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158 Gilbert Road Lot 6Davie County, NC Tax Parcel Report Thursday, December 29, 2016 1 118 15 WW r (7 w =) w f IN[_BROOK U) v GILBERTRD DR GILBERTRD GILBERTRD 236 � i I d r I i I i ; J r rye ; O {' r 15 8 tq 122 O � ; I m I w Z i I WARNING: THIS IS NOT A SURVEY Parcel Information Parcel Number: E50000003302 Township: NCPIN Number: 5851162649 Municipality: Farmington Account Number: 8306912 Census Tract: 37059-802 Listed Owner 1: GUEST BAILEY HOLLAND Voting Precinct: FARMINGTON Mailing Address 1: 158 GILBERT ROAD Planning Jurisdiction: Davie County City: MOCKSVILLE Zoning Class: DAVIE COUNTY R-20 State: NC Zoning Overlay: DAVIE COUNTY QD Zip Code: 27028 Voluntary Ag. District: No Legal Description: 8.040AC LOT 6 FURCHES FA Fire Response District: FARMINGTON Assessed Acreage: 8.04 Elementary School Zone: PINEBROOK Deed Date: 9/2016 Middle School Zone: NORTH DAVIE Deed Book / Page: 010301020 Soil Types: EnB,IrB Plat Book: Flood Zone: Plat Page: Watershed Overlay: DAVIE COUNTY uildin& Extra Building Value: FOreatures Value: Land Value: Total Market Value: Total Assessed Value: 9 �uVis�E,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 hoe any and ad daims or causes of adlon due to nQ U N� NC or arising out of the use or inability to use the GIS data provided by this website. DAVIE COUNTY ENVIRONMENTAL HEALTH P.O. Box 848/210 Hospital Street Mocksville, NC 27028 (336)753-6780 / Fax # (336)753-1680 Account #: 990003645 Billed To: Mitch Lowrey Construction Reference Name: Proposed Facility: Residence OPERATION PERMIT Tax PINIEH #: 5841-97-7322.6 Subdivision Info: Furches Farms Lot # 6 LocationrAddress: Furches Farm Road -27028 Property Size: 8.9_6 ATC Number: 5022 N 3� o �6f this T. D � � tc.J�Odsh3 i /. OS **NOTE** The issuance - Operation Permit all indicate the sxem 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.. � � � l 0 V da 1 000 S System Type: S.T. Manufacturer Tank DateTank Size_ Pump Tank Size System Installed B ,M-tS J� I' E.H. Specialist: Date: Y Y ---�— To 7 ata f C1, -eel �Oaco Lf L t3 t �� J1 ✓ / cor / © ) b f5c `� o a�Y / r7 c� ,4W 57 0 001 ! / \. �- �' DCHD 11/06 (Revised) S " ' DAVIE COUNTY ENVIRONMENTAL HEALTH ` P.O. Box 848/210 Hospital Street 1 Mocksville, NC 27028 h 1 (336)753-6780 / Fax # (336)753-1680 AUTHORIZATION FOR WASTEWATER SYSTEM CONSTRUCTION Account #: 990003645 Tax PIN 'EH #: 5841-97-7322.6 Billed To: Mitch Lowrey Construction Subdivision Info: Furches Farms Lot # 6 Reference name: LocationiAddress: Furches Farm Road -27028 Proposed Facility: Residence Property Size: 8.96 Site Type: 55ew ❑Repair ❑Expansion ATC Number: 5022 **NOTE** This Authorization to Construct (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 change. Residential Specifications: # Bedrooms # Bathrooms# People_ Basement❑ Basement plumbing❑ Non -Residential Specifications: Facility Type # People # Seats Square Footage(or Dimensions of Facility) Lot Size . �4 Type of Water Supply: Ce'County/City ❑Well ❑Community Well 560 � dO� System Specifications: Design Wastewater Flow (GPD) 3 60rank Size GAL. Pump Tank GAL. fi I/ Trench Width G Max. Trench Depth 36 Rock Depth Linear Ft.�� Site Modifications/Conditions/Other: 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. F .. Environmental Health Spe 'alist_ DCHD 11/06 (Revised) a Q Date: / � 01 h Date: / � 01 t CATION FO SITE EVALUATION/IMPROVEMENT PERMIT & ATC Davie County Environmental Health P), P.O. Box 848/210 Hospital Street Mocksville, NC 27028 (336)753-6780/ Fax (336)753-1680 APP 1 ati .For:' P Site Evalugtion/Improvement Permit ❑ Authorization To Construct (ATC) ❑ Both Type, of Application: [<ew System ❑Repair to Existing System ❑Expansion/Modification of Existing System or Facility ***IMPORTANT*** THIS APPLICATION CANNOTBE PROCESSED UNLESS ALL OF THE REQUIRED INFORMATION IS PROVIDED. Refer to the INFORMATION BULLETIN for instructions. A DDT TO A ATT TATrnD A R A TTCYXT Name to be Billed PAc, Low. -,-,j 4,,z Contact Person BillYng Address A.'i, z. hr Home Phone City/State/ZIP �.