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121 Tyler Ct OPERATION PERMIT ar ►ce se n �s Pmt. Davie County Health Department *CDP File Number 12421 1 210 Hospital Street F"30-Ao-()s5 P.O.Box$48 County ID Number Macksville NC 27028 Evaluated For NEW _ Phone:336-753-6780 Fax:336.753-1680 Township: : 7dress: t: RS Parker Homes LLC Property owner. RS Parker Homes LLC PO Box 5927 Address: PO Box 5927 y: High Point City: High Point State)Zip: NC 27262 LPhone;#: NC 27262 Phone#: (336)442-1225 (336)442-1225 - Property Location & Site information Address/Road#: Subdivision: Essex Farm Phase: Lot: 65 121 Tyler Court Advance NC 27006 Directions Structure Hwy,64 East, Right onto Cornatzer, Essex Farm on SINGLE FAMILY left past Beauchamp Rd. #of Bedrooms: 4 #of People: *Water Supply: PUBLIC *IP Issued by. 2140 Nations,Robert 'System Classification/Description: TYPE It A CONY SYSTEM(SINGLE-FAMILY OR 480 GPD OR LESS) *CA issued by: 2140-Nations.Robert Sapralite System? ( Yes QNo Design Flow: 4 g 0 'Distribution Type; GRAVITY-SERIAL Pump Required? Q Yes ( No Soil Application Rate: 0 a 5 'Pre Treatment: Drain field Nitrification Field 1 9 a 0 Sq.ft. *System Type: INFILTRATOR QUICK STAND No. Drain Lines 9 Installer: FranxTransau Total Trench Length: 4 3 6 ft. Certification#: 2771 Trench Spacing: ()Inches O.C. Fest O.C. 'EH S: 2140-Nations.Robert Trench Width: 3 (Inches (Feet Date: 0 1 / 0 7 / 2 0 1 4 Aggregate Depth: inches Minimum Trench Depth: 3 6 Inches Minimum Soil Cover. a 4Inches AppravalyStatus Maximum Trench Depth:p 3 g ® Approved© Disapproved Inches Maximum Soil Cover, 2 4 Inches CDP Fite Number 124321 - 1 Septic Tank County ID Number: F8.0330•AO-065 Manufacturer. Shoaf Let. : STB: 760 Long ._ Gallons: loco Installer: FranakTransou Certification#: 277i Date: 0 8 / 2 4 / a 0 Z 3 *EH S.. 2140-Nations,Robert 'Fitter Brand: POLYLOK PL-122 with Pipe Adapter ST Marker: ❑ Yes 0 NO Date: 0 l y/Oy 34 /'i a 0 1 4 Reinforced Tank: ❑ Yes E NA . ............J / L ❑ Yes ® No �#��pr�rted❑��t�eppra�ed�� Pump Tank Manufacturer. Installer: PT: Certification##: Gallons: *EHS: Date: Date: RiserSealed ❑ Yes ❑ NA RiserHeight:-❑ Yes ❑ NO (Min.6 in.) ��'yi�y�co'1fat.'tt$tu //ice i emforced Tank:. El Yes ❑ No '%C] Appro�red❑ Ctisappt�ve 1 Piece Tank: ❑ Yes_ ❑ NA ' Supply Line - Pipe Size: inch diameter Installer. Pipe Length: feet Certification#: *Schedule: *ENS: Pressure Rated ❑ Yes ❑ NA Date: Approved fittings ❑ Yes ❑ NA Apprrnraltatus� / ��i/�❑;A,pprO�ed❑�Diws�ppr+�ted y� Pump Requirement Pump Type: Installer. Dosing Volume: - Gal Certification#: Draw Down: inches *EHS: *Chain: Date: Valves Accessible ❑ Yes ❑ No Flow Adjustment Valve ❑ Yes ❑ No Check-valve ❑ Yes ❑ Nom<Anoitat status PVC unions C1 Yes ❑ No ❑ Approv d�1 IsapprAved Vent Hole ❑ Yes ❑ No Anti-siphon Hole ❑ Yes 0 No i CDP File Number 124321 - 1 County ID Number: F8•030-A'-O" Electric Equipment N EMA 4X Box or Equivalent ❑ Yes ElN o Installer. Box 12 inches Above Grade ❑ Yes ❑ No Certification#: Box Adj.To Pump Tank ❑ Yes ❑ No Conduit Sealed ❑ Yes ❑ No *EHS: Pump M an u ally 0 p era ble ❑ Yes ❑ No *Activation Method: Date: I Approval Status Alarm Audible ❑ Yes- ❑ NO ,❑ AEbb roried❑ sapproved Alarm Visible ❑ Yes ❑ NO 32 - 2140-Nations,Robert *Operation Permit completed by: Authorized State Age - Date of Issue: 0 1 0 7 2 0 1 4 Owner/Applicant Signature: This system has been installed rin compliance with applicable NC General Statutes:Article 11, Chapter 130A, Rules for Sewage Treatment and Disposal,15A NCAC 18A.1900 of, Seq.,and all conditions of the Improvement Permit and Construction Authorization.This property is served by a TYPE 11 A sewage septic system. Rule.1961 requires that a Type TYPE 11 A. septic system meet the following criteria: Minimum System Review.ByThe Local Health Department: WA Management Entity: OWNER Minimum System Inspection/Maintenance Frequency By Certified Operator wA Reporting Frequency By Certified Operator. NIA