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231 Falling Creek Drive Lot 39Davie County, NC Tax Parcel Report Wednesday, December 21, 2016 WARNING: THIS 1S NOT A SURVEY Parcel Information Parcel Number: H908OA0039 Township: Shady Grove NCPIN Number: 5789645129 Municipality: Account Number: 82518547 Census Tract: 37059-804 Listed Owner 1: JOHNSON ROBERT W Voting Precinct: FAST SHADY GROVE Mailing Address 1: 231 FALLINGCREEK DRIVE Planning Jurisdiction: Davie County City: ADVANCE Zoning Class: DAVIE COUNTY R -A State: NC Zoning Overlay: Zip Code: 27006-7659 Voluntary Ag. District: No Legal Description: LOT 39 FALLINGCREEK FARM PHASE II Fire Response District: ADVANCE Assessed Acreage: 2.44 Elementary School Zone: SHADY GROVE Deed Date: 4/2002 Middle School Zone: WILLIAM ELLIS Deed Book / Page: 004170340 Soil Types: PaD,PcB2,PcC2 Plat Book: 0007 Flood Zone: Plat Page: 189 Watershed Overlay: DAVIE COUNTY Building Value: Outbuilding & Extra Freatures Value: Land Value: Total Market Value: Total Assessed Value: 161 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. Ail users of Davie Countys 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 NC or arising out of the use or Inability to use the GIS data provided by this website. DAVIE COUNTY HEALTH DEPARTMENT Environmental Health Section P. O. Boa 848/210 Hospital Street b Moclisville, NC 27028 (336)751-8760 IMPROVEMENT/OPERATION PERMIT Account #: 990002208 Tax PIN/EH #: 5789-645129.39 RJ Billed To: Robert Johnson Subdivision Info: Falling Creek Lot # 39 Reference Name: Location/Address: 231 Falling Creek Drive -27006 Proposed Facility: Residence Property Size: see map ATC Number: 3104 **NOTE** This Improvement/Operation Permit DOES NOT authorize the construction 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). THIS PERMIT IS SUBJECT TO REVOCATION IF SITE PLANS OR THE INTENDED USE CHANGE. YOUR WASTEWATER SYSTEM CONTRACTOR MUST SEE THIS PERMIT BEFORE INSTALLING SYSTEM. Residential Specification: Building Type /7 #People --3 #Bedrooms Q_ #Baths Dishwasher: Pl"- Garbage Disposal, -Z Washing Machine; Basement w/Plumbing: ❑ Basement/No Plumbing: ❑ Commercial Specification: Facility Type #People #People/Shift #Seats Industrial Waste: ❑ Lot Size Type Water Supply_ Design Wastewater Flow (GPD) Oo!� d Site: New 0' Repair ❑ System Specifications: Tank Size/40 GAL. Pump Tank Other: Required Site Modifications/Conditions: GAL. Trench Width ,�-Z "'Rock Depth Z' le Linear IMPROVEMENT/OPERATION PERMIT LAYOUT - APPROVED EFFLUENT FILTER RISERS) IF 6 " BELOW FINISHED GRADE. ****NOTICE: Contact a representative of the Davie County Health Department for final inspection of this system between 8:30 a.m. to 9:30 a.m. or 1:00 p.m. to 1:30 p.m. on the day of installation. Telephone # is (336)751-8760.**** Environmental Health Specialist's Signature: Date:, DCHD 05/99 (Revised) Account #: 990002208 Billed To: Robert Johnson Reference Name: d.� DAME COUNTY HEALTH DEPARTMENT Environmental Health Section P. O. Boz 848/210 Hospital Street Mocksville, NC 27028 (336)751-8760 Tax PIN/EH M 5789-64-5129.39 RJ Subdivision Info: Falling Creek Lot # 39 Location/Address: 231 Falling Creek Drive -27006 Proposed Facility: Residence Property Size: see map ATC Number: 3104 AUTHORIZATION FOR WASTEWATER SYSTEM CONSTRUCTION **NOTE** This Authorization for Wastewater System Construction MUST BE ISSUED by the Davie County Environmental Health Section prior to issuance of any building permit(s). This Form/Authorization Number should be presented to the Davie County Building Inspections Office when applying for building permit(s) (in compliance with Article 11 of G.S. Chapter 130A, Wastewater Systems, Section .1900 Sewage Treatment and Disposal Systems). THIS