179 Essex Farm Road Lot 10Davie County, NC 'a Tax Parcel Report Tuesday, December 20, 2016
;--- -----
r
WARNING: THIS IS NOT A SURVEY
187
0
Parcel Number:
F803OA0010
Township:
Shady Grove
z
5870640116
Municipality:
of
Account Number:
8304855
LLx
37059-803
Listed Owner 1:
BROWN ISABEL MARIA
Voting Precinct:
FAST SHADY GROVE
LU
179 ESSEX FARM ROAD
Planning Jurisdiction:
0
41
City:
179 --------
Zoning Class:
DAVIE COUNTY R -A
State:
`
107
Zip Code:
27006
Voluntary Ag. District:
No
+
--------
-- ---WYA
Ie
err
0.69
DR
Deed Date:
X0
Middle School Zone:
171
CcI
009830761
Soil Types:
rW
Plat Book:
- -
U
wL
i
;
Plat Page:
290
11.14
9s�ig 1111 data is pmWded as b wlthoaft nty, orguarantes ofany Idnd elthererynased or Implied Including but not limited to the
Davie County, ImplledwnnntlesofinemitantabllgyorlhnmforapaNcularusa./WusersofDavieCounty'sGISrrebsgeshallholdhamlessthe
Ai County of Dade, North Carolina, its agents, consultands, contractors oremployees from anyarui all claims orcauaes of scion due to
N
CpGN'Sl C - orarisin9 out ofthe use orinabirtyto use the GIS data provided bythis website
WARNING: THIS IS NOT A SURVEY
Parcel Information
Parcel Number:
F803OA0010
Township:
Shady Grove
NCPIN Number:
5870640116
Municipality:
Account Number:
8304855
Census Tract:
37059-803
Listed Owner 1:
BROWN ISABEL MARIA
Voting Precinct:
FAST SHADY GROVE
Mailing Address 1:
179 ESSEX FARM ROAD
Planning Jurisdiction:
Davie County
City:
Advance
Zoning Class:
DAVIE COUNTY R -A
State:
NC
Zoning Overlay:
Zip Code:
27006
Voluntary Ag. District:
No
Legal Description:
LOT 10 ESSEX FARM PHASE 1
Fire Response District:
ADVANCE
Assessed Acreage:
0.69
Elementary School Zone: SHADY GROVE
Deed Date:
3/2015
Middle School Zone:
WILLIAM ELLIS
Deed Book / Page:
009830761
Soil Types:
GnB2
Plat Book:
0009
Flood Zone:
Plat Page:
290
Watershed Overlay:
DAVIE COUNTY
Building Value:
Outbuilding & Extra
Freatures Value:
Land Value:
Total Market Value:
Total Assessed Value:
9s�ig 1111 data is pmWded as b wlthoaft nty, orguarantes ofany Idnd elthererynased or Implied Including but not limited to the
Davie County, ImplledwnnntlesofinemitantabllgyorlhnmforapaNcularusa./WusersofDavieCounty'sGISrrebsgeshallholdhamlessthe
Ai County of Dade, North Carolina, its agents, consultands, contractors oremployees from anyarui all claims orcauaes of scion due to
N
CpGN'Sl C - orarisin9 out ofthe use orinabirtyto use the GIS data provided bythis website
Applicant:. RS Parker Hornes/Joy.ppringer
Address 5 . 02 , Hickory , 'kid' ge r Drive
CRY: Greensboro
State/Zip: NC 27409
Phone it: (336) 978-7120
Add ress/Road M Subdivision;
179 Essex Farm Rd
Advance NC 27006
Structure:, .$INGLE FAMILY.
of Bedio0mv. 4'
9 of People:
*WaterSupply: PUBLIC
IIP Issued by. 2140 -Nations, Robed
ICA issued by: 2140. Nations, Robed
Design Flow: 4 8 0
Soil Application Rate. 0 .1 5
Nitrification Field
No. Drain Lines
Total Trench Length:
Trench Spacing:
Trench Width:
Aggregate Depth:
/`ProP!qrtY9wQer-- RS Parker Hornes/Joy.SpIing9r-
Address: 562 Hickory Ridge Drive
CRY: Greensboro
StatefLip: NC 27409
11�
one #: (336) 978-7120
Phase: Lot: 10
Directions,
Hwy 158 to Hwy 801 turn right, go to Comatzer Rd
,on Right, then Essex Faftn :on tight
*System Classification/Description:
Seprolfte System? OYes (§)No
'Distribution Type: PUMP TO GRAVITY Pump Required?
