169 Milo Ln Lot 2 Davie County,NC Tax Parcel Report Wednesday, October 19, 2016
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WARMING: THIS IS NOT A SURVEY
Parcel Information
Parcel Number: G409OA0012 Township: Mocksville
NCPIN Number: 5739591414 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,H-B
State: NC Zoning Overlay:
Zip Code: 27028-0000 Voluntary Ag.District: No
Legal Description: LOT 12 BARNHARDT ACRES Fire Response District: MOCKSVILLE
Assessed Acreage: 5.07 Elementary School Zone: WILLIAM R DAVIE
Deed Date: 512010 Middle School Zone: NORTH DAVIE
Deed Book/Page: 008250226 Soil Types: MrC2,MrB2,ChA
Plat Book: 0008 Flood Zone:
Plat Page: 032 Watershed Overlay: DAVIE COUNTY
Building Value: 237680.00 Outbuilding&Extra 29100.00
Freatures Value:
Land Value: 30240.00 Total Market Value: 297020.00
Total Assessed Value: 297020.00
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
NC County of Davie,North Carolina,its agents,consultants,contractors or employees from any and all claims or causes of action due to
CDU N�� NC or arising out of the use or inability to use the GIS data provided by this website.
DAVIE COUNTY ENVIRONMENTAL HEALTH
` P.O.Box 848/210 Hospital Street
Mocksville,NC 27028
(336)751-8760 Fax#(336)751-8786
OPERATION PERMIT
Account M 989900216 Tax PIN/EH M 5739-49-7376.12
Billed To: Paul Willard Subdivision Info: Barnhardt Acres Lot# 12
Reference Name: Location/Address: Main Church Road-27028 �,,/
Proposed Facility: Residence Property Size: 5 Acres 77 q m4 t v e�1.KLv
ATC Number: 4564
**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 satisfactorilyfor y given period of
time. v 6
System e: S.T.Manufacturer 5td- Tank Date Tank Size
ys Type:�.—..
Pump Tank Size
System Installed By: w ► V, ,A E.H. Specialist: �J Date: ( � b
3
a
all, Z /7- /D� .�Ii�N /po�icrl�t�• l ��F L°QlrLw�.-
DCHD 11/06(Revised) ,, �n+l P7"`5 6441 S►- W nIJ nth#0r-Z+ F"-
I,tl�•
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 M 5739-49-7376.12
Billed To: Paul Willard Subdivision Info: Barnhardt Acres Lot#12
Reference Name: Location/Address: Main Church Road-27028
Proposed Facility: Residence Property Size: 5 Acres
ATC Number: 4564
**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 1 I 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 Typc r #People #Bedrooms > #Baths_,
Basement w/Plumbing:T Basement/No Plumbing
Commercial S cation:Facility Type #People #People/Shift #Seats
Lot Size.14 Water Supply Type.
Wastewater Flow(GPD)' IrLo Site:NdW Repair
System Specifications:Tank Siz CQ()GAL.Pump Tank—GAL.Trench Width-3.o q
idth-3.o1 Trench Depth
Rock Depth_l,/!�t Linear Ft.Z
Other: / �/v ,Qa�t�c�'I ���Jr r `�-+�fe l WnL"J x S
Required Site Modifications/Conditions: VI;P 100 (4-00.. 0 a-1., ViEd I d rrF� aw, 14 J�5
Contact t 1%;County Environmental Health Section for final inspection of this system between
0-9:30a.m.on the ay of installation. Telephone#(336)751-8760.
Apex• 3�0
100
M
-r
Environmental Health Specialist Date:
DCHD 11/06(Revised)
r
Davie County Environmental Health
P.O.Boa 848/210 Hospital Street (e
Mocksville,NC 27028
(336)751-8760/Fax(336)751-8786
IMPROVEMENT PERMIT
Account M 989900216 Tax PIN/EH M 5739-49-7376.12
Billed To: Paul Willard Subdivision Info: Barnhardt Acres Lot# 12
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: Xew ❑Repair ❑Expansion Permit Valid for: Z5 Years ❑No Expiration
Residential Specifications: #Bedrooms 3 #Bathrooms 2- #People Basement❑Basement plumbing❑
Non-Residential Spermcations: Facility Type _ #People #Seats
Square Footage(or Dimensions of Facility)
Design Flow(GPD): !3O Type of Water Supply: ❑County/City Nell ❑Community Well
Site Modifications/Permit Conditions:
c
stem a LTAR
Initial A0Af-L Q
Zt5
Repair
Site Plan pp( 1F3�-ZW Lt.J is
� K 30
f
&P-aa
—N n �
Environmental Health Speciali Date
i.p.11-06
r�
i
F b
- k V9�69•. d
PF
I ,R
9'996
i, ION F ITE EVALUATION/IMPROVEMENT PERMIT & ATC
G 1 2006 avie County Environmental Health
aE� P.O.Box 848/210 Hospital Street
Mocksville,NC 27028
�l�p� ECMA TH (336)751-8760/Fax(336)751-8786
Appl iori or: ❑ Site Evaluation/Improvement Permit ❑ Authorization To Construct(ATC) 340th
Type of Application: ❑New System El 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 cP /-0; f` rA Contact Person
Billing Address 123 Cn f r,)-) i a ( y U Home Phone
City/State/ZIP 'f)o IN,G K.S 1 '7 0 Business Phone
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: IV Site Plan ❑Plat(to scale)
(Permit is valid for 60 months with site plan,no expiration with complete plat.)
