874 Sheffield Rd Davie County,NC Tax Parcel Report 3�,j Tuesday, September 27, 201 t
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WARNING: THIS IS NOT A SURVEY
�g� � Parcel Information
Parcel Number: G20000002601 Township: Calahaln
NCPIN Number: 5810134844 Municipality:
Account Number: 61653250 Census Tract: 37059-801
Listed Owner 1: RITCHIE MICHAEL Voting Precinct: NORTH CALAHALN
Mailing Address 1: 874 SHEFFIELD ROAD Planning Jurisdiction: Davie County
City: MOCKSVILLE Zoning Class: DAVIE COUNTY R-20
State: NC Zoning Overlay:
Zip Code: 27028-8409 Voluntary Ag.District: No
Legal Description: sheffield rd Fire Response District: CENTER
Assessed Acreage: 1.97 Elementary School Zone: WILLIAM R DAVIE
Deed Date: 8/2010 Middle School Zone: NORTH DAVIE
Deed Book/Page: 008330144 Soil Types: MnC2
Plat Book: 10 Flood Zone:
Plat Page: 238 Watershed Overlay: DAVIE COUNTY
Building Value: 0.00 Outbuilding&Extra 4500.00
Freatures Value:
Land Value: 27430.00 Total Market Value: 31930.00
Total Assessed Value: 31930.00
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
n0 Utyq NC or arising out of the use or Inability to use the GIS data provided by this website.
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Da«e Cowity Health Deputment r
4�; t Environmental Heald Section ;
P.O.Box 848 �y
VI 210 Hospital Street �.
Q 'S �L�' `yJ Courter# : 09-40-06
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U Mocksville, NC 27028
Phone:(336)-753-6780 Fax:(336)-753-1680
ON-SITE WASTEWATER CERTIFICATION
(Check One) Replacement Remodeling Reconnection
Name: �;(�tv4w R ( aye X ��Q�hi,e Phone Number_ 3 2U ' a—(J2 I S k (Home)
Mailing Address: g 1 L( S V kWee.(( RA. —(Vo rk)
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Detailed Directions To Site: P--4J U (o Z{
dam- 2 i a ti-F
Property Address: $ 1(I S Va I�U 41 r1( 0 t_ V((t Lt C a 1 0 a
-.Please Fill In The Following Information About The EYJST1JVG Facility: 1
Name System Installed Under: `(,/ISCt-r r-Q,V�- T)Ar-r,(-(( Type Of Facility:
.Date Systbdi Installed(Month/Date/Year): (:P�)(o f /���' -Number Of Bedrooms: a Number Of People "- =
Is The Facility Currently Vacant? YesA) If Yes,For How Long?
Any Known Problems? Yes 49 If Yes,Explain:
Please Fill In The Following Information About The NEW Facility:
Type Of Facility: Qou&kL W 640— T r a,-�lir Number Of Bedrooms: _Number of People_
Pool Size: 14'jq Garage Size:_(AOther:.
Requested By: 91r Date Requested: -:54,A- 12 — n n 1 ,
("Silbsnature)
For Environmental Health Office Use Only
Lroed Disapproved
Comment : R ( -� �2
-5 /
Environmental Health Specialist
*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 pro15�r1 for any given period of time.
Payment: Ls--) Check Money Order # Amount:$, 17111901190 Date:
Paid By: /Lr` Received By:
Account#: o7'T Invoice#: 0 �j?j
'P1 n (� r' QAVIE COUNTY HEALTH DEPARTMENT
Name• 1 - WLLL (::gcg t Environmental Health Section PROPERTY INFORMATION
-7 0P.O.Box 848
Directions to property: (A) Mocksville.NC 27028 Subdivision Name:
Phone#:336-751-8760
�� �►E ]t I Section: Lot:
AUTHORIZATION FOR
WASTEWATER Tax Office PIN:#
SYSTEM CONSTRUCTION
214
AUTHORIZATION NO: l A Road Name.67q -5h1"- F/tZpf?
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**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 Fonn/Authorization Number should be presented to the bavie County Building Inspections
Office when applying for Building Permit.-,,
(In compliance wfthY,tUticln I 1 of O.S.Chapter 130A,Wastewater Systems,Section.1900 Sewage Treatment and Disposal Systems)
r /77 ***NOTICE***THIS AUTHORIZATION FOR WASTEWATER CONSTRUCTION
.�y O IS VALID POR A PERIOD OF FIVE YEARS.
ENVIRO MENT79L—1 r t TH SPECIALI T DAT9 ISSUED
RESIDENTIAL SPECIFICATION:BUILDING,TYPE tt vt�e x%#BEDROOMS #BATHS �' #OCCUPANTS GARBAGE DISPOSAL Yes or No
COMMERCIAL SPECIFICATION:FACILITY TYPPEj� #PEOPLE #PEOPLE/SHIFT #SEATS INDUSTRIAL WASTE:Yes
or No
LOT SIZE TYPE WATER SUPPLY DESIGN WASTEWATER FLOW(GPD)30$0 NEW SITE REPAIR SITE
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SYSTEM SPECIFICATIONS:TANK SIZE GGAL. PUMP TANK �----GAL.•TRENCH WIDTH ROCK DEPTH ,LINEAR FT.,— �Q
OTHER " 1/1ST�tl�tlTtC� 1c�S`
REQUIRED SITE MODIFICATIONS/CONDITIONS: In�STAL� �� cf .1T�c�e
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IMPROVEMENT PERMIT LAYOUT
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**CONTACT A REPRESENTATIVE OF THE DAVIE COUNTY HEALTH DEPARTMENT FOR FINAL INSPECTION OF THIS TEM
BETWEEN 8:30-9:30 A.M.OR 1:00.1:30 P.M.ON THE DAY OF INSTALLATION.TELEPHONE#IS(336)751-8760.