Rule.1961 requires that a Type IV and V septic systems designed fora home/business owner must maintain avalid contract with a public management entity with a certified operator or a private certified operator for the life of the septic system. Rule.1961 requires that Type VI septic systems designed fora home/business owner must maintain a valid contract with a public management entity with a certified operator for the life of the septic system. Rule. 1961 (2)(e)requires a contract shall be executed between the system owner and a management entity prior to the issuance of an Operation Permit for a system required to be maintained by a public or private management entity, unless the system ownerand certified operator are the same. The contract shall require specific requirements formaintenance and operation, responsibilities of the owner and systems operator,provisions that the contract shall be in effect for as long as the system is in use,and other requirements for the continued proper performance of the system. It shall also be a cond Rion of the Operation Permit that subsequent owners of the systems execute such a contract. @Hand Drawing Ulmport Drawing **Site Plan/Drawing attached.** ;:'- Y OPERATION PERMIT 124321 - 1 Davie County Healthpepartment CDP File Number: 210 Hospital Street F8,030-AO-065 P.O.Box W County File Number: Mocksville NC 27028 Date: Olnch Drawing Drawing Type: Operatio n Permit- Scale: , OBbck ft. ON/A - h "�''' ,� s G � ✓' WWW , � 1 I FF �d r 1 - - - CONSTRUCTION For Office Use Only AUTHORIZATION 'CDP File Number 124321 - 1 VAII Davie County Health Department County ID Number: F8.030-AO.065 U- Mocksville 210 Hospital Street Evaluated For: NEW P.O. Box 848 NC 27028 PERMIT VALID UNTIL: Phone:336-753-6780 Fax:336-753-1680 1 1 / a 6 / a 0 1 8 Applicant: RS Parker Homes LLC Property Owner: RS Parker Homes LLC Address: PO Box 5927 Address: PO Box 5927 CRY: High Point CRY: High Point State2ip: NC 27262 State0p: NC 27262 Phone#: (336)442-1225 Phone#: (336)442-1225 Property Location & Site Information r dress/Road #: Subdivision: Essex Farm Phase: Lot: 65 21 Tyler Court dvance NC 27006 Directions Structure: SINGLE FAMILY Hwy 64 East, Right onto Comatzer, Essex Farm on left past Beauchamp Rd. #of Bedrooms: 4 #of People: 'Water Supply: PUBLIC System Specifications Minimum Trench Depth: a 4 Site Classification: 71nches s Minimum Soil Cover. Saprolite System? OYes QNo Design Flow: 4 $ 0 Maximum Trench Depth: 3 6 nes Soil Application Rate: 0 - a 5 Maximum Soil Cover: Inches 'System Classification/Description: 'Distribution Type: TYPE III B.SYSTEM WISINGLE EFFLUENT PUMP Septic Tank: 1 0 0 0 Gallons 'Proposed System: 25%REDUCTION 1-Piece: OYes QNo Pump Required: (E)Yes ONo OMay Be Required Nitrification Field 1 9 a 0 Sq. ft. Pump Tank: 1 0 0 0 Gallons No. Drain Lines 1-Piece: OYes QNo Total Trench Length: 6 4 0 ft GPM—vs— ft. TDH Trench Spacing: _ 9 8FInches t O C.0 Dosing Volume: _ Gallons Trench Width: 3 Inches _ (Feet Grease Trap: Gallons Aggregate Depth: 1 a inches Pre Treatment: ONSF OTS-1 OTS-II Septic Tank Installer Grade Level Required: 01011 O III OIV 1 Pagel of 3 -CDP File Number 124321- 1 County ID Number. F8-030-AO-065 ❑ Open Pump System Sheet Repair System Required:OYes ONo ONO, but has Available Space rDesign System Trench Spacing: ( Inches 0. . ification: Provisionally Suitable — 9 Feet O.C. Trench Width: Q Inches w: 3 o Feet Soil Application Rate: to 275 Aggregate Depth: 1 a inches .� Minimum Trench Depth: a 4 Inches 'System Classification/Description: TYPE III B.SYSTEM W/SINGLE EFFLUENT PUMP Minimum Soil Cover. 1 a Inches *Proposed System: CONVENTIONAL Maximum Trench Depth: 3 6 _ Inches Nitrification Field 1 7 4 5Maximum Soil Cover: a 4 Inches Sq.ft. No. Drain Lines 'Distribution Type: PUMP TO GRAVITY Total Trench Length: 5 8 1 Pump Required: Oyes ONo ()May Be Required Pre Treatment: ONSF OTS-1 OTS-II 'Site Modifications No grading or construction activity is allowed in areas designated for system and repair without approval of Health Department. 