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249 Essex Farm Rd Lot 203avie County, NC t Tax Parcel Report I ��M Wednesday, September 28, 201 t rt4 WARNING: THIS IS NOT A SURVEY __, _,. ,Parcel Information Parcel Number: F803OA0020 Township: Shady Grove NCPIN Number: 5870651139 Municipality: Account Number: 82531980 Census Tract: 37059-803 Listed Owner 1: WILLIAMS RICHARD L Voting Precinct: EAST SHADY GROVE Mailing Address 1: 249 ESSEX FARM ROAD Planning Jurisdiction: Davie County City: ADVANCE Zoning Class: DAVIE COUNTY R -A State: NC Zoning Overlay: Zip Code: 27006-0000 Voluntary Ag. District: No Legal Description: Lot 20 &1/2 of 22 per deed ESSEX FARMS Fire Response District: ADVANCE Assessed Acreage: 1.71 Elementary School Zone: SHADY GROVE Deed Date: 6/2010 Middle School Zone: WILLIAM ELLIS Deed Book / Page: 008280692 Soil Types: GnB2,GaD Plat Book: 10 Flood Zone: Plat Page: 213 Watershed Overlay: DAVIE COUNTY Building Value: 316170.00 Outbuilding & Extra 4460.00 Freatures Value: Land Value: 85500.00 Total Market Value: 406130.00 Total Assessed Value: 406130.00 t.y1 Alldata is provided as is without warranty or guarantee of any kind either expressed or implied including but not limited to the 9 ie� Davie County, Implled 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 C'O 11 ty�� NC or arising out of the use or Inability to use the GIS data provided by this website. D'AVIE COUNTY ENVIRONMENTAL HEALTH P.O. Box 848/210 Hospital Street c r Mocksville, NC 27028 (336)751-8760 Fax # (336)751-8786 /7y OPERATION PERMIT Account #: 990004348 Tax PIN/EH #: 5870-65-1139.20 Billed To: Sonoma Building Company Subdivision Info: Essex Farm Lot # 20 Reference Name: Location/Address: Essex Farm Rd -27006 Proposed Facility: Residence Property Size: 1.066 Acre ATC* I e * Th88ssuance of this Operation Permit shall indicate the system described on the ATC 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. -- 6 YA 6c-/- 1 �- d System Type: S.T. Manufacturer I- Tank Date Tank Size I)' Pump Tank Size System talled By: r? E.H. Specialist: d' ¢� Re. �DCHD 11/06 (R -e-, +b 3C>tr v cev r �6aval-P rK6'& _( L-eo e I 0x / of25� � fir. DAVIE COUNTY ENVIRONMENTAL HEALTH - ` ► P.O. Box 848/210 Hospital Street Mocksville, NC 27028 (336)751-8760 Fax # (336)751-8786 AUTHORIZATION FOR WASTEWATER SYSTEM CONSTRUCTION Account #: 990004348 Billed To: Sonoma Building Company Reference Name: Proposed Facility: Residence ATC Number: 4884 Tax PIN/EH #: 5870-65-1139.20 Subdivision Info: Essex Farm Lot # 20 Location/Address: Essex Farm Rd -27006 Property Size:Zew 6 Acre Site Type: ❑Repair ❑Expansion **NOTE** This Authorization to Construct (ATC) MUST BE ISSUED by the Davie County Environmental Health Section prior to issuance of any building permit(s), (in compliance with Article 11 of G.S. Chapter 130A Wastewater Systems, Section .1900 Sewage Treatment and Disposal Systems). THIS AUTHORIZATION TO CONSTRUCT IS VALID FOR A PERIOD OF FIVE YEARS. This ATC is subject to revocation if site plans, plat or the intended use change. ' / Residential Specifications: # Bedrooms `i # Bathrooms # People Basement❑ Basement plumbing❑ Non -Residential Specifications: Facility Type # People # Seats Square Footage(or Dimensions of Facility) 7 Lot Size( O t �/`�' Type of Water Supply: 2rCounty/City ❑Well ❑Community Well System Specifications: Design Wastewater Flow (GPD) [ O Tank Size GAL. Pump Tank 4%AL. t / Trench Width J� t1 Max. Trench Depth Rock I)epth��Linear Ft. Digo'W 1 a�Z ,��d� C�(lcm 4 Site Modifications/Conditions/Other: Contact the Davie County Environmental Health Section for final inspection of this system between 8:30 — 9:30a.m. on the day of installation. Telephone # (336)751-8760. �I-ev a C' �. Environmental Health Specialist DCHD 11/06 (Revised) X83 �^ /y714 5 10 ";TiYt 16 Date: 7-�� - f 1W i g18j't� Davie County Health Department Environmental Health S &Ot�'� P.O. Box 848 210 Hospital Street Courier # : 09-40-06 Mocksville, NC 27028 Plione: (336) - 753 - 6780 ON-SITE WASTEWATER CERTIFICATION (Check One) Replacement Remodeling Reconnection Fax: (336) - 753-1680 Name: I dt ti P ( n 20"1 [� r I'� fi'&-S Phone Number9//)/L) 1441, Ile IL (Home) Mailing Address: / - l�2 (Work) (/l�ff e, /V L S-10 (O Email Address: 01tul l AM- C "d'�4l i" 4 -9030A 06za Property Address:21/G% C-SSCx-Gj-21,bl r Please Fill In The Following Information � About The EXISTING Facility: Name System Installed Under: �V SLC% eJ b -aLs Type Of Facility: Date System Installed (Month/Date/Year): 206e Number Of Bedrooms: Number Of People: Is The Facility Currently Vacant? Yes N If Yes, For How Long? Any Known Problems? Ye (3 If Yes, Explain: Please Fill In The Following Info Type Of Facility: Pool Size: Requested By:_ Approved s Disapproved n About The f1NE,WC Facility: � */I// �D 'Number Of Bedrooms: Number of People -- -Garaee Size: Environmental Health Specialist. Other: Requested: �- Io -/Z- For Environmental Health Office Use Only Date: *The signing of this form by the Environmental Health Staff is in no way intended, nor should be taken as a guarantee (extended or limited) that the on-site wastewater system will function properly for any given period of time. Payment: Cash Che/c/ Paid By: Ile Money Order # Amount:$ Received By: Account #: '�qo Invoice #: pll9 Date: Y `;Davie' County Health Department 9 his j- ° -Environmental Health Section �^ P.O. Box 848 210.Hospital Street O �'� Courier #: 09-40-06 Mocksville, NC 27028 Phone: (336) - 753 - 6780 ON-SITE WASTEWATER CERTIFICATION Fax: (336) - 753-1680 (Check One) Replacement Remodeling Reconnection Name:� Vf f /� (1I � hi �Q� a l'I fq /it Phone Number. Mailing Address: �, IUC 2700 {o Email Address 9030A 00-2,e) Property Address: Please Fill In The Following Information About The EXISTING Facility: �S Name System Installed Under: 0 60V iLS Type Of Facili Date System Installed (Month/Date/Year): Number Of Bedrooms: -41 Of People: Is The Facility Currently Vacant? Yes No)If Yes, For How Long? Any Known Problems? Ye�O) If Yes, Explain: Please Fill In The Following /Information About The NEW Facility: Type Of Facility: 1-14-iVY .) //.'�WO `/' 4�10� Number Of Bedrooms: i Number of People Pool Size: If / - ----Garage Size: Other: Requested By: / Date Requested: ( ignature) _ For Environmental Health Office Use Only Approved Disapproved Comments: Environmental Health Specialist %� , /%z.