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139 East Rolling Meadow Road Lot 23Davie County, NC ' f 198 188 176 1 222-' 228 125 135-f 166 - 4ZpL�lUC-'MEADO;^J RD -ter 1 152 128 r 136 Tax Parcel Report 142 Wednesday, December 21. 2016 256 253f - --,-� I 244 0 I Z 241 m 107 1 229 I IRISI-ItOAN (7L--'` 217 _..l C,a ' -� 106 1141 91v�� All 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 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 np p p C NC or arising out of the use or inability to use the GIS data provided by this webslte WARNING: THIS IS NOT A SURVEY Parcel Information _ Parcel Number: H9080A0023 Township: Shady Grove NCPIN Number: 5789730441 Municipality: Account Number: 8303034 Census Tract: 37059-804 Listed Owner 1: WALSBURGER JONATHAN ADAM Voting Precinct: EAST SHADY GROVE Mailing Address 1: 139 ROLLINGMEADOW ROAD Planning Jurisdiction: Davie County City: ADVANCE Zoning Class: DAVIE COUNTY R -A State: NC Zoning Overlay: Zip Code: 27006 Voluntary Ag. District: No Legal Description: LOT 23 FALLINGCREEK FARM PHASE I Fire Response District: ADVANCE Assessed Acreage: 2.44 Elementary School Zone: SHADY GROVE Deed Date: 12/2013 Middle School Zone: WILLIAM ELLIS Deed Book / Page: 009470892 Soil Types: PaD,PcB2,PcC2,WATER Plat Book: 0007 Flood Zone: Plat Page: 049 Watershed Overlay: DAVIE COUNTY Building Value: Outbuilding 8r Extra Freatures Value: Land Value: Total Market Value: Total Assessed Value: 91v�� All 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 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 np p p C NC or arising out of the use or inability to use the GIS data provided by this webslte DAVIE COUNTY HEALTH DEPARTMENT T Environmental Health Section ®/ P. O. Boz 848/210 Hospital Street Mocksville, NC 27028 (336)751-8760 IMPROVEMENT/OPERATION PERMIT Account #: 990002177 Tax PIN/EH M 5789-7340441 Billed To: Raymond Wayda Subdivision Info: Falling Creek 1 Lot # 23 Reference Name: Location/Address: 230 Falling Creek Drive -27006 Proposed Facility: Residence Property Size: 2.5 acres ATC Number: 3083 **NOTE** This Improvement/Operation Permit DOES NOT authorize the construction of a septic tank system or any wastewater system. An AUTHORIZATION FOR WASTEWATER SYSTEM CONSTRUCTION must be obtained from this Department prior to the construction/installation of a system or the issuance of a building permit (in compliance with Article 11 of G.S. Chapter 130A, Wastewater Systems, Section .1900 Sewage Treatment and Disposal Systems). THIS PERMIT IS SUBJECT TO REVOCATION IF SITE PLANS OR THE INTENDED USE CHANGE. YOUR WASTEWATER SYSTEM CONTRACTOR MUST SEE THIS PERMIT BEFORE INSTALLING SYSTEM. Residential Specification: Building Type #People #Bedrooms #Baths i S Dishwasher: K Garbage Disposal: ❑ Washing Machine:lr Basement w/Plumbing: 0 Basement/No Plumbing: ❑ Commercial Specification: Facility Type #People #People/Shift #Seats Industrial Waste: ❑ Lot Size C Type Water Supply Design Wastewater Flow (GPD) Site: New ❑ Repair ❑ System Specifications: Tank Size,/�� GAL. Pump Tank MPGAL. Trench Width .,j�j_"' Rock Depth /J ", Linear Ft.,,;� Other: 1 Required Site Modifications/Conditions: nRW.io IMPROVEMENT/OPERATION PERMIT LAYOUT - APPROVED EFFLUENT FILTER. RISER(S) IF 6 " BELOW FINISHED GRADE. ****NOTICE: Contact a representative of the Davie County Health Department for final inspection of this system between 8:30 a.m. to 9:30 a.m. or 1:00 p.m. to 1:30 p. .,on the day of installation. Telephone # is (336)751-8760.**** �J ST �dsG 10,22,0'z Environmental Health Specialist's Signature: Date:o? ^oz DCHD 05/99 (Revised) ok DAVIE COUNTY HEALTH DEPARTMENT 1J Environmental Health Section P. O. Boz 848/210 Hospital Street Mocksville, NC 27028 (336)751-8760 Account #: 990002177 Tax PIN/EH #: 5789-73-0441 Billed To: Raymond Wayda Subdivision Info: Falling Creek 1 Lot # 23 Reference Name: Location/Address: 230 Falling Creek Drive -27006 Proposed Facility: Residence Property Size: 2.5 acres ATC Number: 3083 AUTHORIZATION FOR WASTEWATER SYSTEM CONSTRUCTION **NOTE** This Authorization for Wastewater System Construction MUST BE ISSUED by the Davie County Environmental Health Section prior