750 Sheffield Rd (2)Davie Countv. NC
Tax Parcel Report 'a D ( `f Thursdav, October 6, 2016
WA"I.NU: THIS 1S 1VU1' A NUKVLY
Parcel Information
Parcel Number:
G20000003701
Township:
Calahaln
NCPIN Number:
5810220670
Municipality:
Account Number:
33504000
Census Tract:
37059-801
Listed Owner 1:
HATLEY GARY E
Voting Precinct:
NORTH CALAHALN
Mailing Address 1:
750 SHEFFIELD ROAD
Planning Jurisdiction:
Davie County
City: MOCKSVILLE
Zoning Class:
DAVIE COUNTY R-20
State:
NC
Zoning Overlay:
Zip Code:
27028-8408
Voluntary Ag. District:
No
Legal Description:
0.989 AC SHEFFIELD RD
Fire Response District:
CENTER
Assessed Acreage:
1.03
Elementary School Zone:
WILLIAM R DAVIE
Deed Date:
2/2016
Middle School Zone:
NORTH DAVIE
Deed Book / Page:
010120097
Soil Types:
MnC2
Plat Book:
0004
Flood Zone:
Plat Page:
124
Watershed Overlay:
DAVIE COUNTY
Building Value:
0.00
Outbuilding & Extra
Freatures Value:
0.00
Land Value:
18940.00
Total Market Value:
18940.00
Total Assessed Value:
18940.00
o�v�FI
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
Impliedwarrantles of merchantability or fitness for a particular use. All users of Davie County's GIS website shall hold harmless the
NCounty
CC
of Davie, North Carolina, Its agents, consultants, contractors or employees from any and all claims or causes of action due to
or arising out of the use or Inability to use the GIS data provided by this website.
11: 30
AUTHORIZATION NO: 2 1 DAVIE COUNTY HEALTH DEPARTMENT
Environmental Health Section PROPERTY INFORMATION
Permittee's P.O. Box 848
Name: 67A e i L IL- Y Mocksville, NC 27028 Subdivision Name:
J _ Phone # 336-751-8760
Directions to property: t �) l� I��-�� tc�+� Section: Lot:
AUTHORIZATION FOR
•� �, ./ r_, 77 �
WASTEWATER Tax Office PIN:# _
—� SYSTEM CONSTRUCTION, —
Road Name ►�G.1 t4iZip: 1L
**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 11 of G.S. Chapter 130A, Wastewater Systems, Section .1900 Sewage Treatment and Disposal Systems)
r _/� ✓ ***NOTICE*** THIS AUTHORIZATION FOR WASTEWATER CONSTRUCTION
IS VALID FOR A PERIOD OF FIVE YEARS.
ENVIRONMENTAL HEALTH PECDATE ISSUED
R Il 30 f 'S 2G qq
s ..s DAVIE CbUNTY HEALTH DEPARTMENT
IMPROVEMENT AND OPERATION PE"ITJ PROPERTY INFORMATION
Permittee's a
Names I , { } 1j 4 �`.i L L#r° Subdivision Name:
Directions to property: i,,. i `� r ". I w I• f ; L.�'. Section: Lot:
IMPROVEMENT
p,' 1 L k� ' 1 PERMIT Tax Office PIN:#
Road Name 4S: t r< < i > Zip: C
**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 1 I of G.S. Chapter 130A; Wastewater Systems, Section .1900 Sewage Treatment and Disposal Systems)
r"•"1VU111,L"'"� 1fun YL'K1V111 n.nunj -1 1U rr VU%-A11U1V 11' al1r.
PLANS OR THE INTENDED USE CHANGE. YOUR WASTEWATER
ENVIRONMENTAL HEALTH 6PECIALIST DA ISS D SYSTEM CONTRACTOR MUST SEE THIS PERMIT BEFORE
INSTALLING THE SYSTEM.
RESIDENTIAL SPECIFICATION: BUILDING TYPE 0 0� # BEDROOMS — # BATHS -2- # OCCUPANTS �_ GARBAGE DISPOSAL: Yes ori
COMMERCIAL SPECIFICATION: FACILITY TYPE # PEOPLE # PEOPLEISHIFT/ # SEATS INDUSTRIAL WASTE: Yes/or No
LOT SIZE
,,
I Q. STYPE WATER SUPPLNCV! N—yty DESIGN WASTEWATER FLOW (GPD) NEW SITE REPAIR SITE ✓
SYSTEM SPECIFICATIONS: TANK SIZ6LCQ GAL. PUMP TANK GAL. TRENCH WIDTH:�(V , ROCK DEPTH "-r1 LINEAR FT. —'
OTHERI 10 y 1 C�Cj
REQUIRED SITE MODIFICATIONS/CONDITIONS: 'OS-V%U -y,J
IMPROVEMENT PERMIT LAYOUT
*APPROVED EFFLIIEUT FILTER! tRISMUS1 IF 6" ill:Ltl1261 171I3ISIIFD 5VI E*
tI, OkA S10
�, D,Cj, 3 eon l
I FAX
Z I(, '`�
� a �
100
50L-iST
/ TRµ
Cl ��
y �
**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 (336)751-8760.
OPERATION PERMIT
SYSTEM INSTALLED BY: �hn Y L Y,.
