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135 East Rolling Meadow Road Lot 22Davie County, NC ► I Tax Parcel Report Wednesday, December 21, 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: WAKN11VCT: TMb 1, 14U'1' A bUKVhY Parcel Information H908OA0022 Township: Shady Grove 5789637481 Municipality: 82532136 Census Tract: 37059-804 FINCHER ANTHONY B Voting Precinct: EAST SHADY GROVE 135 EAST ROLLINGMEADOW ROAD Planning Jurisdiction: Davie County ADVANCE Zoning Class: DAVIE COUNTY R -A NC Zoning Overlay: 27006-0000 Voluntary Ag. District: No LOT 22 FALLINGCREEK FARM PHASE I Fire Response District: ADVANCE 1.54 Elementary School Zone: SHADY GROVE 7/2010 Middle School Zone: WILLIAM ELLIS 008320424 Soil Types: PaD,PcB2,PcC2 Land Value: Total MarKet value: Total Assessed Value: DAVIE COUNTY (ED All data Is provided as is without warranty or guarantee of any Idnd either eapreased 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 Courrty of Davie, North Carolina, its agents, consultants, contractorsoremployees 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 pro vided by this websRe. 4vV"0i'*"jr.;"u i,a�+ tiT'.ii'F:"+4=rt -r i 'Ly.An,E' S•..CT j': ti.` T`. ,c.. )-':;.3�- L+ Asa J^y+ , r,c:'+��,. y...:;..,r.Y'r.rs 40'. V" A CAIZIZATION No: DAVIE COUNTY HEALTH DEPARTMENT ` 4"21 q -t It //��� f _ 1 A Environmental Health Section PROPERTY INFORMATION Permittee's P.O. Box 848 Name`.Qt� u/�%/ Mocksville, NC 27028 Subdivision Name: '� Phone # 336-751-8760 Directions to property: Section: Lot: AUTHORIZATION FOR WASTEWATER SYSTEM CONSTRUCTION.Tax Office PIN: Road Name:'kf 'r l Zip: **NOTE** This Authorization for Wastewater System Construction MUST BE ISSUED by the Davie County Environmental Health Section prior to issuance of any BuildingPermits. This Form/Authorization Number should be presented to the Davie County Building Inspections Office when applying for Building Permits. (In compliance with Article 11 of G.S. Chapter 130A, Wastewater Systems, Section .1900 Sewage Treatment and Disposal Systems) ***NOTICE*** THIS AUTHORIZATION FOR WASTEWATER CONSTRUCTION IS VALID FOR A PERIOD OF FIVE YEARS. ENVIRONMENTAL AtALTfi SPE IALIST DATE ISSUED DAVIE COUNTY HEALTH ,, 'DEPARTMENT IMPROVEMENT AND OPERATION PERMITS PROPERTY INFO TION Subdivision Name:,,' ... �; f Di'rcy Cb property: ,!�. ,. , f Section: _Lot: IMPROVEMENT �. - ✓ - �.. PERMIT Tax OfficIN:#.$�% Road Name:,!. Zip: 6 ***NOTICE*** THIS PERMIT IS SUBJECT TO REVOCATION IF SITE PLANS OR THE INTENDED USE CHANGE. YOUR WASTEWATER. ENVIR NMENTAL HEALTH SPECIALIST DATE ISSUED SYSTEM CONTRACTOR MUST SEE THIS PERMIT BEFORE INSTALLING THE SYSTEM. RESIDENTIAL SPECIFICATION: BUILDING TYPE_ # BEDROOMS,.T— # BATHS # OCCUPANTS GARBAGE DISPOSAL: Yes or No COMMERCIAL SPECIFICATION: FACILITY TYPE # PEOPLE # PEOPLEISHIFT # SEATS INDUSTRIAL WASTE YeSir No LOT SIZE -TD C %Vd TYPE WATER SUPPLY ( 6 DESIGN WASTEWATER FLOW (GPD) 7,/,/)'NEW SITE—k"" R§PAIR SITE SYSTEM SPECIFICATIONS: TANK S/DOd GAL. PUMP TANK GAL. TRENCH WIDTHl ROCK DEPTH/ LINEAR FT. i OTHER REQUIRED SITE MODIFICATIONS/CON IMPROVEMENT PERMIT LAYOUT *APPROVED EF EHT FILTER* *RISER(s) IF 6• • BEIW FIRIS:tED VRADE* A< ud i e C/ l7 7 **CONTACT A REPRESENTATIVE OF THE DAVIE COUNTY HEALTH DEPARTMENT FOR FINAL INSPECTION OF THIS SYSTEM BETWEEN 8:30 - 9:30 A.M. OR 1:00 - 1:30 P.M. ON THE DAY OF INSTALLATION. TELEPHONE # IS (XO tX wAX (M0751-8760 OPERATION PERMIT L_S SYSTEM INSTALLED BY: ,Q�� AUTHORIZATION NO. OPERATION PERMIT BY: DATE: **THE ISSUANCE OF THIS OPERATION PERMIT SHALL INDICATE THAT THE SYSTEM DESCRIBED ABOVE 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. DCHD 05/96 (Revised) w .,. uw.