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153 Finn Hollow Lane Lot 2Davie County, NC Tax Parcel Report Wednesday, November 9, 2016 901 All date Is provided as Is withoutwmranty or guarantee of any Idnd either expreased or Implied Including but not limited to the Davie County, Implied wanantles of merchantability or fitness for a particular us a Ag users of Davie County's GIS website shall hold harmless the County of Davis. Norm Carolina, its agents, eonsufiams, contractors or employees from any and all Balms or causes of action due to X01"' NC or arising out of the use or Inability to use the GIS data provided by this websfie. 182 12'e Information - 75 174 134 139 Parcel Number., 162 11 Township: Shady Grove 142 5870435913 Municipality: i Account Number., 82526063 Census Tract: 37059-803 _____ 45,,,-\, 57 WEST SHADY GROVE 155 d59 o 49 152 15'6 m- _ r 162 D r � 1Q ---- --- 147 p `_,154 h�`�.� 39 ON 27006-7344 Voluntary Ag. District: No 12 6 LOT 2 SUTTON & MARTIN Fire Response District: ADVANCE 127 115 . Elementary School Zone: 153 2669 119 Middle School Zone: WILLIAM ELLIS Deed Book / Page: JG o 338 Soil Types: GnB2,GaD,WATER Plat Book: 0010 Flood Zone: 6 107 Watershed Overlay: 2661 Building Value: 355930.00 Outbuilding & Extra 0.00 2653', ,%��0 � CGRNq� Freatures Value: Land Value: 2639, Total Market Value: 417710.00 Total Assessed Value: 417710.00 G� 901 All date Is provided as Is withoutwmranty or guarantee of any Idnd either expreased or Implied Including but not limited to the Davie County, Implied wanantles of merchantability or fitness for a particular us a Ag users of Davie County's GIS website shall hold harmless the County of Davis. Norm Carolina, its agents, eonsufiams, contractors or employees from any and all Balms or causes of action due to X01"' NC or arising out of the use or Inability to use the GIS data provided by this websfie. WARNING: THIS IS NOT A SURVEY Information - _-Parcel Parcel Number., G800000O0508 Township: Shady Grove NCPIN Number: 5870435913 Municipality: Account Number., 82526063 Census Tract: 37059-803 Listed Owner 1: SUTTON ROBERT D Voting Precinct: WEST SHADY GROVE Mailing Address 1: 153 FINN HOLLOW LANE Planning Jurisdiction: Davie County City: ADVANCE Zoning Class: DAVIE COUNTY R -A R-20 State: NC Zoning Overlay: Zip Code: 27006-7344 Voluntary Ag. District: No Legal Description: LOT 2 SUTTON & MARTIN Fire Response District: ADVANCE Assessed Acreage: 6.85 Elementary School Zone: SHADY GROVE Deed Date: 9/2008 Middle School Zone: WILLIAM ELLIS Deed Book / Page: 007710820 Soil Types: GnB2,GaD,WATER Plat Book: 0010 Flood Zone: Plat Page: 005 Watershed Overlay: DAVIE COUNTY Building Value: 355930.00 Outbuilding & Extra 0.00 Freatures Value: Land Value: 61780.00 Total Market Value: 417710.00 Total Assessed Value: 417710.00 901 All date Is provided as Is withoutwmranty or guarantee of any Idnd either expreased or Implied Including but not limited to the Davie County, Implied wanantles of merchantability or fitness for a particular us a Ag users of Davie County's GIS website shall hold harmless the County of Davis. Norm Carolina, its agents, eonsufiams, contractors or employees from any and all Balms or causes of action due to X01"' NC or arising out of the use or Inability to use the GIS data provided by this websfie. OPERATION PERMIT Davie County Health Department 210 Hospital Street P d Box $48 Mocksvill'o NC; 27028' Phone: 336-753-6780 Fax: 336-753-1680 Applicant: Robert Sutton Address: 153 Finn Hollow Lane City: Advance State0l): NC 27006 Phone #: (336) 998-3413 / Property