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141 Laurens Ct, Lot 4 Davie County,NC Tax Parcel Report Tuesday, October 18, 2016 - -------- -- ; - - I ------ LAMENS CT 149 I s 141 125 ROME LN ,r r /l WARNING: THIS IS NOT A SURVEY Parcel Information Parcel Number: E70000011104 Township: Farmington NCPIN Number: 5861747727 Municipality: Account Number: 8305887 Census Tract: 37059-803 Listed Owner 1: FIDLER JOHN H JR Voting Precinct: SMITH GROVE Mailing Address 1: 141 LAURENS COURT Planning Jurisdiction: Davie County City: ADVANCE Zoning Class: DAVIE COUNTY R-20-S,R-20 State: NC Zoning Overlay: DAVIE COUNTY QD Zip Code: 27006 Voluntary Ag.District: No Legal Description: LOT 4 ARMSWORTHY ACRES Fire Response District: SMITH GROVE Assessed Acreage: 0.68 Elementary School Zone: SHADY GROVE Deed Date: 12/2015 Middle School Zone: WILLIAM ELLIS Deed Book/Page: 010080554 Soil Types: GnB2,GnC2 Plat Book: 0007 Flood Zone: Plat Page: 186 Watershed Overlay: DAVIE COUNTY Building Value: 221880.00 Outbuilding&Extra 3360.00 Freatures Value: Land Value: 50000.00 Total Market Value: 275240.00 Total Assessed Value: 275240.00 161 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.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 NCor arising out of the use or Inability to use the GIS data provided by this webs@e. • DAVIE COUNTY HEALTH DEPARTMENT Environmental Health Section P.O.Boz 848/210 Hospital Street Mocksville,NC 27028 /Y-1 v ? (336)751-8760 Cir 3 3 S7 IMPROVEMENT/OPERATION PERMIT Account #: 990002260 Tax PIN/EH#: 5861-74-8864.04 Billed To: Allen Wayne Builders,LLC. Subdivision Info: Armsworthy Acres Lot#04 Reference Name: Location/Address: Laurens Court-27006 Proposed Facility: Residence Property Size: see map ATC Number: 3546 **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 #People _ #Bedrooms #Baths _S Dishwasher Garbage Disposal: ❑ Washing Machine:Za 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) Site: New❑ Repair❑ System Specifications: Tank Size/ GAL. Pump Tank /WGAL. Trench Width �G� Rock Depth Linear Ft.340 Other: //I%/— Required Site Modifications/Conditions: 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 instal elephone#is(336)751-8760.**** a Environmental Health Specialist's Signature: Date: DCHD 05/99(Revised) DAVIE COUNTY HEALTH DEPARTMENT Environmental Health Section P.O.Boa 848/210 Hospital Street Mocksville,NC 27028 (336)751-8760 Account #: 990002260 Tax PIN/EH#: 5861-74-8864.04 Billed To: Allen Wayne Builders,LLC. Subdivision Info: Armsworthy Acres Lot#04 Reference Name: Location/Address: Laurens Court-27006 Proposed Facility: Residence Property Size: see map ATC Number: 3546 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 FIVE YEARS. A Environmental Health Specialist's Signature: Date: 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 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. Septic System Installed By: Environmental Health Specialist's Signature: Date: DCHD 05/99(Revised) E V E APPLICATION FOIi SITE EVALUATION/IMP110VUIENT 1'1'11MIT AUG 5 2M Davie County Health Department Enyironn enta/Hes/t/,Section P.O. Box 848/210 Hospital Street [1rM0 MffALW I Mocksville, NC 27028 DAME OWY (336)751-8760 ***IMPORTANT*** TIIIS APPLICATION CANNOT BB PROCESSED UNLESS ALL THE REQUIRED INFORMATION IS PROVIDED. Refer to the INFORMATION BULLETIN for instructionJ. 1. Name to be Billed /V11_ QA M1' 6ju:ideC5 J!2e_ Contact Person _—T� �9.