�1�)i r�., - 5= lir NC Z710�? Business Phone Name on Permit/ATC if Different than Above Mailing Address Ci PROPERTY INFORMATION *Date House/Facility Corners Flaaaed l NOTE: A survey plat or site plan must accompany this application. Included: ❑ Site Plan ❑Plat(to scale) (Permit is valid for 60 months with site plan, no expiration with complete plat.) Owner's Name—ft.A 3 R -I se o, i.te u e.5 Phone Number Owner's Address City/State/Zip Property Address City Lot Size "i .9 L l+c,t- Tax PIN#15 R 4 % Subdivision Name(if applicable) qr J� ',,ASection/Lot# lti Directions To Site: h, A0hI-Lt. c rl ���. �'.•% - e, WJ ,,, a/, ��i�1•�/;c� ,xt � nit %it _ If the answer to any of the following questions is "Yes",supporting documentation must be attached: Are there any existing wastewater systems on the site? _Yes ,,No Does the site contain jurisdictional wetlands? -No Are there any easements or right-of-ways on the site? _Yes -✓No Is the site subject to approval by another public agency? _Yes vl�o Will wastewater other than domestic sewage be generated? _Yes Yes ✓No IF RESIDENCE FILL OUT THE BOX BELOW # People Z # Bedrooms 3 # Bathrooms _ 3 Garden Tub/Whirlpool F1 Yes ©No Basement: ❑Yes 2No Basement Plumbing: ❑Yes E-iNo 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: RJ26'riventional ❑Accepted ❑Innovative ❑Alternative ❑Other Water Supply Type: . County/City Water ❑ New Well ❑Existing Well ❑ Community Well Do you anticipate additions or expansions of the facility this system is intended to serve? ❑ Yes If yes, what type? ._..... __.... . O 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 t e avie County Health Department to conduct necessary inspections to determine compliance with applicable laws and ru}cs. I u and that I am responsible for the proper identification and labeling of property lines and corners and locatin QnA Wggin staking the house/facility location, proposed well location and the location of any other amenities. Site Revisit Charge Property owner'so owner's legal representative signature Date(s): , Client Notification Date - Date EHS: Sign given ❑Yes ]No Revised 11/06 Account # j &q Invoice # Davie County Environmental Health • P.O. Box 848/210 Hospital Street Mocksville, NC 27028 (336)751-8760/ Fax (336)751-8786 IMPROVEMENT PERMIT Account #: 990005156 Billed To: Ellen Furches Address: 128 Pinebrook Drive City: Mocksville Reference Name: Proposed Facility: Residence Tax PIN/EH #: 5841-97-7322.6 Subdivision Info: Furches Farms Lot # 6 Location/Address: Pinebrook School Rd. -27208 Property Size: 8.96 Acres **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 Permit Valid for: Years ❑No Expiration Residential Specifications: # Bedrooms # Bathrooms # People Basement❑ Basement plumbing❑ Non -Residential Specifications: Facility Type # People # Seats Square Footage(or Dimensions of Facility) Design Flow(GPD): y�C/ Type of Water Supply: C`County/City ❑Well ❑Community Well As stated in 15A NCAC 18A. 1969(5 Site Modifications/Permit Conditions: accepted Systems may also be usedd System Type LTAR Initial Z Repair y(c 1 0 • l -7 [�X Site Plan S{f'tic Ar-- a r"t •,, 0 m 4.✓ Wil' Environmental Health Specialist Date i.p. 11-06 . A PLKATION FOR SITE EVALUATION/IMPROVEM Davie County Environmental Health P.O. Box 848/210 Hospital Street AU Mocksville, NC 27028 G (336)751-8760/ Fax (336)751-8786'/RpNM Application For: )bSite Evaluation/Improvement Permit ❑ Authorization To Construct(A Cd�;6ty Type of Application: Zlew System ❑Repair to Existing System ❑Expansion/Modification of Existing in or Facili ***1MPORT4NT*** THIS APPLICATION CANNOT BE PROCESSED UNLESS ALL OF THE REQUIRED INFORMATION IS PROVIDED. Refer to the INFORMATION BULLETIN for instructions. APPLICANT INFORMATION "Ar Rtj&,+ Name to be Billed G. A_4e 7.' 