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791 Main Church Rd Lot 9 Davie County,NC Tax Parcel Reportll Wednesday, October 19, 2016 `I693i 605 699 ' 701 x �~ 812 O .763 729 �\� 113 ``; 169 yU•`' �'�., 809 1371 823 141,` 872 1 845- 855 45-855 791f� 865 924 'L� y A l �1 WARNING: THIS IS NOT A SURVEY Parcel Information Parcel Number: G409OA0009 Township: Mocksville NCPIN Number: 5739497376 Municipality: Account Number: 82525340 Census Tract: 37059-806 Listed Owner 1: WILLARD JOHNNY PAUL Voting Precinct: NORTH MOCKSVILLE COUNTY Mailing Address 1: 791 MAIN CHURCH ROAD Planning Jurisdiction: Davie County City: MOCKSVILLE Zoning Class: DAVIE COUNTY R-A State: NC Zoning Overlay: Zip Code: 27028-0000 Voluntary Ag.District: No Legal Description: LOT 9 BARNHARDT ACRES Fire Response District: MOCKSVILLE Assessed Acreage: 6.64 Elementary School Zone: WILLIAM R DAVIE Deed Date: 5/2010 Middle School Zone: NORTH DAVIE Deed Book I Page: 008250223 Soil Types: MrC2,MsC,ChA Plat Book: 0008 Flood Zone: Plat Page: 032 Watershed Overlay: DAVIE COUNTY Building Value: 251910.00 Outbuilding&Extra 0.00 Freatures Value: Land Value: 36330.00 Total Market Value: 288240.00 Total Assessed Value: 288240.00 161 All 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 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 NC or arising out of the use or Inability to use the GIS data provided by this website. ' .• DAV IE COUNTY ENVIRONMENTAL HEALTH P.O.Box 848/210 Hospital Street Mocksville,NC 27028 (336)751-8760 Fax#(336)751-8786 OPERATION PERMIT Account #: 989900216 Tax PIN/EH#: 5739-49-7376.09 Billed To: Paul Willard Subdivision Info: Barnhardt Acres Lot#9 Reference Name: Location/Address: Main Church Road-27028 Proposed Facility: Residence Property Size: 5 acres ATC Number: 4563 **NOTE**The issuance 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. ''(�( Q.1 System Type.: L IS.T.Manufacturer ff u-fTank Date ( 6 ' 6Tank Size Q a d Pump Tank Size �- � ' I f l f _ �•j� 3 System Installed By:CU INIAL,/ W' 1`���E.H. Specialist: taLelffate:�� V W et C� , 1. 3oc�► `J '.1 Cv , V /6q(, l DCHD 11/06(Revised) ` 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 M 989900216 Tax PIN/EH#: 5739-49-7376.09 Billed To: Paul Willard Subdivision Info: Barnhardt Acres Lot#9 Reference Name: Location/Address: Main Church Road-27028 Proposed Facility: Residence Property Size: 5 acres ATC Number: 4563 **NOTE**This Authorization to Construct(ATC)MUST BE ISSUED by the Davie County Environmental Health Section prior to issuance of any building per nit(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 FIVE YEARS. This ATC is subject to revocation if site plans,plat or the intended use change. Residential Specification:Building Type 03`IFS #People #Bedrooms 3 #Baths Z Basement w/Plumbing:_Basement/No Plumbing Commercial Spec' kation:Facility Type #People #People/Shift #Seats Lot Size 7 Aa ype Water Supply 0EU—Design Wastewater Flow(GPD)3L&O Site:New System Specifications:Tank Size ICWGAL.Pump Tank_GAL.Trench Width�i Trench Depth {' &4X Rock Depth NJ & Linear Ft.3(c:0 Other: I&O-C6 /o W DOC-1l23 S�c`�l t.