to issuance of any building permit(s). This Form/Authorization Number should be presented to the Davie County Building Inspections Office when applying for building permit(s) (in compliance with Article 11 of G.S. Chapter 130A, Wastewater Systems, Section .1900 Sewage Treatment and Disposal Systems). THIS AUTHORIZATION FOR WASTEWA C NSTRUCTION IS V LID FOR A PERIOD OF FFIVE YEARS. Environmental Health Specialist's Signature: Date: CERTIFICATE OF COMPLETION **NOTE** The issuance of this Certificate of Completion shall indicate the system described on Improvement/Operation Permit 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. Septic System Installed By: Environmental Health Specialist's Signature: Date: DCHD 05/99 (Revised) APPLICATION FOR SITE EVALUATION/IMPROVEMENYPERMIT & Davie County Health Department Environmenta/Health Section P.O. Box 898/210 Hospital Street Mocksville, NC 27028 (336)751-8760 FEB ***IMPORTANT*** THIS APPLICATION CANNOT BE PROCESSED UNLESS ALLLTHE REQIIIREDI. INFORMATION IS PROVIDED. Refer to the INFORMATION BULLETIN for instructions. 1. Name to be Billed 4541WOAC%Y�ff/ �*��7bvC Contact Person Mailing Address//�Jp i} �Ll�,�H�/�� Home Phone n be ec 0 -JI -e- /►"C- City/State/ZIP " ' � Ao` --7D;2 Business Phone I 2. Name on Permit/ATC if Different than Above Mailing Address City/State/Zip 3. Application For: ❑ Site Evaluation ,%Improvement Permit/ATC 0 Both 4. System to Service: AHouse ❑ Mobile Home ❑ Business Industry ❑ Other 20 Bathrooms X4,7- 5. If Residence: # People # Bedrooms 13 # J1Dishwasher ❑ Garbage Disposal Washing Machine Basement/Plumbing CI Basement/No Plumbing ry •If 6. Business/Industry/Other: Specify type # People # Sinks # Commodes # Showers # Urinals # Water Coolers IF FOODSERVICE: # Seats Estimated Water Usage (gallons per day) 7. Type of water supply: County/City 1❑ Well ❑ Community 8. Do you anticipate additions or expansions of the facility this system is intended to serve? 0 Yes *o If yes, what type? ***IMPORTANT*** CLIENTS MUSTCOMPLETETHE REQUIRED PROPERi" Y INFORMATION REQUESTED BELOW. Either a PLAT or SITE PLAN MUST BE SUBMITTED by the client with THIS APPLICATION. Property Dimensions: S AC- WRITE DIRECTIONS (from Mocksville) to PROPERTY: Tax Office PIN: # S 7 B9 `73 Property Address: Road Name 13 61 f' Petptp S (wk- ,-IZD / /L I U s city/zip If in a Subdivision provide information, as follows: 'rb l SJQ G Name: Section: f Block: Lot: 02 3 Date Property Flagged: 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 the Authorized Representative of the Davie Copn(y=Health Department to enter upon above described property located in Davie County and owned by We'6 (/rte be to conduct all testing procedures as necessary to determine the site sui7Z,4'e�� 2 �.. DATE � p ' (/ SIGNATURE THIS AREA MAYBE USED FOR DRAWING YOUR SITE PLAN (Ind/lude all of the following: Existing and proposed property lines and dimensions, structures, setbacks, and septic locations). Site Revisit Charge Date(s): Client Notification Date: EHS: Account No. D- / Revised DCHD (07/99) Invoice No. Q- Lc7 S --- N06'44'35"E 180860' LE NAD EIP......... Es•ieting Iron Plpe Found w/rise KIP......... New 3/I" fro" Pipe Set Stone ..... Old Planted Field Stone Found REBAR..... Esieting Steel Reinforcing Rod found w/rise pt, ......... point on Ground, no monument found or set Certificate of Approval by Planafnq Board The Davie County Planning Board hereby approves the Record Plat for FallingCreek farm subdivision Date ��— Cholrtnon, slyunty Planning Board � BRq,v�N Certificate of Ownership and Dedication We the undersigned hereby certify that We ore the owners of the property described hereon, which is located within Ins subdivision )unsdiction of Davis County, and that We hereby adopt this subdivision plan with our fres consent, and establish minimum building setback lines, and dedicate all streets, alleys, walks, parks and other sites, and easements to public or private use as noted. Date _,isror's ature r.9/ ♦ �`st Date Owner's Signature Date Owner's Signature 1 I SHAMROCK ACRES SC6'44 35"W GCC 430 \ 281.21' 148.79' f M. 2.496 Ac. t 1.290 Ac 1t DO s6' rn �F CP. s, C-24 22! G _ tv L) 1 ` 120 Cr �•� CL Lr v 00 0 �O 248.78' s N05'28'36"E s o N to Cl� Ln `r n`1111►p `�� ° j SO5'01'56"W I 237.61' 0.704 Ac.t 1 Q(� 140.43' 97.18' N00'Oi'09"E 'C 239.00' ' 0) 0.692 Ac.s U <v .0 N �h .h `C_ 6 N \ 50.56' 110.00' I v x 1 Ix I 0 689 cc LD / LP - 61.9 ._ _. .;- 3. A: plication For: 4. &!stem to Serve: 5. If Residence: :y ❑ Dishwasher 6. 