-.. /+ Mailing Address 2110 ✓fo✓frCl a Ile ke 17T• /Q Nome Phone 261 6J S0 _ City/State/ZIP VNN5*,%--5A-k4 zLe, 22103 Business Phone 6,5-) 2. 2. Name on Permit/ATC if Different than Above Mailing Address City/State/Zip 3. Application For: ❑ Site Evaluation XImprovement Permit/ATC ❑ Both R 4. System to Service: )d House ❑ Mobile Home ❑ Businets ❑ Industry ❑ Other S. Type system requested: ,v Conventional ❑*conventional modified ❑ innovative 6. If Residence: 11 People .2 I1 Bedrooms 11 Bat-hroolm:� .2._YZ..__ Dishwasher []Garbage Disposal %Kashing Machine ❑Basement/Plu ming ❑Bazcmcnt/No Plumbing 7. If Business/Industry /Other: verify type�� 11 People I1 Sink:: N Commodes 0 Showers 11 Urinals 11 Water Coolcra IF FOODSERVICE: 1# Seats Estimated Water Usage (gallons per day) S. Type of water supply: A County/City ❑ Well ❑ Conununity 9. Do you anticipate ,additions or UllallSions Of tic facility this systell is intended to scrvc7 ❑ yes Y1 No 1. If yes,lvllat type? 'IMPORTANY"*CLIENTS d1UST COr11PLETL TME REQUIRE-D PROPERTY INFORMATION REQUESTED u� IBELONV. Either a PLAT or SITE �PLAN d1UST BCSUIIrUITTL•D by the client wi111'TIIIS APPLICATION. Property Dimensions: f fif k 15-3 NVIIITh DIRECTION ( oml 1llocl(srille)to PROPI(IZTY: Tax ofee PEN: # SS4 I A ^----- n Property Address: Road Nanlc ZAm r•enS C'f C City/Zip If in a Subdivision provide information,as follows: Nanlc: Section: Bock: Lot: _ Date ]ionic corners flagged: This is to certify that the information provided is correct to the best of illy knowledge. I understand thal ally pernlil(s) issued hereafter arc subject to suspension or revocation,if the site plans or intended use change,or if file iuforluatioll submitted in tllis application is falsified or cllanged. I,also,urtdcrstand that 1 unl responsible fur all charges lircurrcd fruul this application. I,hereby,give consent to the Authorized Representative of(he Davic Comity llcalth Del)arlulcnl to enter upon above described property located in Davie County and owned by4/��h,p R�, to conduct all jnesting procedures as necessary to determine the site suitabili(y. DATE 1� D,7 SIGNATURE TIIIS AREA MAYBE USED FOR DRAWING YOUR SITE PL nclude• • the following: Existing and proposed property lines and dimensions, structures, setbacks, and septic locations). Site Revisit Charge Datc(s): - -- Client Notification Date: EIIS: Sign given Account No. off- .Z-Co o / Revised DCfID(05/03 Invoice No. .-7 c -S ✓ Laurens Cou d) To Baltimore Road S 851100'00"E-- - 197.68' -- -197.68' 1 ER • 1 t � I ` i 1 Lot 5 1 Z Setbacks' y 3 Front =40' , Sides=16 ' Rear =,3v w 85000100" --- 197.68' ! i • Allen Wayne Builders I •° n. Plat Book 7 Page 186 4 Armsworthy Acres ' Scale`1 Inch=30 feet `• " ' _ ' DAVIE COUNTY HEALTH DEPARTMENT Environmental Health-Section SECTION / LOT Soil/Site Evaluation APPLICANT'S NAME_�- LO-� l DATE EVALUATED �� 1Z PROPOSED FACILITY PROPERTY SIZE �S ,� ��~✓ SUBDIVISION ROAD NAME GL��J /cam Water Supply: On-Site Well Community / Public Evaluation By: Auger Boring Pit t/ Cut FACTORS 1 2 3 4 5 6 7 Landscape position Z, Sloe% el HORIZON I DEPTH Texture group Consistence Structure Mineralogy HORIZON II 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 f SITE CLASSIFICATION: EVALUATION BY- v LONG-TERM ACCEPTAN E RATE: c✓ l OTHER(S)PRESENT: REMARKS: �1 /F/�✓ /I e i�^ LEG 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 oiA 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 tructur 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(OI-90) 4 105 110 29f5 \ i Fj 10 30099± SF X 298 I a 3009st SF G a to c^ N `-5F 31920±SF 32 3-7(+ SF j q) \� I / I l 05 103 29 8 u D I-,/W 20' PA 1! 