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247 Essex Farm Road Lot 19Davie Countv. NC Tax Parcel Report Tuesday, December 20, 2016 249 239 O Lr phmtAAll WARNING: TIHS IS NOT A SURVEY data Is provided as Is withoutwammy or guaranies of any kind elther expressed or Implied Induding but not limited to the Impged wanarardles of merchantability or Itness for a pardcularuse. All users of Davie Counys GIS webshe shall hold harmless the county of Davie. Norlh Carolina, fts agents, consultants, cmrtradors or employees from any and all dalms or causes of action due to or arising out ufthe use or Inabirty to use the GIS dm provided by this website. Parcel Information Parcel Number: F803OA0019 Township: Shady Grove NCPIN Number. 5870651025 Municipality: Account Number: 82521386 Census Tract: 37059-803 Listed Owner 1: DAVID S MALLARD CONSTRUCTION Voting Precinct: EAST SHADY GROVE Mailing Address 1:- 120 BRITTINGTON DRIVE Planning Jurisdiction: Davie County City: LEWISVILLE Zoning Class: DAVIE COUNTY R -A State: NC Zoning Overlay: Zip Code: 27023-9794 Voluntary Ag. District: No Legal Description: LOT 19 ESSEX FARM PHASE 1 Fire Response District ADVANCE Assessed Acreage: 0.68 Elementary School Zone: SHADY GROVE Deed Date: 5/2008 Middle School Zone: WILLIAM ELLIS Deed Book/Page: 007580789 Soil Types: GnB2 Plat Book: 0009 Flood Zone: Plat Page: 290 Watershed Overlay: DAVIE COUNTY Building Value: Outbuilding & Extra Freatures Value: Land Value: Total Market Value: Total Assessed Value: phmtAAll Davie County, NC data Is provided as Is withoutwammy or guaranies of any kind elther expressed or Implied Induding but not limited to the Impged wanarardles of merchantability or Itness for a pardcularuse. All users of Davie Counys GIS webshe shall hold harmless the county of Davie. Norlh Carolina, fts agents, consultants, cmrtradors or employees from any and all dalms or causes of action due to or arising out ufthe use or Inabirty to use the GIS dm provided by this website. ION FOR SITE EVALUATIONQMPROVEMENT PERMIT & ATC Davie County Environmental Health - P.O. Box 848/210 Hospital Street - Mocksville, NC 27028 " (336)751-8760/Fax (336)751-8786 - Evaluation/Improvement Permit D Authorization To Construct(ATC) 0 Both Iew System ORepair to Existing System OExpansion/Modification of Existing System or Facility HIS APPLICATION CANNOT BE PROCESSED UNLESS ALL OF THE REQUIRED . . I INFORMATION IS PROVIDED. Refer to the INFORMATION BULLETIN for instructions. -4 73 Name to be Billed A5C /Jc'VB6*PRNcNr eat Ze-7C- Contact Person 7a,fAY Billing Address A.*.Q.x 3fo Home Phone r - City/State2IP 46o4 Lew,4 -C. 27OZ3 Business Phone 7S/- 73o0 - - Name on Permit/ATC if Different than Above Mailing Address City/State/Zip NOTE: A survey plat or site plan must accompany this application Included: 0 Site Plan ylat(to scale) (Permit is valid for 60 months with site plan, no expiration with complete plat) - Owner's Name .De*VELOPnc'Ni cae, 1,44, Phone Number 7S/ • 73� Owner's Address Po Boj-la - City/State/Zip7o2a Property Addres City - Lot Size - Tax PIN# - Q Subdivision Name(i applicable) , d'S5.Fx PAAm - . rSectioo/Lot#_ answer to any of the follm4ing 4uestionsris" yes", support ng documentatio99 most be attdched. - Are there any existing wastewater systems on the s_i[e7 DYes OfJyy - - " Does thesite containjurisdictional wetlands? Dyes ONo Are there any easements or right-of-ways on the site? Ores ❑ o - Is the site subject to approval by another public agency? Oyes <3Np - IF RESIDENCE FILL OUT THE BOX BELOW - #People #Bedrooms :4 #Bathrooms Garden Tub/Whirlpool OYes ONo Basement: OYes ONo Basement Plumbing: OYes ONo - - .t 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: Mriventional DAccepted OInnovative ❑Alternative ❑Other Water Supply Type: O'Ccunty/City Water 0 New Well DExisting Well D Community Well Do you anticipate additions or expansions of the facility this system is intended to serve? 