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151 Fernwood LnDavie Cou�ty, NC Tax Parcel Report Wednesday, October 12, 2016 WARNING: THIS IS NOT A SURV�Y Parcel Infonnation Parcel Number: H4140A0010 Township: NCPIN Number: 5739414533 Municipality: Mocksville Account Number: 82526703 Census Tract: 37059-806 Listed Owner 1: GLEDHILL DAVID Voting Precinct: NORTH MOCKSVILLE COUNTY Mailing Address 7: 151 FERNWOOD LANE Planning Jurisdiction: MOCKSVILLE City• MOCKSVILLE Zoning Class: MOCKSVILLE GR State: NC Zoning Overlay: Zip Code: 27028-0000 Voluntary Ag. District: Legal Description: LOT 21 COUNTRY LANE EST Fire Response District: Assessed Acreage: 0.78 Elementary School Zone Deed Date: 7/2006 Middle School Zone: Deed Book I Page: 006710240 Soil Types: Plat Book: 0005 Flood Zone: Plat Page: 170 Watershed Overlay: Building Value: 229420.00 Outbuilding & Extra Freatures Value: Land Value: 25000.00 Total Market Value: Total Assessed Value: 258240.00 °��°'F Davie County, �o�,N�i NC MOCKSVILLE MOCKSVILLE SOUTH DAVIE GnB2,GnC2 MOCKSVILLE 3820.00 258240.00 No �.. . ...:. �..s: _ .; '•.y '_..� � .. ': -: .. i � Y . � � ,� ,,. �—:...._._,..�: �� . ; ..:.- -.._+.��'• . ,y.,. . �...,;A?^�.�'5.., �-��.:l.0 • .�. t��.�f ,'r%�'_ _ i 1 * " t -'_. i!r ..""'_ , . .e . , . �,. �_�.....� x aa . „ . ,. '- .�.,., 1 , . . ` • �'1. ' AUTt�oRtzATioN rro: j � j � �� DAVIE COUNTY HEALTH DEPARTMENT /�� " ` `�� ` Environmenta! Health Section PROPERTY INFORMATION Permittee's �. i � P.O. Box 848 Name: Y� r��9 �/ �11 Sr% �� 1�1 , Mocksville, NC 27028 Subdivision Name: , /�—/� J Phone # 336-751-8760 Directions to property: l r'��'/ lrJG'4�J Section: Lot: -• AUTHORIZATION FOR � ` � ` �� .� /t , � WASTEWATER Tax Office PIN:# - - / �* � SYSTF,M CONSTRUCTION ( Road Name: Zip: **NOT'E** This Authonzation for Wastewater System Conswction MUST BE ISSUED by the Davie County Environmental Health Section prior to issuance of any Building Permits. This Forrn/Authorization Number should be presented to the Davie Counry Building Inspections Office when applying for Building Permits. (ln compliance with Article 11 of G.S. Chapter 130A, Wastewater Systems, Section .1900 Sewage Treatment and Disposal Systems) ., Lf �/ ***NOTICE*** THIS AUTHORIZATION FOR WASTEWATER CONSTRUCTION '� j� `�/; �(,�.'�-�!� �� ,, ;�� IS VALID FOR A PERIOD OF FIVE YEARS. ENVIRONMENTAL HEALTH SPECIALIST DATE ISSUED , .. I.. � ,: _ `, : ..�: �. . , : . . . ,: � ..., .�. ,. :. : i , , . - . . � , .. � , , . _� . . . .. . . . . . � . . � . .. .. , 1 � � G `=� �`�' : j �j �� DAVIE COUNTY HEALTH DEPARTMENT /�'� `�^ � � .� �` TMPROVEMENT AND OPERATION PERMITS PROPERTY INFORMATION Permittee's `r' / Name: t .� � ,, ;'. . �' � , ; f' �,�', ,,r �' . � . Directions to property: ; r � � �. �' r' , % �r� �'� t; � !J � .', t �� IMPROVEMENT PERMIT Subdivision Name: Section: Lot: _ Tax Offce PIN:# Road Name: Zip: **NOT'E** This Impmvement Pernut DOES NOT authorize the construction or installation of a septic tanlc system or any wastewater system. An AUTHOWZATION FOR WASTEWATER SYSTEM CONSTRUCTION must be obtained from this Department prior to the construction/installation of a system or the issuance of a building pernut '" (In compliance with Article 11 of G.S. Chapter 130A, Wastewater Systems, Section .1900 Sewage Treatment and Disposal Systems) ***NOTICE*** THLS PERNIIT LS SUBJECT TO REVOCATION IF SITE , ; ` � � ; ` -' �' , �-,�`�;; ` PLANS OR Ti� INTENDED USE CHANGE. YOUR WASTEWATER ENVIRONMENTAL HEALTH SPECIALIST DATE ISSUED SYSTEM CONTRACTOR MUST SEE THIS PERMIT BEFORE INSTALLIIVG THE SYSTEM. RESIDENTIAL SPECIFICATION: BUILDING TYPE t� # BEDROOMS �� # BATHS _�_ # OCCUPANTS GARBAGE DISPOSAL: Yes or No COMMERCIAL SPECIFICATION: FACILTI'1' T'YPE # PEOPLE # PEOPLFISHIFT # SEATS INDUSTRIAL WASTE: Yes or No LOT SIZE TYPE WATER SUPPLY � DESIGN WASTEWATER FLOW (GPD) �?