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855 Main Church Rd Lot 4 Davie County,NC Tax Parcel Report Wednesday, October 19, 2016 ' ZI4 ! 9' 113 145 159 JAG? 8 09 169s X823 872 tt 845p; 980. 944 865 55 791 ��� 966 I A 956924C� 95 118 i t ' aiy Vis ' liJ 140 Ly= _ Q 152 120 tt 1175_ 179 165 1179 ? f _ 207 WARNING: THIS IS NOT A SURVEY 'r���r;,�l Try�i�rrn�i�r►_. ___ _ Parcel Number: G409OA0004 Township: Mocksville NCPIN Number: 5739388890 Municipality: Account Number: 8300407 Census Tract: 37059-806 Listed Owner 1: KISER MICHAEL TODD Voting Precinct: NORTH MOCKSVILLE COUNTY Mailing Address 1: 855 MAIN CHURCH ROAD Planning Jurisdiction: Davie County City: MOCKSVILLE Zoning Class: DAVIE COUNTY R-A State: NC Zoning Overlay: Zip Code: 27028-5851 Voluntary Ag.District: No Legal Description: LOT 4 BARNHARDT ACRES Fire Response District: MOCKSVILLE Assessed Acreage: 5.01 Elementary School Zone: WILLIAM R DAVIE Deed Date: 2/2016 Middle School Zone: NORTH DAVIE Deed Book/Page: 010110547 Soil Types: MrB2,MsC Plat Book: 0008 Flood Zone: Plat Page: 032 Watershed Overlay: DAVIE COUNTY Building Value: 193040.00 Outbuilding€:Extra 9000.00 Frestures Value: Land Value: 28260.00 Total Market Value: 230300.00 Total Assessed Value: 230300.00 1001 �TAll 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 l�C or arising out ct the use or inability to use the GIS data provided by this vrebsitc. DAVIE COUNTY ENVIRONMENTAL HEALTH P.O.Bax 848/210 Hospital Street Mocksville,NC 27028 (336)751-8760 Fax#(336)751-8786 OPERATION PERMIT Account #: 989900216 Tax PIN/EH #: 5739-49-7376-04 Billed To: Paul Willard Subdivision Info: Barnhardt Acres Lot#4 Reference Name: Location/Address: Main Church Road-27028 Proposed Facility: Residenc Property Size: 5 acres ATC Number: . 4584 X55 N(aml **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 f r y given ppeerinod of time. J,e d�j,,_ r System Type:_S.T.Manufacturer 5AOa Tank Date Tank Size_�� arX.o Pump Tank Size System Installed By: R-0 ��,-�-�v` E.H. Specialist: half i Date: V0 4 T I O 1/ Wk r �3 3 0 3 vY 2cl' f ti DCHD 11/06(Revised) r at • DAVIE COUNTY ENVIRONMENTAL HEALTH P.O.Box 848/210 Hospital Street n� Mocksville,NC 27028 Y (336)751-8760 Fax#(336)751-8786 AUTHORIZATION FOR WASTEWATER SYSTEM CONSTRUCTION (J Account M 989900216 Tax PIN/EH M 5739-49-7376-04 Billed To: Paul Willard Subdivision Info: Barnhardt Acres Lot#4 Reference Name: Location/Address: Main Church Road-27028 Proposed Facility: Residence Property Size: 5 acres ATC Number: 4584 **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 FIVE YEARS. This ATC is subject to revocation if site plans,plat or the intended use change. Residential Specification:Building Type_' fk #People #Bedrooms 3 #Baths Basement w/Plumbing:—Basement/No Plumbing_ Commercial Specification:Facility Type #People #People/Shift #Seats Lot Size$ Type Water Supply Design Wastewater Flow(GPD) 3voD Site:New✓Repair System Specifications:Tank Size low GAL.Pump Tank I SAL.Trench Width��� Trench Depth i`a X Rock Depth t4 Linear Ft.Z Other: &('Lh� _t t� 2� � 17i►SY"�-1 7j10.3 9�C,� Required Site Modifications/Conditions:I tX I/ALL. &J C,0.')1 E}�2��.