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303 Montclair Drive Lot 13Davie County. NC Tai P;Ar•ccl Rrtwnrl Tbursday. October 20. 2016 P«root 'Number: NCPIN Number: Account Number: L1n-tcd 0-.n,ic. 1: Mailing Address 1: City: State. Zip Code: Legal Description: Assessed Acreage: Deed Date: Beed Book ! Page: Plat Book: Plat Page: Building Vat;.lc: WARNINU:'IHIS 1S N( -"!'A SURVEY Tl t T, /• 1 Ul \.L1 lllltl1111UL1Vli 1=70000001802 To:tr=hip: Shady Grove 5870062127 Municipality: Flood Zone: 17626000 Census Tract: 37059-803 CORNATZER GUY J JR Vcting Precinct: 1,NIEST SHADY GROVE 305 MONTCLAIR DRIVE Planning Jurisdiction: Davie County ADVANCE Zoning Class: DAVIE COUNTY R -A NC Zoning Overlay: DAVIE COUNTY QD 27006-0000 Voluntary Ag. District: No 5.171 AC OFF SALTIN110RE RD Fire Response District: ADVANCE Land VzIu-:: Total Assessed Value: 5.16 Elementary School Zone: SHADY GROVE 2/1989 Middle School Zone: WILLIAM ELLIS 001510776 Soil Hypes: Iv1rC2,PcB2,PcC2,ChA Flood Zone: Watershed Overlay: DAVIE COUNTY ().Co Out-b:Nd'.ng a Extra 24290.00 Freatures Value: 50 ;20.00 Total !'art:-nt Vztuc: 74710.00 74710.00 All data Is provided as is without warranty or guarantee of any kind either expressed or lmpli d Ind. ding hurt 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 cavie, ilcrt'!I Ca: c;]na, its agents, consultants, contractors or employees from any and a:1 cla;rrs or causes of action due to 1 �pDC NC or arising out of the use or Inabiilty to use the GIS data provided by this webslte. it DAVIE COUNTY ENVIRONMENTAL HEALTH P.O. Box 848/210 Hospital Sheet Mocksville, NC 27028 (336)751-8760 Fax # (336)751-8786 AUTHORIZATION FOR WASTEWATER SYSTEM CONSTRUCTION Account #: 990002232 Tax PIN/EH #: 5870-06-2127 Billed To: Guy Cornatzer Subdivision Info: Reference Name: Location/Address: Montclair Drive -27006 Proposed Facility: Residence Property Size:: 6.357 ATC Number: 4923 Site Type: ❑New ❑Repair ❑Expansion **NOTE** This Authorization to Constrict (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 chanize. Residential Specifications: # Bedrooms 3 # Bathrooms � •J�-# People / Basement❑ Basement plumbing❑ Non -Residential Specifications: Facility Type # People # Seats_ Square Footage(or Dimensions of Facility) Lot Size ':3 Type of Water Supply: ounty/City ❑Well ❑Community Well 3 rco System Specifications: Design Wastewater Flow (GPD) Tank Size � ooc GAL. Pump Tank 4� GAL. Trench Width Max. Trench Depth 3G Rock Depth.A�/Linear Ft. - As z►.,ated in IGA NLAC 18 .i90%5) 01'��li Site Modifications/Conditions/Other:=t4�V���a�� . ulu 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. —7 DLG . Environmental Health Speciali S� M%, 'V Date: 1 —d Account #: 990002232 Billed To: Guy Cornatzer Reference Name: Proposed Facility: Residence ATC Number: 4923 DAVIE COUNTY ENVIRONMENTAL HEALTH P.O. Box 848/210 Hospital Street Mocksville, NC 27028 (336)751-8760 Fax # (336)751-8786 OPERATION PERMIT Tax PIN/EH #: 5870-06-2127 Subdivision Info: Location/Address: Montclair Drive -27006 Property Size: 6.357 **NOTE** The issuance 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. System Type: S.T. Manufacturer SCR- Tank Date 3 Tank Size 16Ws-av( Pump Tank Size System Installed By: )t2%UAe, 3axr&r E.H. Specialist: 3o Date: DCHD 11/06 (Revised) J Davie County Environmental Health P.O. Box 848/210 