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158 Kayla Trail0 Davie Countv, NC Tax Parcel Renort 1'j' -A0 Thursday. September 29. 2016 WARNING: THIS 15 NOTA SURVEY Parcel Information Parcel Number: C40000003801 Township: NCPIN Number: 5833313701 Municipality: Account Number: 62266460 Census Tract: Listed Owner 1: ROBINSON KEVIN J Voting Precinct: Mailing Address 1: PO BOX 1057 Planning Jurisdiction: City: MOCKSVILLE State: Zip Code: Legal Description: Assessed Acreage: Deed Date: Deed Book / Page: Plat Book: Plat Page: Building Value: Land Value: Total Assessed Value: Zoning Class: NC Zoning Overlay: 27025-1057 Voluntary Ag. District: 41.94 AC N PINO RD Fire Response District: 40.90 Elementary School Zone: 9/1994 Middle School Zone: 001760293 Soil Types: Flood Zone: Watershed Overlay: 304150.00 Outbuilding & Extra Freatures Value: 263190.00 Total Market Value: 758370.00 Farmington 37059-802 FARMINGTON Davie County DAVIE COUNTY R -A DAVIE COUNTY QD FARMINGTON PINEBROOK NORTH DAVIE EnB,IrB DAVIE COUNTY 408900.00 976240.00 No no tyC� Davie County, NC 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 merchantability or fitness for a particular use. All users of Davie County's GIS website shall hold harmless the County of Davie, North Carolina, its agents, consultants, contractors or employees tram any and all claims or causes of action due to or arising out of the use or Inability to use the GIS data provided by this website. ]] AUTHORIZATION NO: el n DAVIE COUNTY HEALTH DEPARTMENT Environmental Health Section PROPERTY INFORMATION u "� s Permittees µ H� xr, P.O. Box 848 Name: ' d' }l1,,��, S�l�s''� Mocksville, NC 27028 Subdivision Name: Phone #: 704-634-8760 Directions to property: l /9G /� �1%• Section: Lot: AUTHORIZATION FORWASTEWATER �""W may' • SYSTEM CONSTRUCTION Tax Office PIN* ! - s �� r Road Name:-- • Zip: Gi /�� **NOTE** This Authorization for Wastewater System Construction MUST BE ISSUED by the Davie County Environmental Health Section prior to issuance of any Building Permits. This Form/Authorization Number should be presented to the Davie County Building Inspections Office when applying for Building Permits. (In compliance with Article 11 of G.S. Chapter 130A, Wastewater Systems, Section .1900 Sewage Treatment and Disposal Systems) ' ***NOTICE*** THIS AUTHORIZATION FOR WASTEWATER CONSTRUCTION . Z';>, IS VALID FOR A PERIOD OF FIVE YEARS. ENVIRONMENTAL HEALTH ENVIRONMENTAL HEALTH SPE DATE ISSUED 2 DAVIE COUNTY HEALTH DEPARTMENT IMPROVEMENT AND OPERATION PERMITS PROPERTY INFORMATION Permjtiee's °'� >�° # r�r� Name:,' , �' ,�i'.,w€s,. Subdivision Name: Directions to property:' '} "i %�' '-� Section: Lot: IMPROVEMENT PERMIT Tax Office PIAN:# Road Name:#i` ' 1 *s. _ ,�" • Zip: ;', **NOTE** This Improvement Permit DOES NOT authorize the construction or installation 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) ps . {,✓ r : ` r' ,�Y, p e ***NOTICE*** THIS PERMIT IS SUBJECT TO REVOCATION IF SITE PLANS OR THE INTENDED USE CHANGE. YOUR WASTEWATER ENVIRONMENTAL HEALTH SPECIALIS`r DATE ISSUED SYSTEM CONTRACTOR MUST SEE THIS PERMIT BEFORE INSTALLING THE SYSTEM. RESIDENTIAL SPECIFICATION: BUILDING TYPE # BEDROOMS '9 # BATHS P # OCCUPANTS w.T GARBAGE DISPOSAL: Yes or No COMMERCIAL SPECIFICATION: FACILITY TYPE # PEOPLE - # PEOPLE/SHIFr # SEATS INDUSTRIAL WASTE: Yes or No LOT SIZE TYPE WATER SUPPLY rf/,° DESIGN WASTEWATER FLOW (GPD) NEW SITE f/ REPAIR SITE SYSTEM SPECIFICATIONS: TANK SIZE421:;!/ GAL. PUMP TANK GAL. TRENCH WIDTH % � ROCK DEPTH /--� LINEAR FT. OTHER S" {err/ ! f/ v7 ` / � ` t ✓.'' �r4 �! �a - f.