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152 Falling Creek Drive Lot 28Davie County, NC Tax Parcel Report Wednesday, December 21, 2016 State: WAKNI.N T: TMS lS 1VU"1' A 1UKVEY Zoning Overlay: Parcel Information 27006-7655 Voluntary Ag. District: Parcel Number: H908OA0028 Township: Shady Grove NCPIN Number: 5789634134 Municipality: Elementary School Zone: Account Number: 82513003 Census Tract: 37059-804 Listed Owner 1: ANDERSON OLIN O Voting Precinct: EAST SHADY GROVE Mailing Address 1: 152 FALLINGCREEK DRIVE Planning Jurisdiction: Davie County City: ADVANCE Zoning Class: DAVIE COUNTY R -A State: NC Zoning Overlay: Zip Code: 27006-7655 Voluntary Ag. District: No Legal Description: LOT 28 FALLINGCREEK FARM PHASE 1 Fire Response District: ADVANCE Assessed Acreage: 0.69 Elementary School Zone: SHADY GROVE Deed Date: 6/1999 Middle School Zone: WILLIAM ELLIS Deed Book / Page: 003060683 Soil Types: Pc62 Plat Book: 0007 Flood Zone: Plat Page: 049 Watershed Overlay: DAVIE COUNTY Building Value: Outbuilding & Extra Freatures Value: Land Value: Total Market Value: Total Assessed Value: 91.E 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, Implied warranties of merchantability or fitness for a particular use. Ali users of Davie County's GIS website shall hold harmless the nC �TCounty of Davie, North Carolina, its agents, consultants, contractors or employees from any and all claims or causes of action due to l� C or arising out of the use or Inability to use the GIS data provided by this webstte. s:..P`s�v19',N'ty ry �i+ir'7y'"`--!d '-*�( `..�'• iai•Wc'+ �,.._ "i'tt.-...»'"� •y ix .. �. :-z -4- ATI, O;4 4ATIOj4i NO:- 1- 8 7 4 DAVIE �OUNTY HEALTH DEPARTMENT Environmental Health Section PROPERTY INFORMATION Permittee's Name. Mocksville, NC 27028 Subdivision Name: �— Phone # 336-751-8760 Directions to property; Ar Section: .+� Lot: AUTHORIZATION FOR WASTEWATER Tax Office PIN:#6 W91 SYSTEM CONSTRUCTION' / Road Name•"-Lip:��lu **NOTE** This Authorization for Wastewater System Construction MUST BE ISSUED by the Davie County Environmental Health Section prior' .11 to issuance of any Building Permits. This Fortr/Authorization Number should be presented to the Davie County Building Inspections Office when applying for Building Permits. (In compliance with Article I 1 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 EALTH SP CIALIST DATE ISSUED , q '" , DAVIE OUNTY HEALTH DEPARTMENT -,IMPROVEMENT EMENT AND OPERATION PERMITS PROPERTY INFORMATION y �1nme 1r=w121�� if/�,� Subdivision Name: �DueCtjpns is property: Lot: M t : Section: INIPROVEMENT y PEP -NUT Tax Office PIN147W Road Name: Zip, **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 I I of G.S: Chapter 130A, Wastewater Systems, Section .1900 Sewage Treatment and Disposal Systems) ,f } ***NOTICE*** THIS PERMIT IS SUBJECT TO REVOCATION IF SITE. .