105 Tyler Court Lot 61Davie County. NC
Tax PnrrPl R Pnnrt
Tuesday, December 20. 2016
WAKNMG: '1'1i1S 1S NUT A SURVEY
Parcel Information
Parcel Number:
F803OA0061
Township:
Shady Grove
NCPIN Number:
5870631691
Municipality:
SHADY GROVE
Account Number:
8303265
Census Tract:
37059-803
Listed Owner 1:
KYE LEE EDWARD JR/PENNY CRYNER
Voting Precinct:
EAST SHADY GROVE
Mailing Address 1:
105 TYLER COURT
Planning Jurisdiction:
Davie County
City:
ADVANCE
Zoning Class: DAVIE COUNTY R -A R-20
State:
NC
Zoning Overlay:
Outbuilding & Extra
Zip Code:
27006
Voluntary Ag. District:
No
Legal Description:
LOT 61 ESSEX FARM PHASE 1
Fire Response District:
ADVANCE
Assessed Acreage:
0.69
Elementary School Zone:
SHADY GROVE
Deed Date:
3/2014
Middle School Zone:
WILLIAM ELLIS
Deed Book / Page:
009520811
Soil Types:
Gn132
Plat Book:
0009
Flood Zone:
Plat Page:
289
Watershed Overlay:
DAVIE COUNTY
Building Value:
Outbuilding & Extra
Freatures Value:
Land Value:
Total Market Value:
Total Assessed Value:
161
l data is provided as Is without warranty or guarantee of any Idnd 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 ag claims or causes of action due to
NCor arising out of the use or Inability to use the GIS data provided by this website.
avie County Health Department
Environmental Health Section
Phone: (336) - 753 - 6780
P.O. Box 848
210 Hospital Street
Courier # : 09-40-06
Mocksville, NC 27028
Fax: (336) - 753-1680
ON-SITE WASTEWATER CERTIFICATION
(Check One) Replacement Remodeling Reconnection
__ GG j r 0
Name;R.S._Padey Phone Number BIIW "`" ` q e 3
(Home)
Mailing Address: . fl - (Work)
Property
Please Fill In The Following Information About The EXISTING Facility: i
i
P� �n �er�
Name System Installed Under: S, [L_V__ Type Of Facility: ( 1 +
Date System Installed Month/Date/Year : X10 CCU�IC�eI
y ( ) ti � Number Of Bedrooms: _Number Of People: !
Is The Facility Currently Vacant?(2s No If Yes, For How Long? � (� �� n V r u ' +'i r)
i
Any Known Problems? Yes Q4� If Yes, Explain:
Please Fill In The FoIlowing Information About The NEW Facility:
Type Of Facility: bQ j o�hP.A Gari -Q Number Of Bedrooms:Number of People
�
Pool Size: 0.— Garage Size:QL%aD Other:
Requested By: �khDate Requested:
(Si: a e)
For Environmental Health Office Use Only
Ap oved Dis pproved /
Comments: 'ewaf 4 �a,I
*The signing of this form by the Environmental Health Staff is in no way intended, nor should be taken as a guarantee
(extended or limited) that the on-site wastewater system will function properly for any given period of time.
Payment: Cash Check Money Order # Amount:$
i
Paid By Received By:
Account
voice #:
�lohn {�ew��ed�
31q -5q35'
SETBACKS:
FRONT: 45'
SIDE: 10' N82'28' 00" W
REAR: 30' I 100.00'
SETBACK I
SETBACK HOME DIMENSION
NTS
L
10' UTILITY EASEMENT
582.28'00"E 100.00' PRELIMINARY
PLOT PLAN FOR:
TYLER COURT RSP BUILDERS
60' R W PUBLIC LOT 61 OF ESSEX FARMS, PHASE 1
P.B. 8 PC. 288
GRAPHIC SCALE
1 20 '° flaming Engineering, Inc.
