats Estimated Water Usage (gallons per day) 8. Type of water supply: County/City El [I Community c Do you anticipate additions or expansions of the facility this system is intended to serve?i9Yes ❑ No If yes, what type? ***IAIPORTANT*** CLIENTS AIUST COAIPLETETHE REQUIRED PROPERTY INFORMATION REQUESTED BELOW. Either a PLAT or SITE PLAN AIUST BESUBAIITI'ED by (lie client wltli THIS APPLICATION. Property Dimensions: /1� 33 X 7� L/ 1vRITE DIRECTIONS (from Mocksville) to PROPERTY: Tax Office PIN: fl 5710 7 -;Z 1 4011 q i�1? le— Property Address: Road Namcak gh I re- e4• / N 16/ 0 el City/Zip Com' ` of - If in a Subdivision provide information, as follows: Nanic: Section: Block: Lot: LlDatc home corners flagged: This is to certify that the information provided is correct to the best of my knowledge. I understand that any perniil(s) issued hereafter arc 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, understand that I ani responsible for all charges incurred front this application. I, hereby, give consent to the Authorized Representative of the Davie County I callh Department to enter upon above described property located in Davie County and owned by to conduct all testing procedures as necessary to dctcrinine the site suita 1►ty. TE �SIGNATURE TIIIS AREA MAY BE USED FOR DRAWING YOUR SITE PLAN (Include all of the following: Existing and proposed property lines and dimensions, structures, setbacks, and septic locations). LA� w Sign given Revised DCHD (05/03 qqe q'31� EIIS: Account No. Invoice No. ��� 1V r NAME 12 Le'lle IL ADDRESS PROPOSED FACIILTY DAVIE COUNTY HEALTH DEPARTMENT Environmental Health Section j�G� Soil/Site Evaluation _ , DATE EVALUATED PROPERTY SIZE LOCATION OF SITE G� Water Supply: On -Site Well _ Community Public !� Evaluation By: Auger Boring Pit LI -11* Cut FACTORS 1 2 3 4 Landscape position L Sloe Z 16 HORIZON I DEPTH Texture group Consistence Structure Mineralogy HORIZON II DEPTH Texture group Consistence i Structure JC 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: I LONG-TERM ACCEPTANCE RATE: i �_ OTHER(S) PRESENT: REMARKS: LEGEND Landscave 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 ,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 K o V LOT 24 0 182.31' 148.06' 148. 06' 11.57' 1x.06' 148.06' 146.05' i Im c 25000 46 v ILOT 47 LOT 48 N LOT 49 '3 LOT 50 LOT 51 LOT 52 �"jj' m e. LOT 25 `IV /vo0-5G' / Lys_ OAKSHIRY COURT 60' PUBLIC R/W , 10' wt�CAt� EASEMENT o D I 250.00' 74Q•QSL.... — • A ... 3 00' 11'34 E 1037.60' -- - LOT 26 c PNOPOSED 2w ASPHALT IR W /h tCllc"i R ..148.33 i 1833•... _ . _..1 X8.33' ►o^'' ��' �� iai' ,: LOT 25207. 00'' MC-40 �Ct0lOT 37 LOT 39 LOT 38 LOT 42 LOT 40 .43 1 46. ' 146.33 148.33' 146.33' 148.33' 67.33' LOT 28 199.84' 1 390.29' 33c�o ' N LOT 36 o f if - a 1 820.10' TOTAL I $ r �i i L_ 250.00' ,. _.. ._.. O S 00'11'34" E I r 1 r I � .... .._... - - -- _.. _ . •._ ...... •-- -- '�- O 1 -4; 'b ✓ • c LOT 29 LR ell r I I `fir LOT 35 I # I I I I 250.00• ._ tp r, -- .._.. _ _-• _ 10' ururr EASEMENT i r / o!. _ LOT 30 o a ,(. LOT 34. 233.4 `r, • . N -* �b T 31 r gi o?� LOT 33 '; i _ �• !�t W 85.28 25 W •, r (x LOT 32 SI -12 ` 3b / I