Loading...
142 East Rolling Meadow Road Lot 24Davie Countv, NC Tax Parcel Renort Wednesday Decemher 21. 2016 Plat Book: WAlKNMG: TMS 151407 A SURVEY Plat Page: Parcel Information Parcel Number: H908OA0024 Township: Shady Grove NCPIN Number: 5789730280 Municipality: Account Number: 82530102 Census Tract: 37059-804 Listed Owner 1: MOSS ALAN W Voting Precinct: EAST SHADY GROVE Mailing Address 1: 142 EAST ROLLINGMEADOW ROAD Planning Jurisdiction: Davie County City: ADVANCE Zoning Class: DAVIE COUNTY R -A State: NC Zoning Overlay: Zip Code: 27006-0000 Voluntary Ag. District: No Legal Description: LOT 24 FALLINGCREEK FARM PHASE I Fire Response District: ADVANCE Assessed Acreage: 1.28 Elementary School Zone: SHADY GROVE Deed Date: 9/2008 Middle School Zone: WILLIAM ELLIS Deed Book / Page: 007700902 Soil Types: PaD,PcB2,PcC2 Plat Book: 0007 Flood Zone: Plat Page: 049 Watershed Overlay: DAVIE COUNTY Outbuilding 8r Extra Building Value: Freatures Value: Land Value: Total Market Value: Total Assessed Value: 9 h All data is provided as Is wkhout 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, contactors or employees from any and all claims or causes of action due to ra UN�� NC or arising out of the use or Inability to use the GIS data provided by this webs@e. DAVIE COUNTY HEALTH DEPARTMENT ` Environmental Health Section P. O. Boa 848/210 Hospital Street ' Mocksville, NC 27028 (336)751-8760 IMPROVEMENT/OPERATION PERMIT Account M 990001994 Tax PIN/EH M 5789-73-0280.24 Billed To: Thomas Hendrix Subdivision Info: Falling Creek A Lot # 24 Reference Name: Location/Address: Rolling Meadow Road -27006 Proposed Facility: Residence Property Size: 1.290 acres ATC Number: 2972 **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 sT #Bedrooms �,? #Baths 0— Dishwasher: Garbage Disposal: Washing Machine:f– Basement w/Plumbing;, Basement/No Plumbing: ❑ Commercial Specification: Facility Type #People #People/Shift #Seats Industrial Waste: ❑ Lot Size Zt',07 Type Water Supply _ Design Wastewater Flow (GPD) --Y;P0 Site: New Repair ❑ System Specifications: Tank Size/D�97�GAL. Pump Tank /�L GAL. Trench Width �`�Rock Depth Linear Fty�/ Other: Required Site Modifications/Conditions: IMPROVEMENT/OPERATION PERMIT LAYOUT - APPROVED EFFLUENT FILTER. RISERS) 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 m. or 1:00 .m. to 1:30 .m. on ' rAaRmion. Telephone # is (336)751-8760.**** jum/ Environmental Health � Specialist's Signature: Date: L' g2s e DCHD 05/99 (Revised) DAVIE COUNTY HEALTH DEPARTMENT Environmental Health Section P. O. Boa 848/210 Hospital Street Mocksville, NC 27028 (336)751-8760 Account #: 990001994 Tax PIN/EH #: 5789-73-0280.24 Billed To: Thomas Hendrix Subdivision Info: Falling Creek A Lot # 24 Reference Name: Location/Address: Rolling Meadow Road -27006 Proposed Facility: Residence Property Size: 1.290 acres ATC Number: 2972 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 WASTEWAT C NSTRUCTION IS VALID FOR A PERIOD OFFIVEYEARS. 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: DCHD 05/99 (Revised) \w Date: C�2` %-r 101 n �P ON FOR SITE EVALUATION/IMPROVEMENT PERMIT & ATC Q V Davie County Health Department Enuftnmenta/ Health SeWon P.O. Box 848/210 Hospital Street O ZOOS Mockaville, NC 27028 rs2 (336)751-8760 1. l to be billed 1 h6�ih Id i 1{f�,Pl�IC'Y AJC J I- contact Parson Mailing Address � I v 00"a- 5 / , We •VAlI none Phone 74e V 1,,M city/state/sIP /(/.5, 9_e, 'Q9104 business Phone 2. Naas on Pem=it/A1TC if Different than Above Mailing Address City/state/sip S. Application For: 0 Site Evaluation improvement Permit/ATC `:, Both a. eysten to services OrHouse ❑ Mobile Home 0 Business ❑ Industry 0 Other "�•••• 5. If Residence: i People / ! Bedrooms _�_ I Bathrooms 3 M Dishwasher 9Oarbage Diaposal �0 Washing Machine H baseaant/Plumbing D bassuent/No Plumbing S. If business/Industry/Others specify type t# Commodes I showers # Urinals / People i sinks Water Coolers IF FOODSERVICE: g Seats Estimated Water Usage (gallons per day) 7. Type of water supply: 0--County/City 0 Well 0 Community a. Do you anticipate additions or expansions of the facility this system Is Intended to serve? 