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171 Essex Farm Road Lot 9i Davie County, NC Tax Parcel Report . Tuesday, December 20, 2016 a WARNING: TIHS IS NOT A SURVEY G: .� _Parcel Information Parcel Number. F803OA0009 Township: Shady Grove NCPIN Number: 107 Municipality: Account Number: 8306472 co 37059.803 W LANDRY RENE J Voting Precinct: EAST SHADY GROVE i WYAT7; DFS i Davie County 171 1 O i NC Zoning Overlay: Zip Code: 27006 104 LL Legal Description: W Fire Response District: 161 --------- Assessed Acreage: -- u Elementary School Zone: SHADY GROVE LU 6/2016 9�my.18All data Is provided as is wtlhout wartmrty or guarantee of any kind either expressed or Implied Including but not limited to the Davie County, Implletlwamntlas ofinerchantabglty Witness for a parnwlarusn/W users of Davie County's GIs webslte shag hold harmless the County of Davie, North Carolina, Ib agents, consultants, contrasro. oremployees Rom anyand an claims orcauses ofaction duet. AT npRN't't ,. C "arising out ofthe use orinabirdy, to use the GIs data provided by this webshe. WARNING: TIHS IS NOT A SURVEY .� _Parcel Information Parcel Number. F803OA0009 Township: Shady Grove NCPIN Number: 5870549096 Municipality: Account Number: 8306472 Census Tract: 37059.803 Listed Owner 1: LANDRY RENE J Voting Precinct: EAST SHADY GROVE Mailing Address 1: 171 ESSEX FARM ROAD Planning Jurisdiction: Davie County City: ADVANCE Zoning Class: DAVIE COUNTY R -A State: NC Zoning Overlay: Zip Code: 27006 Voluntary All. District: No Legal Description: LOT 9 ESSEX FARM PHASE 1 Fire Response District: ADVANCE Assessed Acreage: 0.69 Elementary School Zone: SHADY GROVE Deed Date: 6/2016 Middle School Zone: WILLIAM ELLIS Deed Book I Page: 010210122 Soil Types: GnB2 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: 9�my.18All data Is provided as is wtlhout wartmrty or guarantee of any kind either expressed or Implied Including but not limited to the Davie County, Implletlwamntlas ofinerchantabglty Witness for a parnwlarusn/W users of Davie County's GIs webslte shag hold harmless the County of Davie, North Carolina, Ib agents, consultants, contrasro. oremployees Rom anyand an claims orcauses ofaction duet. AT npRN't't ,. C "arising out ofthe use orinabirdy, to use the GIs data provided by this webshe. - — ' DAVIE COUNTY ENVIRONMENTAL. HEALTH P.O. Box 848/210 Hospital Street Mocksville, NC 27028 (336)753-6780 / Fax # (336)753-1680 OPERATION PERMIT Account #: 990005625 TaxPINiEH#: 5870-64-2268.9 Hilted To: Nemeh Group Inc. Subdivision' -Info: Essex Farm .Lot # 9 Reference Name: <?s:Location/Address: 171 Essex Farm Rd -27006 ,.- Proposed Facility: Residential PropertytSize: .691 Acre a:= ATC Number: 5727 _ **NOTE** The issuance of this Operation Permit shall indicate the system described on the ATC has been installed in compliance with Article 11 of G.S. Chapter 130A, Section .1900 "Sewage Treatment and Disposal Systems," but shall in NO WAY be taken as a guarantee that the system will function satisfactorily for any given period of time. Q X4.1 System Type: I S.T. Manufacturer �k 0 �'� Tank Date �} Tank Size D v Pump Tank Size doy System Installed By: BOl 50 w 57P� • E.H. Specialist: ate: GPS ..1Me QI _ ,G0 VA I 1 r DCHD 11/06 (Revised) 3a !' a, � ka i o�,Z4Y ' Y DAVIE COUNTY ENVIRONMENTAL HEALTH _ P.O. Box 848/210 Hospital Street Mocksville, NC 27028 (336)753-6780/Fax # (336)753-1680 \ �` AUTHORIZATION FOR WASTEWATER SYSTEM CONSTRUCTION ' Account #: 990005625 Tax PiN/EH # 5870-64-2268.9 ' Billed To: Nemeh Group Inca , ± Subdivisionlnfo!, ,Essex Farm Lot # 9 Reference Name: LocationiAddress: 171 Essex Farm Rd -27006 Proposed Facility: Residential