Owner. Robert Sutton Address: 153 Finn Hollow Lane CRY: Advance Statefzip: NC 27006 hone #: (336) 998-3413 Property Location & Site Information Address/Road #: Subdivision: Phase: Lot: 17- 147 Finn Hollow Lane 147 Advance NC 27006 Directions Hwy 64 E. Turn left on Cornatzer Road, tum left on Structure: SINGLE FAMILY Beauchamp Road. Left on Finn Hollow Lane # of Bedrooms: # of People: "Water Supply: PUBLIC *System Classification/Description: *IP Issued by. *CA issued by: SaprolteSystem? QYes QNo Design Flow: 1 0 0 *Distribution Type: GRAVITY -SERIAL Puji Q Soil Application Rate: 0 3 *Pre Treatment: Drain field Field 3 3 3 S4 ft. *System Type-. INFILTRATOROUICK4STANDARD rNifification . Drain Lines a Installer. ChoyaAOutnn tal Trench Length: 1 0 0 ft. Certification #: 1158 Trench Spacing: -9 Inches O.C. Zeal D.C. *EHS: 2140 -Nations. Robert Trench Width: — 3Inches BFeet 0 9/ 0 4/ 2 0 1 5 Date: Aggregate Depth: inches Minimum Trench Depth: 3 6 Inches Minimum Soil Cover. a 4 Inches Approval Status z Maximum Trench Depth; 3' 6 ®tApproved D►sapproVed Inches Maximum Soil Cover. a 4 Inches CDP File Number 123713 -1 Manufacturer. Shoaf STB: 760 Gallons: NO (Min.6 in.) Gallons: 1000 RiserSealed ❑ Yes Date. 0 5 / 1 6 / x 0 1 5 'Filter Brand: POLYLOKPL-122WdhPipe Adapter ST Marker. ❑ Yes T No nforced Tank: ❑ Yes O No 1 Piece Tank: ❑ Yes ® No County ID Number: G$ -OW -00-005-08 Let. a Long: Installer Choya A Quinn Certification #: 1158 'EHS: 2140 - Nauons, Robert Date: 0 9/ 0 4/ 2 0 1 5 'Approval -Status Pump Tank Manufacturer. Installer. PT: No Gallons: NO (Min.6 in.) Date: / RiserSealed ❑ Yes Riser Height: El Yes nforced Tank: ❑ Yes 1 Piece Tank: ❑ Yes ❑ No ❑ NO (Min.6 in.) ❑ No ❑ No Pipe Size: inch diameter Pipe Length: feet 'Schedule: Pressure Rated ❑ Yes ❑ No rpproved fittings ❑ Yes ❑ No Certification #: 'EHS: Date: / / Approval Status ❑ Approved ❑- Disapproved Installer. Certification #: THS: Date: ❑ Ar / Pump Type: Installer. / Dosing Volume: - Gal Certification M Draw Down: Inches `EHS: . 'Chair: Date: Valves Accessible ❑ Yes ❑ No Flow Adjustment Valve ❑ Yes ❑ No oraval Status Check -valve 1:1Yes 11 No gpprovei'Status PVC, unions El Yes ❑ No -'ro'v'e- Approved Disapproved Vent Hole'':❑ Yes ❑ No Anti -siphon Hole ❑ Yes 0 No CDP File Number 123713 -1, County ID Number: G8-000-00-00"8 NEMA4X Box or Equivalent ❑ Yes ❑ No Installer. Box 12 inches Above Grade ❑ Yes ❑ No Certification #: Box Adj.To Pump Tank ❑ Yes ❑ No Conduit Sealed ❑ Yes ❑ NO *EHS: Pump Manually Operable ❑ Yes ❑ NO *Activation Method: Date: ApprovalStatus`� ' Alann'Audible' ;❑ Yes ❑ No. ❑ �Approvei ❑ Disapproved Alarm Visible ❑ Yes ❑ No = 2140 - Nations, Robert *Operation Permit completed by' Authorized State Agent: Date of Issue: 0 9/ 0 4 / 2 0 1 5 Owner/Applicant Signature: This system has been installed in compliance with applicable NC General Statutes: Article 11, Chapter 130A, Rules for Sewage,Treatment and Disposel,15A'NCAC 18A :7900 et„Seq., and,all conditions of the Improvement Permit and Construction Auth'orizatio'n: Tris property is served by,a Sewage septic system. Rule A961 requires that a Type septic system meet the following criteria: Minimum System Review ByThe Local Health Department: Management Entity: Minimum System Inspection/Maintenance Frequency ByCertified Operator. Reporting Frequency By Certified Operator. Rule .1961 requires that a Type IV and V septic,systems designed fora home/business owner must maintain a valid contract W6a public'Managei ment entity.w�h a certified operatoror a prate certified operator forthe life of the septicsystem: 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. 