< ,� .f• f (f j- y` " PLANS OR THE INTENDED USE CHANGE. YOUR WASTEWATER 1 NVIRONMENTAL HEALTH SPECIALIST DATE ISSUED SYSTEM CONTRACTOR MUST SEE THIS PERMIT BEFORE INSTALLING THE SYSTEM. RESIDENTIAL SPECIFICATION: BUILDING TYPE 1-14 # BEDROOMS # BATHS # OCCUPANTS GARBAGE DISPOSAL: Yes or No COMMERCIAL SPECIFICATION: FACILITY TYPE # PEOPLE # PEOPLE/SHIFT ..�� ,,� # SEATS INDUSTRIAL WASTE: Yes or No LOT SIZEa TYPE WATER SUPPLY DESIGN WASTEWATER FLOW (GPD) ���NEW SITE Aoo� REPAIR SITE SYSTEM SPECIFICATIONS: TANK SIZE —1,-9a—GAL. PUMP TANK GAL. TRENCH WIDTH �1 / ROCK DEPTH ~LINEAR FT. Dl!/ 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. OPERATION PERMIT j' SYA F AUTHORIZATION NO. OPERATION PERMIT BY: DATE: G **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 NOWAY BE TAKEN AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORILY FOR ANY GIVEN PERIOD OF TIME. DCHD 05196 (Revised) APPLICATION FOR SITE EVAUKHON/IMPROVFMMY PERMIT & ATC R .. _ Davie County Health Department D L5 EnWivamental Health 519e fon P.O. Box 848/210 Hospital street DEC I ( FA Mocksville, NC 27028 (336)751-8760 ' ErJUIROS �►IE��A ��EALTH ***IIdPORTANT*** THIS APPLICATION CANNOT BE PROCESSED UNLESS ALL THE REQufRSD INFORMATION IS PROVIDED. Refer to the INFORMATION BULLETIN for instructions. 1. llama to be Billed d //��Contact Person -Q Mailing Address �� Q /� Home phone - D City/ State/ yIP ��Y1dOb �LflP�n �. 1!, �,�2f�L� Business phone Z. flame on Permit/ATC if Different than Above Hailing Address City/State/yip 3. Application For: U Site Evaluation Improvement Permit/ATC 6th 4. system to service: id' House 0 Mobile Home ❑ Business ❑ Industry 0 Other a. I�f Residence: # People # Bedrooms # Bathrooms 'Dishwasher 0 Garbage Disposal Naahing Machine 0 Basement/Plumbing 6Zement/Ho Plumbing 6. If Business/Industry/other: Specify type # Commodes # People # Sims # Showers # Urinals # Nater Coolers IF FOODSERVICE: # Seats Estimated Water Usage (gallons per day) 7. Type of water supply: 0-60unty/City 0 well 0 Community 9. Do you anticipate additions or expansions of the facility this system is intended to serve? 0 Yes B -Na-- If yes, what type? ***IMPbRTANT*** CLIENTS AIUST COMPLETETHE REQUIRED PROPERTY INFORMATION REQUESTED BELOW. Either a PLAT or SITE PIAN AIUST BESUBb11TTED by the client with THIS APPLICATION. Property Dimensions: a �r 25 o WRITE DIRECTIONS (from Mocksville) to PROPERTY: Tax Office PIN: # � �� - �o�''d / �� T-410 /o Property Address: Road Namc % �iT°E' / o City/Zip GD O 4 i.11`0 If in a Subdivision provide information, as follows: Name: / /? C� e Section: � Block: Lot: J2!L�Date Pro rty Flagged: - O C rere- This is to certify that the information -provided Is correct to t best or my tnowled e. I un ermit issued hereafter are subject to suspension or revocation, if the site plans or utended use change, or if the information submitted in this application is falsified or changed. I, also, understand that I am responsMiefor all charges incurredfrom this application. I, hereby, give consent to the Authorized Representative of the Davie County H Depart i to enter upon above described property located in Davie County and owned by al to conduct all testing procedures as necessary to determine the site suitability. „ DATE 1.