// Lt. `fir ; t �lr%f Date :r�%� *The signing of this form by the Environmental Health Staff is in no way intended, nor should be taken as a guarantee (extended or limited) that the on-site wastewater system will function properly for any given period of time. Payment: Paid By Money Order #. Amount:$ /OPOO Received By: Account #: �wb Invoice #: S/.'5 Invoice Date: 41/0/1.2 04/10/2012 16:18 336-998-3546 MBR PAGE 02/02 p k ts:r}*,.Tj W 1 LLI APu s To$ ALAN MOCK TRUSTEE n as N ��• V`s Li F � LOT 20 z 1.066 Ac.+/— e r ?goPoSED �8k s/0 bccX- 145.61 -f45.6' % k 3/9C% �� wy rho a co�P — N2SEry�GT^fjP .; 28'_00" W 276.06' U t r l 1 I LOT 19 \ a / PB 9 PG 290 Q a nf I MILLER BUILDING & REMODELING, LLC X 650 Beauchamp Road 0 C C> Advance, NO 27006 w (336) 808-2140 Curve Radius Chord Bearing and Distance Arc Length Cl 50.00' S 26'-45'-02' w 37.58' 36.53' VICHTY no sca e .ry 73 THIS MAP IS SUBJECT TO ANY EASEWE`• RIGHTS-OF-WAY 3 `s , 89,83, 26 w RECORD PRIOR TOTHE DATE OF THIS MAP WHETHER VISIBLE OR NOT C TITLE SEARCH NOT PROVIDED. 1 M CAROB , 'bfES . = 3 20 P/0 LOT 21 L: D ; V 0.654 Ac.+/— ��'�/� BI�AO�-��• .,,�rrn�nt►t``� S � a o a REMAINDER OF LOT 21 a PB 9 PG 290 n as N ��• V`s Li F � LOT 20 z 1.066 Ac.+/— e r ?goPoSED �8k s/0 bccX- 145.61 -f45.6' % k 3/9C% �� wy rho a co�P — N2SEry�GT^fjP .; 28'_00" W 276.06' U t r l 1 I LOT 19 \ a / PB 9 PG 290 Q a nf I MILLER BUILDING & REMODELING, LLC X 650 Beauchamp Road 0 C C> Advance, NO 27006 w (336) 808-2140 Curve Radius Chord Bearing and Distance Arc Length Cl 50.00' S 26'-45'-02' w 37.58' 36.53' VICHTY no sca e Jul 16 08 02:45p Davie County Environmenta 3367518786 p.1 APPLICATION FOR SITE EVALUATION/IMPROVEMENT PERMIT & ATC Davie County Environmental Health P.O. Bos 8481210 Hospital Street Mocksvllle, NC 27028 (336)751-37601 Fax (336)751-8786 Application Por: ❑.Site EvaluatiorL�Improvement Permit ❑ Authorization To Construcl(ATC) ❑ Both Type ofApplication: ❑New System ❑Repair to Existing System ❑Expansionilvlodification of Existing System or Facility ***IMPORTANT"" THIS APPLICATION CANNOT BE PROCESSED UNLESS ALL OF THE REQUIRED INFORMATION IS PROVIDED. Refer to the INFORMATION BULLETIN for instructions. APPT.ICANT iNFORMATiON Naive to be Billed �? fl(> n'`O� L_Jt� v1 � i r`t� � Contact Person 9t L� Billing Address --.`i � ) Home Phone Cityistatg/ZIY V'S' vim- S��oM r'3 C Business Phone 9 Name or. Permit/ATC if Different than Above Mailing Address (r' PROPERTY INFORMATION `Date Housc/Tacility Corners Flagged _y NOTE: A survey plat or site plan must accompany this application. Included: 2�Site Plan ❑Plat(to scale) (Permit is -valid for 60 months with site pLwa, no expiration with complete plat.) ovmer's Name e G vti-c \ L3L -9 TO 533 (� ��. v � �>� � - Phone Number Owner's Address City/State/Zip Property Address I Ci Lot Size Tax PIN# Subdivision Natne(if applicable) e>t. Section od# Directions To Site: Xthe answer to any of the following questions is "yes', supporting documentation must be attached. C Are there any existing wastewater systems on the site? ❑ Yes 2vo Does the site contain jurisdictional wetlands? ❑Yes 9hlo Are there any easements or right-of-ways on the site? ❑ Yes ANG Is the site subject to approval by another public agency9 