Hospital Street Mocksville, NC 27028 (336)751-8760/ Fax (336)751-8786 IMPROVEMENT PERMIT Account #: 990002232 Tax PIN/EH #: 5870-06-2127 Billed To: Address: City: Reference Name: Guy Cornatzer 223 Montclair Drive Advance Subdivision Info: Location/Address: Montclair Drive -27006 Property Size: 6.357 Proposed Facility: Residence **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: ❑ ew ❑Repair ❑Expansion Pemrit Valid for: 55 --Years ❑No Expiration Residential Specifications: # Bedrooms # Bathrooms I 5�-# People Basement❑ Basement plumbing❑ Non -Residential Specifications: Facility Type # People # Seats_ Square Footage(or Dimensions of Facility) Design Flow(GPD): 3 (E U Type of Water Supply: ounty/City ❑Well ❑Community Well As stated in 16A Pb AL 18A.1969(5) Site Modifications/Permit Conditions: amoptF d Sntemt Tway alto bit usa System Type LTAR Initial cee oall, od6. Repair e c Environmental Health Specialist i.p.1 l-06 Date�i�,� APPLICATION FOR SITE EVALUATION/IMPROVEMENT Davie County Environmental Health-"_- P.O. Box 848/210 Hospital Street Mocksville, NC 27028 (336)751-8760/ Fax (336)751-8786 Application For: 114Site Evaluation/Improvement Permit ❑ Authorization To Const ct(A vv��R� B�Vacility Type of Application: ❑New System ❑Repair to Existing System ❑Expansion/Modifica 'on of Exigfl ***IMPORTANT*** THIS APPLICATION CANNOT BE PROCESSED UNLESS ALL OF7HE REQUIRED INFORMATION IS PROVIDED. Refer to the INFORMATION BULLETIN for instructions. APPLICANT INFORMATION Name to be Billed U, -L �Contact PersonMarwA�e. CormLzcms Billing Address Home Phone City/State/ZIP -C . 1000 U Business Phone Name on Permit/ATC if Different than Above Mailing Address S loryyl {e, City/Sta PROPERTY INFORMATION *Date House/Facility Corners Flagged_ NOTE: A survey plat or site plan must accompany this application. Included: f'I Site Plan ❑Plat(to scale) (Permit is alid for 60 onths with site plan, no expiration with complete plat.) Owners Name � z�r� ('Phone Number Owner's Address' n- 1�.. City/State/Zip CLY1CX_ c �. Property Address !i�Vy\ :;* ity r Lot Size U „ 35 Tax PIN (� �� � �%Q a(0 Z� Z7 Subdivision Name(if applicable) S ctio- ot# Directions To Site: 4-, PAD 2e, -'A A.ares Mr,..�r_to m T--) (L. a �- +I(.,,e- If the answer to any of the following questions is "yes", supporting documentation must be attached. No 14 &0 ` Are there any existing wastewater systems on the site? []Yes Cfio Does the site contain jurisdictional wetlands? Dyes ET l �l S i a Are there any easements or right-of-ways on the site? Dyes 70 Is the site subject to approval by another public agency? Dyes CSN Will wastewater other than domestic sewage be generated? Dyes IF RESIDE CE FILL OUT THE BOX BELOW # People Ll # Bedrooms # Bathrooms ' ?� Garden Tub/Whirlpool ❑Yes 2Ko Basement: ❑Yes Ko Basement Plumbing: ❑Yes ❑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:. /c/onventional ❑Accepted ❑Innovative ❑Alternative ❑Other Water Supply Type: [;�_&unty/City Water ❑ New Well ❑Existing Well ❑ Community Well Do you anticipate additions or expansions of the facility this system is intended to serve? ❑ Yes 2_1 I0 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 any permits) 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 riles. I understand that I am responsible for the proper identification and labeling of property