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338 Brier Creek Road Lot 3r Davie County, NC Tax Parcel Report Tuesday, January 3, 2017 WARNING: THIS IS NOT A SURVEY Parcel Information Parcel Number: H70000005803 Township: Shady Grove NCPIN Number: 5769768599 Municipality: Freatures Value: Account Number: 82512989 Census Tract: 37059-804 Listed Owner 1: KAPP WESLEY ADAM Voting Precinct: WEST SHADY GROVE Mailing Address 1: 153 CORNWALLIS DRIVE Planning Jurisdiction: Davie County City: MOCKSVILLE Zoning Class: DAVIE COUNTY R -A State: NC Zoning Overlay: Zip Code: 27028-0000 Voluntary Ag. District: No Legal Description: 5.95 AC OFF FORK BIXBY RD Fire Response District: CORNATZER - DULIN,ADVANCE Assessed Acreage: 5.79 Elementary School Zone: SHADY GROVE Deed Date: 8/1999 Middle School Zone: WILLIAM ELLIS Deed Book / Page: 003110208 Soil Types: MrB2,GnC2,EnB,MsC,ChA Plat Book: Flood Zone: Plat Page: Watershed Overlay: DAVIE COUNTY Building Value: Outbuilding 8r Extra Freatures Value: Land Value: Total Market Value: Total Assessed Value: All data Is provided as Is without warranty or guarantee of any Idnd either expressed or implied Including but not limited to the i Davie County, Implied warranties of merchantability or fitness for a particular use. All users of Davie County's GIS website shall hold harmless the r County of Davie, North Carolina, its agents, consultants, contractors or employees from any and all claims or causes of action due to� �— �` xNC or arising out of the use or Inability to use the GIS data provided by this website. DAVIE COUNTY HEALTH DEPAI;TR"TENT Environmental Health Section P. O. Boz 848/210 Hospital Street Mocksville, NC 27028 (336)751-8760 IMPROVEMENT/OPERATION PERMIT Account #: 990000673 Tax PIN/EH #: 5769-76-8599 Billed To: Jerry Kapp Subdivision Info: Greenbriar Lot # 3 Reference Name: Wesley Kapp Location/Address: Briar Creek Road -27006 Proposed Facility: Residence Property Size: 5.95 Acres ATC Number: 2112 **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 NA. 1-Ury IE #People Z #Bedrooms #Baths Z Dishwasher: ❑ Garbage Disposal: ❑ Washing Machine: Basement w/Plumbing: ❑ Basement/No Plumbing: 0 Commercial Specification: Facility Type n� #People #People/Shift #Seats Industrial Waste: ❑ Lot SizeJ� 4� ��I'ype Water Supply Design Wastewater Flow (GPD) -2-40 Site: New 2 Repair ❑ System Specifications: Tank Size IC00 GAL. Pump Tank GAL. Trench Width 3C/ Rock Depth 1 Z � ) Linear Ft.-qOO � Other: I JDAtTeA(3011Oj Z"., L-)-"- cl,0.C;0. Required Site Modifications/Conditions: t56CF1%-A-- L2 L -t I t►�l W „J dQ�� 1 IMPROVEMENT/OPERATION PERMIT LAYOUT - APPROVED EFFLUENT FILTER RISER(S) 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 he day of installation. Telephone # is (336)751-8760.