*Yes ONo
'Pre -Treatment:
1 9 a 0 Sq. ft.
6
4 8 0 ft.
9 OInches O.C.
— *Feet O.C.
3 Inches
�Feet
inches
Minimum Trench Depth:
OPERATION PERMIT
1
Davie CountyDepartment.
en.t.
Minimum Soil Cover.
210 Hospital. Street
9
PA Box 848
Maximum Trench Depth" 3
",,maximum
NC,'27028'
Inches
Phone: 336-753-6780 Fax: 336-753-1680
Applicant:. RS Parker Hornes/Joy.ppringer
Address 5 . 02 , Hickory , 'kid' ge r Drive
CRY: Greensboro
State/Zip: NC 27409
Phone it: (336) 978-7120
Add ress/Road M Subdivision;
179 Essex Farm Rd
Advance NC 27006
Structure:, .$INGLE FAMILY.
of Bedio0mv. 4'
9 of People:
*WaterSupply: PUBLIC
IIP Issued by. 2140 -Nations, Robed
ICA issued by: 2140. Nations, Robed
Design Flow: 4 8 0
Soil Application Rate. 0 .1 5
Nitrification Field
No. Drain Lines
Total Trench Length:
Trench Spacing:
Trench Width:
Aggregate Depth:
/`ProP!qrtY9wQer-- RS Parker Hornes/Joy.SpIing9r-
Address: 562 Hickory Ridge Drive
CRY: Greensboro
StatefLip: NC 27409
11�
one #: (336) 978-7120
Phase: Lot: 10
Directions,
Hwy 158 to Hwy 801 turn right, go to Comatzer Rd
,on Right, then Essex Faftn :on tight
*System Classification/Description:
Seprolfte System? OYes (§)No
'Distribution Type: PUMP TO GRAVITY Pump Required?
*Yes ONo
'Pre -Treatment:
1 9 a 0 Sq. ft.
6
4 8 0 ft.
9 OInches O.C.
— *Feet O.C.
3 Inches
�Feet
inches
Minimum Trench Depth:
3
1
Inches
Minimum Soil Cover.
1
9
Inches
Maximum Trench Depth" 3
",,maximum
6
Inches
Soil Cover.
.1
4
Inches
*System Type: INFILTRATOR QUICK 4 STANDARD
Installer frankTansou
Certification #: 2771
*EH S: 2140 -Nations, Robert
Date: 0 a/ I a / 2 0 1 5
CDP Fite Number 158798 -1
Manufacturer. shoal
STB: 760
Gallons: 1000
Date:
0
8/
0 a/
a 0 1 4
*Filter Brand:
POLYLOKPL-122 With Pipe Adapter
STMarker.
❑
Yes
R
No
nforced Tank:
❑
Yes
IN
No
1 Piece Tank:
❑
Yes
(]
No
Manufacturer. shoaf
PT: 42
Gallons: 1250
Date: 0
8/ 0
a/
a 0 1 4
RiserSealed ®
Yes
❑
No
Riser Height: [E
Yes
❑
No (Min.6 in.)
nforced Tank: ❑
Yes
❑r
No
1 Piece Tank: p
Yes
❑
No
Pipe Size: a inch diameter
Poe Length: 1 4 0 feet
*Schedule: 40
Pressure Rated ® Yes
,pproved fittings p Yes
PumpType: Zoeler
Dosing Volume:
Draw Down:
*Chain: STAINLESS
Valves Accessible
I]
Yes
Flow Adjustment Valve
®
Yes
Check -valve
®
Yes
PVC. Unions,
®Yes
Vent Hole
®
Yes
\ Anti -siphon Hole
i]
Yes
County ID Number: Fs
30•AO-010
Lat.
Long: i
Installer. Frank Transou '!
