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141 Sain Road Lot 3Davie County, NC ITax Parcel Report Tuesday, November 15, 2016 1986 1977 5 128 126 197 124840,1 125,.1!111. "---.19 4919 48 1951 `1942 1938 207 1925 1930 1917 1903 14 143 15 183 123 138 SAIN RD 133 11 SAINT RD z 152 �' 148 E Z 166 194 344 324 343 353 f 3611 407 231 5.26,27311 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. Ali users of Gavle Countys GIS webstte 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 F-a7 NC or arising out of the use or inability to use the GIS data provided by this webstia WARNING: THIS IS NOT A SURVEY Parcel Information Parcel Number: H50000002912 Township: Mocksville NCPIN Number: 5749267351 Municipality: Account Number. 8302805 Census Tract: 37059-805 Listed Owner 1: RICE JOSEPH WILLIAM Voting Precinct: NORTH MOCKSVILLE COUNTY Mailing Address 1: 124 CHANDLER DRIVE Planning Jurisdiction: Davie County City: MOCKSVILLE Zoning Class: DAVIE COUNTY R -A State: NC Zoning Overlay: DAVIE COUNTY QD Zip Code: 27028 Voluntary Ag. District: No Legal Description: LOT 3 CHASE MEADOW Fire Response District: MOCKSVILLE Assessed Acreage: 5.02 Elementary School Zone: MOCKSVILLE Deed Date: 4/2014 Middle School Zone: SOUTH DAVIE Deed Book / Page: 009560114 Soil Types: PaD,We13 Plat Book: 0007 Flood Zone: Plat Page: 055 Watershed Overlay: DAVIE COUNTY Building Value: 104420.00 Outbuilding & Extra Freatures Value: 3910.00 Land Value: 62030.00 Total Market Value: 170360.00 Total Assessed Value: 170360.00 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. Ali users of Gavle Countys GIS webstte 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 F-a7 NC or arising out of the use or inability to use the GIS data provided by this webstia M DAVIE COUNTY HEALTH DEPARTMENT Environmental Health Section P. O. Boa 848/210 Hospital Street Mocksville, NC 27028 (336)751-8760 Account #: 990001292 Billed To: VINCENT NEWBERRY Reference Name: Proposed Facility: RESIDENCE ATC Number: 2496 Tax PIN/EH #: 5749-36-0301 Subdivision Info: Chase Meadows Lot # 3 Location/Address: 1411 Sain Road -27028 Property Size: SEE MAP 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 WASTEWATER CONSTRUCTION IS VALID FOR A PERIOD OF FIVE /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 periodof ime. $� 100 c Septic System Installed By: 16 o, :10-1- Environmental Health Specialist's Signature: %M Date: /a —/-7—Ob DCHD 05/99 (Revised) DAVIE COUNTY HEALTH DEPARTMENT Ok Environmental Health Section P. O. Boa 848/210 Hospital Street Mocksville, NC 27028 (336)751-8760 IMPROVEMENT/OPERATION PERMIT Account #: 990001292 Tax PIN/EH #: 5749-36-0301 Billed To: VINCENT NEWBERRY Subdivision Info: Chase Meadows Lot # 3 Reference Name: Location/Address: 141 Sain Road -27028 Proposed Facility: RESIDENCE Property Size: SEE MAP ** TEG.VVbgr. 