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135 Creekview Dr Lot 35 Davie County,NC Tax Parcel Report Tuesday, December 20, 2016 I i 116 + 102 107 115 I 159 `l -CREEKVIEW DR i 171 -.170 ' I ,` 129123 115 107 110 1352 F-- U) 111-'t ---121 133 112 102 IlJLIP - _ I MAGNOLIA DR _130 WARNING: THIS IS NOT A SURVEY _ _ Y Parcel Information Parcel Number: _._ G910OA0035 Township: Shady Grove NCPIN Number: 5880415583 Municipality: Account Number: -- = 82526812 Census Tract: 37059-804 Listed Owner 1: --.: - BAREFOOT KEVIN W Voting Precinct: EAST SHADY GROVE Mailing Address 1: 142 IDLEWILD ROAD Planning Jurisdiction: Davie County City: " =- =-ADVANCE _ Zoning Class: DAVIE COUNTY R-A,R-20 State: NC Zoning Overlay: Zip Code:' - 27006-0000 Voluntary Ag.District: No Legal Description:_ LOT-35 AGNOLIA ACRES PHASE II Fire Response District: ADVANCE Assessed Acreage: 3.23 Elementary School Zone: SHADY GROVE Deed Date: 2/2015 Middle School Zone: WILLIAM ELLIS Deed Book/Page: 009790654 Soil Types: WeC,WeI3 Plat Book: 0008 Flood Zone: Plat Page: 075 Watershed Overlay: DAVIE COUNTY Building Value: Outbuilding&Extra Freatures Value: Land Value: Total Market Value: Total Assessed Value: All data is provided as Is without warranty or guarantee of any kind 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 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 �oaN NC or arising out of the use or Inability to use the GIS data provided by this website. CONSTRUCTION For Office Use Only AUTHORIZATION *CDP File Number 190669- 1 °= Davie County Health Department County ID Number.G9-100-Ao-035 210 Hospital Street Evaluated For. NEW P.O. Box 848 Township: Mocksville NC 27028 PERMIT VALID UNTIL: Phone:336-753-6780 Fax:336-753-1680 1 1 / 1 5 / a 0 a 1 Applicant: Kevin W.and Carlynn J. Barefoot Property Owner. Kevin W.and Cadynn J. Barefoot Address: 142 Idlewild Rd Address: 142 Idlewild Rd City: Advance City: Advance StatefZip: NC: -27006 °StatefZip: NC 27006 Phone#: (336)345-2055 Phone#: (336)345-2055 Property Location 8< Site Information Address/Road #: Subdivision:_,Magnolia Acres Phase: Lot: 35 Creekview Dr Advance NC 27006 Directions Structure... SINGLE FAMILY'_ AMILY - Hwy 64 East, left on Hwy 801, right at 2nd entrance for # _ Peoples Ck Rd, beside Florist. the to Magnolia Acres of Bedrooms: 4 #of People: 4 *Water Supply: PUBLIC System Specifications Minimum Trench Depth: 3 6 CrDesign ication: Provisionally Suitable Inches Minimum Soil Cover. a 4 stem? DYes QNo Inches : 4 $ 0 Maximum Trench Depth: 3 6 Inches Soil Application Rate: 0 . 3 Maximum Soil Cover: a 4 Inches 'System Classification/Description: 'Distribution Type: PUMP TO GRAVITY TYPE III G.OTHER NON-CONN.TRENCH SYSTEMS Septic Tank: _ 1 0 0 0 Gallons 'Proposed System: 25%REDUCTION 1-Piece: DYes QNo Pump Required: QYes ONo OMay Be Required Nitrification Field 1 6 0 0 Sq. ft. Pump Tank: 1 0 B 0 Gallons No. Drain Lines 4 1-#piece: DYes QNo Total Trench Length: 4 3 6 8 GPM—vs— ft. TDH Trench Spacing: nches O . _ Weet O.C. Dosing Volume: _ Gallons Trench Width: — 3 @Inches Feet Grease Trap: Gallons Aggregate Depth: inches Pre Treatment: ONSF OTS-1 OTS-II Septic Tank InstallerGrade Level Required: 01 011 0111 OIV CDP File Number 190669 - 1 County ID Number: G9-100-AO-035, �Y ❑ Open Pump System Sheet Repair System Required:@Yes ONO ONo, but has Available Space rDesign System Trench Spacing: 9 EW3 Inches O. . ification: Provisionally Suitable — Feet O.C. Trench Width: QInches w: 4 8 0 — 3 V Feet Soil Application Rate: 0 - 3 Aggregate Depth; inches Minimum Trench Depth: 3 6 *System Classification/Description: Inches TYPE III G.OTHER NON-CONY.TRENCH SYSTEMS Minimum Soil Cover. a 4 Inches Maximum Trench Depth: 3 6 Inches *Proposed System: 25%REDUCTION Maximum Soil Cover: a 4 N itrification Field 1. 