Owner's Name c�"Q/,_,.,r�/ �r��;,-,,-)'C rd-1- Phone Number_
Owner's Address 6,27 +,;f oC City/State/Zip
Property Address y')/d;n Ch City, )p C es-u.`lie-
Lot Size J-d e firs Tax PIN# -:5-q-7 113!lk
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 (/&No
Does the site contain jurisdictional wetlands? ❑Yes tKNo
Are there any easements or right-of-ways on the site? ESYes ❑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 ._'3 #Bathrooms ,Z Garden Tub/Whirlpool Yes ❑No
- Basement: XYes YINo Basement Plumbing: ❑Yes KNo
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 OKNo
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 perniit(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 corners and locating and flagging
or staking the house/facility location,proposed well location and the location of any other amenities.
Site Revisit Charge
Property owner's or owner's legal representative signature
Date(s):
Client Notification Date:
Date' EHS:
Sign given ❑Yes ❑No Account# 0
Revised 11/06 Invoice# S�w0-
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VICINITY MAP
- - SUrveyef C"ll6caf1on fot C109Urs 1(WE)HEREBY CERRFY THAT I AN(VF ARE)THE
OWNER(S)OF THE PROPERTY OESQY,BED HEREON.w IS O
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a w a6; x�nati1 al Tm¢r I•x w•wrvs•4 I, NY FREE CDNSENT,ESTABLISHED MINIMUM _a I�N•....r IAx e•N..• s N w uy '.w N
.yNa"•y.•Irr..•rx.. y BUILDING SETBACK LINES AND DEDICATE ALL STREET$, m••yyN'.w.'w.w ee• NN.N r•px Q
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NCARTHIS PROPERTY IS E%ENP)IRON DANE COUNTY � ��`SUBOIN9ON RECULAlI0N5 av SECRON 154.01 2' RENEW OFFICER'$CEg1FIGTE f` ,•° •+ > NOT TO SCAL£
OF THE DANE COUNTY CODE £ J. e•SEAL
Nb APPROVAL IS AEOUIRED BY THE Y TME PIAT TO I'NICH THIS[ERTFIGTION IS ATTACH
M1 4_ L31&3
DANE COUNTY PLANNING DEPARTNENT - FRANKA' EETS THE STATUTAORY�R 'WENENTS FOR RECOFDWG
D*°e� ��// //�/. r ! n f' e[ R'� r y N Mp M1♦ �L�nG 'q P_
2.413
\ V/i/ L!/- RF.XEw oFi10ER� �Y A^K7-\tL�
. - 1 ONN fes rNqa,dT a F c.I,-
MAIN CHURCH ROAD
A. I,-
CL-_ 6.06_T�ru RIBBON PAVEMENT SR 1 1405 PUBLIC -
.23L3B-TOIAL. __.__-
1'-Ip' - N -1''-10 E- N 54'-
eCT'.vra+Ce ASneulm
174.85' 7121 ')2.]3' 125.05 t}26]' 135.00' 150.83' 9 6.06'T TA
3p •5 Aq �y� 66.89' 17300' 200.20'A. 1]1.80' CJ�•�_
o-4-Max C' t -i-CL
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s 1 r yl - € m OryueA 66 1 _
am
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M1'S 215.003
216386 SOFL
53
- _ -- �- ' //,♦ � -- 325180 5 FL
.01Ac. 226092 SyFt 5.174
1190 Ac �• - N 6•-4' .IS'E a/Nll rl aw° er'
' rD o1�arse 6.ai:ur«rixAlm..,cil
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1403 Ac
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aN7re eT o
217906 Sg.FL 217867 SAfL 218855 SRfLJ 303382 SRFt.�
5.002 Ac 5.002 Ac 5.024 Ac 6.965 Ac. tiOYy
21M27 S'L 218001 Sg FL /+/ I
• 'I'B.. 5003 Ae. 5.000 Ae 1.' N 52'-30'-50"E- 777.91'TOTAL - °• CaprotNeiw'AxyT
Aw[s 2IT+T L .