1; :9usiness/Other: #" Commodes 7. 8 If Foodservice: 2- Site Evaluation ❑ House ❑ Mobile Home ❑ Improvement Permit & ATC ❑ Business ❑ Industry # People # Bedrooms ❑ Garbage Disposal ❑ Washing Machine ❑ Basement/Plumbing Specify type ; # People _ # Showers # Urinals # Seats Estiiri�ited Water Usage (gallons per day) _ ❑ Both ❑ Other # Bathrooms ❑ Basement/No Plumbing # Sinks # Water Coolers Type of water supply: ❑ County/City ❑ Well ❑ Community" Do you anticipate additions or expansions of the facility this system'is intended to serve? ❑ Yes; ❑ No If yes, what type? PROPERTY INFORMATION REQUIRED: *** IMPORTANT *** A PLAT OF THE PROPERTY MUST 1E SUBMITTED WITH THIS APPLICA' : ':1N. Property Dimensions: % q, 7q %z%e—S 1 WRITE DIRECTIONS (from - " - Tax Office PIN: # 5 7 g!J - 63 - s 7 ©3 1 Mocksville) TO PROPERTY 1 Prol -.rty Address: Road Name �- APPLICATION FOR SITE EVALUATIONAMPROVEMENT PERMIT19 Davie County Health Department' v 1 •N 96 l 0 i7" . city/zip AJVK �� If ir Subdivision p�� p �ti as follows: 77, er Environmental Health Section f- Ntme: Section: Lot #: 3 P. O. Box 848 AUG — 61997 1 Mocksville, NC 27028 . (704)634-8760 ****IMPORTANT**** THIS APPLICATION CANNOT BE PROCESSEd UN ESS 7 ALL THE REQUIRED INFORMATION IS PROVIDED. .4 1. Name to be Billed / W�s� // /e W -ie✓d. �,�, Contact Person G1,)4 A -Mailing Address � S�c�� st, 94_/ Home Phone 99�q City/State/Zip � +vs �N A/ Si4�, /fit e , ` Q 71P 3 " Business Phone 9 2. Name on Permit/ATC if Different than Above 54 mg - - Mailing Address City/State/Zip 3. A: plication For: 4. &!stem to Serve: 5. If Residence: :y ❑ Dishwasher 6. 1; :9usiness/Other: #" Commodes 7. 8 If Foodservice: 2- Site Evaluation ❑ House ❑ Mobile Home ❑ Improvement Permit & ATC ❑ Business ❑ Industry # People # Bedrooms ❑ Garbage Disposal ❑ Washing Machine ❑ Basement/Plumbing Specify type ; # People _ # Showers # Urinals # Seats Estiiri�ited Water Usage (gallons per day) _ ❑ Both ❑ Other # Bathrooms ❑ Basement/No Plumbing # Sinks # Water Coolers Type of water supply: ❑ County/City ❑ Well ❑ Community" Do you anticipate additions or expansions of the facility this system'is intended to serve? ❑ Yes; ❑ No If yes, what type? PROPERTY INFORMATION REQUIRED: *** IMPORTANT *** A PLAT OF THE PROPERTY MUST 1E SUBMITTED WITH THIS APPLICA' : ':1N. Property Dimensions: % q, 7q %z%e—S 1 WRITE DIRECTIONS (from - " - Tax Office PIN: # 5 7 g!J - 63 - s 7 ©3 1 Mocksville) TO PROPERTY 1 Prol -.rty Address: Road Name �- C- • c G 1 •N 96 l 0 i7" . city/zip AJVK �� If ir Subdivision p�� p �ti as follows: 77, er f- Ntme: Section: Lot #: 3 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+ J are subject to suspension or revocation, if the site plans or intended use change, or if the information submitted in this application is i falsified or changed. I, also, understand that I am responsible for all charges incurred 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 4 _ and owned by 1pa to conduct all testing procedures as necessary to determine the site suitability. DATE g-6-97 SIGNATURE j Revised DCHD (06-96) i e - /_ J�- k Y� V DAVIE COUNTY HEALTH DEPARTMENT Environmental Health Section SECTION_ LOTXY Soil/Site Evaluation APPLICANT'S NAME �,��SY�Ui`BGr/ DATE EVALUATED / 2 PROPOSED FACILITY ff SUBDIVISION 4'_e_-/eA Water Supply: On -Site Well Community PROPERTY SIZE ROAD NAME Public !___� Evaluation By: Auger Boring Pit Cut FACTORS 1 2 3 4 5 6 7 Landscape position ,L Sloe % HORIZON I DEPTH Texture group Consistence Structure Mineralogy HORIZON II DEPTH 3 l 3 d r 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 lrl SITE CLASSIFICATION: /—S- ri✓ A� v ` y- 5_,_--516 EVALUATION BY: LONG-TERM ACCEPTANCE RATE: REMARKS: � 'e';?L ✓D 41 v4-- See DCHD (01-90) OTHERR(S)/PRESENT: 'V -y' -51-j9 x6 /0,/4 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