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199 Falling Creek Drive Lot 16i r� Davie Countv. NC Tasr ParrPl R Pnnrt 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: WARNING: THIS IS NOT A SURVEY Parcel Information H908OA0016 Township: Shady Grove 5789631850 Municipality: 82525696 Census Tract: 37059-804 COOKE BRUCE A Voting Precinct: EAST SHADY GROVE 199 FALLINGCREEK DRIVE Planning Jurisdiction: Davie County ADVANCE Zoning Class: DAVIE COUNTY R -A NC Zoning Overlay: 27006-0000 Voluntary Ag. District: No LOT 16 FALLINGCREEK FARM PHASE I Fire Response District: ADVANCE 0.86 Elementary School Zone: SHADY GROVE 1/2006 Middle School Zone: WILLIAM ELLIS 006450919 Soil Types: PaD,PcC2,WATER 0007 Flood Zone: 048 Watershed Overlay: DAVIE COUNTY Outbuilding & Extra Freatures Value: Total Market Value: 91.I� 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 Balms or causes of action due to NC or arising out of the use or Inability to use the GIS data provided by this website. •py��/f�/ S�/�j. � �yam.. 0 0 AUTHORIZATION NO: °" DAME COUNTY HEALTH DEPARTMENT s Environmental Health Section OROPERTY.JNFORMATIO.N Petmittee s Qlrl"fir%/� +JCIf�f' P.O. Box 848:>�/�/� dame: Mocksville, NC 27028 Subdivision Nam Phone # 336-751-8760: Directions to property: Section: Lot* AUTHORIZATION FOR WASTEWATER Tax Office PIN - SYSTEM CONSTRUCTION Road Name: Zip: *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. On mpliance with Article l l of G.S. Chapter 13M, Wastewater Systems, Section :1900 Sewage, Treatment and Disposal Systems) *.**NOTICE***THIS AUTHORIZATION FOR WASTEWATER CONSTRUCTION (f IS VALID FORA PERIOD OF FIVE YEARS. ENVIRONMENTAL HEALTH SPECIALIST DATE ISSUED` *"CONTACT A REPRESENTATIVE OF THE DAVIE COUNTY HEALTH DEPARTMENT FOR FINAL INSPECTION OF THIS SYSTEM BETWEEN 8:30 - 9:30 AM. OR 1:00 - 1:30 P.M. ON THE DAY OF INSTALLATION. TELEPHONE # IS (336)751-8760. r DCHD 05/96 (Revised) uw o:ic r.w+WAl10N/IMPROVEMENF PERMIT & AIC Davie County Health Department EnvironmentalIfealth SmWon P.O. Box 948/210 Hospital Street D Mockaville, HC 27029 (336)751-8760 A 7 1999 ***I?WOltTANT*** THIS APPLICATION CANNOT BE PROCESSED UNLESS ALL W VO NTAL HEALTH INSORMATIOH IS PROVIDED. Refer to the ItUMM UOU BULLBTrA for��{i atrna ��QOUNTY 1. Name to be Billed asc Iy Contact Verson 01'✓4eAA Mailing Address _(U�3S tTt jo U.�1 t�� some Phone —9.2-91 city/state/sir _r I P✓y;.'N� I"�- 27b 1 Z, Bnsinass Phone 3S 3*7 Ae 2. Nasse on Pe=lt/ASC if Different than Above /sailing Address City/state/Lip !. Application for: U_ Site Evaluation X Improvement Permit/ATC 0 Both e. system to service: UH House I] Mobile Home U Business 0 Industry 0 Other a. If Residence: t People _# Bedrooms 3 8 Bathrooms 2_.S7 B'��Dishwasher R/0ar age Disposal M / Nashinq Maehine 0 Basement/Plmobing 0 Basement/so Plumbing S. if Business/industry/Other: Specify type g People g sinks / Caeowdes f shovers g urinals / water coolers If IWDSERVICZ: 1 Seats Estimated Nater Usage tgallons per day) 7. Type of Nater supply: WCounty/City U Well 11 Commenity s. Do you anticipate additions or expausions of the facility this system Is intended to serve! U Yes B-90 If yes, what type. ""*IMPORTANTwo"' CLIENTS 11IUST CVAfPLETE THE REQUIRED PROPERTY INFORMATION REQUESTED BELOW. Either a PLAT or SITE PLAN MUST BESUBMITTED by the dlent with THIS APPLICATION. Property Dimensions: S u naW s 44"LS Tn 011ice PIN: it _5-799- 4,3- I g.Tb Property Address: Road Name ?'eu R 4' a, RJ CitylZip _ Ady • Z7voG If in a Subdivision provide information, as follows: Name: Fe.