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155 Essex Farm Road Lot 7Davie County, NC Tax Parcel Report Tuesday, December 20, 2016 Parcel Number: NCPIN Number: Account Number. Listed Owner 1: Mailing Address 1: City: State: Zip Code: Legal Description: Assessed Acreage: Deed Date: Deed Book / Page: Plat Book: Plat Page: i' 104 161 LUQ LL W 147----------- - WARNING: THIS IS NOT A SURVEY Parcel Information _ FB030A0007 Township: Shady Grove 5870539876 Municipality: 8305247 Census Tract: 37059.803 YOUNT TAMELA Voting Precinct: EAST SHADY GROVE 155 ESSEX FARM ROAD Planning Jurisdiction: Davie County ADVANCE Zoning Class: DAVIE COUNTY R -A NC Zoning Overlay: 27006 Voluntary Ag. District: No LOT 7 ESSEX FARM PHASE 1 Fire Response District ADVANCE 0.69 Elementary School Zone: SHADY GROVE Building Value: Land Value: Total Assessed Value: 7/2015 Middle School Zone: WILLIAM ELLIS 009940674 Soil Types: GnB2 0009 Flood Zone: 289 Watershed Overlay: DAVIE COUNTY Outbuilding & Extra Freatures Value: Total Market Value: [all M data is provided as to withotwarranty or guamdee of any Idol!either expressed or implied Including but not limited to Me Davie County, bnpgedwamntle; of merchantability orlimessfor a paNsularuse All users offAVle Countys GIS wehslte shall hold harmless Me County 0 DavisNordinCarolina, Its agents, consultants, ca bactore oremployees(rom any and all dalms orrauses of action due to NC or arising out ofthe use or Inability to use the GIS data provided by this website. CONSTRUCTION AUTHORIZATION 0.5"RU1. Davie County Health Department 210 Hospital Street P.O. Box 848 Mocksville NC 27028 For Office Use Onl `CDP File Number 157502-1 County ID NumbeC 5870539876 Evaluated For: NEW Township: Phone: 336-753-6780 Fax: 336-753-1680 0 9/ 0 a/ a 0 1 9 Applicant: RS Parker Homes/Joy Springer Address: PO Box 5967 City: High Point State2ip: NC 27262 Phone Address/Road R: 155 Essex Farm Road Advance NC 27006 Structure: SINGLE FAMILY 4 of Bedrooms: 4 m of People: 'Water Supply: PUBLIC Property Owner: RS Parker Homes/Joy Springer Address: PO Box 5967 City: High Point State2ip: NC 27262 Phone �": Subdivision: Essex Farm ,'Site Classification: Provisionally Suitable Saprolite System? OYes ONo Design Flow: 4 8 0 Soil Application Rate: 0 a 7 5 'System Classification/Description: TYPE III B. SYSTEM W/SINGLE EFFLUENT PUMP 'Proposed System: 25%,REDUCTION Nitrification Field 1 7 4 5 Sq. ft. D Phase: Lot: 7 Directions Hwy 158 trun right on Hwy 801 go to Mocks Church Road on right turn. to stopsign, Turn left to the end, left on Cornatzer Rd. Essex Farm on left Minimum Trench Depth: a 4 Inches Minimum Soil Cover. 1 a Inches Maximum Trench Depth: 3 6 Inches Maximum Soil Cover: a 4 Inches 'Distribution Type: PUMPTO GRAVITY Septic Tank: 1 0 0 0 Gallons 1 -Piece: OYes ONo Pump Required: OYes ONo OMay Be Required Pump Tank: 1 0 0 0 Gallons No. ram L nes 6 1 -Piece: OYes ONo Total Trench Length: 4 3 6 ft_ GPM—vs— ft. TDH Trench Spacing:— 9 (Inches O.C. Dosin Volume: _ Gallons Feet O.C. g Trench Width: Olnches — 3 OFeet Grease Trap: Gallons Aggregate Depth: inches Pre -Treatment: ONSF OTS -1 OTS -II Septic Tank Installer Grade Level Required: 01011 0111 OIV d CDP File Number 157502-1. *Site Classification Design Flow: Provisionally Suitable r, County ID Number: 5870539876 :OYes ONo ONo, but has Available Soil Application Rate: 0 a 7 5 *System Classification/Description: TYPE III B. SYSTEM W/SINGLE EFFLUENT PUMP *Proposed System: 25% REDUCTION Nitrification Field No. Drain Lines 6 1 7 4 5 Sq. ft. Total Trench Length: 4 3 6 g, ❑ Open Pump System Sheet Trench Spacing: Inches 0 — 9 Feet O.0 Trench Width: () inches 3 ()Feet Aggregate Depth: inches Minimum Trench Depth: 2 4 Inches Minimum Soil Cover. 