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348 Beauchamp RdDavie Countv, NC 0 Tax Parnal R Pr�nrt Wednesdav, October 12, 2016 Parcel Number: NCPIN Number: Account Number: Listed Owner 1: Mailing Address 1: City: State: Zip Code: Legal Description: Assessed Acreage: Deed Date: Deed Book i Page: Plat Book: Plat Page: Building Value: WAK1VllVCT: '1'tll51� 1VU"1' A SUKVI;Y Parcel Information F80000002805 Township: 5870664516 Municipality: 8304783 Census Tract: DENNIS CHRISTOPHER GLYNN Voting Precinct: 348 BEAUCHAMP ROAD Planning Jurisdiction: Advance Zoning Class: NC Zoning Overlay: 27006 Voluntary Ag. District: 3.403 AC BEAUCHAMP RD Fire Response District: 3.32 Elementary School Zone 2/2015 Middle School Zone: 009810286 Soil Types: Flood Zone: Watershed Overlay: 169520.00 Outbullding & Extra Freatures Value: Land Value: 47100.00 Total Market Value: Total Assessed Value: 216620.00 °��'�' Davie County, �o� NC Shady Grove 37059-803 EAST SHADY GROVE Davie County DAVIE COUNTY R-A No ADVANCE SHADY GROVE WILLIAM ELLIS GnB2,GnC2 DAVIE COUNTY � �� 216620.00 All dah Is provided as Is wlthout warranty or guanntee of any klnd either expressM or Implied Including but not Ilmked to the Implied warran8ea oT mercharMability or fitness for a particular use. Ail users of DaNe County's GIS website ahall hold harmteu the County of Davie, North Grolina, tta agents, consuttaMa, contracton or employees from any and all dafms or cauus of acdon due ta or arising out of the use or Inabllity to use the GIS data prov(ded by this website. FR�`1 :-, ^•+ FAX N0. : Apr. 24 2012 07: 38AM Pl .� � i ��� vie County �e�ilth �epamnent o�'Vr �'�' ' � � ��p�� �vironrnenr�l �ealth Sectior� �e ► Fliouc: (881;) - 758 - ti7RQ � > P.U. liax R4K �./' Z 10 H�spit•al Sh•c:et. �.UUCI(:T # : (��%Q���) • , Mocksville, NC: `Z702H I�:c�: (J;iti) - 7.5I - 87i3(i ON-SITE WASTEWATER CERTIFICATION FOR DVVEY.X�YNG (Check One) Replacement Remodelin� Reconnection Name: � I Ar.►� ��Dc'� \ Phone Number Td 7' 6�%�� (Home) MailingAddre ��{S .pe�.uc�a.n �)/� (Work) ' ,,, _. __. _ ___- -?�6 E��i �5'i�e,-f- I oo@ �4�ao , eoM Detailed Directions To Site:1¢w u/S� fo �/�� �e r e� `T'� a �v Property Address• .'�'/r}�►+ � .� ., � Please Fill Yn T6e �ollowiipg �nformation Aborit The EXISTING Fac�7ity: Name System Instatled Undcr: �-i'1- ��� �1 � �Type Of Facility:_�nld. S�pft c. Date System installed (Monrh/DateJYear):_J_-%S' �3 Nuznber Of Bedrooms: � � Number Of People: .2- Ts The Facility Currently Vacant? Yes o�If Yes, For How Long? � � - Any Known Problems? Yes No If Yes, Explain: _ please Fill In Thc Following Tnformation About The NEW Facility: � of ���i� �_, �o.�.l____ �-� � ) ! 3 � ryp ty: �e��N G�a � � e�„� Number pf Bedr ms: Number of People R.equested By: �y,, Date Requested: �' �s' � .�.- Approved Health For Environmental Health Office Use Only *The signin� u�'this form by the Environmental Hcalth (exter�ded or limited) that the 4n-�ite wastewater s Date: � is in no way intended, nor should be taken as a guarantee will function vroneriv for fayment: Cash Che � Money Order # ����D Amount:S ��d '�a Da� �� Peid Ay:_,,, � . Received By: � �� ^ Account #:_, 1 X� [ � �� :7 ,,,,Invoice #: �� j?/ � f / �/ � �I �,� �v'�,(�,(�' �J��'/Z c-'IJI,a/� '�Sli[�r� rUoc�c7"- �j�-�t,l/ll�'��-{. of time. 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D� ►ve."'a� ¢�t � �3 � --� - �-- � / j-j(AAI.T1�l�► ' _ _ _ ' � 1'f^�"i"AG��� �` ��`'�tA�,� ��-D+�'���i �ar e d r ���.`'� ►D N � :. D X 0 w � m r N m N � � D 3 � � ' --. - .. , -- _ DAVIE COUNTY HEALTH DEPARTMENT IMPROVEMENTS PERMIT AND CERTIFICATE OF COMPLETION *NOTE: Issued in Compliance with G.S. of North Carolina Chapter 130 Article 13c Sewage Treatment and Disposal Rules (10 NCAC 10A .1934-.1968) Permit Number Name —n, �-, l;Ll IL1 � f'/l. � 7TR- . Date �3�T/ Z�"��-�' � .- <•, %' , . , ;��?�'�. Location ; U/ y��rl�1n/c�(�r�� �S�`�T�—,��—��-t��� ��P,�Zn,r� , ��—l'�h!4t?�� �7��— ���1�lrx la ����.� m�-1�.