'Permit Conditions The issuance of this permit bythe Health Department in no wayguarantees the issuance of other permits.The permit holder is responsible for checking with appropriate goveming bodies in meeting their requirements. This Authorization for Wastewater System Construction shall be valid far a person equal to the period of validity of the Improvement Permit,not to exceed live years,and may be Issued at the same time the Improvement Permit Issued(NCGS 130A-336(b)}If the installation has not been completed during the period of validity of the Construction Permit,the Information submitted In the application for a permit or Construction Authorization is found to have been Incorrect,falsified or changed,or the site is altered,the permit or Construction Authorization shall become Invalid,and may be suspended or revoked(.193T(g)).The person owning or controlling the system shall be responsible for assuring compliance with the laws,rules,and permit conditions regarding system location,Installation,operation,maintenance,monitoring,reporting and repair (1938(b)). Applicant[Legal Reps. Signature Required? Oyes ONO Applicant/Legal Reps. Signature- Date: / *Issued By: 2140-Nations.Robert Date of issue: 1 1 / a 6 / a 0 1 3 Authorized State Agent: Malfunction Log Oyes z�� &Hand Drawing Olmport Drawing Total Time:(HH:I, M) **Site Plan/Drawing attached.** Page 2 of 3 a Hours 3 0 Minutes S-8-CKS issued-new ` CO.NSTRUCTION AUTHORIZATION Davie County Health Department CDP File Number: 210 Hospital Street F8-030-AO.065 P.O.Box 848 County File Number: Mocksville NC 27028 Date: 1 1 / 2 6 / 2 0 1 3 Qinch T e: Construction Authorization Scale: . 1 . ON/A = 5 Drawing Drawin .ft. 9 YP AA Q -t i ► <b,�n� I i i ! I i -L-j G i r, S1i -- - , - i \1! i i i I . I pane 3 of 3 • ' CONSTRUCTION AUTHORIZATION Davie County Health Department 210 Hospital street CDP File Number: P.O.Box 848 F8-030•AO-065 Mocksville NC 27028 County File Number: Date: 11 / 26 / 2013 Click below to import an Image from an external location: Drawing Type:Construction Authorization Paae 3 of 3 IMPROVEMENT PERMIT ForOfrce Use Oniv r*CDPFileNumber 124321 -1Davie County Health Departmentunty IO Number.F8-030-AO.065 i- 210 Hospital Street P.O.Box 848 Evaluated For: NEW Mocksville NC 27028 Township: Phone:336-753-6780 Fax:336-753-1680 PERMIT VALID UNTIL: 11/26/2018 *NOTE TO INSPECTIONS DIVISION: Building Permits cannot be Issued with this Improvement Permit. Applicant: RS Parker Homes LLC r roperty owner: RS Parker Homes LLC Address: PO Box 5927 ddress: PO Box 5927 City: High Point ity: High Point State2ip: NC 27262 State/Zip: NC 27262 Phone#: (336)442-1225 Phone#: (336)442-1225 Property Location & Site Information r ress/Road#: Subdivision: Essex Farm Phase: Lot: 65 21 Tyler Court dvance NC 27006 Directions Structure: SINGLE FAMILY Hwy 64 East, Right onto Comatzer, Essex Farm on #of Bedrooms: 4 left past Beauchamp Rd. #of People: `Water Supply: PUBLIC S stem Specifications n tial System (Seprolite Site Classification: Ica n: Minimum Trench Depth: a4 Inches System? OYes @No Maximum Trench Depth: 3 6 Inches Design Flow: 4 8 0 Septic Tank: 1 0 0 0 Gallons Soil Application Rate: 0 - 2 5 1-Piece: OYes GNo .� Pump Required: GYes ONo ()May Be Required *System Classification/Description: TYPE III B.SYSTEM W/SINGLE EFFLUENT PUMP Pump Tank: 1 0 0 0 Gallons 'Proposed System: 25%REDUCTION 1-Piece: OYes GNo Repair System Required:GYes ONo ONO, but has Available Space cssoiRepair System itl e Classification: Provisionally Suitable Minimum Trench Depth: a 4 Inches Application Rate: 0 - 2 7 5 Maximum Trench Depth: 3 6 Inches *System Classification/Description: Pump Required: (E)Yes ONo O Maybe Required TYPE III B.SYSTEM Vv/SINGLE EFFLUENT PUMP *Proposed System: CONVENTIONAL Pagel of 3 CDP File Number 124321 :- 1 County ID Number: F8-030-AO-065 'Site Modifications ❑ Open Fill Sheet No grading or construction activity is allowed in areas designated for system and repair without approval of Health Department. 