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OPERATION PERMIT
_SYSTEM INSTALLED BY:
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AUTHORIZATION NO. ' `OPERATION PERMIT D
**THE ISSUANCE OF THIS OPERATION PERMIT SHALL INDICATE THAT E SYSTEM DESCRIBED A E HAS BEEN INSTAL D INC PLI CE
WITH ARTICLE I 1 OF G.S.CHAPTER 130A,SECTION.1900"SEWAGE TREATMENT AND DISPOSAL SYSTEMS",BUT SHALL IN NO AY BE A AS A
GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORILY FOR ANY GIVEN PERIOD OF TIME. i
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Permit4ee'a DAVIE COUNTY HEALTH DEPARTMENT
�r�[=�LL t-- �``� Environmental Health Section PROPERTY INFORMATION
Name: /
�� P.O. Box 848
Directions to property: ftT'i 1�� Mocksville,NC 27028 Subdivision Name:
Phone#: 336-751-8760
[ L ���'�� Section: Lot:
AUTHORIZATION FOR
WASTEWATER Tax Office PIN:#
SYSTEM CONSTRUCTION
AUTHORIZATION NO: � A Road Name: ,t F �`z�ip 2
`L� .��" 1 �-
**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 comp lia c W*th Article,11 of S.Chapter 130A;Wastewater Systems,Section.1900 Sewage Treatment and Disposal Systems)
***NOTICE***THIS AUTHORIZATION FOR WASTEWATER CONSTRUCTION
D IS VALID FOR A PERIOD OF FIVE YEARS.
ENVIRO M AI`HE EfH SPECIALI T AT ISSUED
RESIDENTIAL SPECIFICATION:BUILD1I4dTY0E' 110 #BEDROOMS #BATHS` 2- #OCCUPANTS�_GARBAGE DISPOSAL:Yes or No
COMMERCIAL SPECIFICATION: FACILITY TYPE #PEOPLE #PEOPLE/SHIFT #SEATS INDUSTRIAL WASTE:Yes or No
LOT SIZE TYPE WATER SUPPLY w"�"/7 DESIGN WASTEWATER FLOW(GPD) ��/ NEW SITE REPAIR SITE V
t
SYSTEM SPECIFICATIONS: TANK SIZE GAL. PUMP TANK GAL. TRENCH WIDTH ROCK DEPTH �� LINEAR FT.
OTHER I/VST CtbtJTI
REQUIRED SITE MODIFICATIONS/CONDITIONS: (��STAL r- n-11 Coli-T000—
IMPROVEMENT
oliT0 V Q
IMPROVEMENT PERMIT LAYOUT
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777
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**CONTACT A REPRESENTATIVE OF THE DAVIE COUNTY HEALTH DEPARTMENT FOR FINAL INSPECTION OF THIS TEM
BETWEEN 8:30-9:30 A.M.OR 1:00-1:30 P.M.ON THE DAY OF INSTALLATION.TELEPHONE#1S (336)751-8760.
OPERATION PERMIT `, ,� �
_SYSTEM INSTALLED BY:� �
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AUTHORIZATION NO. �' `OPERATION PERMIT D
**THE ISSUANCE OF THIS OPERATION PERMIT SHALL INDICATE THAT E SYSTEM DESCRIBED A E HAS BEEN INSTALL D INC PLI CE
WITH ARTICLE 11 OF G.S.CHAPTER 130A,SECTION.1900"SEWAGE TREATMENT AND DISPOSAL SYSTEMS",BUT SHALL IN NO AY BE AKE ASA
GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORILY FOR ANY GIVEN PERIOD OF TIME.
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DCHD 02/02(Revised)
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DAVIE COUNTY ENVIRONMENTAL HEALTH SECTION
APPLICATION FOR IMPROVEMENT PERMIT(REPAIR) (gyp• (n
NAME L C 6 Aa L'Z PHONE NUMBER
ADDRESS �� �-�/� /G �-� SUBDIVISION NAME
d G CS LOT #
DIRECTIONS TO SITE (o
DATE SYSTEM INSTALLED NAME SYSTEM INSTALLED UNDER D-1-n.•t( Ga 1.1 Lc.
TYPE FACILITY NUMBER BEDROOMS 3 NUMBER PEOPLE SERVED �-
TYPE WATER SUPPLY C UfM SPECIFY PROBLEM OCCURRING . .6
(20,Ks c .� Y•
DATE REQUESTED INFORMATION TAKEN BY
This is to car*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.1193