AUTHORIZATION FOR WASTEWATER CONSTRUCTION IS VALID FOR A PERIOD OF FIV/E YEARS. Environmental Health Specialist's Signature: / 1�— Date:U CERTIFICATE OF COMPLETION **NOTE** The issuance of this Certificate of Completion shall indicate the system described on Improvement/Operation Permit has been installed in compliance with Article 1 I 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. Septic System Installed By: Environmental Health Specialist's Signature: Zyj�—// / Date: ;> y`/� y DCHD 05/99 (Revised) 1 Feb 28 02 09:14a davie county envhealth 336 751 8786 P,2 IN FOR SITE EVAI.UATIONAMPROYEMENt PERMIT & ATC Davie County Health Department Environmental Health Section P.O. Box 848/210 Hospital. Street Mocksville, NC 27028 G (336)751-8760 OR * TANTk** THIS APPLICATION CANNOT BE PROCESSED UNLESS ALL THE REQUIRED INFORMATION IS PROVIDED. Refer to the INFORMATION BULLETIN for instructions. 1. Name to be Billed iD & f: (-C ktl . J0l{,15C:VJ Contact Person Mailing Address X3/145 .I (l LI { Y1 (�� . Home Phone 3 3(D 77 City/State/ZIP LX 1dS'70/1-6A 4 t /u i Oft 2A�7"" 10(0 Business Phone '35(.P- 1 � 2— 99 10 2. Name on Permit/ATC if Different than Above � f 1,4 6- AS �V E_ Mailing Address City/State/Zip / 3. Application For: ❑ Site Evaluation ❑ Improvement Permit/ATC 0 Both 4. System to service: House n Mobile Home ❑ Business O Industry ❑ Other S. If Residence: //# People _ a Bedrooms N Bathrooms 2-- /Dishwasher VI Garbage Disposal M/Washing Machine 11 Basement/Plumbing 11 Sasement/No Plumbing 6. if Business/Industry/Other: Specify type # People # Sinks # Commodes # Showers # Urinals # Water Coolers IF FOODSERVICE: # Seats Estimated Water Usage (gallons per day) 7. Type of water supply: LT County/City ❑ Well 0 Community e. Do you anticipate additions or expansions of the facility this system is intended to serve? ❑ Yes O No If yes, what type? ***IMPORTANT*** CLIENTS MUST COMPLETETHE REQUIRED PROPE10-Y INFORMATION REQUESTED BELOW. Either a PLAT or SITE PLAN MUST BESUBMITPED by the client witli THIS APPLICATION. Property Dimensions: .57-49)(538 X SGO' X453 Tax Office PIN: #5789-64-5171-9 Property Address: Road Name 23( /W� lL/WG6WKP, . City/Zip Aut"a 4C. 2 - Ofd o If in a Subdivision provide information, as follows: Name: FALUAGULE2KA-P 1 Section: �� Block. Lot: 39 WRITE DIRECTIONS (from Mocksville) to PROPERTY: .5 40 MI=ST To llvly 801 Egir —T/1— 6ouTH� T4 KJ X'PvAAcL -- T/L A -r 2- e jrmA cf-- -co CPtZ��,7/L ©,J'JC,C'�KDR• r TO En11D OF WL- . L-0� on/ L,E:Fi �PAC,(-- t 8q Date Property Flagged: 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. 1, hereby, give consent to the Authorized Representative of the Davie Couiity-Health Department to enter upon above described property located in Davie Countyand owned by to conduct all testing procedures as necessary to determine the site suitability. DATE —3// % 2oO2-- SIGNATURE Cho �— 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 (07/99) Site Revisit Charge Date(s): Client Notification Date: EHS: Account No. �-o-0 Invoice No. _7 Curve Radius C1 198.48 t VYe are. the owners of the cated within the :'subdivision We hereby adopt #his subdivision .ish minimum building setback .Nalks. parks, and other sites ' e as noted. ration signature ---do-Te— ."') Y signature a e.'x signature date GS Hoots y 288 II=Io0 � j231' O 48 r Zo.00' (to CE l.cl Lc i C U0 Delta ITangentl Arc Length 73'10'33" 1 147.34' 253.49' Z LA LA o o, Bearing Chord S52'33'49"W 73F A' Tax Map H-9 part of Parcel 42 Now or formerly John E.Grenier. Jr. & wife Linda C. (OB -197. Pg -157) P`� Sz.2 ..� i J.C? Pt Pt. C2 `% 71,.Yq 7 Pt t.Pt. L3 '15.�t Pt. L5 �. Pt. � 42.91' ".9. --II Pt. NIP 8 o� 1,0 0 Pt. i. I RESERVED Pt. FOR FUTURE USE 173.026 Sq. Ft. 3.972 Acres± s s� �j Sr�s��l 0sr,, 0Z F J 10' Public Utiliti S 6 Easement 2'0 �8. 