6 0 0 Inches ' Sq ft. - *Distribution Type: PUMP TO GRAVITY No. Drain Lines 3 Total Trench length 4''3 6'` _ Pump Required: QYes ONo OMay Be Required _. ._ 7. PreTreatment: ONSF OTS-1 OTS-11 *Site Modifications r No grading or-construction activity.is allowed in areas designated.for system and repair without approval of Health Department.' Area for the septic system must be cleared of trees *Permit Conditions The issuance ofthis permit bythe Health Department in no way guarantees the issuance of other permits.The permit holder is responsible for checking with appropriate governing bodies in meeting their requirements. This Authorization for Wastewater System Construction shall be valid for a person equal to the period of validity of the Improvement Permit,not to exceed five years,and maybe Issued at the sane time the Improvement Permit issued(NCGS 130A-336(b)).If the installation has not been completed during the period of validity of the Construction Penult,the Information submitted In the application for a permit or Construction Authorization Is found to have been incorrect,falsified or changed,or the site is altered,the permit or Construction Authorization shall become invalid,and maybe suspended or revoked(.1937(g)).The person owning or controlling the system shall be responsible for assuring compliance with the laws,rules,and permit conditions regarding system location,installation,operation,maintenance,monitoring,reporting and repair (1938(b)). Applicant/Legal Reps. Signature Required? OYeS ONO Applicant/Legal Reps.Signature: Date:• / / *Issued By: 2140-Nations,Robert Date of Issue: - 1 1 / 1 5 / a 0 1 6 Authorized State Agen • Malfunction Log Oyes @Hand Drawing Olmport Drawing **Site Plan/Drawing attached.** Page 2 of 3 CONSTRUCTION AUTHORIZATION 190669 - 1 Davie County Health Department CDP File Number: 210 Hospital Street County File Number: G9.100-AO-035 P.O.Box 848 Mocksville NC 27028 Date: 1 1 / 1 5 / .1 0 1 6 O Inch Drawing Drawing Type: Construction Authorization Scale: . OBlock O N/A l z V F1 0 7 I f t I -• II I CONSTRUCTION AUTHORIZATION Davie County Health Department 210 Hospital Street CDP File Number: 190669 - 1 P.O.Box 8,48, G9.100•AO-035 Mocksvine NC 27028 County File Number: Date: _1 1 / 1 5 I a 6 1 6 Click below to import an image from an external location: Drawing Type:Construction Authorization CONSTRUCTION For Office Use Only AUTHORIZATION *CDP File Number 190669- Davie County Health Department County ID Number: G9-100-AO-035 f- 210 Hospital Street Evaluated For: NEW •,,�,,. P.O. Box 848 Township: Mocksville NC 27028 PERMIT VALID UNTIL: Phone: 336-753-6780 Fax: 336-753-1680 1 1 / 1 5 a 0 a 1 Applicant: Kevin W.and Carlynn J. Barefoot Property Owner: Kevin W.and Carlynn J. Barefoot Address: 142 Idlewild Rd Address: 142 Idlewild Rd City: Advance City: Advance State/Zip: NC 27006 State/Zip: NC 27006 -- -Phone#: (336)345-2055 Phone#: (336)345-2055 Property Location & Site Information Address/Road M Subdivision: Magnolia Acres Phase: Lot: 35 Creekview Dr .Advance NC 27006 Directions Structure :_ SINGLE FAMILY Hwy 64 East, left on Hwy 801, right at 2nd entrance for - Peoples Ck Rd, beside Florist. the to Magnolia Acres #of Bedrooms: 4 #of People: 4 "Water Supply: PUBLIC i System Specifications ` Minimum Trench Depth: 3 6 Site Classification: Provisionally suitable Inches Sa rolite S stems Minimum Soil Cover: a 4 p y O Yes .