Pioperly S1zb: 69J Acre Site Type: EKqew ❑Repair DExpansion ATC Number: 5727 **NOTE** This Authorization to Construct (ATC) MUST BE ISSUED by the Davie County Environmental i Health Section prior to issuance of any building permit(s), (in compliance with Article 11 of G.S. Chapter 130A Wastewater Systems, Section .1900 Sewage Treatment and Disposal Systems). THIS AUTHORIZATION TO CONSTRUCT IS VALID FOR A PERIOD OF FIVE YEARS., This ATC is subject to.revocation if site plans, plat or the intended use change. . Residential Specifications: # Bedrooms # Bathrooms ` 1 # People Basements Basement plumbing❑ Non -Residential Specifications: Facility Type # People #_Seats_ Square Footage(or Dimensions of Facility) . -L r CM -Al Lot Size V -- A I 00"r' f'r' Type of Water Supply: - ounty/City D Well OCommunityWell f System Specifications: Design Wastewater Flow (GPD) Tank Size �,�� GAL: Pump Tank �i p OGAL. `'25 J Trench Width 3 L Max. Trench Depth 3 Rock Depth Linear Ft. a • ! 3 t Site Modifications/Conditions/Other: As stated- in 15A NCAC IRA accepted Systems may also be use I Contact the Davie County Environmental Health Section for final 8:30 - 9:30a.m. on the day of installation. Telephoi N .( 0 Environmental Health S DCHD 11/06 (Revised) m of this system between 1751-8760. iSI.`r Or."JAiks V 44_ APPLICATION FOR SITE EVALUATION/IMPROVEMENT PERMIT & ATC - . - Davie County Environmental Health P.O. Box 848/210 Hospital Street , Mockwille, NC 27028 - _-_ _ - (336)753-6780/ Fix (336) 753-1680 _ Application For. ❑Site Evaluation/Improvement Permit -A' Authorization To Construct(ATC) ❑Both Type of Application: 'gNew System ORepair to Existing System DExpamion/Modthcation of Existing System or Facility ***IA4PORTAN7*** THIS APPLICATION CANNOTBE PROCESSED UNLESS ALL OF THE REQUIRED NINFORMATION IS PROVIDED. Refer to the INFORMATION BULLETIN for inswctiom. Name to be Billed Billing Address ! City/StatefMAO Name on Permit/ATC if Home Phone PROPERTY INFORMATION *Date House/Facility Comers Flaeeed NOTE: A survey plat or site plan must accompany, this application. Included:' Site Plan OPlat(m scale) (Permit is v lid for 60 months rth site plan, no expiration with complete plat) (�G Owner's Name ark F N 1 I Phone Number / / 4D -? (D Owner's Address 171 5• r-4 wrJ, errs c City/State/Lip AJJ44r2 rJC 7--7cOt, Property Address 17/ Fss 6d rcxnrvr Rd City fld �r c,n ce Lot Size .eY24 y7 r Tax PIN# 5'X7c,—dc/-2265.9 Subdivision Name(ifapplicable) GESSe,c�s=e,-m Section/Lot#3 Directions To Site: If the answer to any of the following questions is'yer, supporting documentation must be attached. Are there any existing wastewater systems on the site? OYes XNo Does the site containjurisdictional wetlands? OYes mNo Are them any easements or right-of-ways on the site? OYes pNo Is the site subject to approval by another public agency? OYes PNo Will wastewater other than domestic sewage be generated? OYes WNo IF RESIDENCE FILL OUT THE BOX BELOW #People _r #Bedrooms k #Bathrooms Garden Tub/Whirlpool.*Ym ONo 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: OConventional DAccepted Dlnnovative DAltemative OOther Water Supply Type:;<Cmmty/City Water D New Well DExisdng Well O Community Well Do you anticipate additions or expansions of the facility this system is intended to serve? D 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 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 ofentry to the Authorized Representative of the Davie County Health Department to conduct necessary inspections to determine compliance with applicable laws and odes. I understand that I sin responsible for the proper identification and labeling of property