342 76M £ 641 Sq.Ft. of former 96.14. ' o� W to be closed \ _............... ... 264 8 i 61 4 C X61 S �ci z� ) 1CC to v =M L o� h 274.59'4i N 7 . 2p 83, 4 pl27 W FALLINGCREEK FARM-1� / PHASE I I PB 7, Pg. 4915� 3 . 1 .4 O� :c W T'NG L KE 0;e' o !� co Pt. �-' Pt. L9 �' Pt. Pt. CO 14.41' 20.00'(to CL Creek) 100.- 2.3( 39 N 106 349 Sq. Ft. C) P 2.441 Acres± w L N_ ) Ln ^ 0 ' 1T1 O �Lto, "R.v��"� F ^3 N � U s° Co C\/ / �-0\ N89'09'06'E—' 197.80 �� R 59' 0.25' 38.96' �6 ► j Z c0 91, c sp 08 %h� 114.02 S89•09'�W Radius= 57, p FALLINGCREEK DRIVE 60 PUBLIC A/W , / �-0\ N89'09'06'E—' 197.80 �� R 59' 0.25' 38.96' �6 C N T Revised 17 N o w I 35,749 Sq. Ft. 0.821 Acres± o cr �= .rP o o 14 z 1415-513-33"E 9.73 L4 > —� N 74 01,2,1. rt ; 1. APPLICATION FOR SITE EVALUATION/IMPROVEMENT PERMIT & Davie County Health Department Environmental Healtfi Section P.O. Box 848/210 Hospital Street Mocksville, NC 27028 (336) 751-8760 A JAN 2 4 2000 ENVIRONMENTAL HEALTH DAVIE COUNTY ***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 Contact Person RANT 6onFR.EY Mailing Address 2631 PskyNotOA ROAD Home Phone 33A -76o-2008 City/state/ZIP WWsraN:6pLEy4, Nc 171 A Business Phone 134-711.00%.8 2. Name on Permit/ATC if Different than Above Mailing Address 3. Application For: Site Evaluation 4. system to service: eHouse ❑ Mobile Home 5. If Residence: # People City/State/Zip Improvement Permit/ATC ❑ Both ❑ Business ❑ industry ❑ Other # Bedrooms 3 # Bathrooms n Dishwasher H Garbage Disposal U Washing Machine f] Basesient/Plumbing 11 Basement/No Plumbing 6. If Business/Industry/Other: specify type # Commodes # showers # Urinals # People # Sinks # Water Coolers IF FOODSERVICE: # Seats Estimated Water Usage (gallons per day) 7. Type of Water supply: 8/County/City ❑ Well ❑ Community e. Do you anticipate additions or expansions of the facility this system is intended to serve? ❑ Yes B'No If yes, what type? ***IMPORTANT*** CLIENTS MUST COMPLETETHE REQUIRED PROPERTY INFORMATION REQUESTED BELOW. Either a PLAT or SITE PLAN MUST BE SUBMITTED by the client with THIS APPLICATION. Property Dimensions: Tax Office PIN: # 5789 -- 6�4 -l4 8y• 3� Property Address: Road Name lALUN6UL�QIXN4 city/zip A omwa, at 11A If in a Subdivision provide information, as follows: Name: I A LUN60E f<� 7pKtf Section: ?� Block: Lot: Lorf 17 # 3q -11I WRITE DIRECTIONS (from Mocksville) to PROPERTY: Date Property Flagged: /1- 28- cif 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 1 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 Wt JLAC-W L-yX 0M6N1 6"QA1NY to conduct alltesting procedures as necessary to determine the site suitability. DATE 1 T 17,31 IOa SIGNATURE — THIS AREA MAY BE USED FOR DRAWING YOUR SITE PLAN (Include all oft o owing: Existing and proposed property lines and dimensions, structures, setbacks, and septic locations). Site Revisit Charge Date(s): Client Notification Date: I EHS• Account No. X Revised DCHD (07/99) Invoice No. Z2 2 �/ A APPLICATION FOR SITE EVALUATION/IMPROVEMENT PERMIT & ATC f ! ' ` JAN 2 4 2000 Davie County Health Department 4�t. EnPironmentaiHeaidt 5edion Ef;VIRO',4104TAL HEALTH P.O. Box 848/210 Hospital Street DAUIE COUNTY Mocksville, NC 27028 (336) 751-8760 I ***1WORTANT*** THIS APPLICATION CANNOT BE PROCT:SSED UNLESS ALL THE REQUIRED I l INFORMATION IS PROVIDEDRefer to the INFORMATION BULLETIN for instructions. { 1. Name to be Billed ES:N3fAa 1J(,%ALA20FAQE ((�MAWY Contact Person &a 6daniEY Mailing Address 2631 2E»Jc,.oA ROAD Home Phone 934-760- 2408 City/State/ZIP Wigs::5A�fm ._NC 111 A Business Phone DA -311-097A 2. Name on Permit/ATC if Different than Above Mailing Address 3. Application For: R Site Evaluation 