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173 In & Out LnDavie County, NC Tax Parcel Report 4910 Thursday, September 29, 2016 Zvi WARNING: THIS IS NOT A SURVEY All data Is provided as Is without warranty or guarantee of any kind either expressed or Implied Including but not limited to the Implied warranties of merchantability or fitness for a particular use. All users of Davie County's GIs website shall hold harmless the a . ........ . ... - ..., _Parcel Information.. County of Davis, North Carolina, Its agents, consultants, contractors or employees from any and all claims or causes of action due to Parcel Number: F80000013912 Township: Shady Grove NCPIN Number: 5880290491 Municipality: Account Number: 8302052 Census Tract: 37059-803 Listed Owner 1: POTTS TIMOTHY V JR Voting Precinct: EAST SHADY GROVE Mailing Address 1: 173 IN AND OUT LANE Planning Jurisdiction: Davie County City: ADVANCE Zoning Class: DAVIE COUNTY R -A State: NC Zoning Overlay: Zip Code: 27006 Voluntary Ag. District: No Legal Description: 47.440 AC W OFF UNDERPASS Fire Response District: ADVANCE Assessed Acreage: 47.75 Elementary School Zone: SHADY GROVE Deed Date: 2/2014 Middle School Zone: WILLIAM ELLIS Deed Book / Page: 009510407 Soil Types: GnB2,PcC2,GnC2,ChA,RwA,WATER Plat Book: Flood Zone: Plat Page: Watershed Overlay: DAVIE COUNTY Building Value: 33940.00 Outbuilding & Extra Freatures Value: 0.00 Land Value: 222660.00 Total Market Value: 256600.00 Total Assessed Value: 256600.00 Zvi Davie County, All data Is provided as Is without warranty or guarantee of any kind either expressed or Implied Including but not limited to the 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 NC or arising out of the use or Inability to use the GIS data provided by this website. DAVIE COUNTY HEALTH DEPARTMENT IMPROVEMENTS PERMIT AND CERTIFICATE OF COMPLETION .} *NOTE:.Issued in Compliance with G.S. of North Carolina Chapter 130 Article 13c Sew`a e�reatment a is os I les (10 NCAC 10A .1934-.196) Permit Number Name �,�Vt �i_,�f - Date 4910 Location Subdivision Name No. `� Sec. or Block No. Lot Size�o House Mobile Home _ Business —_ Speculation No. Bedrooms _ No. Baths No. in Family 4 Garbage Disposal YES 0 NO p Specifications for System: Auto Dish Washer YES Ej NO 0 000 Auto Wash Machine YES ©i NO 0 Type Water Supply00 ,.This p rmit Void if sewage system described below is not installed within 36 months from date of issue. 1-) _ --- I - r 0�,t Uo � 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 7l, op v-- -- Certificate of Completion h-� 1. �\� Date W_ '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. DAVIE COUNTY HEALTH DEPARTMENT -� a _. IMPROVEMENTS PERMIT AND CERTIFICATE OF COMPLETION "NOTE: Issued incompliance with G.S. of North Carolina Chapter 130 Article 13c Sewage Treatment and Disposal Rules (1.0 NCAC 10A .1934-.19618) Permit Number Name \ 'O Date10 F> Locations t%. 1 t. ��•�, __A ��— r r\-•'�`\S. i ~mow .. ' } : 1 . ,. Out bV 113 Subdivision Name "Lot No. Sec. or Block No. j Lot Size t' House IJ Mobile Home _ Business Speculation No. Bedrooms No. Baths — < No. in Family 1 _ Garbage Disposal YES ❑ NO p Specifications for System: Auto Dish Washer YESd NO 'D / •,- �) ._� ;, Auto Wash Machine YES 2 NO ❑ �� u � ` > > \ It Type Water Supply .r `This.p rmit Void if sewage system described below is not installed within 36 months from date of issue. "o' L 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 dayt, of completion. Telephone Number: 704-634-5985. Final Installation Diagram: y System Installed by Rj= b r J Q Certificate of Completion �\ ` \\� Date �> - 1 _C� *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. C t~ APPLICATION FOR SITE EVALUATION/ IMPROVEMENTS PERMIT Davie County Health Department Environmental Health Section P. 0. Box 665 Mocksville, N.C. 27028 RECEIVE© RIFp 0 2 1987 CONSTRUCTION SHALL NOT BEGIN UNTIL IMPROVEMENTS PERMIT HAS BEEN ISSUED. Home Phone 4'9(:�, 4 3 70 a L{ / � 1. Permit Requested By t r►1 y B"�0 Business Phone 2. Address �� `'x �C Q c�l �) Q vt c c �'7 u` 0Lj 3. Property Owner if Different than Above Address 4. Permit To: a) Install -.L Alter Repair b) Privy Conventional J Other Type Ground Absorption ,;c) Sub -Division in Lot No. 5. System used to serve what type facility: House ✓ Mobile Home Business Industry Other b) Number of people `# 6. a) If house or mobile home, state size of home and number of rooms. 7 House Dimensions Bed Rooms 3 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) Number and type of water -using fixtures: commodes urinals lavatory showers dishwasher sinks garbage disposal washing machine ✓ 8. a) Type water supply: Public Private ✓ Community b) Has the water supply system been approved? Yes No 9. a) Property Dimensions `f O 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? What type? This is to certify that the information is corre to the best of N knowledge. q- a--.�7 Date er Signature OWNER IS SOLELY RESPONSIBLE FOR COMPLIANCE WITH ALL STATE AND LOCAL LAWS Allow 5 days for processing Directions to property: DCHD (6-82) P,�� (A*JJj- DAVIE COUNTY HEALTH DEPARTMENT Environmental Health Section. R O. Box 665 Mocksville, N.C. 27028 SOIL/SITE EVALUATION Name I Ym Date 9-q V Z7 Address S `Z Lot Size V U A v'm FAr.TORR ARFA 1 ARFA ? AREA 3 AREA d t) Topography/ Landscape Position db (� S PS S PS U U U U ?) Soil Texture (12-36 in.) Sandy, S PS S PS Loamy, Clayey, (note 2:1 Clay) PS U U U U 3) Soil Structure (12-36 in.) Clayey Soils S 4T) S PS S PS U U U U I) Soil Depth (inches)& &�) S PS S PS U U U U i) Soil Drainage: Internal PS S PS S PS U' U U External qb bs S PS S PS U U U i) Restrictive Horizons 3 (�) Available Space S PS PS S PS S PS U U U U 1) Other (Specify) S PS S S PS S PS U U () Site Classification U—UNSUITABLE Recommendations/Comments: Described by SITE DIAGRA DCHD (6.82) S—SUITABLE PS, rovisionaliy Suitable