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127 W Rolling Meadow Road Lot 9Davie County, NC t f Tax Parcel Report Wednesday, December 21, 2016 WAKNMG: TMS IS IN(JIT A SURVEY Parcel Information Parcel Number: H9080A0009 Township: Shady Grove NCPIN Number: 5789538110 Municipality: Account Number: 82512945 Census Tract: 37059-804 Listed Owner 1: BRYANT TIMOTHY C Voting Precinct: EAST SHADY GROVE Mailing Address 1: 1911 WILD INDIGO WAY Planning Jurisdiction: Davie County City: HANAHAN Zoning Class: DAVIE COUNTY R -A State: Sc Zoning Overlay: Zip Code: 29410-0000 Voluntary Ag. District: No Legal Description: LOT 9 FALLINGCREEK FARM PHASE I Fire Response District: ADVANCE Assessed Acreage: 0.89 Elementary School Zone: SHADY GROVE Deed Date: 9/2003 Middle School Zone: WILLIAM ELLIS Deed Book / Page: 005150644 Soil Types: PcC2 Plat Book: 0007 Flood Zone: Plat Page: 048 Watershed Overlay: DAVIE COUNTY Building Value: Outbuilding & Extra Freatures Value: Land Value: Total Market Value: Total Assessed Value: Fo- Ail data Is provided as Is without warranty or guarantee of any Idnd either expressed or Implied Including but not limited to the Davie County, Implied warranties of merchantability or fitness for a particular use. All users 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 NC or arising out of the use or Inability to use the GIS data provided by this website. DAVIE COUNTY HEALTH DEPARTMENT Environmental Health Section ` P. O. Boa 848/210 Hospital Street Mocksville, NC 27028 G (336)751-8760 b L IMPROVEMENT/OPERATION PERMIT Account #: 990002128 Tax PIN/EH #: -5789-53-8110PR Billed To: Phase IV Realty Subdivision Info: Falling Creek Lot # 9 Reference Name: Location/Address: 127 West Rolling Meadow Road -2700 Proposed Facility: Residence Property Size: .896 acre ATC Number: 3271 **NOTE** This Improvement/Operation Permit DOES NOT authorize the construction of a septic tank system or any wastewater system. An AUTHORIZATION FOR WASTEWATER SYSTEM CONSTRUCTION must be obtained from this Department prior to the construction/installation of a system or the issuance of a building permit (in compliance with Article 11 of G.S. Chapter 130A, Wastewater Systems, Section .1900 Sewage Treatment and Disposal Systems). THIS PERMIT IS SUBJECT TO REVOCATION IF SITE PLANS OR THE INTENDED USE CHANGE. YOUR WASTEWATER SYSTEM CONTRACTOR MUST SEE THIS PERMIT BEFORE INSTALLING SYSTEM. Residential Specification: Building Type #People #Bedrooms #Batt Dishwasher: ;6' Garbage Disposal: 0 Washing Machine:;?`� Basement w/Plumbing: 21"' Basement/No Plumbing: ❑ Commercial Specification: Facility Type #People #People/Shift #Seats , Industrial13�Waste: Lot Size Type Water Supply _LDesign Wastewater Flow (GPD)Site: New Repair ❑ System Specifications: Tank Size/,000,9 GAL. Pump Tank GAL. Trench Widthc�P� Rock Depth Linear Ft.30'6 Eel= Required Site Modifications/Conditions: IMPROVEMENT/OPERATION PERM AYOUT - APPROVED EFFLUENT FILTER RISER(S) IF 6 " BELOW FINISHED GRADE. ****NOTICE: Contact a esentative of the Davie County Health Department for final inspection of this system between 8:30 a.m. to 9:3 a.m. or 1:00 p.m. to 1: m. on the da yf installation. Telephone # is (336)751-8760.**** Zit 70 s� t .41 ro Environmental Health Specialist's Si ature:?