**** 199 l �a -4 1 - fix. NtT pA,7 cap— i�&- %Ao&NS TO IEia/-%C -.? I So i Environmental Health Specialist's Signature: DCHD 05/99 (Revised) 1 • L DAVIE COUNTY HEALTH DEPARTMENT 7,a =9� Environmental Health Section P. O. Boa 848/210 Hospital Street Mocksville, NC 27028 (336)751-8760 IMPROVEMENT/OPERATION PERMIT Account #: 990000673 Tax PIN/EH #: 5769-76-8599 Billed To: Jerry Kapp Subdivision Info: Greenbriar Lot # 3 Reference Name: Wesley Kapp Location/Address: Briar Creek Road -27006 Proposed Facility: Residence Property Size: 5.95 Acres ATC Number: 2112 **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 At'1 - dM -r, #People Z' #Bedrooms —2— #Baths Z Dishwasher: ❑ Garbage Disposal: 0 Washing Machine: Er Basement w/Plumbing: ❑ Basement/No Plumbing: Commercial Specification: Facility Type #People #People/Shift #Seats Industrial Waste: �/ Lot Size�� &'� ype Water Supply �IJ E Design Wastewater Flow (GPD)2jb Site: New Repair System Specifications: Tank Size lboDGAL. Pump Tank GAL. Trench Widths Rock Depth 12 1 Linear Ft.`:0C)i Other: 3 12151[e ;1"IOa 1S0X5 a Site Modifications/Conditions: —J)t "-r stggk;� tA,),N.Te_, &---Ek s, flw— (A AAa. IMPROVEMENT/OPERATION PERMIT LAYOUT - APPROVED EFFLUENT FILTER RISER(S) IF 6 f4 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.**** X Environmental Health Specialist's Signature: DCHD 05/99 (Revised) 1 Date: DAVIE COUNTY HEALTH DEPARTMENT Environmental Health Section P. O. Boa 848/210 Hospital Street Mocksville, NC 27028 (336)751-8760 Account #: 990000673 Tax PIN/EH #: 5769-76-8599 Billed To: Jerry Kapp Subdivision Info: Greenbriar Lot # 3 Reference Name: Wesley Kapp Location/Address: Briar Creek Road -27006 Proposed Facility: Residence Property Size: 5.95 Acres ATC Number: 2112 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 c G.S. Chapter 130A, Wastewater Systems, Section .1900 Sewage Treatment and Disposal Systems). THIS AUTHORIZATION FOR WASTE W N IS ALID FOR A PERIOD OF IVE YEARS. Environmental Health Specialist's Signature: Date: 9U 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 I 1 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 DCHD 05/99 (Revised) DM. 400-A,%) o�—;6 1 57 ei p 6t/l t�,D,,J& 64�1 I G.� APPUCATION FOR SITE EVALUATION/IMPROVEMENT PERMIT & Davie County Health Department Environmental Healtfi Section P.O. Box 848/210 Hospital Street Mockaville, NC 27028 (336) 751-8760 Nn R- - U W JUL i a i999 ***IMPORTANT*** THIS APPLICATION CANNOT BE PROCESSED UNLESS ALL THE REQUIRED INFORMATION IS PROVIDED. Refer to the INFORMATION BULLETIN for instructions. Contaot person 1. Name to be Billed �C-e-, J /r�yp/> Nailing Address d `� �\ a �. r� �e� J Roma phone Ile %G 6 - Y'/-1/ city/state/ZXP /t -H1 M 3 ".6. 