lines and comers and locating and flagging or staking the house/facility location, proposed well location and the location of any other amenities. ak t; Site Revisit Charge Property o is or owne s legal representative signature Date(sAn ): log Iry I I C, 4rt, , Client Notification Date: Date EHS: Sign given ❑Yes ❑No � 5 4 C Account # ZZt� Revised 11/06I1 � ��� � 1 1 � Invoice # �_�_ 6L.I-�-�- T W GoMAPS - Davie County NC Public Access Davie County, NC - GIS/Mapping System Page 1 of 1 Click Here To Start Over Quick Search:(County ID c •�� �``" ti�1 Active Layer. RffseMap T►ps GIS PARCELS (Map Tips Available) L�'j Map Layers i Results i http://maps.co.davie.nc.usIGoMapslmap/Index.cfm?maimnapservice=gomaps&CFID=412... 11/3/2008 DAVIE COUNTY HEALTH DEPARTMENT ' Environmental Health Section Soil/ Site Evaluation APPLICANT INFORMATION PROPERTY INFORMATION Account #: 990002232 Tax PIN/EH #: 5870-06-2127 Billed To: Guy Cornatzer Subdivision Info: Reference Name: Location/Address: Montclair Drive -27006 Proposed Facility: Residence Property Size: 6.357 Date Evaluated: eg Water Supply: Evaluation By: -11- On-Site Well Community Auger Boring Pit Public Cut FACTORS 1 2 3 4 5 6 7 Landscape position Slope % �-- HORIZON I DEPTH Texture group G• C_ L e Consistence t� Structureto t Mineralogy HORIZON 11 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 O� �. 1 D • .� SITE CLASSIFICATION: r LONG-TERM ACCEPTANCE RATE:_ REMARKS: EVALUATION BY: F" .jyoi� OTHER(S) PRESENT: Cy !", y , CG✓G+ l [f 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 u1_ VFR - Very friable FR - Friable FI - Firm VFI - Very firm EFI - Extremely firm mit 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 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 05/05 (Revised) C° NOTES: Hwy to a L ayn Robe State, Ptofssubnd Land Surveyor. L-31�19Hne 1. Current Parcel Zoning: R/A 2. Watershed classification: WS—IV Protected 3. Total Acreage of Subdivism lots: 9.949 Acnes+/ - 4. Number of proposed lob: 12 Average lot size: 0.829 Acres+/— 5. The subject parcel is not located in a Special Flood Hazard Area as dekennirted by w4ling HUD/Fsma Maps C� Community—Panel No.: 370308 0100 C/bated 12-17-93 6. The subject parcel is predominantly wooded 7. All lots to be served by public water 8. Al lots to be served by private septic tank systems 9. All utilities shall be installed underground 11. 1/21' rebars placed at each comer unless otherwise specified 12. Setbacks: Front -40'; Side -15'; 25' at any street R/W; Rear -30' 50' R/W 20' Pavomen t V Shoulder 10, 1 10' 6' Shoulder 6' Ditch 1/4" per R. 1.5" 1-2 t" 7gr le Terrain Max. SlopeLevel 2 1 Rolling 2 : I Hi I ly 1.5 : I Proposed Street Quantity. 3500 Square Yards +/— Proposed Pavement Removal: 315 Square Yards 1 w R.w 1 I(MAVIL or WTPAMM)f sly I b 417 TYPICAL DETAIL BOX CUL DE SAC X 7H-750 — Test Hde / 750 (Pink Fogs) Protfsrty Comm — Wood StaksslOronge Flvggfng Proposed Street Canter Line — Orange Floggrny' Ill I 100 200 300 rrsl■r..■■■ GRAPHIC SCALE — FEET ■r.r..rrr■ Filed for registration at o'clock M Po and recorded In Plot Rook Pape M. Brent shoef, Resistor of Deeds Filing Fee Paid by DEPUTY -ASSISTANT STATE of NORTH CAROLINA COUNTY of DAVIE I, John OaNtmore. Review Offlosr of Davis County, certify that the map of plat to which this certification is affixed meets all statutory req iwtlenb for recording. 