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258 Bridle Ln (2) Davie County,NC Tax Parcel Report Wednesday, February 15, 2017 374� � I / E .�'` ,r i�OW� 316"12 7' �213� �`249 Zy,�516, •''f r�. ?48-9:2500 191 3521, l 2481"//" . jl 220' r 2475 z ------211 W 3 0 200 - �t 00 255 17u 2415 0 99 �, 406_. ----. --164 j/ 258 t 154 -�' 285 ry ------ - f 434 144 2363'.�f i 24 ,--- 296 295 fr 2337 'f .- 128 2382• 444 ,� ft" r ...... ..... .. ... .. ......................................_............................................__.G._...................._............_...............................................I....................... ._. _..,..._............i....A.._............... WARNING: THIS IS NOT A SURVEY Parc el Information Parcel Number: G70000013901 Township: Shady Grove NCPIN Number: 5870219565 Municipality: Account Number: 82518457 Census Tract: 37059-804 Listed Owner 1: HUMAN E W JR Voting Precinct: EAST SHADY GROVE Mailing Address 1: 258 BRIDLE LANE Planning Jurisdiction: Davie County City: ADVANCE Zoning Class: DAVIE COUNTY R-A,R-20 State: NC Zoning Overlay: Zip Code: 27006-7130 Voluntary Ag.District: No Legal Description: 16.34 AC CORNATZER RD Fire Response District: ADVANCE Assessed Acreage: 14.78 Elementary School Zone: SHADY GROVE Deed Date: ' 4/2002 Middle School Zone: WILLIAM ELLIS Deed Book/Page: 004150100 Soil Types: GnB2,GnC2 Plat Book: Flood Zone: Plat Page: Watershed Overlay: DAVIE COUNTY Building Value: 148060.00 Outbuilding 8r Extra 53440.00 Freatures Value: Land Value: 163580.00 Total Market Value: 365080.00 Total Assessed Value: 365080.00 O kylA 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 �oUp� NC or arising out of the use or Inability to use the GIS data provided by this website. C)PERATION PERMIT or ice se n v Davie County Health Department *CDP File Number 194508-1 3 P Vt2• 210 Hospital Street GM00-00-139-01 P.O.Box 848 County ID Number. Mocksville NC 27028 Evaluated For. REPAIR Phone:336-753-6780 Fax:336-753-1680 Township: Applicant: E.W. Human Jr r operty owner: E.W. Human Jr Address: 258 Bridle Lane dress: 258 Bridle Lane City: Advance dy: Advance State0l): NC 27006 State/Zip: NC 27006 Phone#: Phone#: Property Location & Site Information Address/Road #: Subdivision: Phase: Lot: 258 Bridle Lane Advance NC 27006 Directions Structure: SINGLE FAMILY hwy 158 right on Baltimore Rd. to the end, left on #of Bedrooms: 3 Cornatzer Rd. right on Bridle Lane #of People: *Water Supply: NtA *IP Issued by. *System Classification/Description: TYPE 11 A.CONY SYSTEM(SINGLE-FAMILY OR 480 GPD OR LESS) *CA issued by: 2140-Nations,Robert SaproliteSystem? OYes QNa Design Flow: 3 6 0 *Distribution Type: GRAVITY-SERIAL Pump Required? QYes QNo Soil Application Rate: 0 . a 7 5 *pre Treatment: Drain field rNo. on Field 1 3 0 9 Sq.It. *System Type: INFILTRATOR OUICK 4 STANDARD n Lines 4 Installer: Jamie Barn" Total Trench Length: 3 a 8 ft. Certification#: 101$ Trench Spacing: _ 9 ()Inches O.C. (.)Feet O.C. EH S: 2140-Nations,Robert Trench Width: _ 3 Qlnches « Feet Date: 0 7 / 0 9 / 2 0 1 5 Aggregate Depth: inches Minimum Trench Depth: 3 6 Inches Minimum Soil Cover. a 4 Inches Approval Status Maximum Trench Depth: 3 6 ®,Approved 0 Disapproved _ tnches - Maximum Soil Cover. 2 4 Inches CDP File Number 194508 - 1 County ID Number: 137-0100,00.139.01 Septic Tank Manufacturer. Let. Long: STB: - Gallons: Installer. Date: / / Certification#: 'EHS: "Filter Brand: ST Marker: El Yes El No Date: Reinforced Tank: ❑ Yes ❑ No Approval Status � Piece Tank: ❑ Yes ❑ No ❑ Approved❑ Disapproved Pump Tank Manufacturer. Installer. PT: Certification#: Gallons: THS: Date: / I Date: RiserSealed ❑ Yes ❑ No RiserHeght: ❑ Yes ❑ No (Min.6 in.) 