700 Cunegle Place Greensboro, NC 27409
IN FEET } Phone: 336 .8797 , I= 33688 4n6
1 inch = 40 1k NCISEIS C-0950 DATE: 08-27-13
REF: PR0J\1831-01\dw9\ESSEXFARM.dwg
o
O
b
I
d3
I
NlLh
2.4'
W o
w
to
j
2.42'
Cli
+
PROPOSED 2M'
I
I
RESIDENCE m
O
PROPOSED
22
RESIDENCE
a
SETBACK HOME DIMENSION
NTS
L
10' UTILITY EASEMENT
582.28'00"E 100.00' PRELIMINARY
PLOT PLAN FOR:
TYLER COURT RSP BUILDERS
60' R W PUBLIC LOT 61 OF ESSEX FARMS, PHASE 1
P.B. 8 PC. 288
GRAPHIC SCALE
1 20 '° flaming Engineering, Inc.
700 Cunegle Place Greensboro, NC 27409
IN FEET } Phone: 336 .8797 , I= 33688 4n6
1 inch = 40 1k NCISEIS C-0950 DATE: 08-27-13
REF: PR0J\1831-01\dw9\ESSEXFARM.dwg
CONSTRUCTION For Office Use Only
AUTHORIZATION *CDP File Number 123183 - 1
Davie Count Health Department F8 -030-A0-061
y p County 1D 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 0 9/ 1 9/ a 0 1 8
Applicant:
RS Parker Homes LLC
Address:
502 Hickory Ridge Drive
City:
Greensboro
State/Zip:
NC 27409
Phone #:
(336) 267-8812
/"Address/Road #:
105 Tyler Court
Advance NC 27006
Structure: SINGLE FAMILY
# of Bedrooms: 4
# of People:
*Water Supply: PUBLIC
Property Owner: RS Parker Homes LLC
Address: 502 Hickory Ridge Drive
City: Greensboro
State/Zip: NC 27409
Phone #: (336) 267-8812
Subdivision: Essex Farms Phase: Lot: 61
Directions
Hwy 64 East, left onto Cornatzer Rd. approx 4 to 5 miles,
Subdivision on left after passing Beauchamp Rd.
\Site Classification: Ps Minimum Trench Depth: a 4 Inches
SaproliteSystem? OYes (&No Minimum Soil Cover: Inches
Design Flow: 4 8 0 Maximum Trench Depth: 3 6 Inches
Soil Application Rate: 0 a 7 5 Maximum Soil Cover: Inches
*System Classification/Description: *Distribution Type: GRAVITY - SERIAL
TYPE II A. CONV SYSTEM (SINGLE-FAMILY OR 480 GPD OR LESS) Septic Tank:
1 0 0 0 Gallons
*Proposed System: 25% REDUCTION 1 -Piece: O Yes ® No
Pump Required: O Yes ®No O May Be Required
Nitrification Field
Sq. ft. Pump Tank: Gallons
No. Drain Lines 1 -Piece: OYes ONo
Total Trench Length: 4 3 6 ft, GPM --vs— ft. TDH
Trench Spacing:g
_ O Inches O.C. Dosing Volume: _ Gallons
_8Feet O.C.
Trench Width: B Inches
__8Feet Grease Trap: Gallons
Aggregate Depth:
inches Pre -Treatment: O NSF OTS -1 OTS -II /
Septic Tank Installer Grade Level Required: 01011 O III 01V
Page 1 of 3
CDP File Number 123183 - 1 County ID Number: F8 -030 -AO -061
❑ Open Pump System Sheet
ired:(DYes O No ONo, but has Available
�\iiNNll VJJ�\rlll
Trench Spacing:
Inches O.
*Site Classification:
Ps
— Feet O.C.
Trench Width:O
inches
Design Flow:
4 8
--8Feet
Aggregate Depth:
Soil Application Rate:0
. a
ss
inches
.__.
Minimum Trench Depth:
a 4
*System Classification/Description:
Inches
TYPE II A. CONV SYSTEM (SINGLE-FAMILY OR 480 GPD OR
Minimum Soil Cover:
ESS)
Inches
Maximum Trench Depth:
3 6
*Proposed System:
25% REDUCTION
Inches
Maximum Soil Cover:
Nitrification Field
Inches
Sq. ft.