2,120/L Business phone( 3J6) 2. Name on permit/ATC if Different than Above We S /e y /74W'P Nailing Address �%6 7y KG..Io ry �y ��i•. City/state/SLP 3. Application For: ❑ Site Evaluation 4. System to Service: 0 House Q" Mobile Home 5. If Residence: ❑ Improvement Permit/ATC 0 Business # People 2// # Bedrooms ❑ Dishwasher ❑ Garbage Disposal a/washing Machine S. If Business/Industry/other: Specify type # Commodes # Showers '., c. Z 70/L-. ❑ Industry 0 Other 2 # Bathrooms Z ❑ Basement/plumbing ❑ Basement/No plumbing # People # Sinks # Urinals # Water Coolers IF FOODSERVICE: # SeatsEstimated Water Usage (gallons per day) 7. Type of Mater supply: R// County/City 0 Well /0 Community 9. Do you anticipate additions or expansions of the facility this system Is intended to serve? 6TYes 0 No If yes, what type? /%)A ti 1W T.4/e f� —e, a.�f7r� �7`A y Be�Rav�, h�on7e, ***IMPORTANT*** CLIENTS MUST COMPLETE THE REQUIRED PROPERTY INFORMATION REQUESTED �Eg� BELOW. Either a PLAT or SITE PLAN MUST BESUBMITTED by the client with THIS APPLICATION. P FR NT 5#0E SHOE RCAR Y" Property Dimensions: 36 SX 74Y X G SY X 3C 8 Tax Office PIN: # -5 'i le q -• 'r'6 — �',�" 9q► Property Address: Road Name '0/AR CR/c. 4o1 City/Zip _ �cYycr.,..cL a• G Z 7 ov 6 WRITE DIRECTIONS (from Mocksville) to PROPERTY: i /5V L'-. /71/d /J�./f /o��G /e✓ �/,v R/ If In a Subdivision provide information, as follows: U&PA C.k.R.D. iv--.✓ Rig I-1 • �ti� 0•r R7. Name: �'PEEA/BRii9R TAX / ✓ly��� Section: Block: Lot: S • 03 Date Property Flagged: BAF• //G , 7l �' 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 avle C unty Health De artment to enter upon above described property located in Davie County and owned b , c / T. p.�sv✓ to conduct all testin procedures as necessary to determine the site suitabill DATE "� /Y 9 % 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). Site Revisit Charge I S4 Revised DCHD (07/99) Q,0 G Sy fo (s' loo r&066 tee, N � log IOU 3CY Date(s): Client Notification Date: I EAS: Account No. cla = Invoice No. 0 .. 1 4. to LO ' ALI 1. •� I 1 11 , •/ 14 to Ul ,A+ tot C 1 �►.� ! �r �, �} .N �Ili� -,, , ]' ' �. 1i'1, IL �. �. ",, 11 j• �•' '� 1'� sly e,-1 j ��� ► , �.� 1<►' } ! 1 O' It`y�'.}I, ' ,ice !' j ^ . � •y� '� 1�ij�• t r �,� �� 'U , f • f APPLICANT INFORMATION Account #: 990000673 Billed To: Jerry Kapp Reference Name: Jerry Kapp Proposed Facility: Residence Water Supply: Evaluation By: DAVIE COUNTY HEALTH DEPARTMENT Environmental Health Section Soil/Site Evaluation PROPERTY INFORMATION Tax PIN/EH #: 5769-76-8599 Subdivision Info: Greenbriar Lot # 3 Location/Address: Briar Creek Road -27006 Property Size: 5.95 Acres Date Evaluated: � On -Site Well Community Auger Boring Pit Public Cut �M 14T.00 191 ' �©©�©OLandscape positionConsistenceQ HORIZON I DEPTH HORIZON II DEPTH Consistence r�-NA KIM= IF �® Texture group MRS—M., Consistence imam HORIZON IV DEPTH Consistence Mineralogy • SITE CLASSIFICATION: ��'� EVALUATION BY: LONG-TERM ACCEPTANCE RATE: Z 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 i 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 I " DCHD 05/99 (Revised) ■ ■■M■MMM■■MM■■M■ ■■M■MM■■MMM■■M■ ■■■■■■■■■■■■■■■ ■■■■■■■■■■■■■■■ ■■■■■■■■■■■■■■■ ■■■■■■■■■■■■■■■ ■■■■■■■■■■■■■■■ ■■■■■■■■■■■■■■■ ■■■■■■■■■■■■■■■ ■■■■■■■■■■■■■■■ ■■■■■■■■■■■■■■■ ■■■■■■■■■■■■■■■ ■■■■■■■■■■■■■■■ ■■■■■■ ■■■■■ MENNEN�■■■■■ ■E■■S■EN■■NEE■■ ■M■■MM■■■MMM■■■ ■■■■MM■■■■■■■■■ ■■■■M■■■■■■■■■■ ■■ SUMMONS ■M■■MMMMM■IMMMMM■■ ■NNOMM■■N■I■E■NES■ ■MM■■M■M■■IMM■MMM■ ■M■■■MMMe■1■■■MME■ ■E■■■■M■■■1■MMM■■■ ■■MMEEMUO■I000NSES MM■■■■MME■I■■■■■M■ ■■M■■■■■M■1■■M■■■■ ■MMM■■■■e■1■M■M■■■ ■■■■M■■■M■1MM■■M■■ ■■NEEME■E■ION■SSE■ ■■M■MMMMM■1MM■M■M■ ■MMMMMMMM■1MMMMMM■ ■MMM■■■■■■1■■■■■■■ ■E■■M■NOM■INN■■■E■ ■MMMMMM■■■I■MMM■M■ ■■MMM■M■M■I■MMM■■■ ■■M■MMMM■■I■MMM■■■ ■MM/MMM/■fl/MO■MM■ No on MONSOON MONSOON ■■M■■E■ ■■M■■E■ ■ME■■E■ ■M■■E■■ ■EM■MEME■■M■■M■MEM■ ■ENSUMEMENSEENSOM■ ■E■■ ■E■EMM■■E■■E■ ■ ■ ■ ■■■■■ ENSUE ■MOM■ ■ IMMMM■■■/■/■////■/■I!/Mee■e■///■■/■■/■ I:: ONEEMEi�:::C::i MENNEN MEMNON IMM■■■■■■■■■■■■■■EMI■■■■■■M■■■■■■■■■■■ I■■M■■■■■■■■■■■■■■■I�■■■■■Mee■■■■/■■■■ I■■■■■■■■■■■■■N■■1■■OO■■■■■■■■■■■■/■ Impt llne■a■■/■■■■■■■■■MMI■■�■■■■■■■■■■■■■■■ G�:�I ■■■■■■■■■■■■■■I■trwa■■■MMM■■■■■■■■ /I■!gee■e■�■■■e■■e/eu■■//■■■//w■/■///■ 'Gid; M■■■f■■/■■/■■■■■[■■■■■■■■■■■■■■■■■■ IMM[/,■■■I■■/■■■■■/■■t■■■■■■■■//■//■■■■■ on t { Davie Countv. NC Tax Pnrnf-1 R Pnnrt Friday. December 30. 2016 WAK ING: THIS IS INUT A SURVEY Parcel Information Parcel Number: H70000005803 Township: Shady Grove NCPIN Number: 5769768599 Municipality: Freatures Value: Account Number: 82512989 Census Tract: 37059-804 Listed Owner 1: KAPP WESLEY ADAM Voting Precinct: WEST SHADY GROVE Mailing Address 1: 153 CORNWALLIS DRIVE Planning Jurisdiction: Davie County City: MOCKSVILLE Zoning Class: DAVIE COUNTY R -A State: NC Zoning Overlay: Zip Code: 27028-0000 Voluntary Ag. District: No Legal Description: 5.95 AC OFF FORK BIXBY RD Fire Response District: CORNATZER - DULIN,ADVANCE Assessed Acreage: 5.79 Elementary School Zone: SHADY GROVE Deed Date: 8/1999 Middle School Zone: WILLIAM ELLIS Deed Book / Page: 003110208 Soil Types: MrB2,GnC2,EnB,MsC,ChA Plat Book: Flood Zone: Plat Page: Watershed Overlay: DAVIE COUNTY Building Value: Outbuilding & Extra Freatures Value: Land Value: Total Market Value: Total Assessed Value: Y 0 uKI� Davie County, All data is provided as Is without warranty or guarantee of any Idnd either expressed or Implied including but not limited to the Implied warranties of merchantabiitty 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 t 1�T l� C �� or arising out of the use or Inability to use the GIS data provided by this website. J) Inti +�� • �,�! 