191 Riverbend Dr Davie County, NC Tax Parcel Report "Tuesday, October 25, 2016
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WARNING: THIS IS NOT A SURVEY
Parcel Information
Parcel Number: D8030A0017 Township: Farmington
NCPIN Number: 5882041658 Municipality: BERMUDA RUN
Account Number: 82513252 Census Tract: 37059-803
Listed Owner 1: GWYNN THOMAS L Voting Precinct: HILLSDALE
Mailing Address 1: 191 RIVERBEND DRIVE Planning Jurisdiction: BERMUDA RUN
City: BERMUDA RUN Zoning Class: BERMUDA RUN CR
State: NC Zoning Overlay:
Zip Code: 27006-8500 Voluntary Ag.District: No
Legal Description: LOT 172 BERMUDA RUN GOLF&COUNTRY Fire Response District: CLEMMONS
Assessed Acreage: 1.03 Elementary School Zone: SHADY GROVE
Deed Date: 3/2003 Middle School Zone: WILLIAM ELLIS
Deed Book/Page: 004700310 Soil Types: MrC2,MrB2
Plat Book: 0004 Flood Zone:
Plat Page: 089 Watershed Overlay: BERMUDA RUN
Building Value: 209570.00 Outbuilding&Extra 0.00
Freatures Value:
Land Value: 110000.00 Total Market Value: 319570.00
Total Assessed Value: 319570.00
o��erF All data is provided as is v Mou t warranty or guarantee of any kind either expressed or Implied Including but not limited to Me
Davie County, Implied warranties of memhantabllhy or Moses for a particular use,All users of Davle County's GIS webabe a hall hold harmless Me
County of Delle,Norm Carolina,hs agents,censultaMs,contractors or employees from any and an claims or causes 0 action due to
NC or arising out of Me use or Inability to use Me GIS data proyided by thiswebsite.
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AUTHORIZATION NO: . :9 9 DAVIR COUNTY HEALTH DEPARTMENT
Environm ntalHealthSection PROPERTY INFORMATION
Permittee'.s P.O. Box 848 ,Q
Name: l�l�! / Mocksville,NG27028 Subdivision Name: �"� ��d�l-�l�
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Directions to property: / /� / l'/��; � � Phone# 336-751-8760
Section: Lot:
AUTHORIZATION FOR
WASTEWATER Tax Office PIN:#
SYSTFM CONSTRUCTION
Road Name: Zip:
**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 with Article I 1 of G.S.Chapter,130A Wastewater Systems,Section.1900 Sewage Treatment and Disposal Systems)
***NOTICE***THIS AUTHORIZATION FOR WASTEWATER CONSTRUCTION
IS VALID FOR A PERIOD OF FIVE YEARS.
EI&IRONMENTAL HEALTH SPECIALIST DATE ISSUED
i r r!"'F�� g It•,e ,i a:w i"; 'v i s' y .. ., _. .- ;4',e
i
'. DAVIE COUNTY HEALTH DEPARTMENT /� ✓�-'l�- J
IMPROVEMENT AND OPERATION PERMITS PROPERTY INFORMATION
�e-�' rmittee S_"�,��` 4.4 T••.�.�t / ,�/
Dame::; Subdivision Name: L"/+'f1�`���
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Directions to property: ; `�� J � � Section: Lot:
"sIMPROVEMENT
.• . �.: �r :< !'� 4 PERMIT Tax Office PIN:# _ _
Road Name: Zip:
**NOTE**This Improvement Permit DOES NOT authorize the construction or installation of aseptic 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 130A,Wastewater Systems,Section.1900 Sewage Treatment and Disposal Systems
***NOTICE***THIS PERMIT IS SUBJECT TO REVOCATION IF SITE ,
Le PLANS OR THE INTENDED USE CHANGE.YOUR WASTEWATER
E VIRONMENTAL HEALTH SPECIALIST DATE ISSUED SYSTEM CONTRACTOR MUST SEE THIS PERMIT BEFORE
INSTALLING THE SYSTEM..
RESIDENTIAL SPECIFICATION:BUILDING TYPE_4t !#BEDROOMS!!V #BATHS_ #OCCUPANTS GARBAGE DISPOSAL,Yes or No
COMMERCIAL SPECIFICATION: FACILITY TYPE #PEOPLE #PEOPLE/SHIFT #SEATS INDUSTRIAL WASTE:Yes or No
LOT SIZE TYPE WATER SUPPLY DESIGN WASTEWATER FLOW(GPD) `NEW SITE* REPAIR SITE
SYSTEM SPECIFICATIONS: TANK SIZE GAL. PUMP TANK ��O GAL. TRENCH WIDTH_ ROCK DEPTH,LINEAR FT.
