265 Hidden Creek Drive Lot 17DAVIE COUNTY HEALTH 'DEPARTMENT
IMPROVEMENTS PERMIT AND CERTIFICATE -QF:COMPLETION
*NOTE: Issued in Compliance with G.S. of North Carolina, Chapter'l 30 Article 13c
Sewage Treatment and Disposal Rules (10 NCAC'10A .1934-1968) Permit Number
Name. Date0
4 8"'0
0
Location -1-1/6
)
Subdivision Name 4, " 't- Lot No. Sec. or Block No.
Lot Size House Mobile Home Business Speculation
No. Bedrooms No. Baths �.Z No. In Family
Garbage Disposal; 'YES NO 0. Specifications fq
of
,,r, System:
Auto Dish Washer YES NO 0!
Auto Wash Machine YES NO 0
Type Water p
Supi
I . , Y. — - i -,- "
*This permit Void if sewage system described below Is not installed within 36 months from date of issue.
r
Vv'i 1 1 v:
1. 4F
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
M/
Certificate of Completion. ?4 -- 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 s4all in NO way be taken as a guarantee that the system will function
satisfactorily for any given*period of time.
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-.) Permit Number
Name i 7moi/%r%r' / ,,-s /_'f r,' ;�/ rJi7 Date
Location
Subdivision Name %� �' � � � Lot No. Sec. or Block No.
Lot Size House Mobile Home _ Business Speculation
No. Bedrooms _ No. Baths !t—? No. in Family
Garbage Disposal YES NO ❑
Specifications for, System:
Auto Dish Washer YES NO ❑ C ^ ri %i `
Auto Wash Machine YES NO ❑ % ,Cl, !` �,/, /
Type Water Supply
*This permit Void if sewage system described below is not installed within 36 months from date of issue.
.7
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
Certificate of/Completion Date i
*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.
ti
' - APPLICATION FOR SITE EVALUATION/ IMPROVEMENTS PERMIT
Davie County Health Department
Environmental Health Section
Moc svi�lle, N.C. 27028 RFCE'VED JULp 198
CONSTRUCTION SHALL NOT BEGIN UNTIL IMPROVEMENTS PERMIT HAS BEEN ISSUED.
Home Phone 704- 2-` 1-51= I
1. Permit Requested By CaMIEIZ. CIOti1 571- �D- L. Business Phone '70q-2�{c/_ J+Zcg�
2. Address *-P-O ��X ZEO . Lo'-_ (c0 Z 7 3 iA{
3. Property Owner if Different than Above
Address
4. Permit To: a) Install ✓Alter Repair
b) Privy Conventional ✓ Other Type
Ground Absorption
c) Sub -Division Rtct�ieIN cP'Ct�Sec. Lot No.�
5. System used to serve what type facility: House ✓✓ Mobile Home Business
Industry Other
I1
b) Number of people
a) If house or mobile home, state size of home and number of rooms.
House Dim sion
Bed Roo s Bath Rooms— Den w/Closet
b) If Business, ry or Other, State: Number of persons served
What type business, etc.
Estimate amount of waste daily (24 hours)
Number and type of water -using fixtures:
commodes "3 urinal
lavatory ' showers
dishwasher sinks
3
garbage disposal
washing machine
8. a) Type water supply: Public 6*� Private Community
b) Has the water supply system been approved? Yes ✓ No
9. a) Property Dimensions t'z3 )C 73 6Z_ X t GG ?C 105 3
b) Land area designated to building site
c) Sewage Disposal Contractor N� kC-t-k Re L •P LU VrN1=I /MU Lv--- tc.i v) ��d t� t �(• ,
10. Do you anticipate any additions or expansions of the facility this sewage system is intended to serve? A10
What type?
This is to certify that the information e best of my knowledge.