1 a e:. the.systems execute O* Hand Drawing Olmport Drawing **Site Plan/Drawing attached.** for be r to the,. unless the ce end OPERATION PERMIT Davie County Health Department CDP File Number: 123713-1 210 Hospital Street G8-000.00-005.08 P.O. Box 848 County File Number: Mocksville NC 27028 Date: / / W W Olnch Scale: , Drawing Drawing Type: Operation Permit r)NIA = ft. CONSTRUCTION For office Use only AUTHORIZATION 'CDP File Number 123713-1 Davie County Health Department Ga-000-0o-ooe-os ^'. tY P ,County ID Number: 210 Hospital Street Evaluated For: NEW P.O. Box 848 Township: Mocksville NC 27028 PERMIT VALID UNTIL: Phone: 336-753-6780 Fax: 336-753-1680 1 0/ a 1 r/ a 0 1 8 Applicant: Robert Sutton Property Owner. Robert Sutton Address: 153 Finn Hollow Lane Address: 153 Finn Hollow Lane City: Advance City: Advance State/Zip: NC 27006 State/Zip: NC 27006 Phone #: (336) 998-3413 Phone #: (336) 998-3413 Address/Road #: 147 Finn Hollow Lane Advance NC 27006 Structure: SINGLE FAMILY # of Bedrooms: # of People: *Water Supply: PUBLIC Subdivision: Phase: Lot: Directions Hwy 64 E. Turn left on Cornatzer Road, turn left on Beauchamp Road. Left on Finn Hollow Lane Minimum Trench Depth: a 4 \ Site Classification: Ps Inches Sa rolite System? OYes ®No Minimum Soil Cover: Inches Design Flow: 1 0 0 Maximum Trench Depth: 3 6 Inches Soil Application Rate: 0 3 Maximum Soil Cover: Inches *System Classification/Description: *Distribution Type: GRAVITY -SERIAL TYPE II A. CONV SYSTEM (SINGLE-FAMILY OR 480 GPD OR LESS) *Proposed System: 25% REDUCTION Nitrification Field No. Drain Lines Septic Tank. 1 0 0 0 Gallons 1 -Piece: OYes ®No Pump Required: Oyes ®No O May Be Required Sq. ft. Pump Tank: Gallons 1 -Piece: ®Yes ONO Total Trench Length: 4 0 ft. GPM—vs— ft. TDH Trench Spacing:OFeet O.C. 9 Inches O.C. _ Dosing Volume: _ Gallons O Trench Width: _ 0 6 Olnches ®Feet Grease Trap: Gallons Aggregate Depth: inches Pre -Treatment: ONSF OTS -1 OTS -II / Septic Tank Installer Grade Level Required: 01 Oil 0111 01V CDP File Number 123713 - 1 *Site Classification: PS Design Flow: 1 0 0 County ID Number: ca-000-oo-oos-os ®Yes ONO ONO. but has Available Soil Application Rate: 3 *System Classification/Description: TYPE II A. CONY SYSTEM (SINGLE-FAMILY OR 480 GPD OR LESS) *Proposed System: 28%REDUCTION Nitrification Field No. Drain Lines Total Trench Length: Sq. ft. Trench Spacing: Trench Width: Aggregate Depth: Minimum Trench Depth: a 4 Minimum Soil Cover: ❑ Open Pump System Sheet Q Inches O. C) Feet O.C. 0 6 2Inches ® Feet inches Inches Inches Maximum Trench Depth: 3 6 Inches Maximum Soil Cover: Inches *Distribution Type: GRAVITY - SERIAL 4 0 g, Pump Required: Oyes ®No OMay 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 by the 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. This Authorization for Wastewater System Construction shall be valid for a person equal to the period of validity of the Improvement Permit, not to exceed five 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 (.1937(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? O Yes ONO Applicant/Legal Reps. Signature, Date: *Issued By: 2244 - Daywalt, Andrew Authorized State Agent: Date of Issue: 1 0/ a 1/ a 0 1 3 Malfunction Log OYes ® Hand Drawing O Import Drawing Total Time:(HH:MM) **Site Plan/Drawing attached.** Page 2 of 3 0 0 Hour 30 Minutes S-8 - CA'S issued - new CONSTRUCTION AUTHORIZATION Davie County Health Department 210 Hospital Street P.O. Box 848 Mocksville NC '27028 CDP File Number: County File Number: G8-000-00-005-08 ! Date: 10 /.1 1/,2013 O Inch Scale: , OBlock ft. Lrawme urawing I ype: Lonsirucuon /-wmonzanon O N/A ti tool y�----- -�� t - 1181L: tC-1 T Page 3 of 3 P1 P2 CONSTRUCTION AUTHORIZATION Ji Davie County Health Department ! 