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108 West Rolling Meadow Road Lot 13Davie Countv, NC Tax Parcel Report r 4 181 F t r i 1 I I i I I I 126 I I i 1 t I I IN ROLLINGMEADOW RD ---------- --- 1 r I ! I I j I ! I -- ---------------127 ---...—------------._'� Wednesday, December 21, 2016 188 176 N 125 166 1 1 11 I I ! E ROLLIN6MEADMI RD I r 1 ( i 5 it 152 1r WARNING: THIS IS NOT A SURVEY Parcel Information _ Parcel Number: NCPIN Number: Account Number: Listed Owner 1: Mailing Address 1: City: State: Zip Code: Legal Description: Assessed Acreage: Deed Date: Deed Book / Page: Plat Book: Plat Page: Building Value: Land Value: Total Assessed Value: H908OA0013 Township: Shady Grove 5789631385 Municipality: Fire Response District: 82527002 Census Tract: 37059-804 OSBORNE KENNETH D Voting Precinct: EAST SHADY GROVE PO BOX 391 Planning Jurisdiction: Davie County ADVANCE Zoning Class: DAVIE COUNTY R -A NC Zoning Overlay: 27006-0391 Voluntary Ag. District: LOT 13 FALLINGCREEK FARM PHASE I Fire Response District: 0.69 Elementary School Zone: 9/2006 Middle School Zone: 006810515 Soil Types: 0007 Flood Zone: 048 Watershed Overlay: Outbuilding & Extra Freatures Value: Total Market Value: No ADVANCE SHADY GROVE WILLIAM ELLIS PcB2, PcC2 DAVIE COUNTY E61 l data is provided as Is without warranty or guarantee of any Idnd either expressed or Implied Including but not limited to the Davie County, Implied warranties ofmerchantability orfitness fora particular use. All users of Davie County's GIS website shall hold harmless the Carolina,ntCounty of Davie, North Caroa, Its agents, consultas, contractors or employees from any and all claims or causes of action due to NC or arising out of the use or Inability to use the GIS data provided by this websHe. F'+r �.N'.:'b..b%'.F tri a;;,;nys'% $".''. hyb,,"y.'r'9•.;,t )nuc: 3t `c y"" 64i S. -a °,Y4"t w"''.'"�L-.'..'i . 1 J i �a �- DV)(a ~ ;A[ `T =- ATION NO; I A7 3 DAVIE OUNTY HEALTH DEPARTMENT _ Environmental Health Section PROPERTY INFORMATION 121 411 Permittee"�s - f, y P.O. Box 848` / Name: . Mocksville; NC 27028 Subdivision Name: ' Phone # 336-751-8760 XF Directions to property; Section: Lot: AUTHORIZATION FOR WASTEWATER Tax Office PIN:# = SYSTEM CONSTRUCTION Road Name: b"• f 10. **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*** , NOTICE THIS AUTHORIZATION FOR WASTEWATER CONSTRUCTINO IS VALID FOR A PERIOD OF FIVE YEARS. ENVIRONMENTACHEAI.TH SPVrIAI IST' `DATE ISSUED. DCHD 05/96 (Revised) APPLICATION FOR SITE EVAWATION/IMPROVEMENT PERMIT & ATC Davie County Health Department Environmental Heaft SftWon r�. • ' P.O. Box 848/210 Hospital Street DEC 1 1 1998 Mocksville, NC 27028 (336)751-8760 ENVIRONMENTAL,HEALTH ***ZWORTANT*** THIS APPLICATION CANNOT BE PROCESSED UNLESS ALL THE REQUIRED INFORMATION IS PROVIDED. Refer to the INFORMATION BULLETIN for �)instructions. 