=� ��,off- Pad.Ll-)6 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. _ 114-7' PSR L-It _I .t iota` H I,J. AIN .�CC -�; TC, NN �C,t6r�K •!5�STEt� Environmental Health Speciali Date: 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 IMPROVEMENT PERMIT Account #: 989900216 Tax PIN/EH #: 5739-49-7376-04 Billed To: Paul Willard Subdivision Info: Barnhardt Acres Lot#4 Address: 173 Colonial Lane Location/Address: Main Church Road-27028 City: Mocksville Property Size: 5 acres Reference Name: Proposed Facility: Residenc **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: ew ❑Repair ❑Expansion Permit Valid for: Years ❑No Expiration Residential Specifications: #Bedrooms _#Bathrooms .7- #People Basement❑ Basement plumbing❑ Non-Residential Specifications: Facility Type #People #Seats Square Footage(or Dimensions of Facility) Design Flow(GPD): avo Type of Water Supply. ounty/City�Vell ❑Community Well Site Modifications/Permit Conditions:( System Type LTAR Initial Repair ©,2 Site Plan r 1 co U� v Environmental Health Specialist % Date_ ? 07 i.p.11-06 r►- M °^' � •.: �� '� ��r ' 'tea ��, ��"^ . as a � � r e 1 c � dry Y 5 4 x - -:F ♦a 5 :aef r ��x aa' - � s j � �� -d► � � � /fie x MlZffl FAW NNNA Al Ala .� 't�+�:v F c .� � ?+� s y,« � .$r`�,aR.. •po,e gd 7:' sy""px`: APPLIC ITE EVALUATION/IMPROVEMENT PERMIT & ATC E V E � Davie County Environmental Health Dr, P.O.Box 848/210 Hospital Street Mocksville,NC 27028 t DEC 1 1 2006 k (336)751-8760/Fax(336)751-8786 Ap licati}n Fo • on/Imprk ement Permit ❑ Authorization To Construct(ATC) VBoth Typ of Appli6i% System pair 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 1_ / )f 11 a VI-CA Contact Person { I, Billing Address 11-3 Cr,f n n i U ( 1. aJ Home Phone City/State/ZIP Y ll G K.s u i 1 1� .&C -J r7 0 -!,A Business Phone 3 V,S" 7,`-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 ,r-�,,- rd-)- Phone Number Owner's Address > City/State/Zip L/ Property Address i�7�,'n C_f7, City 70 c s'�.. Lot Size Jye rc-s Tax PIN# .513 �3� 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 NNo Are there any easements or right-of-ways on the site? E Yes ❑No Is the site subject to approval by another public agency? ❑Yes XNo Will wastewater other than domestic sewage be generated? ❑Yes QNo IF RESIDENCE FILL OUT THE BOX BELOW #People #Bedrooms . ' #Bathrooms -2 Garden Tub/Whirlpool XYes ❑No Basement: UYes ❑No Basement Plumbing: ❑Yes Flo 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 ;K 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 Health Department to conduct necessary inspections to determine compliance with applicable laws and rules. rI 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# C� �- -�`A Revised 11/06 Invoice# M161 \ 5403A \ ` 3995 1 \ 5174 4535 yd `P,� MsC Ch� MrB 7 7� 23. 