210 Hospital Street CDP File Number: P.O. Box 848 G8-000-00-005-08 Mocksville NC 27028 County File Number: Date: 10/ 11 /.0.0,1.3. Click below to import an image from an external location: Drawing Type: Construction Authorization 1 � � Crr 3� o ��� � � ` Page 3 of 3 P1 P2 - -- IMPROVEMENT PERMIT -W Davie County Health Department Inches Y ta. 210 Hospital Street P.O. Box 848 Inches Mocksville NC 27028 / For Office Use Only *CDP File Number 12V13-1 County ID Number: GB -000-00-005-08 Evaluated For: NEW ,Township: Phone: 336-753-6780 Fax: 336-753-1680 PERMIT VALID UNTIL: 10/21/2018 *NOTE TO INSPECTIONS DIVISION: Building Permits cannot be issued with this Improvement Permit. Applicant: Robert Sutton Address: 153 Finn Hollow Lane City: Advance State/Zip: NC 27006 Phone it: (336) 998-3413 /Address/Road #: n �Q ubdivision: 147 Finn Hollow Lane y Advance NC 27006 Structure: SINGLE FAMILY # of Bedrooms: # of People: *Water Supply: PUBLIC Property Owner: Robert Sutton Address: 153 Finn Hollow Lane City: Advance State/Zip: NC 27006 Phone #: (336) 998-3413 Phase: Lot: 'L Directions Hwy 64 E. Turn left on Cornatzer Road, turn left on Beauchamp Road. Left on Finn Hollow Lane Repair System Required: ®Yes ONO ONO, but has Available Space Repair System *Site Classification: Ps Minimum Trench Depth: oZ 4 Inches Soil Application Rate: 3 Maximum Trench Depth: 3 6 Inches *System Classification/Description: Pump Required: OYes ®No O Maybe Required TYPE II A. CONY SYSTEM (SINGLE-FAMILY OR 480 GPD OR LESS) *Proposed System: 25%REDUCTION Page 1 of 3 Minimum Trench Depth: oC 4 Inches Saprolite System? O Yes ® No Maximum Trench Depth: 3 6 Inches Design Flow: 1 0 0 Septic Tank: 1 0 0 0 Gallons Soil Application Rate: 3 1 -Piece: O Yes ® No Pump Required: OYes ® No O May Be Required *System Classification/Description: TYPE II A. CONY SYSTEM (SINGLE-FAMILY OR 480 GPD OR Pump Tank: Gallons *Proposed System: 25% REDUCTION 1 -Piece: O Yes O No Repair System Required: ®Yes ONO ONO, but has Available Space Repair System *Site Classification: Ps Minimum Trench Depth: oZ 4 Inches Soil Application Rate: 3 Maximum Trench Depth: 3 6 Inches *System Classification/Description: Pump Required: OYes ®No O Maybe Required TYPE II A. CONY SYSTEM (SINGLE-FAMILY OR 480 GPD OR LESS) *Proposed System: 25%REDUCTION Page 1 of 3 CDP File Number 123713 = 1 County ID Number: GS -000-00-005-08 *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 by the 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 valid for 5 years from date of issue with a site plan (means a drawing not necessarily drawn to ® scale that shows the existing and proposed property lines with dimensions, the location of the facility and appurtenances, the site for the proposed Wastewater system, and the location of water supplies and surface waters). Plat The Improvement Permit shall be valid without expiration with plat (means a property surveyed prepared by a registered land O surveyor, drawn to a scale of one Inch equals no more than 60 feet, that includes: the specific location of the proposed facility 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 Issuance and 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(Q). 