No. Drain Lines
*Distribution Type:
GRAVITY - SERIAL
Total Trench Length:
4 3
6
Pump Required: Oyes
(8) No O May Be Required
ft.
1-1
Pre -Treatment: O NSF
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 fora 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 13OA-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 (A 937(g)). The person owning or controlling the system shall be responsible for assuring compliance
with the laws, rules, and permit donditions regarding system location, installation, operation, maintenance, monitoring, reporting and repair
(1938(b)).
Applicant/Legal Reps. Signature Required? O Yes ® No
Applicant/Legal Reps. Signature- Date:
*Issued By: 2244 - Daywalt, Andrew Date of Issue: 0 9 / 1 9 / a 0 1 3
Authorized State Agent: OWUIS Malfunction Log Oyes
® Hand Drawing O Import Drawing Total Time:(HH:MM)
**Site Plan/Drawing attached.** 0 1 Hours 0 0 Minutes
Page 2 of 3
S-8 - CA'S Issued - new
r
CONSTRUCTION AUTHORIZATION
Davie County Health Department CDP File Number: 123183-1
210 Hospital Street
County File Number: F8 -030 -AO -061
P.O. Box 848
Mocksville NC 27028 Date: 09 . /,19 , /)01 3
O Inch
Drawing Drawing Type: Construction Authorization�� Scale: , O N/A
k ft.
i
Page 3 of 3
P1 P2
CONSTRUCTION For Office Use Only
AUTHORIZATION •CDP File Number 123183-1
Davie County Health Department County ID Number: F8-030-AO.061
t, 210 Hospital Street 9�-%A Evaluated For: NEW
P.O. Box 848 1°y � � 0 Township:
Mocksville NC 27028 PERMIT VALID UNTIL:
Phone: 336-753-6780 Fax: 336-753-1680 0 9/ 1 9/ 2 0 1 8
Applicant: RS Parker Homes LLC
Address: 502 Hickory Ridge Drive
City: Greensboro
State/Zip: NC 27409
Phone #: (336) 267-8812
i
Address/Road #:
105 Tyler Court
Advance NC 27006
Structure: SINGLE FAMILY
# of Bedrooms: 4
# of People:
*Water Supply: PUBLIC
Property Owner: RS Parker Homes LLC
Address: 502 Hickory Ridge Drive
CRY: Greensboro
StatefZip: NC 27409
Phone #: (336) 267-8812
Subdivision: Essex Farms
Phase: Lot: 61
Directions
Hwy 64 East, left onto Comatzer Rd. approx 4 to 5 miles,
Subdivision on left after passing Beauchamp Rd.
system Specifications
Page 1 of 3
Minimum Trench Depth: 2 4 Inches
Site Classification: PS
Minimum Soil Cover.
Saprolite System? QYes QNo
Inches
Design Flow: 4 8 0
Maximum Trench Depth: 3 6 Inches
Soil Application Rate:0 2 7 5
Maximum Soil Cover: Inches
'System Classification/Description:
'Distribution Type: GRAVITY - SERIAL
TYPE IIA CONY SYSTEM (SINGLE-FAMILY OR 480 GPD OR LESS) Septic Tank:
1 0 0 0 Gallons
'Proposed System: 25% REDUCTION
1 -Piece: QYes (j)No
Pump Required: QYes @No OMay Be Required
Nitrification Field
Sq. ft. Pump Tank: Gallons
No. Drain Lines
1 -Piece: QYes QNo
Total Trench Length: 4 3 6 8
GPM—vs— ft. TDH
Trench Spacing:_
QInches O.C. Dosing Volume: _ Gallons
(8 Feet O.C.
Trench Width:
Inches
8Feet
_ _
Grease Trap: Gallons
Aggregate Depth:
inches
Pre Treatment: ONSF OTS -1 OTS -II
Septic Tank Installer Grade Level Required: 01 011 OIII OIV
Page 1 of 3
CDP -File Number 123183-1 County ID Number: F8-030-AO.061
. . 6 ❑ Open Pump System Sheet
Kepalrbystem Kequirea:V Tes IJIVu kir4o, out nas Avallaoie apace
/Repair System
Trench Spacing: Inches 0.