� Date: gn DCHD 05/99 (Revised) ° DAME COUNTY HEALTH DEPARTMENT Environmental Health Section P. O. Bog 848/210 Hospital Street Mocksville, NC 27028 (336)751-8760 Account #: 990002128 Tax PIN/EH #: 5789-53-8110PR Billed To: Phase IV Realty Subdivision Info: Falling Creek Lot # 9 Reference Name: Location/Address: 127 West Rolling Meadow Road -2700 Proposed Facility: Residence Property Size: .896 acre ATC Number: 3271 AUTHORIZATION FOR WASTEWATER SYSTEM CONSTRUCTION **NOTE** This Authorization for Wastewater System Construction MUST BE ISSUED by the Davie County Environmental Health Section prior to issuance of any building permit(s). This Form/Authorization Number should be presented to the Davie County Building Inspections Office when applying for building permit(s) (in compliance with Article 11 of G.S. Chapter 130A, Wastewater Systems, Section .1900 Sewage Treatment and Disposal Systems). THIS AUTHORIZATION FOR WASTEWATER CONSTRUCTION IS VALID FOR A PERIOD OF FIVE YEARS. Environmental Health Specialist's Signature: CERTIFICATE OF COMPLETION Date: **NOTE** The issuance of this Certificate of Completion shall indicate the system described on Improvement/Operation Permit 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.=T ,� Septic System Installed By: Environmental Health Specialist's Signature: DCHD 05/99 (Revised) Date: l APPLICATION FOR SITE EVAWATION/IMPROVEMENT PERMIT & ATC Davie County Health Department • Enviinnmenfa/Meff/di section • P.O. Box 848/210 Hospital Street / Mocksville, NC 27028 (336)751-8760 ***XhPCRTANT*** THIS APPLICATION CANNOT BE FJW=88ED UNLESS T, INFORMATION IS PROVIDED. Refer to the INrORHRTION BULLETIN ! r i I. Maas to be Billed Mailing address 0 0 /J Wo L1/fc! � city/state/Sip AALS, _ Al P o� Contact Person e- ALAI Home Phone Business Phone 2. Hams on Permit/ATC it Different than Above Mailing Address City/state/sip 3. Application For: ❑ Som�ite Evaluation 4. systen to services 0 -House ❑ Mobile Home S. If//Residence : e"0ishwasher t# People SAO REQU=RED 3 '2 *Pations . ❑ Improvement Permit/ATC W/Both ❑ Business ❑ Industry ❑ Other t# Bedrooms - #Bathroomsa E�oarbage Disposal ff-ir"hing Machine W9sw-nt/Pluabing 0 Baeeaent/No Plumbing S. if Business/industry/Othsrt specify type # commodss a showers # People # sinks # urinals # Rater Coolers IF FOODSERVICE: # Seats Estimated Water Usage (gallons per day) 7. Type of water supply: 216ounty/City ❑ well ❑ Community e. Do you anticipate additions or expansions of the facility this system Is intended to serve? ❑ Yes "0 If yes, what type? ***IMPORTANT*** CLIENTS MUST COMPLETETHE REQUIRED PROPERTY INFORMATION REQUESTED BELOW. Either a PLAT or SITE PLAN MUST BESUBAHTTED by the client with THIS APPWCATION. Property Dimensions: . o 1 P4 Tax OMce PIN: 05711-53- G! Property Address: Road Name ILLOV CS City/Zip AQUi4 &e --Z eQ 291j If In a Subdivision provide Information, as follows:. Name: Fit1.C� r rY er'.e e F YM " Section: _� Blocks Lot: WRITE DIRECTIONS (from Mocksville) to PROPERTY: Zon LS Prr'a.o k �� 1�LI¢L� Ly•e�JC" � �P' Date Property Flagged: 9 This is to certify that the information provided is correct to the best of my knowledge. I understand that any permit(@) Issued hereafter are subject to suspension or revocation, If the site plans or intended we change, or if the information submitted in this application Is falsified or changed. 1, also, understand that I am responsible for all charges Incurred from this application. I, hereby, give consent to the Authorized Representative of the Davie County Health Department to enter upon above described property located in Davie County ad owned by to conduct all testing procedures as necessary to deterpdne the oil suits b ty. DATE 9—.T—l�r TURE _.. _==g: � � � THIS AREA MAY BE USED 1 property Hues and dimensions, Revised DCHD (07/99) NG YOUR SITE PLAN (Inclui setbacks, and septic locations). of the following: Existing and proposed Site Revisit Charge I Date(s): I Client Notification Date: I EAS: Account No. Invoice No. `� wuh/.1 ['IIJ1/A♦ LlYINIYI A7 J/ fAINSWA(17/JN 4/, (SI.N J/ /IIGh1 •II P[INNMC OJPSA(tam 1r f .....! r.r rw .r «r..wr• Nr..w•.I V I..1 PL4r AP JrALLA I/MIt SU/OfYIffOM ILlf SPPAJYSL ,�,•, f. MW [IAIrCU ,u11W y+'��,r rM.,lw .,._.1. � � . 