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244 Essex Farm Road Lot 24Davie 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: Building Value: Land Value: Total Assessed Value: WAKNING: THIS 1.S' 1VU'1' A SUKV.LY Parcel Information F8030A0024 Township: Shady Grove 5870644929 Municipality: 8304059 Census Tract: 37059-803 KEYSER BRIAN M Voting Precinct: EAST SHADY GROVE 244 ESSEX FARM ROAD Planning Jurisdiction: Davie County ADVANCE Zoning Class: DAVIE COUNTY R -A NC Zoning Overlay: 27006 Voluntary Ag. District: LOT 24 ESSEX FARM PHASE 1 Fire Response District: 0.69 Elementary School Zone: 8/2014 Middle School Zone: 009670191 Soil Types: 0009 Flood Zone: 290 Watershed Overlay: Outbuilding 8r Extra Freatures Value: Total Market Value: No ADVANCE SHADY GROVE WILLIAM ELLIS GnB2 DAVIE COUNTY EO �T 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, Impliedwarnntles of merchantability or fitness for a particular use. All user: 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 or causes of action due to 1� C or arising out of the use or Inability to use the GIS data provided by this website. - - ` DAVIE COUNTY ENVIRONMENTAL HEALTH ` VAD. Box 848/210 Hospital Street Mocksville, NC 27028 (336)751-8760 Fax # (336)751-8786 AUTHORIZATION FOR WASTEWATER SYSTEM CONSTRUCTION Account #: 990005088 Billed To: David Stenson Construction Reference Name: Proposed Facility: Residence ATC Number: 4866 Tax PIN/EH #: 5870-64-2265.24 Subdivision Info: Essex Farm Lot # 24 Location/Address: 244 Essex Farm Rd -27006 Property Size: .6689 Site Type: ew ❑Repair ❑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=Tfeatinent 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: # Bedrooms3— # Bathrooms 7 • / # People_ Basement❑ Basement plumbing❑ Non -Residential Specifications: Facility Type # People # Seats, Square Footage(or Dimensions of Facility) Lot Size 6, Lo 7 Q er Type of Water Supply: OCounty/City ❑ W jell ❑ Community Well qfSystem Specifications: Design Wastewater Flow (GPD)`ank Size / GAL. Pump Tank �� "AL. Trench Width 3 ( Max. Trench Deptb] ( Rock Depthfl4 Linear Ft. As stated in 15A NCAC 18A.1969(� of �5-t0 'P t 'j 1"t Site Modifications/Conditions/Other: acepoted Systeme m•,y aiso ba- 4C 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. J h Environmental Health DCHD 11/06 (Revised) 4t7' _or; 1 u, c `( c Tfo VV%iA tit, 11.4 Date: f DAVIE COUNTY ENVIRONMENTAL HEALTH 1 P.O. Box 848/210 Hospital Street Mocksville, NC 27028 Gj (336)751-8760 Fax #(336)751-8786te 1 Account #: 990005088 OPERATION PERIl�ax PIN/EH M. 5870-64-2265.24 Billed To: David Stenson Construction Subdivision Info: Essex Farm Lot # 24 19 Reference Name: Location/Address:.244 Essex Farm Rd -27006 �Q Proposed Facility: Residence Property Size: .689 2f ATC Number: 4866 �U iY **NOTE** The issuance of this Operation Permit shall indicate the system described on the ATC has been installed 4 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 satisfactoril f rRy given period of time. 0 e d System Type: S.T. ManufactureTank Date Tank Size / Pump Tank Size A � c, System Installed By:(-IIr"lu e r ^��C E.H. Specialist: JV��tco!%aie: IB� %i 14' flan to I OR SITE EVALUATION/IMPROVEMENT PERMIT & ATC Davie County Environmental Health P.O. Boz 848/210 Hospital Street V r Mocksville, NC 27028 V �1 j� ' O 2Wa (336)751-8760/ <(3`WIPlicat nFor. S' provement Permit tion To Construct(ABoth Type of A ew System Repair to Existing Systn of Existing System or Facility • 1P� } HIS APPLICATION CANNOTBEPROCESSED UNLESS ALL OF THE REQUIRED TION IS PROVIDED. Refer to the INFORMATION BULLETIN for instructions. I I t.VJU Name to be Billed C -0W: t i) Contact Person 1y-�K: 1Ys Billing Address Home Phone % 5 — City/State/ZIP 1 Business Phone Name on Permit/ATC if Mailing Address PROPERTY INFORMATION *Date House/Facili ers Flag NOTE: A survey plat or site plan must accompany this application. Included: Site P 10 Plat(to scale) (Permit is valid for 60 months with site plan, no expiration with complete pl Owner's Name Phone Number S Owner's Address City/State/Zip �-e.t�,t3v►�1s�lx. �73 Property Address Q44 t=S9eXq--,rP-i.City RWGrlc-2.