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 (A 938(b)). Applicant/Legal Reps. Signature Required? Oyes ONO Applicant/Legal Reps. Signature: Date: / / *Issued By: 2244-Daywalt,Andrew Date of Issue: 1 0 / a I/ a 0 1 3 Authorized State Agent: O without Expiration? a'`� ®CCrere ate CA? ®Hand Drawing OlmportDrawing **Site Plan/Drawing attached.** TotalTime:(HH:MM) 0 0 Hours 3 0 Minutes Page 2 of 3 Activity Code: s-4 - IP's Issued: new, valid for 60 mos. Drawim • IMPROVEMENT PERMIT Davie County Health Department 210 Hospital Street P.O. Box 848 Mocksville NC 27028 Improvement Permit Page 3 of 3 CDP File Number: 123713 -1 County File Number: c8-000-00-005-08 Date: / / Q Inch Scale: O Block QN/A I I I Soya IMPROVEMENT PERMIT Davie County Health Department 210 Hospital Street P.O. Box 848 Mocksville NC 27028 CDP File Number: 123713 -1 County File Number: c8-000-00.005-08 Date: 10/ 11 /a013 Click below to import an image from an external location: Drawing Type: Improvement Permit Page 3 of 3 P1 P2 APPLICETION FOR SITE EVALUATIONAMPROVEMENT PERMIT & ATC CF,� Davie County Environmental Health • 12� P.O. Box 848/210 Hospital Street o PAJD I b ii Mocksville, NC 27028 Z �3 qac• 1 (336)753-6780/ Fax.(336)753-1680 R�elved6 ; d! Application For: 0 Site Evaluation/Improvement Permit O Authorization To Construct (ATC) 0 Both Type of Application: ❑New System URepair to Existing System DExpansion/Modification of Existing System or Facility ***IMPORTANT*** THIS APPLICATION CANNOTBE PROCESSED UNLESS ALL OF THE REQUIRED INFORMATION IS PROVIDED. Refer to the INFORMATION BULLETIN for instructions. APPLICANT Name _ Address Email' ISaberr (Z 1PhAJ, Com Name on Permit/ATC if Different than Mailing Address 153 fiAn Noll PROPERTY Contact Person qa pex_+ Home Phone 3SLa -Y/3'- Y / l3 Business Phone 3310 - S 13 -� l91 NOTE: A survey plat or site plan must accompany this application. Included: 0 Site Plan OPlat(to scale) (Permit ii valid for 60 months with site plan, no expiration with complete plat.) Owner's. Name `-; 0oao ,7- S�TTDN Phone Number_ Owner's Address 15-3 fin/ Ablt.Ow L40 City/State/Zip HAV%i�.Y,E Lot Size Tax PIN# Subdivision Name(if app ica e) Sectio ot# Di 'ctions To Site: Z6e— 71 / 1 /J 0/ Ve, If the answer to any 6f the following questions is `•Yes',supportin documentation must be attached: Are there any existing wastewater systems on the site? v -Yes • No Does the site contain jurisdictional wetlands? _Yes X0 Are there any easements or right-of-ways on the site? _Yes __ /;g Is the site Ojb ,qt to approval by another public agency? _Yes Will wastewater other than domestic sewave be venerated? Yes o IF RESIDENCE FILL OUT THE BOX BELOW #People # Bedrooms # Bathrooms Garden Tub/Whirlpool DYes ONo Basement:OYes ONo Basement Plumbing: DYes []No �/� ' �7 �t�t IF NON -RESIDENCE FILL OUT THE BOX BELOW C? Q-000 -(i�'U(-0b Type of Facility/Business 0 Fr -1 ce- S9Nc e_ Total Square Footage of Building ,5 17 ' # People # Sinks I— # Commodes _I # Showers I # Urinals Estimated Water Usage (gallons per day)(Attach documentation of similar facility water consumption) FOODSERVICE ONLY: # Seats Type system requested: Konventional DAccepted Dhmovative DAltemative ❑Other Water Supply Type: 6County/City Water D New Well OExisting Well U Community Well __.._.---...— -- - Do you anticipate additions or expansions of the facility this system is intended to serve? 0 Yes M 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 corners and loccility location, proposed well location and the location of any other amenities. t Property owner's or owner's legal representative signature Site Revisit Charge Date(s): TO _Z -(_3 Client Notification Date: Date EHS: 113 Sign given DYes ONo Account # Revised 11/06 Invoice # co(2(