Date Owner Signature'
OWNER IS SOLELY RESPONSIBLE FOR COMPLIANCE WITH ALL STATE AND LOCAL LAWS
Directions to property:
DCHD (6-82)
Allow 5 days for processing
_�. DAVIE COUNTY HEALTH DEPARTMENT
Environmental Health Section
P. O. Box 665
Mocksville, N.C. 27028
SOIL/SITE EVALUATION
Nametate
Address
Lot Size
FACTORS AREA 1 AREA 9 AREA .1 AREA A
1) Topography/ Landscape Position
S�
PS
S
U
U
2) Soil Texture (12-36 in.) Sandy,,
Loamy, Clayey, (note 2:1 Clay)
( PSS
�lT
PS
AU
3) Soil Structure (12-36 in.)
Soils�pg
A7)
SClayey
U
U
U
t) Soil Depth (inches)
(ff�>
<±
ct5
U
U
U
U
>) Soil Drainage: Internal
S
—0
S
U
U
U
External
U
U
U
U
i) Restrictive Horizons
�0
Available Space
S
S
U
S
S
4V
1) Other (Specify)
S
PS
S
PS
S
PS
S
PS
U
U
U
U
1) Site Classification
-
C
U—UNSUITABLE S—SUITABLE PS—Provisionally Suitable
Recommendations/Comments: e ,�'ga'de—
Described by �LJ,igG� Title �� Date
SITE DIAGRAM
///
,�eG%r lii�x, 11aie
�o
1,4 CAP OY 1K. -rO,
DCHD (6.82)
DAVIE COUNTY HEALTH DEPARTMENT
Environmental Health Section
R O. Box 665
Mocksville, N.C. 27028
SOIL/SITE EVALUATION /
Name—�'%C��� del Date—
Address
ate Address Lot Size
FACTORR ARFA 1 ARFA 9 ARFA.1 ARFA A
1) Topography/ Landscape Position
S
S
S
PS
PS
PS
U
U
U
2) Soil Texture (12-36 in.) Sandy,
S
S
S
S
Loamy, CIS, (note 2:1 Clay)
PS
PS
d Yll->
PS
PS
U
U
3) Soil Structure (12-36 in.)
S
S
S
S
Clayey Soils
PS
PS
PS
U
U
1) Soil Depth (inches)
S
S
S
S
PSS
Q�
PS
PS
U
U
i) Soil Drainage: Internal
S
S
S
S
PS
U
PS
U
External
S
S
PS
S
PS
U
U
U
i) Restrictive Horizons
Available Space
S
50
S
S
PS
S
PS
• U
U
U
1) Other (Specify) _ ,�p�� -
S
PS
S
PS
S
PS
S
PS
U
U�
U
U
1) Site Classification
61 f
`%• ,
Recommendations/ Comments:
Described by
SITE DIAGRAM
DCHD (6-82)
S—SUITABLE PS—Provisionally Suitable
r /' . -.
Title Date
10
M
Ptt%ie (guuntg Pealth Repartment
cRnme Aculth '�geurg
P. O. BOX 665
flaclzsbille, North ( arulina 27028
OFFICE OF THE DIRECTOR
March 27, 1987
Mr. Gilbert Davis, Jr.
P. 0. Box 786
Clemmons, NC 27012
Mr. Davis:
This letter is in regard to the re-evaluation of lots 17 and 18
in the Hidden Creek subdivision in Davie County.
On March 26, 1987, the lots were re-evaluated and classified pro-
visionally suitable; however, ;due to the lack of sufficient provisionally
suitable soil in the repair area the systems will be limited to 360 gal-
lons per day or three bedrooms. Based on house locations a pump may also
need to be used on said lots.
If you have any questions feel free to call this office.
Sincerely,
Robert B. Hall, Jr., R. S.
Environmental Health
Enclosures (2)
RH/wd
TELEPHONE
17041 634.5985
Davie County Xealtl De artment
and .dome Ae-altI An�
9 '
210 HOSPITAL STREET / P.O. BOX 665
MOCKSVILLE, N.C. 27028
PHONE: (704) 634-5985
February 22, 1988
Hubbard Realty
Attn: Mary Gullickson
285 S. Stratford Rd.
Winston-Salem, NC 27103
Re: Sewage System Installation
Hidden Creek/Lot 17
Dear Ms. Gullickson:
The septic tank system that serves this residence was designed,
inspected and approved by this office on January 29, 1988.
With proper maintenance and use it should function properly.