4. system to Service: eHouse ❑ Mobile Home City/State/Zip 'i Improvement Permit/ATC 0 Both ❑ Business ❑ Industry ❑ Other 5. If Residence: # People # Bedrooms 3 # Bathrooms 1" 0 Dishwasher fl Garbage Disposal H Washing Machine 0 Basement/Plumbing ❑ Basement/No Plumbing 6. If Business/Industry/Other: Specify type # People # Sinks # Commodes # Showers # Urinals # Water Coolers IF FOODSERVICE: # Seats Estimated Water Usage (gallons per day) 7. Type of Water supply: B'County/City 0 Well ❑ Community e. Do you anticipate additions or expansions of the facility this system is intended to serve? ❑ Yes eNo If yes, what type? ***IMPORTANT*** CLIENTS MUSTCOMPLETETHE REQUIRED PROPERTY INFORMATION REQUESTED BELOW. Either a PLAT or SITE PLAN MUST BESUBMITTED by the client with THIS APPLICATION. Property Dimensions: Tax Office PIN: # 5-181-64-148 J0 Property Address: Road Name FAL.UM44Akoc-L-nivG city/zip A otowCE . Nc Ila If in a Subdivision provide information, as follows: Name: I A LUN6tI1,CH< 4C 111wr Section: �~ Block: Lot: L0rfl? 13KI WRITE DIRECTIONS (from Mocksville) to PROPERTY: Date Property Flagged: /2- 28' 51 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 ani 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 bJCTrVlt-uJ ► dKcIM6�1 LowfQAJy 1 to conduct all testing procedures as necessary to determine the site suitability. DATE l / 7,31 SIGNATURE Tr - THIS AREA MAY BE USED FOR DRAWING YOUR SITE PLAN (Include all oft o owing: Existing and proposed property lines and dimensions, structures, setbacks, and septic locations). ,nnaP LOT- 3q Revised DCHD (07/99) Site Revisit Charge Date(s): Client Notification Date: I EHS• Account No. J Invoice No. ? APPLICATION FOR SITE EVAUJATION/IMPROVEMENT PERIWIT & AT Davie county Health Department JUL 2 0 1999 Environmental Ifealth Section P.O. Box 848/210 Hospital Street ENVIRONMENTAL HEALTH Mockaville, NC 27028 DAVIE COUNTY (336)751-8760 ***nV0RTANT*** THIS APPLICATION CANNOT BE PROCESSED UNLESS ALL THE REQUIRED INFORMATION IS PROVIDED. Refer to the INFORMATION BULLETIN for instructions. 1. Name to be Billed WETOAQ -1 DGVEL44 MENV contact Person �y�C�J1' �T%4FriEY Mailing Address 2 bsl R<INaKId iZcA2` tome Phone S36'" %L<7 '1--', City/stats/ZI? WWI tcN�i:>�E^�`1 � I1C il1CZ Business Phone -.5 36 ' 17-2 'vel 74 2. Name on Permit/ATC if Different than Above Mailing Address City/State/Zip �/ 3. Application For: O 8ite Evaluation ❑ Improvement Permit/ATC ❑ Both 4. system to service: E(House 0 Mobile Home 0 Business 0 Industry ❑ Other 3. If Residence: # People # Bedrooms - # Bathrooms dDishvasher d Garbage Disposal {]/ hashing Machine ❑ Basement/Plumbing O Basement/No Plumbing 6. If Business/Industry/Other: Specify type # People # Sinks # Commodes # shovers # Urinals # hater Coolers IF FOODSERVICE: # Seats Estimated Water Usage (gallons per day) 7. Type of water supply: d County/City ❑ Well 0 Community a. Do you anticipate additions or expansions of the facility this system is intended to serve? 0 Yes d"No If yes, what type? ***IMPORTANT*** CLIENTS MUST COMPLETE THE REQUIRED PROPERTY INFORMATION REQUESTED BELOW. Ei.oer a PLAT or SITE PLAN MUST BESUBKHIED by the client with THIS APPLICATION. ,kisc Property Dimensions: ,.y;4401J2--,(ALuA V%( -CK fj:0Acrt(0) P-01) icr 33 FA--W::v.cCx: t"s.L Tax Oflice PIN: # 5'7hJ-�4•,z481. J --f-1 2.1L-HS.33 Property Address: Road Name r/I.t:4-.(9C<4C DRAK City/Zip AOvA-1C-,11c -270; If in a Subdivision provide information, as follows: Name. F- �5 • 1 li ,Li 'c'ft f< -K Section: Block.. R U Lot: _ WRITELLDIRECTIONS (from MockrAlle) to PROPERTY: ('Twy' 4-1 ( S i ' LC- c�/ �(% R 1GuT' c..