Certification #: 2771
THS: 2140- Nations. Robert
Date: 0 a/ 1 a/ 2 0 1 5
Approval, Status
® Approved D Disapproved
Pump Tank
Installer Frank Transou
Certification #: 2771
THS: 2140 -Nations, Robert
Date: 0 a/ 1 a/ 2 0 15
Approval Status
❑O Approved O' Disapproved
pply Line
Installer. frank Transou
Certification #: 2771
THS: 2140- Nations. Robert
❑ No Date: 0 a/ 1 a/ 2 0 1 5
❑ NO A'pprov8l'$tetus
® Approved ❑ Disapproved
Installer.
Gal Certification #:
Inches *EHS: 2140- Nations, Robert
0 No
CDP Filp Number 158798-1
N EMA 4X Box or Equivalent
[E Yes
Box 12 inches Above Grade
Q Yes
Box Adj. ToPump Tank,
91 .Yes;
conduit Sealed
I] Yes
Pump Manually Operable
ff] Yes
'Activation Method:
PIGGYBACK
Alarm Audible 91 Yes.
Alar Visible R Yes
*Operation Permit completed
Authorized State
Owner/Applicant Signature:
County ID Number. F8-030-ao•010
❑
NO
Installer.
Faniktransou
❑
No
Certification#:
2771
❑
No
❑
No
"EH S:.2t4D;Nations,,Robert
❑
1.L.
No
.Date:
0 '.1 / 1 `a_ /.a,;0_`1 5i.
Approval Status;
❑ Noi I];gpprove `d❑ Disapproved`
❑ No
2140 - Nations, Robert
Date of Issue: 0 a/ 1 a/ 2 0 1 5
This system has been installed in compliance w1h applicable NC General Statutes: Article 11, Chapter 130A, Rules for
Sevtage,Treatment and Disposal,15ANCAC,M ;1900 et, Seq.,and oil ,conditions of the improvement Permit and
Construction Authorization. Ttlis property is served bye SeWdge, Septic System.
=Rule :7961 requires that a Type septic system meet the following criteria:
Minimum System Review ByThe Local Health Department:
Management Entity:
Minimum System Inspection/Maintenance Frequency By Certified Operator.
Reporting Frequency By Certified Operator.
Rule .1961 requires. that a Type IV and V septic:systems designed fora hometbusiness_owner must maintain a valid contract
with a public rilanagement entitywxh a certified operatoror a'privste certified operator for , life ofth'e septic system.
Rule .1961 requires that Type VI septic systems designed fora home/business owner must maintain a valid contract with a
public management entdywith a certified operator for the Iffe of the septic system.
®Hand Drawing OlmportDravving =;
**Site Plan/Drawing attached.**
OPERATION PERMIT
Davie County Health Department
210 Hospital Street
P.O. Box 848
Mocksvilie NC
DmwinE Drawing Type: Operation Permit
27028
(00
CDP File Number. 158798-1
County File Number: F8.030 -AO -010
Date: ././ /W/
O Inch
Scale:. . . OBlock
ON/A
CONSTRUCTION
AUTHORIZATION
Davie County Health Department
210 Hospital Street
1 P.O. Box 848
Oo..A
Mocksville NC 27028
Phone: 336-753-6780 Fax: 336-753-1680
Applicant:
Address:
City:
State2ip:
RS Parker Homes/Joy Springer
502 Hickory Ridge Drive
Greensboro
NC
Phone #: (336) 978-7120
27409
Address/Road #: Subdivision:
179 Essex Farm Rd
Advance NC 27006
Structure: SINGLE FAMILY
# of Bedrooms: 4
# of People:
'Water Supply: PUBLIC
+`Site Classification: Provisionally suitable
SaproliteSystem? OYes @NO
Design Flow: 4 8 0
Soil Application Rate: 0 a 5
'System Classification/Description:
TYPE III B. SYSTEM W/SINGLE EFFLUENT PUMP
*Proposed System: 25% REDUCTION
Nitrification Field
No. Drain Lines 6
Total Trench Length:
Trench Spacing:
Trench Width:
Aggregate Depth:
1 9 a 0 Sq. ft.