�G�1'f�i _ REQUIRED SITE MODIFICATIONS/CONDITIONS: CT A VIE **CONTBETWE8:30 REPRESENTATIVE9:30 A.M. OR 00 1: 0 P.M. ON THE D4Y 04INST LLAjfION.. TELEPHONE #T FOR FINAL ECTION OF THIS S (704) 634-8760.SYSTEM OPERATION PERMIT SYS INS ALL D B 1 Q � ti N AUTHORIZATION NO. 1240 OPERATION PERMIT BY: Gum " DATE: **THE ISSUANCE OF THIS OPERATION PERMIT SHALL INDICATE THAT THE S EM DESCRIBED AB 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. DCHD 05/96 (Revised) �• APPLICATION FOR SITE EVALUATIONAMPROVEMENT Davie County Health Department Environmental Health Section P. O. Box 848 Mocksville, NC 27028 (704)634-8760 ****IMPORTANT**** THIS APPLICATION CANNOT BE PR( ALL THE REQUIRED INFORMATION IS PROVIDED. 1. Name to be Billed F- l l St N<,D 0 _ Contact Person _ Mailing Address dQ �L A '19Al L— Home Phone ! �' -.2E'47 City/State/Zip W �t'-5� �1(-'� N C— P�7(32,% Business Phone S14�n -�- 2. Name on Permit/ATC if Different than Above Mailing Address City/State/Zip 3. Application For: Site Evaluation 0 Improvement Permit & ATC ❑ Both 4. System to Serve: li-�' House ❑ Mobile Home ❑ Business ❑ Industry ❑ Other 5. If Residence: #'People # Bedrooms_ # Bathrooms 3 Dishwasher a'Garbage Disposal WW—ashing Machine ❑ Basement/Plumbing ❑ Basement/No Plumbing 6. If Business/Other: Specify type # People # Sinks # Commodes If Foodservice: 7. Type of water supply # Showers # Urinals # Seats Estimated Water Usage (gallons per day) ElCounty/City U Well # Water Coolers ❑ Community 8. Do you anticipate additions or expansions of the facility this system is intended to serve? ❑ Yes q/No Tf vPc what tvnP? PROPERTY INFORMATION REQUIRED: *** IMPORTANT *** A PLAT OF THE PROPERTY MUST BE SUBMITTED WITH THIS APPLICATION. Property Dimensions. 14,-)- a av5 Tax Office PIN: # J`6 33 - —� ( - 3-70 Property Address: Road Name a60Ja- city/zip 4,. br) "PL If in Subdivision provide information, as follows: Name: Section: Lot #: WRITE DIRECTIONS (from Mocksville) TO PROPERTY - 60 t ROPERTY:60l C�o 1 S ONO 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 byC , J ` (,j 19�e l:J'J"� to conduct all testing procedures as necessary to determine the site suitability. 21 DATE ?�`�'ri O SIGNATURE Revised DCHD (06-96) � I 3 -W25'5 -2"E _620.73_ _ _ _ _ I� I - 233.14' CHORD41.9495 ACRES IP,Or; fcuN� 1\ R=263.23' OLC CORNER \ RR SPIKE\ F _ACED \ R �\ �5ro \ sus \ RR SPIKI \ PLACED N 40011'45"W 159.32' CHORD 1RR SPIKE — R=966.91' PLACED PINO ROAD N 23036'44"W rn N C= O N i IRON PLACED _ - I OF FARM ROAD I U) f O 00 Q ° L. W. WEST JR. W o l D.B. 120 PG. 509 �a f \ r .- o= ~� O o Z I� ofPR 3PIK9' PLACED -' S 88°00 00"E 719.44' "RON a`4cfU ate' O PR SPIKE zf P!.ACED ' 0 „ � I 3 -W25'5 -2"E _620.73_ _ _ _ _ I� I - 233.14' CHORD41.9495 ACRES IP,Or; fcuN� 1\ R=263.23' OLC CORNER \ RR SPIKE\ F _ACED \ R �\ �5ro \ sus \ RR SPIKI \ PLACED N 40011'45"W 159.32' CHORD 1RR SPIKE — R=966.91' PLACED PINO ROAD N 23036'44"W rn N C= O N i 0 �v a-�J. � T x �pca-l�✓ ti,� "1�8�u`f -CL ��Yr. �v �� , �� APPLICATION FOR SITE EVA IXATIO /I PROVEMEN PERMIT y__ r�,� D �� ?� �' Davie County Health Department • �p C�I I✓ ' r Environmental Health Section OAF P. O. Box 665 lq l-/ 7Mocksville, NC 27028 1. Application/Permit Requested By Ie, (N ►1�g1 NS�N Mailing Address 171(, grODV-V�i DR(Y/L W(NstON-Sli1fM SIG a.7166, 2. Name on Permit if Different than Above 3. Application for: General Ev luation 4. System to Serve: (29 ❑ Business ❑ Industry 5. If house, mobile home: Subdivision —0-0-1'4U No. of People 04 No. of Bedrooms L7 No. of Bathrooms 3 Dwelling Dimensions AV)VT 2LW -<2?. 