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865 Main Church Road Lot 3 Davie County,NC Tax Parcel Report Wednesday, October 19, 2016 169 809 823 ai C/Rcy�i' 871 55 845 944 791 X9$0966 ', 865 956 +� 1 924 ', ' 957 ! t C f` 118 z ; O� 140 Q 0, r'-- '? ;��•U 112 152 'co t� f 1 4175 '. 179 -i65 \179 ;. WAI2NMG: THIS IS NOT A SURVEY Parcel inlnnrlµllt"11 Parcel Number: G409OA0003 Township: Mocksville NCPIN Number: 5739386765 Municipality: Account Number: 82524310 Census Tract: 37059-806 Listed Owner 1: SECRETARY OF HOUSING AND URBAN Voting Precinct: NORTH MOCKSVILLE COUNTY Nlailing Address 1: ATLANTA HOMEOWNERSHIP CENTER Planning Jurisdiction: Davie County City: ATLANTA Zoning Class: DAVIE COUNTY R-A State: GA Zoning Overlay: Zip Code: 30303-0000 Voluntary Ag.District: No Legal Description: LOT 3 BARNHARDT ACRES Fire Response District: MOCKSVILLE Assessed Acreage: 5.20 Elementary School Zone: WILLIAM R DAVIE Deed Date: 412016 Middle School Zone: NORTH DAVIE Deed Book/Page: 010150416 Soil Types: GnB2,MsC Plat Book: 0008 Flood Zone: Plat Page: 032 Watershed Overlay: DAVIE COUNTY BuildingValue: 171000.00 Outbuilding&Extra 6000.00 Freatures Vaiue: Land Value: 24460.00 Total Market Value: 201460.00 Total Assessed Value: 201460.00 0 Dry 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 N C or arising out of the use or inability to use the GIS data provided by this website. DAVIE COUNTY HEALTH DEPARTMENT • Environmental Health Section P.O.Boz 848/210 Hospital Street Mocksville,NC 27028 (336)751-8760 Account #: 990001679 Tax PIN/EH#: 5739-38-6765 Billed To: Edward Barnhardt Subdivision Info: $xUZ.N`t j9RD1' X devz$ LotAF Reference Name: Location/Address: Main Church Road-27028 Proposed Facility: Residence Property Size: 5.190 acres ATC Number: 4533 As stated in 15A NCAC 18A.1969(5) accepted Systems may also be usetld 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 Tre tment and Disposal Systems). THIS AUTHORIZATION FOR WAS CT10 S A R A PERIOD OF FIVE YEARS. Environmental Health Specialist's Signa e: 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.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 eriod of time. 6O� 1 12>irl-3 Z e" 7�e CQ 4 S fiFZ t t Z r -ZY G" 3 11 V - ?A CW6. 98 = -_ 441-( -- 'Its , --.� soe f 4 , Septic System Installed By: Environmental Health Specialist's SignaturDate: Z— DCHD 05/99(Revised) DAVIE COUNTY HEALTH DEPARTMENT • Environmental Health Section P.O.Boz 848/210 Hospital Street " Mocksville,NC 27028 (336)751-8760 IMPROVEMENT/OPERATION PERMIT Account M 990001679 Tax PIN/EH M 5739-38-6765 A Billed To: Edward Barnhardt OV Subdivision Info: t51gfetvhp��,4LTZc5 Lot #3 Reference Name: Location/Address: Main Church Road-27028 Proposed Facility: Residence Property Size: 5.190 acres e ATC Number: 4533 **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 4&ZC #People #Bedrooms #Baths 2— Dishwasher: Dishwasher: ❑ Garbage Disposal: ❑ Washing Machine: ❑ Basement w/Plumbing: ❑ Basement/No Plumbing: ❑ Commercial Specification: Facility Type WELL- #People #People/Shift #Seats Industrial Waste: ❑ Lot Size J5 QcQ� W Type Water Supply ELL- Design Wastewater Flow(GPD)t=42J-.-,0 Site: New 200,Repair❑ System Specifications: Tank SizJVQ0 GAL. Pump Tank GAL. Trench Width cam-i Rock Depth I Z" Linear Ft. Other: ALA--]WWT n1(j F—LOW WV Vj: 'S h imp-I&I-o'1 Required Site Modifications/Conditions: A)SrALL 0,) CPV7 t:� J >p,- IMPROVEMENT/OPERATION p IMPROVEMENT/OPERATION PERMIT LAYOUT- APPROVED EFFLUENT FILTER RISER(S)IF 6 BEL7this FINISHED GRADE. ****NOTICE: Contact a representative of the Davie County Health Department for final inspectistem between 8:30 a.m.to 9:30 a.m.or 1:00 p.m.to 1:30 p.m.on the day of installation. Telephone#is(336)751-8760. _,95I