'Permit Conditions The issuance of this permit bythe Health Department in no way guarantees the issuance of other permits.The permit holder is responsible for checking with appropriate governing bodies in meeting their requirements. Site Plan The Improvement Permit shall be wild for 5 years from date of Issue with a site plan(means a drawing not necessarily drawn to sate that shows the existing and proposed property lines with dimensions,the location of the facility and appurtenances,the site forthe proposed Wastewater system,and the location of water supplies and surface waters). Plat The Improvement Permit shall be wild without expiration with plat(means a property surveyed prepared by a registered land surveyor,drawn to a sale of one inch equals no morethan 60 feet,that includes:the specific location of the proposed facility O and appurtenances,the site for the proposed Wastewater system,and the location of water supplies and surface waters. Plat also means,for subdivision lots approved by the local planning authority and recorded with the county register of deeds,a copy of the recorded subdivisions plat that Is accompanied by a site plan that Is drawn to scale). The Department and Local Health Department may Impose conditions on the Issuanceand may revoke the permits for failure of the system to satisfy the conditions,the rules,or this article.This permit Is subject to revocation If the site plan,plat.or Intended use changes(NCGS 130A-335(o).The person owning orcontrolling the system shall be responsible forassuring compliance with the laws,rules,and permit conditions regarding system location,Installation,operation,maintenance;monitoring, reporting,and repair(.1938(b)} ApplicanVLegal Reps. Signature Required? OYeS ONO Applicant/Legal Reps. Signature, Date: 1 1 / a ? / a 0 1 3 *Issued By: 2140-Nations,Robert Date of Issue: 1 1 / a 6 / 2 0 1 3 Authorized State Agent: OValid without Expiration? O Create CA? 01-land Drawing Ol nport Drawing **Site Plan/Drawing attached.** Total Time:(HH:IAII) Hours I.1 inutes Page 2 of 3 Activiv Code: S4-IRS issued:new.valid for 60 mos. IMPROVEMENT PERMIT 124321 - 1 ' Davie County Health Department CDP File Number: 210 Hospital Street F8.030-AO.065 P.O.Box 848 County File Number: Mocksville NC 27028 Date: 1 1 / 2 6 / 2 0 1 3 Q Inch Drawing Drawing Type: Improvement Permit Scale: . 1 . ON/A01310 _ 5 0 QN/A ft. i , 1 , i , I I .—j Vu ---� - I I ; i Page 3 of 3 IMPROVEMENT PERMIT - Davie County Health Department 210 Hospital Street CDP File Number. 124321 - 1 P.O.Box 848 FS-030-AO-065 Mocksville NC 27028 County File Number: Date: 1 1 / 2 6 / 2 0 1 3 Click below to import an Image from an external location:Drawing Type: Improvement Permit Donal of Z DEPARTMENT OF TRANSPORTATION PLANNING DEPARTMENT/REVIEW-OFFICER E bW a Cess•Nary bY1 a2'pet ae.s.m,wN.mr aem.,.Nw •w11°01gp, DIVISION OF HIGHWAYS FINK SUBDIVISION PLAT APPROVAL a•+r aYRY w.R.mr m:Fw+pae.(a.eau+,•Aa+ew Y r9n 19II RDI61Mnow AT-.-.0'4aa1 AY❑ ti T• F•tt).tlM ae OmnawM M a• r!ar.aYNY MkN�1 `�.(N CAP NIS EASEMENTS M NWTS-0F-MAY ll/ ,SD NID IIECPOO N EXISTING SUBDIVISION ROADS ..ars a+"a� +w wr a aN uN,NY N>.wa,to wwW N t:ta.aao..w ar �i -( aa"+Yi.Yw ma++ iyrr�.r'i.w r..y a�pN.s ppw w eemau,p Na ai.r-a0 s Nm,.,ra �(}'•(�E� RE PAIOR TO NE DATE OF M mF ryM+YwwN/a nyrmwn n•„M M w tlwe_ NIS M •HENER VISIBLE NOT MM T 9saw AT N APPROVED AT PB 9 PG 366 N+a°iY„/°in1e""•„+'"^my"„rm„ym�+,�,aM wAr. wr N_-....-_ sw wr N N Lr0 ea.� _R F�('iE,L :1L•... M IM TITLE SFARLTI NOT PROVIDED. DATE 7,ALLY 2W8 - _ ,O ff rwN r.eaa M e,.4 WwN•bW Co.sy.r a orw wants,A.0L_ xc IEeapoas, - ESSEX. FUTURE A PHASE ARM EASEMENT wry- TµT J AREA FOR SEPTIC REPAIR •Yrs 8R „N FOR USE BY LOT 65 susama DISCLOSURE VARIANT Y ESSEX FARM O ALL NAnlmeD wsgwnrnT• vE New tr+rvtm AS wLwtsn EYWT Ia1 nr lrtTm I N.rr wiry aN ew wsuwn.,pa ws.n wr.an neA e.