225 Palomino RdDavie Countv, NC
Tax Parcel Report Fridav, October 7, 201 E
WARNING: THIS 1S NOTA SURVEY
Parcel Information
Parcel Number:
H909OA0005
Township:
Shady Grove
NCPIN Number:
5789854006
Municipality:
Account Number:
82528583
Census Tract:
37059-804
Listed Owner 1:
GRACHEN JOSEPH T
Voting Precinct:
EAST SHADY GROVE
Mailing Address 1:
225 PALOMINO ROAD
Planning Jurisdiction:
Davie County
City:
ADVANCE
Zoning Class:
DAVIE COUNTY R -A
State:
NC
Zoning Overlay:
Zip Code:
27006-0000
Voluntary Ag. District:
No
Legal Description:
LOT 5 HIDDEN MEADOW
Fire Response District:
ADVANCE
Assessed Acreage:
5.11
Elementary School Zone:
SHADY GROVE
Deed Date:
9/2009
Middle School Zone:
WILLIAM ELLIS
Deed Book / Page:
008051036
Soil Types:
PcB2,PcC2
Plat Book:
0007
Flood Zone:
Plat Page:
238
Watershed Overlay:
DAVIE COUNTY
Building Value:
272560.00
Outbuilding & Extra
Freatures Value:
35610.00
Land Value:
68920.00
Total Market Value:
377090.00
Total Assessed Value: 377090.00
t �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
�7 County of Davie, North Carolina, Its agents, consultants, contractors or employees from any and all claims or causes of action due to
1\
�oUp�� C or arising out of the use or Inability to use the GIS data provided by this website.
Davie County Environmental Health
P.O. Box 848/210 Hospital Street
Mocksville, NC 27028 ° �".
(336)753-6780 / Fax (336)753-1680
WELL PERMIT
Account #: 989900093
Billed To: Shelton Construction Services
Reference Name:
Proposed Facility- Residential Wet(
4"
Tax PIN,EH #: 5789-83-2266.05
Subdivision Into: Hidden Meadow Lot # 5
LocationiAddress: Hidden Meadows Trail -27006
Property Size: See Map J;
ATC Number: -588 oos3 Nkutu+tt•/
Actions of the employees of the Davie County EH Section shall in no way be taken as a guarantee that this
well will produce water of any particular quantity or quality or for any amount of time. This permit is valid
for period of 5 years from the date of issuance. This permit may be revoked if it is determined that there
has been a material change in any fact/circumstances upon which this permit was issued.
Permit Type: New 0' Repair ❑ Abandonment ❑
\�roposed Well Location Diagram
Certificate of Completion Diagram
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Driller: c�CrJj�
Certification #:
Grout Inspected: — ' f0
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Well Head Inspected:
GPS Coordinates: �Q
EHS: Date:
EHS: ate: '%%
W.P. 7-08
J
ICATION FOR PRIVATE W tLL PERMIT
Davie County Environmental Health
P.O. Box 848/210 Hospital Street
Mocksville, NC 27028
(336)753-6780 / Fax (336)753-1680
/ ***IMPORTANT***
S APPLICATION CANNOT BE PROCESSED UNLESS ALL OF THE REQUIRED INFORMATION IS PROVIDED.
APPLICANT INFORMATION
Name �_. _. ��_ /� Contact Person l 5>__A1, ���•
Address Home Phone
City/State/ZIP _ s t w y` . 7._70Z Business Phone i t..
Name on Permit if Different than Above a=te - -4. C:- _ _ . I <- • t -J- ..,}.
Mailing Address S - City/State/Zip _
PROPERTY INFORMATION .*Date House Facili�v Corners Flagged
,4/h :5- / / (')
NOTE: A survey plat or site plan must accom any this application. Included:.1'l�lan []Plat (to cale)
Owner's Name Phone Numbers %Z 7
Owner's Address 4 City/State/Zi
Property Address r _ fe, _ City - _
Lot Size -i Tax PIN#
Subdivision Name(if applicable) . _. � ,. , Section/Lot#
Directions To Site:
DEVELOPMENT INFORMATION
Permit Type: New Well ' i./ Well Repair Well Abandonment Other (specify)
Facility Type: Residential L/ Food Service Church Commercial Other
Are There Any Septic Systems Currently On The Site? YES NO !ice'
Do You Intend To Install A New Septic System On This Site? YES Z/ NO
TERMS AND CONDITIONS:
This application must be accompanied by a plat or site plan of the property that includes the existing and proposed property lines
with dimensions, the specific location of the facility and any existing or future appurtenances, the location of any existing septic
system, sewer lines, water lines, any existing water supplies and any surface waters. The applicant is responsible for identifying
and marking the property lines and corners. The applicant is responsible for making the site accessible.
By signing this application, the applicant signifies that they understand the terms and conditions and that they give permission for
Davie County Environmental Health representatives to perform necessary field evaluations and procedures deemed necessary to
determine the best location for a well.
Signed
7/30/09
Site Revisit Charge
Date(s):
Client Notification Date:
EHS:
Account # 4093
Invoice #
X_
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' DAVIE COUNTY ENVIRONMENTAL HEALTH
P.O. Box 848/210 Hospital Sfre6t
Mocksville, NC 27028
(336)753-6780/Fax #(336)753-1680
AUTHORIZATION FOR WASTEWATER SYSTEM CONSTRUCTION
4
Account #: 989900093 Tax PIN/EH #: 5789-83-2266.05
Billed To: Shelton Construction Services Subdivision Info: Hidden Meadow Lot # 5
Reference Narne: Location/Address: Hidden Meadows Trail -27006
Proposed Facility: Residential Property Size: See Map
,STC Number: 5007 Site Type: EXZ-w- ❑Repair ❑Expansion
**NOTE** This Authorization to Construct (ATC) MUST BE ISSUED by the Davie County Environmental
Health Section prior to issuance of any building permit(s), (in compliance with Article 11 of G.S. Chapter 130A
Wastewater Systems, Section .1900 Sewage Treatment and Disposal Systems). THIS AUTHORIZATION TO
CONSTRUCT IS VALID FOR A PERIOD OF FIVE YEARS. This ATC is subject to revocation if site plans, plat
or the intended use change.
Residential Specifications: # Bedrooms -1 # Bathrooms �-6 People Basement❑ Basement plumbing❑
Non -Residential Specifications: Facility Type # People # Seats
Square Footage(or Dimensions of Facility) �%%
Lot Size 5-6-76 Type of Water Supply: ❑County/City ClWell�unity Well
System Specifications: Design Wastewater Flow (GPD) q90 Tank SizeGAL. Pump Tank �/AL.
Trench Width.3& Max. Trench Depth 7 Rock Depth Linear Ft. L� Yy
F+s stated in 15A NCA 18A.1969(51
Site Modifications/Conditions/Other: accepted Systems may al&o be used
Contact the Davie County Environmental Health Section for final inspection of this system between
8:30 - 9:30a.m. on the day of installation. Telephone # (336)751-8760.
;
Environmental Health Specialist
DCHD 11/06 (Revised)
n z- 5