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187 Cedarwood Place Lot 7Davie County, NC . Tax Pnrral R Pnnrt 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: WAK1V11V1T: "l'rilb la 1VU1 A IUKVEY Parcel Information J7080B0007 Township: Fulton 5768107609 Municipality: 60325500 Census Tract: 37059-804 REINSVOLD ROGER W Voting Precinct: FULTON 151 MARBROOK DRIVE Planning Jurisdiction: Davie County MOCKSVILLE Zoning Class: DAVIE COUNTY R-20 NC Zoning Overlay: Land Value: Total Assessed Value: 27028-0000 LOT 7 HERITAGE OAKS PHASE ONE 0.68 6/2016 010220997 0007 005 Voluntary Ag. District: No Fire Response District: FORK Elementary School Zone: CORNATZER Middle School Zone: WILLIAM ELLIS Soil Types: GnB2 Flood Zone: Watershed Overlay: DAVIE COUNTY Outbuilding & Extra Freatures Value: Total Market Value: 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 �oC ty s� NC or arising out of the use or Inability to use the GIS data provided by this website. Account #: 990002904 Billed To: Jeff Raynor Reference Name: Proposed Facility: Residence ATC Number: 3570 DAVIE COUNTY HEALTH DEPARTMENT Environmental Health Section P. O. Boa 848/210 Hospital Street Mocksville, NC 27028 (336)751-8760 Tax PIN/EH #: 5768-10-7609 Subdivision Info: Heritage Oaks Lot # 7 Location/Address: 187 Cedarwood Place -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 CON UCTION IS VALID FOR A PERIOD OF FI YEARS. Environmental Health Specialist's Signature: Date: 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. Ch ter P 30A Section .1900 "Sewage Treatment and Disposal Systems," but shall in NO WAY be taken as a gu t that�e system will function satisfactorily for any given period of time. Septic System Installed By: Environmental Health Specialist's Signature: jj4 �� Date: DCHD 05/99 (Revised) DAVIE COUNTY HEALTH DEPARTMENT a, �b+r•Zp _ Q 3 j Environmental Health Section Ck= SS 3 d • P. O. Boz 848/210 Hospital Street Mocksville, NC 27028 (336)751-8760 IMPROVEMENT/OPERATION PERMIT Account #: 990002904 Tax PIN/EH #: 5768-10-7609 Billed To: Jeff Raynor Subdivision Info: Heritage Oaks Lot # 7 Reference Name: Location/Address: 187 Cedarwood Place -27028 Proposed Facility: Residence Property Size: see map ATC Number: 3570 **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 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 #Baths_ Dishwasher: 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 � _ Design Wastewater Flow (GPD) � Site: Ney,12Repair ❑ System Specifications: Tank Size[} GAL. Pump Tank Other: Required Site Modifications/Conditions: / GAL. Trench Width f Rock Depth 1-.2f Linear Ft±[} 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 ofinstplation. Telephone # is (336)751-8760.**** Environmental Health Specialist's Signature: i Date: DCHD 05/99 (Revised) r ATION FOR SITE EVALUATION/IMPROVEMENT PERMIT & ATC Davie County Health Department SEP- 2003 Entrironmentaifileaithsection P.O. Box 848/210 Hospital Street Mocksville, NC 27028 ENYIRONMENTIIL NFA1]H (336)751-8760 ***IMPORTANT*** THIS APPLICATION CANNOT BE PROCESSED UNLESS ALL THE REQUIRED INFORMATION IS PROVIDED. Refer to the INFORMATION BULLETIN for instructions. 1. Name to be Billed Ayry � 3� +f � �' � C I�1O Contact Person / �^z / -7 Mailing Address �/ j�w/ �(ST (rN i�rn 1�i2 Home Phone •3736-6 t�[J 6 / �� City/State/ZIP LINW000 /Yt_ 9729-7 Business Phone 7��� Z o- E309 2. Name on Permit/ATC if Different than Above S me j Mailing Address 5ftmt City/State/Zip 3. Application For: �❑ Site Evaluation ��mprovement Permit/ATC ❑ Both 4. System to Service: Lfl House ❑ Mobile Home ❑ Business ❑ Industry ❑ Other 5. Type system requested: a --Conventional ❑ conventional modified ❑ innovative 6. If Residence: # People # Bedrooms_ # Bathrooms 251shwasher []Garbage Disposal B ashing Machine ❑Basement/Plumbing ❑Basement/No Plumbing 7. If Business/Industry /Other: verify type # Commodes # Showers IF FOODSERVICE: #Seats 8. Type of water supply: 2 County/City # Urinals # People # Sinks # Water Coolers Estimated Water Usage (gallons per day) ❑ Well ❑ Community 9. Do you anticipate additions or expansions of the facility this system is intended to serve? ❑ Yes If yes, what type? ***IMPORTANT' CLIENTS MUST COMPLETE THE REQUIRED PROPERTY INFORMATION REQUESTED BELOW. Either a PLAT or SITE PLAN MUST BE SUBMITTED by the client witl: THIS APPLICATION. Property Dimensions: Tax Office PIN: # 5 76-PIO /(o © /• Property Address: Road Name 187 GlAt"0a PL City/Zip %1s,c fjVJ& /dL $'70Ze If in a Subdivision provide information, as follows: Tp Name: Mrit - 061C Section: Block: Lot: WRITE DIRECTIONS (from Mockssvville) to PROPERTY: -to _%iCt l bo M 6.4 (r- -4 ort L f, qDate home corners flagged: 7 -'5 - S This is to certify that the information provided is correct to the best of my knowledge. I understand that any permi(s) 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, understand that I ant responsible for all charges incurred front this application. I, hereby, give consent to the Authorized Representative of the Davie Comity Health 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 suitabilit . DATE /" �d 3 SIGNATURE THIS AREA MAY BE USED FOR DRAWING YOUR SITE PLAN (Incl a f the 'olldwing: Existing and proposed property lines and dimensions, structures, setbacks, and septic locations) lv © 0 Site Revisit Charge Sign given Revised DCHD (05/03 Datc(s): Client Notification Date: EHS: Account No. dam! O Y / Q Invoice No. =ii�-777� DAVIE COUNTY HEALTH DEPARTMENT - Environmental Health Section Soil/Site Evaluation NAME ADDRESS PROPOSED FACIILTY DATE EVALUATED '7/,Y6�� PROPERTY SIZE ��y.¢C LOCATION OF SITE Water Supply: On -Site Well _ Community Public Evaluation By: Auger Boring Pit Ll---' Cut FACTORS 1 2 3 4 Landscape position IL - Slope Slo e R HORIZON I DEPTH Texture group Consistence Structure Mineralogy HORIZON II DEPTH ;M - 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 SITE CLASSIFICATION: � EVALUATED BY: 1V0 - LONG -TERM ACCEPTANCE RATE: L 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- 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 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