'l' Home Phone Q ( 0) -VS-9 Business Phone �9 1 D) ?-7 3 S 'O �iSepticTank Installation Permit ❑ Mobile Home ❑ Place of Public Assembly ❑ Other ❑ Unknown Section Lot # 6. If business, industry, place of public assembly, other: Specify type No. of People Served No. of Commodes No. of Lavatories No. of Sinks No. of Urinals No. of Water Coolers No. of Showers Water Usage Figures _ 7. Type of water supply: ❑ Public 1, Private 8. Property Dimensions If 2 acf iES Sewage Disposal Contractor 9. Do you anticipate additions/expansion of the facility this sytem is intended to serve? If yes, what type? ❑ Basement/Plumbing ❑ Basement/No Plumbing L1CWashing Machine Dishwasher Garbage Disposal ❑ Yes Z No ❑ Community 'NOTE: Improvements Permits shall be valid for a period of 5 years from date issued. Improvements Permits are subject to revocation, if site plans or the intended use change. Effective October 1, 1989. Directions to Property: 11-,, 1 (Mo q J+PIC,r C 801 -�V VJ26k--C-J O nclPO o� -J-�V J t eLA-J- Qi✓�-O SS P—J CS CriV1\ I_ This is to certify that the information provided is correct to the best of incurred from this appli a n. TE and I understand I am responsible for all charges SIGNATURE CONSENT FOR SITE EVALUATION TO BE DONE ON ABOVE DESCRIBED PROPERTY MUST CHECK ONE: ❑ 1. 1 OWN the property. ❑ 2. 1 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 of the Lro County It� ment to enter upon above described property located in Davie County and owned by - C� ' to conduct all testing procedures as necessary to determine said site's suitability for a ground absorption sewage treatment and disposal system. DATE SIGNATURE DCHD'(1193) t 1 i } Aii Ago -Tj�� • y . yy • for � C YT t c v e'Sdr �MF11111h;� Z7.67 N 4.21_c34 pt 7 4 -1 c� A ✓• r cA 907645 .32 1. ti' ` f nh. Kn6=, a 3. 32 T o ww t 8.24 Ac-g #,* •• `T Q 0 ?C S4 897 #i Ni J•, lab �µ Y •� 724. 6 8 8.19 Ac d 189336` ;. P/0 38A � •�• � J 7'e Y -.n Y CHAPS y ID HURCH �. 75 1 t\ '}F r L' i d •Y n 4' t c •�. 151.14 •o: IJ 11 # t^ r \W nY 1 ' DAVIE COUNTY HEALTH DEPARTMENT Environmental Health Section E al S011101te v uaL on NAME ' ills ADDRESS PROPOSED FACIILTY / ll te�� 4 DATE EVALUATED d. PROPERTY SIZE 2 -I Oo LOCATION OF SITE "i_ ✓ C� V&410-, I Water Supply: On -Site Well Community Public Evaluation By: Auger Boring t/ Pit Cut FACTORS 1 2 3 4 Landscape position 2 - Slope Slo e % < HORIZON I DEPTH Texture group 4elL X- Consistence Structure MineralogX 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 vl LONG-TERM ACCEPTANCE RATE ,, SITE CLASSIFICATION: ��t�, Y ✓ �> _ , � .��_� D EVALUATED UATED BY: 116 LONG-TERM ACCEPTANCEI�ATE: REMARKS: _ l�U�(3� ��! �/ DCHD(01-901 OTHER(S) PRESENT: END 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 CONSISTENCE Moist VFR--Vc.r-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 3C -Single grain M -Massive CR -Crumb GR -Granular ABK-Angular blocky SBK-Subangular blocky PL -Platy PR -Prismatic Mineraloay 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 ■��\��/��■��/��■ ■0�� ■ ■��n��/��■��■��■��`�■■ ■��■��■■��■ ■�■��r�■��0��■ ■��■��■��■�■/�■■��■■��■�■��■ ■��■��■�■��■��■ ■��t1�■■��■��■��\��■��■■�■ ■��■t�■��■��■��■��■��■ ■��lE��■��■�■■��■■��■�■�� ■��■��■■ ....��.....................................C.............■........ .■...,�...........■...■.......■.......■...■■..■.■.■.■.■..■■■■.■...■ ■��i■�1��■��■��■ ■��1��11��■��■��■■ ■��\��■��\��■�■�■�� ■�//��L•��r��■/��■��■■��■ ■�i��■��iiC��!