'Site Classification: PS —0 Feet O.C.
Trench Width: Inches
Design Flow: 4 8 0 _0 Feet
Soil Application Rate: 0 - 2 7 5 Aggregate Depth: inches
'System Classification/Description: Minimum Trench Depth:2 4 Inches
TYPE II A CONV SYSTEM (SINGLE-FAMILY OR 480 GPD OR LESS) Minimum Soil Cover Inches
'Proposed System: 25% REDUCTION Maximum Trench Depth: 3 6 Inches
Maximum Soil Cover:
Nitrification FieldInches
Sq. ft.
No. Drain Lines 'Distribution Type: GRAVITY -SERIAL
Total Trench Length: 4 3 6 ft. Pump Required: Oyes GNo 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 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.
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 smetime the Improvement Permit Issued (NCGS 13OA-336(b)} If the installation has not been
completed during the period of valldity 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 attered, the permit or Construction Authorization shall become
Invalid, and may be suspended or revoked (.1937(8)). 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)).
ApplicanULegal Reps. Signature Required? Oyes ONO
Applicant/Legal Reps. Signature- Date:
'Issued By: 2244 - Daywalt, Andrew Date of Issue:. 0 9 / 1 9 / 2 0 1 3
Authorized State Agent:QJLklk-�Malfunction Log OYes
OHand Drawing Olmport Drawing Total Time:(HH:MM)
**Site Plan/Drawing attached.**
Page 2 of 3 1 Hours _ . O Minutes
S-8 - CKS issued - new
CONSTRUCTION AUTHORIZATION
Davie County Health Department
210 Hospital Street
P.O. Box 848
Mocksville NC 27028
Drawing Drawing Type: Construction Authorization(ao
CDP File Number: 123183 - 1
County File Number: F8-030-AO.061
Date: 09/ 19/2013
Olnch
Scale: OBlock
ON/A
' I
Pane 3 of 3
u ' .
APPLICATION FOR SITE EVALUATION/IMPROVEMENT PERMIT & ATC
Davie County Environmental Health RECEIVED/66,,-
RECENEA P.O. Box 848/210 Hospital Street
�T��3 Mocksville, NC 27028
0' SEP Q A 2013
(336)753-6780/ Fax (336)753-1680
Application For: ❑ Site Env luation/Improvement Permit L04horization To Constr ALT+ioth
Type of Application: 14Kew System ❑Repair to Existing System ❑Expansion/Modification of Existing System or Facility
***IMPORTANT*** THIS APPLICATION CANNOTBEPROCESSED UNLESS ALL OF THE REQUIRED
INFORMATION IS PROVIDED. Refer to the INFORMATION BULLETIN for instructions.
APPLICANT INFORMATION
NameLZContact Person eofe"A , Ap e iSWt
Address 5671 We
7710—c—
i Home Phone B3(p• ZCo?' 1 Z
City/State/ZIP 2_2S6D9 Business Phon
Email Email:� Ca111e5.4
Name on Permit/ATC if Different than Above
Address City/State/Zi
rKyr1111C1 Y IINrUKIV1AI1U1N TLate House/%aclltty Uorners 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 plan, no expiration with complete plat.)
Owner's Name e. Phone Number •G
Owner's Address 50Z Wr_Kory 12r6cV,City/State Zip
Property Address City
Lot SizeO Tax PIN# g- 0 � � D- p 61
Subdivision ame(if applicable) 5a 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?
—No
Are there any easements or right-of-ways on the site?
_Yes
_Yes
01q0
Is the site subject to approval by another public agency?
*--No
Will wastewater other than domestic sewage be generated?
_Yes
Yes
Ro
IF RESIDENCE FILL OUT THE BOX BELOW
# People 6' # Bedrooms . !J # Bathrooms 3 Garden Tub/Whirlpool es []No
Basement: ❑Yes o O Basement Plumbing: ❑Yes U411
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: L' onventional ❑Accepted [Innovative ❑Alternative ❑Other
Water Supply Type: L;-�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 ❑ 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 permits) 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 Departm�tduct necessary inspections to determine compliance with applicable laws and rules.