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3653' 2a1,51' ' Y 1 274.2a' tE9 BB C,T a H.H. /
m maw
------------ d aNu S 51'-IB'-20'W 551.08'TOTAL. a rdRo 5 52 J'-'0'W 600.83307AL -5 54.-Q W 477.]1 TOTAL
5 52'-30-50 W 353.]8 [wN[I1 -
a.C9Rx[3 CONTROLLED ACCESS a rales -
N
"'6 9632fi11 INTERSTATE 40
°gggE 153391316 P vol
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��O fNC4GP5 30 W a _______ _-__-__.__-.__________-__._.-_-____ _____-_-_-_-.-__ 7
DUAL LANE CONCRETE RIBBON PAVEMENT -
NCCS
.0 SBRACE' - - -
N 797600.836 - -
E 1531416.566 _ OWNER: - I.W. B-bg DI.1.NR.
EDWARD C. BARNHARDT A/W' LI N 65'-48-20'E 141.64'
DORIS W BARNHARD7 L2 S 5'-56'-00•E 16205' -
677 MAIN CHURCH ROAD - L3 s as-2a=o-W iii2 '
MOCKSIALLE NC 27022 - - LS S 6Y-55-40'IN nazi
1 - - PHONE If 336-751-3575 -
TAX MAP REF. G 4 PARCEL 3307 - -
TOTAL AREA 62.89E ACRES -
REFERENCE DEED D438 326 - of T wP. AIFNHA�D T A CRE5
- REFERENCE DEED DBS 59 PIC
178 - U
• - MINIMUM SETBACK LINES + TO-D, srAtE DATE ]De Na
FRONT= 40' - - W. Rae:,, CAara 8•w g aw DIM- Arc Leegth
REAR.- 30' - IAOCKSV/LL£ DA VI£ VC 5-0J-0J S-JOIN/
SIDE = 15' C' 3766.46' N 55'-12'-30'C 146.64' 6.65'
C2 3766.46' N 56=3f1'-Sd E 2510' I14S Io'
EACH LOT WLL BE SERVED BY SEPARATE SEVER SYSTEM G ]766.46' N 59•-51'-50'E 415/2' 4113]' '
C4 ]766.46' N 63•-IY-30'E 36.74' 25.71
WATERSOURCE WILL BE BY PRIVATE WELLS -
ALL DISTANCE HORIZONTAL GROUND MCAnQII Land Surveying, F.C.
IRONS PLACED AT ALL CORNERS EXCEPT AS NOTED 1;QM° Y Y 9
- -rc r••.N cx. 858 We6t 4th Street Wln3tan-Salem,N.C.27101
-THIS PROPERTY IS SUB.ECT TO ANY EASEMENTS,AGREEMENTS OR RIGHTS _- wPH°c'4 r•e _ Phone e 336-631-9805 '
OF WAY OF RECORD IF ANY,PRIOR THE DATE CF THIS PLAT AND NHICH r'L m`=1j 14� - FOK /336-724-2125
y WERE NOT VISIBLE AT THE TIME OF MY INSPECTION. -.A+Npn-•r-rar _ 'uq Aw u...rs
-pA[x'.NH.
-ALL AREAS BY COORDINATES - [N•N nary -n Cww.I•Va..•.:I mx SCALE r'+2LG'
TCO rDo
0 200 400
• DAVIE COUNTY HEALTH DEPARTMENT
" Environmental Health Section
Soil/Site Evaluation
APPLICANT INFORMATION PROPERTY INFORMATION
Account #: 989900216 Tax PIN/EH#: 5739-49-7376.12
Billed To: Paul Willard Subdivision Info: Barnhardt Acres Lot# 12
Reference Name: Location/Address: Main Church Road-27028
Proposed Facility: Residence Property Size: 5 Acres Date Evaluated: y
Water Supply: On-Site Well / Community Public
Evaluation By: Auger Boring Pit Cut
FACTORS 1 2 3 4 5 6 7
Landscape position
Slope% 20 0
HORIZON I DEPTH '9 S 0-30 O • 31
Texture group Gt_ C-1-
Consistence
1-Consistence a kllclsv [-
Structure CSL <MineralogySV-
HORIZON H DEPTH .31
Texture group G
Consistence r 5
Structure < <-
Mineralogyw
HORIZON III DEPTH '3p
Texture group
Consistence
Structure
MineralogyS C
HORIZON IV DEPTH
Texture group
Consistence
Structure
Mineralogy
SOIL WETNESS
RESTRICTIVE HORIZON
SAPROLITE — --
CLASSIFICATION 5
LONG-TERM ACCEPTANCE RATE O• �7• p•3S
Pc�Gl1�.,n,.P
SITE CLASSIFICATION: EVALUATION BY:
LONG-TERM ACCEPTANCE RATE: OTHER(S)PRESENT: PAQ< Wi ll�
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 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 FI-Firm VFI-Very firm EFI-Extremely firm
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 -
LYotes
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)
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