108 Eastridge Court Lot 2 s f
Davie County,NC Tax Parcel Report Tuesday, December 20, 2016
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WARNING: THIS IS NOT A SURVEY
Parcel Information
Parcel Number: E8110D0002 Township: Shady Grove
NCPIN Number: 5881130830 Municipality:
Account Number: 82526502 Census Tract: 37059-803
Listed Owner 1: CASE RODNEY L Voting Precinct: EAST SHADY GROVE
Mailing Address 1: 108 EASTRIDGE COURT Planning Jurisdiction: Davie County
City: ADVANCE Zoning Class: DAVIE COUNTY R-A,R-20
State: NC Zoning Overlay:
Zip Code: 27006-0000 Voluntary Ag.District: No
Legal Description: LOT 2 EASTRIDGE Fire Response District: ADVANCE
Assessed Acreage: 1.17 Elementary School Zone: SHADY GROVE
Deed Date: 5/2006 Middle School Zone: WILLIAM ELLIS
Deed Book/Page: 006640520 Soil Types: Gn132
Plat Book: 0006 Flood Zone:
Plat Page: 099 Watershed Overlay: DAVIE COUNTY
Building Value: Outbuilding$Extra
g Freatures Value:
Land Value: Total Market Value:
Total Assessed Value:
O
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Davie County, implied warranties of merchantability or fitness for a particular use.All users of Davie County's GIS website shall hold harmless the
r County of Davie,North Carolina,Its agents,consultants,contractors or employees from anyandaltdaimsorcausesofadlondueto
NC or arising out of the use or inability to use the GIS data provided by this website.
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AUTHORIzA . NO, DAME OUNTY HEALTH DEPARTMENT
' 932
EnvironmentalHealth Section PROPERTY INFORMATION
.Permittee's (e O. Box 848 _
Name:
/�^' .r,S�JMocksville,NC 27028 Subdivision Name: Q'
,+w Phone# 336-751=8760 /
Directions to property: L/ •�� ''°f AUTHORIZATION FOR Section: O Lot:
>
WASTEWATER Tax Office PIN:#�l _ .
SYSTEM CONSTRUCTION
Road Name: IZip: ��
**NOTE**This Authorization for Wastewater System Construction MUST BE ISSUED by the Davie County Environmental Health Section prior
to issuance of any Building-Permits:This Form/Authorization Number should be presented to the Davie County Building Inspections
Office when applying for Building Permits. .
(In compliance with Article I 1 of G.S.Chapter,I30A,Wastewater Systems,Section.1900 Sewage,Treatment and Disposal Systems)
***NOTICE***THIS AUTHORIZATION FOR WASTEWATER CONSTRUCTION
IS VALID FOR PERIOD OF FIVE YEARS.
ENVIRONMENTAL HEALTH SPECIALIST s DATE ISSUED:
��,} i+ y.., t � :aa.p s"F t.+ x ^ r �r }+'• '-+v-ark r^.:.-;y✓' :,.7, -, -:../_'. _„ -,;..._y ♦,,,y kbi:,
lie
DAME OUNTY HEALTH DEPARTMENT /
IMPROVEMENT AND OPERATION PERMITS PROPERTY INFORMATION
Name. � ;�] Subdivision Name:,,.+ !�'
Directions to property: Section: 1`r Lot:
' IMPROVEMENT
PERMIT Tax Office PIN:#lt�
` Road Name
rt;bl E'fir-zip:
**NOTE**This Improvement Permit DOES.NOT authorize the construction or installation of a septic tank system,or any wastewater system.An
AUTHORIZATION FOR WASTEWATER SYSTEM CONSTRUCTION must.be obtained from this Department prior to the .
coti'struction/installation of a system or the issuance of a building permit.
(In compliance with Article"11 of G.S.Chapter-130A,Wastewater Systems,Section.1900 Sewage;Treatment and Disposal Systems)
***NOTICE***THIS PERMIT IS SUBJECT TO REVOCATION IF SITE
. ✓p� f;;+ ' :) '%! ,�:. r% , PLANS OR THE INTENDED USE CHANGE.YOUR WASTEWATER
ENVIRONMENTALEEALTH SPECIALIST DATE ISSUED SYSTEM CONTRACTOR MUST SEE THIS PERMIT BEFORE
INSTALLING THE SYSTEM. ,
RESIDENTIAL SPECIFICATION:BUILDING TYPE #BEDROOMS !Y #BATHS #OCCUPANTS GARBAGE DISPOSAL:Yes or No
COMMERCIAL SPECIFICATION: FACILITY TYPE�1 #PEOPLE #PEOPLEISHIFT #SEATS INDUSTRIAL WASTE:Yes or No
LOT SIZE r ` LY ( DESIGN WASTEWATER FLOW(GPD)�� NEW SITE_ �r REPAIR SITE,
31 TYPE WATER SUPPLY� , r •fir �
SYSTEM SPECIFICATIONS:TANK SIZE,4��GAL. PUMP TANK GAL. TRENCH WIDTH ROCK DEPTH LINEAR FT
OTHER /
REQUIRED SITE MODIFICATIONS/CONDITIONS:
IMPROVEMENT PERMIT LAYOUT
r^
yrlC
. .
