2018 Hwy 801S Davie County,NC " ` Tax Parcel Report Friday, December 16, 2016
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-_ WARNING: THIS IS NOT A SURVEY
Parcel Information
Parcel Number:-, P812OA0007 Township: Shady Grove
NCPIN Number:,?: F: 5880205388 Municipality:
Account Number:.- -. 297880 Census Tract: 37059-804
Listed Owner 1: --�- ADVANCE-MASONIC LODGE#710 Voting Precinct: EAST SHADY GROVE
Mailing Address 1: -_ PO BOX 257!',, Planning Jurisdiction: Davie County
City: ADVANCE Zoning Class: DAVIE COUNTY R-20
State: NC Zoning Overlay:
Zip Code.__.: 27006-0000 Voluntary Ag.District: No
Legal Description:;_- 0.82 AC FEED MILL-RD - Fire Response District: ADVANCE
Assessed Acreage.-= = 0.74 Elementary School Zone: SHADY GROVE
Deed Date: = 12/1988 Middle School Zone: WILLIAM ELLIS
Deed Book/Page: 001460478 Soil Types: PcB2
Plat Book: Flood Zone:
Plat Page: Watershed Overlay: DAVIE COUNTY
Building Value: Outbuilding&Extra
Freatures Value:
Land Value: Total Market Value:
Total Assessed Value:
9 t �� 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 Davis,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.
,
't DAVIE COUNTY HEALTH DEPARTMENT
' IMPROVEMENTS PERMIT AND .CERTIFICATE OF COMPLETION
4 <f
*NOTE:Issued in Compliance With Article II of G.S.Chapter 130a
Sanitary Sewage Systems ` r 7 t'<p= `l Permit Number
' r
Name � i,�. ^P � fy;,,,'c` �lrrr� �» �fi1�,i to ,.S`'/1 h� N.2
4.
Location
Subdivision Name Lot No. Sec. or Block No.
Lot Size /�l' House Mobile Home Business tl Speculation•
No. Bedrooms .No. Baths _
�— No. in.Family
Garbage Disposal YES ❑ NO Specifications for System:
Auto Dish Washer" YES ❑ NOj
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 if site plans or the intended use change.
Q
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.-
• g y �
� r
f
Certificate of Completion /X� 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.
APPLICATION FOR SITE EVALUATION/IMPROVEMENTS PERMIT
Davie County Health Department
1 Environmental Health Section
R O. Box 665
/ Mocksville, N.C. 27028 11
- CONSTRUCTION SHALL NOT BEGIN UNTIL IMPROVEMENTS PERMIT HAS BEEN ISSUED/.
Home Phone 7
1. Permit RequestedByr1 7/D Business Phone
2. Address e
3. Property Owner if Different than Above
Address
4.,Permit To: a) Installle—'_ 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 Home Business
IndustryOther_L. —
b) Number of people 00
6. aj If house or mobile home, state size of home and number of rooms.
House Dimensions
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 A urinals garbage disposal
lavatory showers washing machine
dishwasher sinks
8. a) Type water supply: Public u- Private Community
b) Has the water supply system been approved? Yes+/" No
9. a) Property Dimensions
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? 4�3,,&f—
What type?
This is to certify that the information-is orrect to the best of my knowledge.
cr
ate 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)
' DAVIE COUNTY HEALTH DEPARTMENT
ENVIRONMENTAL HEALTH SECTION
SITE EVALUATION CONSENT FORM
1. Complete the form below and return to the Davie County Health Department.
2. Carefully follow the procedures as outlined in the enclosed "Information Bulletin."
NOTE: THE ABOVE MUST BE COMPLETED BEFORE A SANITARIAN WILL BE ABLE TO
BEGIN THE REQUESTED EVALUATION.
DETACH HERE AND RETURN TO: Davie County Health Department, Environmental
Health Section, P. O. Box 665, Mocksville, N.C. 27028
Davie County Health Department
Environmental Health Section
Site Evaluation Consent Form
LOCATION OF PROPERTY: DATE RECEIVED
(office use only)
yes no 1. 1 am the owner of the above described property.
yes no 2. 1 am not the owner
nof�the above described property, however, I certify that I
have consent froml�-�[�* _�� � _��� , owner to obtain a
owner's name
site evaluation by the Davie County Health Department for the purpose of
determining the suitability for a ground absorption sewage treatment and
disposal system.
yes no 3. 1 hereby give consent to the authorized representative of the Davie County
Health Department to enter upon the above described property and conduct all
testing procedures as necessary to determine its suitability for a ground
absorption sewage treatment and disposal system.
f .
DATE '-SIGNATURE
4. 1 hereby authorize the Davie County Health Department to release site
evaluation results from the above described property to the following:
—Owner only
— Owners designated representative
_Anyone requesting results
✓Only those listed below
DATE SIGNATURE 4 9�yi Z
DCHD(11/84)
rt
DAVIE COUNTY HEALTH DEPARTMENT
Environmental Health Section
P. O. Box 665
Mocksville, N.C. 27028
SOIL/SITE EVALUATION
Name /—r-,2 r
Address Lot Size t-0
FACTORS AREA 1 AREA 2 AREA 3 AREA 4
1) Topography/Landscape Position S S S S
PS PS
U U U
2) Soil Texture (12-36 in.) Sandy, S S S
Loamy, Clayey, (note 2:1 Clay) PS PS
V`kf' U U
3) Soil Structure (12-36 in.) S S S
Clayey Soils PS PS
U U
4) Soil Depth (inches) Sy�,, S S
11-eS TT PS PS
U U
5) Soil Drainage: Internal S S S S
PS PS
�T U U
External S S S
(f7a PS PS
U U U
6) Restrictive Horizons
7) Available Space` 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—SUITABLE ES—Provisionally Suitable
Recommendations/Comments:
Described by Title Date I
SITE DIAGRAM
ee--
DCHD(6-82)
Davie County Nealtl De artment
N �n
and .dome ealtfi• ye cy
210 HOSPITAL STREET I P.O.BOX 668
MOCKSVILLE.N.C. 27028
PHONE:(704)634.5985
January 24, 1989
Advance Masonic Lodge 710
Attn: Billie E. McDaniel, Sr.
Route 3, Box 470
Mocksville, NC 27028
Re: Site Evaluation
Highway 801
Dear Mr. McDaniel:
On January 23, 1989, as-you requested a representative from this office
visited the above mentioned site. The soil was found provisionally suitable
for the installation of a ground absorption sewage system. The building
must be staked before a permit can be issued.
If you have any questions, please feel free to contact this office.
Sincerely,
Robert B. Hall, Jr. , R.S.
Environmental Health Section
RH/wd
Enclosure
cc: Advance Masonic Lodge (03-12-92)
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