200 Redfield Rd Davie County,NC Tax Parcel Report Tuesday, December 20, 2016
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- WARNING: THIS IS NOT A SURVEY
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= Parcel Inforrriation i
Parcel Number: B60000001104 Township: Farmington
NCPIN Number:: 5853379521 Municipality:
Account Number: -- 8307124 Census Tract: 37059-802
Listed Owner 1:- HARPER STEPHEN A ' Voting Precinct: FARMINGTON
Mailing Address-1:' 8220 KILDARE STREET ' ; Planning Jurisdiction: Davie County
City: CLEMMONS Zoning Class: DAVIE COUNTY R-A
State: -- NC - Zoning Overlay: DAVIE COUNTY QD
Zip Code: 27012 Voluntary Ag.District: No
Legal Description: 4.97 AC OFF ARROWHEAD RD. Fire Response District: FARMINGTON
Assessed Acreage:, _- 5.11 Elementary School Zone: PINEBROOK
Deed Date:> -- _ 11/2016 Middle School Zone: NORTH DAVIE
Deed Book/Page: 010340487 Soil Types: EnC,MsC,ChA,MsB
Plat Book: Flood Zone:
Plat Page: 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
SOU ty4 NC or arising out of the use or Inability to use the GIS data provided by this website.
i
Y
IMPROVEMENT PERMIT Foyoffice use only
*CDP Fite Number 231037`- 1
;.¢"t• Davie County Health Department
210 Hospital Street
County ID Number.5853379521
Evaluated For. NEW
P.O. Box 848
Mocksville NC 27028 Township:
Phone:336-753-6780 Fax:336-753-1680 pERrd1T VALID UNTIL 11I2/2021
*NOTE TO INSPECTIONS DIVISION: Building Permits cannot be issued with this Improvement Permit.
Applicant: Stephen and Katherine Harper Property Owner: James and Carol Hutchins
Address: 8220 Kildare Street Address: 1948 Farmington Road
City: Clemmons City: Mocksville
State2ip: . NC 27012 State/Zip:, NC 27028
Phone#: (336)778-2972 , `Phone#:
Property Location & Site Information
Fddress/Road #: Subdivision: Phase: Lot:
field Drvie
le NC 27028 Directions
Structure: - SINGLE FAMILY 1-40 east to exit 180 Left on Hwy 801 turn right on
#of Bedrooms: - Spillman Rd right on Arrowhead Rd Left on Redfield
it of People:
*Water Supply: NEW WELL
System Specifications
nitial System
*Site Classification:� ProvisionallySuitable
Minimum Trench Depth: 3 6 Inches
Saprolite System? OYes @No Maximum Trench Depth: 3 6 _ Inches
Design Flow:
3 6 0 Septic Tank: 1 0 0 0
Gallons
Soil Application Rate: 0- a 5 1-Piece: OYes ONo
Pump Required: OYes No OMay Be Required
*System Classification/Description:
TYPE III G.OTHER NON-CONN.TRENCH SYSTEMS Pump Tank: Gallons
*Proposed System: 25%REDUCTION 1-Piece: OYes ONo
___1)
Repair System Required:CYes ONO ONO, but has Available Space
Repair System
*Site Classification: Provisionally suitable Minimum Trench Depth: 3 6 Inches
Soil Application Rate: 0 a 2 5 Maximum Trench Depth: 3 6 Inches
u
*System Classification/Description: Pump Required: OYes Q No O Maybe Required
TYPE III G.OTHER NON-CONN.TRENCH SYSTEMS
*Proposed System: 25%REDUCTION
Pagel of 3
' r
CDP File Number 231037 - 1 County ID Number: 5853379521 '
'Site Modifications ❑ Open Fill Sheet
No grading or construction activity is allowed in areas designated far system and repair without approval of Health Department.
"Permit Conditions
The issuance ofthis permit bythe Health Department in no wayguarantees the issuance of other permits.The permit holder
is responsible for checking with appropriate governing bodies in meeting their requirements. ;
$Ite 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 stows the existing and proposed property lines with dim enslons,the location of the facility and appurtenances,the
site for the proposed Wastewater system,and the location of water supplies and surfacewaters).