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Y M••�•r♦ r.... r.rir Yr• rrr. r.r .Yw..., A.•,.r• ♦ A.w Yr ..,,.w . wY..... rr..0 w.r .. t'AtLINCCRlX fPA"P,MdI YIAlA. Yl1l10YlA AJSfYlL• OJYiIOPYtNt CYrYAAf IlfflNCtA DJYJLOIYJAi COAPOAI f. Put AC rMJLW AJIO 01NJfWI_fl/fY. /[ !)101 0/0 IMUS •1 -P tr.r 1rn I If. loss b.r vw « 1.12 M1. in anoint nine enc •.vnr.lwY s - 0 DAVIE COUNTY HEALTH DEPARTMENT Environmental Health Section P. O. Boz 848/210 Hospital Street Mocksville, NC 27028 (336)751-8760 IMPROVEMENT/OPERATION PERMIT Account M 989900228 Tax PIN/EH #: 5789-53-8110 Billed To: Castlegate Construction, Inc. Subdivision Info: Falling Creek Sec. 1 Lot # 9 Reference Name: Marshall Horton Location/Address: Rolling Meadow Road -27006 Proposed Facility: Residence Property Size: 3/4 Acre ATC Number: 2225 **NOTE** This Improvement/Operation Permit DOES NOT authorize the construction of a septic tank system or any wastewater system. An AUTHORIZATION FOR WASTEWATER SYSTEM CONSTRUCTION must be obtained from this Department prior to the construction/installation of a system or the issuance of a building permit (in compliance with Article 11 of G.S. Chapter 130A, Wastewater Systems, Section .1900 Sewage Treatment and Disposal Systems). THIS PERMIT IS SUBJECT TO REVOCATION IF SITE PLANS OR THE INTENDED USE CHANGE. YOUR WASTEWATER SYSTEM CONTRACTOR MUST SEE THIS PERMIT BEFORE INSTALLING SYSTEM. Residential Specification: Building Type 0 fjOS . #People #Bedrooms :FS #Baths 72 -- Dishwasher: Dishwasher: Garbage Disposal: 0**� Washing Machine: 2r"-- Basement w/Plumbing: Basement/No Plumbing: ©� Commercial Specification: Facility Type #People #People/Shift #Seats Industrial Waste: Lot Size 0. Type Water Supply CWt3W Design Wastewater Flow (GPD) Site: New 13`� Repair System Specifications: Tank SizejbM GAL. Pump Tank CX�(DOAL. Trench Width � Rock Depth �?,L Linear Ft.siont Other: 4 �St .tF�i i1oa�7Y-�'�� r 11 3s -y jI L�� 9t0-�, Required S �difications/Conditions: Cz-ATiQ, Y-� 16 tr� PQM U'h,9 IMPJtOVEMENT/i?RF�RATION PERMIT LAYOUT- APPROVED EFFLUENT FILTER. RISER(S) IF 6 "BELOW FINISHED GRADE. ** NOTICE: Contact a representative of the Davie County Health Department for final inspection of this ,syslembelwon 'Ia.m, to 9:3 m. or 1:00 p.m. to 1:30 p.m. on the day of installation. Telephone # is (336)751-8760.**** XN \ � 1 cot X 3fo �lc�t2�• Environmental Health Specialist's Signature: DCHD 05/99 (Revised) I& Date: DAVIE COUNTY HEALTH DEPARTMENT Environmental Health Section P. O. Boa 848/210 Hospital Street Mocksville, NC 27028 (336)751-8760 Account #: 989900228 Billed To: Castlegate Construction, Inc. Reference Name: Marshall Horton Proposed Facility: Residence ATC Number: 2225 Tax PIN/EH #: 5789-53-8110 Subdivision Info: Falling Creek Sec. 1 Lot # 9 Location/Address: Rolling Meadow Road -27006 Property Size: 3/4 Acre AUTHORIZATION FOR WASTEWATER SYSTEM CONSTRUCTION **NOTE** This Authorization for Wastewater System Construction MUST BE ISSUED by the Davie County Environmental Health Section prior to issuance of any building permit(s). This Form/Authorization Number should be presented to the Davie County Building Inspections Office when applying for building permit(s) (in compliance with Article 11 of G.S. Chapter 130A, Wastewater Systems, Section .1900 Sewage Treatment and Disposal Systems). THIS AUTHORIZATION FOR WASTEWATER-001%TRlaIC1iQN IS VALID FOR A PERIOD OF FIVE YEARS. Environmental Health Specialist's CERTIFICATE OF COMPLETION Date: eXI <-/qq **NOTE** The issuance of this Certificate of Completion shall indicate the system described on Improvement/Operation Permit 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. Septic System Installed By: Environmental Health Specialist's Signature: DCHD 05/99 (Revised) Date: Zs APPUCA.ION FOR SITE EVALUATION/IMPROVEMENT PERMIT do AlL5 l5 ow : Davie County Health Department Environmental Hew/th Secdon AUG 3 1 1999 P.O. Bos 648/210 Hospital Street Mockaville, NC 27028 (336)751-8760 I* * * IMPORT7INT* * * THIS APPLICATION © MOT BE PW=SSJM MM288 ALL THE RZQUIMM I XIMF402I0t1 18 PROVIDZD. Refer -to the INFORMATIOH SULLZTIH for instructions. 