ol
vY
**CONTACTA 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 (336)751-8760.
OPERATION PERMIT
SYSTE INSTALLED BY:
AUTHORIZATION NO.- OPERATION PERMIT BY: DATE: D�9
**THE ISSUANCE OF THIS OPERATION PERMIT SHALL INDICATE THAT THE ESCRIBED 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 05196(Revised)
APPUCATION FOR SITE EVALUMION/IMPROVEMENT PERMIT do ATC
t Davie County Health Department
t Environmental Health 5&W=
d
P.O. Box 848/210 Hospital Street
Mockoville, NC 27028
(336)751-8760 ` Y 2 Q 19%
***nWORTANT*** THIS APPLICATION CNNDr BLP PROCESSED UNLESS ALL RE
INFORMATION IS PROVIDED. Refer to the INFORMATION BULLETIN for ins EE—N—A�
n,�LTH
1. Name to be Billed LIP /(�ntact Person1fJ_
Mailing Address - Same Phone
City/state/Zip f1 // / Business Phone
Z. Name on Permit/ATC if Different than Abwe
Mailing Address City/state/Zip
3. Application For: U Site Evaluation 0 Improvement Permit/ATC H Both
a. system to service: O'House 0 Mobile Home 0 Business 0 Industry 0 Other
S. If Residence: /# Q People 9 # BedrooBedrooms # Bathrooms
H-D4Ahrasher S45/;:rbage Disposal wilashing Machine Basement/Plumbing 0 Basement/No plumbing
6. if Business/Industry/other: Specify type # People # sinks
# Commodes # showers # Urinals # Nater Coolers
IS FOODSERVICE: # Seats ��� Estimated slater Usage (gallons per day)
7. Type of water supply: [1County/City 0 Well 0 community
e. Do you anticipate additions or expansions of the facility this system Is intended to serve! 0 Yes U44
If yes,what type'
***IMPORTANT***CLIENTSAIUSTCOMPLETETHE REQUIRED PROPERTY INFORMATION REQUESTED
BELOW. Either a PLAT or SITE PLAN MUST BESUBAIITTED by the client with THIS APPLICATION.
Property Dimensions: 1 WRITB DIRECTIONS(from MockrAlle)to PROPERTY:
og3 , 000 ', .
Tax Office PIN: # 5991 .:&Q L22 LOLL
Property Address: Road Name � 11 � -rig
Citylzip � IU.��►�—�1�_�L .tf �� ��I ��r��
If in a Subdivision provide information,as follows:
Name:
Section: Block: Lot: Date Property Flagged:
This is to certify that the information provided is correct to the best of my knowledge. I understand that any permit(s)
Issued hereafter are subject to suspension or revocation,if the site plans or intended use change,or if the information
submitted In this application is falsified or changed. I,also,anAnWand that I am nponsible for all charges lacnnmd f-om
this aNUration. 1,hereby,give consent to the Authorized Representative of the Davie County Health Departmen
to enter upon above described property located in Davie County and owned by
to conduct all testing procedures as necessary to determine the site suitability.
DATE �- SIGNATURE
VV
THIS AREA MAY BE USED FOR DRAWING YOUR SITE PLAN(Incluail of the following: Existing and proposed
property lines and dimensions, structures, setbacks, and septic locations.
Account No.
Revised DCHD(07/98) Invoice No.
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,TOTAL
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Lot .%t DAVIE COUNTY HEALTH DEPARTMENT
a Environmental Health Section
R O. Box 665
Mocksville, N.C. 27028
SOIL/SITE EVALUATION
Name— Date
Address S A M e Lot Size
FACTORS AREA 1 AREA 2 AREA 3 AREA 4
1) Topography/Landscape Position S S
PS PSS PS PS
U b-J U U
2) Soil Texture (12-36 in.) Sandy, S S
Loamy, Clayey, (note 2:1 Clay) P� PS PS PS
U U U
3) Soil Structure (12-36 in.) S S
Clayey SoilsPS PS PS PS
U U
4) Soil Depth (inches) S S
PS PS PS
U U U
5) Soil Drainage: Internal S S
PS PS PS
U U U U
External S S S
' � PS PS
U U U U
6) Restrictive Horizons
7) Available Space S QD 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
U—UNSUITABLE S—SUITABLEPS Provisionally Suitable
Recommendations/Comments: '� - -1!�`
Described by �g- Title �� �- - s � Date
SITE DIAGRAM
@S
CX3
X '
e�
DCHD(6-82)