Plat The Improvement Permit shall be wild without expiration with plat(means a property surveyed prepared by a registered land
Q surveyor,drawn to a scale atone inch equals no morethan 60 feet,that Includes:the specific location of the proposed facility
and appurtenances,the site for the proposed Wastewater system,and the location of water supplies and surface waters. Plat
also means,for subdivision lots approved by the local planning authority and recorded with the county register of deeds,a copy
of the recorded subdivisions platthat 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 rules,or this article.This permit is subject to revocation if the site plan,plat,or intended
use changes(NCGS 130A'335(f)).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 / 0 a / a 0 1 6
Authorized State Agent: OValid without Expiration?
O Create CA?
01-land Drawing Olmport Drawing
**Site Plan/Drawing attached.**
Page 2 of 3
• ' IMPROVEMENT PERMIT 231037 - 1
Davie County Health Department CDP File Number:
210 Hospital Street 5853379521
P.O.Box 848
County File Number:
Mocksville NC 27028 Date:
Q Inch
Drawing Drawing Type: Improvement Permit Sc . OBlock
d ON/A
� I
f-�
IMPROVEMENT PERMIT +
Davie County Health Department
290 Hospital street CDP File Number: 231037 - 1
P.O.Box$48 5853379521
Mocksvilie NC 270213 County File Number:
Date: 1 1 1 0 21 2 0 1 6
Click below to import an image from an extemal location: Drawing Type: Improvement Permit
' NCDENR
Division of Environmental Health
On-Site Wastewater Section "`Date: i i ! e a l e i e
Soil/Site Evaluation *File#: 2 3 1 0 3 7
For On-Site Wastewater System PIN #: 5853379521
"Owner James and Carol Hutchins Proposed Facility SINGLE FAMILY
Proposed Design Flow (.1949) Location of Site 200 Redfield Drvie
Property Size 4.97 Water Supply NEW WELL Evaluation Method Auger
14940 Horizon SOIL MORPHOLOGY
Profile-furLan scape Depth 1941 Other Profile
POS Mineralogy Matrix Mottle Factors
Slope% (1N) Texture Structure Consistence Color Color
1 L 0-11 SL 1-Wea' ,gr vfr ns np .1942 Wet.
3 ojo 1148 SC 3-Stng sbk fi Is P .1943 Depth
GPS
Saprolite an) .1944 Rest.
Horizon
EHS .1947 Class Ps
Nations,Robe Proffie 0 5
LTAR
2" L 0-5 SL 1-Wea' ,gr vfr ns np 1942 Wet.
7. 3 5-48 SC 3-Stni sbk fi s
% 9 P .1943 Depth
GPS Saprolite:pn) .1944 Rest.
Horizon
.1947 Class Ps
EHS
Co rofile Nations,RobeP °hie 6 2 5
LVAR
3 0-5 SL 1-Wea'..gr vfr ns np .1942 Wet.
% 5-48 SC 3-Stng sbk fi s P .1943 Depth
GPs Saprolitcon) .1944 Rest.
Horizon
EHS .1947 Class Ps
Copy Profile Profile
LTAR 0 5
.1942 Wet.
% .1943 Depth
GPS Saprolite:pn) .1944 Rest.
Horizon
EHS .1947 Class
Copy rofile Profile
LTAR
.1942 Wet.
% .1943 Depth
GPS Saprolite:(in) .1944 Rest.
Horizon
EHS 1947 Class
Copy ofile Profile
LTAR—
Available Space(A 945) PS OtherFactors(.1946) Ste Classification (.1948)Ps
Initial LTAR: o a 5 Repair LTAR: 0 . a a 5 Others Present:
Comments:
Evaluated By. Nations,Robert
NCDENR '
Division of Environmental Health
On-Site Wastewater Section Date: �� 1 .° a ° 6
Soil/Site Evaluation Flog: 23 1 9 3 7
For On-Site Wastewater System PIN 1#: 5 8 5 3 3 7 9 5 2 1
1d9d0 Horizon SOIL MORPHOLOGY
Lan scape .1941 Other Profile
Profile# POS Depth Factors
Slope°�0 (IN) Texture Structure Consisteonce Color Color
.1942 Wet.
°f° .1943 Depth
GPS Saprolite:(in) .1944 Rest.
Horizon
.1947 Class
EHS
copy-p—rofil Profile
LTAR
.1942 Wet
% .1943 Depth
— GAS Saprolde:Qn) .1944rizRonst.
1947 Class
EHS
C°pyffonl Profile -
L J LTAR
1942 Wet.
% .1943 Depth
GPS Saprolite:Qn) 1944Rnst.