•ul. 100 011c cvswuA1l0NI/IMPIl0VEMENI PERM1I do ATC Davie County Health Deparbuent Env/nronmenfal Health SMWOH P.O. Box 848/210 Hospital Street Mockaville, HC 27028 13361751-8760 ***IIWORTANT*** THIS APPLICATIOII CANNOT BLS PR=SMW MUMSS ALL YH maNATION IS PROVIDED. Refer to the INrORMATION BULLBTIH for ,i Vol, 1. Mame to be Biuea 6r 01,Ay% 0- c/3c.JfC0V— Contact Parson N010"eXA Nailing Address G�L� 3S �r�� . 1�.� i �� some Ptvone eihr/state/LIP �p.,,.�.v:n :c ti1C. 2 b I l Business Phone 7232- 3:5 3-7 luetic/ a. Name on Permit/ATC if Different than Above Nailing Address City/state/Lip 3. Application for: U� Site Evaluation )X Improvement Permit/ATC 0 Both 4. System to service: II House 0 Mobile Home 0 Business 0 Iadnatsy 0 Other S. It Residence: # People �-F-- i Bedrooms 13 t# Bathrooms Z 9 . B'Dishxasher Q'Oanbage Disposal 9 Hashing Nachl" 11 Basesent/Plumbing 0 Basement/No Plumbing 6. If Business/Industry/other: specify type # People / sinks f commodes ! shovers * urinals i Nater Coolers IP IWDSERVICE: t Seats �� Estimated slater Usage (gallons per day) 7. 2"m of water supply: Ot" County/City 0 well 0 Community s. Do you anticipate additions or expansions of the facility this system is intended to nerve! 0 Yes B-90 If yes, what type! ""IMPORTANT"" CLIENTS MUST COSMLETE THE REQUIRED PROPERTY INFORMATION REQUESTED BELOW. Either a PLAT or SITE PLAN MUST BESUBMITTED by the client with THIS APPLICATION. Property Dimensions: Stt rY s 44" Tax Office PIN: # 5_79L l03- 71091 Property Address: Road Name W oaf.. 6, pi City/Zip AdU • 2,700L it in a Subdivision provide information, as follows: Name: FC.Il i ✓t Q r,."-ek. Section: Block: Lot: Z 2 WRITE DIRECTIONS (from Moduville) to PROPERTY: Date Property Ragged: 1% 7 - 99 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 use change, or It the Information submitted in this application Is talsified or changed. I, also, andaatand that I ane nespom9lefor all charges lncunwd frons this aMUcadon. 1, hereby, give consent to the Authorized Representative of the Davie County Health Department to enter upon above described property located in Davie County and owned by to conduct all testing procedures as necessary to determine the die suitability. DATE�q SIGNATURE THIS AREA MAY BE USED FOR DRAWING YOUR SITE PLAN (include all of the following: Existing and proposed property lines and dimensions, structures, setbacks, and septic locations). Revised DCHD (07/98) Account No. T 9� Invoice No. 1. Mame to be Biuea 6r 01,Ay% 0- c/3c.JfC0V— Contact Parson N010"eXA Nailing Address G�L� 3S �r�� . 1�.� i �� some Ptvone eihr/state/LIP �p.,,.�.v:n :c ti1C. 2 b I l Business Phone 7232- 3:5 3-7 luetic/ a. Name on Permit/ATC if Different than Above Nailing Address City/state/Lip 3. Application for: U� Site Evaluation )X Improvement Permit/ATC 0 Both 4. System to service: II House 0 Mobile Home 0 Business 0 Iadnatsy 0 Other S. It Residence: # People �-F-- i Bedrooms 13 t# Bathrooms Z 9 . B'Dishxasher Q'Oanbage Disposal 9 Hashing Nachl" 11 Basesent/Plumbing 0 Basement/No Plumbing 6. If Business/Industry/other: specify type # People / sinks f commodes ! shovers * urinals i Nater Coolers IP IWDSERVICE: t Seats �� Estimated slater Usage (gallons per day) 7. 