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148 Linda Lane Lot 2Dav ?016 av f Ag data Is provided as Is withoutwarranty, or guarantee of any kind elther expressed or Implied Including but not limited to the 9 6• Davie County, Implied vanardles of merchantabggyorranesa for a particular use. All user, or Davie County's Ghimbsge shall hold harmless the County of Davie, North Carolina, Its agents, consultands, contractor, oremployees, from any and all clalms or causes of action duet* �Ob 4 NC or adeing out of the use orinabllltyto use the GIS data provided by this veWge WARNING: THIS IS NOT A SURVEY Parcel Information:.___.._ Parcel Number: 1616OA0002 Township: Mocksville NCPIN Number: 5758036631 Municipality: Account Number: 82527736 Census Tract: 37059-805 Listed Owner 1: HIGH TOP LAND COMPANY LLC Voting Precinct: NORTH MOCKSVILLE COUNTY Mailing Address 1: 973 NC HIGHWAY 801 NORTH 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 2 CAROLINA HOME PLACESECTION ONE Fire Response District: MOCKSVILLE Assessed Acreage: 0.52 Elementary School Zone: CORNATZER Deed Date: 1/1993 Middle School Zone: WILLIAM ELLIS Deed Book / Page: 1993EO200 Soil Types: Gn62 Plat Book: 0005 Flood Zone: Plat Page: 196 Watershed Overlay: DAVIE COUNTY Building Value: 0.00 Outbuilding & Extra Freatures Value: 0.00 Land Value: 17000.00 Total Market Value: 17000.00 Total Assessed Value: 17000.00 av f Ag data Is provided as Is withoutwarranty, or guarantee of any kind elther expressed or Implied Including but not limited to the 9 6• Davie County, Implied vanardles of merchantabggyorranesa for a particular use. All user, or Davie County's Ghimbsge shall hold harmless the County of Davie, North Carolina, Its agents, consultands, contractor, oremployees, from any and all clalms or causes of action duet* �Ob 4 NC or adeing out of the use orinabllltyto use the GIS data provided by this veWge a . DAVIE COUNTY ENVIRONMENTAL HEALTH P.O. Box 848/210 Hospital Street Mocksville, NC 27028 . (336)751-8760 Fax # (336)751-8786 AUTHORIZATION FOR WASTEWATER SYSTEM CONSTRUCTION Account #: '990002446 Tax PIN/EH #: 5758-03-6631 Billed To: RW Thomas Builders, LLC Subdivision Info: Carolina Home Place Lot # 2 Reference Name: Location/Address: Linda Lane -27028 Proposed Facility: Residence Property Size: 200x200 ATC Number: 4573 **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 complianc0 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 FIVE YEARS, This ATC is subject to revocation if site plans, plat or the intended use change. Residential Specification: Building Type 5 r #People _#Bedrooms ,?#Baths 0. Basement w/Plumbing: T Basement/No Plumbing T Commercial Specification: Facility Type #People #People/Shift _ #Seats Lot Size Type Water Supply Design Wastew ter Flow (GPD) _ Site: New Repair System Specifications: Tank Size b0')GAL. Pump Tank AL. Trench Width _J6 Trench Depth 3& I Rock Depth'Linear Ft t G On Required Site Modifications/Conditions: Contact the Davie County Environmental Health Section for fmal inspection of this system between x•sn _ o•an� m nn f6n dov of inafolloHnn Tnlan6nnn ff /17617C1_Q7611 -30" d )L_ L -J K�tP 5L) -;4"m GS s / w Environmental Health Specia DCHD 11/06 (Revised) c ti CA S DAVIE COUNTY ENVIRONMENTAL HEALTH P.O. Box 848/210 Hospital Street Mocksville, NC 27028 (336)751-8760 Fax #(336)751-8786 Account #: 990002446 OPERATION PERAfIL PIN/EH #: 5758-03-6631 Billed To: RW Thomas Builders, LLC Subdivision Info: Carolina Home Place Lot # 2 Reference Name: I Location/Address: Linda Lane -27028 Proposed Facility: Residence Property Size: 200x200 ATC Number: 4573 **NOTE** The issuance of