1. Name to be Billed 'Q Contact Person !i[/ //CLr1J )Sailing Address � i / �L Ham Phone336 Business Phone 33G 4 2. Name on Permit/ASC if Different than Above Nailing Address City/State/Zip 3. Application For: U Site Evaluation )< Improvement Permit/ATC ktoth s. system to service: 9"House ❑ Mobile Home ❑ Business ❑ Industry ❑ other s. If Residence: # People # Bedrooms # Bathrooms B'Dishxasher 0 Garbage Disposal "as !Lachine p Basement/Plumbing Plumbing 6. If Business/Industry/Other: Specify type # People # Sims # Commodes # Showers # urinals # Hater Coolers IS FOODSERVICE: # Seats Estimated slater Usage (gallons per day) 7. Type of water supply: 13-County/City ❑Well 0 Community o. Do you anticipate additions or expansions of the facility this system is intended to serve? ❑ Yes q'No If yes, what type? ***IMPORTANT'** CLIENTS MUST COMPLETE THE REQUIRED PROPERTY INFORMATION REQUESTED BELOW. Either a PLAT or SITE PLAN AIUSTRESUIM117TED by the client with THIS APPLICATION. Property Dimensions: `7r� X .5 WRITE DIRECTIONS (from Mocksville) to PROPERTY: Tai Office PIN: # � rT % _ 6. x`70-3 � 0l3� V U r v I Property Address: Road Name 0 r /� lNQ 7rl� 19 �iree K d City/Zip If in a Subdivision provide information, as follows: a 6 e P, -r r'hpr Name: s21� L� //,.P? 12 C Al- 4'd Section: �_ Block; Lot: DAt�eProrrty Flagged: This is to certify that the information provided is correct to t e of my know Issued hereafter are subject to suspension or revocation, if the site plans or intended use change, or If the lnrormation submitted In this application is falsified or changed. I, also, understand that I am responsible for all charges incurred from this application. 1, hereby, give consent to the Authorized Representative of the Da a 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 IZ `' //— 67 P 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 (07/98) Account No. �p1 Invoice No. !� n..+•11< w.•L2ft°IEt1IIiL llrl CAAUMJ IJfig AMIrr AY Yr • �I SLIrl.��d w ./� MAI/ CJYLW -//r!l /9U/Rr /i l CJA XA -ftAr rrl Ay/07 I/•�� - JMlrrl�4WQf r •r�rrrrn ' tom' � SEAL O.7 •- G t 1.1429 i 2 : w .�'y 1�.FlIRyt `,' . � O - � F � z CLI 3 31 32 slpF y O 18 t9 20 I c pi 29 Fr J Q� I r- f l . 70 5icllt c_� O� _ _ > FALLINGCREEK DRIVE C-t5 334 b4' C-�! Hoo'3�'43�w '�0' PUBU _ 5oS 11' �- - 210.31' _ 316.00' 700 OG k- _ _ _ — 25 4r 123.00' C-14 C- 13 C-12 n I .� � Q701 r+ Q_ 6 5 13 O ; 6 is 43 a s •.� h 0.000 Ac ! >, O 0.703 Ac I; ` p i S ; / �' 0.693 Ao.1 obit Ac ! ! H . 0 820 Ac 1 8 14 23509- u u rti g i� 0.662 Ac.1 _ ; �NOT]2'c0'[ C-1 0696 A4-1 I j ^ 0970 At.t 7� .� !ac) 'r$ :_ 1 2 a R •� 126 36' 51.79' e Y�. ( 0.723 Ac.1 C-9 C-3 lie 2e' 113.37 r Ii01721'w \�J%�,. 0 I�k133! j ,��' \� 200.35' u t ; 517�ot•E— 0663 Ac.1 \ o. , 4a/Y• 1• NO3'23'27E ► u ® g. O ti I 13• l�n 0 700 Act !� j32 Exi51w6 Pole. - }w Y� 1 t y -6 0 sit Ac.t '" s71� 0.707 Acs f 252.31' O H03'39'33'E o b 1 O ' 0.696 Ac 1 �� 8 74 I6197.34' 3650 Ac.1 s 26t.Sr 3313' 192 70' s HO< Ib'OC'E % Sill 4-C 703 )9' 15 ]I' .��- 1+02 OS'20'E 696 49' tOTAt Pwcii 44 Q HO Ol'20'E s Rknora K lott.rl 08 170. PQ 833 � '/ Q7 �a�l��_y.C��k 6. If Business/Other: Specify type # People # Sinks # Commodes # Showers # Urinals # Water Coolers If Foodservice: # Seats Estimated Water Usage (gallons per day) s 7. Type of water supply: ❑ County/City ❑ Well ❑ Community c' r} 8. Do you anticipate additions or expansions of the facility this system is intended to serve? ❑ Yes , .; .J❑ No , If yes, what type? v PROPERTY INFORMATION REQUIRED: *** IMPORTANT *** A PLAT OF THE PROPERTY MUST BE SUBMITTED WITH THIS APPLICATION. Pro'.rtyDimensions: �� 0 7q %the -S 1 WRITE