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201 Essex Farm Road Lot 13Davie County, NC + Tax Parcel Report Tuesday, December 20, 2016 209 - 193 [all AO data Is provided as is wfthoutvamrdy or guarndee of any Idnd either expressed or implied including but not limited to the Davie Countyn, Implied amantes of merchantability ortBnessfor a padimlaruse. All users of Davie County's GIS webaft hall held harmless the County of OaAq NoM Carolina,bagents,wnsulUntd rnn o.oremployeeshom any and aildalmsorcausesofadiondueto NC or arising out ofthe use orinabirdyto use the GIS data provided by this mbahe. WARNING: THIS IS NOT A SURVEY Information . Parcel Number: F8030A0013 Township: Shady Grove NCPIN Number: 5870640455 Municipality: Account Number. 82531114 Census Tract: 37059-803 Listed Owner 1: MERCED TERRY D Voting Precinct: EAST SHADY GROVE Mailing Address 1: 201 ESSEX FARM ROAD Planning Jurisdiction: Davie County City: ADVANCE Zoning Class: DAVIE COUNTY R -A State: NC Zoning Overlay: Zip Code:. 27006-0000 Voluntary Ag. District: No Legal Description: LOT 13 ESSEX FARM PHASE 1 Fire Response District: ADVANCE Assessed Acreage: 0.69 Elementary School Zone: SHADY GROVE Deed Date: M009 Middle School Zone: WILLIAM ELLIS Deed Book / Page: - 008050184 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: [all AO data Is provided as is wfthoutvamrdy or guarndee of any Idnd either expressed or implied including but not limited to the Davie Countyn, Implied amantes of merchantability ortBnessfor a padimlaruse. All users of Davie County's GIS webaft hall held harmless the County of OaAq NoM Carolina,bagents,wnsulUntd rnn o.oremployeeshom any and aildalmsorcausesofadiondueto NC or arising out ofthe use orinabirdyto use the GIS data provided by this mbahe. Account #: 990003745 Billed To: Arena Builders Reference Name: Proposed Facility: Residence ATC Number: 4815 DAVIE COUNTY ENVIRONMENTAL HEALTH P.O. Box 848/210 Hospital Street Mocksville, NC 27028 (336)751-8760 Fax # (336)751-8786 OPERATION PERMIT Tax PIN/EH #: 5870-64-2265.13 Subdivision Info: Essex Farm Lot # 13 Location/Address: Cornatzer Rd -27006 Property Size: 0.691 "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," Wt shall in NO WAY be taken as a guuantee that the system will function satisfactorily for any given period of time. f '�y{1� /- . 9 jjj System Type: � CJ S.T. Manufacturer t�1o67 Tank Date! Tank Size ,,,��r��, �0 I'nup Tank I System InstalledBy:�((iVt.-S dt-�,yi E.H. Specialist: �i3�� ✓t�J Date: s 0) A /f Al If -/o - v9 C(4 cc" -Ad 16 _j- ... to 'o-�C. PP6 p � / A y r S �14 eQ • DAVIE COUNTY ENVIRONMENTAL HEALTH P.O. Box 84.8/210 Hospital Street Mocksville, NC 27028 (336)751-8760 Fax # (336)751-8786 OPERATION PERMIT Account #: 990003745 Tax PIN/EH #: 5870-64-2265.13 Billed To: Arena Builders Subdivision Info: Essex Farm Lot # 13 Reference Name:. Location/Address:" Comatzer Rd -27006 Proposed Facility: Residence \ Property Size: 0.691 ATC Number: 4815 **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 NOWAY be taken as a guarantee that the systemwill function satisfactorily for any given period of, hme % , . . System Type: ` S.T. Manufacturer a Tank Date Tank Size�0 Pump Tank Size d * y V� O� r System Installed By jakA—Set.0 E.H. Specialist: OljvlG% Date:_��^^ s ��o 'of �PgPs G �ko tp q ccvr`"! = u< (N s n 0 DAVIE COUNTY ENVIRONMENTAL HEALTH P; 0. Box 8481210 Hospital Street' Mocksville, NC 27028 (336)751-8760 Fax # (336)751-8786 AUTHORIZATION FOR WASTEWATER SYSTEM CONSTRUCTION Account #: 990003745 Tax PIN/EH #: 5870-64-2265.13 Billed To: Arena Builders Subdivision Info: Essex Farm Lot # 13 Reference Name: Location/Address: Comatzer Rd -27006 Proposed Facility: Residence. Property Size: 0.691 ATC Number: 4815 Site Type: ❑New ORepair ❑Expansion **NOTE** This Authorization to Construct (ATC) MUST BE ISSUED by the Davie County Environmental . 