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119 Tyler Court Lot 64F' 1 Davie County, NC Tax Parcel Report Tuesday, December 20, 2016 WARNIING: THIS IS IVU"1' A SURVEY Parcel Information Parcel Number: F8030A0064 Township: Shady Grove NCPIN Number: 5870635610 Municipality: Account Number: 82528109 Census Tract: 37059-803 Listed Owner 1: PSC DEVELOPMENT COR INC Voting Precinct: EAST SHADY GROVE Mailing Address 1: P O BOX 5967 Planning Jurisdiction: Davie County City: HIGH POINT Zoning Class: DAVIE COUNTY R-A,R-20 State: NC Zoning Overlay: Zip Code: 27262-0000 Voluntary Ag. District: No Legal Description: LOT 64 ESSEX FARM PHASE 1 B Fire Response District: ADVANCE Assessed Acreage: 0.69 Elementary School Zone: SHADY GROVE Deed Date: / Middle School Zone: WILLIAM ELLIS Deed Book / Page: Soil Types: Gn132 Plat Book: 9 Flood Zone: Plat Page: 388 Watershed Overlay: DAVIE COUNTY Building Value: Outbuilding & Extra Freatures Value: Land Value: Total Market Value: Total Assessed Value: E01 All 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 all claims orcauses of action due to NC or arising out of the use or Inability to use the GIS data provided by this website. Cs /' PLICA' SITE EVALUATION/IMPROVEMENT PERMIT & ATC Davie County Environmental Health P.O. Box 848/210 hospital Street Mocksville, NC 27028 (336)751-8760/Fax(336)751-8786 te-Ev"aTuation/Improvement Permit ❑ Authorization To Construct(ATC) ❑ Both ❑New System ❑Repair to Existing System ❑Expansion/Modification of Existing System or Facility I* * *IMPORTANT* * *THIS APPLICATION CANNOT BE PROCESSED UNLESS ALL OF THE REQUIRED INFORMATION IS PROVIDED. Refer to the INFORMATION BULLETIN for instructions. APPLICANT INFORMATION Name to be Billed .dSC T Contact Person %cRAy &f=t!X Billing Address A -a • d.x 3f0 Home Phone City/State/ZIP &oeBusiness Phone 7S/ - 73oo Name on Permit/ATC if Different than Mailing Address YKUYhKI Y 1NPUKMAIIUN 'Yate 17iouse/lacility homers 1'1a ea 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 f4SC /��'y8eoiorr�i�+i coy, i�G Phone Number 7S/ - 73— Owner's Address 4o Bow City/State/Zip 2 7oZ6 Property Adbes City Lot Size i Tax PIN# - Z Subdivision Name(if applicable)� E�Sa . Sectiiou/�/L.ot# �7 DirentioncToSite- Iii4 Ct3St LO Aw- r3 _iw?flf -on, If the answer to any of the following auestionstis "yes", supporting documentati -g0 must be atti ched. Are there any existing wastewater systems on the site? Dyes 2p Does the site contain jurisdictional wetlands? ❑Yes ❑No Are there any easements or right-of-ways on the site? 91fles ❑ o Is the site subject to approval by another public agency? ❑Yes t�� Will wastewater other than domestic sewage be generated? Dyes C3 0 IF RESIDENCE FILL OUT THE BOX BELOW # People # Bedrooms _!;!� # Bathrooms Garden Tub/Whirlpool Dyes ❑No Basement: Dyes ❑No Basement Plumbing: Dyes ❑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: 01 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 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 or o er's legal represents ' re Date(s): 7 Client Notification Date: Date EHS: Sign given Dyes ❑No Account # Revised 11/06 Invoice # -�� 73 i • ^ DAVIE COUNTY HEALTH DEPARTMENT Environmental Health Section Soil/ Site Evaluation APPLICANT INFORMATION PROPS�Ty INFORMATION Account : Tax PIN/EH #: 581 1'165. Billed To: PSC Development Corp. Inc. Subdivision Info: Essex Farm Lot # 64 Reference Name: Brad Coe Location/Address: Cornatzer Rd -27006 Proposed Facility: Residence Property Size: 0.689 Acre Date Evaluated: .7 Water Supply: On -Site Well Community Public Evaluation By: Auger Boring Pit Cut SITE CLASSIFICATION: EVALUATION BY. LONG-TERM ACCEPTANCE RATE: Q OTHER(S) PRESENT: REMARKS: LEGEND Lalidgeape 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 3 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,. SBK - Subangular blocky PL - Platy PR - Prismatic ABK - Angular blocky - Mineral= 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 Classification S(suitable), PS (provisionally suitable), U(unsuitable) LTAR - Long-term acceptance rate - gal/day/ft2 Landscape position HORIZON I DEPTH Consistence Structure HORIZON II DEPTH Texturegroup consistence Mineralogy SOME NNRWAMW4.W=�� HokizoN Ill DEPTH Texturegroup Consistence Mineralogy HORIZON IV DEPTH Texture group Consistence SOIL WETNESS .J�STRICTIVE HORIZON SAPROLITE CLASSIFICATION SITE CLASSIFICATION: EVALUATION BY. LONG-TERM ACCEPTANCE RATE: Q OTHER(S) PRESENT: REMARKS: LEGEND Lalidgeape 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 3 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,. SBK - Subangular blocky PL - Platy PR - Prismatic ABK - Angular blocky - Mineral= 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 Classification S(suitable), PS (provisionally suitable), U(unsuitable) LTAR - Long-term acceptance rate - gal/day/ft2 -. Davie County Environmental Health P.O. Box 848/210 Hospital Street Mocksville, NC 27028 (336)751-8760/ Fax (336)751-8786 Account #: 990004425 IMPROVEMENT PEPjWPIN/EH #: 5870-64-2265.64 Billed To: PSC Development Corp. Inc. Subdivision Info: Essex Farm Lot # 64 Address: PO Box 340 Location/Address: Cornatzer Rd -27006 City: Mocksville Property Size: 0.689 acre Reference Name: Brad Coe Proposed Facility: Residence WAY **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 1�0& Wastewater Systems). This Improvement Permit is subject to revocation if site plans, plat or the intended use change. Pemrit Type: ,E New ❑Repair. ❑Expansion Permit Valid for: 05 Years,3Qo Expiration Residential Specifications: # Bedrooms # Bathrooms # People Basement❑ Basement plumbing❑ 4 Non -Residential Specifications: Facility Type # People # Seats Square Footage(or Dimensions of Facility) Design Flow(GPD):� Type of Water Supply: Bounty/City ❑ Well ❑ Community Well Site Modificatio/P rmit C nditions:.wc i1�1 nVA Environmental Health