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142 Falling Creek Drive Lot 29Davie County. NC Tax Parcel R ennrt 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: Land Value: Total Assessed Value: WARNILNG: '17i1S 1S 14(3'1' A SURVEY Parcel Information H908OA0029 Township: Shady Grove 5789634032 Municipality: 8303474 Census Tract: 37059-804 PARSONS TORRANCE GREGORY Voting Precinct: EAST SHADY GROVE 142 FALLINGCREEK DRIVE Planning Jurisdiction: Davie County ADVANCE Zoning Class: DAVIE COUNTY R -A NC Zoning Overlay: 27006 Voluntary Ag. District: LOT 29 FALLINGCREEK FARM PHASE I Fire Response District: 0.70 Elementary School Zone: 5/2014 Middle School Zone: 009570634 Soil Types: 0007 Flood Zone: 049 Watershed Overlay: Outbuilding & Extra Freatures Value: Total Market Value: No ADVANCE SHADY GROVE WILLIAM ELLIS Pc132 DAVIE COUNTY Ag 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. Ali users of Davie County s GIS website shall hold harmless the County of Davie. North Carolina, Its agents, consultants, contactors or employees from any and aN daims or causes of action due to r'O tyt'� NC or arising out of the use or inability to use the GIS data provided by this website. AUTHOR, I!ATI6N No: I 3'3 DAVIE , LINTY HEALTH DEPARTMENT ?RTY nvironmental Health Section PROPFORMATION 'Permitteels P.O. Box 848 �f i,/ -�� Name: ` Mocksville, NC 27028 Subdivision Name: Phone #.,336-751=8760 Directions to property: Section: " 0/Lot: AUTHORIZATION FOR . WASTEWATER Tax Office PIN:# .,W-4- — SYSTEM CONSTRUCTION Road Name: r **NOTE** This Authorization for Wastewater System Construction MUST BE ISSUED by the Davie County Environmental Health Section prior to issuance of any Building-Permits. This Form/Authorization Number should be presented to the Davie County' Building Inspections Office when'applying for Building Permits. (In compliance with Article 1 I, of G.S. Chapter 130A, Wastewater Systems, Section .1900 Sewage Treatment and Disposal Systems) ***NOTICE*** THIS AUTHORIZATION FOR WASTEWATER CONSTRUCTION �"�4„ W �� IS VALID FOR A PERIOD OF FIVE YEARS. ' ENVIRONMENTAL HEALTH SPECIALIST DATE ISSUED . ire - A hW yp.w+. a�`,x+• ^-+.. .P+»'c:: '.•;._ . r ..: � , ..ry,.J,y[y.:. t 1 9 DAME COUNTY HEALTH DEPARTMENT "; `� ' �•' ' ""' IMPROVEMENT AND OPERATION PERMITS PROPI.RTY INFORMATION Y `eILtfe:�y w Narte:�`��'f,i,,di Subdivision Name: Dlre�ctions to property:. l f - Section: Lot: J : IMPROVEMENT PERMIT' Tax Office PIN:#t:'S"�` - Road Name: **NOTE** This Improvement Permit DOES NOT authorize the construction or installation 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) ***NOTICE*** THIS PERMIT IS SUBJECT TO REVOCATION IF SITE PLANS OR THE INTENDED USE CHANGE. YOUR WASTEWATER SYSTEM CONTRACTOR MUST SEE THIS PERMIT BEFORE ENVIRONMENTAL HEALTWSPECIALIST DATE ISSUED INSTALLING THE SYSTEM. RESIDENTIAL SPECIFICATION: BUILDING TYPE _ # BEDROOMS .s: # BATHS �2_ # OCCUPANTS GARBAGE DISPOSAL: Yes or No COMMERCIAL SPECIFICtATION: FACILITY TYPE # PEOPLE # PEOPLE/SHIFT # SEATS INDUSTRIAL WASTE: Yes or No ; LOT SIZE-�o, PE WATER SUPPLY DESIGN WASTEWATER FLOW (GPD) NEW SITE_(/ REPAIR SITE SYSTEM SPECIFICATIONS: TANK SIZE ,W GAL.:. PUMP TANK GAL. TRENCH WIDTH J— 5' ROCK DEPTH /oma LINEAR FT. OTHER REQUIRED SITE MODIFICATIONS/CONDITIONS: **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 (336)751-8760. IDDa AUTHORIZATION NO. " OPERATION PERMIT BY: DATE: r **THE ISSUANCE OF THIS OPERATION PERMIT SHALL INDICATE THAT THE Y DESCRIBED ABOVE HAS BEEN INSTALLED IN COMPLIANCE Wrm 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 0/96 (Revised) APPLICATION FOR SITE EVALUATION/IMPROVEMENT PERMIT & ATC D • Davie County Health Department Environmental Health Section FEB ' 2 M P.O. Box 648/210 Hospital Street Mockaville, NC 27028 (336) 751-8760 ENVIRONMENTAL HEALTH ***II-1PORTANT*** THIS APPLICATION CANNOT BE PROCESSED UNLESS ALL THE REQUIRED INFORMATION IS PROVIDED. Refer to the INFORMATION BULLETIN for instructions. 1. Name to be Billet! cel % • /�L��/l��'� Contact person /� �J •� Mailing Address ZD 1 t;tZl' +J 74l w Some phone '7-- City/State/ZIP LeuJ; S!>.'!� 17i', -:7 -70 -1 --?Business Phone '7��rr0 Z. Name on Permit/ATC if Different than Above Hailing Address City/State/Zip 3. Application For --44 Site Evaluation JWImprovement Permit/ATC ❑ Both 4. system to serviab i] House ❑ Mobile Home ❑ Business ❑ Industry ❑ Other Is. If Residence: # People # Bedrooms --3' # Bathrooms 2 - Ji Dishwasher 0 Garbage Disposal ---H Washing Hachine 0 Basement/Plusbing --U Basement/No Plumbing 6. If Business/Industry/other: Specify type # People # Sinks # Commodes # Showers # Urinals # Water Coolers IF FOODSERVICE: i} Seats Estimated stater Usage (gallons per day) 7. Type of water supply: County/City ❑ wall 0 Community S. Do you anticipate additions or expansions of the facility this system is intended to serve? 0 Yes --@ No If yes, what type? ***IMPORTANT'** CLIENTS AIUSTCOAtPLETETHE REQUIRED PROPERTY INFORMATION REQUESTED BELOW. Either a PLAT or SITE PLAN MUST BESUBA117TED by the client with THIS APPLICATION. Property Dimensions: Z2 S "C.W WRITE DIRECTIONS (from Mocluville) to PROPERTY: Tax Office PIN: # l% � 9 - 1?�' f�D3Z �006�� L o,� 0 L" / ©� Property Address: Road Name City/Zip wglo�/9sv'G G. If in a Subdivision provide information, as follows: LD % 2-7 t5a - Name: Al.' Section: Block: Lot: I Date Property Flagged:.1�.2� This is to certify that the information provided is correct to the best or 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 falsified or changed. I, also, understand that I am responsiblefor all chmges Incurred from this application. I, hereby, give consent to the Authorized Representative or the DaviCounty Health Department to enter upon above described property located in Davie County and owned by ,�ctl►/IcL �, �1'I���CI� to conduct all testing procedures as necessary to determine the site sujt&Wty. DATE �2 -2— �9g SIGNATURE//.! THIS AREA MAY BE USED FOR DRAWING YOUR SITE PLAN (Include all or the following: Existing and proposed property lines and dimensions, structures, setbacks, and septic locations). Revised DCHD (07/98) Account No. Invoice No. APPLICATION FOR SITE EVALUATIONAMPROVEMENT PERMITn F' Davie County Health Department ��`� lJ v Environmental Health Section D P. 0. Box 848 AUG 61907 Mocksville, NC 27028 (704)634-8760 ' ****IMPORTANT**** THIS APPLICATION CANNOT BE PROCESSEd UNLESS J ALL THE REQUIRED INFORMATION IS PROVIDED. 