1657 County Line Rd (2)Davie County, NCI 0
a � Tax Parcel Report �6 Tuesday, September 27, 2016
293 °w /
5366
11657;
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y' �5
I
5147
"1 ....� I X1651
WARNING: THIS IS NOT A SURVEY
0541
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i
112 `
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All data is provided as is without warranty or guarantee of any kind either expressed or implied including but not limited to the
Davie County, NC 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 from any and all claims or
causes of action due to or arising out of the use or inability to use the GIS data provided by this website.
Parcel Number
F100000048
Township:
Calahaln
i
NCPIN Number.
4890975147
Municipality:
Census Tract:
37059-801
Account Number:
82525320
Listed Owner 1I
BECK VILLARD K
Voting Precinct:
NORTH CALAHALN
Mailing Addreal 1:
1648 COUNTY LINE ROAD
Planning Jurisdiction:
Davie County
City:
HARMONY
Zoning Class:
DAVIE COUNTY R -A
State:
NC
Zoning Overlay:
Zip Code:28634-8909
Voluntary Ag. District:
No
Legal Description:
13.137AC COUNTY LINE RD LIFE
ESTATE
Fire Response District:
SHEFFIELD - CALAHALN
Assessed Acre age:
13.01
Elementary School Zone:
WILLIAM R DAVIE
Deed Date:
8/2003
Middle School Zone:
NORTH DAVIE
Deed Book f Page:
i
2005EO224
Soil Types:
PaD,PcC2,RnD,CeB2,ChA
Plat Book:
Flood Zone:
X
Plat Page:
Watershed Overlay:
WS -III -BW
Building Value:
0.00
Outbuilding & Extra
18230.00
Freatures Value:
i
Land Value:
88560.00
Total Market Value:
f
106790.00
Total Assessed Value:
106790.00
r[f]
All data is provided as is without warranty or guarantee of any kind either expressed or implied including but not limited to the
Davie County, NC 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 from any and all claims or
causes of action due to or arising out of the use or inability to use the GIS data provided by this website.
Permittee'sDAVIE COUNTY HEALTH DEPARTMENT
me:Av'vi
Na,`'� Environmental Health Section PROPERTY INFORMATION
r^ P.O. Box 848
Directions to property: ���` al:r= t��' Mocksville, NC 27028 Subdivision Name:
f � fi
) t Phone #: 336-751-8760
;�at.IJ'I i Section: Lot:
AUTHORIZATION FOR
�C > i f�'� FI tl�1: f T^WASTEWATER Tax Office PIN:# - -
t�r SYSTEM CONSTRUCTION �^y
AUTHORIZATION NO: O d A Road Nam
Jtp:
**NOTE** This Authorization for Wastewater System Construction MUST BE ISSUED by the Davie County Environmental Health Section prior
to issuance of any Building Permits. This Form/Authorization Number should be presented to the Davie County Building Inspections
Office when applying for Building Permits.
(In compliance with,Article 1 I of G.S. Chantr�r 130A, Wastewater Systems, Section .1900 Sewage Treatment and Disposal Systems)
,. ***NOTICE*** THIS AUTHORIZATION FOR WASTEWATER CONSTRUCTION
oz— IS VALID FOR A PERIOD OF FIVE YEARS.
VIRONbfENI4rHEALTH SPECIAL DATL ISSUED
RESIDENTIAL SPECIFICATION: BUILDING TYPE tA I # BEDROOMS # BATHS # OCCUPANTS ' GARBAGE DISPOSAL: Yes or No
COMMERCIAL SPECIFICAT�IIOnNJ: FACILITY TYPE # PEOPLE # PEOPLE/SHIFT� # SEATS INDUSTRIAL WASTE: Yes or No
LOT SIZE PAP o� PETER SUPPLY ' T DESIGN WASTEWATER FLOW (GPD) " ��"� NEW SITE REPAIR SITE r'
SYSTEM SPECIFICATIONS: TANK SIZE GAL. PUMP TANK GAL. • TRENCH WIDTH ROCK DEPTH LINEAR FT. '
OTHER 4
REQUIRED SITE MODIFICATIONS/CONDITIONS:
IMPROVEMENT PERMIT LAYOUT
415 TW 6
�- TcU�� L-iC xIST1t'(�
�,a�i 1W YVl Axl TI�11?
