120 Tyler Court Lot 66Davie County, NC , i Tax Parcel Report Tuesday, December 20, 2016
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CORNATZER RD
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WARNING: THIS IS NOT A SURVEY
Parcel Information
Parcel Number: F803OA0066 Township: Shady Grove
NCPIN Number: 5870635238 Municipality:
Account Number: 82528109 Census Tract: 37059-803
Listed Owner 1: PSC DEVELOPMENT COR INC Voting Precinct: EAST SHADY GROVE
Mailing Address 1: P 0 BOX 5967 Planning Jurisdiction: Davie County
City: HIGH POINT Zoning Class: DAVIE COUNTY R-20
State: NC Zoning Overlay:
Zip Code: 27262-0000 Voluntary Ag. District:
Legal Description: LOT 66 ESSEX FARM PHASE 113 Fire Response District:
Assessed Acreage: 0.69 Elementary School Zone:
Deed Date: / Middle School Zone:
Deed Book / Page: Soil Types:
Plat Book: 9 Flood Zone:
Plat Page: 388 Watershed Overlay:
Building Value:
Outbuilding & Extra
Freatures Value:
Land Value: Total Market Value:
Total Assessed Value:
No
ADVANCE
SHADY GROVE
WILLIAM ELLIS
GnB2
DAVIE COUNTY
161
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County of Davie, North Carolina, its agents, consultants, contractors or employees from any and all claims orcauses of action due to
N`'�+ or arising out of the use or Inability to use the GIS data provided by this website.
CONSTRUCTION
AUTHORIZATION
Davie County Health Department
r` 210 Hospital Street
•off;,,. P.O. Box 848
Mocksville NC 27028
(11' For Office Use Only
*CDP File Number 157505-1
County ID Number: 5870635238
Evaluated For: NEW
�, Township:
Phone: 336-753-6780 Fax: 336-753-1680 0 9/ 0 a/ a 0 1 9
Applicant: RS Parker/Joy Springer FAddress:
wner: RS Parker/Joy Springer
Address: PO Box 5967 PO Box 5967
City: High Point High Point
State2ip: NC 27262 NC 27262
Phone #: Phone #:
Property Location & Site Inform
Address/Road #:
120 Tyler Court
Advance
Structure:
# of Bedrooms:
# of People:
*Water Supply:
NC 27006
SINGLE FAMILY
4
PUBLIC
Subdivision: Essex Farm
Phase: Lot: 66
Directions
Hwy 158 east, right on Hwy 801. right on Mocks Church
Rd. to stop sign turn left on Beauchamp rd. to the end,
Left on Cornatzer Rd. Essex Farm on left
Page 1 of 3
\
Minimum Trench Depth: 3 0 Inches
Site Classification:
Provisionally suitable
\
Saprolite System?
QYes QNo
Minimum Soil Cover. 1 a Inches
Design Flow:
Maximum Trench Depth: 3 6 Inches
Soil Application Rate:
0 . a 5
Maximum Soil Cover: 1 8 Inches
*System Classification/Description:
'Distribution Type: GRAVITY - PARALLEL (eq. d -box)
TYPE III E. PPBPS GRAVITY DOSED SYSTEM Septic Tank:
1 0 0 0 Gallons
*Proposed System: 50% REDUCTION
1 -Piece: QYes QNo
Pump Required: QYes ONo (D May Be Required
Nitrification Field
1 9-1
0 Sq ftPump Tank: 1 0 0 0 Gallons
No. Drain Lines
7
1 -Piece: QYes QNo
Total Trench Length:
3 a 0 ft.
GPM—vs— ft. TDH
Trench Spacing:
_ 8
Denches t O.C. C.0 Dosing Volume: _ Gallons
Trench Width:
a
Inches
gFeet
_
Grease Trap: Gallons
Aggregate Depth:
inches Pre Treatment: ONSF OTS -1 OTS -II
Septic Tank Installer Grade Level Required: 01011 O III 01V
Page 1 of 3
,CDP FAe Number 157505.-1 County ID Number: 5870635238
❑ Open Pump System Sheet
System ttequirea:w us vivo vivo, out nas AvaiiaDie space
/Repair System
*Site Classification: Provisionally Suitable
Design Flow: 4 8 0
Soil Application Rate: 0 a 5
*System Classification/Description:
TYPE III E. PPBPS GRAVITY DOSED SYSTEM
*Proposed System: 50% REDUCTION
Nitrification Field 1 9 -2 0
Sq. it.
No. Drain Lines 7
Total Trench Length: 3 a 0 ft
Trench Spacing: Q Inches 0.
$ Feet O.C.
Trench Width: Inches
a Feet
Aggregate Depth:
inches
Minimum Trench Depth:
3
0
Inches
Minimum Soil Cover.