9=. , T*T2__T17k R/W _ Rlyht-of_�, Center ante Una ken nabor IF Lkw R=9 Ir" - Ed aam Center PCurb end � Foos of Curb P�p$ - Poser Kola � - leen Rabor Sett I //Monurnenr, D!1 =&= PA - Property Une R p�� C A - Controlled Atxese of CP - Conerels Pipe -thell CW - Competed Metal Pheook -F- 100 Flood BouBoundary In y lMMklee„ Curb ��/ ' I t Tax Map F-7 s - -- I Tax Lot 23.04 Betty Sue Comatzer Tucker IDB 208 O PG 155 Zoning: R/A I Vicinity Map (Not to Scab) I � 1, George Robert •tape, certify that this plat was drew ander eg supsrvislon from as ec►ual survey rude under cry supervision (deed descriptles recorded nP Reek , Page ate.) (other): that the bounder lea not , survaye0 aro clearly ladleated as dram fruitsIsfortnotlen found is Rees Pegs that the ratio of precision as calculated Is V10,000; that this Tax M a p F-7 plat wee pr *pored In secerdenae with 47 so as attended. WltPess my orlRlael ' slonsturo, registration Poseur sod seal Tax Lot 18.02 I :k Is def of A.O. Seal or S t atop Cd1ams R_ Stent Guy J. Cornatzer, Jr. Tax Map F-7 a/w Marcello B. Comatzer DB 151 • PG 776 ' Tax Lot 18.04 : R/A I Stacoy L” Myer' ZoningTax Map F-7 DS 51 O PG 779 Zoning: R/A I Tax Lot 23.03 Glenda Comatzer Mills a/h Gregory Phillip Mills I DB 152 O PG 711 Zoning: R/A ----------- I 1� surveyor L 3162 Registration Monier is-.- \ ' The Davie County Planning Board hereby approved RCP j I the Mal plot for the POND+/- Subdivision. Branch —+( \ 8_ P►.C_ � Dab 730 - I \ \\ / i Cftairrnan, County Planning Board wood l= --- I i"E 145.01 • ` � �-_—_� _ , \ W I DEPARTMENT OF TRANSPORTATION TH-73 DMSION OF HIGHWAYS X X735 PV0POSED SLIUVO N AMC coon"oxnm SwIMsoS �sxmm 740 r •f+ - g tatE 2001.DISTRICT D004EER it }� 1 2' w Off 'flasembly � 2 wTE TN J6 TH-737 O 8 1 ♦ i ` X t 1 .00'\ \ 1.031 Acres +/- 8 weed S 89.44'07"E 345.01' 750 415'+/- 1 ✓ _ -- 2" SDR 21 PVC W/L 1- - I M - 738 X TH - 739 Q1)p 1 hereby cerWy that the Davie Convoy Health 0.792 Acres +/- 1 -- Deparbnerlt has evaluated the Subdivision 1 entitled with 1 TH - 740 10 S I T eepa)t to artteric a14 conditlons established 1 X TH-741 760 x--0.792 Acres +/ by state low or prornulgated thereunder and the ` I ; some is found to comply with such arterio and 1 345.01' 1 oondrdn is EXCEPT as found In such evaluation. jTH-742 rH 7� 9Wood 1* For detoNs d this evaluation and for lirilltatiorte X _ x see the written report on file at the saki ' 0.792 Acres +/- 1 345.01' 111112MANT NOTICE: THIS CERTIFICATE DOES NOT CONSTM) E A PERMR OR X 770 - 1 Fire vont 7H- 744 h •� � f 1 $ X TM_745 S g � t _. - --- - APPROVAL OF warmDUAL LOTS IN SAID SUIDIVIS10N J ' Mood L1 . 0.792 Acres +/- - g FOR WALIA1710N OF SEWA0E FACILITIES 345.01' 468'+/- 1 - TH_ 6" 14/L 1 X X 8 Dab County. Health Officlol 0.792 Acres +/- 8 N r I345.01' 1 I Tax Map F-7 Tax Lot 18.09 '8_ X7.9 © g C 780 i y 0.792 Acres h �Clltford E. Brown I 1 3 01' a/w Harriett T. Brown ' O PG DB 178 807 1 \'� I xistin/y 30' Easement ove a Zoning: R/A I 1O TH-758 TH-759 00 7 Q X X _ I Rom isting cul-de-sac see t removal quantity 0.935 Acres + � / t . S 89e44'07"E 345,01, I Ballunore . Montclair Drive e ,Easement t , S °0'44' Fire k ant ,/l 205• r 60 Public R/W 20'+1 -Pavement . _ _ _ t— _ _ �= � _ 7 PB 6 ® PG 76 �, 134.93 13x66' T,_,5,, , ximate location of b I X X X -\ ETI D�field verified `\ i\ flood lone -730 'I T X 732 7N- 756 Fire I w I01 310'+ 6" SDR 21 PVC _ Z 1 / _ Length subject to actual ma/y_. _ _ - 0.702 Acnes location of exisitng fin hydrant _- X X �► X 0.693 Acf� n+- +/- n+- 755 TM_ 7s7 753 Q ihi to A / Rood L 150.41 138.72' 138.72' 136.73' 01 N 89°80'25"W 568.58' Tax Lot 23.02 Tax Map F-7 I Preliminary Plan Of Baltimore Heights Phase 2 Part of Tax Lot 18.02 Tax Map F-7 f n Deed Book 151 O Page 776 J / Montclair Drive 9.949 Acres +/— by Computer SCALE TOWNSHIP COUNiY STATE DATE 1" - 100' Shady Grove Davie North Carolina 4-07-2002 ,mw,ED. Stone Land Surveying Company ,w o, RS,BN Gear" Rebert Sone, Pts L-3162 3602 MAPPED: 113 Drum Lane Phone (336) 998-4733 IMP NO. GRS.JC Mocksville, N.C. 27028 3802 t Hwy to a L ayn Robe State, Ptofssubnd Land Surveyor. L-31�19Hne Otto FDI, i w , 0, A d tier. ® or LrJy. : a That this phi Is of o survey Mot crashes a rtbsiddon of land w*dn Mr arae of a eaunpr or rrnaddpoft that has an atinarhoe the repdatu pooch of lank h. lhet tis plat Is of a survey out is Meshed In ouch 0 *111 d o sewn or roialp ft hetet Is unta*deMd as to an ertRnerw Mot tyuMw , - d Mrtk O a That t i piat h M a wewy d m w' " pored er pwaeh of lank d. 'that #6 PM Is of a aavrr of sinew oalegs ) such as ilia 11 neanbboeen of end poroeh, a east -ardaad survey or otlor •tlewM to M» "A" of ""kan; a lid Mho bdanM - a vl" to Mie euv%w b atssh the t ern anew to snob a dehrn a wft M the but of nV praleedortd oUft w- provldao onlWod In (a) thnxril+ (4) oboes Ped=" Lard MNV% ►. L-310 I (we) hereby o@rWy that I an (we are) the owrw(s) of the propel► described hereon. whish Is located In Rhe subdivision Priodietien of Davis Cavity and thou hereby adopt this rA dvidon plan with my free 19n ' t. MWAR Ilsd miNnnrn buidrp sed moll IR1ss end dedicate all °Ill to alleys, walks, port and OWNERS: other styes and eaeornanb to public or privets use as noted. Guy L Comatzer. Jr. Marcella B. Comatzer oats 223 Montclair Drive Advance, N.C. 27006 oerParW Ph.:(336) 998-5033 Clifford E. Brown Dote • Harriett T. Brown 221 Montclair Drive Does OWW(e) Advance, N.C. 27006 Filed for registration at o'clock M Po and recorded In Plot Rook Pape M. Brent shoef, Resistor of Deeds Filing Fee Paid by DEPUTY -ASSISTANT STATE of NORTH CAROLINA COUNTY of DAVIE I, John OaNtmore. Review Offlosr of Davis County, certify that the map of plat to which this certification is affixed meets all statutory req iwtlenb for recording. 9=. , T*T2__T17k R/W _ Rlyht-of_�, Center ante Una ken nabor IF Lkw R=9 Ir" - Ed aam Center PCurb end � Foos of Curb P�p$ - Poser Kola � - leen Rabor Sett I //Monurnenr, D!1 =&= PA - Property Une R p�� C A - Controlled Atxese of CP - Conerels Pipe -thell CW - Competed Metal Pheook -F- 100 Flood BouBoundary In y lMMklee„ Curb ��/ ' I t Tax Map F-7 s - -- I Tax Lot 23.04 Betty Sue Comatzer Tucker IDB 208 O PG 155 Zoning: R/A I Vicinity Map (Not to Scab) I � 1, George Robert •tape, certify that this plat was drew ander eg supsrvislon from as ec►ual survey rude under cry supervision (deed descriptles recorded nP Reek , Page ate.) (other): that the bounder lea not , survaye0 aro clearly ladleated as dram fruitsIsfortnotlen found is Rees Pegs that the ratio of precision as calculated Is V10,000; that this Tax M a p F-7 plat wee pr *pored In secerdenae with 47 so as attended. WltPess my orlRlael ' slonsturo, registration Poseur sod seal Tax Lot 18.02 I :k Is def of A.O. Seal or S t atop Cd1ams R_ Stent Guy J. Cornatzer, Jr. Tax Map F-7 a/w Marcello B. Comatzer DB 151 • PG 776 ' Tax Lot 18.04 : R/A I Stacoy L” Myer' ZoningTax Map F-7 DS 51 O PG 779 Zoning: R/A I Tax Lot 23.03 Glenda Comatzer Mills a/h Gregory Phillip Mills I DB 152 O PG 711 Zoning: R/A ----------- I 1� surveyor L 3162 Registration Monier is-.