-. Lot SizeTax PIN# Subdivision Name(if applicable) , Section/L.ot# , 2? Directions To Site; (l;�F-C-CrAc: r -55r— If the answer to any of the following questions is `yes", supporting documentati ust be attached. Are there any existing wastewater systems on the site? Yes Does the site contain jurisdictional wetlands? Yes Are there any easements or right-of-ways on the site? Yes o Is the site subject to approval by another public agency? Yes o Will wastewater other than domestic sewage be generated? Yes o IF RESIDE CE FILL OUT THE BOX PELOW # People # Bedrooms # Bathrooms Garden Tub/Whirlpool Yes No Basement. Yes (No Basement Plumbing: Yes 617a 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: ConventionalAccepted Innovative Alternative Other Water Supply Type: Vounty/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 corners and locating and flagging or staking the house/facility location, proposed well location and the location of any other amenities. Site Revisit Charge Property owner's or owner's legal representative signature Client Notification Date: Date EHS: Sign given Yes . No Account # o b 0 Revised 11/06 Invoice # 5.34' LO -r#24 i co ESS I EX FARM i I i i� I L I I p -00r 1 - I- �j ................. ................... cc so 0:00, w 60.00o L' - Iw w so.00, 'o Lu ............ 5[ n r-- ERNE ,.,. 5.34' LO -r#24 i co ESS I EX FARM i I i i� I L I I p -00r A� C TION FOR SITE EVALUATION/IMPROVEMENT PERMIT & ATC Davie County Environmental Health O �G P.O. Box 848/210 Hospital Street Mocksville, NC 27028 (336)751-8760/ Fax (336)751-8786 ON OU 'PlicationFor: MY��Site Evaluation/Improvement Permit ❑ Authorization To Construct(ATC) ❑ Both Type of Application: ❑New System ❑Repair 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. -W3 Name to be Billed ASCV6GooKrNT mat: /.x- Contact Person %cRRY ,64en cl Billing Address A.* -&ax 3fo Home Phone City/State/ZIP _&ocrsuicc.r t►G Z 7018 Business Phone 757- 73o0 Name on Permit/ATC if Different than Above Mailing Address City/State/Zin YKUYhKIY 11NVUIUV1AIWIN 'Uateriouse/raclllt L;orners; Plaggea NOTE: A survey plat or site plan must accompany this application. Included: 0 Site Plan lat(to scale) (Permit is valid for 60 months with site plan, no expiration with complete plat.) Owner's Name A&-- ,i0.-VBG0A1fcriJi cG�, iaG Phone Number 7S/ - 7.3-10 Owner Address /°o 4X City/State/Zip^ 2 7oZt3 Property Address City Lot Size — Tax PIN# 5j!R- &- - Z 44 Subdivision Name(if appjicable)„ Esse=x Sectiop/Lot# 7 A If the answer to any of the following (luestionstis "yes", supporting documentatiog must be attIched. Are there any existing wastewater systems on the site? ❑Yes 13?p Does the site contain jurisdictional wetlands? []Yes❑110 Are there any easements or right-of-ways on the site? l3'ies ❑ o Is the site subject to approval by another public agency? ❑Yes 13N� Will wastewater other than domestic sewage be generated? ❑Yes Ca1Vo # People # Bedrooms ::6 # Bathrooms Garden Tub/Whirlpool ❑ Yes ❑No Basement: ❑Yes ❑No Basement Plumbing: ❑Yes ❑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: Q'County/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 agging or staking the house/facility location, proposed well location and the location of any other amenities. Site Revisit Charge Prope rt -or o er's legal represents re Date(s): 7 Client Notification Date: Date. EHS: Sign given ❑Yes❑No Account# Revised 11/06 Invoice 4 I DESIGN LAYOUT Aj A) z ww Cn N N � J n 0.948 Ac. +/— m S v GPS II 4 BR QP PINK 38' HOME w BLUE 46' 2). / � B 60.wYELO 52 so. 3p. ORNG 65' R 2 RED 60 � cF PIN 40 \� s6• DRIVE 3p� < N 82-28'-00" W 