/ For Office Use Only
*CDP File Number 158798-1
County ID Number: F"30-Ao-010
Evaluated For: NEW
Township:
1 0/ 1 0/.2 0 1 9
Property Owner. RS Parker Homes/Joy Springer
Address: 502 Hickory Ridge Drive
City: Greensboro
State/Zip. NC 27409
Phone #: (336) 978-7120
Phase: Lot: 10
Directions
Hwy 158 to Hwy 801 tum right, go to Comatzer Rd on
Right, then Essex Farm on right
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: PUMP TOGRAVITY
Septic Tank:
1 0 0 0 Gallons
1 -Piece: OYes ®No
Pump Required: @Yes ONo OMay Be Required
Pump Tank: 1 0 0 0 Gallons
1-Piece:OYes ®No
4 8 0 ft. GPM—vs— ft. TDH
9 2 9 Inches O.C. Dosing Volume: Gallons
— �r Feet O.C. —
3 @Inches
Feet Grease Trap: Gallons
inches Pre Treatment: ONSF OTS -1 OTS -II
Septic Tank Installer Grade Level Required: 01011 0111 OIV
CDP File Number .158798 - 1
it
*Site Classification: Provisionally Suitable
Design Flow: 4 8 0
Soil Application Rate: 0 a 5
*System Classification/Description:
TYPE III B. SYSTEM W/SINGLE EFFLUENT PUMP
*Proposed System: 250/6 REDUCTION
Nitrification Field
No. Drain Lines 6
1 9 a 0 Sq. ft.
Total Trench Length: 4 8 0 ft
County ID Number: F8 -030-A0-010
❑ Open Pump System Sheet
No ONO, but has Available Space
Trench Spacing: — 9 2Inches 0.1
w Feet O.C.
Trench Width: Inches
3 2 Feet
Aggregate Depth:
inches
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: PUMP TO GRAVITY
Pump Required: @Yes ONo OMay Be Required
PreTreatment: 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.
7!
^Permit Conditions
The issuance of this permit bythe Health Department in no way guarantees the issuance of other pertmits.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 ofthe Improvement Permit, not
to exceed five years, and may be issued at the same time the Improvement Permit Issued (NCGS 130A336(11)} If the installation has rat 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 rncone" 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 awning 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: 1 0 / 1 0 / .1 0 1 4
Authorized State Agent:gg:r Malfunction Log Oyes
®Hand Drawing Olmport Drawing
**Site Plan/Drawing attached.**
Page 2 of 3
CONSTRUCTION AUTHORIZATION
Dayie County Health Department
210 Hospital Street
P.O. Box 848
Mocksville NC 27028
Drawing Drawing Type: Construction Authorization
CDP File Number. 158798 -1
County File Number: F8-030-Ao-010
Date: 10/10/2014
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WIN
Paoe 3 of
APPLICATION FOR SITE EVALUATION/IMPROVEMENT PERMIT & ATC
-
Davie County Environmental Health
rP.O. Boa 848/210 Hospital Street l� ^•CENED -
P 1 ( - Mochsville, NC 27028
Date: -- �1,� _____.(336)753-6780/ Fax (336) 753-1680 (�
Rec@RRiff8ik7n Fon Evylum on/Improvement Permit YAuthorizati!RIO Cons � - -
pe o pp cauon.- L ew System CRepair to Existing System ❑Expansion/Modification of Existing System or Facility -
"""IMPORTANT""" THIS APPLICATION CANNOT BE PROCESSED UNLESS ALL OF THE REQUIRED
INFORMATION IS PROVIDED. Refer to the INFORMATION BULLETIN for instructions.
t1l'YL1l.tLLV l
Name to be Billed R6 PW K2)" �iDtY12`7 - Contact Person I.A 6pr —s (aer
Billing Address .rToa Wim LOrV Q I� Home Phone'` —� 0
City/State/ZIP (ter oo r15b o (� C a1 0 Business Phone 19 - -rm1
Name on Permit/ATC ifDierent than
rreVrnrcr r LnrumwAiiun -"ate nouseiracuny Corners rraggeu
NOTE: A survey plat or site plan must accompany this application. Included: O Site Plan �(m scale)
(Permit is alid fe 0 onths w'tl site plan, no expiration with complete plat.) - -
Owner's Name J� Ir S - Phone Number
Owner's Address 5007 City/Stat Zip�441lIm^!O
Property Address I7 ) City VQ f)CQ_fYt, - n..n
Directions To Site:
If the answer many of the following questions is "yes", supporting documentation must be attached.
