215 Chestnut Trail Lot 7Davie County, NC Tax Parcel Report Wednesday, November 16. 2016
WARNMG: THIS 1S NOT A SURVEY
Parcel Information
Parcel Number: 1600000045 Township: Shady Grove
NCPIN Number: 5758867584 Municipality:
Account Number: 8300626 Census Tract: 37059-804
Listed Owner 1: HOLLIFIELD LARRY W JR Voting Precinct: WEST SHADY GROVE
Mailing Address 1: 215 CHESTNUT TRAIL Planning Jurisdiction: Davie County
City: MOCKSVILLE Zoning Class: DAVIE COUNTY R-20
State:
NC
Zoning Overlay:
Zip Code:
27028
Voluntary Ag. District:
No
Legal Description:
LT 7 CHESTNUT WAY 2.728AC
Fire Response District:
CORNATZER - DULIN
Assessed Acreage:
2.63
Elementary School Zone:
CORNATZER
Deed Date:
1/2012
Middle School Zone:
WILLIAM ELLIS
Deed Book / Page:
008800775
Soil Types:
GnB2,EnB
Plat Book:
0004
Flood Zone:
Plat Page:
153
Watershed Overlay:
DAVIE COUNTY
Building Value:
228260.00
Outbuilding 8r Extra
Freatures Value:
13570.00
Land Value:
39150.00
Total Market Value:
280980.00
Total Assessed Value:
280980.00
E01All data Is provided as Is without warranty or guarantee of any Idnd either expressed or Implied Including but not limited to the
Davie County, Impliedwarnrdles of merchantability or fitness for a particular use. All 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 ENVIRONMENTAL HEALTH
P.O. Box 848/210 Hospital Street
• ' ` • Mocksville, NC 27028
(336)751-8760 Fax # (336)751-8786
OPERATION PERMIT
Account #: 990005114
Tax PIN/EH #:
5758-86-7584
Billed To: Larry Hollifield
Subdivision Info:
Chestnut Way Lot # 7
Reference Name:
Location/Address:
Chestnut Trail -27028
Proposed Facility: Residence
Property Size:
2.63 Ac.
ATC *ffjV; Th e85
iissuance of this Operation Permit shall indicate the system described on the ATC has been installed
in compliance with Article 11 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. 6
System Type: S.T. Manufacturer Tank Date ! Tank Size (/
Pump Tank Size
System Installed By: f —P�/ lrli H. Specialist: Date:
!s�I1
DCHD 11/06 (Revised)
-----------------
��
DAVIE COUNTY ENVIRONMENTAL HEALTH
P.O. Box 848/210 Hospital Street
Mocksville, NC 27028
(336)751-8760 Fax # (336)751-8786
AUTHORIZATION FOR WASTEWATER SYSTEM CONSTRUCTION
Account #: 990005114
Billed To: Larry Hollifield
Reference Name:
Proposed Facility: Residence
SON -
ATC Number: 4885
PIN/EH #: 5758-86-7584
Subdivision Info: Chestnut Way Lot # 7
Location/Address: Chestnut Trail -27028
Property Size: 2.63 Ac.-
Site
c:Site Type:ew Kew ❑Expansion
**NOTE** This Authorization to Construct (ATC) MUST BE ISSUED by the Davie County Environmental
Health Section prior to issuance of any building permit(s), (in compliance with Article 11 of G.S. Chapter 130A
Wastewater Systems, Section .1900 Sewage Treatment and Disposal Systems). THIS AUTHORIZATION TO
CONSTRUCT IS VALID FOR A PERIOD OF FIVE YEARS. This ATC is subject to revocation if site plans, plat
or the intended use change.
Residential Specifications: # Bedrooms_ #Bathrooms #People . Basement❑ Basement plumbing❑
Non -Residential Specifications: Facility Type # People # Seats
Square Footage(or Dimensions of Facility)
Lot Size �O 3 G �' 'e`er Type of Water Supply: County/City ❑Well ❑Community Well
System Specifications: Design Wastewater Flow (GPD)�C�� Tank Size JI 6c" ,AL. Pump Tank _O -GAL.