this Operation Permit shall indicate the system 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. System Type: S.T. Manufacturer Tank Date Tank Size Pump Tank Size System Installed By: E.H. Specialist: Date: APPLICATION FOR SITE EVALUATION/IMPROVEMENT PERMIT & ATC Davie County Environmental Health P.O. Box 848/210 Hospital Street Mocksville, NC 27028 (336)751=8760/ Fax(336)751-8786 Application For: D Site Evaluation/Improvement Permit 9- uthorization To Construct(ATC) D Both Type of Application: ONew System DRepair to Existing System DExpansion/Modification of Existing System or Facility ***IMPORTANT*** THIS APPLICATION CANNOT BE PROCESSED UNLESS ALL OF THE REQUIRED INFORMATION IS PROVIDED. Refer to the INFORMATION BULLETIN for instructions. APPLICANT INFORMATION Name to be Billed Y• • �lh �d ��S Contact Person -?d AbV%lp— "AS Billing Address LL '� • Home Phone /o(rni -470 City/State/ZIP Ata I / A16 Business Phone Name on Permit/ATC if Different than Mailing Address ' NOTE: A survey plat or site plan must accompany this application. Included: D Site Plan DPlat(to scale) (Permit is valid for 60 months with site plan, no expiration with complete plat.) Owner's Name LV a2r?. yh i Phone Number Owner's Address 111 F a, QAAO, City/State/Zip Property Address City Lot Size Z40)( 7-01) Tax PIN# 5-1 Subdivision Name(if applicable)_(T&O-& a YItP f�'*ee Section/Lot# Z Directions To Site: 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? D Yes TNo Does the site contain jurisdictional wetlands? Dyes CI110 Are there any easements or right-of-ways on the site? DYes -ffffo Is the site subject to approval by another public agency? Dyes iTN� Will wastewater other than domestic sewage be generated? Dyes �No IF RESIDENCE FILL OUT THE BOX BELOW . # People # Bedrooms -1 # Bathrooms Garden Tub/Whirlpool es DNo Basement: DYes Dlo Basement Plumbing: Dyes &To� IF NON -RESIDENCE FILL OUT THE BOX BELOW Type of FacilityBdsiness Total Square Footage of Building # People # Sinks # Commodes # Showers # Urinals Estimated Water Usage (gallons ,per (Attach documentation of similar facility water consumption) FOODSERVICE ONLY: # Seats Type system requested:. conventional DAccepted DInnovative CAltemative DOther Water Supply Type: ounty/City Water O New Well DExisting Well O Community Well Do you anticipate additions or expansions of the facility this system is intended to serve? ❑ Yes 2-11-0— 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 permits) 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 corners and locating and flagging or stlting t}i ouse/facility location, proposed well location and the location of any other amenities. Site Revisit Charge Property own s or owner's legal representative signature a' Date(s): 3 / Client Notification Date: Dae EHS: Sign given Dyes DNo Account # Revised 11/06 Invoice# /_/N» APPLICATION FOR SITE EVALUATION/IMPROVEME ERMIT & A D Davie County Environmental Health JAN 17 2007 1 P.O. Box 848/210 Hospital Street Mocksville, NC 27028 ENNRONMIMAL HEALTH (336)751-8760/ Fax (336)7§T 8786 11AV IIfuly Application For: O Site Evaluation/Improvement Permit BIkuthorization To Construct(ATC) 0 Both Type of Application: DNew System ORepair to Existing System DExpansion/Modiftcation of Existing System or Facility ***IMPORTANT*** THIS APPLICATION CANNOT BE PROCESSED. UNLESS' ALL OF THE REQUIRED INFORMATION IS PROVIDED. Refer to the INFORMATION BULLETIN for instructions. Name to be Billed Lo v , s-- S rYi r 5 Contact 1 Billing Address 1 N 8 A 7iu dr9 l kut/.a- Home City/State/ZIP ,M �lssu'l/t Hc- a9oag Business Name on Pemmit/ATC if Different than Above Mailing Address PROPERTY INFORMATION *Date House/Facility Corners Flagged 1 - 1'1- (3'1 NOTE: A survey plat or site plan must accompany this application. Included: 0 Site Plan OPlat(to scale) (Permit is valid for 60 months with site plan, no expiration with complete plat.) Owner's Name Loyl65 - S M: -S -e- Phone Number Owner's Address Epi— City/State/Zip PropertyAddress Ln�.wc City Lot Size Dbe,gg b„ :) oo.