� ` %�' �.� 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. 2q� Invoice No. J t3 &Aerl cKrm Mer AL_", -/ irrrewr..• ,�� rarra tucaur -&Arlt CWMT I -13- -t2- ! -t1- I -10- I-5"4MA0U ACNES _ I I' P86P,IUa101 tawW 506'1 33•w AAP --w,.,.,, �. r...r 2!1.21' rw �- ah• ew. M 0.w ter" Ier.-.AI /fir AV Iv. rwwN I �w� 4 wd W•w�i. raw. •.e y�y� ser a porti C-27 y � a ` 1 ►acN 41, lac Mar M-9 J herald E Grows 1 r er of 0.8.162.1`9 1ZK& \ 8 2 496 Ac ! `i7 c 1.546 As 24878. -- NO5'26'361 Y 21 0.70{At.! 4 N>9t'00' E F-110.00• 0.892 Act ' I 0.701 Ac., \ "1 t1 08 C-31 C-17 C_10 81.59 --•rte L�1 _... roIWi tuourc-nrAirri currrr •- " � s� �t� - /orrrsi ewrrR v SEAL Z : I ►•1628 — •�7 ♦q)y r VIP 148. 24 5 1.290 Ac.: C-21 I �w� 4 wd W•w�i. raw. •.e y�y� ser a porti C-27 y � a / ►acN 41, lac Mar M-9 J herald E Grows 1 0.8.162.1`9 600 \ g xx• A ti I IL �y W I I $ h W tr � so5nr3a•w --- I� 2]7 oila Parcel 40.01, Tac Yap M-9 \ Worn S. 140.13 971 Crew. \ a 0.8.163.10,.777 \ 240-29, \ / -%\ S10'19'�1 E � 8 2 496 Ac ! `i7 c 1.546 As 24878. -- NO5'26'361 Y 21 0.70{At.! 4 N>9t'00' E F-110.00• 0.892 Act ' I 0.701 Ac., \ "1 t1 08 C-31 C-17 C_10 81.59 --•rte L�1 _... roIWi tuourc-nrAirri currrr •- " � s� �t� - /orrrsi ewrrR v SEAL Z : I ►•1628 — •�7 ♦q)y r VIP 148. 24 5 1.290 Ac.: C-21 I C-20 C-27 y iv / ►acN 41, lac Mar M-9 J herald E Grows 1 0.8.162.1`9 600 \ g xx• A S IL �y $ ul �i u SOS 12 44 w 122 4Y 108.16• 17.lei $0119'05'w ---- 366.27 126.00' 1 126.00' 1 US 00' a 1 0 6101 Ac.t N 0 891 Ac.s' w 0.703 Ac.s 0 ODD Ac.t .+ � 0 6610 AC.: „ � .4 LO tL y 20 1 O Z 1 r A Q �' gGICµ 1 ' 0 — —12— 6_�' �— 106 32' C-210 C-� 129 01'- C m 125 1 m FALLINGCREEK DRIVE So_11• 2202Y �w7 N0119'OS'E C-32 Noo'36./3•w 0 (60' PUBLIC R/w1) — — 1 y / ►acN 41, lac Mar M-9 J herald E Grows 1 0.8.162.1`9 600 \ IL �y / / 4 — vd' Parcel 40.01, Tac Yap M-9 \ Worn S. 1.020 Ac.! Crew. \ a 0.8.163.10,.777 \ 240-29, \ / -%\ S10'19'�1 E � 0.774 At.* �� 2 SOS 28']6'w —� ' Parcel 40. � h-, , o.e.7e�, X71 \\ 0.707 A" SOS 12 44 w 122 4Y 108.16• 17.lei $0119'05'w ---- 366.27 126.00' 1 126.00' 1 US 00' a 1 0 6101 Ac.t N 0 891 Ac.s' w 0.703 Ac.s 0 ODD Ac.t .+ � 0 6610 AC.: „ � .4 LO tL y 20 1 O Z 1 r A Q �' gGICµ 1 ' 0 — —12— 6_�' �— 106 32' C-210 C-� 129 01'- C m 125 1 m FALLINGCREEK DRIVE So_11• 2202Y �w7 N0119'OS'E C-32 Noo'36./3•w 0 (60' PUBLIC R/w1) — — 1 r ' APPLICATION FOR SITE EVALUATIONAMPROVEMENT PERMIT Davie County Health Department Environmental Health Section P. 0. Box 848 Mocksville, NC 27028 (704) 634-8760 ****IMPORTANT**** THIS APPLICATION CANNOT BE PROCESSE ALL THE REQUIRED INFORMATION IS PROVIDED. I. Name to be Billed �1 �s� // %e UJ bekoe o ot� 20. Contact Person G V)4 y ' Mailing Address 2 26- 5-4At .5 tt b � ri-,0, Home Phone City/State/Zip U; ,vs io tt/ �i4 � .