OTHER
REQUIRED SITE MODIFICATIONS/CONDITIONS:
MPROVEMENTPERMITLAYOUJAPPRAVED EFFLUENT FILTER* *RISER(S)` IF 6" BELOW FINISHED GRADE*
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6, 6•
**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(ROGac15 �149J80.
(336)751-8760
OPERATION PERMIT
SYSTEM INSTALLED BY:
AUTHORIZATION NO. OPERATION PERMIT BY: 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) _
i� . [ ��p xti-a-_ l�3'�.K..rH�L'.r"�p.,,u_ Y V?' ' �.�is� ` �.q- �, y''��` i,°:.•i'-.o . (_ ' -`^,.p> r'„ r ,:•a •r � 7(-r
y j ;q 9 DAVIE COUNTY HEALTH DEPARTMENT
IMPROVEMENT AND OPERATION PERMITS PROPERTY INFORMATION
,,,.. .-•``Permittee'g �_�;= �. .,..- � '
Name: 1 t i.1 k'... . Subdivision Name: C�j��IG�/
Directions to property: 411V i Section: Lot:
IMPROVEMENT
PERMIT Tax Office PIN:#
Road Name: 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 of G.S.Chapter 130A,Wastewater Systems,Section.1900 Sewage Treatment and Disposal Systems5
r ,r ***NOTICE***TILS PERMIT IS SUBJECT TO REVOCATION
IF SITE
PLANS OR THE INTENDED USE CHANGE.YOUR WASTEWATER
ENVIRONMENTAL HEALTH SPECIALIST DATE ISSUED SYSTEM CONTRACTOR MUST SEE THIS PERMIT BEFORE
INSTALLING THE SYSTEM.
RESIDENTIAL SPECIFICATION:BUILDING TYPE_� #BEDROOMS_ #BATHS_, #OCCUPANTS GARBAGE DISPOSAL:Yes or No
COMMERCIAL SPECIFICATION: FACILITY TYPE #PEOPLE #PEOPLEISHIFT #SEATS INDUSTRIAL WASTE:Yes or No
LOT SIZE TYPE WATER SUPPLY DESIGN WASTEWATER FLOW(GPD) NEW SITE REPAIR SITE
SYSTEM SPECIFICATIONS: TANK SIZEAAZr GAL. PUMP TANK AQ GAL. TRENCH WIDTH ROCK DE -2`!J LINEAR FT.. �
OTHER
REQUIRED SITE MODIFICATIONS/CONDITIONS:
IMPROVEMENT PERMIT LAYOUI.APPROVED EFFLUENT FILTERS *RISER(S) IF 61' BELOW FINISHED GRADE
{ R
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r _
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**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#I9s(3 OOt 097460.
(336)781-8760
OPERATION PERMIT
SYSTEM INSTALLED BY:
F
i
F
AUTHORIZATION NO. OPERATION PERMIT BY: DATE:
"THE ISSUANCE OF THIS OPERATION PERMIT SHALL INDICATE THAT THE SYSTEM DESCRIBED ABOVE HAS BEEN INSTALLED IN COMPLIANCE
WITH ARTICLE I 1 OF G.S.CHAPTER 130A,SECTION.1900"SEWAGE TREATMENT AND DISPOSAL SYSTEMS",BUT SHALL IN NOWAY BETAKEN ASA
GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORILY FOR ANY GIVEN PERIOD OF TIME.
DCHD 05/96(Revised) s
DAVIE COUNTY ENVIRONMENTAL HEALTH SECTION
APPLICATION FOR IMPROVEMENT PERMIT(REPAIR)
NAME /G� PHONE NUMBER 1
ADDRESS ��� �l/r�? 6 ar/ SUBDIVISION NAME
LOT #
DIRECTIONS TO SITE
DATE SYSTEM INSTALLED NAME SYSTEM INSTALLED UNDER
TYPE FACILITY NUMBER BEDROOMS NUMBER PEOPLE SERVED
TYPE WATER SUPPLY SPECIFY PROBLEM OCCURRING
DATE REQUESTED INFORMATION TAKEN BY
This is to certify that the information provided is correct to the best of my knowledge,and that I understand I am responsible for all charges incurred from this application.
SIGNATURE OF OWNER OR AUTHORIZED AGENT
Rev.1/93
DAVIE COUNTY HEALTH DEPARTMENT
" (Septic Tank) Improvements Permit and Certificate of Completion
(Ground,Absbrption Sewage_Disposal' System - G.S. Chapter130-Article 13C)
OWNER OR,,CONTRACTOR i d 41 .i7.=.I r DATE PERMIT
LOCATION %C? f - f'l (:�/fiNC t- />� s� N? 1745
45
- S.R. N0.
SUBDIVISION NAME r'=1AII LOT NO. 1'71'1__111'_ SECTION OR BLOCK NO.
HOUSE ❑ MOBILE HOME BUSINESS ❑
House Trailer 800 Gal. 400 Sq. Ft.
NO. BEDROOMS NO. BATHROOMS Two Bedroom House 800 Gal. 600 Sq. Ft.
GARBAGE DISPOSAL UNIT YES ❑ NO ❑ Three Bedroom House 900 Gal. 900 Sq. Ft.
AUTO. DISHWASHER YES ❑ NO ❑ Four Bedroom House 1000 Gal. 1200 Sq. Ft.
AUTO. WASH. MACHINE YES ❑ NO ❑ f;� .,�
SITE SUITABLE YES ❑ NO ❑
SIZE OF TANK gal.
NITRIFICATION FIELD sq. ft.
DEPTH OF STONE IN LINES:
WATER SUPPLY: Individual ❑ Public ❑ = (�/�
IMPROVEMENTS PERMIT BY t %; r"/.'L INSTALLED BY c�7
CERTIFICATE OF COMPLETION
tBY Date
(8/16/73) *Construction must comply with ll other applicable State and local egu ations
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