185-46- 30 15 0 30 VALVE BOX MAP FOR Michael Hauser Q WATER METER R/W RIGHT—OF—WAY SCALE COUNTY TOWNSHIP DATE PREC. RATI( QS SEWER MANHOLE — RUNNING WATER 1' = 30' Davie 19 DEC 2007 1 : 10,000 C IRON FOUND —EE OVERHEAD POWER LINE C IRON SET PROPERTY DESC: Layout/Site Plan for Lot 23 Essex Farm A MONUMENT UPOWER POLE PROPERTY UNE (surveyed) MY SEAL AND SIGNATURE ———— PROPERTY LINE CERTIFY THAT THIS MAP IS COE FORESTRY & SURVEYING JOB # (not surveyed) THE RESULT OF AN ACTUAL P.O. BOX 36 070721-23 CI ID1TV DCDCnD\ICn I IAInCD w.l I of for .I r 7'1171 � w W o : -o 4 Z E I 21 LU I , 1 i 75.34 go I / _ — ' i / \ / 0 I o 0 1 i/ S's6• I z m � N I W U I LL J Z p 0 0 W I z i S J Z � I LOT # i Y I i o 0 ►— ►— 24 _ C) W w % / ', ESSEX Fq z N Q x w v m I � /%ii RM i w >w ,/ i p W - LLJ uj a I 20.00' j; I m w z LL i 0 L LL I O REVISIONS/SKETCHES I W Q LL1 i eree /% i- 1 O ^ / CICU I I 2 2-5-08 I z !�/ "wee' i I W W i cn Y / LO 3 I co 4 ol 0 LL F— X < < i o � i I CO I I it DRIVE I O Q W i C) —J 50.00' I; — M N z' �t O W N 0 ~ *k Cl) Z - - W - - _ I Cl) 200.00 - -- ; > Q I . Davie County Environmental Health P.O. Box 848/210 Hospital Street Mocksville, NC 27028 (336)751-8760/ Fax (336)751-8786 Account M 990004425 IMPROVEMENT PERS*'1PIN/EH #: 5870-64-2265.2 K Billed To: PSC Development Corp. Inc. Subdivision Info: Essex Farm Lot # ';'-H Address: PO Box 340 Location/Address: Cornatzer Rd -27006 City: Mocksville Property Size: G. La 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 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 130A, Wastewater Systems). This Improvement Permit is subject to revocation if site plans, plat or the intended use change. Permit Type: IVNew ❑Repair ❑Expansion Permit Valid for: K5 Years ❑No Expiration Residential Specifications: # Bedrooms 4 # Bathrooms # People Basement❑ Basement plumbing❑ Non -Residential Specifications: Facility Type # People # Seats_ Square Footage(or Dimensions of Facility) Design Flow(GPD): Ll g© Type of Water Supply: LgLounty/City ❑Well ❑Community Well As stated in 15A NCAC 18A.19691T Site Modifications/Permit Conditions: meeepted-Systefng- may else be—us,- Site Plan System Type LTAR Initial Cl c r J -Q c) 0- —17 SRe air G1cc �k Z 6d k 0-7Environmental Health Specialist �� ` Date b' _ DAVIE COUNTY HEALTH DEPARTMENT Environmental Health Section Soil/ Site Evaluation APPLICANT INFORMATION NF RMATION Account Tax PIN/EH #: 587U-0 - . Billed To: PSC Development Corp. Inc. Subdivision Info: Essex Farm Lot # 21 j Reference Name: Brad Coe Location/Address: Cornatzer Rd -27006 Proposed Facility: Residence Property Size: 0.867 ac. Date Evaluated: Water Supply: On -Site Well Community Public V Evaluation By: Auger Boring Pit b/. Cut FACTORS 3 4- 4 5 6 7 Landsca e'position t_ V Slope % : 3 HORIZON I DEPTH — 3& a - y9 Texture group C C c Consistence t'rr Structure K '5P, k 5 Mineralogy 5F k E: y t` VIP HORIZON H DEPTH' Texture group Consistence Structure Mineralogy HORIZON III DEPTH Texture group Consistence Structure Mineralogy HORIZON IV DEPTH Texture group Consistence Structure Mineralogy SOIL WETNESS RESTRICTIVE HORIZON SAPROLITE . CLASSIFICATION LONG-TERM ACCEPTANCE RATE a7 d • 7 O SITE CLASSIFICATION: �)Ce rTQ �12 LONG-TERM ACCEPTANCE RATE: ©' a 75 REMARKS: LEGEND EVALUATION BY- R 0�0 X) dk jy ✓l S OTHER(S) PRESENT - 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 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 Moist VFR - Very friable FR - Friable FI Firm VFI - Very firm EFI - Extremely firm 3yrA NS - Non sticky SS - Slightly sticky S - Sticky . VS -Very Sticky NP - Non plastic SP - Slightly plastic P - Plastic VP - Very plastic SC - Single grain M - Massive CR - Crumb GR - Granular ABK - Angular blocky SBK - Subangular blocky PL - Platy PR - Prismatic 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 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)