1 2 2MPI L 1 ` EytinRONMENTAEK pAV!E C FOR SITE EVALUATION/IMPROVEMENT PERMIT & ATC Davie County Health Department EnvironmentaiHeaith Section O. Box 848/210 Hospital Street Mocksville, NC 27028 (336) 751-8760 ***IMPORTANT*** THIS APPLICATION CANNOT BE PROCESSED UNLESS ALL THE REQUIRED �I INFORMATION IS PROVIDED. Refer to the INFORMATION BULLETIN for iAptructi.ops. 1. Name to be Contact Person Mailing Address V ��% U '% Home Phone City/state/ZIP ( 7 B ess Phone 2. Name on Permit/ATC if Different thanAbove97a _`jam/� Mailing Address a3a? ZQiC/ A , ( ZZ� Ci /State/Zip 3. Application For: a -Site Evaluation ❑ Improvement Permit/ATC ❑ Both 4. System to Service: i48 -House ❑ Mobile Home ❑ Business ❑ Industry ❑ Other S. If Residence: # People 2 � �/ # Bedrooms ,3 # Bathrooms Dishwasher El Garbage Disposal 17 Washing Machine ❑ Basement/Plumbing fi 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: R County/City &, .O'Well ❑ Community 8. Do you anticipate additions or expansions of the facility this system is intended to serve? ❑ Yes `P -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: ,5R,//d- y ZYI' •960" c Tax Office PIN: # Property Address: Road Name City/Zip '� If in a Subdivision provide information, as follows: (�, (� mwrf �� • • Ia- Name: Section: Block: Lot: S�ib"-� Date Property Flagged: /r t This is to certify that the information 7� on prove a is c rect to the best of my knowledge. I understand that any p&mit(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 suite DATE O / SIGNATURE W12V-0 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). Site Revisit Charge Date(s): Client Notification Date: EHS: Revised DCHD (07/99) Account No. Invoice No. I 3 S� DAVIE COUNTY HEALTH DEPARTMENT Environmental Health Section P. O. Boz 848/210 Hospital Street Mocknille, NC 27028 (336)751-8760 IMPROVEMENT/OPERATION PERMIT Account #: 990000673 Tax PIN/EH #: 5769-76-8599 Billed To: Jerry Kapp Subdivision Info: Greenbriar Lot # 3 Reference Name: Wesley Kapp Location/Address: Briar Creek Road -27006 Proposed Facility: Residence Property Size: 5.95 Acres ATC Number: 2112 **NOTE** This Improvement/Operation Permit DOES NOT authorize the construction of 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 l 1 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 NA-lbPAjE #People Z #Bedrooms �- #Baths Z Dishwasher: ❑ Garbage Disposal: ❑ Washing Machine: G2r' Basement w/Plumbing: ❑ Basement/No Plumbing: ❑ Commercial Specification: ccFacility Type nnom�,, #People #People/Shift #Seats Industrial Waste: ❑ Lot SizeJ'q /-C�C.C"SType Water SupplyCVbW� i> Design Wastewater Flow (GPD) ZL Site: New 2 Repair ❑ System Specifications: Tank Size ICOO GAL. Pump Tank GAL. Trench Width --7;(o , ' Rock Depth I Z � t Linear Ft. -!100' I P, �T124 f?