'F pprovet StatusAe einforced Tank; ❑ Yes ❑ No - m ❑ Approved❑ Disapproved 1 Piece Tank: ❑ Yes ❑ NO Supply tine Pipe Size: inch diameter Installer. Pipe Length: feet Certification#: *Schedule: THS: Pressure Rated ❑ Yes ❑ No Date: Approved fittings ❑ Yes ❑ No Approval Status ❑ Approved❑ Disapproved ------------ u p Requirement Pump Type: installer: Dosing Volume: — Gal Certification#: Draw Down: Inches THS: "Chain: Date: Valves Accessible ❑ Yes ❑ NO Flow Adjustment valve ❑ Yes ❑ N o Check-valve ❑ Yes ❑ NO Approval Status PVC unions El ❑ No ❑ Approved Disapprovetl Y Vent Hole ❑ Yes ❑ No ,\ Anti-siphon Hole El Yes 0 No CDP Fite Number 194508 - 1 County ID Number: X7.000.00.139.01 Electric Equipment N EMA 4X Box or Equivalent ❑ Yes ❑ No Installer: Box 12 inches Above Grade ❑ Yes ❑ No Box Adj.To Pump Tank Certification#: ❑ Yes ❑ N o Conduit Sealed ❑ Yes ❑ No *EHS: Pump Manually Operable ❑ Yes ❑ NO / *Activation Method: Date: Apptaval Stafus Alarm Audible ❑ Yes ❑ No ❑ Approved Disapproved Alarm Visible ❑ Yes ❑ No 2140-Nation,Robert *Operation Permit completed by: Authorized State Agent: Date of Issue: 0 7 0 9 2 0 1 5 Owner/Applicant Signature: This system has been installed in compliance with applicable NC General Statutes:Article 11, Chapter 130A, Rules for Sewage Treatment and Disposal, 15A NCAC 18A.1900 et. Seq.,and all conditions of the Improvement Permit and Construction Authorization.This property is served by a TYPE It A. sewage septic system. Rule.1961 requires that a Type TYPE Ilk septic system meet the following criteria: Minimum System Review ByThe Local Health Department: NIA Management Entity: OWNER Minimum System Inspection/Maintenance Frequency By Certified Operator: NIA Reporting Frequency By Certified Operator. N/A Rule.1961 requires that a Type IV and V septic systems designed fora home/business owner must maintain a valid contract with a public management entity with a certified operator or a private certified operator for the life of the septic system. Rule.1961 requires that Type VI septic systems designed for a home/business owner must maintain a valid contract with a public management entity with a certified operator for the life of the septic system. Rule. 1961 (2)(e)requires a contract shall be executed between the system owner and a management entity prior to the issuance of an Operation Permit for a system required to be maintained by a public or private management entity, unless the system owner and certified operator are the same. The contract shall require specific requirements for maintenance and operation, responsibiities of the owner and systems operator,provisions that the contract shall be in effect for as long as the system is in use,and other requirements for the continued proper performance of the system. It shall also be a condition of the Operation Permit that subsequent owners of the systems execute such a contract. 4Hand Drawing Olmport Drawing **Site Plan/Drawing attached.** OPERATION PERMIT 194508 w ,) Davie County Health Department CDP File Number: 210 Hospital Street I G7-000-00-13901 P.O.Box 848 County File Numbet4 Mocksville NC 27028 Date: ! Olnch Drawing Drawing Type: Operation Permit Scale: . ON Ak I I { I I � Ll �j I � I -7,0 I � FT_ JI --- -------- I�" I I _ ► �' - I I t 4 t � I � ► � ► I � t ...<�_.....�,.u..o.......�i�....»�+w++M...a. .-...e-++��..w..�c.v�-.�....�«r..n+.m.».. _.. __ rS...�... .,a....r....�u.wr.»nt,........w.-» -- ....�.w.�.s...�.».� �...y�� s CONSTRUCTION For office Use Only AUTHORIZATION "CDP File-Number 194508- 1 Davie Count Health Department G7-000-00-139-01 Y P County ID Number: 210 Hospital Street Evaluated For: REPAIR P.O. Box 848 Township: Mocksville NC 27028 PERMIT VALID UNTIL: Phone: 336-753-6780 Fax:336-753-1680 0 6 / 0 4 / a 0 a 0 Applicant: E.W. Human Jr Property Owner: E.W. Human Jr Address: 258 Bridle Lane Address: 258 Bridle Lane City: Advance City: Advance State/Zip: NC 27006 StatelZip: NC 27006 Phone#: Phone#: Property Location & Site Information Address/Road#: Subdivision: Phase: Lot: 258 Bridle Lane Advance NC 27006 Directions Structure: SINGLE FAMILY hwy 158 right on Baltimore Rd. to the end, left on #of Bedrooms: 3 Cornatzer Rd. right on Bridle Lane #of People: "Water Supply: NSA System Specifications Minimum Trench Depth: rDesign ification: Provisionally suitable a _ Inches ystem? Minimum Soil Cover. OYes �No 1 a Inches w: 3 6 0 Maximum Trench Depth: 3 6 Inches Soil Application Rate: 0a 5 Maximum Soil Cover: a 4 Inches 'System Classification/Description: 'Distribution Type: GRAVITY-PARALLEL(eq.d-box) TYPE II A.CONV SYSTEM(SINGLE-FAMILY OR 480 GPD OR LESS) SeptlC Tank: Gallons =Proposed System:25%REDUCTION 1-Piece: OYes ONo Pump Required: OYes ONo OMay Be Required Nitrification Field 1 3 0 9 Sq. 8. Pump Tank: Gallons No.Drain Lines 3 