5024A CP- 6216 01 fs '4 I 4651' 5002A 4124 MrC2 " 5002A 2)53 s \ OOOA 8096 6 q, � 5 8889 � a 190A 6765 5013A m 4667 Ms \ k, •11„"i! r la.aaN V 9178 ' r . Plat 5 q 12 3�— + CER0F TE OF OWNERSHIP VICINITY MAP SUr yor C3rtlRcetla for Claaura Y(YE)HEREBY CERTIFY THAT I AN(YE ARE)THE - - u•AM OWNERS)a<MC PROPERTY aC TS.HEREON,w IS Survey°.CeYVRCW-for Subdl,[,[- Q w�...v�•"'M•' LOGlrO AT INE SMBgN51oN.1.RISOICTION OF DANE L-__rW rRAwAIH to__��-M M l.N l-]+I q0 CWNif AMID SHAT 1 HEREBY ADOPT,HIS SUBOINSION 6v..I.,Nuns._ M UeP ]].n iee Im.=1_1 PLAN YIN MY FREE CONSENT.ESTABLISHED MININUY •�Ir w.ar•M w I.4�tii H�MN`w Z N• 1 119 11�.•-•..�..�..♦H BUllIC SEIBAO[LINES ANO DEgGIE ALL STREETS, ~..w.v.ww...wl..r...I.W r•e�~v 2 Q ALLE7!i ua N N w s....r TIM.Ie.ww w.Hn w9..w..wi11.�mnIrNNHr Q pO �r//�� ';T'S.PARKS.AND DINER 4TE5 ANO _I. W.I I' .. EASENINTS TO PUBLIC OR PRIVATE USE AS NOTED. N e- _ ,J✓J� a.3 ��GE.fa�E �. �N. r _ M°r..'.:�" �" 0O fR.� 0 1E �llZl}(�l . l.a•In wr.n.Ilw NN w.> M o ~.ie 1.Ir.wI.I.•.sieH Y 7. Yj'f•(N ...Aq0� ._r L•_ � - 1 eaWRr•�•i'y{ R DATE l+wr. wwr Uwe.+Iu.N� SITE• �SZ P� li N`E i SEAL % 0 DARE)(/2 SUIS PROPERLY IS EXEMPT FROM OHNE COUNTY 1cc••ff .H1()'>0 1. - NOT•TO SCALE Of THE A E COUTIONS BY SFCTON 15401 %£ L 31 W a i RENEW OFFICERS CERTFIGLE NEA I OF THE DANE COUNTY CODE J- J �(;♦•.•7R>FR41P I'e' S.l;Zvj' . RENEW OWER a DANE COUNTY SEAL NO APPROVAL IS REQUIRED 81 THE �.(/ Y1 CERTIFY ME PIAT'TO WHICH TMS CERTIFICATION IS ATTACH :£ L 31W��ZYYYrrrrr] I •a c Vy 0� DANE COUNTY PLANNryO DEPARTMENT j°flANKV HEFTS SHE STITVigtY R RENEWS FOR RECORDWG %( 6ys ..Nr ywww.L1.•.Y,+. P + ?� R W OFFICER l-9_aQ2 - -/� vs a�A• InN nd,L_Q_M sI y/.L/LG .03 .. `� - - - i a•.>r..r.r qr E c.R.pN..I IN.1. MAIN CHURCH ROAD 0.— x6.05 TDT11 RIBBON PAVEMENT SR/1405 PUBLIC I - 29211-10 L.-----._._.__—.______— '— _L_.—__._ ,-20 Il'-+0-E- - NSI'-1'-10' - 9 4.06'i 1A _ rt„Y vNwa6 ASUsa1m 171.83' 7121 ry172.35 125.0566,M, 132W' 125.00' 150.6]' 175,00' 2OQ20 +33,80' o-1-aaz �• ; -1—CL ' 1 ,b r-eNI rwo . r' F�•+�^,�cJy 3 3/ +—THA s.w.Mloi wuw Lo•K Op rs 1 r y� '- 8 °'� P.w 1.¢L ' cc>A.rN4rsl�rw ]l pa 4_]w.� � � I O O ® O © !yRy i O "�' Hi••=� ;RONN MKL�i uIP, F•� "y $ _ M1y� 217917 SRFL ry h - u 1 u o = •N -299.67' 3.007/Ar_ O - - _ H A HM+ralANa/ l5 7 1216]86 S4.FL M1 - - I' 1 225380 SR.FL M I$ / / 1017 K. + i .• 5.171•.e. FN j m,.P9 a umNN.w,A/W 226091 Sy FI 5190 Ac • l M ooln w sur«roi p . j W I n it ♦ rryOet Qiu iL . A+uYa6 ,b X97!