1
a
Inches
Maximum Trench Depth:
3
6
Inches
Maximum Soil Cover:
1
8
Inches
*Distribution Type: GRAVITY -PARALLEL (eq. d -box)
Pump Required: Oyes ONo May Be Required
Pre Treatment: 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 by the 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 maybe Issued at the same time the Improvement Permit issued (NCGS 130A-336(b)� If the 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 become
Invalid, and maybe 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:
t
*Issued By: a�t!^ 5 Date of Issue: _ .
Authorized State Agent: Malfunction Log Oyes
OHand 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
CDP File Number: 157505 - 1
County File Number: 5870635238
Date: / /
Q Inch _
Tiwlwincs rlr�w;nn Ytp.. • ( nnefmrrfinn AtAhnri-7!nfinn Scale: . , 0610Ck
Paoe 3 of 3
(0l0 r_sw
APPLICATION FOR SITE EVALUATION/IMPROVEMENT PERMIT & ATC
Davie County Environmental Health
P.O. Box 848/210 Hospital Street
Mocksville, NC 27028
% (336)753-6780/ Fax(336)753-1680
Application For: V Sit�e�E�v luation/Improvement Permit 'Authorization To Constmct(ATC). ✓Both'
Type of Application: '1Kew System -Repair to Existing System C Expansion/Modiftcation of Existing System or Facility
***IMPORTANT"* THIS APPLICATION CANNOT BE PROCESSED UNLESS ALL OF THE REQUIRED
INFORMATION IS PROVIDED. Refcr to the INFORMATION BULLETIN for instructions.
APPLICANT INFORMATION
Name to be Billed
Billing Address
City/State/ZIP
Contact Person r
_ Home Phone
Business Phone n S i
Name on Permit/ATC if Different than Above OC.
Mailing Address City/State/Zio r—
PROPERTY INFORMATION
*Date House/Facility Comers
NOTE: A survey plat or site plan must accompany this application. Included: C Site Plan
(Permit is ali for 60 m nths w' site plan, no expiration with complete plat.)
Owner's Name Phon
Owner's Address City/Sta e/Zip
Property Address City
Lot Size b •CP Tax PIN# $'
Subdivision Name(if applicable) Iction/Lot#Directions To Site: 5�i O ( ��C1srnai-Zer.nn TS
If the answer to aty-bf the following questions is "yes", supporting documentation must be attached.
Are there any existing wastewater systems on the site? []yes y
Does the site contain jurisdictional wetlands? CYes �No
Are there any easements orright-of-wayson the site? Eyes S.2Vo
Is the site subject to approval by another public agency? El Yes &i ?0
Will wastewater other than domestic sewage be generated? CYes
A Mi
scale)
IF RESIDENCE FILL OUT THE BOX BELOW
# People # Bedrooms # Bathroo Garde ub/Whirlpool es []No
Basement: -Yes � Basement Plum ing: Dyes
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: -nonventional -Accepted Clnnovative EAlternative COther.
Water Supply Type: _ ounty/City Water C New Well CExisting Well C Community Well
Do you anticipate additions or expansions of the facility this system is intended to serve? 7- Yes -vi o
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
RepresentativLgin
Davie County Health Department to conduct necessary inspections to determine compliance with applicable
la and ruleerstand that I am responsible for the proper identification and labeling of property lines and comers and
1 ca ' n or staking the house/facility, location, proposed well location and the location of any other amenities.
Pr p wn iso wner's legs epresentative signature Site Revisit Charge
1 Date(s):
Client Notification Date:
Date EHS:
Sign given -.'Yes _No
Revised 1106
Accountft Jy
Invoice # 1 —
S
Y, 30S
R-20 SETBACKS:
FRONT: 45'
SIDE: 15'
SIDE: 25'(STREET)
REAR: 30'
�2.
ss `°•
'-
SO ,9� k5
/ 66
1 /
PROPOSED
1 RESIDENCE
}go ho
1 /
L
SETBACK
30.48'33'1► 1 UTILITY
CH=35.00' EMENT
R=50'
TYLER COURT
50' ROY (PUBLIC)
GRAPHIC SCALE
40 0 20 40 so
( IN EM
1 inch = 40 ft.
PRELIMINARY
PLOT PLAN FOR:
RS PARKER HOMES
LOT 66 OF ESSEX FARMS, PHASE f —B
P.B. 9 PC. 388
Raming 69inatring, Inc.