�taSJ�- 1F��T t�U {�'��T ��j4t !►a�Is�.�.---�;�,� r��My.. �- r
p� Aj-(AE,
1003v3u ''x/2 T0744- CaAAle-
**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 THE DAY OF INSTALLATION. TELEPHONE # IS (336)751-8760.
- . -- r •w .,. . �. -.-
u
r AUTHORIZATION NO. OPERATION PERMIT B DATE: ` bz,
**THE ISSUANCE OF THIS OPERATION PERMIT SHALL INDICA THAT THE SYSTE D SCRIBED ABOVE HAS BEEN INSTALLED 11 COMPLIANCE
WITH ARTICLE 11 OF G.S. CHAPTER 130A, SECTION .1900 "SEWA TREATMENT AND DISPOSAL SYSTEMS", BUT SHALL IN NOWAY BETAKEN ASA .
GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORIL FOR ANY GIVEN PERIOD OF TIME.
DCHD 02/02 (Revised) j
I
DAVIE COUNTY HEALTH DEPARTMENT ._.,.
Environmental Health Section
PO Box 848/210 Hospital Street JUL 2 5 2'7 ^ t
Mocksville, NC 27028 r
Phone: (336)751-8760 ENVIRONS^,E1VTA1 UE<iCTN
DAVIE COUNry
ON-SITE WASTEWATER CERTIFICATION FOR DWELLING
(Check One) REPLACEMENT ❑ REMODELING ❑ RECONNECTION ❑
Please Fill In The Following Information About The Existing Dwelling:
ae. J 11 m y j1 e
Name System Installed Under: I N f w iwE 4— e^- 6 - -'t ct Type Of Dwelling
Date System) Installed(Month/Day/Year): 7 Number Of Bedrooms: 3 Number .Of People:
Is The Dwelling Currently Vacant? Yes No 0 If Yes, For How Long?
Any Known Problems? Yes ❑ Nof Yes, Explain:
Please Fill In The Following Information About The New Dwelling:
Type Of
Requested By:.
W
Of Bedrooms: Number Of People: 3
Date Requested: / - S/ Lo-'?-
For Environmental Health Office Use Only
Approved ❑ Disapprove��d^r/�/n/❑ n `"j�,r-� r� /�n �_ ,. -yam
C'nMMpntc- 0"'t alp RV{/,�'" 1 1 ��/�/l/�2, / V Ln/i^`te&e-
*The signing of this form by the Environmental Health Staff is in no way intended, nor should be taken as a
guararitee(extended or limited) that the on-site wastewater system will function properly for any given period of time.
.o
ry
Payment: Cash ❑ Check ❑ Money Order ❑ # Amount: $ z Date:
Paid By: Received By: ��7e
Account # I_ —p— Invoice #: - "�
rya-' i" i.*� r � '...,. � • �� �S� � .l •,r � J t ;,� � ..1 w..� k
DAVIE COUNTY HEALTH DEPARTMENT
Environmental Health Section
PO Box 848/210 Hospital Street
Mocksville, NC 27028
Phone:. (336)751-8760
ON-SITE WASTEWATER CERTIFICATION FOR DWELLING
"(Check One) REPLACEMENT o REMODELING ❑ RECONNECTION ❑
Name: it Phone Number: `'1q Q -60 (Wbet) (Home)
Mailing Address: 1 ULA A lUl e W 3 (Work)
C -'
: � -
Detailed Directions To Siten� ` Vy iii �l P -Nd dd _Rd Q n ( Alt h"&.0 U fc-�) YYl 1 VP 5 60 W Y)
-he`d d 4� 0_.� Arn-A., U►)L6 - 5- 66w no rich _ V:011oto
r Ue I��Gu C rc � ar•rt/n�- 6 �aCc' o bay Y) CA_— c i `� S 0, \(74. ^G' � `
Property Address: ��� l'b� rAQ Lne 2d :N-fch l NC- dCa[3 A
Please Fill In The Following Information About The Existing Dwelling.
