315 Sandy LnDavie County, NC
Tax Parcel Renort bbal _vi d Thursday. October 6, 2016
WAK1V11VU: 1111N 1N INU1 A JUKVLY
Parcel Information
Parcel Number:
170000009102
Township:
Fulton
NCPIN Number:
5778050393
Municipality:
Account Number:
56329000
Census Tract:
37059-804
Listed Owner 1:
PERKINS MICHAEL L
Voting Precinct:
FULTON
Mailing Address 1:
187 SPRING VALLEY LN
Planning Jurisdiction:
Davie County
City: ADVANCE
Zoning Class: DAVIE COUNTY R -A
State:
NC
Zoning Overlay:
Zip Code:
27006-7342
Voluntary Ag. District:
No
Legal Description:
3.025 AC OFF FORK BIXBY
Fire Response District:
FORK
Assessed Acreage:
3.07
Elementary School Zone:
CORNATZER
Deed Date:
10/2005
Middle School Zone:
WILLIAM ELLIS
Deed Book / Page:
006310027
Soil Types:
WeC,WeB
Plat Book:
Flood Zone:
Plat Page:
Watershed Overlay:
DAVIE COUNTY
Building Value:
0.00
Outbuilding & Extra
Freatures Value:
4610.00
Land Value:
28590.00
Total Market Value:
33200.00
Total Assessed Value:
33200.00
1@71
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
NC County 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.
--Permittee's 'f 1 ,DAVIE COUNTY HEALTH DEPARTMENT
Name:
f j,11� �, }°`` "' I Environmental Health Section
� Ltr
P.O. Box 848
)
j d 4PROPERTY INFORMATION "% V
Directions to property: � �' � Mocksville, NC 27028 Subdivision Name:
Phone #: 336-751-8760
Section: Lot:
AUTHORIZATION FOR
r' A40 i t+ , i /,ijj ctj,, WASTEWATER
SYSTEM CONSTRUCTION Tax Office PIN:# - -
AUTHORIZATION NO: ®0'"� A Road Name: Sk .�```� fY `�Z
**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 applyigg for Building Permits.
(In compliance'withA cle I 1,6f G:S- Ch`dper 130A, Wastewater Systems, Section .1900 Sewage Treatment and Disposal Systems)
***NOTICE*** THIS AUTHORIZATION FOR WASTEWATER CONSTRUCTION
IS VALID FOR A PERIOD OF FIVE YEARS.
ENVIRONMENTATrtfEAhTH SVECIALIS DA!ISSL D
I
�_ '7
RESIDENTIAL SPECIFICATION: BUILDING TYPE i441 # BEDROOMS S # BATHS 1+ `- # OCCUPANTS GARBAGE DISPOSAL: Yes or No
COMMERCIAL SPECIFICATION: FACILITY TYPE # PEOPLE # PEOPLE/SHIFT II # SEATS INDUSTRIAL WASTE: Yeses/or No
LOT SIZE 4PE WATER SUPPLY / �Ur DESIGN WASTEWATER FLOW (GPD) �S �� NEW SITE REPAIR SITE ►r
SYSTEM SPECIFICATIONS: TANK SIZE GAL. PUMP TANK GAL. TRENCH WIDTH ROCK DEPTH P� LINEAI R FT.
OTHERS `, l I �i l pr l k��l-C �f.'r t + �� �"` iU( ,7�i?�►! UtjST'}'^..
REQUIRED SITE MODIFICATIONS/CONDITIONS: �CTI`t��t 0rj
IMPROVEMENT PERMIT LAYOUT "- JT Off*
-1(--- C'01 Gertz/
fAc-v J)lrr- D1r_l<
3
J. Vit✓ Q G'r
C nJ r��a
f
f---- ----� (� u r f"o l
1 r
Nr,)y { QC -1 cF t� STt*�•h
II FOR FINAL INSPECTION OF THIS SYSTEM PLEASE CALL BETWEEN 8:30 - 9:30 A.M. ON THE DAY OF INSTALLATION. TELEPHONE # IS (336) 751-8760. u
OPERATION PERMIT _
GAJICK L4. --\ (�u�>
SYSTEM INSTALLED BY: S"d-MN.1 1'JLJ ,)
AUTHORIZATION NO. �� OPERATION PERMIT BY: DATE: D
**THE ISSUANCE OF THIS OPERATION PERMIT SHALL INDICATE THAT TH YSTEM SCRIBED A VE 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 07102 (Revised)
**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 Pen -nits.
(In compliance with Article 11 1if G.S'nlipter 13 A, Wastewater Systems, Section .1900 Sewage Treatment and Disposal Systems)
F+ F/ ***NOTICE*** THIS AUTHORIZATION FOR WASTEWATER CONSTRUCTION
IS VALID FOR A PERIOD OF FIVE YEARS.