�►v� _ T71 "(Z► °� -�X Required Site Modifications/Conditions: 1 r1SS"Alk 0.� C-E, L L e& PaoL.1A! L. Contact the Davie County Environmental Health Section for final inspection of this system between 8:30—9:30a.m.on the d4y of installation. Telephone# 336)751-8760. l�QJ 12 Qi )b ►�' 120 Environmental Health Specialist L Date: D DCHD 11/06(Revised) t v' Davie County Environmental Health P.O.Boa 848/210 Hospital Street Mocksville,NC 27028 ` (336)751-8760/Fax(336)751-8786 EUPROVEMENT PERMIT Account M 989900216 Tax PIN/EH#: 5739-49-7376.09 Billed To: Paul Willard Subdivision Info: Barnhardt Acres Lot#9 Address: 173 Colonial Lane Location/Address: Main Church Road-27028 City: Mocksville Property Size: 5 acres Reference Name: 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: Of Years ❑No Expiration Residential Specifications: #Bedrooms 3 #Bathrooms 2 #People Basement2lgasement plumbing❑ Non-Residential Specifications: Facility Type #People #Seats Square Footage(or Dimensions of Facility) Design Flow(GPD): 3�--Q Type of Water Supply: ❑County/City 4!Well ❑Community Well .Site Modificatiions/Pernlit Conditions: L_)o-A--, , 1!S 4- System -S stem Type LTAR Initial i�:- Repair Site Plan I�IJE i Environmental Health Speciali Date i.p.11-06 ji Q �III1�TE TE EVALUATION/IMPROVEMENT PERMIT & ATC avie County Environmental Health DEC 1 1 2006 G; P.O.Box 848/210 Hospital Street Mocksville,NC 27028 DWR0 vMt OUN HEALTH '= (336)751-8760/Fax(336)751-8786 Appy ion or: ❑ Site Evaluation/Improvement Permit ❑ Authorization To Construct(ATC) VBoth Type of Application: ❑New System ❑Repair to Existing System ❑Expansion/Modification 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. APPLICANT INFORMATION Name to be Billed_✓t7 u r Lo ,r-CA Contact Person Billing Address f 1713 r"I-) i a ( I- 1J Home Phone City/State/ZIP 120 p G Ks u I 1 e. ;/1/C'_ Q 17 0 -�A Business Phone 27 :7 4; Name on Permit/ATC if Different than Above Mailing Address City/State/Zip PROPERTY INFORMATION *Date House/Facility Corners Flagged NOTE: A survey plat or site plan must accompany this application. Included: (V Site Plan ❑Plat(to scale) (Permit is valid for'60 months with site plan,no expiration with complete plat.) Owner's Name d1;;AA4 (-di- Phone Number Owner's Address 6,717 Jam-4f2 C�, '� City/State/Zipy/J6 cJ�r-,,,, //, Property Address /))c,'o Lot Size J-4 e Tax PIN# -5-13 Subdivision Name(if applicable) Section/Lot# Directions To Site: If the answer to any of the following questions is"yes",supporting documentation must be attached. Are there any existing wastewater systems on the site? ❑Yes (4No Does the site contain jurisdictional wetlands? ❑Yes't1No Are there any easements or right-of-ways on the site? [ Yes ❑No Is the site subject to approval by another public agency? ❑Yes KNo Will wastewater other than domestic sewage be generated? ❑Yes 1XNo IF RESIDENCE FILL OUT THE BOX BELOW #People #Bedrooms #Bathrooms ;4' Garden Tub/Whirlpool WYes ❑No Basement: XYes ❑No Basement Plumbing: ❑Yes D1No 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: ❑Conventional ❑Accepted ❑Innovative ❑Alternative ❑Other Water Supply Type: ❑ County/City Water X New Well ❑Existing Well ❑ Community Well Do you anticipate additions or expansions of the facility this system is intended to serve? ❑ Yes KNo 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 HealthDepartment 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 corners and locating and flagging or staking the house/facility location,proposed well location and the location of any other amenities. 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Surveyor Carllri tlf for ORsure "1 00 HEREBY CERTFY MAT I AM EVE ARE)THE - O-R(s)Or ME PROPERTY DESCNBED HEREON.WROI IS Surveyor CN11RootlKm 1KX Sub DlVlslOn Q _ :,je.v4��s,tea:.w !0 IN ME A1BOn°40N JUpI501CTON OF DANE ru]•,N uS r.TA1 COUNTY ANTI MAT I HEREBY ACOPT MIS•UBOIN990N L---------- D I/w�i�•'��••I•'I]i.•'• ••~yPw.__-.: PLAN WM MY FREE CONSENT.ESTABLISHED MINIMUM n..niry N•'•�•"'��I°�'•M1°v M�r Ik.,..IUB ow .a•s..v..n. i1.4I WI 6.I^'^^r a°�.HW•IM.I BULDIIC SETBACK LINES AND DEdCSTE'ALL STREETi -• I�•�•Iw.uo+�lr N rw.�w.w•.. 'a•M• Q A/J/ .�TT--//w l'M• ALLEYq WALvi PARKS.AND OTHER 9705 AIA - _• •,•I•••'Ir'••"A°°I I•'e 2 LLQPQ s,y•Y,{G_Y._T.3c _-- __]Is] EASCMINtS TO PUBLIC ON PRIVATE USE AS NOTED. ulI pr�NMy w 4 4-w��Y�t>. . yw r U lI•�w x...4. �I {tC?{ 0D A• DATE �rTO-� • ln�l•,n we.m.lr wr••.�i:eu: ...I Iw°�hw�i+w��rM• PN _ oHCAROL �_IrI�..- x_.. 5.,I�_1�••F_�'.G^_ -_-_t]...T�i:..r- ur DATE tP {•S OPt of I5 t141f.�`5 MPROPERTY IS EYEMPT fpoN DANE COUNIT `• SEAL m� SUBOIN90N RELVLATIONS BY SECTION 154.01 £ L 3163 gyp• RENEW TY-A'S CERTIFICATE NOT TO SCALE M 1 Of E DANE COUNTY CODE Ve OI°,LP - �• _�RENEW ORTIFFp DANE COUNTY A\0 NO APPROVAL IS REOUIFEO BY THE tY1 CEROFT ME PIAT TO IHIW MIS CERTIFICATION IS ATTACH I£ L 3163 - U a DANE COUNTY FLANNNO DEPARTMENT FAAIN MEETS ME STATUTORY R IRENENis FOR RECORO010. S b- G .R..w OffICCR ! /OATEN- FRANK7'\�~P4� .1 raW r..r.l� eWar o..E Ka..rrr r 9..w MAIN CHURCH ROAD Cl- 6.ofi'-Toru - RIBBON PAVEMENT SR/1405 PUBLIC 1 _3.9L3B-1071L- _- _rO E 0 __NT N st'_ f0" - 9 4.06'T TA xnY s«PL.o.s;w.aN 174.83' 7331 N172.33 1]5.03 1}263' 9110D' 15683' 173.00' 200.10' 1 - 68.86' 11180' C] o-IA. 0-CL ; M • ( o-rnl ti } . 1 :' 7/ •• y'+'r"b-! .11 d/ mA eN•rrroT wRNN Lank n>,.u�cs r 7� ••"'°�� @ M1rAu TAA P-L 8 4 N LSC e.w«Ar6,�nr O / O O' ® O © O N Qp 1 O S > •P 39 6 o-. i RON/INIi`Mal rAol Mr]W v ]N F.57eI 217917 5'R.FL X 5.003// ^ •, - '_" HN ra.w/ LS 1 'N r.