- \ ' The Davie County Planning Board hereby approved RCP j I the Mal plot for the POND+/- Subdivision. Branch —+( \ 8_ P►.C_ � Dab 730 - I \ \\ / i Cftairrnan, County Planning Board wood l= --- I i"E 145.01 • ` � �-_—_� _ , \ W I DEPARTMENT OF TRANSPORTATION TH-73 DMSION OF HIGHWAYS X X735 PV0POSED SLIUVO N AMC coon"oxnm SwIMsoS �sxmm 740 r •f+ - g tatE 2001.DISTRICT D004EER it }� 1 2' w Off 'flasembly � 2 wTE TN J6 TH-737 O 8 1 ♦ i ` X t 1 .00'\ \ 1.031 Acres +/- 8 weed S 89.44'07"E 345.01' 750 415'+/- 1 ✓ _ -- 2" SDR 21 PVC W/L 1- - I M - 738 X TH - 739 Q1)p 1 hereby cerWy that the Davie Convoy Health 0.792 Acres +/- 1 -- Deparbnerlt has evaluated the Subdivision 1 entitled with 1 TH - 740 10 S I T eepa)t to artteric a14 conditlons established 1 X TH-741 760 x--0.792 Acres +/ by state low or prornulgated thereunder and the ` I ; some is found to comply with such arterio and 1 345.01' 1 oondrdn is EXCEPT as found In such evaluation. jTH-742 rH 7� 9Wood 1* For detoNs d this evaluation and for lirilltatiorte X _ x see the written report on file at the saki ' 0.792 Acres +/- 1 345.01' 111112MANT NOTICE: THIS CERTIFICATE DOES NOT CONSTM) E A PERMR OR X 770 - 1 Fire vont 7H- 744 h •� � f 1 $ X TM_745 S g � t _. - --- - APPROVAL OF warmDUAL LOTS IN SAID SUIDIVIS10N J ' Mood L1 . 0.792 Acres +/- - g FOR WALIA1710N OF SEWA0E FACILITIES 345.01' 468'+/- 1 - TH_ 6" 14/L 1 X X 8 Dab County. Health Officlol 0.792 Acres +/- 8 N r I345.01' 1 I Tax Map F-7 Tax Lot 18.09 '8_ X7.9 © g C 780 i y 0.792 Acres h �Clltford E. Brown I 1 3 01' a/w Harriett T. Brown ' O PG DB 178 807 1 \'� I xistin/y 30' Easement ove a Zoning: R/A I 1O TH-758 TH-759 00 7 Q X X _ I Rom isting cul-de-sac see t removal quantity 0.935 Acres + � / t . S 89e44'07"E 345,01, I Ballunore . Montclair Drive e ,Easement t , S °0'44' Fire k ant ,/l 205• r 60 Public R/W 20'+1 -Pavement . _ _ _ t— _ _ �= � _ 7 PB 6 ® PG 76 �, 134.93 13x66' T,_,5,, , ximate location of b I X X X -\ ETI D�field verified `\ i\ flood lone -730 'I T X 732 7N- 756 Fire I w I01 310'+ 6" SDR 21 PVC _ Z 1 / _ Length subject to actual ma/y_. _ _ - 0.702 Acnes location of exisitng fin hydrant _- X X �► X 0.693 Acf� n+- +/- n+- 755 TM_ 7s7 753 Q ihi to A / Rood L 150.41 138.72' 138.72' 136.73' 01 N 89°80'25"W 568.58' Tax Lot 23.02 Tax Map F-7 I Preliminary Plan Of Baltimore Heights Phase 2 Part of Tax Lot 18.02 Tax Map F-7 f n Deed Book 151 O Page 776 J / Montclair Drive 9.949 Acres +/— by Computer SCALE TOWNSHIP COUNiY STATE DATE 1" - 100' Shady Grove Davie North Carolina 4-07-2002 ,mw,ED. Stone Land Surveying Company ,w o, RS,BN Gear" Rebert Sone, Pts L-3162 3602 MAPPED: 113 Drum Lane Phone (336) 998-4733 IMP NO. GRS.JC Mocksville, N.C. 27028 3802 t ***IMPORTANT*** THIS APPLICATION CANNOT BE PROCESSED UNLESS ALL THE REQUIRED INFORMATION IS fee- to the INFORMATION BULLETIN for instructions. 