0 Yes "o If yes, what type? ""IMPORTANTPI" CLIENTS MUST COMPLETE THE REQUIRED PROPERTY INFORMATION REQUESTED BELOW. Either a PLAT or SITE PLAN MIDST BE SUBMITTED by the client with THIS APPLICATION. Property Dimensions: 1. c2 20 f "eS WRITE DIRECTIONS (from Mockr011e) to PROPERTY: Tax Office PIN: #-5789-73-Do29�0 �v , L4S �m1Ilio/J4 Property Address: Road Name ciaysr' p City/Zip ALA'Vey ]UC',�70d1 e - If In a Subdivision provide information, as follows: Name: FA Lb d�4 An PP a Section: L— Block: A_ Lot: ,94 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 County Health Departipent to enter upon above described property located In Davie County and owned by Ue-s �V ,a w Pe'ye-4,duh to conduct sit testing procedures as necessary to determine the to sul filty. DATE SIGNATURE THIS AREA MAY BE USED FOR DRAWING YOUR SITE PLAN (Incfulk all of the following: Existing and proposed property lines and dimensions, structures, setbacks, and septic locations). Site Revisit Charge `Date(s): Client Notification Date: I EIIS: Revised DCHD (07/99) Account No. l I I Invoice No. Q ❑ Dishwasher 6. If Business/Other: # Commodes If Foodservice: j 8. i r ❑ Garbage Disposal ❑ Washinp,,Machine ❑ Basement/Plumbing Specify type # People _ # Showers # Urinals # Seats Estimated Water Usage (gallons per day) 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 BE SUBMITTED WITH THIS APPLICATION. Property Dimensions: qql 74 %4z{, 1 WRITE DIRECTIONS (from Tax Office PIN: # ?5 7 g! - 63 - -.5703 r, Property Address: Road Name-SIR-QL.a./ APPLICATION FOR SITE EVALUATIONAMPROVEMENT PERMIT 1 L G 1 Davie County Health Department �` ` Environmental Health Section V y P o. Box 848 AUG_- 61997. a9�s 1 1 0 Mocksville, NC 27028 Section: (704)634-8760 1 ****IMPORTANT**** THIS APPLICATION CANNOT BE PROCESSED ALL THE REQUIRED INFORMATION IS PROVIDED. I. Name to be Billed ljes� // %c cc! -qbey� Zy. Contact Person 61,14V l+aailing Address t� s�t�h Sfh b l �ord �C/ Home Phone 9 9Y16 c% City/State/Zip ,vs �V A/ si4 4t, At e, Q 769 3 Business Phone 9 9 SI—116- i 2. Name on Permit/ATC if Different than Above 5,4 m e-- ! Mailing Address City/State/Zip 3. Application For: O- Site Evaluation ❑ Improvement Permit & ATC ❑ Both :i 4. S ,stem to Serve: ❑ House ❑ Mobile Home ❑ Business ❑ Industry ❑ Other `f s 5. If Residence: # People # Bedrooms # Bathrooms ❑ Dishwasher 6. If Business/Other: # Commodes If Foodservice: j 8. i r ❑ Garbage Disposal ❑ Washinp,,Machine ❑ Basement/Plumbing Specify type # People _ # Showers # Urinals # Seats Estimated Water Usage (gallons per day) 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 BE SUBMITTED WITH THIS APPLICATION. Property Dimensions: qql 74 %4z{, 1 WRITE DIRECTIONS (from Tax Office PIN: # ?5 7 g! - 63 - -.5703 1 Mocksville) TO PROPERTY . 1 Property Address: Road Name-SIR-QL.a./ VLQ:��cL• 1 L G 1 - City/Zip ACiy rr Wd e d /l/ �en/Lem 1 D If in Subdivisionprovide inform tion, as follows: ,rJRm�A �- a9�s 1 1 0 Name: 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 the Authorized Representative of the Davie County Health Department to enter upon above described property located in Davie County, and owned by m 4_14Z to conduct all testing procedures as necessary to determine the site suitability. r DATE g —� cl SIGNATURE . Revised DCHD (06-96) t &C 1 1 DAVIE COUNTY HEALTH DEPARTMENT Environmental Health Section SECTION I LOTsW Soil/Site Evaluation APPLICANT'S NAMES ��/ �� rx/ DATE EVALUATED ��7 /` r✓ PROPOSED FACILITY SUBDIVISION Water Supply: On -Site Well Community Evaluation By: Auger Boring Pit _1 Z PROPERTY SIZE 1 twe o ROAD NAME /, "oJ e.' Public CC,---" Cut FACTORS 1 2 3 4 5 6 7 Landscape position ,C._ Slope % HORIZON I DEPTH Texture group Consistence Structure Mineralogy HORIZON II DEPTH r �G Texture group Consistence Structure i( 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: EVALUATION BY: LONG-TERM ACCEPTANCE RATE: OTHER(S) PRESENT: REMARKS: ��74 (J•�G' ��- (O� i �- S��i�� Or A�� w�/O�'Cfl�" 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 (01-90)