•tool % . •.? g` y'•7218]as S9.iL 226092 xz5]80 SaFL y5•`5 _ r > u I / a ! 3.017 Ac. + i 5.174 A. 1,j°1•O M A. 5.190 Ac A mr.+°eWe>wNlumr A/W _ ♦ o 0 0 0 y k j� o n jr A � ru�o-i�-•]PN¢l 2]5376 S.".. I o^ R3 5.403 Ac. O M1 ono.nLMAo 4b Iw y y N N, 8 v ! w 1 1 amr6..T w ----------------- d" 217908 S,,FL 217867 - 59R 318855 Safl.o /303383 SRF1.' �] 215UO2 Ac 1024 Ac 6.965 Ac. .9 002 Aa 5. ♦ 3100 SaFI. /r H 5.000Aa 1 • 10.3 AA9c 1 o01 ti0 Lc eav1N TAM A/W e•. N 53'-30AI'-50"E- 777.9,'TOt ; s W s:rwADT ALIS .�• IMI ]1 Mal 9 [F .. >e) ~, �'IlTtlf SaFL u-'al e� ,, ; _ I • 5.077 Aa 40.67 1}HT ,4q HWM y ]6.5]' 6.50' 1 T 1 )4,g• d LJ a Taro ! ------ 5 551.08'TOTAL a rgRe -S 52'-34'-90'W 600.83'TOTAL -5 51'- 169. _ I�N Taro ivxr 6.N% 1 0]'-}0'W 477.31'iOTAI S 53'-]0'-50 W 35].]8 186.cR.ix� CONTROLLED ACCESS 1 of fv]n a IPAO LawC YLaA1aI pgyg8g46 9 t\E E;gSJJS°�,a INTERSTATE 40 D19� a --------------------------------------------------------- ___._ ____.- OSB 5A- OUAL LANE CONCRETE R1919014 PAVEMENT / N 79]600.826 E 15]]416.566 OMER: LN• B.a q DNI... EDWARD C. BARNHARDT A/W - - Lt N 65'-48'-2o E 141.60 DORIS W BARNHARDT L2 s s-5c-D0'E 963.05' - 677 MAIN CHURCH ROAD - L3 S as•-2s•-3U'W 59.24• _ MO CKSVILLE NC 27022 L4 s r-9a'-9D'W 41.12' 1 PHONE N 336-751-3675 - L5 5 63•-ss'-1o'w .non'. TAX MAP REF. C 4 PARCEL 3.307 - • - TOTAL AREA 62.BIC ACRES - PIAT YAP DBS REFERENCE DEED D 438 PC 326 - of BARNHARDT ACRES REFERENCE DEED 59 PG 178 MINIMUM SETBACK LINES + ToW/m6P couNrr STALE DATE doe Na • FRONT v 40' a... Re61e. Cha•6 B°r.Mg.1 01.1- Arc Lmgth - ,uOCKSV/LCF DAV/£ NC 11 S-OJ-OJ S-JOIIJ REAR 3D' Ct }76fi.16' N 55'-12'-b'C 746.64' 14fi.65 $IDE . 15' CI ]766.16• N M'-30' E 25.10' 21 fQ EACH LOT WLL BE SERVED BY SEPARATE SEVER SYSTEM C3 3766.46' N 59-51'-50'E 415.12' C4 3766.46' N 6}'-1]'-3W E 26.74' 26.74 WATERSOURCE WILL BE BY PRIVATE YELLS , ALL DISTANCE HORIZONTAL GROUND MCAnaII Land Surveying, P.C. IRONS PLACED AT ALL CORNERS EXCEPT AS NOTED - ¢axe Y Y g -I.w.,PI•...I...4 868 Weal 4th Street Wlnston-Sole .N.C. 27101 -MIS PROPERTY IS SUBJECT TO ANY EASEMENTS•AGREEMENTS,OR RIGHTS- - -°�'�"• Phone 1 336-631-9805 OF-WAY OF RECORD IF ANY.PRIOR THE DATE OF THIS PLAT AND WHICH -rr`6-y-e -Ipy 'y Foo /336-724-2125 WERE NOT VISIBLE AT THE TIME OF MY INSPECTION. •�.H^I r••r - A.a ur1 •I�•� -cA cml.l... I - -ALL AREAS BY COORDINATES -17 n HW1.." -CAu:.m.,I 7� r� SO LF- r'. 