lines and comers and locating and flagging or staking the houselfacility location, proposed wall location and the location of any other amenities. Property owner's or owner's legal representative signature Site Revisit Charge Date(s): Client Notification Data. Date EHS: Sign given DYes ONo Account# ( Revised 11/06 Invoice # N 07W49'E l - Lot 9 Qp lot t8 Z Lot 10 - W N O Co C O � - pr O pop G O o t 5i Proposed Nouse Caraiio Pmposed laroLdFor i 2W Mark D. Full and i Nikki L full $� W 9 o4Esm Farm Phase l `31 DaneCmmly.NC PB91`9289 N 07°32W E 100.00' Essex Farm Road --------------- ----------- PmpwW By: \\ PPA C-2341 m SM SWark Road Pb fteaxy N.C.27040 1 0 / Scale 1 inch 40 feet IMM4624 Rx 1 n ( - _ Demilm9,2010 a Davie County Environmental Health P.O. Box 848/210 Hospital Street - Mocksville, NC 27028 (336)751-8760/ Fax(336)751-8786 IMPROVEMENT PERMIT Account #: 990004425. Tax PIN/EH #: 5870-64-2265.09. Billed, To: PSC Development Corp. Inc. Subdivision Info: Essex Farm Lot # 09 ' 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 permit(in compliance with Article 11 of G.S. Chapter 130A, Wastewater Systems). This Improvement Permit is subject to revocation if site plans, plat orlhe intended use change. Permit Type: 19New DRepair. DExpansion Permit Valid for: IDS Years DNo Expiration Residential Specifications: #Bedrooms# Bathrooms— # People— BasementO Basement plumbingO 'Non -Residential Specifications: Facility Type # People_ # Seats— Square Square Footage(or Dimensions of Facility) DesignFlow(GPD): 'Vic) Type of Water Supply: &County/City DWell ❑Community Well As stated in 15A NCAC 18A.1969(5� Site Modifications/PermitConditions aeGe SSystem i � System.Type LTAR InitialCir nj -eco J Repair Glcc vn�F T 30l L Environmental Health Speciali Date Ia—((I—Q1 q a a 9APP IIQCATI R SITE EVALUATION/IMPROVEMENT PERMIT &ATC �� Davie County Environmental Health P.O. Box 848/210 Hospital Street A�G Mocksville, NC 27028 NtN (336)751 -87601 Fax (336)751-8756 �ENjP e . A #Af)� C e Evaluation/Improvement Permit D Authorization To Cmistr ct(ATC) D Both Typ ofA ton: ONew System ❑Repair to Existing System DExpansion/Modification of Existing System or Facility "IMPORTANP" THIS APPLICATION CANNOT BE PROCESSED UNLESS ALL OF THE REQUIRED AYYLit—ANI 1N1'UNIVIAHUN - / Name to be Billed ASC /Je'U aprrrAr liAt. iAC- Contact Person 7o ?Ay [8476 rt Billing Address 4-* - 1„x •3fo - Home Phone - - City/State/LIP /yoerr r+G 27oZ8 Business Phone 7S/73o0 Name on Pmmit/ATC if Different than Above Mailing Address City/State/Zip r1(UYCKlx 11,4rV1 VL`IIIUry `Vale noose/ractllt lAmerSrm cu NOTE: A survey plat or site plan most accompany this application. Included: O Site Plan lat(to scale) - (Permit is valid for 60 months with site plan, no expiration with complete plat) Owner's Name ,�-vE600rsPi4- 4% /PIC. Phone Number 7S/-73� Owner's Address Po Box_j-fa -City/State2ip/-iG 27oz Property Address Citryy Lot Size (�. Taxi? #_ - - ZZ „ If the answer to any of the following yumtions4s'yes", supporting documentatio99 mus[ ce attached. Are there any existing wastewater systems on the site? OYes 2J11 Does the site containjunsdictional wetlands? - Dyes 20. Are there any easements or right-of-ways on the site? Ulm ONo Is the site subject to approval by another public agency? Oyes 11f�1 Will wastewater other than domestic sewage be generated? Dyes f3No IF RESIDENCE FILL OUT THE BOX BELOW #People #Bedrooms_ #Bathrooms Garden Tub/Whirlpool❑Yes ONo Basement:OYes ONo Basement Plumbing: ❑Yes ONo 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: ✓ C-1111entional OAccepted ❑Innovative ❑Altemative ❑Other - Water Supply Type: ti'County/City Water D New