�y 1 t o l " u -"-- q, & C' Other: ��� Required Site Modifications/Conditions: F�� L�.2�.J� �t� �� t►J IMPROVEMENT/OPERATION PERMIT LAYOUT - APPROVED EFFLUENT FILTER RISER(S) 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/�he day of installation. Telephone # is (336)751-8760.**** / / / -* 2ZA lS� Pa;Q "', V1- - � y I - a LL < r ►ssve7 -r�y� H9 - 2ccx- 1A ► T t,J 7 ►.J c� 7 \sow `,% Environmental Health Specialist's Signature: a1 DCHD 05!99 (Revised) "I certify lhol on JULY 19, 1999 we surveyed the property shown on th*1 at, all of, which wos done under my supervision" United Gmile&'Ent—iffeirinyt� 1022 west First Street. ., V&1043 Ii7%/ Winston-Salem, North Corolino 27101 •• t. 1 ! 4 lh irq. �m T.b ��',oa w tri :, ••...•• •,: VUNr���. l ^ SO Legend EW EXISTING IRON PIPE IP IRON PLACED CM CONCRETE MONUMENT MN MAGNETIC NORTH BM BENCH MARK P/L PROPERTY UNE R/W RIGHT-OF-WAY C/L CENTERLINE EP EDGE OF PAVEMENT FC FACE OF CURB PC POINT OF CURVATURE LC LONG CURVE PT POINT OF TANGENCY CH CHORD S STOOP P PORCH OH OVERHANG CP CARPORT SCALE: 1" = 100' ISO. � _ a9`�•-� cpp 1{1Jv O u 9 � tN- •a3 rro.9 F 6N io �a Note: FLOOD ZONE x THIS MAP OR DRAWING AND ANY FEMAACCOMPANYING DOCUMENTS ARE FURNISHED COMMUNITY PANEL NO. 37,036 I DOC To THE PERSON(S) NAMED THEREON AND MAP REVISED DECEMBER t 7• ci.Q�3 t NQ A4TERAT10N5 OR USE BY OTHERS IS PERMITTED UNLESS AUTHORIZED BY UNITEO MAP NOT FR R C RDATION. ' LIMITED ENGINEERING k LANO SURvEYNG.PA 5.9103,, C.+- THIS PIAT 15 SUEUECT TO ANr EA.SEWEKTS• PRECISION 5 0� DMD AREA, AGREEMENTS, OR RIGHTS-OF-WAY OF RECORD PRtdR TO DATE OF THIS PLAT. EVIDENCE OF WHICH WAS NOT VISIBLE AT THE TIME OF OUR INSPECTION. O 100 200 BAR GRAPH MAP FOR: WESLEY ADAM KAPP BEING: PARCEL NO. 58.03 AS SHOWN ON TAX PHOTO NO. H-7 P. B. 5 PG. 99 D.B. 116 ­�l PG. 725 SHADY GROVE TOWNSHIP DAVIE COUNTY, N. C. DATE: JULY 19, 1999 BRIER CREEK ROAD I MAP NO. 1-39159 a sr� aloin cmc. RD. � g LOCATION MAP (NOT TO SCALE) DAVIE COUNTY HEALTH DEPARTMENT Environmental Health Section Soil/Site Evaluation APPLICANT INFORMATION PROPERTY INFORMATION Account M 990000673 Tax PIN/EH #: 5769-76-8599 Billed To: Jerry Kapp Subdivision Info: Greenbriar Lot # 3 Reference Name: Wesley Kapp Location/Address: Briar Creek Road -270P6 Proposed Facility: Residence Property Size: 5.95 Acres Date Evaluated: Water Supply: On -Site Well Community Evaluation By: Auger Boring Pit Public Cut MIN fill Landscape position HORIZON I DEPTH Consistence Mineralogy HORIZON 11 DEPTH 5 W0.101 FEA M Consistencer ��ffsm.Consistence HORIZON III DEPTH Rul HORIZON IV DEPTH Consistence Mineralogy • ��� �� CLASSIFICATION i����� SITE CLASSIFICATION: Q S LONG-TERM ACCEPTANCE RATE: REMARKS: 10 -To Landscape Position 1 Z�� So tL LEG 11 � EVALUATION BY: C orl OTHER(S) PRESENT: 22 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) ■ ■ ■■E■ MEMO SEEN ■■N■ MEMO mono mono ■ME■ SEEN ■O■■ ■ ■■■■■a■■■■■11■/■\ice\SSSS■■N■■■■■��� ■■■■■■■■■■I,L/■■/■■■■f!3/\'�\■�/SSSS■■ ■■■■�:■■■■■■■■■■►/■■■■■■■■■ ■■■IL's■■ ■■■■■■■■■■■■■■n�■■■■■■E■■' ■■Sri■■■■ ■■■■■■■■■■■■ice C!1��■�!