00* IW 4� • 5 - 1N DAVIE COUNTY HEALTH DEPARTMENT Environmental Health Section Soil/Site Evaluation APPLICANT INFORMATION PROPERTY INFORMATION Account #: 989900216 Tax PIN/EH#: 5739-49-47376.09 Billed To: Paul Willard Subdivision Info: Barnhardt Acres Lot#9 Reference Name: Location/Address: Main Church Road-2708 Proposed Facility: Residence Property Size: 5 acres Date Evaluated: `� Water Supply: On-Site Well Community Public Evaluation By: Auger Boring Pit / Cut FACTORS 1 2 3 4 5 6 7 Landscape position L L �- Slo e% (i HORIZON I DEPTH o• - Texture groupt L Consistence S Structure Mineralogy '5 Sa S HORIZON H DEPTH 3( 7T-101 Texture grouC_ Consistence F, vS ve g-SIP Structure k SEL Mineralogy t)c• HORIZON III DEPTH 3W 1 q-32- -3 Texture group ) Consistence VG` Structure MineralogyS.. HORIZON IV DEPTH 3 Texture group Consistence ,J Structure Mineralogy SOIL WETNESS 2 -f RESTRICTIVE HORIZON 2 SAPROLITE _ CLASSIFICATION V SF> 7TT- LONG-TERM ACCEPTANCE RATE SITE CLASSIFICATION: EVALUATION BY: LONG-TERM ACCEPTANCE RATE: �'�� OTHER(S)PRESENT. Vl� ► REMARKS: 62A�ta P44AEb 0­1 kms..'s p3 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 CONSISTENCE Moist VFR-Very friable FR-Friable F1-Firm VFI-Very firm EFI Extremely firm YY�t 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 Mineralogy 1:1,2:1,Mixed rloSes 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 05105(Revised) ■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■\\SII■■■■■■■■■■■■■■■/■!■■■■■■■■■■ ■■■■■■■■■■■■■■■■■■■/■■■■■■■■■■■■■■/it■■■■■■■■■■■■■■■■■■■■■■■■/■■■■■ ■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■ ■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■ ■■■■■■■/■■■■■■■■■■/■■■G■■■■■/■■■�i■■■/■■■■■■■■■■■■■■■11111■■■■■■■■■■ ■■■■■■■■■■■■■■■■■■G■■/■■■■[�C�1■■■■■■a■■■■■■■■■■■■■■■■■■�/�1■■■■'■■■■■■ iiiiiiiiiiiiMENNEN iiiiiiiiiiiiEMENI iiMEMMili ■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■ . � Davie County Health Department 9 t836� Environmental Health Section 7 r P.O. Box 848 ; 210 Hospital Street SNOliW 0�I � 2011 'Courier# : 09-40-06 APR Mocksville, NC 27028 Phone:(336)-753-6780iYl _ Fax: (336)-753-1680 ON-SITE WASTEWATER CERTIFICATION (Check One) Replacement . Remodeling Reconnection (j{�;/�� Name: j,3h /') Phone Number (Home) Mailing Address: L(' ' A 9�/��J 73 9/ , .Cl Work) i a/ f�'IlSr�,/CS✓/ rQ,JV�`Zs Email Address: Detailed Directions To Site:—t ® Property Address: i1y 671 r Please Fill In The Following Information About The EXISTING Facility: Name System Installed Under: < rd Type Of Facility: 14$� Date System Installed(Month/Date/Year): Z 6 "d i Number Of Bedrooms: , Number Of People: Is The Facility Currently Vacant? Yes No If Yes,For How Long? , Any Known Problems? Yes oNoIf Yes,Explain: Please Fill In The Following Information About The NEW Facility: Type Of Facility: G'U�� 191 / Number Of Bedrooms:�Number of People Pool Size: GarageSize: L!50)e O Other: Requested By: �� (t ) t ,1 P X� �C Date Requested: /� / (Signature) For Environmental Health Office Use Only �ro Disapproved Comments: 4f 77;1 Environmental Health Specialist Date: �I *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: as Check Money Order # Amount:$ Date: RZI Paid By: Received By: Account#: - 6-7 3 Invoice#: � �a