As stated in 15A NCAC 18A.1969(5 20' . t I71q, uccepted Systems may also be used �V1= 10 D F&VV I— lA� p 114 ti--ToaZ l9R'TO 3W-nja1-tf,.I U aCV,V, a•J S�S'r Envi onmental Health Specialist's Signature: e: DCHD 05/99(Revised) i o• APPLICATION FOR SITE EVALUATION/IMPROVEMENT PERM Davie County Health Department O Environmental Health Section P.O. Box 848/210 Hospital Street AUG Mocksville, NC 27028 9 (336)751-8760 QV{�/ ft ***IMPORTANT*** THIS APPLICATION CANNOT BE PROCESSED UNLESS ALMN.VMjrj1 �a INFORMATION IS PROVIDED. Refer to the INFORMATION BULLETIN for ins 1. Name to be Billed liy/�d' �t � Y/L�f��O✓ Contact Person Mailing Address G�$ [J/itX//✓L�f� /f�� Home Phone City/State/ZIP ��f[ le c 9O'-'O Business Phone /�( �"g, 2. Name on Permit/ATC if Different than Above Mailing Address City/S ate/Zi144 A441 p �O + PP % �L opvvlr 3. Application For: Site Evaluation Im rovemen Permit/ATC ❑ Both a. System to Service: ❑ House 6d'Mobile Home ❑ Business ❑ Industry ❑ Other 5. Type system requested: ❑ Conventional ❑ conventional modified ❑ innovative 6. If Residence: # People # Bedrooms # Bathrooms Dishwasher []Garbage Disposal Washing Machine ❑Basement/Plumbing ❑Basement/No Plumbing 7. If Business/Industry /Other: verify type # People # Sinks # Commodes # showers # Urinals # Water.Coolers IF FOODSERVICE: # Seats Estimated Water Usage (gallons per day) 8. Type of water supply: 13County/City M well ❑ Community 9. Do you anticipate additions or expansions of the facility this system is intended to serve? ❑Yes ❑No 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 with THIS APPLICATION. Property Dimensions: 57 a WRITE DIRECTIONS(from Mocksville)to PROPERTY: 17 Tax Office PIN: "Oj j�' l S8�Qy ►'� `1�-`�—�r Property Address: Road Name � I/ M G'4!�' �- G2�- 1 City/Zip (if'(S't'6�1 If in a Subdivision provide information,as follows: Name: I'/1/ Section: Block: Lot: Date home corners flagged: This is to certify that the information provided is correct to the best of my knowledge. I understand that any permit(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 am responsible for all charges incurred from this application. I,hereby,give consent to the Authorized Representative of the Davie County 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 suitability. DATE SIGNATURE THIS AREA MAY BE USED FOR DRAWING YOUR SITE PLAN(Include all of the following: Existing and proposed property lines and dimensions, structures, setbacks, and septic locations). Site Revisit Charge Date(s): Client Notification Date: EHS: Sign given Account No. IIU Revised DCHD(05/03 Invoice No. 3 i\ G` 9 �7 �s I 5.000A 8096 5.003A 8889 5.190A 6765 5.013A c 4667 w 4 J 3 245 244 20 (64 � DAVIE COUNTY HEALTH DEPARTMENT • Environmental Health Section PO Box 848/210 Hospital Street Mocksville,NC 27028 Phone: (336)751-8760 /Fax: (336)751-8786 August 16,2004 Edward Barnhardt 677 Main Church Road Mocksville,NC 27028 Re: 2-5+Acre Tracts/Main Church Rd Tract 3 Tax PIN#: 5739-38-6765 Tract 10 Tax PIN#: 5739-49-9635 Dear Client: As requested, a representative from this office visited the above site(s)August 12 and 16,2004 to perform site evaluations. Based on information provided on the Application for Site Evaluation and results of the evaluations,both tracts are classified provisionally suitable for the installation of on-site wastewater systems. It should be noted that a pump station may be required on tract 10 due to topography, soil conditions and/or house location. System design will be determined at the time an Improvement Permit is applied for and issued. Before a representative of this office will revisit the site to issue an Improvement Permit/Authorization to Construct,the