ODS
Ion
F1,
1 V4 --
AUTHORIZATION
--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)
APPUCAl10N FOR SITE EVALUATION/IMPROVEMENT PERMIT do
* Davie County Health Department D d
Environmenb/Nealfh S&HOn
P.O. Box 848/210 Hospital Street t's` R 17
Mockaville, NC 27028
(336) 751-8760 __._ ___ _ _
I ***ZHPORTANT*** THIS APPLICATION CANNOT BE PROCESSED UNLESS ALL THE REQU I
INFORMATION IS PROVIDED. Refer to the INFORMATION BULLETIN for instructions.
1. name to be Billed
Lo V Contact person
Mailing Address 1 O `MO r1 AIC 1 1 11 %� a -/�7C � Home Phone
City/state/LIP j� n>cL75)' N (i _ � / O2T Business Phone
2. name on Permit/ASC if Different than Above
Mailing Address City/state/Lip
3. Application For: U Site Evaluation ftYlmprovement Permit/ATC 0 Both
4. system to service: House ❑ Mobile Home 0 Business 0 Industry ❑ Other
s. If Residence: # People ! # Bedrooms _ # Bathrooms 2
H/ Dishwasher 0 Garbage Disposal q'Washing Machine 0 Basement/Plumbing 0 Basement/no Plumbing
6. If Business/Industry/Other: Specify type # People # sinks
# Commodes # showers # Urinals # Water Coolers
IF FOODSERVICE: 11 Seats Estimated Water Usage (gallons per day)
7. Type of Nater supply: W County/City ❑ Well ❑ Con=unity
s. Do you anticipate additions or expansions of the facility ibis syste is I I ded to serve! 0 Yes 0 No
If yes, what type? �!'� .� 3d , / X4':?� d / /;>-2d mow►. ��/ rye
***IMPORTANT*** CLIENTS 11tUST compLETETHE REQUIRED PROPERTY INFORMATION REQUESTED
BELOW. Either a PLAT or SITE PIAN MUST BE SUBMITTED by the client with THIS APPLICATION.
Property Dimensions: 7. ( '4C' V4 WRITE DIRECTIONS (from Mocksville) to PROPERTY:
Tai Office PIN: # U 2 -16670
I M; 1�-s �" ,S k; (-f�-'e a
Property Address: Road Name `7 hct�N `C� L�n, QY,- ( h* , 7� sh��
City/Zip 1' L)ChI' l l f= 2i70 5-
If in a Subdivision provide information, as follows: b P4 s,- - 4-6 L r r-de,1,J
Name: !E�J 44- n u0"
Section: Block: Lot: Date Property Flagged: 3 / 7' 9g 'L� 0'17 t
This Is to certify that the information provided is correct to the best of my knowledge. I understand that any permit(s)
Issued hereafter are subject to suspension or revocation, If the site plans or Intended use change, or if the information
submitted In this application Is falsified or changed I, also, understand that I ane responsible for all charges lscurred from
this application. 1, hereby, give consent to the Authorized Representative of the Davie County Health Department
to enter upon above described property located in Davie County and owned by
to conduct all testing procedures as necessary to determine the site suitabilih.
DATE 3//%X1 SIGNATURE Ae5ZII-�
THIS AREA MAY BE USED FOR DRAWING YOUR SITE PLAN (Include all of the following: Existing and proposed
property lines and dimensions, structures, setbacks, and septic locations).
Revised DCHD (07/98)
Account No. 7"
Invoice No.�7
PLAT MAP
Hatley
_--file No.
de --f field Road ------ ------ --- - - --- ---
,ille — county_ I7av_e_____—_ sra�e ._IJC iiP code 27028
pry Hatley - -- - -- -- - — - ---
f4
0
O /
6 , 'ad° 1 'p Isi�a o� o
2 Z
14'�
l 1, 1 •
f� 4, dot•
f4
0
O /
6 , 'ad° 1 'p Isi�a o� o
2 Z
form P45 -• 'TOTAL 2000' appraisal software by a la mode, Inc. 1-800-ALAMODE
al � ;.
f� 4, dot•
y
J
rn `.
--1
tr
z
v
m
J
0
fi �v
z
w
v
o.0 c
1 % -
s ,v5
-�.ln-� S%
ti
S,�i
t` O
O
1+
to 9
t
r IN
form P45 -• 'TOTAL 2000' appraisal software by a la mode, Inc. 1-800-ALAMODE