�. /�� e , 2 71,9 3 Business Phone 9 9�' H7 j 2. Name on Permit/ATC if Different than Above -'5'a4 rrtg- Mailing Address City/State/Zip 3. Application For: O' Site Evaluation ❑ Improvement Permit & ATC ❑ Both 4. 5. 6. 7 Sy3tem to Serve: 0 House ❑ Mobile Home ❑ Business ❑ Industry ❑ Other If Residence: # People # Bedrooms # Bathrooms' O Dishwasher 0 Garbage Disposal ❑ Washing Machine ❑ Basement/Plumbing 0 Basement/No ,Plumbing If Business/Other: Specify type # People # Sinks # Commodes # Showers # Urinals # Water Cook If Foodservice: # Seats Estimated Water Usage (gallons per day) 7. Type of water supply: ❑ County/City '` El Well ❑Community 8. Do you anticipate additions or expansions of the facility this system is intended to serve? 0 Yes } ' f0 No If yes, what type? PROPERTY INFORMATION REQUIRED: *** IMPORTANT *** A PLAT OF THE PROPERTY MUSTBE - SUBMITTED WITH THIS APPLICATION. Propsrty Dimensions: 7 q, 7q A-tte-5 1 WRITE DIRECTIONS (from 7 g! -r 7 ©3 63 1 Mocksville) TO PROPERTY. Tax Office PIN: # -- - - 1 " Property Address: Road Name �-� �-�L-� /c - yLU-kXC- t 1d City/Zip AJil;4 e e—. we � D t� 1 1 If in Subdivision provide inform tion, as follows: Avg QA) L-SY Name: //i�� Section: Lot #: - • 1 i This is to certify that the information provided is correct to the best of my knowledge. I understand that any permit(s) issue:,' hereafter are subject to suspension or revocation, if the site plans or intended use change, or if the information submitted in this appli - on is falsified 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 and owned by to conduct all testing procedures as necessary to determine the site suitability. DAT: g -tfl- d 7 SIGNATURE i., Tl/wil ' DAVIE COUNTY HEALTH DEPARTMENT Environmental Health Section SECTION_ LOT Soil/Site Evaluation APPLICANT'S NAME l�C� �y��✓' DATE EVALUATED ����14� PROPOSED FACILITY PROPERTY SIZE � /Ic SUBDIVISION ROAD NAME /4c�G` Water Supply: On -Site Well Community, Evaluation By: Auger Boring Pit Public °__1 Cut FACTORS 1 2 3 4 5 6 7 Landscape position 14 Slope % HORIZON I DEPTH Texture group Consistence Structure Mineralogy HORIZON II DEPTH 4 N Texture group Consistence Structure /G / Mineralogy' t HORIZON III DEPTH Texture group Consistence Structure Mineralogy HORIZON IV DEPTH Texture group Consistence Structure Mineralogy SOIL WETNESS RESTRICTIVE HORIZON SAPROLITE CLASSIFICATION S LONG-TERM ACCEPTANCE RATE , SITE CLASSIFICATION: LONG-TERM ACCEPTANCE RATE: REMARKS: DCHD (01-90) n EVALUATION BY: AQZ OTHER(S) PRESENT: LEGEND 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