1 a Inches Maximum Trench Depth: 3 6 Inches Maximum Soil Cover: .2 4 Inches *Distribution Type: PUMPTO GRAVITY Pump Required: OYes ONo OIAay Be Required Pre -Treatment: ONSF OTS -1 OTS -II *Site Modifications No grading or construction activity is allowed in areas designated for system and repairwithout approval of Health Department. 7! `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. 2( 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 Me 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 became 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? Oyes ONo Applicant/Legal Reps. Signature: Date: / / *Issued By: 2140 -Nations, Robert Date of Issue:. 0 9 / 0 .2 / 2 0 1 4 Authorized State Agent: Malfunction Log OYes QHand Drawing Olmport Drawing **Site Plan/Drawing attached.** Page 2 of 3 CONSTRUCTION AUTHORIZATION Davie County Health Department 210 Hospital Street P.O. Box 848 Mocksville NC 27028 Dr.1wing Drawing Type: Construction Authorization CDP File Number: 157502 - 1 County File Number: 5870539876 Date: 09 / 0 2 / 2 0 1 4 Olnch Scale: . OBlock ()NIA Pane 3 of 3 L ID . . . . . . . . . . I L T-1 T If ot F Pane 3 of 3 F5 APPLICATION FOR SITE EVALUATION/IMPROVEMENT PERMIT &-ATC - Davie County Environmental Health - .. - - - P.O. Bos 848/210 Hospital Street - - - -;Mocksville, NC 27028 - - (336)753-6780/ Fax (336) 753-1680 Application For: -Sit�e Ev IuatioNlmprovement Permit Vx(Authorization To Constmct(ATC) �ZBmh -- Type of Application ;ZVw System ❑Repair to Existing System. DExpansion/Modifiwtion of Existing System or Facility - ***l,VIPORT.INT•** THIS APPLICATION CANNOTBE PROCESSED UNLESS ALL OF THE REQUIRED INFORMATION IS PROVIDED. Refer to the INFORMATION BULLETIN for instructions. - APPLICANT INFORMATION Name to be Silted S Ra- Contact Person- _ _ Billing Address Home Phoae City/State/ZIP --' Business Phone S Name on Permit/ATC if Different than Above- Mailing Address —� City/State/Zip PROPERTY INFORMATION *Date House/FacilityComen Flagged - _ - - NOTE: Asurvey plat or site plan must accompany this application. - Included: C Site Plan Iat(to scale (Permit is alid for 60 m nths w' site plan, no expiration with complete plat.) _ Owner's Name Phon Nu bel' - Owner's Address City/StatefZip I C PropertyAddress f City Got Size (fir Tax PIN# ---lll - - Subdivision Name(if applicable) Section/Lot# - Directions To Site:o aI d n nrn Q Qf'r I n f0 ESFK - - If the answer tany of the fol''I"ow__i__n//g questions is "yes", supporting documentation must be attached. - - Are there any existing wastewater systems on the site., , . Dyes S�yy - - - - - Does the site contain jurisdictional wetlands? Dyes Flo _ Are there any easements or right-of-ways on the site? Dyes Fico _ - Is the site subject to approval by another public agency? Dyes FeiQ�o Will wastewater other than domestic sewage be generated? "DYes rllV0 IF RESH)ENCE FILL OUT THE BOX BELOW - # People # Bedrooms # Bathrooms , arden T /Whirlpool Yefes DNo Basement: Dyes ONS Basement Plu brag: ❑Yes &Ntt' - - IF NON-RESIDENCE FILL OUT THE BOX BELOW b - - 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: �konventional DAccepted Chmovative CAltemative COther Water Supply Type: ounty/City Water D New Well CExisting Well C Community Well - i Do you anticipate additions or expansions of the facility this system is intended to serve? D Yes 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 - changcs, or if the information submitted in this application is falsified or changed I hereby grant right of entry to the Authorized - Representative 8 the Davie County Health Department to conduct necessary inspections to determine compliance with applicable I and rules understand that f am responsible for the proper identification and labeling of property lines and corners and I ca' nfi in or staking the houselfacility location, proposed