Horizo
.1947 Class
EHS..
Copy rofil Profile
LTAR
.1942 Wet.
.1943 Depth
GPS Saprolite:(ln) .1944 Rest.
Horizon
EHS .1947 Class
copy,.Profil ProfiLTARle
u
.1942 Wet.
% .1943 Depth
GPS Saprolite:(in) .1944 Rest.
Horizon
EHS .1947 Class
COpy„PJOriI LTAR
u LTAR
Comments:
Attach Image
The"Open Drawing Form"button, opens the the drawing form.
The "Import"button, attaches the drawing, or other image into the space below. --
Open Drawing Form
Profile: 1 i X Y Z
Profile: 2 X Y Z
Profile: 3 X Y Z
Profile: X Y Z
Profile: X Y Z
Profile: 12 X Y _ Z
Profile: X Y Z
Profile: i X Y Z
Profile: X Y Z
Profile: X Y_ Z
,a APPLICATION FOR SITE EVALUATION/IMPROVEMENT PERMIT& EIVED
Davie County Environmental Health
i..
P.O.Box 84&710 Mocksvillc,NC Z7028tal t OCT
10 2016
(336)753-67801 Fax(336)753-1680 nn
Application For. I✓5itc vnivation/improvement Permit Authorization To Construct(ATC) I BotVC HEALTH
Type ofApplication: IvNew System CtRcpair to Existing System ` Expansion/Modification of Existing System or Facility
'••1b1PORTAM"-THIS APPLICATION CANNOT HE PROCESSED UNl TSS ALL OF THE REQUIRED
INFORMATION IS PROVIDED. Refer to the INFORMATION BULLL•TIN for instructions.
APPLICANT INFORMATION
Name S-�D�1P_n &KLfh—trine J-�arper contact Person :b+1geyint: Hay-per _
Address 9-%Q V_iJcigV J. Home Phone 33 Co • `I'10• AR I A �
City/State!ZIP C 1 G 1 r nQ nS, tJ a'1!j 1 a Bae=4%Phone 33 Ce• G�t 5 • 3 1 ei'1 _ i
tca'Fm�lArp oanet�o(Ze tr. t^Emil: kv�ylnlnu�rQ('rca�ta�opG 'Yti
Name on Permit/ATC if Di jJerew than Above (v a w►r-)_ City/State/Zip �sav,ne�
PROPFRTY INFORMATION *Date HousciTacilit Corners Fla=cd %t� O
NOTE: A survey plat or site plan must accompany this application. Includcd..[�itc Pla<*lat(to scale)a
(Permit is valid for 60 months with site plan,no cxp' ation with complete plat.) �-
Otvncr's Nanic t?.5N Q. t- \1 l k1,,�-►_ Phone Number-
Owner's
umberOwner's Address tf b City/State/Zip Ko G %lie- 1 1C 4-) 0
Property Address t 1 City Mo( K t y/ .
Lot Sizc rTax PIN#:"a
Subdivision Namc(if applicable) Section/Lot1E
Directions To Site: -110 t O� • i 1-1 ` d WOW
h
If the answer to any of the following questions is"Ycs",supporting documentation must be attached: ,
Arc there any existing wastewater systems on the site? Yes No
Docs the site contain jurisdictional wetlands? Yes No
Are there any,easements or right-or ways,on the site? Yes No
Is the site subject to approval by another public agency? , Yes No ,
Will wastewater other than domestic`sewa ?'= Yes No
IF RESIDENCE FILL O E BOX BELOW N W\H
#People Bedroo,ns 3 i! a ootns 3 Garden Tub/Whirlpool t Yes , � o
Basement: ('t Yes _ o Basement Plumbing: 1 No_
IF NON-RESIDENCE FILL OX BELOW
Type of Facility/Business i ` 1G until ',,14 a Total Square footage of Buildin�jo M6� t`A 000 fl People�_
t/Sinks 3- tl Co _ des ` 3 H Shower's -H Urinals 0
Estimated Water Usage(gallons per day) (Attach documentation of similar facility water consumption
FOODSERVICE ONLY: #Scats
Type system requested: PtConventional :.PAccepted .,Innovative [:;Alternative 1110ther_
kater Supply Type:O County/City'Water; New Well I,1Existing Well FI Community Well
D you anticipate additions or expansions ohk facility this system is intended to serve? L Yes 1VNo
If yes, what type?
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