700 Carnegie Place Greensboro, NC 27409
Phone: 336.852.9797 *Fax: 336-852.9766
NCBELS C-0930 DATE: 08-13-14
REF: PR0J\1831-01\dwg\ESSEXFARM.dwg
Davie County Environmental Health
P.O. Box 848/210 Hospital Street
Mocksville, NC 27028
(336)751-8760/ Fax (336)751-8786
Account #: 990004425 IMPROVEMENT PERNJTpIN/EH #: 5870-64-2265.66
Billed To: PSC Development Corp. Inc. Subdivision Info: Essex Farm Lot # 66
Address: PO Box 340 Location/Address: Cornatzer Rd -27006
City: Mocksville Property Size: 0.689 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: QfTew ❑Repair. ❑Expansion Permit Valid for: 1?5 Years ❑No Expiration
Residential Specifications: # Bedrooms It # Bathrooms # People Basement❑ Basement plumbing❑
Non -Residential Specifications: Facility Type # People # Seats
Square Footage(or Dimensions of Facility)
DesignFlow(GPD): Type of Water Supply: ounty/City ❑Well ❑Community Well
Site Modifications/Permit Conditions.:
N
- r
PLIC
2 3 2p01
ASG
FOR SITE EVALUATION/IMPROVEMENT PERMIT & ATC
Davie County Environmental Health
P.O. Box 848/210 Ilospital Street
Mocksville, NC 27028
(336)751-8760/ Fax (336)751-8786
uation/Improvement Permit ❑ Authorization To Construct(ATC) ❑ Both"+
System ❑Repair to Existing System ❑Expansion/Modification of Existing System or Facility
.j.
* * *IMPORTANT" * THIS APPLICATION CANNOT BE PROCESSED UNLESS ALL OF THE REQUIRED
INFORMATION IS PROVIDED. Refer to the INFORMATION BULLETIN for instructions.
APPLICANT INFORMATION
Name to be Billed ASC /Oc'V64oPrlrr+T �Z% Contact Person 7J'WAY ,847 cr.0
Billing Address A-0 -Q�X 3-/0 Home Phone
City/State/ZIP&ousui� riG 'Z 702 8 Business Phone 7S/ - 73oo
Name on Permit/ATC if Different than Above
Mailine Address
YKUYriKl Y lNl`UKMAl1UN 'Date t4ouse/tacnity Comers k1aggecl
NOTE: A survey plat or site plan must accompany this application. Included: ❑ Site Plan lat(to scale)
(Permit is valid for 60 months with site plan, no expiration with complete plat.)
Owner's Name �D SC ,O�-y8aoprtFi +i ccs i�G Phone Number 7S/ - 73---Q
Owner's Address City/State/Zip
Property A res City
Lot Size Tax PIN#
Subdivision Name(if applicable)Es c Sectiop/Lot#
Directions To Site: /o �f C��S � 6VAE .c7/2/W/3^��f�' ��QScS A-041
If the answer to any of the following guestionscis "yes", supporting documentatiogg must be attdched.
Are there any existing wastewater systems on the site?
Dyes L31Vp
Does the site contain jurisdictional wetlands?
Dyes o
Are there any easements or right-of-ways on the site?
&3 es ❑ o
Is the site subject to approval by another public agency?
Dyes t��
Will wastewater other than domestic sewage be generated?
Dyes C3'No
IF RESIDENCE FILL OUT THE BOX BELOW
# People # Bedrooms !;6 # Bathrooms Garden Tub/Whirlpool Dyes ❑No
Basement: Dyes ❑No Basement Plumbing: Dyes ❑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: ff-C-O.ventional ❑Accepted ❑Innovative ❑Alternative ❑Other
Water Supply Type: 3'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 ging or staking the house/facility location, proposed well location and the location of any other amenities.
Site Revisit Charge
Prope rt -or oer's legal represent§ re
Date(s):
Client Notification Date:
Date EHS:
Sign given Dyes ❑No Account #
Revised 11/06 Invoice #
• DAVIE COUNTY HEALTH DEPARTMENT
•
eta J• ,
Environmental Health Section
Soil/ Site Evaluation
APPLICANT
INFORMATION Tax PIN/EH #: 587�6'�=1 5. INFORMATION
Billed To: PSC Development Corp. Inc. Subdivision Info: Essex Farm Lot # 66
Reference Name: Brad Coe Location/Address: Cornatzer Rd -270
Proposed Facility. Residence Property Size: 0.689 Acre Date Evaluated: "— _ G
Water Supply: On -Site Well Community Public J
Evaluation By: Auger Boring Pit / Cut
FACTORS
1
2
3 4 5 6 7
Landscape position
Slope %
HORIZON I DEPTH
—
n
6'—
Texture group
GL
C
G
Consistence
At e
V I'ii
Structure
NO
Mineralogy
HORIZON II DEPTH
0—
—Texture
Texture rou
Consistence
sr
Structure
/L
Mineralogy
HORIZON III DEPTH
Texture group
Consistence
Structure
Mineralogy
HORIZON IV DEPTH
Texture grouph
Consistence
�
Structure
Mineralogy
SOIL WETNESS
�--
RESTRICTIVE HORIZON
SAPROLITE
/
CLASSIFICATIONk�a-7
a.
LONG-TERM ACCEPTANCE RATE
,
SITE CLASSIFICATION:
LONG-TERM ACCEPTANCE RATE:
REMARKS:��%
LEGEND
EVALUATION BY:b�
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
CONSISTENCE
Moist
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
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
IVotec
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 (Revkedl