0 Yes - - ONo 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 permit(s) 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 rules. I understand that I am responsible for the proper identification and labeling of property lines and comers and locating an agging or staking the house/facili location, proposed well location and the location of any other amenities. Site Revisit Charge I?ropert r. r oro er's legal represents re Date(s): - Client Notification Dale: Date -1 - EHS: Sign given OYes ONo - Account # Revised 11106 Invoice# Landscape posi6on •.uuamwuw . .' M�ti K _t. t . Structure' Mineralogy HORIZON H DEPTH'. :, S- (pq to 21 - 26 '7, (925 Texturegroup. Consistence. (; G•` Structure Mineralo HORIZON III DEPTH,-"_,'. °. TeXtUregroup Consistence; Structure 4: '''Ivlineralo � HORIZON;IV.-DEPTH t'..Texture .group-, - Consistence Structure .-Mifieralogy SOIL WETNESS RESTRICTIVE HORIZON SAPROLITE.. CLASSIFICATION 3 LONG-TERM ACCEPTANCE RATE SITE CLASSIFICATION: 1"J EVALUATION BY: L� ©. . ..LONG-TERM ACCEPTANCE RATE. p OTHERS) PRESENT: REMARKS: 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 loamL - Loam SI Silt SICL Silty clay loamSIL -,Silty loam CL - Clay loam SCL - Sandy clay loam' SC - Sandy clay SIC - Silty clay' (C - Clay CONSISTFNCF. Moist V FR - Very friable FR - Friable FI = Firm V aid FI Very firm EFI - Extremely firm 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- Subangularblocky` PL Platy PR -Prismatic Mineralogy . 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) DAVIE COUNTY HEALTH DEPARTMENT Environmental. Health Section , Soil/Site Evaluation APPLICANT INFORMATION PROPERTY INFORMATION Account #: 990004425 Tax PIN/EH #: 5870-64-2265.19 Billed To PSC Development Corp. Inc. Subdivision Info: Essex Farm Lot # 19 / Reference Name: Brad Coe "Location/Address: Cornatzer Rd -27006 Proposed Facility: Residence Property Size 0.691 Ac, Date Evaluated: l 8 Water Supply: On -Site Well Community Public Evaluation By: Auger.Boring Pit— 'r,a _,:Cut Landscape posi6on •.uuamwuw . .' M�ti K _t. t . Structure' Mineralogy HORIZON H DEPTH'. :, S- (pq to 21 - 26 '7, (925 Texturegroup. Consistence. (; G•` Structure Mineralo HORIZON III DEPTH,-"_,'. °. TeXtUregroup Consistence; Structure 4: '''Ivlineralo � HORIZON;IV.-DEPTH t'..Texture .group-, - Consistence Structure .-Mifieralogy SOIL WETNESS RESTRICTIVE HORIZON SAPROLITE.. CLASSIFICATION 3 LONG-TERM ACCEPTANCE RATE SITE CLASSIFICATION: 1"J EVALUATION BY: L� ©. . ..LONG-TERM ACCEPTANCE RATE. p OTHERS) PRESENT: REMARKS: 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 loamL - Loam SI Silt SICL Silty clay loamSIL -,Silty loam CL - Clay loam SCL - Sandy clay loam' SC - Sandy clay SIC - Silty clay' (C - Clay CONSISTFNCF. Moist V FR - Very friable FR - Friable FI = Firm V aid FI Very firm EFI - Extremely firm 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- Subangularblocky` PL Platy PR -Prismatic Mineralogy . 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) n Davie County Environmental Health P.O. Boz 848/210 Hospital Street Mocksville, NC 27028. (336)751-8760/ Fax(336)751-8786 Account #: 990004425 :IMPROVEMENT PF-�q*,1F'INIEH #: 5870-64-2265.19 Billed To: PSC Development Corp. Inc. __Subdivision Info: Essex Farm Lot # 19 Address: PO Box 340 Location/Address: Cornatzer Rd -27006 City: Mocksville Property Size: 0.691 acre Reference Name: Brad Coe 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:Aew ❑Repair. DExpansion Permit Valid for: 05 Years/FfNo Expiration Residential Specifications: #Bedrooms 4 #Bathrooms_#People BasementOBasement plumbing0 Non -Residential Specifications: Facility Type - # People_ # Seats_ - Square Footage(or Dimensions of Facility) DesignFlow(GPD): f i� Type of Water Supply: Bounty//City DWell DCommunity Well Site Modifications/Permit Conditions: 'i�—)(Utier `S -of Jf Vex. wwa—=k Sile Plan �e ra lI S stemT e LTAR Initial TLn-> 1p.2J Repair g7.2� Sile Plan �e ra lI