11 P,Ll G) 17" /;7/�/ ,3 a, �.. . � , - ,. ,, � � '. ass '�,,„ , «r�x�� •' �y'rrI4M 1 � •�� r•. i � ' Y„r �t yw� �`I +f".�'n'.4'�.3kr� � � '' r �tf��T =-'- jM :.t. �,��':�+�1". .r;�x' �� ?;'�v �6Cyi,.'I, �� . ��. ,:;95'Gc `" s�`r►'�� ,?T:�:��'' .�� •�,., _ �, •'�� , ir' i. . .,�,-,} .✓ ;5�,�e'^,,�„ .l;':, .... .. .fr"�.t,.,.: •}a:•.: Y�'�`�'� ..a<`' yr::'+.::r.9odit::4d'N., ..4... .i:r:..:.:,.Ja,.y. ..q,`' .. q�s„^...•, �.f..P..y.✓.yc:'�f': .)� .:.r>1' eS.,�•.t�a4�t,. '':1%;;..,,F` ..�_.�, l+ :.:•i 61 i Gg. KAOL ZO'd Wll 7002 9 AeW 9177-ZlC-9££:XeJ H91H H1AS80A ISR may- 2- '-, + APPLICATION FOR SITE EVALUATION/IMPROVEMENT PERMIT& 1 Davie County Health Department Environmental Health Section P.O. Box 848/210 Hospital Street Mocksville, NC 27028 ESNVI (336)751-8760 ***IMPORTANT*** THIS APPLICATION CANNOT BE PROCESSED UNLESS ALL THE REQUIRED INFORMATION IS PROVIDED. Refer to the INFORMATION BULLETIN for instruct' ns. 1. Name to be Billed Contact Person 7 Mailing Address C .Z C� Home Phone g City/state/ZIP Business Phone 2. Name on Permit/ATC if Different than Above Mailing Address .SA City/State/Zip 3. Application For: ite Evaluation ❑ Improvement Permit/ATC ❑ Both 4. system to service: House ❑ Mobile Home ❑ Business 0 Industry ❑ Other 5. If Residence: / People I Bedrooms 13 1 Bathrooms II Dishwasher 11 Garbage Disposal 11 Washing Machine II Basement/Plumbing 1I 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) 1. Type of water supply: County/City ❑ Well ❑ Community a. Do you anticipate additions or expansions of the facility this system is intended to serve? ❑Yes If yes,what type? ***IMPORTANT***CLIENTS MUST COMPLETE THE REQUIRED PROPERTY INFORMATION REQUESTED BELOW. Either a PLAT or SITE PLAN MUST BESUBMITTED by the client with THIS APPLICATION. PropertyDimensions: �� i ��2C _ _ - WRITE DIRECTIONS(from Mocksville)to PROPERTY: Tax Office PIN: g �1-;Y—Fn'-Z/1 'fill �3 f� I Property Address: Road Name City/Zip &r-kc �ry W-4&4/ If in a Subdivision provide information,as follows: fG' ! Na7=1S` Section: Block: Lot:` 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. 1,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 :NATURE DATE - 3'^ e- TMS 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: Account No. (J gL! Revised DCHD(07/99) Invoice No. J�U DAVIE COUNTY HEALTH DEPARTMENT Environmental Health Section _ P.O.Boz 848/210 Hospital Street Mocksville,NC 27028 (336)751-8760 Account #: 990003223 Tax PIN/EH#: 5861-74-7727 Billed To: Karl Koeval . Subdivision Info: Armsworthy Acres Lot#4 Reference Name: Location/Address: Laurens Court-27006 Proposed Facility Residence Property Size: 197.68 x 152.5 ATC Number: 3772 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 I VALID FOR A PERIOD OF FIVE YEARS. / Environmental Health Specialist's Signature: /7 Date: 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 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. SG- 'kip /S J6 /d 0 GroG=� Septic System Installed By: Environmental Health Specialist's Signature: ,�� 0 Date: � r2� DCHD 05/99(Revised) DAVIE COUNTY HEALTH DEPARTMENT Environmental Health Section ' P.O.Boa 848/210 Hospital