•AwnR Y I FUTURE PHASE NP60)tMp1•AOO MESE SHILL we eDSL%RC e1 INE raLawas brtSH awry Na,a•FanelY ewe•w+enulr +a a•ae yp,b•N a w I Ix L Oe4a 6 o1n FY IDat0.Nay Y w r mwe N•+ YRYW e 00T uR Lew,TPe,M I+nawNna Y a•Omw M tlM RK.i wet b•C.OW M Yal,wO/ wee"N N THE 61NMDa1.1 AY R[YaMtIN ICI! WW%'+r•4 o>rmwl N^Mean rA•MI wwur ome•+4 YNN eM I ' F 10'easement la use by -s. ewl alt pN+..M..a•e+p••+aM•+one N a-F r mw,*,rq " enrr YniW n+M N YaIWY aYme.+b Y+Ym,ea•II+I s a lot 65 for Installation and �+'wee+'+'•^•:a•orlolwl Nwa N YM ALL r N mR4eM r•W.Iww. I 12829 S FL malntmann of a• lla -b. �a w. a.+y N� N�a0« r ml.^p,rq mFLMI�wA stAl AMNCPVST�M -% N LLS9ATAND[MIX 1118 NrRG1S0 I Sq,rt. pump Ilne 7 a aN but rYl Y N•ew+r M M erYIW rasa r Nola M IYeI !)CMIATIw a ALL Nrsow,ENn 2'n WColllE Ae9w IOO.pp' L NIM.pN Y N a vrr N TILDE M N ar M 1M rwmMnNW N W wwTDuxce a ua REatRm NNIOAralewr wTa NOAeD 6n 1 I S'42'-2 100 GO' F e.w/,...m.Ma.aw r.�w°'.WFan a w w m- w4Tn UNIX 1 wK CDNn ummN 6 -0°'E 2 DIP.02, p e awmvL+. e0A0SH Acool III •02 _a._ -a NN tl+YMmYIYn•w=.V,= rY M O,w on Y aWl Hol 1 w w,M M mtln D)n1bV1•lal M NX r•!eeKDTIv[Ilt➢I a ANY LOT Mow W Nf R[CMO RAT MM A 11•a c a).N'• YIom,RP d 1a W.2'(M my aleY+IM MRIs N b Mrlpm NINn.1 Y,wnmrl DleaoNRle a wr stawl•u1utY roe coL:r ANo wwtANlw Ttr sequxro I� N w.wwp a ra. snNL`S Ano ne cornu. u) 33125 Sq•FL ,-------- Lu 3760!125 S4.Ft. 0.780 Aar/- (r0 IaAa+/-3 bNR a cAa Re bum em+vr eNe 'ESSEX FARMPhass 1' I PB 9 PO 290 7^y H$ mTyll W11PF1NVn a-AW(-.soan a aNau SYSTEMS II CAW OF epllll DAsa,u mwn a I Iw N"rya«.i twM�r.•n�"rrn"wuNON.T t s..nµn.�.:alX. Y L e+ww��YNn�r W w,n.a FMu..tilNy as �1 •�A �R R wr.WaNp��.r wN W r a:.'myNN w.mr.w a..W NOME q M tlN RmaugM N900wL 1w•I:NY Y,rlrw•,e4 I aY,+•�+Y I+MN wr•4 M�ILMMw wee M t RLb,oN ml Ma N NYp ra IW N� I I I i N P K Mltlw nMl al w N-aN WaoFna::wL Ast"mNN I Nrp I 1 N g wo-_NOTIx NO mrinNmcAaNan conflYn t 3 85118'-22'I A aeYnT d AWRNK a Au RMIVMYAL Lan N um f w' -x -O Sage' SAaI :I Fal NaAMANS,a NWAN fAcuT:a A+rr R+riNYW A.MSW W 6 E I JOOOS Sa.Ft 1 4 100. I I 'v' Davy Xwa Ontpa YF CamYYeA Dabs ••• _ -1 _• WYATRIVE T DR1,11 N28 �7p p0` 2 o9R (publ NOTES: top:at 41.p}• IRON PIPES SET AT ALL CORNERS l0p,p� UNLESS OTHERWISE NOTED 91,10E ALAN MOCK At lInM• o' umefor tion by ALL UTILITIES ARE UNDERGROUND WB 2000E 24648 _.+ � � �� lot 63 fa Installation and = malnlenonae of D seP11c 4 ry R 3 Pump on. DRIVEWAYS MAY NOT 8E INSTALLED 01�+ WITHIN 30 FEET OF A STREET INTERSECTION _ A�v ^' gs� k•,�T C� TYPICAL BUILDING SETBACKS: -� / " d a A +L d �`ti l,�j• 21MMERMAN FAMILY.LLC FRONT 45 FEET 1 DB 320 PG 663 REAR 30 FEET SIDE 10 FEET ` 1 a Iit& STREET SIDE 15 FEET 1 .F _ LENTH OF PUBLIC STREETS(this map): 736'+/- e,' Naa a9t - Ear oaR TOTAL AREA SUBDIVIDED(this map): 10,012 Aa+/- t • � eN_A- ' F- LOTS 1 AND 69 ARE SUBJECT TO A SIGNAGE CONSTRUCTION AND MAINTENANCE ALAN MOCK trust•• 1 + - 3 ( 3000ttsayl. + o,9 EASEMENT- SEE RESTRICTIVE COVENANTS PS 6 Po 274 v. $^ � W 0.689 A. .+/-k 12 lots we rioted by this plot with an awa9s N 30001 Sq.Ft. j1 el%e of 30,484 square feet.+/ •�, p gY $e QLt 0.689 Aa+/- 8 Curve Radius Chad Bowing and plotance All:L•n9th A R� n b N , m All lot*shown hereon will be eerwd by Public water, I u( ti y ! 1 No lots Mown hereon as affected by special flood howl C1 1599.37' N 74112'-50'W 304.13' ]04.61' t ) a`• a•ae os detamined from 1-11 flood map. C2 IS90.Jr N 60•-33'-38•W 50.03' 50.ON C3 1599.]7' N er-35'-03•W e as, 89.09' 1 i M1'Iro"➢ C4 35.00' S 59155'-01'E 26.84' 27.35' Sr M1� Cs 09.3r s 47143-2T E 10.12' 10.22• +a L_3, m THIS PLAT WAS PREVIOUSLY RECORDED IN PLAT BOOK C6 1399.07' N 63'-43'-Jt'W 126.]1• 126.35' C7 35.00' N 7v-s9'-OTE :e.e{• 2z5s' t soon Sq.FL 9 AT PAGE 088. IT IS BEING RE-RECORDED TO SHOW Ce 50.00• N 80123'-I3•E 46.er 48.79' N 3,- _�, .e}� \ 0.669 Aa+/- r A SEPTIC REPAIR AREA AND ASSOCIATED ACCESS C9 50.00' S 51110'-24'E 35.00' 35.76' 2 28'- p..