(&No Inches Design Flow: ' "' 4 8 0 I Maximum Trench Depth: 3 6 Inches Soil Application Rate 0 3 Maximum Soil Cover: a 4 Inches "System Classification/Description: "Distribution Type: PUMP TO GRAVITY TYPE III G.OTHER NON-CONY.TRENCH SYSTEMS Septic Tank: 1 0 0 0 Gallons "Proposed System: 25%REDUCTION 1-Piece: O Yes ®No Pump Required: ®Yes O No O May Be Required Nitrification Field 1 6 0 0 Sq.ft. Pump Tank: 1 0 0 0 Gallons No. Drain Lines 4 1-Piece: OYes ®No Total Trench Length: 4 3 6 ft, GPM--vs— ft. TDH Trench Spacing: — O Inches O.C. — ®Feet O.C. Dosing Volume: Gallons Trench Width: — 3 OInches ®Feet Grease Trap: Gallons Aggregate Depth: inches Pre-Treatment: O NSF OTS-1 OTS-11 Septic Tank Installer Grade Level Required: 01011 O 111 01V Page 1 of 3 CDP File Number 190669 - 1 County ID Numbers G9-loo-AO-035 ❑ Open Pump System Sheet Repair System Required:®Yes ONO ONO, but has Available Space CDesign System Inches O. . Trench Spacing: 9 O fication: Provisionally suitable — ®Feet O.C. Trench Width: Inches w: 4 8 0 — 3 Feet Aggregate Depth: Soil Application Rate: 0 3 inches : *System Classification/Description: Minimum Trench Depth3 6 Inches TYPE III G.OTHER NON-CONV.TRENCH SYSTEMS Minimum Soil Cover: a 4 Inches - Maximum Trench Depth: 3 6 Inches *Proposed System: 25%REDUCTION Maximum Soil Cover: a 4 Nitrification Field 1 6 0` Inches Sq.ft. *Distribution Type: PUMP TO GRAVITY No.Drain'Lines 3 Total Trench Length: Pump Required: ®Yes O No O May Be Required 436 'ft " ' Pre-Treatment: O NSF OTS-I OTS-II *Site Modifications -No grading or construction activity is allowed in areas designated for system and repair without approval of Health Department. Rememch­d� Area for the septic system must be cleared of trees 699 *Permit Conditions - The issuance of this permit by the Health Department in no way guarantees the issuance of other permits.The permit holder is responsible for checking with appropriate governing bodies in meeting their requirements. R.��9 _ 2000 This Authorization for Wastewater System Construction shall be valid for a person equal to the period of validity of the Improvement Permit,not to exceed five years,and may be issued at the same time the Improvement Permit issued(NCGS 130A-336(b)).If the installation has not been completed during the period of validity of the Construction Permit,the information submitted in the application for a permit or Construction Authorization is found to have been incorrect,falsified or changed,or the site is altered,the permit or Construction Authorization shall become Invalid,and may be suspended or revoked(.1937(g)).The person owning or controlling the system shall be responsible for assuring compliance with the laws,rules,and permit conditions regarding system location,installation,operation,maintenance,monitoring,reporting and repair (1938(b)). Applicant/Legal Reps. Signature Required? O Yes ONO Applicant/Legal Reps. Signature: Date: *Issued By: 2140-Nations,Robert Date of Issue: 1 1 1 5 a 0 1 6 Authorized State Agen Malfunction Log OYeS ®Hand Drawing O Import Drawing **Site Plan/Drawing attached.** Page 2of3 • CONSTRUCTION AUTHORIZATION 190669 - 1 Dade County Health Department CDP File Number: 210 Hospital Street G9-100-AO-035 P.O.Box 848 County File Number: Mocksville NC 27028 Date: 11 / 1 5 / 2 0 1 6 O Inch ! iI LI 'I Scale: ! IO Bl o c kDrawing DrawingType: Constuction Authorization Q N/A .� , ......., ......... ................................._ ....................L.......... . ................L.... .......................... ...._................i..... .. . .............. . ......................... L ..... .................................1 ...............................................I .._ ft. !...............' .................. I. ....... �! ......... i ....... j 1. . l I __..... ........ ..... 1 .. ..1.... ..I . L. 1 f.. 4 1 . 