1. Mum to be billed Nailing Address Contact person am& phone citr/state/::p AY-4AIC-g6 eJt- -07M O // susinese shoo. Z. name on Remit/M if Different than Above 4 Hailing AddressCi.r/S /sip 3. Application For: 0Site Evaluation Improvement Permit/ATC 0 Both 4. stews to servioei t House 0 Mobile Home 0 Business 0 Industry 0 other S. If Residence: # People ? - / Bedrooms $6.3 # Bathrooms Z H Dishwasher 81"rbage Disposal W4K , inq Usobine D aaseaent/plumbing Wii; aaaantMo probing S. if ausiness/Industry/others Specify two # Commodes # people # Sinks # showers # Urinals # Nater Coolers II1' 1=8=RVICE: # Seats Estimated Nater Usage (gallons per day) 7. Type of Mater supply: R County/City 0 Well 0 Community 9. Do you anticipate additions or expansions of the facility this system Is intended to serve? 0 Yes i/No V yes, what type? ***IMPORTANT*** CLIENTS MUST COMPLETETHE REQUIRED PROPERTY INFORMATION REQUESTED BELOW. Either* PLAT or SITE PLAN MUST BESI/BAHTTED by the client with THIS APPLICATION. Property Dimensions: 7S x ; x 2417,1c 2/6 Tax Oilice PIN: # S 7�7 S3 l a Property Address: Road Name a�l,�✓ City/Zip ✓V1VL6—kt 27 If in a Subdivision provide Information, as follows: Name:. ian--c Section: ! Block: Lot: l WRITE DIRECTIONS (from Mockeville) to PROPERTY: Date Property Flagged: This Is to certify that the information provided is correct to the best of my knowledge. I understand that any permit(s) Issued hereafter are subject to suspension or revocation, if the site plans or Intended we change, or if the Information submitted In this application Is falsified or changed 1, also, understand that I am responsible for all charges Incurred from this appUcatlon. I, hereby, give consent to the Authorized Representative of the Da* H th Dep ent to enter upon above described property located in Davie County and owned by to conduct all 7ttin 143 procedures as necessary to determine the site tabWty. DATE �SIGNATURE THIS AREA MAY BE USED FOR DRAWING YOUR SITE PLAN (Include all of the following: Existincnd proposed property lino and dimensions, structures, setbacks, and septic locations). V FT ---7 � OCT 2 2 iQa Revised DCHD (07/99) VL/ : 130. j U Site Revisit Charge Date(s): Client NotiBcstion Date: 1 EAS: Account No. -2.2 Invoice No. AU6 S 1 Lb Ga i o0 `s�t APPLICATION FOR SITE EVALUATIONAMPROVEMENT PERMIT T� �� n n L/ 17 2 Davie County Health Department l I LS Environmental Health Section u P. O. Box 848 AUG - 6.1997 Mocksville, NC 27028 PROPERTY INFORMATION REQUIRED: *** IMPORTANT *** A PLAT OF THE PROPERTY MUST BE /,� - SUBMITTED WITH THIS APPLICATION. Property Dimensions: % 9, Z 74 Athe.s 1 WRITE DIRECTIONS (from Mocksville) TO PROPERTY: Tax Office PIN: # 5 7 Si - 63 - -�s 7 o3 ; Aw C Property Address: Road Name %�- iR -Qe �� / �L2�2�� ci- • 1 _`. P City/Zip �d(/{4N�d✓ NC . 