�._ Cb NOTE:NATCHED AREA RECORDED EASEMENT FOR USE BY LOT 65. C10 50.00' S 10111•-55'E 35.00' 35.76• TTLER COURT }°•R -- p PB 9 PC 269 ON 1/31/03 C11 50.00' S!0'-{d'-J}•W 33.00' }3,76• 8 26'_0p• /W'(publle) 0 1 AT THE DAVIE CO.REGISTER IRONS SET FOR SEPTIC EASEMENT AREA C12 30.00' S 86130'-33'W 57.71• 61.32' !" -'3],07_ a �� S 77• OF DEEDS AND MAP REVISION DATE NOVEMBER 26,2013 3 760\ pOJ3' owna/devNopr;y4'-26� y 4-1 1 !);1 PSC DEVELOPMENT COR.INC. VICINITY MAP(no scale) OB i , sox (� m Boo Sa/ ) POC SVI 340 0.669 Ac.+/- A 30001.+/ MOCK36-75 73 27023 0.889 Ae.+/- pn.306-731-7000 N AN N w Na.aW Yl..so.r N FNa+wr W erlame 10.29' .r �1 ;!'> p'eJ. 30001 54 Ft 0 Y 0.669 Aa.+/- �A 100 SO 0 1�p LEGEND i as M Line Surveyed(a cdcNat•d) -- 1nrs;y,1• --_C7___ Be".�.Il.ta•L 17,e N 0'-1'-Oe'W PLAT MAP OF "`ref ---' ---rn ESSEX FARM Phase I-B, revised Line Not SurNgad ---- YwN.a -N 39'-10'-48'W S2a12' Iron Found • CORNATZER ROAD SR 1616 to m loo' AREA BY COORDINATES 41^'ryed by CJ\DH�'✓C Pointhotmaum•nt•d _® 40'R/W ON NORTH SIDE WHERE 21 DEC 2007 PRECISION 1 1 10.000+ drp1l•e b Dec Syan a GeN -... Y Caa•b monument ADJOINING SUBDIVISION(TOTAL OF 70') pAV1E C0.Na SHADY GROVE 70MNSNIP Poral Pa• OTHERWISE 60'R W PUBLIC Sanitay Sew Yon Hde / (PUBLIC) PARCEL ID6 FBOOD00022 Well Electrk Owh•od Une1 DB 713 PG BIB Street Address Em C E S %FORESTRY t SURVEYING Job 07072PiBrev "Itourg,NC 27373 338 769-4673 r •s APPLICATION FOR SITE EVALUATIONAMPROVEMENT PERMIT & ATC ,PAID Davio County Environmental Health A� P.O.Bo 848/210 Hospital Street 4 e r Mocksville,NC 27028 Its" 0l - (336)753-6780/Fax(336)753-1680 /�/ � - Application For: e Evaluation/Improvement Permit ❑Authorization To Construct(ATC) ❑ Both Type of Application: (New System ❑Repair to Existing System . ❑Expansion/Modification of Existing System �Facili ***IMPORTANT***THIS APPLICATION CANNOT BE PROCESSED UNLESS ALL OF THE REQUIRED INFORMATION IS PROVIDED. Refer to the INFORMATION BULLETIN for instructions. APPLICANT INFORMATION Name. �c�1�P; HO—NIPS LLC Contact Person( Address P10 aO,Y 69v27 Home Phone �1 City/State/ZIPoq;Gj i�f /UL 77a-6 2 Business Phone ;,3 3 VgyZ /2,,25 Email Email: �, ys�,"� 6, js,, h - ,- was-�o 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: ❑ Site Plan ❑Plat(to scale).:, (Permit is valid for 60 months with site pt., ,no expiration with co let'plat.) Owner's Name QS�N�( �b*c-) t a s 4L I Phone Number. Owner's Address City/State/Zip Property Address City Lot Size Tax PIN# Subdivision ame(if applicable) S 5 Px •s M 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 .-1110- Does the site contain jurisdictional wetlands? Yes so Are there ariy easements or right-of--ways on the site? s No Is the site,subject to approval by another public agency? _Yes `No Will wastewater other than domestic sewage be generated? Yes IF RESIDENCE FILL OUT THE BOX BELOW #People #Bedrooms _ #Bathrooms Garden Tub/Whirlpool ❑Yes o Basement: ❑Yes o. : Basement Plumbing: ❑Yes lido 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: t�,Cbnventional ❑Accepted ❑Innovative ❑Altemative ❑Other Water Supply Type: 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 L901 If yes,what type? " This is to certify that the information provided on.this application is true and convect 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 t responsible for the proper identification and labeling of property lines and corners and locating and ging or taki house/facility location,proposed well location and the location of any other amenities. Property owne—s , wner's lega 'presentative signature Site Revisit Charge Date(s): j Client Notification Date: Date EHS: f Sign given ❑Yes ❑No Account# Revised 11/06 Invoice# R-20 SETBACKS• FRONT: 30' SIDE: 15' SIDE: 25'(STREET) REAR: 30' soo•1z•sep \ SETBACK 65 / \ PROPOSED �o RESIDENCE ,s.2V 22-2V SETBACK ` PROPOSED RESIDENCE 0, UTILITY EMENT to ' 51E +. Ca=ss 