` ENVIRONMENTfCCHFQfiH SPECIAOST1 DATE ISSULD
RESIDENTIAL SPECIFICATION: BUILDING TYPE fsf l) #BEDROOMS "�S #BATHS 'Y1 �.- # OCCUPANTS ! GARBAGE DISPOSAL: Yes or No
COMMERCIAL SPECIFII}CATION: 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 GAL. TRENCH WIDTH ROCK DEPTH iJ A LINEAR FT. �� L
OTHER1`-'L�(�.%j(�^�'ti�7�T4 nim
REQUIRED SITE MODIFICATIONS/CONDITIONS:N1"ll-��
IMPROVEMENT PERMIT LAYOUT�jl f �
...ts)j� l ilt•_,..�..4%f
,f
_:-7 f�
Wtf f t\ (_-T C;(- - ti, Vii: PA
11 FOR FINAL INSPECTION OF THIS SYSTEM PLEASE CALL BETWEEN 8:30 - 9:30 A.M. ON THE DAY OF INSTALLATION. TELEPHONE # IS (336) 751-8760. 11
OPERATION PERMIT
�0IcAc �t S��U ,,�m(5)
SYSTEM INSTALLED BY: 5jjt=t_1A-^,-J 7_�110+J,)
. Z % 1
;t'
'� 1 \1 l'
AUTHORIZATION NO. n OPERATION PERMIT BY: DATE:
**THE ISSUANCE OF THIS OPERATION PERMIT SHALL INDICATE THAT THE '3 _STEM E!�CRIBED AIfOVEHAS BEEN INSTALLED IN COMPLIANCE
WITH ARTICLE I 1 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.
DOW 02102 (Revised)
V
Permittee si F t" l',,,r�;DAVIE COUNTY HEALTH DEPARTMENT
1iib : �.li�, ! t' r ,1
(�.0,
_ Name._. _
Environmental Health Section'
�. PROPERTY
•,{, I `�
INFORMATION V
17" .•
, l ( 1 ' �`
P.O. Box 848
Directions: to property:
Mocksville, NC 27028
Subdivision Name:
ly ; yt ,% {-E.'s } t`6 ,! ; L1 , j
Phone #: 336-751-8760
'
Section:
Lot:
F )
' ; t') fi r' ; r . °11` t'h� �
AUTHORIZATION FOR
WASTEWATER
,
SYSTEM CONSTRUCTION
Tax Office PIN:#
- -
d A
AUTHORIZATION NO:
Road Name:
**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 Pen -nits.
(In compliance with Article 11 1if G.S'nlipter 13 A, Wastewater Systems, Section .1900 Sewage Treatment and Disposal Systems)
F+ F/ ***NOTICE*** THIS AUTHORIZATION FOR WASTEWATER CONSTRUCTION
IS VALID FOR A PERIOD OF FIVE YEARS.