� Subdivision Name Lot No. Sec. or Block No. Lot Size ___1�(� House Mobile Home ~ Business __ Speculation No. Bedrooms _� _ No. Baths _� — No. in Family ��_ Garbage Disposal Auto Dish Washer Auto Wash Machine Type Water Supply YES ❑ NO � YES � NO � YES � NO ❑ Specifications for System: IOU�'r�,;�c, D- �o� �-c s���c 3-/� r��'�� I'nil /i ��fil���iW /� C �!" �� / ~ �� //C! � "This permit Void if sewage system described below is not installed within 36 months from date of issue. � ::���^__.�=� � ____ ..___ _ _ .___ .__._.__ __.-- Improvements permit by ; , E i i;, '`Contact a representative of the Davie County Health Department for final inspection of this system between 8:30- 9:30 A.M. or 1:00-1:30 P.M. on day of completion. Telephone Number: 704-634-5985. .� /1 Final Installation Diagram: ��System Installed by.����`'i��''- `-�'`��� �.���/`'� �: ��� ` _�_____.__.�..1 __________.. �z_��;. �'�/. , ��� Certificate of Completion �" ��! >' -% Date --'' �� / �_` , � ,. 'The signing of this certificate shall indicate that the system descrit�ed above has been installed in compliance with the standards set forth in the above regulation, but shali in NO way be taken as a guarantee that the system will function satisfactorily for any given period of time. , y _` , ` ' ' � DAVIE COUNTY HEALTH DEPARTMENT Environmental Hea�th Section P. 0. Box 665 Mocksville, N.C. 27028 SOIL/SITE EVALUATION Name �i. L. �AR-T�R . J�. �q�- �a l�� Date s Z-5`-�3 Address �-}' �- ��'� ►07 Lot Size � �� i�-r�tJav�ce ►'�C Z7oalo FACTORS 1) Topography/Landscape Position 2) Soil Texture (12-36 in.) Sandy, Loamy, Clayey, (note 2:1 Clay) 3) Soil Structure (12-36 in.) Clayey Soils 4) Soil Depth (inches) 5) Soil Drainage: Internal External 6) Restrictive Horizons S �� U S �% U � U � PS U S � U � PS U S �� U S �� U S � �� PS U S _� U � PS U AREA 3 S PS U S PS U S US PS U S PS U PS U AREA 4 S PS U S PS U S PS U PS U S PS U PS U 7) Available Space S S S � -� PS PS � U U U 8) Other (Specify) S S S S pg PS PS PS U U U U 9) Site Classification �S /� U—UNSUITABLE S—SUITABLE PS—Provisionali Suitable Recommendations/Comments: 5�1lvw S�S-1• ro ��-. �.- ���` `�-�w PJ�.� C� n Q, - ��'�(� Described by Q • �� � R � S � Title �^^� � '� �`�` �`�"`�`�ti Date � ' 2s "�3 SITE DIAGRAM 2 „ „ 1 _ � � 0 3 DCHD (6-82) � ���R'��'�,�� �i Fg k � �r vw �+P S �� �) b O CX. S M � . ,. ^ , � `'`• APPLICATION FOR SITE EVALUATION/IMPROVEMENTS PERMIT � Davie County Health Department � Environmental Health Section P. O. Box 665 Mocksville, N.C. 27028 CONSTRUCTION SHALL NOT BEGIN UNTIL IMPROVEMENTS PERMIT HAS BEEN ISSUED. Home Phone �4/a) f9R �68 1. Permit Requested By N�• L. C'�rk��r _�r. Business Phone ��'l� �1'(a�- �'�9(0 2. Address ��' Z ��J ui�}-,�u - 270 ��- 3. Property Owner if Different than Above �— Address 4. Permit To: a) Install� Alter Repair b) Privy Conventional �ther Type Ground Absorption c) Sub-Division Sec. Lot No. 5. System used to serve what type facility: House Mobile Hom'e�. Business Industry Other b) Number of people a 6. a) If house or mobile home, state size of home and number of rooms. House Dimensions ��f- � X '70� Bed Rooms� Bath Rooms � 3�`F Den w/Closet b) If Business, Industry or Other, State: Number of persons served �— What type business, etc. �� Estimate amount of waste daily (24 hours) — 7. Number and type of water-using fixtures: commodes�� urinals garbage disposal � lavatory a showers a washing machine � dishwasher �� sinks —�� 8. a) Type water supply: Public � Private Community b) Has the water supply system been approved? Yes � No 9. a) Property Dimensions � �-�- b) Land area designated to building site '-� c) Sewage Disposal Contractor S{ -���-- �•��--'��-� 10. Do you anticipate any additions or expansions of the facility this sewage system is intended to serve? �a What rype? ' This is to certify that the information is correct to the best of my knowledge. : � - ��-8'3 c� � Date Owner Sig ature � OWNER IS SOLELY RESPONSIBLE FOR COMPLIANCE WITH ALL STATE AND LOCAL LAWS Allow 5 days for processing Directions to property: �o � � j t2-� - c� -�-�- -�,l- - �.�.� 9 �� � . DCHD (6-82) ��.v� � f�"�- Pa�-- �I '� yr`� v-- � - 0 i �.�,.— �°� � � � 4 � � a '�.�'