00 RAD-s0' ass TYLER COURT 13.1r I ?x 50' R/1I (PUBLIC) ,a 8.50 ys,�• m 18.83' HOME DIMENSIONS PRELIMINARY NTS PLOT PLAN FOR. RS PARKER HOMES LOT 65 OF ESSEX FARMS, PHASE 1—B P.B. 9 PC. 388 GRAPHIC SCALE 40 ° 1111� 40 so Rmial 61imm6g, Inc. 100 Camegle Place Gmmboro,NC 27409 R m:3364524M*Fax 33MR4766 1 inch = 40 ft. NCBEL.S C-0950 DATE 09-19-13 REF: PRW\1831-01\dwg\ESSEXFARM.dwg APP ION FOR SITE EVALUATION/IMPROVEMENT PERMIT&ATC D Q� Davie County Environmental Health u J 2Q 2 P.O.Box 848/210 hospital Street Mocksville,NC 27028 e(I/ oo\ (336)751-8760/Fax(336)751-8786 ENS pP�'(App�ii or: O'Site Evaluation/Improvement Permit ❑Authorization To Construct(ATC) ❑Both ype 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 -ilk 73 Name to be Billed ASC 1)c'✓66oP".rm r mit, Contact Person 7,'Y iAy ,&(7c v,C Billing Address A.*-A6X d./o Home Phone City/State/ZIP_�foCCswc� JC- Z lot B Business Phone. 7S/- 7.3oo 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:❑Site Plan lat(to scale) (Permit is valid for 60 months with site plan,no expiration with complete plat.) Owner's Name_�,Glsy��oPrrc��i c��iAG Phone Number 7S/-7.3-10Owner's Address 40 doh 116:� City/State/Zip Property Addr ss City Lot Size �, Tax PIN#�� r Subdivision Name(if ap licable) ES = Sectio ot# O Directions To Site: C S 2 Z4-0J,1, Aifk6mG►�21 f cc./ r If-the answer to any of the following 4uestionslis"yes",supporting documentatiogg must be a ched. Are there any existing wastewater systems on the site? ❑Yes 2p Does the site contain jurisdictional wetlands? ❑Yes❑ 0 Are there any easements or right-of-ways on the site? 14es❑ o Is thesite subject to approval by another public agency? ❑Yes EW IN wastewater other than domestic sewage be generated? Dyes l3No IF RESIDENCE FILL OUT THE BOX BELOW #People #Bedrooms �— #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: 6-Conventional ❑Accepted ❑Innovative ❑Altemative ❑Other Water Supply Type:Otounty/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 s r oro er's legal representa' re Date(s): Client Notification Date: Date EHS: Sign given ❑Yes❑No Account# Revised 11/06 Invoice# DAVIE COUNTY HEALTH DEPARTMENT • Environmental Health Section Soil/Site Evaluation APPLICANT INFORMATION PROPERTY INFORMATION Account : 99 Tax PIN/EH#: 58[u_tA-ZZ60:60 Billed To: PSC Development Corp. Inc. Subdivision Info: Essex Farm Lot#65 A, Reference Name: Brad Coe Location/Address: Cornatzer Rd-2700 Proposed Facility: Residence Property Size: 0.689 Acre Date Evaluated: g 1 1 7 . Water Supply: On-Site Well Community Public Evaluation By: Auger Boring Pit Cut FACTORS ?j 8 I lob 416(o fl to t 6 7 Landscape position Slope% o HORIZON I DEPTH 0—Ii- O-ZWD -_3o- Jp Texture group C-2 i 5; a Consistence A-- Structure Mineralogy HORIZON II DEPTH ' - -ZsI - 3 • o-/ A-4 Texture" ot► f, C S,-G4 q P 5,C_4-,4 G Consistence LITO Structure Mineralogy HORIZON III DEPTH -. 2 t Texture group Consistence ` Structure Mineralogy' HORIZON IV DEPTH - Texture ^rou Consistence. Structure Mineralogy SOIL WETNESS RESTRICTIVE HORIZON: `- SAPROLITE 1 CLASSIFICATION' .— j Cls LONG-TERM ACCEPTANCE RATE .ZSj1 o-Tii- SITE CLASSIFICATION: EVALUATION BY: LONG-TERM ACCEPTANCE RATE: OTHER(S)PRESENT: 70 REMARKS .. LEGEND Landscape-Tosi ion-- R Ridge- t S.-,,Shoulder L-Linear slope FS-Foot slope N-Nose slope CC-Conc_ave•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 CONSISTF,NCF, - VFR-Very friable FR-Friable FI-Firm VE-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 Mineralor-v 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 DCHI)05/05(Reviced) Davie County Environmental Health P.O.Box 848/210 Hospital Street Mocksville,NC 27028 (336)751-8760/Fax(336)751-8786 Account M 990004425 IMPROVEMENT PERlW1IN/EH M 5870-64-2265.65 Billed To: PSC Development Corp. Inc. Subdivision Info: Essex Farm Lot#65 Address: PO Box 340 Location/Address: Cornatzer Rd-27006, City: Mocksville Property Size: 0.689 