*o _ Tax PIN# 6758-03-(0(03/ To Site: US I -)&✓v Wo 7-o B3rrAxi- el+ /ROO Job OW A erred?- 6'-aoy7— 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 BNo Does the site contain jurisdictional wetlands? ❑Yes BNo Are there any easements or right-of-ways on the site? ❑Yes f390 Is the site subject to approval by another public agency? ❑Yes 2No Will wastewater other than domestic sewage be generated? Dyes RK0 IF RESIDENCE FILL OUT THE BOX BELOW # People # Bedrooms 3 # Bathrooms -2, Garden Tub/Whirlpool -2Yes ONo Basement: OYes i2No Basement Plumbing: ❑Yes 2K5 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: ❑Conventional DAccepted DInnovative ❑Alternative ❑Other Water SupplyType:,E<o-unty/City Water 0 New Well ❑Existing. Well 0 Community Well Do you anticipate additions or expansions of the facility this system is intended to serve? 0 Yes a811Qo If yesi 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 and flagging or sta a house/facility location, proposed well location and the location of any other amenities. I Site Revisit Charge "Property owner's or owner's legal repr sentative signature Sign given DYesONo Account# ZqqOO16-� Revised 11/06 Invoice # Date(s): / 7--a7 Client Notification Date: Date EHS: Sign given DYesONo Account# ZqqOO16-� Revised 11/06 Invoice # tll/i//Ztltll tltl: YL 3dbLf�]/]S �IIIR( YUINIS IYnAJ" PAUk W Lot 2 0.62 acres 26868.09 sq ft -Ilk k. � - LOT 4 PLAT BOOK 5, PAGE 196 Lot 3 0.51 acres 22000.00 sq ft ,5 ✓` CHARLES MISE z5,.65 DEED BOOK 91, PAGE 564 PREuuwarf NOT FOR SALES. CWVEYNXEA°raw'" hp: - ORIMCOr+DAMN Ftk name: l3 I a lone r.w. LEGEND InYP�eYygtlbYwrMnn49��b.>MObalwn ArlmENRb YEKIVYtlIeew gkp,elert SITE Th Ybwe, MYMOY,w�6wmYuesrtmll�i�tlfYlO�uwY.iMl�p�YyYwrbhubiMN NYc4s�e mN//e�nlY4wbl�wwm�vortlwillb W�wl�t,ab1�MY�.4&uriOletGIMM. 0 Iron pipe found S.S. Sanitary Sever ess Private San.Sew. Une Acc& U LN. Lot 3, Section 1 . Iron pipe tet P.S.S.LBM.E. Plat Book 5, Page 196 x professional la—an —surveyors #MI. Mocksville Township RRAN RigM of Way - Meft Easement eETM Cn. A PVMT. Pavement Power Pole,g S.R. State Road Computed Point ( Not Set) DRNG. Drainage p Monument us. iYww MAW.Meettenance MBL Minimum l Max Building Une M PLAT NORTH UTIL. UTIL Uggty Easement ^� — overhead Power Line Fence Una Location Map: NotTo Sca4 P.B.S, PG. t Lot 2 0.62 acres 26868.09 sq ft -Ilk k. � - LOT 4 PLAT BOOK 5, PAGE 196 Lot 3 0.51 acres 22000.00 sq ft ,5 ✓` CHARLES MISE z5,.65 DEED BOOK 91, PAGE 564 PREuuwarf NOT FOR SALES. CWVEYNXEA°raw'" hp: - ORIMCOr+DAMN Ftk name: l3 I a lone r.w. Plot Plan For. InYP�eYygtlbYwrMnn49��b.>MObalwn ArlmENRb YEKIVYtlIeew gkp,elert _ Th Ybwe, MYMOY,w�6wmYuesrtmll�i�tlfYlO�uwY.iMl�p�YyYwrbhubiMN NYc4s�e mN//e�nlY4wbl�wwm�vortlwillb W�wl�t,ab1�MY�.4&uriOletGIMM. „,;;�,.„r�-.�Y�..o„..a».�,.�a�o. R.W. Thomas Bldrs. 132 (nda lu,F:o,-,y- T :,'' deine am .