CYes)?No Will wastewater other than domestic sewave be venerated? ❑Yes l@.No IF RESIDENCE FILL OUT THE BOY BELOW People # Bedrooms u Bathrooms Garden TubAVhirlpool 5rVcs ENo Basement: fAYes CNo Basement. Plumbing: ,ZYes CNo IF NON -RESIDENCE FILL OUT THE BOX BELOW Type of Facility!Business Total Square Footage of Building # People # Sinks # Commodes # Showers # Urinals Estimated Water Usage (gallons per day) (Attach documentation of similar facilitywater consur ip tion) ` FOODSERVICE ONLY: #k Seats Type system requested:, ❑CcnventionaL DAccepted ❑Innovative ❑Altemative ❑Other Water Supply Type: jX County/City Water 0 New Well uExisting Well ❑ Community Well Do you anticipate additions or expansions of the facility this system is intended to serve? 3 Yes If yes, what type? J<N1 0 This is to as-tify that the information provided on this application is true and correct to the best of my larowledgc. 1 understand that any petmit(s) or ATC(s) issued hereafter are subject to suspension or revocation if the site is altered, the intended use changes, or it the inferm ion submitted in this application is falsified or changed l hereby grant right of entry to the Authorized Representative of tbsvavit County Health Department to conduct nceessary inspections to detenmine compliance with applicable laws and rules. I ur ersta d that I responsible f r the proper identification and labeling ofprcperty lines and comers and locating and flagging or stakin CZe hou !fa cation, proposed well location and the location of any other amenities. Site Revisit Charge Pr aerty owner's or owne 's legal r s�ntative signature _ Date(s): Client Notification Date: Da z EHS: p Sign given E Yes ❑No A;.count ## Revised 11!Oo` Invoice # ��/ `! `� IALAN MOCK TRUSTEE THIS MAP IS SUBJECT TO ANY EASEMENTS OR RIGHTS—OF—WAY OF RECORD PRIOR TO THE DATE OF THIS MAP WHETHER VISIBLE OR NOT TITLE SEARCH NOT PROVIDED. `��I�CA a ►�►iiiii e\Qof ESS p�f2�' � 1 I A � LOT 19 \\ 0 — // PB 9 PG 290Cl- Cl tY Lj- Wo I W In w Curve Radius Chord Bearing and Distance Arc Length Cl 50.00' S 26'-45'-02" W 37.58' 38.53' site b /Ir 60 30 0 60 orno of d MAP FOR SONOMA BUILDING CO. Q WATER METER R/W RIGHT—Or—WAY SCALE COUNTY TOWNSHIP DATE PREC. RATIO ® SEWER MANHOLE — RUNNING WATER 1` 60' DAME SHADY GROVE 20 MAY 2008 1 10,000 + 0 IRON FOUND IRON SET —E—f— OVERHEAD POWER LINE PROPERTY DESC: LOT 20 of `ESSEX FARM PHASE i` PB 9 PG 290 O MONUMENT O POWER POLE PROPERTY LINE (surveyed) MY SEAL AND SIGNATURE JOB # -- — — PROPERTY LINE CERTIFY THAT THIS MAP IS COE FORESTRY do SURVEYING (not surveyed) THE RESULT OF AN ACTUAL P.O. BOX 36 08075 SURVEY PERFORMED UNDER WALLBURG, N.C. 27373 DRAFTED BY: SURVEYED BY ® POINT NOT MONUMENTED MY SUPERVISION. MDC PHONE/FAX (336) 769-4673 DH\JC FOR SITE EVALUATION/IMPROVEMENT PERMIT & ATC Davie County Environmental Health P.O. Box 848/210 Hospital Street Mocksville, NC 27028 (336)751-8760/ Fax (336)751-8786 ua'tion/Improvement Permit ❑ Authorization To Construct(ATC) ❑ Both System ❑Repair to Existing System ❑Expansion/Modification of Existing System or Facility jam* *IMPORTANT* * *THIS APPLICATION CANNOT BE PROCESSED UNLESS ALL OF THE REQUIRED INFORMATION IS PROVIDED. Refer to the