Sincerely,
Robert B. Hall, Jr., R.S.
Environmental Health
RH/wd
Davie County,NC : Tax Parcel Report Wednesday, February 15, 2017
~.,4 r268
---_--- — ------
266
252
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--236 d
271 ,-_ - ---- �, I, HIDDEN
HIDDEN CREEK DR CREEK DR
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.........._................................................................................._._ 1..._.............._.._._.��................................................................5.._......._.................,.-.i��.^..�:Y.�...�:.........� ...._,1..........._.
WARNING: THIS IS NOT A SURVEY
Parcel Information _ -
Parcel Number: E915OA0017 Township: Farmington
NCPIN Number: 5871378288 Municipality:
Account Number: 18819000 Census Tract: 37059-803
Listed Owner 1: CRAWFORD GILMER ALLEN Voting Precinct: HILLSDALE
Mailing Address 1: 265 HIDDEN CREEK DRIVE Planning Jurisdiction: Davie County
City: ADVANCE Zoning Class: DAVIE COUNTY R-20-S,R-A,R-12-S
State: NC Zoning Overlay: DAVIE COUNTY QD
Zip Code: 27006-0000 Voluntary Ag.District: No
Legal Description: LOT 17 HIDDEN CREEK Fire Response District: ADVANCE
Assessed Acreage: 1.56 Elementary School Zone: SHADY GROVE
Deed Date: 2/2008 Middle School Zone: WILLIAM ELLIS
Deed Book/Page: 007450423 Soil Types: GnB2,GnC2,ChA,WATER
Plat Book: 0005 Flood Zone:
Plat Page: 179 Watershed Overlay: DAVIE COUNTY
Building Value: 207560.00 Outbuilding&Extra 0.00
Freatures Value:
Land Value: 65000.00 Total Market Value: 272560.00
Total Assessed Value: 272560.00
161 All data Is provided as Is without warranty or guarantee ofany 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.
�tttrie (�Ountg �ettlth �e�ttrtment
ttn�, �ame �ettlt�I ��enc� .
P. O. BOX 665
c9CIASttille, �qorth Carolina 27028
OFFICE OF THE DIRECTOR March '27, 1987 TELEPHONE
17041 634.5985
r
Mr. Gilbert Davis, Jr.
P. 0. Box 786
Clemmons, NC 27012
' Mr. Davis:
This letter is in regard to the re-evaluation of lots 17 and 18
in the Hidden Creek subdivision in Davie County.
On,March 26, 1987, the lots were re-evaluated and classified pro-
visionally suitable; however, due to the lack of sufficient provisionally
suitable soil in the repair area the systems will be limited to 360 gal-
lons per day or three bedrooms. - Based on house locations a pump may also ,
need to be used on said lots.
If you have any questions feel free to call this office.
Sincerely,
i
Robert B. Hall, Jr. ,. R. S.
Environmental Health
Enclosures (2)
RH/wd
C;2
'fes,
DAVIE COUNTY HEALTH DEPARTMENT
Environmental Health Section
R 0. Box 665
Mocksville, N.C. 27028
f SOIL/SITE EVALUATION
ime ; �,���/� t
Dz e
(dress Lot Size
FACTORS AREA 1 AREA 2 AREA 3 AREA 4
Topography/Landscape Position S S ,F�:+
" U J�>
U
Soil Texture (12-36 in.) Sandy,
Loamy, Clayey, (note 2:1 Clay) ( PSS PS AU
Soil Structure (12-36 in.) S S S
Clayey Soils
U U U
Soil Depth (inches) S
Cy
P �,S,J CID
U U U U
Soil Drainage: Internal � S S C
P
U U U
External
U U U U
) Restrictive Horizons
Available Space S S S S
U
Other (Specify) S S S S
PS PS PS PS
U U U U
Site Classification - C
U—UNSUITABLE S—SUITABLE PS—Provisionally Suitable
iecommendations/Comments: e �,0,�� ?21e,
)escribed by Title T> �l/i,/ Date
;ITE DIAGRAM
ro
Geek
3 Zed.,,o n M.1y. 16 -e
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