206 Lybrook Rd (2) Davie County,NC Tax Parcel Report Friday, December 9, 2016
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_ WARNING: THIS IS NOT A SURVEY
_ Parcel Information p I
.:.Parcel Number: ,E80000_001304 Township: Farmington
- ..,NCPIN Number: i_5871783173 Municipality: BERMUDA RUN
-Account Number: 8306830 Census Tract: 37059-803
-Listed Owner 1: CARLSON GREGG LOUIS Voting Precinct: HILLSDALE
-Mailing Address 1: 206 LYBROOK ROAD Planning Jurisdiction: BERMUDA RUN
-City: "ADVANCE- -' Zoning Class: BERMUDA RUN,DAVIE COUNTY R-20,CR
State: __--_ NC Zoning Overlay: DAVIE COUNTY QD
Zip'Code:. 27006 Voluntary Ag.District: No
-Legal Description: 5.488 AC L•YBROOK RD Fire Response District: SMITH GROVE,ADVANCE
.-Assessed Acreage: 5.55 Elementary School Zone: SHADY GROVE
Deed Date: _9/2016 Middle School Zone: WILLIAM ELLIS
Deed Book/Page: 010280521 Soil Types: GnB2,GnC2,GaD,ChA
Plat Book: Flood Zone:
Plat Page: Watershed Overlay: BERMUDA RUN,DAVIE COUNTY
Building Value: Outbuilding 8r Extra
Freatures Value:
Land Value: Total Market Value:
Total Assessed Value:
O uM1� 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
�oC N•C NC or arising out of the use or Inability to use the GIS data provided by this website.
3
` HEALTH DEPARTMENT RELEASE For Office Use Only
*CDP File Number 231009- 1
Davie County Health Department
f 210 Hospital Street County ID Number.
P.O. Box 848 HDRMWC
Evaluated For.
Mocksville NC 27028
Phone:336-753-6780 Fax:336-753-1680 PERMIT VALID 1 0 / a 6 / a 0 a 1
UNTIL:
Applicant: Tim Moss & Sons Home Property Owner: James and Molly Kincaid
morovemen s
Address: 717 Green Valley Road Suite Address: 206 Lybrook Rd
City: Greensboro City: Advance
StatefZip: NC 27408 State/Zip: NC 27006
Phone#: Phone#:
Property Location&Site Information
Cddress206 Lybrook Road Subdivision: Phase: LotRoad#Advance NC 27006
SINGLE FAMILY Township:
Structure: Directions
#of Bedrooms: 3 -#of People: Hwy 158 east right on Hwy 801,left on Lybrook Rd
'Water Supply: N/A
Basement: ❑Yes o No Type of Business:
Total sq. Footage: No.Of Employees:
'Proposed Improvement:
Garage 26x24/Porch 18x8
'Release Conditions
Maintain 5 foot setback to any portion of the sseptic system and its subsequent repair area.
This release in no way expresses or implies that the existing subsurface sewage treatment and disposal
system serving the site will continue to function for any period of time.
Applicant/Legal Reps.Signature Required? Oyes ONo
Applicant/Legal Reps.Signature,• *Date:
*Issued By: 2140-Nations,Robert *Date of Issue: 1 0 a 6 a 0 1 6
Authorized State Agent:
,Z�-�fz'__I,�
**Site Plan/Drawing attached.**
O Hand Drawing Olmport Drawing i
r
HEALTH DEPARTMENT RELEASE
Davie County Health Department CDP File Number: 231009 - 1
210 Hospital Street
1
P.O.Box 848 County File Number:
Mocksville NC 27028 Date: 1 0 / a 6 / 2 0 1 6
QWNvd�
Olnch
Scale: OBlock
Drawing Type: Health Department Release ON/A
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Davie County Health Depcii t1hlelht
4i 6� Environmental Health Section
P.O.Box 848 t
210 Hospital Street a
0, Courier# : 09-40-06
gec���0ab ' Niocksville,NC 27028
Phone:(336)-753-6780 Fax:(336)-753-1680
ON-SITE WASTE`VATER RT CATION
(Check One) Replacement emodeling Reconnection
*-Name:�M d( c,-/ � Phone Number 33� -65r-7e-s/ (Home)
Mailing Address: ru-, Vc ,��v ��T (`Nock)
AICJ 27ya�
Detailed Directions To Site: 'aJ f g0/ Sd c
Property Address: p-0 (s0 L 4 iy+d c - c_Q__ 7d-0 6
Please Fill In The Following Information About The EXISTING Facility: -
Name System Installed Under: V^ k-il awij Type Of Facility:
Date System Installed(Month/Date/Year): - Z Number Of Bedrooms: Number Of People
Is The Facility Currently Vacant? Yes If Yes,For How Long?
�Vo
Any Known Problems? Yes 1 If Yes,Explain:
Please Fill In The Following InforNdreA
on About The N�ETVFacility:
Type Of Facility: (2-n,4 r,4 EI kY 6 Number Of Bedrooms: Number of People
Pool Size: Garage Size: C Other:
)(Requested By: t"" �` Date Requested: /a- -7
(Signature)
For Environmental Health Office Use Only
Approved Disapproved
Comments:
Environmental Health Specialist Date:
*The signing of this form by the Environmental Health Staff is in no way intended,nor should be taken as a guarantee
(extended or limited) that the on-site wastewater system will function properly for any given period of time.
Payment: Cash K6hecP Money Order # Amount:$ Q Date:
Paid By: 22 Received By:
Account#: JI� Invoice#:
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