Street Mocksville,NC 27028 (336)751-8760 IMPROVEMENT/OPERATION PERMIT Account #: 990003223 Tax PIN/EH#: 5861-74-7727 Billed To: Karl Koeval Subdivision Info: Armsworthy Acres Lot#4 Reference Name: Location/Address: Laurens Court-27006 Proposed Facility Residence Property Size: 197.68 x 152.5 ATC Number: 3772 **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 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 #People .,5' #Bedrooms_ � #Baths Dishwasher:,Z Garbage Disposal: 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) Site: New 0'Repair❑ System Specifications: Tank SizeLBD P GAL. Pump Tank GAL. Trench Width��Rock Depth, Linear FA.-,l Other: Required Site Modifications/Conditions: 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 ins ection 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(3 6 751- 760.**** Environmental Health Specialist's Signature: �� Date: DCHD 05/99(Revised) 7 vim= s' APPLICATION FOR SITE EVALUATION/IMPROVEMENT PERMIT&ATC Davie County Health Department Environmental HealtbSection P.O. Box 848/210 Hospital Street Mocksville, NC 27028 (336)751-8760 ***IMPORTANT*** THIS APPLICATION CANNOT BE PROCESSED UNLESS ALL THE REQUIRED INFORMATION IS PROVIDED. /��Re�fper to the INFORMATION BULLETIN for instructions. /fir, �j 1. Name to be Billed 1-64AL k9'E- KL Contact Person /< t t- KO6iV/�L.. or�'+ U v' •,/- lab Som�rser - G+ 336-9qO-6467 Mailing Address Home Phone A' / City/State/ZIP NyolCo- Ot-700( Business Phone 2. Name on Permit/ATC if Different than Above i' Mailing Address City/State/Zip 3. Application For: ❑ Site Evaluation Improvement Permit/ATC ❑ Both 4. System to Service: House ❑ Mobile Home ❑ Business ❑ Industry ❑ Other 5. Type system requested: Conventional ❑ conventional modified ❑ innovative 6. If esidence: # People 5- # Bedrooms _ # Bathrooms if Garbage DisposalU1Washing Machine O*ement/Plumbing ❑Basement/No Plumbing 7. If Business/Industry /Other: verify type # People - # Sinks # Commodes # Showers # Urinals # Water Coolers IF FOODSERVICE: #�/Seats Estimated Water Usage (gallons per day) 8. Type of water supply: Od County/City ❑ Well ❑ Community 9. Do you anticipate additions or expansions of the facility this system is intended to serve? ❑Yes Q'-No If yes,what type? ***IMPORTANT***CLIENTS MUST COMPLETE THE REQUIRED PROPERTY INFORMATION REQUESTED BELOW. Either a PLAT or SIIT�E PLAN MUST BE SUBMITTED by the client with THIS APPLICATION. Property Dimensions: 1 /, lJ o • WRITE DIRECTIONS(from Mocksville)to PROPERTY: e Tax Office PIN: # 5'961-747-72--7 ON 15-2 4-3 W 4-J re, Property Address: Road NameAbamct— JOv% 01M `�li'NOrei"1"O 1_aU1'P,(�tS�r City/Zip P24-41a- On L4W4 S If in a Subdivision provide information,as follows: �- 104- 6v) )e 4 Name: ArIMSWOri� 1 hu-e-s llt k Section: Block: Lot: _ Date home corners flagged: OM c J eveiav 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,unnderstand that I an:responsible for all charges incurred fn•onn 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__4/30101 SIGNATURE THIS AREA MAY BE USED FOR DRAWING YOUR SITE PLAN(Include all of the following: Existing and proposed property lines and dimensions, stru tres,'s�et$bpcks, and septic locations). 30' l Site Revisit Charge Sel64 1 _- t �sAGSL0.M 2S (-- -t� � - y t Date(s): � Client Notification Date: is / .NOI)SE 0 EHS: Sign given y `I 3 Account No. Revised DCHD(05/03 �9S Invoice No. �1 7 S�s4, 6c •