well location and the location of any other amenities. P p rt} wn iso owner's legs presentative signature Site Revisit Charge - - Date(s): - - _ - Client Notification Date: ' . Date - - EHS: _ - Sign given DYes DNa - Account # Revised 11/06 .Invoice # SETBACKS FRONT: 45 N07'32'00'E - SIDE: 15' , REAR: 30' 100.00' SETBACK O I I I I 1 a JO' 1.00' 22.00' cc c en oD I V iu 2.00' I 2.00'.. PROPOSED I � 0 RESIDENCE 'd PSE TBACK io 00 10' UTILITY EASEMENT - - N07032'00'E 100.00' ESSEX FARM ROAD 50' R/W (PUBLIC) GRAPHIC SCALE 40 _ 0 20 - 40 so . ( IN FEET ) 1 inch = 40 ft PROPOSED RESIDENCE N 22.58' 19.50' 19.50' 1 J ME DIMEN UK PRELIMINARY PLOT PLAN FOR: RSP BUILDERS LOT 7 OF ESSEX FARMS, PHASE 1 P.B. 9 PC. 289 R ming Engincnring, Inc. 700CamegiePlace Greensboro,NC27409 Phone: 336-852.9797 *Fax: 336.852.9766 NCBELS C-0950 - DATE: 08-13-14 REF: PR0J\1831-01\dwg\ESSDffARM.dwg I 3 vi I t�aluatio SITE EVALUATION/IMPROVEMENT PERNUT & ATC Davie County Environmental Health - P.O. Box 848/210 Hospital Street ' Mocksville,NC.27028 . (336)751-8760/Fax (336)751-8786 Iprevenient Permit D Authorization To Comtruct(ATC) D Both DRepairto Existing System- OExpansion/Modification of Existing System or Facility - - t• THIS APPLICATION CANNOT BEPROCESSED UNLESS ALL OF THE REQUIRED APPLICANT INFORMATION Name to be Billed,6SC /Jc ur,00yrrrN7 Cex, i,.tc - Contact Person. -7ZuxY 2,f 7r Billing Address A -6 -Asx 3-c Home Phone - - - CiTy/State/ZIP _rti/ncrrwcc.-� tIr: z 702 a - Business Phone 7S/ - 73oo - Name on Permit/ATC if Different than Above Mailing Address - City/State/Zip - - Murnxt r 11Nrvruv1. 11VIN •r,are nouseir i r,omers ria eu NOTE: A survey plat or site plan must accompany this application. Included: D Site Plan lat(to scale) - _ - (Permit is valid for 60 months with site plan, no expiration with complete plat.) - Owner:s Name�OSe .02VdLoFrlFNi crM� irtc. Phone Number 7S/-73� Owner's Address - fo Bow j4. City/State2ip /t�ocs3' �zrcr' faC 2 7029 Property Addre s - - - - City - LotSize'Tax PIN# Subdivision Name(if aonlicable) ess.Fx fAz, SectiotdLot# ie answer to any of the toll0wnng questmns4s'yes', supporting documentano99 must be attficned. - No - . Are there any existing wastewater systems on the site? DYes Does the site containjurisdictional wetlands? - DYes DNo Are there any easements or right-of-ways on the site? Dies ❑ o - Is the site subject to approval by another public agency? - OYes 13Npp 71 Will wastewater other than domestic sewage be generated? DYes - - IF RESIDENCE FILL OUT THE BOX BELOW - #People #Bedrooms_ #Bathrooms Garden Tub/Whirlpool DYes ONo Basement DYes ONo Basement Plumbing: ❑Yes DNo - - 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:f�$Conventional OAccepted Dlndovative []Alternative -[]Other'. Water Supply Type: H'County/City Water O New Well DExisting Well �D Community Well - Do you anticipate additions or expansions of the facility this system is intended to serve? D Yes D 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 locating an gging or staking the houseJfacili lorxtion, proposed well location and the location of any other amenities. Site Revisit Charge Piopertr �T�or er's legal represents re I Client Notification Date: Date - EHS: Sign given-OYes DNo - - Account# 'Revised 11/06 - Invoice# DAVIE COUNTY HEALTH DEPARTMENT Environmental Health Section Soil/ Site Evaluation PROPERTY INFORMATION Tax PIN/EH #: 5870-tj4-2Zb0.Ut Subdivision Info: Essex Farm Lot # 07 Location/Address: Cornatzer Rd -27006 0.691 Ac. Date Evaluated: q- _X-C) —!O� APPLICANT INFORMATION. Account #: 990004425 Billed to: PSC Development Corp. Inc. Reference Name: Brad Coe Proposed Facility:. Residence Property Size: On -Site Well Community Auger'Boring Pit / Public ✓ ' ✓ Cut FACTORS 143 41--t /! K 4 5 6 7 Landscape position 4 L Slope % + Z 2 HORIZON I DEPTH o - - Texture group 4Z - C C Consistence -el r P 41 r Structure .: :.. 