� P(-ePL(j c-XCK4- Date Property Flagged: 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 to conduct all testing procedures as necessary to determine the site suitability. DATE :1 h9I29 SIGNATURE f THIS AREA MAY BE USED FOR DRAWING YOUR SITE PLAN (Include all of the f owing: Existing and proposed property lines and dimensions, structures, setbacks, and septic locations). Site Revisit Charge Date(s): I Client Notification Date: `EHS: Revised DCHD (07/99) Account No. -�� Invoice No. O ~ \ I Shamrock Acres I \ TAMA M. O'MARA \ PB 6 Pg 183 & 184 \ DB 157• PG 1 14 I 13 \ 2238.60' , �7' \ 81' 710 1 / b YY �° V 720 v \ 730 / 233. >� / �lbo 760. — ` ` \ \ \ _ — / 740 J o- `\ 21 2. 1 ..V 40 S '�' 92' 2 I 223-59' `•a � ` � � -•— _ _........ 6x/st,-615�� Tc Be I \ have 1� const. 21Q fAbv u \ Is 0 47 / \ 237.61' '^ / 140.43' 97.18' S \ \ LL d R= 150' a 1 Exi 5t; A? g IJ: Z / \' G ` ^ 19N �1 n Ptia e o- h $ide Pltch N be re.oveal w;i{•i Phase 1Z ) by \ i`^QIn9 (Tr Const. (TYR) 1 .04' N05 3 0"E s0' _ 1 v __ 1 1Q8 90.3 i 61_P77M' Tenl o�oCy = S 1 1. .p � R 5y 0 iia. er ��..` J \ �, / L:, LTONi UTLET STRUCTURH��9.84' 104.88'6 •K: - 10 5 ONE R 500' F 16 • j I\ l0 15 � `° APPROXIMATE LIMITS N oK 14 \44RBA c1qi 165, \ ` N 130. 1 \. s I� � 1•. 7,2. I 1 EXISTING LAKE v Parcel 42.05 Wanda Gaye Hoots / DB 138, Pg 288 I I I 1 \ \ I \ 1I1 • �O I �, M ~ \ I Shamrock Acres I \ TAMA M. O'MARA \ PB 6 Pg 183 & 184 \ DB 157• PG 1 14 I 13 \ 2238.60' , �7' \ 81' 710 1 / b YY �° V 720 v \ 730 / 233. >� / �lbo 760. — ` ` \ \ \ _ — / 740 J o- `\ 21 2. 1 ..V 40 S '�' 92' 2 I 223-59' `•a � ` � � -•— _ _........ 6x/st,-615�� Tc Be I \ have 1� const. 21Q fAbv u \ Is 0 47 / \ 237.61' '^ / 140.43' 97.18' S \ \ LL d R= 150' a 1 Exi 5t; A? g IJ: Z / \' G ` ^ 19N �1 n Ptia e o- h $ide Pltch N be re.oveal w;i{•i Phase 1Z ) by \ i`^QIn9 (Tr Const. (TYR) 1 .04' N05 3 0"E s0' _ 1 v __ 1 1Q8 90.3 i 61_P77M' Tenl o�oCy = S 1 1. .p � R 5y 0 iia. er ��..` J \ �, / L:, LTONi UTLET STRUCTURH��9.84' 104.88'6 •K: - 10 5 ONE R 500' F 16 • j I\ l0 15 � `° APPROXIMATE LIMITS N oK 14 \44RBA c1qi 165, \ ` N 130. 1 \. s I� � 1•. 7,2. I 1 EXISTING LAKE v Parcel 42.05 Wanda Gaye Hoots / DB 138, Pg 288 I I I 1 \ \ I \ 1I1 • �O I �, J • IN APPLICANT INFORMATION DAVIE COUNTY HEALTH DEPARTMENT Environmental Health Section Soil/Site Evaluation Account #: 989900136 Billed To: Westview Development Co. Reference Name: Brant Godfrey Proposed Facility: Residence Property Size: Water Supply: Evaluation By: On -Site Well Auger Boring AP0)q'' /at 37 PROPERTY INFORMATION Tax PIN/EH #: 5789-64-7482.36 Subdivision Info: Falling Creek Sec. XBlk AO Lot # 36 Location/Address: Falling Creek Drive -27006 See Map Date Evaluated: ! 2-.21/- o Community Pit t/ Public Cut FACTORS 1 23 4 5 6 7 Landscape position V L Slope% C HORIZON I DEPTH Texture group Consistence Structure Mineralogy HORIZON II DEPTH !i �' Texture group Consistence r / Structure Me 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 i SITE CLASSIFICATION: ��-a LONG-TERM ACCEPTANCE RATE: REMARKS: EVALUATION BY: dG/ OTHER(S) PRESENT: "'A J4 - e4 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 DCHD 05/99 (Revised) APPLICATION FOR SITE EVALUATION/IMPROVEMENT PERMIT & ATC Davie County Health Department Environmental Heal[fi Section P.O. Box 848/210 Hospital Street Mocksville, NC 27028 (336) 751-8760 JAN 2 4 2000 j I ***IMPORTANT*** THIS APPLICATION CANNOT BE PROCESSED UNLESS ALL THE REQUIRED I INFORMATION IS PROVIDED. Refer to the INFORMATION BULLETIN for instructions. 