�� ";�h: �° Lot 3, Section 1 Caroina Home Place four points surveyors AIC Plat Book 5, Page 196 x professional la—an —surveyors #MI. Mocksville Township _ I ,o,�f Parkway a—_ - _ _ _ . Davie County, NC JAN 17,2007 10:23A 3362735759 r t, ',ate ~ 'Davie County Nealt/i 'Department and :7fame NealtFi ✓lyency ,; r 210 HOSPITAL STREET/ P.O. BOX 665 - I MOCKSVILLE, N.C. 27028 PHONE: (704) 634-5985 i December 20, 1989 Jesse Boyce Zoning Officer County Office. Building. South Main Street Mocksville, NC 27028 Re: Site Evaluation Carolina Homeplace/'Lot 2 Dear Mr. Boyce: This letter is in regard to Lot 2 in Carolina Homeplace on Bethel Church Road in Davie County. Based on the soil conditions on said lot the size could be reduced from 26,000 square feet to 20,000 square feet and still be large enough to accommodate a septic tank system and its repair. If you have any questions, feel free to call. Sincerely, �J Robert. B. Hall, Jr., R.S. Environmental Health Section RH/wd cc: Charles Mise ~ DAVIE COUNTY HEALTH DEPARTMENT Environmental Health Section. P. O. Box 665 Mocksville, N.C. 27028 SOIL/SITE EVALUATION Name Date pS Address Lot Size yl�elo yw U F FACTORS AREA 1 AREA 2 AREA 3 AREA 4 Topography/ Landscape Position CS pS PS U U U U !) Soil Texture (12-36 in.) Sandy, Loamy, Clayey, (note 2:1 Clay) PSPS (SrtT S PS U U 1) Soil Structure (12-36 in.) Clayey Soils S��- PS (PS) ��tltl�� S PS S PS U U y Soil Depth (inches) PS S S PS S PS U U Soil Drainage: Internal PS S PS U S PS U External pS PS S PS U S PS U I) Restrictive Horizons Available Space S S S PS__,. S PS U U 1) Other (Specify) S PS S PS S PS S PS U U U q Site Classification pU U—UNSUITABLE S—SUITABLE PS—Provisionally Suitable Recommendations/ Comments: e Described by Title ✓ 4 All Date AZZ SITE DIAGRAM F DCHD (6.821 20 fa DAVIE COUNTY HEALTH DEPARTMENT Environmental Health Section SoiVSite Evaluation APPLICANT INFORMATION PROPERTY INFORMATION Account #: .989900571 Tax PIN/EH #: 5758-03-9972.02 Billed To: Shuler Building Subdivision Info: Carolina Home Place Lot # 02 Reference Name: Location/Address:. Linda Lane -27028 Proposed Facility: Residence Property Size:'' see map, Date Evaluated: ' 'Water Supply: On-Site.Well Community Public Evaluation By: Auger Boring Pit Cut FACTORS . 1 2 3 4 5 6 7 Landscape position L G L Slope % HORIZON I DEPTH Texture group Consistence 1 Stmcture SB/� Mineralogy HORIZON II DEPTH LN - 1-f S 4 —4,6 ... Texture groupSGL 5 Consistence Structure 56k L 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. P/h EVALUATION BY: LONG-TERM ACCEPTANCE RATE: 3 OTHER(S) 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 y y .:.. S -.Sand LS -Loam sand SL` -Sand 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 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 Mineraloev 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 05/99 (Revised) PLAT NORTH P.B.5, PG.196 °31 10 00 Iron pipe found 0 Iron pipe set RMI Right of Way PVMT. Pavement 0 Power Pole DRNG. Drainage MAINT. Maintenance UTIL. Utility ESMT. Easement LEGEND S.S. Sanitary Sewer P.S.S.L.&M.E. Private San.Sew. Line Access & Maint. Easement S.R. , ; State Road -a Computed Point ( Not Set) El Monument MBL Minimum / Max Building Line _ ^ _ Overhead Power Line Fence Line ENEW-W O j Lot 2 0.62 acres . 26868.09 sq ft /Y I1t G .65 4AO 1;-J- 1--- .... . .... off,\ SITE LINDA IN. BETHEL CH. RD. U.S.HWY64 Location Map: Not To Scale Lot 3 0.51 acre ?000.00 S CHARLES MISE DEED BOOK 91, PAGE 5�4 I a� IL L m a - L0UISE G. MISE W. B. 1993—E-200 DEED REF. D.B. 146, PG. 555 D.B. 128, PG. 825 40 20 0 40 80 120 }��--------II SCALE IN FEET NOTES: .. /Zy� ELIZABETH S. PEPPER TOTAL AREA 1.166 ACRE THE REMAINDER OF LOT #2 CAROLINA HOME PLACE 0.524 ACRE 44aet�tf8��!":sss I, GRADY L. TUTTEROW, CERTIFY THAT UNDER MY DIRECTION AND SUPERVISION, THIS MAP �``�..•• ""'"'••• Q( '• WAS DRAWN FROM AN ACTUAL FIELD SURVEY MADE TUTTE W SURV ING CO.1 MP NY. a) PROFESSIONAL LAN SU VEY R L-2527 � RTUTTEROWVEYING COMPANY4. O107 N SALISBURY ST. MOCKSVILLE, N.C. 27028 (336) 751-5616