7d/i �/� rr /1 1 O N Per'GLe� Lr If in Subdivisionprovide inform tion, as follows: 1 ,rJRr -A ye'r a9�S 1Pp. jQ 0AJ )-SY Name: ely 1 Section: Lot #• 1 1 This : ; to certify that the information provided is correct to the best of my knowledge. I understand that any permits) issued hereafter are subject to suspension or revocation, if the site plans or intended use change, or if the information submitted in this application is falsif --d or changed. I, also, understand that I am responsible for all charges incurred from this application. I, hereby, give consent to the Aahorized Representative of the Davie County Health Department to enter upon above described property located in Davie County and owned by c - to conduct all testing procedures j as necessary to determine the site suitability. is " DATE --9-6-92 SIGNATURE Revised DCHD (06-96) ^L (704) 634-8760 ****IMPORTANT**** THIS APPLICATION CANNOT y BE PROCESSE } ALL THE REQUIRED INFORMATION IS PROVIDED. >9 Name to be Billed�es� // %e uJ die✓ -� 'e, - Contact Person Address _ S�tV�Sfh af >O rMailing � 6 Home Phone Sia q City/State/Zip �� �/s �N it/ -5641, A( e Q 749 3 Business Phone 9 9 �- 6 7 2. Name on Permit/ATC if Different than Above _ 5,4rrLis– Mailing Address City/State/Zip 3. Application For: 6d' Site Evaluation ❑ Improvement Permit & ATC _1 Both 4. System to Serve: ❑ House ❑ Mobile Home ❑ Business ❑ Industry ❑ Other 5. If Residence: # People # Bedrooms # Bathrooms ,a ❑ Dishwasher ❑ Garbage Disposal ❑ Washing Machine ❑ Basement/Plumbing ❑ Basement/No Plumbing " 6. If Business/Other: Specify type "% i # People # Sinks 101 #r Commodes # Showers ` ` # Urinals # Water Coolers;' If Foodservice: # Seats Estimated Water Usage (gallons per day) 7.`" 7 pe of water supply: ❑ County/City ', ❑Well ❑ Community a 8. Do you anticipate additions or expansions of the facility this system is intended to serve? ❑ Yes ; ❑ �No If yes, what type? PROPERTY INFORMATION REQUIRED: *** IMPORTANT *** A PLAT OF THE PROPERTY MUST BE /,� - SUBMITTED WITH THIS APPLICATION. Property Dimensions: % 9, Z 74 Athe.s 1 WRITE DIRECTIONS (from Mocksville) TO PROPERTY: Tax Office PIN: # 5 7 Si - 63 - -�s 7 o3 ; Aw C Property Address: Road Name %�- iR -Qe �� / �L2�2�� ci- • 1 _`. P City/Zip �d(/{4N�d✓ NC . 7d/i �/� rr /1 1 O N Per'GLe� Lr If in Subdivisionprovide inform tion, as follows: 1 ,rJRr -A ye'r a9�S 1Pp. jQ 0AJ )-SY Name: ely 1 Section: Lot #• 1 1 This : ; to certify that the information provided is correct to the best of my knowledge. I understand that any permits) issued hereafter are subject to suspension or revocation, if the site plans or intended use change, or if the information submitted in this application is falsif --d or changed. I, also, understand that I am responsible for all charges incurred from this application. I, hereby, give consent to the Aahorized Representative of the Davie County Health Department to enter upon above described property located in Davie County and owned by c - to conduct all testing procedures j as necessary to determine the site suitability. is " DATE --9-6-92 SIGNATURE Revised DCHD (06-96) ^L .. ]DAVIE COUNTY HEALTH DEPARTMENT Environmental Health Section Soil/Site Evaluation APPLICANT'S NAME -A:f� 11 PROPOSED FACILITY SUBDIVISIONL Water Supply: On -Site Well Community Evaluation By: Auger Boring Pit SECTION---/- LOT DATE EVALUATED PROPERTY SIZE ROAD NAME Public Cut FACTORS 1 2 3 4 5 6 7 Landscape position ,G Slope % HORIZON I DEPTH Texture group Consistence Structure Mineralogy HORIZON II DEPTH (- Texture group Consistence / Structure /I 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 SITE CLASSIFICATION: LONG-TERM ACCEPTANCE RATE: REMARKS: DCHD (OI -90) LEGEND Landscaue Position EVALUATION BY: MZ21 OTHER(S) PRESENT: 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 Wet 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 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 '0.7 0 3 c. -t 235.09 692 N C-10 c 698 or_ f., 'Cc oc 0. X23 Ac.9 OP N -3.3 6U CO0 2 < 200 35' N 0 5 *2 3'12 7 P IIDD 7 00 z oll C.692 A a) 6 J-) Pe LIS" Z OC NCY39'35"E 896 Ac.z. 7 118 '8- 34' 3 6 8 C 1 1 V 192.70': N04'1 6'C')O" S89" 4'u4/l, 896 49' TCT,:, e, o cc Parce. 44 Q B i -7 CURVE D �UR\E ABLE — � LENGTfi ---------------- - T