1. Name to be Billed �EJZn9se)b0twoom(mT Contact Person &Nt 6d0FX01 Mailing Address 2631 R4-YtJai.OA %LOAD Home Phone 331,-760-2408 City/State/ZIP AK )-yt Business Phone .1U -111-00%A 2. Name on Permit/ATC if Different than Above Mailing Address 3. Application For: 8'Site Evaluation 4. System to Service: L7 HOuse ❑ Mobile Home City/State/Zip Improvement Permit/ATC ❑ Business ❑ Industry ❑ Other ❑ Both 5. If Residence: # People # Bedrooms 3 # Bathrooms . O Dishwasher H Garbage Disposal ❑ washing Machine f] Basement/Plumbing ❑ Basement/No Plumbing 6. If Business/Industry/Other: Specify type # People # Sinks # Commodes # Showers # Urinals # Water Coolers IF FOODSERVICE: # Seats// Estimated Water Usage (gallons per day) 7. Type of water supply: W/C-ounty/City ❑ Well ❑ Community B. Do you anticipate additions or expansions of the facility this system is intended to serve? ❑ Yes BrNo If yes, what type? ***IMPORTANT*** CLIENTS MUSTCOMPLETE THE REQUIRED PROPERTY INFORMATION REQUESTED BELOW. Either a PLAT or SITE PLAN MUST BESUBMITTED by the client with THIS APPLICATION. Property Dimensions: Tax Office PIN: # Property Address: Road Name IALUMd4A(QK-NivG City/Zip A 17wtc . Nt17CA If in a Subdivision provide information, as follows: Name: FA u tN6ut,t C -K �7 Section: Block: Lot: Lory 17 13 41 WRITE DIRECTIONS (from Mocicsville) to PROPERTY: Date Property Flagged: 1.1-18-51 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 ant 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 Wcfryfow �" /H cIM6�1 Low►QA�� to conduct all testing procedures as necessary to determine the site suitability. DATE /I 7A /Oa SIGNATURE 47GWWJ I0 THIS AREA MAY BE USED FOR DRAWING YOUR SITE PLAN (Include all of thk ollowing: Existing and proposed property lines and dimensions, structures, setbacks, and septic locations). Site Revisit Charge Date(s): I Client Notification Date: I EHS: Revised DCHD (07/99) Account No. A?c Invoice No. ��� r APPLICATION FOR SITE EVAUTATION/IMPROVEMENT PERMIT & ATC Davie County Health Department Environmental Health S&Won P.O. Box 848/210 Hospital Street Mocksville, NC 27028 (336)751-8760 D � T L � l l U JUL 2 0 1999 ENVIRONMENTAL HEALTH DAVIE COUNTY ***ZHP0RTAIVT*** THIS APPLICATION CMDrOT BE PROCESSED UNLESS ALL THE REQUIRED INFORMATION IS PROVIDED. Refer to the INFORMATION BULLETIN for instructions. 1. Name to be Billed I�UESTvtF.,� 1>e1JELaPM-01JV Contact person 3�'.C,►J1' G'•;4FnFy Hailing address 2b^si RC~I1J13e-4d Z -AV some phone sh--Wo' 6 city/state/zip WWI I IX 2MUL Businese phone _336 -77'7 -oh74 2. Name on Perait/ATC if Different than above Hailing Address 3. Application for: e8ite Evaluation City/stats/Sip 0 Improvement Permit/ATC ❑ Both e. system to service: ©(House 0 Mobile Home ❑ Business ❑ Industry 0 Other 5. If Residence: 4 People i Bedrooms -5-1t i Bathrooms E(Dishwasher d Garbage Disposal O/ Washing Machine O Basement/Plumbing O Basement/No plumbing 6. If Business/Industry/Other: specify type # People i sinks # Commodes f showers # Urinals # Water Coolers If FOODSERVICE: # Seats Estimated hater Usage (gallons per day) 7. Type of water supply: County/City ❑ Well O Community e. Do you anticipate additions or expansions of the facility this system is intended to serve? 0 Yes d` o If yes, what type? ***IMPORTANT*** CLIENTS MAST COMPLETETHE REQUIRED PROPERTY INFORMATION REQUESTED BELOW. Either a PLAT or SITE PLAN MUST SESUBMI 1rri by the client with THIS APPLICATION. '414. / Property Dimensions: "' � 2-, (At-uA;,W%"K (OAc,•Co) 1:•►o ur 33 FAv.wc-r.Ec c► t<Z Tax 08icePIN: # 5'78'1-44—z48L �- 57 � Gc•= 533 Property Address: Road Name PAIAC�- c DR- City/Zip AouAH1c-,+1C 27y%; If in a Subdivision provide information, as follows: L L Name: LU ciZE£-X (-i frt. i%En L) Section: Block: A U Lot: WRITE DIRECTIONS (from Mockwiile) to PROPERTY: /fwY 6-1 t-A.S-" LICF7' <.AJ V,6(, rt WAT -r-J C 1XX-K Date Property Flagged: 18 I ct `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 1 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. DATE Aq! 2ci SIGNATURE e- I � c THIS AREA MAY BE USED FOR