I understan t am r sp ible fer identification and labeling of property lines and corners and locating and flagging
or staki e s ci ' loca ' nwell location and the location of any other amenities.
ZAZZS_0:;� -- Site Revisit Charge
Property owner's or owner's legs representative signature
• Client Notification Date:
Date EHS:
Sign given ❑Yes ❑No Account #
Revised 11/06 ,) 1/7-.31
� 3 Invoice #
w
C
.078 ■� N
.Z6'Yl 8 8 .0077 0p• Qi �V ep CO
ci•
LLJ
a a �
R O Z o Z� N
00'f0 ZY9l OD9 �_ Z
O0)ai Glp 8cr
a� � � �04y�
0 �1 N $,
.00'LZ zi'zz O 0. 0
til aq
co (ri v
a 0.xNa z
,10.00s
zaoo,zs./.Om
m Iw O
IN w
N m E-4 V
w
Lw U
0W I J
�o I� W V 0. W
afw O
`..
cc
N ul Fg
10' UTILITY EASEMENT
— — to 1-4
.10*009 L7,.00,zs.zom Q; o
(DIWnd) AAT ,05
UVO&T HUYL11 XLYSS9
a
; o
V.
�
Q
m
w
C
.078 ■� N
.Z6'Yl 8 8 .0077 0p• Qi �V ep CO
ci•
LLJ
a a �
R O Z o Z� N
00'f0 ZY9l OD9 �_ Z
O0)ai Glp 8cr
a� � � �04y�
0 �1 N $,
.00'LZ zi'zz O 0. 0
til aq
co (ri v
a 0.xNa z
,10.00s
zaoo,zs./.Om
m Iw O
IN w
N m E-4 V
w
Lw U
0W I J
�o I� W V 0. W
afw O
`..
cc
N ul Fg
10' UTILITY EASEMENT
— — to 1-4
.10*009 L7,.00,zs.zom Q; o
(DIWnd) AAT ,05
UVO&T HUYL11 XLYSS9
APP C ION FOR SITE EVALUATION/IMPROVEMENT PERMIT &ATC
Davie County Environmental Health
P.O. Box 848/210 Hospital Street
t A�Cj 2 Mocksville, NC 27028
(336)751-8760/Fax(336)751-8786
C?•` Apel catign For: ite'Evaluation/Improvement Permit ❑ Authorization To Construct(ATC) ❑ Both
T�e of -App kation: ❑New System ❑Repair to Existing System ❑Expansion/Modification of Existing System or Facility
* * *IMPORTAN7* * * THIS APPLICATION CANNOT BE PROCESSED UNLESS ALL OF THE REQUIRED
INFORMATION IS PROVIDED. Refer to the INFORMATION BULLETIN for instructions.
APPLICANT INFORMATION 'u.r, o , „ i
Name to be Billed ASC 1)cry6G*py-rrNT 52%, Contact Person %cTiPRY ,8f7r a'/
Billing Address A.6 - &x 310 Home Phone
City/State/ZIP _�oer riG Z 702 B Business Phone 75/ ' 73p0
Name on Permit/ATC if Different than Above
Mailing Address City/State/Zip
PROPERTY INFORMATION *Date House/Facility Comers Flagged
NOTE: A survey plat or site plan must accompany this application.
Included: ❑ Site Plan R?lat(to scale)
(Permit is valid for 60 months with site plan, no expiration with complete plat.)
Owner's Name -ASC ,mak VPevprs�i�i eeKf i�G
Phone Number
7S/- 73—
Owner'sAddress 4,0 dog
City/State/Zip^
7"ia
Property Address
City
Lot Size O,wq Tax PIN#�
=
Subdivision Name(if applicable) Ea
Sectio } ot#
A-041
Directions To S' C-115 2
Z /� Gf
sPrADP Mr-
a�
f the answer to any of the following uestions is "yes", supporting documentauo} must be a hed.
Are there any existing wastewater systems on the site?
❑Yes [3NpI
Does the site contain jurisdictional wetlands?
Dyes ❑No
Are there any easements or right-of-ways on the site?