INFORMATION BULLETIN for instructions. APPLICANT INFORMATION Name to be Billed ASC /%e'y6Goyr/rNT Contact Person 7a'1PRY &frc v', - Billing Address 4.0 .Q„X 3fo Home Phone City/State/ZIP _&per_ s'4C— Z 7018 Business Phone 7S/ - 73p0 Name on Permit/ATC if Different than Above Mailine Address City/State/Zit) FK(-)rhK1 Y INPUKNIAIIUN •llate Housen, acility comers k laggea NOTE: A survey plat or site plan must accompany this application. Included: ❑ Site Plan lat(to scale) (Permit is valid for 60 months with site plan, no expiration with complete plat.) Owner's Name X4:99V% yE�o 4r oji cqt� iaG Phone Number 7S/ - 73c>Q Owner's Address 40 Bow City/State/Zip 4-36 17az8 Property Address City Lot Size Tax PIN# Subdivision Name(if applicable) Ec' S Sectiiog/Lot# Z0 Directions To Site: h �f &l4S PP XAl v � N 4-01" If the answer to any of the following Questionsris "yes", supporting documentatiogg must be atttiched. Are there any existing wastewater systems on the site? ❑Yes t3N Does the site contain jurisdictional wetlands? ❑Yes C3No Are there any easements or right-of-ways on the site? Cres ❑No Is the site subject to approval by another public agency? ❑Yes U� Will wastewater other than domestic sewage be generated? []YesC3No IF RESIDENCE FILL OUT THE BOX BELOW # People # Bedrooms _6 # Bathrooms Garden Tub/Whirlpool ❑Yes ❑No Basement: ❑Yes ❑No Basement Plumbing: ❑Yes ❑No IF NON -RESIDENCE FILL OUT THE BOX BELOW Type of Facility/Business Total Square Footage of Building # People # Sinks # Commodes # Showers # Urinals Estimated Water Usage (gallons per day) (Attach documentation of similar facility water consumption) FOODSERVICE ONLY: # Seats Type system requested: eConventional ❑Accepted ❑Innovative ❑Alternative ❑Other Water Supply Type: Cr ounty/City Water ❑ New Well ❑Existing Well ❑ Community Well Do you anticipate additions or expansions of the facility this system is intended to serve? ❑ Yes ❑ No If yes, what type? This is to certify that the information provided on this application is true and correct to the best of my knowledge. I understand that any permit(s) or ATC(s) issued hereafter are subject to suspension or revocation if the site is altered, the intended use changes, or if the information submitted in this application is falsified or changed. I hereby grant right of entry to the Authorized Representative of the Davie County Health Department to conduct necessary inspections to determine compliance with applicable laws and rules. I understand that I am responsible for the proper identification and labeling of property lines and comers and locating an ging or staking the house/facility location, proposed well location and the location of any other amenities. Site Revisit Charge Prope r s or o er's legal represents re Date(s): % Client Notification Date: Date / EHS: Sign given ❑Yes ❑No Account # Revised 11/06 Invoice # -�73 10 40 DAVIE COUNTY HEALTH DEPARTMENT Environmental Health Section Soil/ Site Evaluation APPLICANT INFORMATION Account #: 990004425 Billed To: PSC Development Corp. Inc. Reference Name: Brad Coe Proposed Facility: Residence Property Size: PROPERTY INFORMATION Tax PIN/EH #: 5870-b4-22bb Subdivision Info: Essex Farm Lot # 20 Location/Address: Cornatzer Rd -27006 1.066 acre Date Evaluated: Af �7 I? (rl �.._ Water Supply: On -Site Well Community Public Evaluation By: Auger Boring Pit "J Cut SITE CLASSIFICATION: {�S LONG-TERM ACCEPTANCE RATE: 2 __ REMARKS: EVALUATION BY:F, OTHj(S) PRESENT. ;WOW07 t�J4 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 clay loam SIL - Silty loam CL - Clay loam SCL - Sandy clay loam SC - Sandy clay SIC - Silty clay C - Clay Moist VFR - Very friable FR - Friable FI - Firm VFI - Very firm EFI - Extremely firm YYer NS - Non sticky SS - Slightly sticky S - Sticky VS -Very Sticky NP - Non plastic SP - Slightly plastic P - Plastic VP - Very plastic Structure SC - Single grain M - Massive CR - Crumb GR - Granular ABK - Angular blocky SBK - Subangular blocky PL - Platy PR - Prismatic Mineral= 1:1, 2:1, Mixed 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 05/05 (Revised) Landsca0e position HORIZON I DEPTHTexture gmup Consistence HORIZONIIDEPTH Texture �od ConsistenceStructure �r��r�ii�rra�c.��■��■� Consistence ��■i�lr�� Mineralogy IV DEPTH -HORIZON Consistence SOILWETNESSRESTRICTIVE HORIZON SAPROLITE • R V5 SITE CLASSIFICATION: {�S LONG-TERM ACCEPTANCE RATE: 2 __ REMARKS: EVALUATION BY:F, OTHj(S) PRESENT. ;WOW07 t�J4 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 clay loam SIL - Silty loam CL - Clay loam SCL - Sandy clay loam SC - Sandy clay SIC - Silty clay C - Clay Moist VFR - Very friable FR - Friable FI - Firm VFI - Very firm EFI - Extremely firm YYer NS - Non sticky SS - Slightly sticky S - Sticky VS -Very Sticky NP - Non plastic SP - Slightly plastic P - Plastic VP - Very plastic Structure SC - Single grain M - Massive CR - Crumb GR - Granular ABK - Angular blocky SBK - Subangular blocky PL - Platy PR - Prismatic Mineral= 1:1, 2:1, Mixed 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 05/05 (Revised) Davie County Environmental Health P.O. Box 848/210 Hospital Street Mocksville, NC 27028 (336)751-8760/ Fax (336)751-8786 Account #: 990004425 IMPROVEMENT PERTWTIN/EH #: 5870-64-2265.20 Billed To: PSC Development Corp. Inc. Subdivision Info: Essex Farm Lot # 20 Address: PO Box 340 Location/Address: Cornatzer Rd -27006 City: Mocksville Property Size: 0.691 acre Reference Name: Brad Coe Proposed Facility: Residence **NOTE**This Improvement Permit DOES NOT authorize the construction of a wastewater system. An Authorization To Construct a wastewater system must be obtained from this office prior to the construction/installation of a wastewater system or the issuance of a building permit(in compliance with Article 11 of G.S. Chapter 130A, Wastewater Systems). This Improvement Permit is subject to revocation if site plans, plat or the intended use change. Permit Type: Aew ❑Repair ❑Expansion Permit Valid for: 0 Years to Expiration Residential Specifications: # Bedrooms— IL # Bathrooms # People Basement❑ Basement plumbing❑ Non -Residential Specifications: Facility Type # People # Seats_ Square Footage(or Dimensions of Facility) Design Flow(GPD):4eo Type of Water Supply: �;eounty/City ❑ Well ❑ CommunityWell Site Modifications/Permit Conditions: �ti _ `g (" JAD-: _ S stem Type LTAR Initial -I O.ZE R an n i r I e-% 09.0 Environmental Health Specialist