DRAWING YOUR SITE PLAN (Include all of the f owing: Existing and proposed property lines and dimensions, structures, setbacks, and septic locations). Site Revisit Charge I Date($): Client Notification Date: EHS: Revised DCHD (07/99) Account No. /1(6�1 Invoice No. 11627 \ \ I Sharnrock Acres \\ TAMA M. O'MARA PB 6 Pg 183 & 184 I DB 157, PG 697 \ I 14 13 \ 1 \ I I 1�• \ 11 I — ± 2238.60' 1\ I1 pp / �\ \\ \ � o N 7,30 23 J50/ /760 740 r _ _ tL1 V \ N ld \40 92' 4,51" 223.59' ro 2jcxlst. eld9, To _L I iiemDvCd CO+A 270 ' 750' o 237.81• � 6 \ ' 140.43 97.18' � I � e 110-00, PT. 52.a� 17 18 a' \ a6, R = 150' 19 1 ,., v�,4{Q II• w, 3 \ h 6e reMoved H ;f! Pt,aSe II jj / \ Matiin9 CTj, •% 1 04, Con St. CTYR) ny o \ �{ . 1 NO 3 20;'E� \ 8j4 'a�3s' ; /./j� 84.08• 1\ 08 43.70' 90.3 i G� j Tcm orocy ©1 R D 1 4/ 381 0-7.1Sed mP.At 1 /S � 6�I I / ;•., � STONi bUTLET STR�GTl1RE��9.84• .� ,� 104.881.. 2 i M\ 3 \ Trap •K�:' • �� 10 ✓ 12'w x t (( R _ 0 `C — 500 F 16 15 \ APPROXIMATE \ 125' _ _ �— Q AN L1 R MIT$ Wr 14 P,q15TUHEO \ 1 M O J \ R E,A 04 / '� E 'L�luo• \� \ a �� �C w Q �. \ � I\ , \ \• 37O �� \ p 46j• \ I J EXISTING LAKE Parcel 42.05 I I \ Wanda Gaye Hoots DB 138, Pg 288 DAVIE COUNTY HEALTH DEPARTMENT Environmental Health Section Soil/Site Evaluation APPLICANT INFORMATION Account #: 989900136 Billed To: Westview Development Co. Reference Name: Brany Godfrey Proposed Facility: Residence Property Size: Water Supply: On -Site Well PROPERTY INFORMATION Tax PIN/EH #: 5789-64-7482.37 Subdivision Info: Falling Creek Sec. ZBIk AO Lot # 37 Location/Address: Falling Creek Drive -27006 See Map Date Evaluated: Community Evaluation By: Auger Boring Pit Public Cut FACTORS 1 2 3 4 5 6 7 Landscape position c t Slope % HORIZON I DEPTH Texture group Consistence Structure r Mineralogy HORIZON II DEPTH Texture groupG Consistence Structure dJ 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: I°s /,S LONG-TERM ACCEPTANCE RATE: / REMARKS: �% 1��<���✓ `' LEG9k EVALUATION BY: .4&1 OTHER(S) PRESENT: -:1- Landscape „/ 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 DCHD 05/99 (Revised) _ DAVIE COUNTY HEALTH DEPARTMENT " Environmental Health Section Soil/Site Evaluation APPLICANT INFORMATION Account #: 989900136 Billed To: Westview Development Co. Reference Name: Brant Godfrey Proposed Facility: Residence Property Size PROPERTY INFORMATION Tax PIN/EH #: 5789-64-7482.39 Subdivision Info: Falling Creek Sec. 2' Blk. AO Lot # 3y Location/Address: Falling Creek Drive -27006 See Map Date Evaluated: Water Supply: On -Site Well Community Evaluation By: Auger Boring Pit Public Cut FACTORS 1 2 3 4 1 5 6 7 Landscape position L Slope % HORIZON I DEPTH Texture group1 Consistence Structure Mineralogy HORIZON II DEPTH Z'/y' Texture groupCi Consistence r 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 r SITE CLASSIFICATION: �7/�� '(' EVALUATION BY: ✓�'/� LONG-TERM ACCEPTANCE RATE: !i" OTHER(S) PRESENT: REMARKS: �� 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 No es 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 05/99 (Revised) APPIICATION FOR SITE EVALUATION/IMPROVEMENT PERMIT & Davie County Health Department Environmental Health Section P.O. Box 848/210 Hospital Street Mockaville, NC 27028 (336) 75'1-8760 JUL 2 0 1999 ENVIRONMENTAL HEALTH DAVIE COUNTY ***IMPORTANT*** THIS APPLICATION CANNOT BE PROCESSED UNLESS ALL THE REQUIRED INFORMATION IS PROVIDED. Refer to the INFORMATION BUTJATIN for instructions. 1. Name to be Billed WE:SW:� DLI1ELO{ MIZNT' COMO A,01 Mailing Address 2 b3' k'I'(rAV Contact Person 3Qr.N7' 6'Zn;=nEY Boma phone city/state/SIV WWI 0'— 11ke" Business Phone 33b -372 -0,37,- 2. 