• �I e R 1 1 - 1 fo 2353w Aa L 0 1 4" ----------------- 217906 SgYL 217867 SRiL 218855 SR.Ft,V 7j 303182 5,11,4 ' 5.002 A. S.o02 Ae 5.024 Ae 6.965 - - 217927 SaFL 116001 SR.FI. /r • `H 1003 Ae 1000 AG 1', 2 4" Ce 11—A/w N 5T-30'-30-E- 777.91'TOTAL >a Dams W a vNNAmOT y `�C .l -+.LJ r,wisoeru]i uQl uv b- �rwP¢i �:274+1.3R.FL > 6 J 3.077 Ac 40.67 6.04' +J R r -� av raw I 4y 36 ..33' 6 O' 1 T t • Y3 a raw / --- _ 83' _477 "' 169. •• ----------- mar 0[�tamN1l 1-5-20'W 551.08'TOTAL d rOw CONIOLLED S 52-3 A=SS'-10- TOTAL '1 W S 54.-OJ'-30'W 47788'.]1'"' S 52'-30'-50-W 351M LtnImNA.Ian[� OI r ,�la•L,NCAA 989.6 pL E 1533926,31 6 Ill INTERSTATE 40 099 619�9 r - D FNDTOR 30 W _---______—__._ _ S JA-y n ------------------------------------------------DUAL LANE CONCRETE RIBBON PAVEMENT - _ - NOGS CR0558RACE- N 7976 825 - E 1533.16.566 OY44ER. _ LN. Bea..g IN--- 1 - EDWARO C. BARNHARDT A/W L7N 65'-115-20-E 141.64' - DORIS W BARNHARDT - L2 S T-56'-UO-E 162.03' 677 MAIN CHURCH ROAD - L3 S a5=25-30'W 59.21' - MOCKSVILLE NC 27022 - L1 9 1=+6-Io'w 1 PHONE 9 336-751-3675 L5 S 63'-53'-40-w 1,8.71" TAX MAP REF. 0 4 PARCEL 3307 TOTAL AREA 62.880 ACRESREFERENCE DEED 09 - ' REFERENCE DEED OB 598PCG1786 Q,MA. BARNHARDT ACRES MINIMUM SETBACK LINES + m1RlS"m C,LN" srA,E DATE ,IDB MM FRONT 40' EM... R166. Ch—B—IH9 ew DIA H ArC LIHIgtH AIOCKSV/LL£ DA VIE' rvC 5-OJ-OJ S-J01Ff REAR >. 30 [, 3766.46' N 55'-,1'-l0'E 1a6.61' 166.65' SIDE = 15' C2 3766.16' N 56'- - 30'-50-E 25.10' 24 t0' EACH LOT VILL BE SERVED BY SEPARATE SEVER SYSTEM C1' ]766.46' N 59'-51-50-C 421/2' 11135 . U 3766.16' N 6J'-15-10'E 28.74' 21]4' WATER SOURCE VYLC BE BY PRIVATE YELLS - ALL DISTANCE HORIZONTAL GROUND MCAnOIiy Land- Surveying, P.C. IRONS PLACED AT ALL CORNERS EXCEPT AS NOTED �QMO - Irr 868 West 4th S(reet Vfi ata SDlem,N.C.27101 -MIS PROPERTY IS SUBJECT TO ANY EASEMENTS,AGREEMENTS OR MONTS- - Ana - Q—~Du. Phone a 336-631-9805 ! - OF-WAY OF RECORD IF ANY,PRIOR 1HE DATE WH OF THIS PLAT AND ICH -rA6m�I7 w. - �W.w°'"s fox /336-724-2125 A.a n.a N..I.n. -./+ • WERE NOT VISIBLE AT ME TIME OF MY INSPECTION. -VA .Hw. SCALE, J-.T07' -ALL AREAS BY COORDINATES -TN M1 xNr^'� 200 100 O 700 Ip0 1 �. •� DAVIE COUNTY HEALTH DEPARTMENT • Environmental Health Section ;",-,. Soil/Site Evaluation APPLICANT INFORMATION PROPERTY INFORMATION Account #: 989900216 Tax PIN/EH#: 5739-49-7376-04 Billed To: Paul Willard Subdivision Info: Barnhardt Acres Lot#4 Reference Name: Location/Address: Main Church Road-27028 Proposed Facility: Residenc Property Size: 5 acres Date Evaluated: J L4 Water Supply: On-Site Well u Community Public Evaluation By: Auger Boring Pit Cut FACTORS 2 3 4 .5 6 7 Landscape position iL L L Slope% . 7n -2.0 2Z 2-Ac 3 220 HORIZON I DEPTH o•1 - O- 13 Zj Texture group CSL- G . G L L Consistence rr$ 5V Structure MineralogyL HORIZON II DEPTH - I 46 Texture groupSG r Consistence SV Structure Mineralogy HORIZON III DEPTH 1 '5- r' + - T Texture groupSC f Consistence ;