� 22
Trench Width 3 Z Max. Trench Depth- (r_ Rock Depth Linear Ft.,J
Site Modifications/Conditions/Other: 23
— --tai in 15A N0�4C-d;�,:1-�1
rrCe� d Systems may also hn tr-..
Contact the Davie County Environmental Health Section for final inspection of this system between
8:30 - 9:30a.m. on the day of installation. Telephone # (336)751-8760.
Environmental Health Specialist.
DCHD 11/06 (Revised)
5 "-
C
to`f&)
8'–d -7—d8
j
Y
f Davie County Environmental Health
P.O. Box 848/210 Hospital Street
Mocksville, NC 27028
(336)751-8760/Fax(336)751-8786
IMPROVEMENT PERMIT
Account #:
990005114
Billed To:
Larry Hollifield
Address:
862 US HWY 64 East
City:
Mocksville
Reference Name:
Proposed Facility: Residence
Tax PIN/EH M 5758-86-7584
Subdivision Info: Chestnut Way Lot # 7
Location/Address: Chestnut Trail -27028
Property Size: 2.63 Ac.
**NOTE**This Improvement Permit DOES NOT authorize the construction of a wastewater system. An
Authorization To Construct a wastewater system must be obtained from this office prior to the
construction/installation of a wastewater system or the issuance of a building permit(in compliance with
Article 11 of G.S. Chapter 130A, Wastewater Systems). This Improvement Permit is subject to
revocation if site plans, plat or the intended use change.
Permit Type: Aew ❑Repair ❑Expansion Permit Valid for: N�'Yearrs ❑No Expiration
Residential Specifications: # Bedrooms 3 # Bathrooms # People (r Basement❑ Basement plumbing❑
Non -Residential Specifications: Facility Type # People # Seats
Square Footage(or Dimensions of Facility)
Design Flow(GPD): 3 ( Type of Water Supply:'County/City ❑Well ❑Community Well
As stated in 15A NCAC 18A.1969(5�
Site Modifications/Permit Conditions: accepted Systeme may also be net
Sy stem Type LTAR
Initial
Ai—
Repair
Environmental Health Specialist
i.p.11-06
Date ;7-.23 —616
't
-APPLICA% R SITE EVALUATION/IMPROVEMENT PERMIT & ATC
c ' Davie County Environmental Health
P.O. Box 848/210 Hospital Street
Mocksville, NC 27028
(33.6)751-8760/ Fax (336)751-8786
A plicationP'or:11, a uation/ImprovementPermit ❑ Authorization To Construct(ATC) XBoth
T e of Ap on: /New System ❑Repair io Existing System ❑Expansion/Modification of Existing System or Facility
'IMPORTANT " THIS "IPPL.IC`ATION CANNOT BE PROCESSED UNLESS ALL OF THE REQUIRED
INFORMATION IS PROVIDED. Refer to the INFORMATION BULLETIN for instructions.
APPLICANT INFORMATION
Name to be Billed Lay, Contact Person La rrN
Billing Address a. - Home Phone '6 6-11,51-0-8J9
City/State/Zrp vl C 970,RR RwiuessPhone 33(o-q6q-2422
Le -i t
Name on Permit/ATC if Different than Above
Mailing Address City/State/Zip
PROPERTY INFORMATION *Date
NOTE: A survey plat or site plan must accompany this application
(Permit is •valid for 60 months with site plan,,no expiration s
Owner's Name i I VA l�
Owner's Address c, i3 .` lie
Property Address 60 L6A49dAA1
Lot Size Tax PIN# 15z5g8 %$
Subdivision Name(if applicable)
Directions To Site:
louse/Facility Corners Flagged '7-1-0-Y
Included: ❑ Site Plan ❑Plat(to scale)
i omplete plat.),,
1K . Phone Number
—City/State/Zip C Q
City Air(/,'
If the answer to any of the following questions is "yes", supporting documentation must be attached.