` ENVIRONMENTfCCHFQfiH SPECIAOST1 DATE ISSULD
RESIDENTIAL SPECIFICATION: BUILDING TYPE fsf l) #BEDROOMS "�S #BATHS 'Y1 �.- # OCCUPANTS ! GARBAGE DISPOSAL: Yes or No
COMMERCIAL SPECIFII}CATION: 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 GAL. TRENCH WIDTH ROCK DEPTH iJ A LINEAR FT. �� L
OTHER1`-'L�(�.%j(�^�'ti�7�T4 nim
REQUIRED SITE MODIFICATIONS/CONDITIONS:N1"ll-��
IMPROVEMENT PERMIT LAYOUT�jl f �
...ts)j� l ilt•_,..�..4%f
,f
_:-7 f�
Wtf f t\ (_-T C;(- - ti, Vii: PA
11 FOR FINAL INSPECTION OF THIS SYSTEM PLEASE CALL BETWEEN 8:30 - 9:30 A.M. ON THE DAY OF INSTALLATION. TELEPHONE # IS (336) 751-8760. 11
OPERATION PERMIT
�0IcAc �t S��U ,,�m(5)
SYSTEM INSTALLED BY: 5jjt=t_1A-^,-J 7_�110+J,)
. Z % 1
;t'
'� 1 \1 l'
AUTHORIZATION NO. n OPERATION PERMIT BY: DATE:
**THE ISSUANCE OF THIS OPERATION PERMIT SHALL INDICATE THAT THE '3 _STEM E!�CRIBED AIfOVEHAS BEEN INSTALLED IN COMPLIANCE
WITH ARTICLE I 1 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.
DOW 02102 (Revised)
V
DAVIE COUNTY HEALTH DEPARTMENT s
IMPROVEMENTS PERMIT AND CERTIFICATE OF COMPLETI(1�41 �J
*NOTE: Issued in Compliance With Article II of G.S Chapter 130a
r,,. -Sanitary Sewage Systems Permit Number
Namea
to NO 7 302
a� ,sir, ,.s �,�"'; � ,r"J'. c �,+r�' ; 'T
r
Location,
f _
t I �t s` >f' f, r , , , f.; E r r : r� �''akh. cz-_..-
Subdivisiow.Name Lot No. Sec. or Block No.
Lot Sized j— House `f} Mobile Home Business _— Speculation
I
No. Bedrooms No. Baths` No. in Family —
Garbage Disposal YES (] NO �p
Spec'ficaUa�s foci System:
Auto Dish Washer YES f] NO ❑ CC- yr' r -f
Auto Wash Ma shine YES ❑" NO ❑
Type Water Supply
*This permit Void if sewage system described below is not installed within 5 years
This permit is subject to revocation if site plans or the intended use change. r
}
1 I
Improvements permit by
mate or issue.
a. .
*Contact a representative of the Davie County ealth Department for final inspection of this system between 8:30-
9:30 A.M. or 1:00-1:30 P.M. on day of cdinplelipn. Telephone Number 704-634-5985.
Final Installation Diagram: �,t System Installed by
f ter'
F
i
t 1
Certificate of Completion Date `
'The signing of this certificate shall indicate that the system described above has been installed in compliance with
the standards set forth in the above regulation, but shall in NO way be taken as a guarantee that the system will function
cnfiefarfnrily fnr onv nk,an -;-A of fi..,n
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 ❑
Mailing Address: /�X
Al. L 7;71424 - -
Detailed Diirectio To Site: G jteLm 414)Win) G P 3 . 2 .z.c.� ,
Property
Number: _?� ` J i� 5�0 y (Home)
('P//�°� {.2 • ?f o=> (Work)
Please Fill In The Following Information About The Existing Dwelling:
Name System Installed Under: L", /, c x,� Type Of Dwelling: s�4/
Date System Installed(Month/Day/Year): [�'9� Number Of Bedrooms:_N ber Of People:
d Is The Dwelling Currently Vacant? Yes,4� No ❑ If Yes, For How Long? lzyaOn) C
Any Known Problems? Yes ❑ No) i If Yes, Explain: 4
Please Fill In The Follllowing Information About The
Type Of Dwelling:Ae7"X0e-11C771P)A-Y--)Number Of Bedr or
Requested By:
(Signature) - L
For Environrf e l/146Xlt
Approved ❑ Disapproved H' q
C ommPntc- i t)liT C �. A l Wldll
Iii
Environmental Health
_Number Of People:
_Date Requested:
Office Use Only
o?A 11 13P((7
*The signing of this form by the Environmen 1 Health Staff is in no way intended, nor should be taken as a
guarantee(extended or limited) that the on-site wastewater sy w#li unf ction properly for any given period of time.
L
Payment: Cash ❑ h k �oney Order ❑ #1. Z —1 Amount: $ L� '� Date:
Paid By: tiz Received By/
Account #: '7010006 774, Invoice #: 5-1 -7%