2"m of water supply: Ot" County/City 0 well 0 Community s. Do you anticipate additions or expansions of the facility this system is intended to nerve! 0 Yes B-90 If yes, what type! ""IMPORTANT"" CLIENTS MUST COSMLETE THE REQUIRED PROPERTY INFORMATION REQUESTED BELOW. Either a PLAT or SITE PLAN MUST BESUBMITTED by the client with THIS APPLICATION. Property Dimensions: Stt rY s 44" Tax Office PIN: # 5_79L l03- 71091 Property Address: Road Name W oaf.. 6, pi City/Zip AdU • 2,700L it in a Subdivision provide information, as follows: Name: FC.Il i ✓t Q r,."-ek. Section: Block: Lot: Z 2 WRITE DIRECTIONS (from Moduville) to PROPERTY: Date Property Ragged: 1% 7 - 99 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 use change, or It the Information submitted in this application Is talsified or changed. I, also, andaatand that I ane nespom9lefor all charges lncunwd frons this aMUcadon. 1, hereby, give consent to the Authorized Representative of the Davie County Health Department to enter upon above described property located in Davie County and owned by to conduct all testing procedures as necessary to determine the die suitability. DATE�q SIGNATURE THIS AREA MAY BE USED FOR DRAWING YOUR SITE PLAN (include all of the following: Existing and proposed property lines and dimensions, structures, setbacks, and septic locations). Revised DCHD (07/98) Account No. T 9� Invoice No. MENT OF TRANSPORTATION F HIGHWAYS ON ROAD CONSTRUCTION sRTIFICATION CINEER�' P•' P_P TF_n�t'SF_iQ . ts� IE COUNTY _13_ I -- N06'44'35"E 1808 6C' pe Pound w/etea Pipe Set Id Stone Found Rainforotng Rod no monument g Board hereby approves the subdivision a e r l i' 1 • /•'Ye"- Planning Board —12 PLANNI NC DEPARTMENT/REVIEW OFFICER FINAL SUBDIVISION PLAT APPROVAL This is to cenith that this plat owls the recordsne requirements Athe ntfl Dsw(oprrwnt Ordmance Subdivision Rspvlattons fbr nvM County ! it.. Officer of Davits County. certify that the map or plat to uAwh this osritftoarion u affimit meets all stand r"usn-4nts fbr recorrdmg , c 1 Approved ,A�itL.-. ._ ;_f..�,_,..,.-r,• Dtnelor of ilew,w4ae/14uu. Officer Thts the ; S, day of -it 1e- 19 19 q .NORTH CAROLINA DAPI£ rOt'.VTY —11— 1 —10— SHAMROCK ACRES - P 9 6.F t; '833'E4 t I I I S06'44 35",N 430.010, ^1 . ^1t , �. BRa.tiC� kation y that We are the owners of the if located within the subdivision that We hereby adopt this subdivision estobllsn minimum bullding setback lays, walks, parks and other sites, to use as noted. � E.c�TG'o,PiP I 1, I nl S35'01'56"4 - 237.61' 140 43' SURVEYORS CERTIF I. John E. Beeson certify that my supervision from an actual survey m (description recorded in Deed Book I . that the ratto o is It: 10. + : that this plat uxis pro 49-30 as amen4ed. Wit rwss m onptnal si and seal th' day of—.d A.D. SVt''1.eyOT NORTH CAROLINA-FORSYTH COUNTY -9- =8' 4 148.79' 1 �\ Z �23-CO A. LA 0CO Ns 2.496 Ac. t S 4 )0 , 6 Si 'Y9 � h C24, C-24 4E . w 110 00 I � I w f I U C-20 N cD C-27 Z_ po NCV 00�U me I CO (p (�•� N CO 0 70' Ac.= n C 689 " 0 fn I 00 tom. w �. T'lo 248.78' C11 l tT O M ._. _ _. 0 - 00 00 U, i ccf-- lD ,.;uBHT N D CP 00 c 00 N n i 0.704 Ac.t U n� C 7� C nl S35'01'56"4 - 237.61' 140 43' SURVEYORS CERTIF I. John E. Beeson certify that my supervision from an actual survey m (description recorded in Deed Book I . that the ratto o is It: 10. + : that this plat uxis pro 49-30 as amen4ed. Wit rwss m onptnal si and seal th' day of—.d A.D. SVt''1.eyOT NORTH CAROLINA-FORSYTH COUNTY -9- =8' 4 148.79' 1 �\ Z �23-CO A. LA 0CO Ns 2.496 Ac. t S 4 )0 , 6 Si 'Y9 � h C24, C-24 4E . w 97 18' o . — NOC'01 09 , A . ) 239.00' 1 a' 12900' Parce 1.028 Ac.t 2a0'99 52'E C, 0.774 Ac.