-Illei Leek i e. ,rw-. Section: Block: Lot: WRITS DIRECTIONS (from Mockwille) to PROPERTY: 6 Or—Ze"r/- k'0 /'V — gz / -,P.�U"'o• i/�•U-L � �•Qt-ops u�.. Le,F1- Date Property Flagged: L/- ?- q I This is to certify that the information provided Is correct to the best of my knowledge. 1 understand that any permit(s) Issued hereafter are subject to suspension or revocation, if the site plans or Intended use change, or if the Inrormation submitted In this application Is falsified or changed. I, aW, anAnwand that Ian mVondble for all chwgrs Incuffed front this appllcdon. 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 the snitability. DATEy�� 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 (07198) Account Na 9� Invoice Na 4.21 ^5 ` ?34.64- 33 ~-- ^JC2`C3'20^F 896.49' TC'AL Y � ccrre� 4c, C-3 9V 9vp-onu 87. C v/e'o ng Ou 55.00 SO� 10 500 ��;3 5. 07 4 0.00 JjZ OR -9 2F�l 14425 S14 TA 2P-33 35 E 07313 -)9 3t -.E 3snr ^- C-3 9V Ou 55.00 10 500 ��;3 5. 07 4 0.00 APPLICATION FOR SITE EVALUATIONAMPROVEMENT PERMIT — n—nr7m, Davie County Health Department 7 Environmental Health Section D P O. Box 848 AUG 61997 Mocksville, NC 27028 (704)634-8760 `} ****IMPORTANT**** THIS APPLICATION CANNOT BE PROCESSE ALL THE REQUIRED INFORMATION IS PROVIDED. 1. Name to be Billed ulesd` // %c uJ ZeV� Contact Person i Mailing Addresst� sr�C [Ufl Sth b �O ed 2 Home Phone 9 I '1 City/State/Zip vs y n/ .5ti4 A( , V 71 Business Phone9 9g,-116 2. Name on Permit/ATC if Different than Above .54 m.i?-� Mailing Address City/State/Zip 3. Application For: 2 Site Evaluation ❑ Improvement Permit & ATC ❑ Both 4. System to Serve: 5. If Aesidence: L Dishwasher 6. If Business/Other: # Commodes If Foodservice: ❑ House ❑ Mobile Home # People ❑ Garbage Disposal Specify type ❑ Business ❑ Industry # Bedrooms ❑ Washing Machine t.i . s ❑ Basement/Plumbing # People # Showers # Urinals # Seats Estimated Water Usage (gallons per day) ❑ Other # Bathrooms . ❑ Basement/No Plumbing. # Siaks # Water Coolers 7. Type of water supply: ❑ County/City ❑ Well 8. Do you anticipate additions or expansions of the facility this system is intended to serve? If yes, what type? I PROPERTY INFORMATION REQUIRED: *** IMPORTANT *** A PLAT OF THE PROPERTY MUST.BE /,� SUBMITTED WITH THIS APPLICATION. Property Dimensions: % 9, 74 Atte--s 1 WRITE DIRECTIONS (from Mocksville) TO PROPERTY: ' Tax Office PIN: # �� 7 '1!J- 63 --- . J % ©3 � �' G �L. Property Address: Road Name -�-a/ ` City/Zip d l oJVd !' If in ,subdivision provide informhon, as follows. 1 - Fame: T/`l�/'%�� (.frto 1 .Z ,%s 1 .Section• Illy Lot #• � 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 the Authorized Representative of the Davie County Health Department to enter upon above described property located in Davie County, and owned by Z& < a to conduct all testing procedures as necessary to determine the site suitability. DATE g—fo— c/ SIGNATURE " DAVIE COUNTY HEALTH DEPARTMENT Environmental Health Section Soil/Site Evaluation APPLICANT'S NAME PROPOSED FACILITY SUBDIVISION Water Supply: On -Site Well Community Evaluation By: Auger Boring Pit _L SECTION LOTZ DATE EVALUATED/%_ PROPERTY SIZE ROAD NAME Public Cut FACTORS 1 2 3 4 5 6 7 Landscape position I Sloe % HORIZON I DEPTH Texture group Consistence Structure Mineralogy HORIZON II DEPTH 1 Texture groupG Consistence 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 SITE CLASSIFICATION: 4— LONG-TERM ACCEPTANCE RATE: REMARKS: DCHD (01.90) Landscape Position EVALUATION BY: 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