234 Merrells Lake RdDavie County, NC
Tax Parr.el R ennrt
Friday. September 30, 2016
WAlC IAU: THIS IS ALIT A SURVEY
Parcel Information
Parcel Number: J70000006102 Township: Fulton
NCPIN Number: 5768600862 Municipality:
Account Number: 8305759 Census Tract: 37059-804
Listed Owner 1: BARNEY DAVID Voting Precinct: FULTON
Mailing Address 1: 234 MERRELLS LAKE ROAD Planning Jurisdiction: Davie County
City: MOCKSVILLE Zoning Class: DAVIE COUNTY R-20
State:
NC
Zoning Overlay:
Zip Code:
27028
Voluntary Ag. District:
No
Legal Description:
.701 AC MERRELLS LAKE RD
Fire Response District:
FORK
Assessed Acreage:
0.69
Elementary School Zone:
CORNATZER
Deed Date:
11/2015
Middle School Zone:
WILLIAM ELLIS
Deed Book/ Page:
010050824
Soil Types:
GnB2
Plat Book:
Flood Zone:
Plat Page:
Watershed Overlay:
DAVIE COUNTY
Building Value:
62120.00
Outbuilding & Extra
Freatures Value:
0.00
Land Value:
14690.00
Total Market Value:
76810.00
Total Assessed Value:
76810.00
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 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.
STP a.♦
10
AUTWRIZATION NO. 10'1 9A DAVIE COUNTY HEALTH DEPARTMENT
Environmental Health Section PROPERTY INFORMATION
Permittee's� '� '� P.O. Box 848
. Name: C't1r�t�--Moc�sville, NC 27028 Subdivision Name:
Phoned# 336-751-8760
Directions to property: ! k.+� l�� L '1� Section: "
—,� AUTHORIZATION FOR
WASTrvuA rAR
Lot:
t �(�-�-1-I" !A" !' I1"'T SYSTEM CONSTRUCTION Tax Office PIN:# - _
Road Nae: W0:-1✓Lc-t-1._ LA Zip; G. /G,.
**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 wi"icle 11 of G.S. Chapter I JOA; Wastewater Systems, Section.] 900 Sewage Treatment and Disposal Systems)
***NOTICE*** THIS AUTHORIZATION FOR WASTEWATER CONSTRUCTION
IS VALID FOR A PERIOD OF FIVE YEARS.
ENVIRO,NIF T L HEALTH SPEdALIST DATE ISSU( D
DAVIE COUNTY HEALTH DErGTMENT
IMPROVEMENT AND OPERATION PERMITS PROPERTY INFORMATION
Perinittee's . r
} f�
—Name:, -- �hJ i- i 1 i _ 1.'�-' Subdivision Name:
Directions to property:
��'� �;_1 E ' t.. t..(~. i,; r'� Mfr • w� �°'•; � ,• ,I
Section: Lot:
IMPROVEMENT
PERMIT Tax Office PIN:# - -
cj r
Road Nariie: (0 i i fl V, 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
construction/installation of a system or the issuance of a building permit.
(In compliance with Article I I of G.S. Chapter I OA, Wastewater Systems, Section .1900 Sewage Treatment and Disposal Systems)
***NOTICE*** THIS PERMIT IS SUBJECT TO REVOCATION IF SITE
PLANS OR THE INTENDED USE CHANGE. YOUR WASTEWATER
ENVIRONMENT L HEALTH SPECIALIST DA ISSU D SYSTEM CONTRACTOR MUST SEE THIS PERMIT BEFORE
r t � INSTALLING THE SYSTEM.
RESIDENTIAL SPECIFICATION: BUILDING TYPE # BEDROOMS --7, # BATHS # OCCUPANTS -: GARBAGE DISPOSAL: Yes or No
COMMERCIAL SPECIFICATION: FACILITY TYPE �) # PEOPLE # PEOPLE/SHIFT # SEATS INDUSTRIAL WASTE: Yes
or
No
LOT SIZE' f kk- TYPE WATER SUPPLY L'2� ,T DESIGN WASTEWATER FLOW (GPD) -Zf ^� NEW SITE REPAIR SITE ✓
SYSTEM SPECIFICATIONS: TANK SIZE GAL. PUMP TANK GAL. TRENCH WIDTH ^� ROCK DEPTH 119 LINEAR FT.
OTHER sn (21 N21-1
0r�
1�lJ X I ►�, `T�
LI L I.�lr <. 9'07 C,
REQUIRED SITE MODIFICATIONS/CONDITIONS: - Fa -r)
IMPROVEMENT PERMIT LAYOUT -APPROVED EFFLUENT 0gLTER* *RISE'R(S) IF 611; EELO'W FItIlEMED GRADE*
VI T ^J.
e
,0
D WtA�A
"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 THE DAY OF INSTALLATION. TELEPHONE # IS (-imA d'81 m; 3t
`(336)751-8760
OPERATION PERMIT
INSTALLED BY:
'76 90
�O,Ul
F
will
'Valf c 0
AUTHORIZATION NO. 'OPERATION PERMIT BY: G DATE:
"THE ISSUANCE OF THIS OPERATION PERMIT SHALL INDICATE THAT THE SYSTEM DESCRIBED 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 05/96 (Revised)
1
'+ DAVIE COUNTY HEALTH DEPARTMENT I
IMPROVEMENT AND OPERATION PERMITS PROPERTY INFORMATION
Perrbittee's
Subdivision Name:
• Directions to property: t:.Y i = ' i i i'.- ' Section: Lot:
IMPROVEMENT
f- r, ;
1t . PERMIT vN Tax Office PIN:#
Road Nle: i",�, i LL 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
construction/installation of a system or the issuance of a building permit.