appropriate application must be completed and submitted to this office. The location of the facility the system is to serve must be staked off. If you have any questions, feel free to contact this office at 751-8760. Sincerely, Jeff . Beauchamp,R.S. Environmental Health Section Enc(s) DAVIE COUNTY HEALTH DEPARTMENT Environmental Health Section Soil/Site Evaluation APPLICANT INFORMATION PROPERTY INFORMATION Accdunt #: •990001679 Tax PIN/EH#: 5739-38-6765 Billed To: Edward Barnhardt Subdivision Info: Reference Name: Location/Address: Main Church Road- 7028 Proposed Facility: Residence Property Size: 5.190 acres Date Evaluated: L Water Supply: On-Site Well Community Public Evaluation By: Auger Boring �✓ Pit Cut FACTORS 1 2 3 4 5 6 7 Landscape position [_ Sloe% 19 Zo 10 HORIZON I DEPTH O— t E,54CA, O Texture group 'S:C t_ G�Consistence Structure Mineralogy' HORIZON II DEPTH Texture group C Consistence S5 Structure Mineralogy i HORIZON III DEPTH Texture group Consistence Structure Mineralogy HORIZON IV DEPTH Texture group F Consistence Structure Mineralogy SOIL WETNESS RESTRICTIVE HORIZON SAPROLITE c%— CLASSIFICATION LONG-TERM ACCEPTANCE RATE ` SITE CLASSIFICATION: EVALUATION BY: LONG-TERM ACCEPTANCE RATE;/© 2'0, 2� 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 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 Wet NS-Non sticky SS-Slightly sticky S-Sticky VS-Very Sticky 7 NP-Non plastic SP-Slightly plastic P-Plastic VP-Very plastic j 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 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 05/99(Revised) ■■■■■■■■■■■■■■■■■■■t■t■■e■t■■��■■■■■■■■e■■/■■■■■■1/t■■et■e■■■■■OMEN■ ■■■■■/■e■■e■■■■■■■■■■■■■e■■ete■■ ■■■/e■■■■■t■t�iee/■e■ee■e■■■■■e■■ iiiiiiEMMONSiiiiiii MENNENMOMERiMENNENMEMNON ■■■■■■■■■■/■■■■■■■■■■■■■■■■■got■■■■■■■■■■■■■■■■1�■■■■■■■■■■■■■■■■■■■ Ronson ■■■■■■■■■■■■■/■■■■■■■■■■■■/'�■■■/■■/■■■■/■■■til■//■//■■/■■■■■■■■■■■■ ■■e■et■■e■■■/■/■■■■■■■e■■■■/■■■■■■■■■■■■■■■ell■■■e■■■■e■■/■■■■■■■■■ ■■■■e■■■■■■■■■■■■■■■■■■■■■r1■■■■e��cue>t■e■■■tiiet■e■e/■■/ee■■■ee■■e/■ ■■e■e■■e■■■■t■■■Mee■/■■/■e■■/■e■ ■■■■�e■e■r�■/■■e■/■■■e/■■■■e■e■■■ ■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■rye:::!■■■1\■■■'/■■■■■/■■■■e■■■■■■■■■■■ ■//■//■//■/■■/■■■■/■■■t■■/■■■■elle■/�l■■■\■■■■t■■■■■■■■■■■■■■/■■■■/■ ■■■■■■■■■t■■■■/■■■e■/■■■■I�t�■I.111■■ ■■■■■■�■�■■ee■/ee■■t/■■■■■e■■ee■ ■■■■■■ee■e■■■■/■t■e■/■■■�l■ee■■/■ ■■■■■■e��■■/■ee■■e■■■e/■ee■■ee■■■ r r • . 1 • • DAVIE COUNTY HEALTH DEPARTMENT Environmental Health Section PO Box 848/210 Hospital Street Mocksville,NC 27028 Phone: (336)751-8760 /Fax: (336)751-8786 August 16, 2004 Edward Barnhardt 677 Main Church Road Mocksville,NC 27028 Re: 2-5+Acre Tracts/Main Church Rd Tract 3 Tax PIN#: 5739-38-6765 Tract 10 Tax PIN#: 5739-49-9635 Dear Client: As requested, a representative from this office visited the above site(s)August 12 and 16,2004 to perform site evaluations. Based on information provided on the Application for Site Evaluation and results of the evaluations,both tracts are classified provisionally suitable for the installation of on-site wastewater systems. It should be noted that a pump station may be required on tract 10 due to topography, soil conditions and/or house location. System design will be determined at the time an Improvement Permit is applied for and issued. EPem-iit/AuthonrLzation re representative of this office will revisit the site to issue an Improvemen to Construct,the appropriate application must be completed and this office. The location of the facility the system is to serve must be staked If you have any questions, feel free to contact this office at 751-8760. Sincerely, j Jeff . Beauchamp,R.S. Environmental Health Section Enc(s) ,4-j 0 4-a