1APPUCATION >FUft SITE L1'ALUAI16,4/IRtI'1t0YBfENI . LIl,1ll / [x y ( c)�N4-T12-e Mailing Address Davie County Health Department I Home Phone 1 y • � ,,�,a <<�L� Environments/Nes/m Section P.O. Box 848/210 Hospital Street �� fj�p Al J in"tt �� 4 i,�d " ,, . ; G•,. ,.�''`" ockw11e, N 27 M 028 a (336)751-8760EfdUff'._, 1...'.li:(_ _- ,. f I�� hLlii ***IMPORTANT*** THIS APPLICATION CANNOT BE PROCESSED UNLESS ALL THE REQUIRED INFORMATION IS PROVIDEDD. Refer to the INFORMATION BULLETIN for instructions. 1. Name to be Billed / [x y ( c)�N4-T12-e 2- J!2 , Contact Person G 11 y __ _T Mailing Address (g o�1 � 73 /;7 o A-, •-c I Home Phone City/State/ZIP A- -, -C / /V! �. 2 7 qU t, Business Phone V •-) u 3 D 2. Name on Permit/ATC if Different than Above Mailing Address City/State/Zip 3. Application ror: EKSite Evaluation ❑ Improvement Permit/ATC Il Both 4. System to Service: "ouse ❑ Mobile Home ❑ Business ❑ Industry IJ Other 5. If sidence: It People ;t Bedrooms # Bathrooms Dishwasher CI Garbage Disposal I ashing Machine t Basement/Plumbing II Basement/No Plumbing 6. If Business/Industry/Other: Specify type # Commodes # Showers # Urinals # People # Sinks # Water Coolers IF FOODSERVICE: # Seats Estimated Water Usage (gallons per day) 7. Type of water supply: O-County/City U Well CI Community s. Do you anticipate additions or expansions of the facility this system is intended to serve? ❑ Yes )&No If yes, what type? ***IMPORTANT*** CLIENTS MUST COMPLETE THE REQUIRED PROPERTY INFORMATION REQUES'T'ED BELOW. Either a PLAT or SITE PLAN MUST BESUB311TTED by the client with THIS APPLICATION. Property Dimensions: /v - Tax Office^ IN: # " S 6 - ` S 5 C13 Property Address: Road Name �O^}C.(ai� pr ✓� City/Zip /loly Z ?o o G If in a Subdivision provide information, as follows: Name: MiO Section: Block: Lot: /.3 WRITE DIRECTIONS (from Mocksville) to I'1 OPERTY: Date Property Flagged: w t H /( rr "'C- This is to certify that the information provided is correct to the best of my knowledge. I understand that any permits) 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 incrrrred 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 determine the site suitability. DATE - G L SIGNATURE THIS 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). Revised DCHD (07/99) Site Revisit Charge Datc(s): Client Notification Date: EMS: Account No.�- Invoice No.V �Ry 1� � r • 1 APPLICANT INFORMATION DAME COUN'T'Y HEALTH DEPARTMENT Environmental Health Section Soil/Site Evaluation Account M 990002232 Billed To: Guy Comatzer Reference Name: Proposed Facility: �e*dence Water Supply: On -Site Well PROPERTY INFORMATION Tax PIN/EH #: 5860-95-1543.13 Subdivision Info: Baltimore Heights Lot # 13 Location/Address: Montclair Drive-270P6/� Property Size: see map Date Evaluated: L ye Z_ Community Evaluation By: Auger Boring Pit Public L� Cut FACTORS 1 2 3 4 5 6 7 Landscape position L. Slope % U HORIZON I DEPTH V& Texture group, Consistence Structure Mineralogy HORIZON II DEPTH Texture group Consistence / J Structure ,� S 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 SITE CLASSIFICATION: (/ n LONG-TERM ACCEPTANCE RA' REMARKS: 0 EVALUATION BY:"`L/ /OTHER(S) PRESENT: �-T zll /�5) 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 CONSISTENCE Moist 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 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 05/99 (Revised)