DIRECTIONS,(from 1 Mocksville) TO PROPERTY: TIM Office PIN: # 7 g! - 63 - S 7 o 3 1 Property Address: Road Name JI 1 d O1' / City/Zip AdUowe D r Lem If in. Subdivisionprovide rforM`tion, as follows: / 1 Name: Illy Section: Lot #: 1 - 1 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 c the Authorized Representative of the Davie County Health Department to enter upon above described property located in Davie County ' and owned by—IL < a J to conduct all testing procedures as necessary to determine the site suitability. } DATE g -to cl SIGNATURE Revis :d DCHD (06-96) ` &Ck `" r APPLICATION FOR SITE EVALUATIONAMPROVEMENT PERMIT T nn /7 R 1.1 v Davie County Health Dep trtment Environmental Health Section P. O. Box 848 AUG - 6 1997 Mocksville, NC 27028 (704)634-8760 ****IMPORTANT**** THIS APPLICATION CANNOT BE PROCESSED ;3 ALL THE REQUIRED INFORMATION IS PROVIDED. kites � 61,)4v 1. Name to be Billed Contact Person - Mailing Address e2 2t5- 5[ UVA Sir A I AO rd SCG/ Home Phone 9 fl V.- 5 416 g City/State/Zip �i, ,ys �N nr i4 �w�. At e , 0971,93 Business Phone 9 9g, - // 6- 7 • 94�-aloo., 2. Name on Permit/ATC if Different than Above 54 m6 - Mailing Address City/State/Zip ;r 3. A.plication For: OSite Evaluation ❑ Improvement Permit & ATC ❑ Both 4. Sy;tem to Serve: ❑ House ❑ Mobile Home ❑ Business ❑ Industry ❑ Other 5. If Residence: # People # Bedrooms # Bathrooms ❑ Dishwasher ❑ Garbage Disposal ❑ Washing Machine ❑ Basement/Plumbing ❑ Basement/No Plumbing 6. If Business/Other: Specify type # People # Sinks # Commodes # Showers # Urinals # Water Coolers If Foodservice: # Seats Estimated Water Usage (gallons per day) s 7. Type of water supply: ❑ County/City ❑ Well ❑ Community c' r} 8. Do you anticipate additions or expansions of the facility this system is intended to serve? ❑ Yes , .; .J❑ No , If yes, what type? v PROPERTY INFORMATION REQUIRED: *** IMPORTANT *** A PLAT OF THE PROPERTY MUST BE SUBMITTED WITH THIS APPLICATION. Pro'.rtyDimensions: �� 0 7q %the -S 1 WRITE DIRECTIONS,(from 1 Mocksville) TO PROPERTY: TIM Office PIN: # 7 g! - 63 - S 7 o 3 1 Property Address: Road Name JI 1 d O1' / City/Zip AdUowe D r Lem If in. Subdivisionprovide rforM`tion, as follows: / 1 Name: Illy Section: Lot #: 1 - 1 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 c the Authorized Representative of the Davie County Health Department to enter upon above described property located in Davie County ' and owned by—IL < a J to conduct all testing procedures as necessary to determine the site suitability. } DATE g -to cl SIGNATURE Revis :d DCHD (06-96) ` &Ck `" r DAVIE COUNTY HEALTH DEPARTMENT Environmental Health Section Soil/Site Evaluation APPLICANT'S NAME a%<4-/ --4/ PROPOSED FACILITY SUBDIVISION t— ee Water Supply: On -Site Well Community Evaluation By: Auger Boring Pit C// DATE EVALUATED SECTION_ LOT PROPERTY SIZE , ROAD NAME Public v Cut FACTORS 1 2 3 4 5 6 7 Landscape position Slope % HORIZON I DEPTH Texture group Consistence Structure Mineralogy 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 LONG-TERM ACCEPTANCE RATE r SITE CLASSIFICATION: f LONG-TERM ACCEPTANCE RA o u : • T' �I� tom. -�� LI DCHD (01-90) EVALUATION BY: OTHER(S) PRESENT: LIGEND 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