2496 N Is mprovement/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 s1 #Baths_ Dishwasher: ❑ Garbage Disposal: ❑ Washing Machine: Basement w/Plumbing: ❑ Basement/No Plumbing: ❑ Commercial Specification: Facility Type #People #People/Shift #Seats Industrial Waste: ❑ Lot Size Type Water Suppl Design Wastewater Flow (GPD),- Site: New Repair ❑ tl ! System Specifications: Tank Size/ e -o GAL. Pum Tank GAL. Trench Width Rock Depth/ Linear Ft.j6M Other: Required Site Modifications/Conditions: 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.m. on the day of installation. Telephone # is (336)751-8760.**** it G i i BOX C, ss Environmental Health Specialist's Signature: ate: -� DCHD 05/99 (Revised) Ole APPLICATION FOR SITE EVALUATION/IMPROVEMENT PERMIT & AT Davie County Health Department D Eni innlnental Health SeWon U1 2 0 2000 P.O. Box 848/210 Hospital Street Mockaville, NC 27028 ----- (336) 751-8760 ***IMPORTANT*** THIS APPLICATION CANNOT BE PROCESSED UNLESS ALL THE REQUIRED INFORMATION IS PROVIDED. Refer to the INFORMATION BULLETIN for instructions. 1. Name to be Billed !�/N�t�h / s C !a �e�i/ Contact Person Mailing Address /707 C0a' /h-/ 1d •,. L' Homophone City/State/ZIP !`«Y %S v/!Ir )1J C a 70,9 Busiasss Phone 2. Name on Permit/ATC if Different than Above Mailing Address 1 3. Application For: O Site Evaluation .H" C_ittyy/State/Zip Improvement Permit/ATC 0 Both s. system to Ssrviee: House ❑ Mobile Home 0 Business ❑ Industry 0 Other s. If Residence: # People # Bedrooms 3 # Bathrooms Z_ ❑ Dishwasher ❑ Garbage Disposal YKW..hJLng Machine ❑ Basement/Plumbing ❑ Basement/No Plumbing 6. If 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: -ll County/City ❑ Well ❑ Community e. Do you anticipate additions or expansions of the facility this system Is intended to serve? 0 Yes 0190 If yes, what type? ***IMPORTANT*** CLIENTS MUST COMPLETETHE REQUIRED PROPERTY INFORMATION REQUESTED BELOW. Either a PLAT or SITE PLAN MUST BESUBMITTED by the client with THIS APPLICATION. Property Dimensions: s,ee Tax Office PIN: # �7��1' 36 — a 30 Property Address: Road Name /11-// -S"' a city/zip Aar//fv(/1r r -C v,TcdB If in a Subdivision provide information, as follows: Name: ay-( C Alr'AJ t' uyS Section: Block: Lot: WRITE DIRECTIONS (from Mockkssvilllllee) to PROPERTY: /S -J' A At C��/vC arJ �r%f Date Property Flagged: 7-- 010— 0 0 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 pians 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 to conduct all testing procedures as necessary to determine the site suitabil . DATE: -0�0' Qt] SIGNATURE THIS AREA MAY BE USED FOR DRAWING YOUR SITE PLAN (Include all of the following:sting and proposed property lines and dimensions, structures, setbacks, and septic locations). Site Revisit Charge Date(s): I Client Notification Date: `EHS: D Account No. / :�' 4 12 - Revised Revised DCHD (07/99) Invoice No. I Oa Q Z O O J�1,O c N m 0 Lci IR S 86.59 52 'E Q i 0 ;N^ � b U V -J. , .90" (le vn + x.46'25 , A-38p„ta}uawanod —�+, az �� a�rn d ,09 Grovd 0 JLU Q =) N � � c N O O� o w m 100.09' S 89'26'30"E o �o L- 0 cu ti •-�►= uto O O J�1,O c N m 0 Lci IR S 86.59 52 'E Q 0 ;N^ � b U V -J. , .90" (le vn + x.46'25 , A-38p„ta}uawanod —�+, az �� a�rn d ,09 Grovd APPLICATION FOR SITE EVALUATIONAMPROVEMENT PET F A C Davie County Health Department Environmental Health Section P. O. Box 848 SEP 15 1998 Mocksville, NC 27028 P I (704) 634-8760 cuvirintiMP TAI HFALIH ****IMPORTANT**** THIS APPLICATION CANNOT BE PROCESSED UNLESS ALL THE REQUIRED INFORMATION IS PROVIDED. 