0,37, 2. Name on Permit/ATC if Different than Above Mailing Address City/state/Sip / 3. Application For: Ci Site Evaluation ❑ Improvement Permit/ATC 0 Both s. system to service: House 0 Mobile Home 0 Business ❑ Industry ❑ Other S. If Residence: t People i Bedrooms • Bathrooms Ei Dishwasher E( Garbage Disposal O/ washing Machine O Basement/Plumbing O Basement/No Plumbing 6. If Business/Industry/Other: Specify type / People i Sinks # Commodes f showers # Urinals i Nater Coolers IF FOODSERVICE: # Seats Estimated Water Usage (gallons per day) 7. Type of Nater supply: Q County/City 0 Well 0 Community 9. Do you anticipate additions or expansions of the facility this system is intended to serve? 0 Yes ❑ No If yes, what type? ***IMPORTANT*** CLIENTS MAST C0MPLETETHE REQUIRED PROPERTY INFORMATION REQUESTED BELOW. El.ber a PLAT or SITE FLAN KUST BESUBMIITED by the client with THIS APPLICATION. Yw%1sE- Property Dimensions: ' �44:wj 2, (&uwcn«rt WAci tco) WRITE DIRECTIONS (from MockvAlle) to PROPERTY: :;.Io Lcr 33 f1�.Wc=ncCx► is L Tax Office PIN: 11WV( S►', LC -FJ �,.! 9di, fLle,ui' Property Address: Road Name `/l�6tR.0<4( DR.V. CW f KIPL<� c:tOX4, City/zip A0u4Htr.,gc -2-7,X%; If in a Subdivision provide information, as follows: Name: G �5 � t,Ll c7Zf£� Section: Block: AO Lofi Date Property Flagged: 8 ctci 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 applicatlom 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. DATE 71I�I25 SIGNATURE c THIS AREA MAY BE USED FOR DRAWING YOUR SITE PLAN (Include all of the fdIowing: Existing and proposed property lines and dimensions, structures, setbacks, and septic locations). Site Revisit Charge 1 Date(s): I Client Notification Date: I EHS: Revised DCHD (07/99) Account No. Invoice No. /%� \ � � Shamrock Acres OB8 1577,. RGC 6 696. 14 13 \ \ T —I— 1ShamrockS 6 Pg 183 & 184 I \ 79Z I1'� �� 11 -- — � 4-L5't 2238.60' � I \ \ 77 710 �► \� _ \ \ LO N _ 4 10, — / \ 72-0 'i \ 233 / X60/ 76i �� —� \ \ � \ \ / _ -.5 0 V2 00- -92 223.5 ' \ N 2 5e w:const. . —Z14 �r ; a`; Remev¢d n rL pp u 750, n \ I \ \ \ 1 I 237.61' 8 \ \ 140.43' 97.18' ! i 110.0C�: ' PT .• tr52.�i 1 1 U p� Cb I\ AL Q` R = 150' n Eri9tinq B 101, 4-5 19 \ ^� �' 91J .n P414 e rj 3 i h" Duch N be remeved h \ Matiin iT w7•fio ase II \ _ i \ ro \ „ 9 Y Con St,CTYR) h' 1 .04 N05 3 20"E \, 5.58' 84.08• ; W r'7 �45.70' _ 90.3 o 0 TcrA ofo�y _ � r>� �,R 0 113.8�j' 47' LJ Sediment v3 2 �9.s4- •� %6. •�., l,'It UTLET STAUcpURE 104.88' lJ / ✓►2•wK1 �R = 500' 3�s.•, I I\ \ (i \ /Di � Q C}:A48 •A" 5 DME II`"16 15 1 — -1 � APPROXIMN ATE �T�� 2s'� _ _ �— Qc161IT5 OP:14 CV L4 ^' j 4 \r71REAR�ED �� J m � 130• 1 \ I1ry1'2 Ln EXISTING LAKE V Parcel 42.05 I ( I 0 I. do Gaye Hoots DB 138, Pg 288 DAVIE COUNTY HEALTH DEPARTMENT Environmental Health Section Soil/Site Evaluation APPLICANT INFORMATION Account #: 989900136 Billed To: Westview Development Co. Reference Name: Brant Godfrey Proposed Facility: Residence Property Size: Water Supply: Evaluation By: PROPERTY INFORMATION Tax PIN/EH #: 5789-64-7482.39 Subdivision Info: Falling Creek Sec. j' Blk. AO Lot # 3f � Location/Address: Falling Creek Drive -27006 See Map Date Evaluated: On -Site Well Community Auger Boring Pit Public Cut FACTORS 1 2 3 4 5 6 7 Landscape position L Slope % /111 HORIZON I DEPTH Texture group Consistence Structure i Mineralogy HORIZON II DEPTHSC Texture group (11 C/ Consistence f / Structure / ,3' /C Mineralogy ' / ' HORIZON III DEPTH Texture group Consistence Structure Mineralogy HORIZON IV DEPTH Texture group Consistence Structure Mineralogy SOIL WETNESS RESTRICTIVE HORIZON SAPROLITE Ilk - CLASSIFICATION LONG-TERM ACCEPTANCE RATE SITE CLASSIFICATION: v�� � a 7,pa—ay EVALUATION BY:� LONG-TERM ACCEPTANCE RATE: A�h�OTHER(S) PRESENT: i REMARKS: Landscane 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 DCHD 05/99 (Revised)