278 Fork Bixby RdDavie County, NC Tax Parcel Report 41A(. 6 Wednesday, September 28, 2016
WARNING: THIS IS NOTA SURVEY
Parcel Number:
J7050B000101
Township:
Fulton
NCPIN Number:
5778202579
Municipality:
Account Number:
57813000
Census Tract:
37059-804
Listed Owner 1:
POTTS DAVID B
Voting Precinct:
FULTON
Mailing Address 1:
278 FORK BIXBY ROAD
Planning Jurisdiction:
Davie County
City:
ADVANCE
Zoning Class:
DAVIE COUNTY R-20
State:
NC
Zoning Overlay:
Zip Code:
27006-7218
Voluntary Ag. District:
No
Legal Description:
0.973AC FORK BIXBY RD
Fire Response District:
FORK
Assessed Acreage:
0.97
Elementary School Zone:
CORNATZER
Deed Date:
8/2009
Middle School Zone:
WILLIAM ELLIS
Deed Book / Page:
008040604
Soil Types:
PcB2,PcC2
Plat Book:
Flood Zone:
X
Plat Page:
Watershed Overlay:
WS -IV -P
Building Value:
155730.00
Outbuilding & Extra
120.00
Freatures Value:
Land Value:
26000.00
Total Market Value:
181850.00
Total Assessed Value:
181850.00
141
Davie County, NC
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07W /2
DAVIE COUNTY HEALTH DEPARTMENT
IMPROVEMENTS PERMIT AND CERTIFICATE OF COMPLETION
1 *NOTE: Issued in Compliance with G.S. of North Carolina Chapter 130 Article 13c
Sewage Treatment andDisposal Rules (10 NCAC 10A .1934-.1968) Permit Number
Name ��1¢,c 1 ��n/ — Date
Subdivision Name
Lot No. Sec. or Block No.
Lot Size Ae, 5'
H� e
Mobile Home Business __ Speculation
No. Bedrooms
No. Baths
No. in Family
Garbage Disposal
YES E] NO
p,-'
Specifications for System: h /�
Auto Dish Washer
YESNO
J
Auto Wash Machine
YES NO
Type Water Supply
e�a
.3�dX3X%?
'This permit Void if sewage system described below is not installed within 36 months from date of issue.
Improvements permit by —L rl�
'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.
Final Installation Diagram: System Installed by 7AO`' `, _
Certificate of Completion `` '`'` �' 1 -Date
"The signing of this certificate shall indicate that the system described above has been installed in compliance with
the standards set forth in the above regulation, but shall in NO way be taken as a guarantee that the system will function
satisfactorily for any given period of time.
RECEjV_ ,
i'
r " APPLICATION FOR SITE EVALUATION/ IMPROVEMENTS PERMITr"s
Davie County Health Department ,
Environmental Health Section
P. 0. Box 665
Mocksville, N.C. 27028
CONSTRUCTION SHALL NOT BEGIN UNTIL IMPROVEMENTS PERMIT HAS BEEN ISSUED.
/ Home Phone
1. Permit Requested By Business Phone
2. Address 01 c (-a
3. Property Owner if Different than Above
Address
4. Permit To: a) Install LfAlter Repair
b) Privy Conventional Other Type
Ground Absorption
c) Sub -Division Sec. Lot No.
5. System used to serve what type facility: House Mobile HomelG�usiness
� Industry Other—
b)
ther b) Number of people
6. a) If house or mobile home, state size of home and number of rooms.
House Dimensions /�l'-- 70 11 4.
--
Bed Rooms Bath Rooms Den w/Closet -
b) If Business, Industry or Other, State: Number of persons served
What type business, etc
Estimate amount of waste daily (24 hou
7. Number and type of water -using fixtures:
commodes urinals garbage disposal
lavatory showers 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 Zf) '�5 &"C
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?
What type? J /r �-1 k�o�l
This is to certify that the information is correct to the best of my knowledge.
/e) -- — Ej� �'
Date V Owner Signature
OWNER IS SOLELY RESPONSIBLE FOR COMPLIANCE WITH ALL STATE AND LOCAL LAWS
Allow 5 days for processing
Directions to property:
DCHD (6-82)
e DAVIE COUNTY HEALTH DEPARTMENT
Environmental Health Section
P. O. Box 665
Mocksville, N.C. 27028
SOIL/SITE EVALUATION
Name—
Address
Date /716
Lot Size
FACTORS ARFA 1 ARFA 9 ARFA 3 AREA A
1) Topography/ Landscape Position
SS
S
S
PS
PS
PS
U
U
U
U
2) Soil Texture (12-36 in.) Sandy,
S
S
S
Loamy, Clayey, (note 2:1 Clay)PS
PS
PS
PS
U
U
U
3) Soil Structure (12-36 in.)
S
S
S
S
Clayey Soils
PS
PS
PS
U
U
U
1) Soil Depth (inches)
S
S
S
S
PS
PS
PS
U
U
U
i) Soil Drainage: Internal
S
S
S
S
PS
PS
PS
U
U
U
External
S
S
S
PS
PS
PS
PS
U
U
U
i) Restrictive Horizons
Available Space
S
S
S
S
PS
PS
PS
U
U
U
►) Other (Specify)
S
S
S
S
PS
PS
PS
PS
U
U
U
U
1) Site Classification
U—UNSUITABLE
Recommendations/Comments:
Described by _
SITE DIAGRAM
DCHD (6-82)
S—SUITABLE /PS—Provisionally Suitable
Title ��� Date