176 Falling Creek Drive Lot 191
Davie Countv, NC
Tax Parcel Rennrt
Wednesdav, December 21, 2016
State: NC
Zip Code: 27006
Legal Description: LOT 19 FALLINGCREEK FARM PHASE I
Assessed Acreage: 0.70
Deed Date: 1/2012
Deed Book / Page: 008791000
Plat Book: 0007
Plat Page: 049
Building Value:
Land Value:
Total Assessed Value:
Zoning Overlay:
Voluntary Ag. District:
Fire Response District:
Elementary School Zone:
Middle School Zone:
Soil Types:
Flood Zone:
Watershed Overlay:
Outbuilding & Extra
Freatures Value:
Total Market Value:
No
ADVANCE
SHADY GROVE
WILLIAM ELLIS
PcB2
DAVIE COUNTY
QED
�T 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. 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
1N C or arising out of the use or Inability to use the GIS data provided by this website.
WAKNMti: "1'H1N 1l 1VU"1' A NUKVEY
Parcel Information
Parcel Number:
H908OA0019
Township:
Shady Grove
NCPIN Number:
5789634406
Municipality:
Account Number:
8300606
Census Tract:
37059-804
Listed Owner 1:
SEMPLE RONALD JOHN
Voting Precinct:
EAST SHADY GROVE
Mailing Address 1:
176 FALLINGCREEK DRIVE
Planning Jurisdiction:
Davie County
City:
ADVANCE
Zoning Class:
DAVIE COUNTY R -A
State: NC
Zip Code: 27006
Legal Description: LOT 19 FALLINGCREEK FARM PHASE I
Assessed Acreage: 0.70
Deed Date: 1/2012
Deed Book / Page: 008791000
Plat Book: 0007
Plat Page: 049
Building Value:
Land Value:
Total Assessed Value:
Zoning Overlay:
Voluntary Ag. District:
Fire Response District:
Elementary School Zone:
Middle School Zone:
Soil Types:
Flood Zone:
Watershed Overlay:
Outbuilding & Extra
Freatures Value:
Total Market Value:
No
ADVANCE
SHADY GROVE
WILLIAM ELLIS
PcB2
DAVIE COUNTY
QED
�T 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. 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
1N C or arising out of the use or Inability to use the GIS data provided by this website.
UTHGRIZATION NO:" DAVIE COUNTY HEALTH DEPARTMENT
Environmental Health Section PROPERTY INFORMATION
Permittee s - P.O. Box 848
Name: �•�' _� Mocksville,NC 27028 Subdivision Name: i++ �'J1�
Phone# 336-751-8760 „
Directions to property.' C� �i %�rf Section: Lot:
AUTHORIZATION FOR
WASTEWATER Tax Office PIN:* •R' �
SYSTEM CONSTRUCTION
.02
Road Name : c,7 p: � .
**NO.TE**ThisAuthorization for Wastewater System Construction.MUST BE ISSUED by the Davie County;Environmental Health Section prior
tci issuance of any Building'Permits.This FornVAuthorizationNumber should be presented to the Davie County Building Inspections
'Office when applying for Building Permits.
(In compliance with Article l l of G.S.Chapter 130A,Wastewater Systems,Section.1900 Sewage:Treatment,and Disposal Systems)
***NOTICE***THIS AUTHORIZATION FOR WASTEWATER CONSTRUCTION
K .r
IS VALID FOR A PERIOD OF FIVE YEARS.
ENVIRONMENTAL HEALTH S ECIALIST DATE ISSUED .
VCHD U31" (Keylsw)
t APPU AIION FOR SITE EVALUATION/IMPROVEMENT PERMIT &
r ► Davie County Health Department D v
/ Envitvnmenfal Heaft SmWon
P.O. Box 848/210 hospital Street FEB .-
111"�" Mockaville, NC 27028
(336) 751-8760
ENVIRONMENTAL HEALTH
***IMPORTANT*** THIS APPLICATION CANNOT BE PROCESSED UNLESS ALL THE REQUIRED
INFORMATION IS PROVIDED. Refer to the INFORMATION BULLETIN for instructions.
1. name to be Billed ^'moi l� �FA4C. Contact Person QZn- Qd
Nailing Address 1'- 1 �X z I�j (p ?J3 11 // Home Phone -L -L O42' S &p6
City/State/ZIP 1/�� IVIS II7V1- SQ (fir. . l�L 1, . z'1114 Business Phone
2. Name on Permit/ATC if Different than Above
Nailing Address City/State/Zip
3. Application For: U9-'House
SiSite Evaluation Improvement Permit/ATC ❑ Both
4. system to Service: 9 House ❑ Mobile Home ❑ Business ❑ Industry ❑ Other
a. if Residence: �# People # Bedrooms 3 # Bathrooms z-
R Dishwasher WGarbage Disposal WWashing Hachins 11 Basement/Plumbing 17 Basement/No Plumbing
6. If Business/industry/other: Specify type # People # Sinks
# Commodes
# Showers # Urinals # Nater Coolers
IF FOODSERVICE: T Seats Estimated hater Usage (gallons per day)
7. Type of water supply: W County/City ❑ Well ❑ Commmityy
e. Do you anticipate additions or expansions of the facility this system is intended to serve! ❑ Yes Pilo
If yes, what type'
***IMP17RTANT***CLIE14TSAIUSTCOAIPLETETHE REQUIRED PROPERTY INFORMATION REQUESTED
BELOW. Either a PLAT or SITE PIAN MUST BESUBIHI TED by the client with THIS APPLICATION.