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 4 # Bathrooms_ #People_ Basement❑ Basement plumbing❑ Non -Residential Specifications: Facility Type # People_ # Seats_ Square Footage(or Dimensions of Facility) Lot Size A UgtS . Type of Water Supply: Bounty/City OWell ❑CommunityWell System Specifications: Design Wastewater Flow (GPD) 4$0 Tank Size/t00 GAL. Pump Tank/DOO GAL. i Trench Width 3A Max. Trench Depth:�9L Rock Depth %v Lin= Ft. Site Modifications/Conditions/Other: As Stated in 1561 RSC#C 3.84.1S�i9(6) 1aiE*.31' 0�1no Contact the Davie.County Environmental Health Section for final inspection. of this system between 8:30 — 9:30a.m. on the day of installation. Telephone # (336)751-8760. 6G q 'iSII i nes ramp To 5?LP&" -R�oX UsE -ro ii- Dvironmental Health Specialist .•run -1 1 IM (PP, t! ON &Acbt UN&) 73 7 OJ)! 6G q 'iSII i nes ramp To 5?LP&" -R�oX UsE -ro ii- Dvironmental Health Specialist .•run -1 1 IM (PP, t! ON &Acbt UN&) 73 7 Fub 04 US 10:14aoawle county envhealth 336 701 H7H6 P•r Are there any existing wastewate: systems on the site? Oyes Ot40 Does the site containjmisdiciior.sl wetlands? Oyes ljxp _ _ - Am there any easements or right-of-ways an the site? Oyes A Is the site subject to approval by motherpublic agency? Oyes IX - Will wastewater other than dome;tie sewa¢e he Penerated? Oyes (ion Date _ EHS: APPLICATION FOR SITE EVALUATIONAMPROVEMENT PERMIT & A Davie Coanty Environmental Health FEB — 5 2008- - P.O Box 848210 Hm mital Street - Mocksville, NC 27023 (336)751-8760/ Fax (336)751-8786 {{// ENVIRONMENTAL HEALTH Application For. USite EvaluationRmprovement Permit pAAuthorialion To Construct(ATC) - fl Both DAVIE COUNTY Type of Application UNew System CRepair to Existing System UExpan;ion/Modifiration of Existing System or Faci ty •''LWPORT.tN?+** THIS APPLICA110N GNNOTBE PROFESSBDUNLESS ALL OF THE REQUBLED - RJFORMATIOMISPROVIDED. Rela to the INFORMATION BULIE7TN for instructions. Name to be Billed Lo &C, Contact Person IF(co-Ac tC we _ Billing Address t amo S 132 Home Phone --4z-?6 _ - 'Zy - City/StatePLIP (�I t.nlf1 13 lair Business Phone Z7ts1 Name on Permit(ATC NOTE: A surveyplat or site plan must accompany this application laclu kA: O Site (Permit is vSjt�dJ fnr6/r0 months w 1h site plan, no expirationwhh complete plat) Owner's Name YrTH Property A� Lot Size/Al Subdivision answer to any of the followmg questions is "yes", supporting documents inn enual be attathcd. Are there any existing wastewate: systems on the site? Oyes Ot40 Does the site containjmisdiciior.sl wetlands? Oyes ljxp _ _ - Am there any easements or right-of-ways an the site? Oyes A Is the site subject to approval by motherpublic agency? Oyes IX - Will wastewater other than dome;tie sewa¢e he Penerated? Oyes (ion #People.. r.v__ #Bedmoris� :I _. • #Batbroo Garden Tub/Whirlpool�YYes 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 doc[mxmtation of similar facility water consumption) - FOODSERVICE ONLY: # Seats - -- Type system requested:.) G zwentioml (IAccepted Olmovativc OAtteneadve OOther - - Water Supply Type:)�fomty/City Water - O New Well OFxisling Wall _ O Community Well Do you anticipate additions or expansions of the facility, this system is intended to xrve? O Yes - 19<6 If yes, what type? _ - This is to certify duct the information provided on this application is true and correct to the best ofmy knowledge. I understand that any permit(s) or ATC(s) issued hereafter no subject to suspension or rcwcatiun if the sitq is altered, the intended use changes, or if the information submitted in this applicatioa is falsified or changed. I hereby gram right agany m the Authorized Representative of the Davie Comty,r�H,/Jealth atmtent m induct ucoessary inspections m dete mice compliance with applicable laws and rules. Imdenand(halsYra ible for tiu:Rvpa identification a�labeting ofpwpertylines and comma and locating and flagging or staking the u ty location, proposed well location and the location of any other omeuitics. (- ( Site Revisit Charge - propeAy owner's or ownei s legal represenative signature 2 / I -AR Date(s): Clicnt Notification Date: - Date _ EHS: Sign given OYes DNo Amount # Revised 11106 - Invoice # Lot 12 DVE08100 Pmposed Layout for Arena Builders Lot 13 Essex Fan Ld 13 i i st et i ssou•w t Lot 14 LION FOR SITREVALUATIONAMPROVEMENT PERMIT & ATC Davie County Environmental Health P.O. Box 848/210 Hospital Street Mocksville, NC 27028 - - (336)751-8760/ Fax(336)751-8786 - aluation/Improvement Permit O Authorization To Construct(ATC) O Both - INew System ORepaa to Existing System DExparision/Modification of Existing System or Facility THIS APPLICATION CANNOT BE PROCESSED UNLESS ALL OF THE REQUIRED 'ROVIDED. Refer to the INFORMATION BULLETIN for instructions. APPLICANT INFORMATION Name to be Billed 165C AcyTa*, Billing Address - 4.0. ?-/a 3fo City/State/ZIP _&xrrwac'.- Name on Permit/ATC if Different than Mailing Address PKUPEXI Y 1NPUKAIAIIUN -- NOTE: A survey plat or site plan must accoml (Permit is valid for 60 months with site Owner's Name �A,Sc ��OeVP6oPn8rrr r Owner's Address po 0 .tfa Property Address �•.,9y- Lot Size lti •U�71 laxk Subdivision Name(ifapplicable) _ ESs intact Person 7"Aeb J47( -Ire Home Phone isiness Phone 7S/ - 7900 no expiration with complete plat) t Pta ea let([o scale) - - Numb er-'7S/• 73� If the answer to any of the following Questionsris'yee', supporting doe mentatio99 must be attilched. - - Are there any existing wastewater systems on the site? Dyes L3Nyy - Does the site containjurisdictional wetlands? DYes ONo - Are there any easements or right-of-ways on the site? Dies ONo - - Is the site subject to approval by another public agency? OYes ti� , Will wastewater other than domestic sewage be generated? OYes RNo #People- - #Bedrooms_" #Bathrooms Garden Tub/Whirlpool DYes ONo Basement:. DYes ONo - Basement Plumbing: DYes ON. 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 - - 73 Type system requested: ��6Cnventional OAccepted Ohmovative OAltemative -OOther - Water Supply Type: 06unty/City Water O New Well OExisting Well O Community Well Do you anticipate additions or expansions of the facility this system is intended to serve? O Yes . O 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 no responsible for the proper identification and labeling of property lines and comers and c locating an gging or staking the house/facility location, proposed well location and the location of any other amenities. - - - Site Revisit Charge Prope r. r ., oro er's legal represents re � Date(s): - Client Notification Date: op EHS: Sign given DYes ONo - Account# Revised 11/06 Invoice# - _ DAME COUNTY HEALTH DEPARTMENT Environmental Health Section Soil/ Site Evaluation APPLICANT INFORMATION PROPERT' INF RM TION Account #: 990004425 Tax PIN/EH #> 5870- - Billed To: PSC Development Corp. Inc.