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Page 3 of 3 CONSTRUCTION AUTHORIZATION Davie County Health Department 210 Hospital street CDP File Number: 190669- 1 P.O.Box 848 G9-100-AO-035 Mocksville NC 27028 County File Number: Date: IL/ 15 / a 0 16 - Click below to import an image from an-external location: Drawing Type: Construction Authorization Page 3 of 3 P1 P2 APPLICATION FOR SITE,EVALUATIONAMPROVEMENT PERMIT & ATC ` Da'vieContyEnvironmental{Health> u ��,� ' P O :Boz 848/210;Hospital Street COj 6o ksville,NC1.27028 1 (336)753 6780/Fax(336)753`1680 = ✓ ` 1 Applies ' or: ❑ Site Evaluation/ImproSement'PermitAuthorization To Construct(ATC) (Both Type of Application: KNew System ❑Repair to Existing System ❑Expansion/Modification of Existing System or Facility ***IMPORTANT***THIS APPLICATION CANNO T BE PR 0 CESSED UNLESS ALL OF THE REQUIRED INFORMATION IS PROVIDED. Refer to the INFORMATION BULLETIN for instructions:: APPLICANT INFORMATION Name 9e-VvV\. Contact Person Ove^- h' ho Address O Cil ate,' 2 Home Phone. ,33 C 4t!L­Mn.F5— City/State/ZIP C Business Phone X: (A ---<QR ©go 7) Email a bA Email: Name on Permit/ TC if Dif erent than Above •` ' Mailing Address s/ City/State/Zip C-e.r-Y#,4 1 e. AJ C Z PROPERTY INFORMATION_ `_ i '*Date House/Facility Comers Flagged w NOTE: A survey plat or site plan must accompany thislapplication: Included:'❑-.Site Plan ❑Plat(to scale) (Permit is v lid for 60 months site p n,no expiration with complete plat.). 7 Owner's Name Phone Number Owner's Address 0 t 2 GCQ., City/State/Zip C(,e >. (AJc 2'Z O 12- Property 2Property Address t 35City._,- ry—CQG� Lot Size 3.3 At-r-#-s Tax PIN# , ,t Subdivision Name(if applicable . Section/Lot# Dir tions To Site: Al L f I thea we r to any of the following questions is"Yes",supporting documentation mus a attached: Are there any existing wastewater systems on the site? _Yes No Does the site contain jurisdictional wetlands? ' Yes ?�-No Are there any easements or right-of-ways on the site?. _Yes-�cNo - Is the site subject to approval by another public agency?- Yes )CNo Will wastewater other than domestic sewage be generated? _Yes No IF RESIDENCE FILL OUT THE BOX BELOW #People #Bedrooms ' �� ' ; #;Bathrooms .. L, Garden Tub/Whirlpgoles ❑No Basement: es ❑No Basement Plumbing: es' ❑No 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: ccepted ,❑Innovative ❑Alternative ❑Other`--_ Water Supply Type-�CCounty/City Water ❑New Well ❑Existing Well ❑ Community Well - Do you anticipate additions or expansions of the facility this system is intended to serve? ❑ Yes ❑No If yes,what type? This is to certify that the information provided on this application is true and correct to the best of my knowledge. I understand that permits)IP(s)or CA(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.Permits issued will expire 5 years from the date of issuance. 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 staking the house/facility location,proposed well location and the locaf n of any other amenities. Site Revisit Charge Date(s): :im Client Notification Date: l ` EHS: ' er's legal representative signature a Account# Revised 11/1 Invoice# For Office Use Only IMPROVEMENT PERMIT 'CDP Fite Number 196669.1 e� 4 Davie County Health Department r� County iD N utn ber'G9-1 WAO!!'035 210 Hospital Street r P.O. Box 848 Evaluated For �"NEW"'' Mocksville NC 27028 Township: Phone:336-753-6780 Fax:336-753-1680 PERMIT VALID UNTIL 2/2/2020 *NOTE TO INSPECTIONS DIVISION: Building Permits cannot be issued with this Improvement Permit. Applicant: even nd Carlynn J. Property Owner: Jeanette O. Cornatzer Qlre.