e Cie -
Name System installed Under: ^ w f �L" a^- K r) c( Type Of Dwelling:
Date System' Installed(Month/Day/Year): Number Of Bedrooms: 3 Number Of People
Is The Dwelling Currently Vacant? Yes No ❑ If Yes, For How Long? °
Any Known'Problems? Yes ❑ No f Yes, Explain:
Please, Fill In Tiie..Following Information About The New Dwelling.
Type Of Dwellin : ` W Number Of Bedrooms: Number Of People
Requested By: 4Date Requested: 74
(Signatur )
For Environmental Health Office Use Only
Approved ❑ Disapproved ❑
Comments:
0'"IP, Y" eey. -T 1 y to 12C:/t 2- Jo W Lg2G�'
j
Environmental Health Specialisttu
"'The signing of this form bythe Environmental Health"Staffs in no way untended, nor shouidbe taken as a
guarantee(extended or limited) that the on-site wastewater system yvill function properly for any given period of time.
o�
Payment: Cash ❑ Check ❑ MoneyLOrder ❑ # rr Amount: $ . Ca Da -
Paid By: ~' Received Bye
Account #: Invoice #: -�
yy . '
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fit+ � t�' � ,•! � t
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DAVIE 'COUNTY HEALTH �'DEPARTMENT
'OF
r z
IAND CERTIFICATE" PERMCOMPLETION, Y
�9
*NOTE:
Issued in Compliance wit h'G.S. of North .Carolina Chapter, 130 Article 13c' `„
r
Seyvage Treatment 'and Disposal Rules (10 NCAC .10A 1934-`1968) Permit Number;
,
`k
Name
,�% Date 4673
The signing of this certificate shall indicate that ystem described above.his'been.installed incompliance with
stand'
therds set:forth in the above regulation;'but shall..in NO way be takemas a'guarantee that the system�will function
"
C
' satisfactorily for any given period of time. '
APPLICATION FOR SITE EVALUATION/ IMPROVEMENTS PERMIT
Davie County Health Department
����
Environmental Health Section C rr
P. 0. Box 665 T� �LC'y
Mocksville, N.C. 27028
CONSTRUCTION SHALL NOT BEGIN UNTIL IMPROVEMENTS PERMIT HAS BEEN ISSUED.
Home Phone qq� -5/eo
1. Permit Requested By Business Phone
2. Address +• 1 60Z A-3(ocltY
3. Property Owner if Different than Above I _
Address RE I box 32 IJ00.rrvmnu nc •3�
4. Permit To: a) Install ✓ Alter Repair
b) Privy Conventional Other Type
Ground Absorption
c) Sub -Division Sec. Lot No. -
5.
o. 5. System used to serve what type facility: House Mobile Homed Business
Industry Other
b) Number of people
6. a) If house or mobile home, state size of homeandnumber of rooms.
House Dimensions X 7�
Bed Rooms Bath RoomsjDen 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:
commodesurinals garbage disposal
lavatory showers washing machine
dishwasher sinks _ 8
8. a) Type lwater supply: Public Private Community
b) Has the water supply system been approved? YesV No
9. a) Property Dimensions
b) Land area designated to building site
c) Sewage Disposal Contractor
10. Do you anticipate any additions or expansions of the facility this sewage system is intended to serve? No
What type?
This is to certify that the information is correct to the best of my knowledge.
D ja(/. A0 19E 7
Date OJvner Signature
OWNER IS SOLELY RESPONSIBLE FOR COMPLIANCE WITH ALL STATE AND LOCAL LAWS
Allow 5 days for processing
Directions to property:
�N w k " be I4, dr ► v e. vac., o,� '�hc, r i c�lr- �-� L'c3t�, Li nQ3 C1
DCHD (6.62)
L,DJ