■■■■ ■■■■■:lLl. ■/■■■■■■■■■■■■/`�■ rid■■■■■■■■■■■l��■ ■■■■■■■■■■■■■■■■■■■■■■■■■■\`!Z■/SSSS ■■■■■■■■■■■■■■■■■■■■■■■■■■■■■\`\SSSS ■■■■■■■■■■■■■/■■■■■■■■■■■ SSSS■■/■ ■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■ ■■■■■■■■■■llll■■/■■■■■■■■■/SSSS■/■■ ■■■■■SSSS■/:1I�■■■■■■■■■■■■■■■■■■■■■ ■■■■■SSSS■■\rl■■■■■■■■■■■■■■■■■■■■■■ ■■■■■■■■■■fit■■■/■■■■■■■■■■■■■■■■■■■ ■■■■■■■■■■LTJ■■■■■■■■■■■■■�■■■■■■■■ ■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■ ■■■■SSSS■\!■■■■■■■■■■■■■■■■■■/SSSS■ ■■■■■■■■■tea■■■■■■■■■■■■■■■■/SSSS■■■ ■■■■■■■■®Pi■■■L'.7/!/■■■■■LIQ■■■■■■■■■■ ONE ■E iil�lMNE Rmm MOMMEM 'XME M EM J■■■■■i.�l1■■■It■■■■■■■■Sri SSSS■■i:■I■tl■It■1■■■■■■■■\� SSSS■■Iii■I■■I■It■I■■■I�■■!■ ■ENO■■1/1■IM■IMIN■IM■■HO on ■■■■■oral■■I■I■■Imm■■�r■■m■ F�■■■■\1■■■OIC■I■■■■■■■■■ SSSS■■■\■■■■■■■■■■■■!■ I1fI■■■■■■■■■■■■■I■■■■WON ri■iii■■■■■■■�1�■■■■I■■■ ■E■■E■■N■■■■■■MMERNM■■ M■■■ M■■■ ■■■ ■ ■ ■ SEEN mono ■■E■ ■■momm■■■■ ■■■E■IM■■E■ ■■■E■IEE■E■ ■EEE■IEE■E■ ■■■E■I■■E■■ ■■■E■I■E■■■ ■E■E■I■■O■■ ■■E■■I■E■■■ E■■E■I■EEE■ ■■■■■ISE■■■ ■■■E■I■E■E■ ■ENE■I■■EM■ ■E■E■I■■EM■ ■EEE■1MMMM■ ■■m■■I■■m■■ ■■■E■I■■EN■ ■■■E■J■■EN■ ■E■E■I■■E■■ ■E■E■IM■M■■ ■E■E■I■EM■■ ■■■■■I■EM■■ ■ ■ ■ Davie G'ountVWealth Department Environmental Wealth Section PO Box 848 / 210 Hospital Street Mocksville, NC 27028 Phone: (336)751-8760 . July 24, 2001 Mr. Jerry Kapp Re: Wesley Kapp 7074 Kenbridge Drive Clemmons, NC 27012 Re: Site Evaluation - 5.95 Acre Tract/Brier Creek Road Tax PIN #: 5769-76-8599 Dear Mr. Kapp: As requested, a representative from this office visited the above site on July 23, 2001. Based on the information provided on the Application for Site Evaluation and after the evaluation was completed, the site was found to be provisionally suitable for the installation of an on-site sewage disposal system. Due to complex topography, a creek that bisects and poor soil conditions over much of this tract, the area for the septic system is limited. The area along the back ridge should be reserved for the installation of the septic system. Its elevation may necessitate a pump station. Actual design and dimensions of the septic drain field will be determined at the time an improvement permit is issued. Before a representative of this office will revisit the site to issue an Improvement Permit/Authorization to Construct the appropriate application must be completed in full and submitted to this office. The location of the facility the system is to serve must be staked off. If you have any questions, feel free to contact this office at (336)751-8760. Sincerely, Jeff G. Beauchamp, R.S. Environmental Health Section enc(s)