Well DExisting Well D Community Well �Do you anticipate additions or expansions of the facility this system is intended to serve? O Yes ONo 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 pennit(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 understapd that I am responsible for the proper identification and labeling of property lines and comers and locating an ging or staking the houselfacility location, proposed well location and the location of any other amenities. Site Revisit Charge Property. r s or o er's legal represents re - - - Date(s): Client Notification Date: Date I Al Z , - EHS: 1 Sign given Dyes ONo - Account# Revised 11/06 - t - - Invoice -114)73 . I PAGE 2 OF 2 I control comer S 86'-18'-22" w } S 82'-28'-00" 50.98' w E y 0 301.00' Cc o v o 3 N 0 0 30100 Sq.Ft. ri o K'YWAY -ustee 0.69T.+/- 0 50' R 18 S 82'- 28'-00" E o o /r -109.61- - S 82-- N N 301.00' /I QP © I 30098 Sq.Ft. I 80 C 0.691 Ac.+/- o 3 S 82'-28'-()0,- E_ o I o N t` 0 301.00' M N Q N O © ^ N p 0 N 00 _ 0, 0 30100 Sq.Ft.I I N^ 0, 0.691 Ac.+/- 9 %� I O y M c v S 82'-28'-00" o ^ ELO N 301.00' o m © } } I S 82-28•-0p. 30100 Sq.Ft.00 w E_ 100.00' s 82'-28•_00" 0.691 Ac.+/- 0 \ O O J 9.61' 90.J9' 00 82 -28'-00" E _O 1 I Zr n o <N 301.00' 6 1 . 5 rn } bo 30106 Sq.Ft. I 3 Z 3 0.691 Ac.+/- b W W O '00 I LL O _ S 82'-28 -00" i o (A+ i d+ w N- 301.00' E I M a C:in ti u o. �o no O 4 1 oro "�i� an O O O "' N O ^ 0 30100 Sq.Ft. I I o n rn N Z 0.691 Ac.+/- o © 0 + .0 I i 82 S 82-28'-00" 0 E 301.00' 3 I C? IL 0 30100 Sq.Ft. 0 100.00'- '� -100,00'- 9.65' 0.691 Ac.+/- 0 N 82 28 / d S 82-28'-0 00" -00" W'- > 7YWAY 3 50 R/W S (Public) Ol E y 301.00' I 82•_28•_ a 0 ti �f - 126.28' 00 E' I -8337.- C a 30100 Sq.Ft. I w ^ 0.691 Ac.+/- I \ oo } m S 0o 00" w I } 0 01. 00' 32070 Sq.Ft. o , 0.736 Ac.+/- 68 '? c 30001 N N Sq.Ft. , 30010 Sq.Ft. i� I M 0,0.689 Ac.+/- ; °� 0.689 Ac.+/- I 1 (6 `- O1 I Z N -sign C So-, -to C2 J"' �C6___ es„t. CRNA r�ER10ROq _C3 _ _ _ 4.58 ^naa p SR 1616 6n nye 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' 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' 50.00' N 80°-23'-13" E 46.87' 48.79' 50.00' S 51'-10'-24" E 35.00' 35.76' 50.00' S 10'-11'-55" E 35.00' 35.76' 50.00' S 30°-46'-33" W 35.00' 35.76' 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:' • i Residence Property Size: Water Supply: On -Site Well PROPERTY INFORMATION Tax PIN/EH #: 5870-64-2265.09 Subdivision Info: Essex Farm Lot # 09 Location/Address: Corn atzer Rd -27006 0.691 Ac. Date Evaluated: _ aa Q - Community Evaluation By: Auger Boring Pit Public FACTORS 140 ) 7lyJ �l+j� 4 5 6 7 Landscape position L -L Slope % y HORIZON I DEPTH v 3 —6- At . Texture.grou _ Consistence r {y r Structure d Mineralogy XP . HORIZON II DEPTH-- EPTH Texture Texture group S -C- 5; Consistence 'y Structure .. r Mineralogy 5 HORIZON III DEPTH Texture group Consistence Structure . Mineralogy HORIZON IV DEPTH Texture group -Consistence Structure Mineralogy SOIL WETNESS RESTRICTIVE HORIZON / SAPROLITE .CLASSIFICATION t LONG-TERM ACCEPTANCE RATE Q, , �79 0,'.k SITE CLASSIFICATIONEVALUATION BY: �U 6 .j j o C1 vis LONG-TERM ACCEPTANCE RATE: ©`a OTHER(S) PRESENT: ,REMARKS LEGEND 'Landscape Position - R - Ridge - S - Shoulder i 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 loamSIL - 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 . 33 et . NS N on Bucky SS - Slightly Bucky 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 1:1; 2:1, Mixed 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 chrorira 2 or less Classification - S(suitable), PS(provisionally suitable), U(unsuitable) LTAR - Long-term acceptance rate - gal/day/ft2 DCHD 05/05 (Revised)