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: ❑New ❑Repair. ❑Expansion Permit Valid for: 05Years ❑No Expiration Residential Specifications: #Bedrooms #Bathrooms #People Basement❑ Basement plumbing❑ Non-Residential Specifications: Facility Type #People #Seats Square Footage(or Dimensions of Facility) DesignFlow(GPD): Type of Water Supply: ❑County/City ❑Well ❑CommunityWell Site Modifications/Permit Conditions: System Type LTAR Initial Repair Site Plan Environmental Health Specialist Date -Vxmz MR PRUSO RY HNN80 PIMPON3 OILY. ALL IDIS OLL ream 7! AP/IOMY.m TW CMWfY WM CEPMOM oa ON A LOT N IOf WOL TM IMP Z Do"SY UM AS A COOK OUOE.9011E ADA6SRO M OLL 8E ROCES W N 1NE FED CK 10 SOL OVO AW AMD 70P00RAPU0 BMEO AAAMM , 116 MV OILY 1EFIECIS VORM SOL 3MBUT FOR ON-M SWW TNN"SM 806E DRER COI®OEIMMMNS VW IWEOf WE SUMS M 11FD SIMIAD R CORSIOnIm N caummo f OE91011 AME. r) 10$Env=IIMY N1019f y UE 10C SEM CK FRW AOf OELL 00'senwx room 80WAF.P06MS an URL Va e II bo O 60 LOT 6 5 C) <o -1 0 —OLU 66v "wa 50'x- house 4 BR dr;►'e 1500 g tanks • u repair lines dashed GRAPHIC SCALE 1" = 50' 50 0 50 100 BASE MAP PROVIDED BY CLIENT j SHW wm Priam wmn cm MIO w".m ow ' swm SYSHM LOOT ESM FARMS Soil & Environmental Consultants, PA R SKETCH MAP oc t.PMO n nc e.C—A rM o.++.e.Nw owoaalls.H.ow M-"* � o�c faMMti AOAN owaPw 1ov a ao "A"°'"E I`~KC=ff"A""°PAR ONLY. r �,MV MO Fl E LAYO UT APMI0IRL W liE OglMIY NF/twvmmLTI OEPARMMM ON A IAf BI IAf 9186. 7FES MAP "UD r USD AS A COEVAL WM SOME AM MEMS ME.L!E MELEE W N 111E "m~NIUMMM& ms Mw aur Nn==mum sm 9MdS m FOR OK-SRE so=wa srs nm SSE ORER COINVERiO O THO MT W WE SU MM TW SHDUD K CaBOEUED N 0EVEUWV0fr CSM AND 1) 1W SETBACK FRCP FROFEMY IPE low SETBACK FROM AMY ML aD'SUSVK FROM SM M;F0105 OR tAKrL sr.asapapq$am opal RSO 6� �Z c� RED 36, "CSO P1BLUE 131' �? 80. i� ti,�Gso' 50'x3 6Q j 1 house 1 65 GRAPHIC SCALE 1" = 50' 50 0 50 100 BASE MAP PROVIDED BY CLIENT stEfr ratr<: NOIELF INE ■+p t CK m"W so rim" SEM SYSMM SKEMN ,,,,vu''01JT MM FAW Soil & Environmental Consultants, PA $ aAMe amore aMul oKnluA EM,.,ea,n:><C.o�n..A�..,Cr..�.M.Fa•F9w a.o�s+aa.R.a.0 M7•fat K0V�Mm Appraisal Card Page 1 of 1 DAVIE COUNTY NC 11/18/2013 10:18:27 AM PSC DEVELOPMENT COR INC Return/Appeal Notes: F8-030-AO-065 121 TYLER CT UNIQ ID 968455 SPLIT FROM ID 9568 2528109 NN:08-DMSION OF REAL ESTATE ID NO:5870635446 COUNTY TAX(100),FIRE TAX(100) CARD NO.1 of 1 eval Year:2013 Tax Year:2014 LOT 65 ESSEX FARM PHASE IB 0.690 AC 1.000 LT SRC= Appraised by 17 on 09/17 013 07002 MOCKS CHURCH TW-07 C- EX- AT- LAST ACTION 20130917 9 CONSTRUCTION DETAIL MARKET VALUE DEPRECIATION CORRELATION OF VALUE OTAL POINT VALUE .Eff. BASE O BUILDING USE MOD Area UAL RATE RCN EYB AYB REDENCE TO ^' 1 ADJUSTMENTS 97 00 %GOOD EPR.BUILDING VALUE-CARD OTALADJUSTMENT TYPE:Vacant EPR.OB/XF VALUE-CARD � ACTOR MARKET LAND VALUE-CARD 48,45 OTAL QUALITY INDEX STORIES: OTAL MARKET VALUE-CARD 48,45( Z OTAL APPRAISED VALUE-GRD 48,45 -i OTAL APPRAISED VALUE-PARCEL 48,45 n OTAL PRESENT USE VALUE-PARCEL S OTAL VALUE DEFERRED-PARCEL CZ OTAL TAXABLE VALUE-PARCEL 48,45C ., PRIOR UILDING VALUE BXF VALUE -AND VALUE RESENT USE VALUE EFERRED VALUE OTALVALUE PERMIT CODE I DATE NOTE I NUMBER AMOUNT OUT:WTRSHD: SALES DATA FF. ECORD DATE DEED INDICATE SALES OOK 10PAGE M0WjY TYPE L/l/i PRICE HEATED AREA NOTES SUBAREAUNIT ORIG% SIZE ANN DEP % OB/XF DEPR GS RPL OD UA DESCRIPTIO T NIT PRICE GOND LDG / FACT V RATE V COND VALUE TYPE AREA CS OTAL OB/XF VALUE REPLACE d SUBAREA TOTALS — BUILDING DIMENSIONS T co NO INFORMATION 0 IGHEST THER ADJUSTMENTS TOTAL w ND BEST USE LOCAL FRON DEPTH/ LND COND ND NOTES O LAND UNIT LAND UNT TOTAL ADJUSTED LAND LAND SE CODE ZONING TAGE DEPT SIZE MOD FACT RF AC LC TO OT TYPE PRICE UNITS TYP ADJST UNIT PRICE VALUE NOTES FR RES 0100 0 0 1 1.0000 1 0 0.8500 57,000.0 1.00C IT 0.85 48,450.00 48450 c c OTAL MARKET LAND DATA 48,450 OTAL PRESENT USE DATA http://maps.co.davie.nc.us/ITSNet/AppraisalCard.aspx?parcel=F803OA0065 11/18/2013