�oio Address: 142 Idlewild Rd Address: City: Advance City: Adavnce StatefZip; NC 27006 Statefzip: NC 27006 Phone#: Phone#: Property Location & Site Information r dress/Road#: Subdivision: Phase: Lot:(�,�reekview Drdvance NC 27006 Directions Structure: SINGLE FAMILY Hwy 64 East, left on Hwy 801, right at 2nd entrance #of Bedrooms: 4 for Peoples Ck Rd, beside Florist. the to Magnolia #of People: Acres *Water Supply: PUBLIC System Specifications nitial S stem *Site Classification: Provisionally Suitable Minimum Trench Depth: a 4 Inches Saprolite System? OYes @No / Maximum Trench Depth: 3 6 Inches Design Flow: 4 8 0 Septic Tank: 1 0 0 0 Gallons Soil Application Rate: 0 3 1-Piece: OYes QNo Pump Required: @Yes ONo OMay Be Required *System Classification/Description: TYPE III B.SYSTEM W/SINGLE EFFLUENT PUMP Pump Tank: 1 0 0 0 Gallons *Proposed System: 25%REDUCTION- 1-Piece: OYes QNo Repair System Required:OYes ONo ONo, but has Available Space Repair System *Site Classification: Provisionally suitable Minimum Trench Depth: -14 Inches Soil Application Rate: - 3 Maximum Trench Depth: 3 6 CInches 7 *System Classification/Description: Pump Required: @Yes ONo O Maybe Required TYPE III B.SYSTEM VV/SINGLE EFFLUENT PUMP *Proposed System: 25%REDUCTION Pagel of 3 COP File Number 190669-" 1 County ID,Number: G9=100-Ao-035 *Site Modifications ❑ Open Fill Sheet No grading or construction activity is allowed in areas designated for system and repair without approval of Health Department. a *Permit Conditions The issuance of this permit bythe Health Department in no way guarantees the issuance of other permits..The permit holder is responsible for checkingwith appropriate governing bodies in meeting their requirements. i Site Plan The Improvement Permit shall be valid for 5 years from date of issue with a site plan(means a,drawing not necessarily drawn to scale that shows the existing and proposed property lines with dimensions,the location ofthefacility'and appurtenances,the site forth proposed Wastewater system,and the location of water supplies and surface waters). Plat The Improvement Permit shall be valld without expiration with plat(means a property surveyed prepared by a registered land surveyor,drawn to a scale of,one Inch equals no morethan 60 feet,that lncluder.the,specific location ofthe proposed facility a and appurtenances,the site for the proposed Wastewater systern,andthe location ofwater supplies and surface waters. Plat also means,for subdivision lots approved by the local planning authority and recorded with the county registerof deeds,a copy of the recorc�d subdivisions plat that is accompanied by a site plan that Is drawn to scale). The Department and Local Health Department may Impose conditions on the Issuance and may revoke the permits for failure of the system to satisfy the conditions,the rhes,or this article:This permit ls subjectto revocation If the site plan,plat;orIntended use charges(NGGS 13OA-335(f)).The person owning orcontrolling the system shall be responsibtefiorassuring compliance with the laws,rules,and permit conditions regarding system location,installation.operation,maintenance,monitoring, reporting,and repair(1938(b). Applicant/Legal Reps.Signature Required? OYes ONO Applicant/Legal Reps.Signature; Date: 1 *Issued By: 2140-Nations,Robert Date of issue: 0 a 1 0 a 2 0 I 5 e QValld without Expiration? Authorized State Ag -�,` O Create CA? @Hand Drawing Uimport Drawing **Site Plan/Drawing attached.** Page 2 of 3 IMPROVEMENT PERMIT 190669 - 1 Davie County Health Department CDP File Number: 210 Hospital Street G9-100-AO-035 P.O.Box Baa County File Number: Mocksville NC 27028 Date: Q Inch Drawing. 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