Are there any existing wastewater systems on the site? ❑Yeso
Does the site contain jurisdictional wetlands? Dyes o
Are there any easements or right-of-ways on the site? Dyes o
Is the site subject to approval by another public agency? Dyes o
Will wastewater other than domestic sewage be generated? ❑Yes o
IF RESIDENCE FILL OUT THE BOX BELOW
# People T # Bedrooms ?� # Bathrooms 1— Garden Tub/Whirlpool ❑YesA'No
Basement: ❑�YFess ) J Qo Basement Plumbing: Dyes ALqo
IF NON -RESIDENCE FILL OUT THE BOX BELOW
Type of Facility/Business Total Square Footage of Building # People
# Sinks # Commodes # Showers # Urinals
Estimated Water Usage (gallons per day) (Attach documentation of similar facility water consumption)
FOODSERVICE ONLY: # Seats
..Type system requested:. kqonventional ❑Accepted ❑Innovative ❑Alternative ❑Other
Water Supply Type: County/City Water ❑ New Well ❑Existing Well ❑ Com unity Well
Do you anticipate additions or expansions the facility is system is intended to serve? es ,Io
If yes, what type? ����J���TTTTT
.w C, - -
This is to certify that the information provided on this application is true and correct to the best of my knowledge. I understand that
any permit(s) or ATC(s) issued hereafter are subject to suspension or revocation if the site is altered, the intended use changes, or if
the information submitted in this application is falsified or changed. I hereby grant right of entry to the Authorized Representative
of the Davie County Health Department to conduct necessary inspections to determine compliance with applicable laws and rules.
I understand that I am responsible for the proper identification and labeling of property lines and corners and locating and flagging
or staki the house/faciMW
well location and the location of any other amenities.
roperty o s r owner' gal representative signature Site Revisit Charge
Date(s):
Client Notification Date:
Date EHS:
Sign given ❑Yes ❑No Account #
Revised 11/06 Invoice #
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7
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APPLICATION FOR SITE EVALUATION/IMPROVEMENTS PERMf=r
Davie County Health Department U
Environmental Health Section
P. O. Box 665
Mocksville, NC 27028
1. Application/Permit Requested By
Mailing Address
�Q, MI
r41
��
Home Phone 3
Business Phone
2. Name on Permit if Different than Above
3. Application for: gQG neral Evaluation Tank Installation Permit
_'�(eptic
4. System to Serve: House ❑ Mobile Home
❑ Place of Public Assembly
❑ Business ❑ Industry rf� ❑ Other ❑ Unknown
5. If house, mobile home: Subdivision V Section Lot #1�
I \
❑ Basement/Plumbing
No. of People
❑ Base'ment/No Plumbing
No. of Bedrooms
❑ Washing Machine
No. of Bathrooms
❑ Dishwasher
Dwelling Dimensions
❑ Garbage Disposal
6. If business, industry, place of public assembly, other: Specify type
No. of People Served No. of Sinks
No. of Commodes No. of Urinals
No. of Lavatories No. of Water Coolers
No. of Showers Water Usage Figures
/
7. Type of water supply: Z Public ❑ Private
❑ Community
8. Property Dimensions 2Z / L'- Sewage Disposal Contractor
9. Do you anticipate additions/expansion of the facility this sytem is intended to serve? ❑ Yes
ENo
If yes, what type?
*NOTE: Improvements Permits shall be validfrom date issued. Improvements Permits are subject to
revocation, if site plans or the intended use change. Effective October 1, 1989.
Directions to Property:
�'ht?sin�t�
rill
� I
Tax Office PIN: # 5'7. 8r,4 7 sa
PROPERTY ADDRESS, as 011ows:
Road Name: Ilk lr/
City: 0 V/l/e--
SUBMIT A PLAT WITH THIS APPLICATION.
Revisions effective October 1, 1995.
This is to certify that the information provided is correct to the best of my knowledge, and I
incur fr m this application.
DATE SIGI
I am responsible for all charges
CONSENT FOR SITE EVALUATION TO BE DONE ON ABOVE DESCRIBED PROPERTY
MUST CHECK ONE: ❑ 1. 1 OWN the property. I DO NOT OWN the property.