❑i'es ❑ o
Is the site subject to approval by another public agency?
❑Yes TN�
Will wastewater other than domestic sewage be generated?
❑Yes CkNo
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 ❑Alternative ❑Other
Water Supply Type: Btounty/City Water ❑ New Well ❑Existing Well ❑ Community Well
Do you anticipate additions or expansions of the facility this system is intended to serve? ❑ Yes
If yes, what type?
❑ No
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 r s oro er's legal representa ' re
Date(s):
7 Client Notification Date:
Date EHS:
Sign given ❑Yes ❑No Account#
Revised 11/06 Invoice #
4
• DAVIE COUNTY HEALTH DEPARTMENT
Environmental Health Section
Soil/ Site Evaluation
APPLICANT INFORMATION
Account #: 990004425
Billed To: PSC Development Corp. Inc.
Reference Name: Brad Coe
Proposed Facility: Residence Property Size:
PROPERTY INFORMATION
Tax PIN/EH #: 5870-64-2265.61
Subdivision Info: Essex Farm Lot # 61
Location/Address: Cornatzer Rd -27006
0.689 Acre Date Evaluated: `7
Water Supply: On -Site Well Community
Evaluation By: Auger Boring Pit
Public
Cut
SITE CLASSIFICATION:
LONG-TERM ACCEPTANCE RATE:
REMARKS:
EVALUATION BY--
OTHER(S)
Y--
OTHER(S) PRESENT:
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
Moist
VFR - Very friable FR - Friable FI - Firm VFI - Very firm EFI - Extremely firm
Wd
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
Notes f
Horizon depth - In inches
Depth of fill - In inches J
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 chror-a 2 or less
Classification - S(suitable), PS(provisionally suitable), U(unsuitable)
LTAR - Long-term acceptance rate - gal/day/ft2 DCHD 05/05 (Revicerl)
Landscape position
—Texture group
Consistence
wljmTA
Mm FRISIV-722
-Mineralogy
W -M
Texture group
Consistence
HORIZON III D'
Texture group�
Consistence
HORIZON IV DEPTH
Texture group
Consistence
�■����������s
MineralogySOIL
WETNESS
-RESTRICTIVE HORIZON
SAPROLITE
SITE CLASSIFICATION:
LONG-TERM ACCEPTANCE RATE:
REMARKS:
EVALUATION BY--
OTHER(S)
Y--
OTHER(S) PRESENT:
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
Moist
VFR - Very friable FR - Friable FI - Firm VFI - Very firm EFI - Extremely firm
Wd
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
Notes f
Horizon depth - In inches
Depth of fill - In inches J
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 chror-a 2 or less
Classification - S(suitable), PS(provisionally suitable), U(unsuitable)
LTAR - Long-term acceptance rate - gal/day/ft2 DCHD 05/05 (Revicerl)
Davie County Environmental Health
P.O. Box 848/210 Hospital Street
Mocksville, NC 27028
(336)751-8760/ Fax (336)751-8786
Account #: 990004425 IMPROVEMENT PERq1dJ'PIN/EH #: 5870-64-2265.61
Billed To: PSC Development Corp. Inc. Subdivision Info: Essex Farm Lot # 61
Address: PO Box 340 Location/Address: Cornatzer Rd -27006
City: Mocksville Property Size: 0.689 acre
Reference Name: Brad Coe
Proposed Facility: Residence
-4
-
**NOTE**This Improvement Permit DOES NOT authorize the construction of a wastewater system. An
Authorization To Construct a was 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.
Perinit Type: "XI -w ❑Repair. ❑ExpansionPermit Valid for: 0 Years Xo Expiration
Residential Specifications: # Bedrooms 4 # Bathrooms # People Basement❑ Basement plumbing❑
Non -Residential Specifications: Facility Type # People # Seats
Square Footage(or Dimensions of Facility)
DesignFlow(GPD): Type of Water Supply�ounty/City ❑Well ❑Community Well
Site Modifications/Permit Conditions.:
Site Plan
Environmental Health Speci
- �� - . .
MANWITPLd 17113,74M 0 '
ESgCX, WM
Date