�� ■��■��■��■� ■��■��■�� ■�Ii��O�iiC�� —��■ ��\�� ■ ■�/� ■�� ■■ ■�I� oi�■ i`��----��l��— ■�1��1��■��■��/r�CiC�=��niCs��■��■ ■�1��■It■��■��■��i:��■��■��■ ■�Il��u��■�■��■ ■��■��■��■■ ■�I�■■��/��■��■��■��■��■��■��■■i�■\■■ ■�%��■■��■��■��■■��■��\��H��■ ■��■��■��■��■��a��■��■��■ �a�■�■��■■�■ ■�i�■��■��■��/i��7��R��■�� ■�1��/1��■��■��■ ��r��I��l�r��0�� ■r��i��■��■�■��s�i��■��_��r��.��i�=�■��■■��_■ ■��■■��■��■��■■��.�� ■��■�■ �� iiiii�ii�iiiiiiiiiiiiii��i�iiiiii�iiiiiiiiii�i�i�iiiiiii�iiiiii�i=iii ■��■��■��N��■��N��■��_�� ■��■��■■��■■��■��■�� ■��■ ■��■��a■��■��■■■��■��■ N�■��■�_� iiiiiiiiiiiiiiiiiiiiii'■iiiiiiiiiiii�iiii�iiiiiiiiioiCii�iiiiiii�iiiii ■i��■��o��■ ■ii��i��■■��■�� ■��u�� ■I1■�'��■��■��RC��0�■v�� ■��■ u��M��C��■��■��■��■�� ■11��/��r��\�� 1��N��t�� ■�1�■�1��■��\��■��■��■��■/��■��■��■ ■�l■�\1��■��■��■��■ ��Gi��il��■��\�� ■�l'��1��■■��■��I�■��Ir�� ■��e■ ■■t��■��■■■��■��■n�rr�i■��■�■�■��C��■��■ ■�I1��1��N��11�il:IJ�irl��i �� b�� ■■I��1��/■��/J��`■�� ■�I��t'�■Y��■�/�!�:�i�� \�� ■ ��■��■��■ ::�;:::►:�:::::::::::::::::::::::::":::: :.:::�:CC ::�L:C::C=::::::� ...�...,..........................i1....�.,.... ........... .... ��I�� N�� ■��I��11■��\■■��■�■\�� ■ �� iii�iiiii�■iiiiiiiiiiiiiiiiiiiiiiiii�i�ini ��a� �� ■ �i■ ..■.■..C..■...� ��1��/��■��N��n �� \��■�� ...��...�...............................s:':�'S': ' : ��. ::::�: ....�....�...........................:::..�..� �.�.C..�........ ...`............................�3..... .. . ................ ........►........................ �: ■■■...■.■.....■.. ....�............ ....■.......■■.... .. :::::�:: 'C:::::::::.:::::::::::::::.0=�.:. :C:S�'.:CG:C::=C�:: ....��.. ►...�.......................... ■..■�. .■.� ......... .. .....n..■.,..............■............ .■. ■■. ■ ■... ... ■...■. .....�.........................�......'�..._�....5......�...C. .. .....�....►...................... ....... ....■..............�... ■��■�►��■s��i�� _��N��■ ■��■��■�■■��■��H��=�� ■�� ■�■��st��■��■��■�� ■� �a��■ ��\��\��N��H� ��M�� ......■.................C.............:C ........................ ........�............ .......................... .................. .............�.......�........... ................................ .........�...�...................i�................................ ..........�■....................................................... ..............,........................ ........................... ..........►........................................................ ...........,...►..............................................■...■. .................................................................. ...._.......,...►................................................... .... ......,�...,................ ................................ .............�...................�................................ ■��/��,�� i ��■��■ � f ' � rDavie County NealK De artment t Men and .dome .peal i y cy 210 HOSPITAL STREET / P.O. BOX 665 MOCKSVILLE. N.C. 27028 PHONE: (704) 634.5985 Mr. Kevin Robinson 1716 Brookwood Drive Winston-Salem, N.C. 27106 August 1, 1994 Re: Site Evaluation Wesley Chapel Rd./House I Dear Mr. Robinson: As requested, a representative from this office visited the aforementioned site on July 27, 1994. Based upon the information provided on the application for a site evaluation and after the evaluation was completed, the site was found to be provisionally suitable for the installation of a modified, oversized on-site sewage disposal system. If you have any questions, please feel free to contact this office. Sincerely, Robert B. Hall, Jr., R:S. Environmental Health Section RH/wd Enclosure