(In compliance with Article 11 Pof G.S. Chapter 130A, Wastewater Systems, Section .1900 Sewage Treatment and Disposal Systems)
***NOTICE*** THIS PERMIT IS SUBJECT TO REVOCATION IF SITE
"" rr'?• t� % PLANS OR THE INTENDED USE CHANGE. YOUR WASTEWATER
)NMENTAL HEALTH SPECIALIST DA E ISSUED SYSTEM CONTRACTOR MUST SEE THIS PERMIT BEFORE
INSTALLING THE SYSTEM.
RESIDENTIAL SPECIFICATION: BUILDING TYPE _ # BEDROOMS ^3 # BATHS # OCCUPANTS "�7 GARBAGE DISPOSAL: Yes or No
1.
COMMERCIAL SPECIFICATION: FACILITY TYPE # PEOPLE # PEOPLE/SHIFT # SEATS „ INDUSTRIAL WASTE: Yes or No
/�r f
LOT SIZE ` ' " Q -r TYPE WATER SUPPLY CLL�DESIGN WASTEWATER FLOW (GPD) - f 't--� NEW SITrZ REPAIR SITE
t
SYSTEM SPECIFICATIONS: TANK SIZE GAL. PUMP TANK GAL. TRENCH WIDTH 1 -7 ROCK16EPTH 1 5� LINEAR FT.
OTHER 1, 1� C.
REQUIRED SITE MODIFICATIONS/CONDITIONS:
1
IMPROVEMENT PERMIT LAYOUT gA3?aPROVED EFFI..IMENI T IL I L 1
IF 617! R NW FItaiwHED GPiADE*
� �1 uLcj
1 �
"CONTACT A REPRESENTATIVE OF THE DAVIE COUNTY HEALTH DEPARTMENT FOR FINAL INSPECTIQNOF THIS SYSTEM
BETWEEN 8:30 - 9:30 A.M. OR 1:00 - 1:30 P.M. ON THE DAY OF INSTALLATION. TELEPHONE # S (1U 6k4''Mbf II
751—fI7£Q
OPERATION PERMIT
S
?D�
4 INSTALLED BY:
7�
re KA414
Y
u
r
pE �. l
/k t/r" f O
'e r
AUTHORIZATION NO.iI (0_1 LA0PERATION PERMIT BY: �- /l�iDATE:
"THE ISSUANCE OF THIS OPERATION PERMIT SHALL INDICATE THAT THE SYSTEM DESCRIBED 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 05/96 (Revised)
tt'ev -tab
DAVIE COUNTY HEALTH DEPARTMENT
Environmental Health Section
PO Box 848/210 Hospital Street
Mocksville, NC 27028
Phone: (336)751-8760
ON-SITE WASTEWATER CERTIFICATION FOR DWELLING
(Check One) REPLACEMENT REMODELING ❑ RECONNECTION ❑
Name: t e�'k�W e �/� S PhoneNumber: 1 O I `2� (Home)
Mailing Address: oG -5_3 10L Ae7e 1`s Z aA' –_ 1e/• (Work)
Detailed Directions To Site: �� �S ��YY40
."— e1v e11T /_& /sem � �/�� c�.�� %D
Property Address:
Please Fill In The Following Information About The �Existing Dwelling: /� (' /
Name System Installed Under: �1 �//.S A�/ r� S Type Of Dwelling: / " � ' 5i;e l�
Date System Installed(Month/Day/Year): 6 Number Of Bedrooms: --2— Number Of People:
Is The Dwelling Currently Vacant? Yes ❑ No 2Y If Yes, For How Long?
Any Known Problems? Yes ❑ No P If Yes, Explain:
Please Fill In The Following Information About The New Dwelling:
�j _/ / v -1e
Type Of Dwelling:/2 A, � �`0idl< Number Of Bedrooms: � Number Of People: .�
Requested By:
For Environmental Health Office Use Only
Approved ❑ Disapproved CT'
Environmental Health
Requested:ii
—r S /24 /gg -1eD Abb 7v
"The signing of this form by the Environmental Health Staff is in no way intended, nor should be taken as a
Quarantee(extended or limited) that the on-site wastewater system will function vroverly for anv given period of time.
Payment: Cash ❑ Check ❑ Money Order ❑ # Amount: $ Date:
Paid By: Received By: pp
Account #: �" b Invoice #: 0
/)//1 1t9900-457//_ 677 y6-