`Subdivision Info: Essex Farm Lot # 13 Reference Name: Brad Coe Location/Address: Cornatzer Rd-27006 Proposed Facility: • Residence Property Size: 0.691 Ac: Date Evaluated: "-T ` c2G —O 7 Water Supply: On-Site Well Community Public Evaluation By; Auger Boring Pit F./ Cut FACTORS 1 2 a; 3 4 5 6 7 Landscape position L. slope % HORIZON I DEPTHD -- - D- re . Texture groupG o G Consistence p rr Structure 3 k Ic Mineralogy - y p X HORIZON IL DEPT Texture group,5T Consistence:::. Structure...576 k Mineralo F�oQ 1, F 'YHORIZON Ili DEPTH_. 4- Texture _Texture rou Consistence; Structure . Mineralogy, , HORIZON IV DEPTH . Texture group. Consistence -Structure 1 Mineralogy SOIL WETNESS �— RESTRICTIVE HORIZON J' .SAPROLITE �• ,� CLASSIFICATION LONG-TERM ACCEPTANCE RATE ? 6.y-f' O •a 7 SITE CLASSIFICATION: 5 C4,4 a L( -e EVALUATION BY: LONG-TERM ACCEPTANCE RATE: OTHER(S) PRESENT:: REMARKS: LEGEND Landscape PositionI - .. - 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 CONSIST ,N F. VFR - Very friable _. FR - Friable FI - Firm VFI - Very flim EFI Extremely firm ` lYet 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 Mineraloev ,. 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 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 (Revisedl **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. Pmnit Type: D<ew DRepair. DExpansion Permit Valid for: &S"Years DNo Expiration Residential Specifications: #Bedrooms#Bathrooms_#People— Basemento Basement plumbing!] Non -Residential Specifications: Facility Type # People_ # Seats_ Square Footage(or Dimensions of Facility) DesignFlow(GPD):Type of Water Supply: adounty/City DWell ❑Community Well As stated in 15A NCAC 18A.1969(5) Site Modifications/Permit Conditions: aeMRi wS'�(etwmc may also be useod siOlan SystemType_- LTAR Initial i� Cc D gt P,7 � -- Rep a r Ca D!To eco' � k�fr` ,r Y SN C/ 3 0/ aS` �6# �r��' �5ou.se vtronmental Health Specialist /// �^�,Date \0- \ �9, Z Davie County Environmental Health P.O. Boz 848/210 Hospital Street Mocksville, NC 27028 (336)751-8760/ Fax (336)751-8786 Account #: 990004425 IMPROVEMENT PERTWnPIN/EH M. 5870-64-2265.13 . Billed To: PSC Development Corp. Inc. Subdivision Info: Essex Farm Lot # 13 Address: PO Box 340 Location/Address: Comatzer 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. Pmnit Type: D<ew DRepair. DExpansion Permit Valid for: &S"Years DNo Expiration Residential Specifications: #Bedrooms#Bathrooms_#People— Basemento Basement plumbing!] Non -Residential Specifications: Facility Type # People_ # Seats_ Square Footage(or Dimensions of Facility) DesignFlow(GPD):Type of Water Supply: adounty/City DWell ❑Community Well As stated in 15A NCAC 18A.1969(5) Site Modifications/Permit Conditions: aeMRi wS'�(etwmc may also be useod siOlan SystemType_- LTAR Initial i� Cc D gt P,7 � -- Rep a r Ca D!To eco' � k�fr` ,r Y SN C/ 3 0/ aS` �6# �r��' �5ou.se vtronmental Health Specialist /// �^�,Date \0- \ �9, Z