'fib K' Mineralogy 3 E>c p p HORIZON H DEPTH ' 3g_ T .Texture group S.r, Consistence;; Structure Mineralogy HORIZON III DEPTH Texture group - Consistence .' Structure I^ ""Mineralogy HORIZON IV DEPTH Texturegroup Consistence Structure Mineralogy- - - SOIL WETNESS �- RESTRICTIVE HORIZON -- . SAPROLITE - 15 l CLASSIFICATION CLASSIFICATION LONG-TERM ACCEPTANCE RATE 0,115, Q SITE CLASSIFICATION: TANG -TERM ACCEPTANCE' RATE: REMARKS: . EVALUATION BY: PWD M C(\ i 6014 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 Textur& 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 VFI - Very firm . EFI - Extremely frai 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 )Votes _. 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 05/05 (Revised) Davie County Environmental Health P.O. Boz 848/210 Hospital Street Mocksville, NC 27028 .(336)751-87.60/ Fax (336)751-8786 IMPROVEMENT PERMIT Account #: 990004425 .1:; Tax PIN/EH #: 5870-64-2265.07 Billed To: PSC Development Corp. Inc. Subdivision Info: Essex Farm Lot # 07 , Address: PO Box 340 Location/Address: Cornatzer Rd -27006 ' City: Mocksville Property Size: 0.691 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 pernmt(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: Oew (]Repair. DExpansion Permit Valid for: Years DNo Expiration Residential Specifications: # Bedrooms #Bathrooms # People_ BasementO Basement plumbingO Non -Residential Specifications: Facility Type # People_ # Seats_ Q Square Footage(or Dimensions of Facciility) DesignFlow(GPD): L' t+� Type of Water Supply: I�'County/City DWell DCommunityWell As stated in 15A NCAC 18A.1969(5) Site Modifications/PermitConditions: accepted Systems may also be used System Type LTAR Initial Adctin-t� - i a..)--75 . Repair - A:c�ea{._ec) _. O. 75 --- bvironmental Health Specialist Date rt)—Ju- C./ r IN .01.00' N 74'-12'-50" 't 0 304.15' 304.61' - N A o - p - 30100 Sq.Ft. N 80'-33'-58" o WYWAY 50' R 0.691 Ac.+/- 50.03' 1599.37' o ustee i8 S 82'- 87'-35'-03" W _o F -109.61- S 82 E 35.00' I i -100 N 301.00' E 26.84' / Co ® S I m n 30098 Sq.Ft, 18.12' o 8p 3 0.691 Ac.+/- N S 82• W o _o I I �+ o -00 E N p, to 301.00' 26.84' 27.55' `" n 0 O I I cooN oo n I Ot I ON N^ O4 o' 301 Sq.Ft. 48.79' 50.00' 0.691 Ac.+/- 51'-10'-24" o `" v S 82'-28'-00" E 0 50.00' _o I ^ + ^ N 301.00' E 35.00' I ® I w5 82-2a-oo ' E ^ 30100 Sq.Ft. 35.00' O 8 82•-28'-00' 100,00' 0.691 Ac.+/- S oo' 0 J s.81, so..ts• S82 -28 � '-00" E 61.52' o 301.00' ' to Co _Cd at ^ w . 30106 Sq.Ft. 1 3 z 3 } to 0.691 Ac.+/- w $ , o } IV+ 0 pj - S 82'-28'-00" E, 000 v !L+ w a N a o n a o M$ 301.00' ^ _y c j 0 00 n 0 N 0 ® wrn n 0 "? n 0 30100 Sq.Ft. I N o n o I 0.691 Ac.+/- o u f i 82 z S o a I z 82'-28'-00" E , a 301.00' I ®L-100.00'- Of 00 0 30100 Sq.Ft. o 9.65' 0.691 Ac.+/- 0 N 82-28=00` W_ / Cl S 82'-28'-00 C; 0 > 3 T-YWA Y S 82'-28' 50p R/W (Public) EI 301.00' x f -726.2 E - o © ti /I - 83.37- a 30100 Sq.Ft. 0.691 Ac.+/- o } S 82'-28'-00" E oo w o• l } as w rn 301.00' h 32070 Sq.Ft. `o . N' a 0.736 Ac.+/- o 30001 Sq.Ft. r I 1 n N 0.689 Ac.+/- i _g 30010 30010 Sq.Ft. I Ch N ° ;�\°`° 0.689 Ac.+/- to Z r, Cl I z N -- \ -- - or30 elan L } C�RNA7ZE m 7o toe R ROAD SR 7616 eo° hy*WA rve Radius Chord Bearing and Distance Arc Length 1599.37' N 74'-12'-50" W 304.15' 304.61' 1599.37' N 80'-33'-58" W 50.03' 50.03' 1599.37' N 87'-35'-03" W 89.08' 89.09' 35.00' S 59'-55'-01" E 26.84' 27.55' i 50.00' S 47'-48'-22" E 18.12' 18.22' 1599.37' N 83'-43'-31" W 126.31' 126.35' ' 35.00' N 74'-59'-02" E 26.84' 27.55' i 50.00' N 80'-23'-13" E 46.87' 48.79' 50.00' S 51'-10'-24" E 35.00' 35.76' 0 50.00' S 10'-11'-55" E 35.00' 35.76' 1 50.00' S 30'-46'-33" W 35.00' 35.76' 2 50.00' S 86'-30'-33" W 57.71' 61.52'