17—k �c'--1i " Contact Person 6 rj4 Billing Address J'CJ // Home Phone City/State/ZIP ;/i tJc'.%7'�i S" Business Phone _ �l'�/��- /V3 ` Name on Permit/ATC if Different than Above Mailing Address City/State/Zip VKUYLKI Y 11NfUKN1AI1UN " Date Housed acuity Comers nagged NOTE: A survey plat or site plan must accompany this application. Included: ❑ Site Plan ❑Plat(to scale) (Permit is Valid for 60 months with site plan, no expiration with complete plat.) Owner's Name z' a (` 1,;Z 3 Phone Number_ Owner's Address City/State/Zip Property Address G1 City Lot Size _ Tax PIN# , 5 q / x'71132 _juSubdivision Name(if applicable)"- 3�—S �,y�> > Section/Lot# Directions T9,Site: 15,3 C-454 .1. Fia rm'1N' T * t,' h FJ ,',;i A it k"Z. J'4" 1 If the answer to any of the following questions is "yes", supporting documentation must be attached. Are there any existing wastewater systems on the site? ❑Yes 1ANo Does the site contain jurisdictional wetlands? ❑Yes &No Are there any easements or right-of-ways on the site? ❑Yes KNo Is the site subject to approval by another public agency? ❑Yes 9No Will wastewater other than domestic sewage be generated? ❑Yes $No IF RESIDENCE FILL OUT THE BOX BELOW # People # Bedrooms # Bathrooms Garden Tub/Whirlpool ❑Yes ❑No Basement: ❑Yes ❑No 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:. l Conventional [Accepted 01nnovative ❑Alternative []Other Water Supply Type: Vcounty/City Water ❑ New Well ❑Existing Well ❑ Community Well Do you anticipate additions or expansions of the facility this system is intended to serve? ❑ Yes If yes, what type? ❑ No 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 pernzit(s) or ATC(s) issued hereafter are subject to suspension or revocation if the site is altered, the intended use changes, or if the inforniation 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/facijity. _location, proposed well location and the location of any other amenities. Site Revisit Charge `Property o ier's or' owner's legal representative signature Date(s): Client Notification Date: Date EHS: Sign given ❑Yes ❑No Account #_�_ Revised 11/06 Invoice # A AREA- 10.000 AC. rrua Arrau mole .r hmow �a�L•l�l��( `'C r %A Sit 41* mc c� 370 I .. 370 I I 7onl., I j ATH I � r7 I V �ocg w I �afa a'�w 01 vI�N t� oi PINEBROOK ,DRIVE' `5'R• >432' 365 363 363 457 648 (o ri TRACT 5 X AREA = +-5.92 ACRES AREA INCLUDES RIW m TRACT 6 C �L AREA = +-10.45 ACRES AREAINCLUDES R/1I V � O490 612 N TRACT 4 _--_ . CILBE. M APPLICANT INFORMATION Account #: 990005156 Billed To: Ellen Furches Reference Name: Proposed Facility: Residence DAVIE COUNTY HEALTH DEPARTMENT Environmental Health Section Soil/ Site Evaluation PROPERTY INFORMATION Tax PIN/EH #: 5841-97-7322.06 Subdivision Info: Furches Farms Lot # 06 Location/Address: Pinebrook School Rd. -27208 Property Size: 10.45 Acres Date Evaluated: 6 _ ) U Water Supply: On -Site Well Community Public Evaluation By: Auger Boring Pit z�_ Cut FACTORS 4 5 6 7 Landscape position V Slope % HORIZON I DEPTH 0- 1 0to •- 0-34 Texture Texture grou G G Consistence �� {I u F,!' Structure a F'9)lwy 1 Ab Mineralogy 1 ` 7 HORIZON H DEPTH _ Texture group L C_ e_ L Consistence ' Structure mr 'Th 1^0 c., -.bb ' Mineralogy ��_ %' V SC t HORIZON III DEPTH Texture group Consistence Structure Mineralogy HORIZON IV DEPTH Texture group Consistence Structure Mineralogy SOIL WETNESS RESTRICTIVE HORIZON SAPROLITEOV4 "4 CLASSIFICATION 4"5 h . r LONG-TERM ACCEPTANCE RATE r t '1)– SITE CLASSIFICATION: LONG-TERM ACCEPTANCE RATE: �• 7 �� REMARKS: LEGEND EVALUATION BY: U OTHER(S) PRESENT:����� .. i 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 Moist VFR - Very friable FR - Friable FI - Firm VFI - 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 - 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) T TA D T