Property Dimensions: ISI.9 6 X 233.3'7 X 11 C X 2 R6.IS WRITE DMEUnONS (from Mocksville) to PROPERTY:
Tax Office PIN: # 5199 - (a3 S 1 b3 4 0/9;') 1!v' '%o 601 4
Property Address: Road Name i`c� l 1w•q Gf cGk,
cityinp Adv w ce i mc Z"700c
If in a Subdivision provide information, as follows:
el -
Name: 'r0J --Q C -v CC <
Section: Block: Lot: k_
Artuamrro — Zwl +�caaIes
Cv c r -k Rcl a ccese, a le -4
V Prop er�l.�, atA I ie -F+.
rp t k t-
Date Property Flagged: -2— 1- aq
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 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 --T(o k . -UA C.
to conduct all testing procedures as necessary to determine the site suitability.
DATE 2 I -" �q SIGNATURE �� �
THIS AREA MAY BE USED FOR DRAWENG YOUR SITE PLAN (Include all of the following: LV�ft and proposed
property lines and dimensions, structures, setbacks, and septic locations).
Ret ised DCHD (07198)
Account No.�
Invoice No. _
PROPERTY INFORMATION REQUIRED: *** IMPORTANT *** A PLAT OF THE PROPERTY MUST -BE
SUBMITTED WITH THIS APPLICATION.
Property Dimensions: % q, r- 7q Atte-5 1 WRITE DIRECTIONS (from
Mocksville) TO PROPERTY:
I-tx Office PIN: # 5 7 gq 63 - J 7 0 3 I
L Jet -OL -
Prop .rty Address: Road Name ��iR.-QC.a/ VL¢�ci-. 1
II 1 d oP-
city/zip AJV;4Wdd 144L-. ,tQia0 G ��' rr
1 D/ n Le.
If in�ubdivis p�de � `stn, as follows:/v,js 1
}'
Name:
2' 1
1
Section• Lot # 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 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 responsible for all charges incurred from this application. I, hereby, give consent to
I the Authorized Representative of the Davie,. County Health Department to enter upon above described property located in Davie County
and owned by ��`siI ;P0 < 1 �,! to conduct all testing , ro'cedures
as necessary to determine the site suitability.
a � /7
Davie County Health Department 1JEnvironmental
APPLICATION FOR SITE EVALUATIONAMPROVEMENT PERMITTAUG
Health Section
P O. Box 848
- 61997
•
Mocksville, NC 27028
a
(704) 634-8760
'
****IMPORTANT**** THIS APPLICATION CANNOT BE PROCESSE6
UN ESS
ALL THE REQUIRED INFORMATION IS PROVIDED.
1.
Name to be Billed
1je5 // %e W bevel - �,�. Contact Person G V IA % ;-
Mailing Address
s s�� S%�N b �O rd SCG/ Home Phone
City/State/Zip
�/; ,vs�4 rt/ 54k&,% At Lo, n? ZA9 3 Business Phone 9 9�?' // 6 7
2.
Name on Permit/ATC if Different than Above Sao m e—
M;�iling Address
City/State/Zip
3.
A_.3plication For:
@---Site Evaluation ❑ Improvement Permit & ATC ❑ Both;
4.
System to Serve:
❑ House ❑ Mobile Home ❑ Business ❑ Industry ❑ Other
s
j 5.
If Residence:
# People # Bedrooms 4 Bathrooms`
G Dishwasher
❑ Garbage Disposal O Washing Machine ❑ Basement/Plumbing ❑ Basement/No Plumbing
6.
If'Business/Other:
Specify type # People # Sinks
# Commodes
# Showers # Urinals # Water Coolers''
If Foodservice:
# Seats Estimated Water Usage (gallons per day)
i
d 7.
Type of water supply: O County/City ❑Well ❑ Community
a`
8.
Do you anticipate
additions or expansions of the facility this system is intended to serve? ❑ 'Yes - 0.,' No
,i
If yes, what type?
I
PROPERTY INFORMATION REQUIRED: *** IMPORTANT *** A PLAT OF THE PROPERTY MUST -BE
SUBMITTED WITH THIS APPLICATION.
Property Dimensions: % q, r- 7q Atte-5 1 WRITE DIRECTIONS (from
Mocksville) TO PROPERTY:
I-tx Office PIN: # 5 7 gq 63 - J 7 0 3 I
L Jet -OL -
Prop .rty Address: Road Name ��iR.-QC.a/ VL¢�ci-. 1
II 1 d oP-
city/zip AJV;4Wdd 144L-. ,tQia0 G ��' rr
1 D/ n Le.
If in�ubdivis p�de � `stn, as follows:/v,js 1
}'
Name:
2' 1
1
Section• Lot # 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 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 responsible for all charges incurred from this application. I, hereby, give consent to
I the Authorized Representative of the Davie,. County Health Department to enter upon above described property located in Davie County
and owned by ��`siI ;P0 < 1 �,! to conduct all testing , ro'cedures
as necessary to determine the site suitability.
DAVIE COUNTY HEALTH DEPARTMENT
Environmental Health Section
Soil/Site Evaluation
SECTION_/ LOTa
APPLICANT'S NAME AgDATE EVALUATED
PROPOSED FACILITY PROPERTY SIZE
SUBDIVISION 2 r ROAD NAME
Water Supply: On -Site Well Community Public
Evaluation By: Auger Boring Pit Cut
FACTORS
1 2 3 4 5 6 7
Landscape position
.L
Slope %
HORIZON I DEPTH
Texture group
Consistence
Structure
Mineralogy
HORIZON II DEPTH
Texture group
Consistence
i
Structure
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
L
SITE CLASSIFICATION:
LONG-TERM ACCEPTANCE RA
REMARKS:
DCHD (O1-90)
EVALUATION BY:
OTHER(S) PRESENT:
v 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