206 Gladstone Rd r _ �
Davie County,NC Tax Parcel Report Friday, December 16, 2016
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WARNING: THIS IS NOT A SURVEY
Parcel Number: L50000001308 Township: Jerusalem
NCPINNumber:, : 5746056238 Municipality:
Account Number: 8285130 Census Tract: 37059-807
Listed Owner I:- BOGER-SYLVIAJ .Voting Precinct: COOLEEMEE
- Mailing Address 1: 200 GLADSTONE ROAD Planning Jurisdiction: Davie County
City:-- MOCKSVILLE Zoning Class: DAVIE COUNTY R-A
State: NC Zoning Overlay: DAVIE COUNTY CZOD
Zip Code: 27028-0000 Voluntary Ag.District: No
Legal Description: 1.00 AC GLADSTONE RD Fire Response District: JERUSALEM
Assessed Acreage: 1.01 Elementary School Zone: COOLEEMEE
Deed Date: 5/1992 Middle School Zone: SOUTH DAVIE
Deed Book/Page: 001630673 Soil Types: CeB2
Plat Book: Flood Zone:
Plat Page: Watershed Overlay: DAVIE COUNTY
Building Value: Outbuilding&Extra
Freatures Value:
Land Value: Total Market Value:
Total Assessed Value:
161 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, 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
NC or arising out of the use or Inability to use the GIS data provided by this website.
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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<i / 1 / k �f�/,d!�/�, /..y Date � 3
Location //" f;.i� /�r% !"� ./`� s / - / /� ( '�—i ✓�t/1 %%s'
Subdivision Name Lot No. Sec. or Block No.
Lot Size < ,7_rJC House ��� Mobile Home _ Business -- Speculation
No. Bedrooms ;�� No. Baths J No. in Family _
Garbage Disposal YES ❑ NO '2- Specifications for System:
Auto Dish Washer YESNO ❑ �, a
Auto Wash Machine YES [� NO ❑ ��✓ � '/ � �.
Type Water Supply /�/'•� __— �� -�
"This permit Void if sewage system described below is not installed within 36 months from date of issue.
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Improvements permit by
'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 ,X, ,{'
y�
Certificate of Completion ` Date---?h
"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.
pp APPLICATION FOR SITE EVALUATION/IMPROVEMENTS PERMIT
Davie County Health Department .L
(p Environmental Health Section ,�►�
�l R O. Box 665 �t �
�p Mocksville, N.C. 27028
CONSTRUCTION SHALL NOT BEGIN UNTIL IMPROVEMENTS PERMIT HAS BEEN ISSUED.
Home Phone ,�2Q/-
1. Permit Requested By Business Phone
2. Address
3. Property Owner if Different than Above
Address
4. Permit To: a) Install_l�Alter Repair
b) Privy Conventional Other Type
Ground Absorption
c) Sub-Division Sec. Lot No.
5. System used to serve what type facility: House Mobile Homes
Industry Other
b) Number of people r�
6. a),If house or mobile home, state size of home and number of rooms.
House Dimensions—/a X
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 hours)
7. Number and type of water-using fixtures:
commodes urinals garbage disposal
lavatory Z showers Z washing machine
dishwasher sinks
8. a) Type water supply: Public Private Community
b) Has the water supply system been approved? Yeses No
9. a) Property Dimensions cPs
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? Ally
What type?
This is to certify that the information is correct to the best of my knowledge.
Date Owner Si Lure
OWNER IS SOLELY RESPONSIBLE FOR COMPLIANCE WITH ALL STATE AND CAL LAWS
Allow 5 days for processing
Directions to property:
Y D
DCHD(6-82)
�1 F�hadjl
certify that on June OS
11 . 19 BI 1 surveyed the property shown no this plat;
nea are aeeurately shown hereon; that a atruetore located on Nb
property
adjacent street or properly, and that no structure on adjacent property encroaches on the pr,rnhea
C Cv
Registered Land Surveyor L-2623
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IS
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Fletcher E. Huffman p SUBvEi!
2 D. CO
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IN 83433.48"WI
nae S80°-01.38• I
1 found 85.89' S83'SW-30'E .•e.. I.
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3 iron .ae 112.03' -wi
0 -found James C. Spry i l
0.8.104, P. 516
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C. F. Seomm Pis "L 1.346 ACRES
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von o'0"d 120.34 HOS Tobi 16t S89•-2Y-58"W 989 29' 58'
found 80'
60 �— ' —
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Pmoos reood .
is"Iron ;
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found 1 120 119 0 - I 1
in 118 1117 116 115 1
121 t ; S I oto
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in
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0
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a\t m 580°•26'•29 ,rox
.rn � 100 x•d 1
n Ing el GLADSTONE RD.
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9 �
1i NOTE: This plot is subject to
j 46es, N any Easements.Agreement
W.66
• \�2 or Rights of Way of
jl /e \4 record prior to date
of the plot. -
SURVEY FOR
GAIL OTIS HUMBLE
117,118 Property of '
LOT NO. MAP OF E.G. Morns and H R Hpndrix BLOCK NO. t
DEED BOOKPAGE zoic JERUSALEM TOWNSHIP
PLAT BOOK I PAGE as DAV I E COUNTY, N. C.
eCALE: 1 INCH- 100 eeQ
Joe No 1090 /.
'. ., uurxaq were,w,x, •aurM1r Ce.—�ixr,ex.4ux MIYOI /�
DAVIE COUNTY HEALTH DEPARTMENT
. Environmental Health Section
R O. Box 665
Mocksville, N.C. 27028
l SOIL/SITE EVALUATION
Name Date
Address Lot Size
FACTORS AREA 1 AREA 2 AREA 3 AREA 4
1) Topography/Landscape Position S S S
PS PS PS
U U U
2) Soil Texture (12-36 in.) Sandy, y�.� 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
4) Soil Depth (inches) S S S S
PS PS PS
U U U
5) Soil Drainage: InternalS S S
;SP—S)
PS PS PS
U U U
External S S S S
PS PS PS
U U U
6) Restrictive Horizons
7) Available Space S S S
PS PS PS PS
U U U U
8) Other (Specify) S S S S
PS PS PS PS
U U U U
9) Site Classification /1-) 1
U—UNSUITABLE S—SUITABLE PS—Provisionally Suitable
Recommendations/Comments: x y
Described by Title „� �" Date
SITE DIAGRAM
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DCHD(6-82)