/� f% NEW SITE REPAIR SITE `� SYSTEM SPECIFICATIONS: TANK SIZE GAL. PUMP TANK GAL. TRENCH WIDTH REQUIRED SITE MODIFICATIONS/CONDITIONS: � / ROCK DEPTH �a! y LINEAR FT. OrJ IMPROVEMENTPERMITLAYOi;t'j*yjJ�.''t.��VED EFFI..U�rar Fi�rEa� �RI8ERt5) IF f�" II�LOId FIESISi�4�D GRAD�� , Y � ,_ .�_..�_ ._. _.. . ,_ .._.:.. Q ... __.. . � � �1 _ 1�� **CONTACT A REPRESENTATIVE OF THE DAVIE COUNTY HEALTH DEPARTMENT FOR FINAL INSPECTION OF THIS SYSTEM BETWEEN 8:30 - 930 A.M. OR 1:00 - 1:30 P.M. ON THE DAY OF INSTALLATION. TELEPHONE #�� (�pg] �34F3'j60. f 3.�� ) 75 f —�7�+� SYSTEM INSTALLED BY: AUTHORIZATION NO. ��« •�-�- J= OPERATION PERMIT BY: � r�' f '� � �b '� 7��x **THE ISSUANCE OF THIS OPERATION PERMIT SHALL INDICATE THAT THE SYSTEM DESCRIBED ABOVE 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. DCHD OSH6 (Revised) i , � ..; , , , ,� . t � a" ` - • . . . . o ;� � �l� % 4 � � � _ . . . �'...;�f V ,....J�.. �.r-^� �"��,,,� I ,h, � , � ;� � „�,� DAVIE COUNTY HEALTH DEPARTMENT � - .• �' TMPROVEMENT AND OPERATION PERMITS PROPERTY INFORMATION Pegmittee's ,+, Name: . :Y. �: Directions to property: � ' • -< - :' '�a � Il�IPROVEMENT PERMIT Subdivision Name: Section: Lot: Tax Office PIN:# Road Name: Zip: _ **NOTE** This Improvement Permit DOES NOT authorize the construction or installation of a septic tank system or any wastewater system. An AU'I'HORIZATTON FOR WASTEWATER SYSTEM CONSTRUCTION must be obtained from this Department prior to the construction/installation of a system or the issuance of a building pernut. "" (In compliance with Article 11 of G.S. Chapter 130A, Wastewater Systems, Section .1900 Sewage Treatment and Disposal Systems) _ ***NOTTCE*** THIS PERMIT IS SUBJECT TO REVOCATION IF SITE �' J� PLANS OR TE� INTENDED USE CHANGE. YOUR WASTEWATER ENVIRONMENTAL HEALTH SPECIALIST DATE ISSUED SYSTEM CONTRACTOR MUST SEE THI.S PERNIIT BEFORE INSTALLING T'HE SYSTEM. RESIDENTIAL SPECIFICATION: BUILDING TYPE �_ # BEDROOMS �.,,� # BATHS =' # OCCUPANTS GARBAGE DISPOSAL: Yes or No `' COMMERCIAL SPECIFICATION: FACILITY TYPE # PEOPLE # PEOPLE/SHIFT # SEATS INDUSTRIAL WASTE: Yes or No LOT SIZE TYPE WATER SUPPLY �� DESIGN-�'ASTEWATER FLOW (GPD) --.�4 ��' NEW SITE REPAIR SITE J �. ' SYSTEM SPECIFICATIONS: TANK SIZE GAL. PUMP TANK GAL. TRENCH WIDTH ROCK DEPTH i' LINEAR Ff. �:� ��. .F ��`'� � ` � OTHER REQUIRED SITE MODIFICATIONS/CONDITIONS: 'IMPROVEMENTPEitMITLAYOEP�?�,�C'�ii34J�Ii E�Li.6I:P�T iCIL.TEi�i�� ,`��E�{ i� �Fi-i &T t��LC�'�� =IS��aEs�d.� i��"�3}�� t � � � �� t`y, h4n� . . - a,,�('3.�,.. �bk f a" V � t ��/�`,� � x **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 �7A4)763�kt8760. I: 3�D? �S—�7�,�� SYSTEM INSTALLED BY: � ,�y.�t�.� AUTHORIZATION NO. ��OPERATION PERMIT BY: ��'H� —�'" DATE: _�%�' � **THE ISSUANCE OF THIS OPERATION PERMIT SHALL INDICATE THAT THE SYSTEM DESCRIBED ABOVE 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. � DCHD OS/96 (Revised) DAVIE COUNTY ENVIRONMENTAL HEALTH SECTION APPLICATION FOR IMPROVEMENT PERMIT (REPAIR) ? �� C� �l �� /i% PHONE NUMBER ADDRESS /�� / UBDIVISION NAME ��CG l�-- , /�C � �� LOT # DIRECTIONS TO SITE DATE SYSTEM INSTALLED NAME SYSTEM INSTALLED UNDER TYPE FACILITY (aS� c NUMBER BEDROOMS 3 NUMBER PEOPLE SERVED TYPE WATER SUPPLY SPECIFY PROBLEM OCCURRING DATE REQUESTED INFORMATION TAKEN BY This is to cs►tity that the informaGon provided is correct to the best of my knowledga, and that I understand I am responsible for all charges incurred from this application. SIGNATURE OF OWNER OR AUTHORIZED AGENT Rev. 1�93 �iti �91��-oi� /� ��io �� -�2 ��