1. Name to be Billed V.,� // /e W Zn, Contact Person 61,)4 f 'railing Address tS SrjA Sti„ /0 Al 11 Home Phone 49iY' g �0 g City/State/Zip t1 i ,y s �N R/ r4 �.n�. nt e , 2 719 3 Business Phone 9 9 g - /1 c 7 2. Name on Permit/ATC if Different than Above Sao me— PROPERTY INFORMATION REQUIRED: *** IMPORTANT *** A PLAT OF THE PROPERTY MUST'BE Mailing Address SUBMITTED City/State/Zip /,�/� r1 e Property% Dimensions: `7 , , 74 Atte!,5 - 1 WRITE DIRECTIONS (from - 3. Application For: QSite Evaluation ❑ Improvement Permit & ATC ❑ Both 4. System to Serve: ❑ House ❑ Mobile Home ❑ Business ❑ Industry ❑ Other ;! 5. If Residence: # People # Bedrooms # Bathrooms ❑ Dishwasher ❑ Garbage Disposal ❑ Washing Machine ❑ Basement/Plumbing ❑ Basement/No Plumbing 6. If Business/Other: Specify type # People # Sinks — 1 1 # Commodes # Showers V., # Urinals # Water Coolers'' If Foodservice: # Seats Estimated Water Usage (gallons per day) 7. Type of water supply: ❑ County/City ❑ Well ❑ Community 8. Du you anticipate additions or expansions of the facility this system is intended to El 'Yes A.;,,,❑ ,.No . (serve?'; '• If ves, what type? - I � a .. " PROPERTY INFORMATION REQUIRED: *** IMPORTANT *** A PLAT OF THE PROPERTY MUST'BE SUBMITTED WITH THIS APPLICATION. /,�/� r1 e Property% Dimensions: `7 , , 74 Atte!,5 - 1 WRITE DIRECTIONS (from - Tax Office PIN: # : � 7 99 - 63 - 7 0 3 1 Mocksville) TO PROPERTY: 1 Property Address: Road Name 1 I City/Zip l�dr/owe /q.G' . we d 1 r If in Subdivisionprovide inform tion, as follows: 1 Name: Section: Lot #: a 1 '' — 1 1 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 sutject to suspension or revocation, if the site plans or intended use change, or if the information submitted in this application is falsi,&d or changed. I, 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 DAVIE COUNTY HEALTH DEPARTMENT Environmental Health Section SECTION LO_ Soil/Site Evaluation APPLICANT'S NAME Zl�` /t &2 DATE EVALUATED PROPOSED FACILITY �t PROPERTY SIZE SUBDIVISION ROADNAME Water Supply: On -Site Well Community Public L/ Evaluation By: Auger Boring Pit L_____ Cut FACTORS 1 2 3 4 5 6 7 Landscape position JL Slope % G HORIZON I DEPTH Texture group Consistence Structure Mineralogy HORIZON II DEPTH d + rff N Texture group Consistence Structure , MineralogyJ , ' 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 I L SITE CLASSIFICATION: LONG-TERM ACCEPTANCE RATE: REMARKS: LEGEND Landscape Position EVALUATION BY: 16'1e_%' 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 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 DCHD (O1-90) 1 N84'17'15"W 92-51' rn [368.27' 501'19'05"W — 235 t 25' >0 125' 130' 105' 247' '`' 123' 124' Lo J N3�VN \��0 ' N / N O V125' 125' 124' 25' ._. 65' 136' ^ 126' -PROPO 6 -6 -WATER., 228' o a 201' 126 � o 40' o N o N 2N N A X- 7' o 2 239'c LAI iV 04 O ' M126' 134' 260' 196' �' O �. oloo LO ty, ol" 30' L ( 2,� ' m 252' 1 >6 00 � �o ° (10 85' 210' N04-1 6'00"E 589'14 C° 2 i5l i 8 3 C N o 22°03 2 " I •`t M u7 ,50 0 / -