* 237.08 S05'28'36"4 1�1 C27, Il�a� 0.707 Ac.t S05'42'44"W --- 230.63' 122.47' 1 108.1 0.692 Ac x W �. C 700 Ac.t rn N � o � 110 00 I � I f I U C-20 N cD C-27 Z_ po NCV 00�U me (p (�•� N CO 0 70' Ac.= n C 689 " 0 fn �_ 00 00 �. T'lo 248.78' C11 l tD T ti — N05'28' 36"E __. ._. _ _. 0 - 00 U, ,.;uBHT N D CP Q) c 00 N i 0.704 Ac.t U 97 18' o . — NOC'01 09 , A . ) 239.00' 1 a' 12900' Parce 1.028 Ac.t 2a0'99 52'E C, 0.774 Ac.* 237.08 S05'28'36"4 1�1 C27, Il�a� 0.707 Ac.t S05'42'44"W --- 230.63' 122.47' 1 108.1 0.692 Ac x W �. C 700 Ac.t rn N � o � 110 00 I � I f N cD 00�U me ^� 0.69 C 692 Act 0 70' Ac.= n C 689 " 0 00 N W U. �. Q 1D C11 l tD T r :� �� - C" '' �' r— U, ,.;uBHT c .. 5 ALL/THE REQUeUIRED INFORMATION IS PROVIDED. 1. I`'sme to be Billed Vo-s�y /e w rev Gin, Contact Person G t, 1! Mailing Address -,22L Sr�cV� Sfh b �o rd ul Home Phone 9 City/State/Zip it/ .56 A( e 7 I0 3 Business Phone 9 99' 6- 7 2. Name on Permit/ATC if Different than Above 5"4 me - Mailing Address 3. Application For: 4. System to Serve: 5. If Residence: ❑ Dishwasher 6. If Business/Other: # Commodes City/State/Zip OSite Evaluation ❑ Improvement Permit & ATC ❑ House ❑ Mobile Home ❑ Business ❑ Industry # People # Bedrooms ❑ Garbage Disposal ❑ Washing Machine ❑ Basement/Plumbing Specify type # People _ # Showers # Urinals ❑ Both ❑ Other # Bathrooms ❑ Basement/No Plumbing #St,s # Water Coolers' If Foodservice: # Seats Estimated Water Usage (gallons per day) 7. T ,pe of water supply: ❑ County/City ❑ Well ❑ Community 8. Do you anticipate additions or expansions of the facility this system is intended to serve? ❑ Yes,,'., 140No If yes, what type? MPORTANT ***A PLAT OF THE PROPERTY MUSTBE ' SUBMITTED WITH THIS APPLICATION. Property Dimensions: q9, � Tax Office PIN: # -15- 7 g! - 63 Property Address: Road Name -XC- City/Zip Adyl4w e-- If in Subdivision provide inform tion, as follows: ,,8» Vjg7,4�A ���/� �'/ac's Name: IN 2 S sction: Lot #: 2 - WRITE DIRECTIONS (from Mocksville) TO PROPERTY: L 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 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. 1, hereby, give consent to the Authorized Representative of the Davie County Health Department to enter upon above described property located to Davie County and owned by < w.,. -y to conduct all testingirocedures i ; S.'. as necessary to determine the site suitability. j DATE g -�- cI SIGNATURE (�,�-- Revised DCHD (06-96) ^ L i f DAVIE COUNTY HEALTH DEPARTMENT i Environmental Health Section SECTION_ LOT�2 Soil/Site Evaluation APPLICANT'S NAME �i��9 yh`a°�r/' DATE EVALUATED ��—'F PROPOSED FACILITY SUBDIVISION Water Supply: On -Site Well Community, Evaluation By: Auger Boring Pit , / PROPERTY SIZE �`��L ROAD NAME 40:9, &e, Public / Cut FACTORS 1 2 3 4 5 6 7 Landscape position 14— (,Slo Slope e % 40 IYX HORIZON I DEPTH Texture group Consistence Structure Mineralogy HORIZON II DEPTH Texture group(i Consistence Structure s 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: V LONG-TERM ACCEPTANCE RATE: REMARKS: DCHD (01-90) LEGEND EVALUATION BY: Z // 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 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