1. Name to be Billed 1 '.4 I A C• Agj V A U u Contact Person A &=2.7 S� 0 N c Gfo Sroi�r LArlo SV&%/cNrKl(I Q . Mailing Address A ^TTr`1 2031 4- Y STo r l a Home Phone City/State/Zip 3 00 •SdyTrl / IA "J S'r , ,/✓fid ��.SJ LLd , nIL Business Phone 336'-751- y I -I.S / 2.7ot8 2. Name on Permit/ATC if Different than Above 10 1 A C . A G V A LL b Mailing Address .I As'4 %3 100'J A"UIL City/State/Zip ip 3. Application For: Q Site Evaluation ❑ Improvement Permit & ATC ❑ Both 4. System to Serve: 5. If Residence: ❑ Dishwasher 6. If Business/Other: # Commodes _ If Foodservice: ❑ House ❑ Mobile Home ❑ Business ❑ Industry ❑ Other # People # Bedrooms # Bathrooms ❑ Garbage Disposal ❑ Washing Machine ❑ Basement/Plumbing ❑ Basement/No Plumbing 7. Type of water supply: Specify type # Showers # Seats 1( County/City # People # Urinals Estimated Water Usage (gallons per day) _ ❑ Well # Sinks # Water Coolers 8. Do you anticipate additions or expansions of the facility this system is intended to serve? If yes, what type? ❑ Community Cl Yes ❑ No PROPERTY INFORMATION REQUIRED: *** IMPORTANT *** A PLAT OF THE PROPERTY MUST BE SUBMITTED WITH THIS APPLICATION. Property Dimensions: S C`- p LA. T 1 WRITE DIRECTIONS (from Tax Office PIN: # S y �1 - -3 (O - z 2 Mocksville) TO PROPERTY: sArN 120 1"� R4 Property Address: Road Name ��g�� City/Zip If in Subdivision provide information, as follows: � c..'e., pAA,Q0S6-0 S\1,3 0tJrSiu,� . ° Name: 6V'6'0r J ► S ) mJ Section: Lot #: 1 y4pL bcLc/` tj; l Le- - _1 jG✓LCy2, 0.C -J Q 4JL0.0-r'/ This is to certify that the informatibn provided is co ect 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 \j and owned by ► S r►J r z* G • A G VA LLO to conduct all testing procedures as necessary to determine the site suitability. DATE -X- c/ - 1f - 745 SIGNATURE ; Revised DCHD (06-96) /Jct I �l �, a�� i ;r DAVIE COUNTY HEALTH .DEPARTMENT - Environmental Health Section • Soil/Site Evaluation NAME ' ` y ADDRESS PROPOSED FACIILTY DATE EVALUATED PROPERTY SIZE S� LOCATION OF SITE Water Supply: On -Site Well Community Public A--' Evaluation By: Auger Boring Pit Cut FACTORS 1 2 3 4 Landscape position Sloe % 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 SITE CLASSIFICATION: _ 2_ LONG-TERM ACCEPTANCE RATE - REMARKS: aer ire,z✓ 1� DCHD(01-901 EVALUATED BY: (S) PRESENT: LEGEND /off Z 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 (;lay 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 watef 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 ■o■ ■o■ ■E■ ■ Existing Iron Bar 3 Y) COI- C,4 0) N m Z g256'k0� 1&1/2" EIP � 2ya °38'40"E 345.90' 65.67' T—Bar w/cap P.24' IRS N rn rn p its N m res V 'W'w V, S 03°00'3511WIRS °-' non nn, IRS 03' Lot 3 4.915 Acres � 118 N 02020'10"E 754.48- 35"E 280.00' iIRS cn p ! Z I 1 � Lot 4 bt. 2 - 3.504 Acres .!Acres t/— rA p 1 ZZ 759.25' 10M, IRS 1039.25' S 0 :': '55'35"W i ,j T—Bor w/cop z rn 0 V O' m T—Ear w/cap N 17- 3p,5 0,,4. ?0799, 1" EIP Control C rn IRS Ga w cn T—Bar Contra