If you checked Box #2, the rest of this form MUST be completed by the owner or a person authorized by the owner:
I hereby give consent to the authorized representative ofAq Davie oun ealth Department to enter upon above described
property located in Davie County and owned by P 7 0 4'e lam'
to conduct all testing procedures as necessary to determine said site's suftbiR for a ground absorption sewage treatment
and disposal system. „ n �-
DATE - V , -SIGNATURE
DCHD (1199)
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6c Ick �i�
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II
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LL 56
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DAVIE COUNTY HEALTH DEPARTMENT
Environmental Health Section
Soil/Site Evaluation
NAME\;
ADDRESS S O�
PROPOSED FACIILTY
DATE EVALUATED
49
ONNUMI
PROPERTY SIZE „t o� C�s�,
LOCATION OF SITE
Water Supply: On -Site Well _ Community Public V
Evaluation By:(Z.�,I- Auger Boring Pit Cut
FACTORS
1
2
3
4
Landscape position
Sloe %
"
HORIZON I DEPTH
15"
Texture group
C L
V
Consistence
F 1
V 1="I
IFT
1-Z
Structure
'Ass
Mineralogy1
HORIZON II DEPTH
Texture groupL
Consistence
y —T
Structure
%kAsB
k
Mineralogy
• '
HORIZON III DEPTH
Texture group
Consistence
Structure
Mineralogy
HORIZON IV DEPTH
Texture group
Consistence
Structure
Mineralogy
SOIL WETNESS
V.5
'y -1
RESTRICTIVE HORIZON
—
SAPROLITE
—
CLASSIFICATION
S
"05
.5.
.S.
LONG-TERM ACCEPTANCE RATE
SITE CLASSIFICATION: •'W\3'S- EVALUATED BY: 'ns 9_
LONG-TERM ACCEPTANCE RATE: .3 HER(S) PRESENT: "�O o wo
REMARKS: 1 3.4 i', _4)-o.t-+.. i \"� lk4 U_C
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 -;lay loam, SIL -Silty loam CL -Clay loam SCL-Sandy clay loam
SC -Sandy clay SIC -Silty clay C -Clay
Moist
VFR- V -,---y 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(01-901
•
■mmm■
■■mm■
■mmm■
■m■m■
` Davie County NealtFl Department
and .Mame Neall§ .fyency
210 HOSPITAL STREET I P.O. BOX 665
MOCKSVILLE. N.C. 27028
PHONE: (704) 634-5985
March 14, 1996
Billy Carter
813 Cornatzer Rd.
Mocksville, MC 27028
Re: Site Evaluation
Chestnut Way/Mocksville
Tax PIN: 45758-86-7584
Dear Mr. Carter:
As requested, a representative from this office visited the aforementioned
site on March 8, 1996. Based upon 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.
If you have any questions, please feel free to contact this office.
Sincerely,
Charles E. Little, R.S.
Environmental health Section
CL/wd
Enclosure(s)
• DAVIE COUNTY HEALTH DEPARTMENT
Environmental Health Section
Soil/ Site Evaluation
APPLICANT_ INFORMATION
Account #: 990005114
Billed To: Larry Hollifield
Reference Name:
Proposed Facility: Residence
Water Supply: On -Site Well
RROPLRTY INFORMATION
Tax PIN/EH #: 5758-866-75
Subdivision Info: Chestnut Way Lot # 7
Location/Address: Chestnut Trail -27028
Property Size: 2.63 Ac. Date Evaluated: 7—:)3-0e
Community
Evaluation By: Auger Boring '00� Pit
Public
Cut
FACTORS
1 2 3 .4 5 6 7
Landscape position
Sloe %
HORIZON I DEPTH
O — 4y, V,— Y
Texture group
Consistence
Structure
/
Mineralogy—
HORIZON H DEPTH
Texture group
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
_ 7 O. 'D? d•
SITE CLASSIFICATION:
LONG-TERM ACCEPTANCE RATE:
REMARKS:
EVALUATION BY:
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
Moist
VFR - Very friable FR - Friable FI - Firm VE - Very firm EFI - Extremely firm
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)
TTAn T __-........- ----- -..._ _..1