Are there any existing wastewater systems on the site? Oyes Vo -
Does the site contain jurisdictional wetlands? - Dyes rMo
"Are there any easements or right-of-ways on the site? Dyes o
Is the site subject to approval by another public agency? Dyes Io
#People . #Bedrooms #Batjuooms Garden Tub/Whirlpool Wes DNo
Basement: DYes SRQo Basement Plumbine: Dyes o
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: Part
ventional DAccepted ❑Innovative OAltemative 00ther
Water Supply Type:�County/City Water D New Well OExisting Well - ' D 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 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 -
1 'in a and agging or staking t e home/facility location, proposed well location and the location of any other amenities.
Pr pe own is �
or own s legal representative signature Site Revisit Charge
- Date(s): -
- Client Notification Date:
Date - EHS: '
Sign given Dyes DNo
Revised 11/06
/0
Account#
Invoice #1,_,_f—,_i_ I
SETBACKS: N07.32'00'E
FRONT: 45'
SIDE: 15' 100.00'
REAR: 30'
PROPOSED
RESIDENCE
DO
SETBACK
co
If7
10 UTILITY -EASEMENT `t
N07.32'00'E -
100.00'
ESSEX FARM ROAD
50' - RIW (PUBLIC)
GRAPHIC SCALE
40 0 20 40 w
IN FEET )
1 inch = 40 1t
li
i
50.00'
PROPOSED
RESIDENCE
C
50.00'
7
PRELIMINARY
PLOT PLAN FOR:
RSP BUILDERS
LOT 10 OF ESSEX FARMS, PHASE 1
P.B. 9 PC. 290
F��ming F.oginrcring, Inc.
8518 Tdad Drive, NC 27235
Phone:336-852-9797 *Fax: 336-8529766
NCBE7S C-0950 DATE: 09-29-14
REF: PR0J\1931-07\Ow9\E55RFAUM.Ow9
ATION FOR SITE EVALUATION/IMPROVEMENT PERMIT & ATC
UV Davie Count- Environmental Health
P.O. Box 48/210 Hospital Street
Mocksville, NC 27028
(336)751-8760/Fax(336)751-8786
tion Site Evaluation/Improvement Permit . D Authorization To Construct(ATC) D Both
,,,ap\yOOPJ E(};y pplication: ONew System ORepair to Existing System OExpansior Mlodification of Existing System or Facility
U • "'IMPORTANY*** THIS APPLICATION CANNOT BEPROCESSED UNLESS ALL OF THE REQUIRED
INFORMATION IS PROVIDED. Refer to the INFORMATION BULLETIN for instructions.
APPLIUANI INV VRMAI ION - / IWY44,73
Name to be Billed ASC Arra .p",rAT cw. i x Contact Person %cRRti Bv7c v,C
Billing Address Aci-A.rr 31,o - Home Phone -
City/State)ZIP 4rQf �cc�t .qac. L 7cz 8 Business Phone 7S/ - 73o0 - -
v
Name on Permit/ATC if Different than Above - - -.
Mailing Address City/State/Zip
rnvrnr�rr uvrvnvuyrrvry 'Lore nuwcrracwi wrucirra cu
NOTE: A survey plat or site plan must accompany this application. Included: O Site Plan a lat(to scale)
(Permit is valid for 60 months with site plan, no expiration with complete plat)
If the answer to any of the following 4uestionsris "yes", supporting documentatio99 must be mulched.
Are there any existing wastewater systems on the site?
DYes ONy - -
210
Does the site containjurlsdictional wetlands? -
Oyes
Are there any easements or right-of-ways on the site?
ales 0190 -
Is the site subject to approval by another public agency? - -
DYes IrNp
Will wastewater other than domestic sewage be generated?
DYes [?No
IF RESIDENCE FILL OUT THE BOX BELOW -
#People # Bedrooms _ -# Bathrooms Garden Tub/Whirlpool DYes ONo
Bem
asent: DYes ONo Basement Plumbing: DYes ONo
tMIZI CBL>t1163!7_xCI"�lyU1.1[�18YW4;IaaaY.�:]:11IaY.'I
type of Facility/Business Total Square Footage of Building # People
i Sinks- . # Commodes # Showers # Urinals
'Estimated Water Usage (gallons per day) (Attach documentation of similar facility water consumption)
"OODSERVICE ONLY: # Seats - -
Type system requested:��2fConventional DAccepted OImovative DAlternative--OOther
Water Supply Type: 13-County/City Water 0 New Well. Misting Well _. O 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 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 'tgging or staking the house/facili location, proposed well location and the location of any other amenities.