1-Piece: OYes ONo Total Trench Length: 3 a GPM vs— ft. TDH Trench Spacing: Inches O.C. 9Feet O.C. Dosing Volume: _ Gallons Trench Width: Inches 3 "Feet Grease Trap: LGallonsAggregate Depth: inches PreTreatment: ONSF OTS-1S-11 Septic Tank InstallerGrade'Levei Required: U1011 0111 Dflnn i of 14 CDP File Number 194508 - 1 County ID Number. G7-000-00-139-O,t ❑ Open Pump System Sheet Repair System Required:OYes ONo ONo, but has Available Space 1. rDesign System Trench Spacing: Q Inches 0. . ification: Provisionally Suitable — Feet O,C. Trench Width: Inches w: _ Feet SoilApplication Rate: Aggregate Depth: inches *System Classification/Description: Minimum Trench Depth: Inches Minimum Soil Cover. Inches Maximum Trench Depth; *Proposed System: _ Inches Maximum Soil Cover: Nitrification Field Inches Sq.ft. No. Drain Lines *Distribution Type: Total Trench Length: Pump Required: QYes ONo OMay tae Required Pre Treatment: ONSF OTS-1 OTS-II 'Site Modifications No grading or construction activity is allowed in areas designated for system and repairwithout approval of Health Department. *Permit Conditions The issuance of this permit bythe Health Department in no wayguarantees the issuance of other permits.The permit holder is responsible for checking with appropriate governing bodies in meeting their requirements. This Authorization for Wastewater System Construction shall bevalid fora person equal to the period of validity of the Improvement Permit,not to exceed five years,and may be Issued at the sametime the Improvement Permit issued(NCGS 130A-336(b)).If the installation has not been completed during the period of validity of the Construction Permit,the information submitted In the application for a permit or Construction Authorization is found to have been Incorrect,falsified or changed,or the site Is altered,the permit or Constructlon Authorization shall become Invalid,and may besuspended or revoked(.1937(g)).The person owning or controlling the system shall be responsible for assuring compliance with the laws,rules,and permit conditions regarding system location,Installation,operation,malntenance;monitoring,reporting and repair (193&(b)). Applicant/Legal Reps. Signature Required? OYes ONo Applicant/Legal Reps. Signature: Date:_ *Issued By: 2140-Nations,Robert Date of Issue: . 0 6 / 0 4 / a 0 1 5 Authorized State Agent: Malfunction Log OYeS &land Drawing Olmport Drawing **Site Plan/Drawing attached.** Page 2 of 3 CONSTRUCTION AUTHORIZATION Davie County Health Department CDP File Number: 194508 - 1 210 Hospital Street P.O. Box 848 County File Number: G7-000-00.139.01 Mocksville NC 27028 Date: 0 6 / 0 4 / 2 0 1 5 Q inch Drawing Drawing Type: Construction Authorization ac's Scale: . . QBlock Q NIA �. VI ,�a i CONSTRUCTION AUTHORIZATION ` Davie County Health Department 210 Hospital Street CDP File Number: 194508 - 1 P.O.Box 848 G7.000.00.139-0 Mocksville NC 27028 County File Number: Date: 06 / 0 4 / 2 0 1 5 Click below to import an image from an external location: Drawing Type:Construction Authorization DAVIE COUNTY HEALTH DEPARTMENT - IMPROVEMENTS PERMIT AND CERTIFICATE OF COMPLETION '"*NOTE:Issued in Compliance With Article II of G.S.Chapter 130a Sanitary Sewage Systems t-L, ec;X Voz;:7 Permit Number Name ✓� /�sr t SF,��,y:n« f�/., ��/Oate �.C��?,'i%'2 N2 6986 C Location _ -, .• � .' r '- �.-i //���,✓r..:.�- ..-. . Jar'— Subdivision Name Lot No. Sec. or Block No. Lot Size ���' House �' Mobile Home — Business Speculation r No. Bedrooms No. Baths -2 No. in Family — Garbage Disposal YES ❑ NO p' Specifications for System: Auto Dish Washer YES [] NO ❑ Auto Wash Ma^hine YES © NO ❑ Type Water Supply *This permit Void if sewage system described below is not installed within 5 years from date of issue. This permit is subject to revocation site plans or the intended use change. 1 G-7-Ux 0' I 1v_ �qD J Improvements permit by *Contact a representative of the Davie Codi nt�HeralZh De artment for final inspection of this system between 8:30- 9:30 A.M. or 1:00-1:30 RM, on day of compte-ti . Te kplione Number 704-634-5985. Final Installation Diagram: �, 'J)Iem alled by I l JV E Certificate of Completion E-'�� 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 anticfartnrily fnr anv nivan narinrf of tiMA