Site Revisit Charge
Prope r r or o er's legal repmsenta re -
Date(s):
Client Notification Date:
Data 1 - EHS: -
Sign given DYes ONo
Revised 11/06
Account#
Invoice 9
I
s r 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:
Slope %
Water Supply:
Evaluation By:
PROPERTY INFORMATION
Tax PIN/EH #: 5870-64-2265.10
Subdivision Info: Essex Farm Lot # 10
Location/Address: Cornatzer Rd -27006
0.691 Ac. Date Evaluated: — ae —�-7
On -Site Well, Community Public
Auger Boring Pit �� Cut
FACTORS
/
/ (�!
4 5 6 7
Landscape position
Slope %
HORIZON I DEPTH
Texture grou
fs
Consistence
r
StructureMineralo
j,1
SF k 17HORIZON
II DEPTH
j
-Texture rou
5 t C
1C__.Consistence
r
Structure
/c
Mineralogy
HORIZON III DEPTH
Texture group .
Consistence
Structure
Mineralogyr
HORIZON IV DEPTH
Texture group
Consistence
Structure
Mineralogy
SOIL WETNESS
RESTRICTIVE HORIZON
_
SAPROLITE .
CLASSIFICATION -
o
o
LONG-TERM ACCEPTANCE RATE
y7
Zs
SITE CLASSIFICATION: w:� aro1L EVALUATION BY: Vit j A loc 'I
o'. a
LONG-TERMACCEPTANCE RATE: OTHER(S) PRESENT..a / /
REMARKS: A S-01 $oil Co -r (or,
LEGEND Cot
Landscape Position 0� '� �'`
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 .
CONSTSTF.NCF.
Mois
VFR - Very friable FR - Friable FI - Firm VFI - Very firm EFI - Extremely firm
NS - Non sticky SS - Slightly sticky S - Sticky VS - Very Sticky
NP - Non plastic SP - Slightly plastic P - Plastic VP - Very plastic
rStructure
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
iynlss
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 (Revisrdl
1 i
**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 or the intended use change.
Permit Type: R<ew ❑Repair. ❑Expansion Permit Valid for: Med ears DNo Expiration
Residential Specifications: #Bedrooms 7�#Bathrooms #People_BasementOBasement plumbing❑
Non -Residential Specifications: Facility Type # People_ # Seats_
Square Footage(orDimensionsofFacility) '
DesignFlow(GPD): 118- Type of Water Supply: o ounty/City []Well ❑CommunityWell
Site Modifications/PermitConditions As stated in 15A NCAC 18A.i969(5)
SUM-Vted Systems may a So a use
System Type LTAR
Initial Ck Cr– cmbeA 0141$—
Repair QCc cn��� O•a f
Environmental Health Specialist - -
.r
Davie County Environmental Health
P.O. Boz 848/210 Hospital Street
Mocksville, NC 27028
(336)751-8760/ Fax (336)751-8786
IMPROVEMENT PERMIT
Account #:
990004425
Tax PIN/EH #:
5870-64-2265.10
Billed To:
PSC Development
Corp. Inc. Subdivision Info: ,
Essex Farm Lot # 10
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 or the intended use change.
Permit Type: R<ew ❑Repair. ❑Expansion Permit Valid for: Med ears DNo Expiration
Residential Specifications: #Bedrooms 7�#Bathrooms #People_BasementOBasement plumbing❑
Non -Residential Specifications: Facility Type # People_ # Seats_
Square Footage(orDimensionsofFacility) '
DesignFlow(GPD): 118- Type of Water Supply: o ounty/City []Well ❑CommunityWell
Site Modifications/PermitConditions As stated in 15A NCAC 18A.i969(5)
SUM-Vted Systems may a So a use
System Type LTAR
Initial Ck Cr– cmbeA 0141$—
Repair QCc cn��� O•a f
Environmental Health Specialist - -
.r