732 Underpass Rd Davie Coun . ,NC i Tax Parcel Report Thursday, February 9, 2017 .
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WARNING: THIS IS NOT A SURVEY
. =Parcel-Information - � _
Parcel Number: F90000000302 Township: Shady Grove
NCPIN Number: 5880579945 Municipality:
Account Number: 82512949 Census Tract: 37059-804
Listed Owner 1: SMITH EDWARD A Voting Precinct: EAST SHADY GROVE
Mailing Address 1: 732 UNDERPASS ROAD Planning Jurisdiction: Davie County
City: ADVANCE Zoning Class: DAVIE COUNTY R-A
State: NC Zoning Overlay:
Zip Code: 27006-7526 Voluntary Ag.District: No
Legal Description: 5.00 AC UNDERPASS RD LOT 3 Fire Response District: ADVANCE
Assessed Acreage: 4.68 Elementary School Zone: SHADY GROVE
Deed Date: 7/1999 Middle School Zone: WILLIAM ELLIS
Deed Book/Page: 003080844 Soil Types: WeC,Pc132
Plat Book: 0005 Flood Zone:
Plat Page: 214 Watershed Overlay: DAVIE COUNTY
Building Value: 99540.00 Outbuilding 8r Extra 2750.00
Freatures Value:
Land Value: 63720.00 Total Market Value: 166010.00
Total Assessed Value: 166010.00
DATA 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 Davis,North Carolina,Its agents,consultants,contractors or employees from any and all claims or causes of action due to
�'oUty c NC .or arising out of the use or Inability to use the GIS data provided by this website.
DAVIE COUNTY HEALTH DEPARTM� '
IMPROVEMENTS PERMIT AND CERTIFICATE OF COMPLETION i
NOTE:Issued in Compliance With Article II of G.S.Chapter 130a
L -
Sanitary.Sewage Systems �'" Permit Number
Name Z1 f1-,, Date -2- L> N2 58H
Location ,�'��'" ITe'l 1/F
Subdivision Name Lot No. Sec. or Block No.
Lot Size 5��11�_ House t-r Mobile Home _ Business Speculation
No. Bedrooms No. Baths_ _ No. in Family
Garbage'Disposal Disposal YES E] NO 0--- Specifications for System:
Auto Dish Washer YES NO
Auto Wash Machine YES NO ❑
Type Water Supply
*This permit Void if sewage system described below is not installed within 5 years from date of issue.
This permit is subject to revocation if site plans or the intended use change.
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Improvements permit by --A l ZZ
*Contact a representative of the Davie.County Health Department forfinal inspection of this system between 8:30-
9:30 A.M. or 1:00-1:30 P.M. on day of completion. Telephone Number: 704-634-5985.
Final Installation Diagram: System Installed by -4-��-
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2-
Cert'
Cert' icate of Completi n Date
'The signing of this certificate shall indicate that the system d scribed abov has been installed in compliance with
the standards set forth in the above regulati n, but shall in NO ay be taken a a guarantee that the system will function
satisfactorily for any given period of time. ft
APPLICATION FOR SITE EVALUATION I IMPROVEMENTS PERMIT
Davie County Health Department
Environmental Health Section O
P. 0. Box 665 'Fv C5V G
Mocksville, N.C. 27028
CONSTRUCTION SHALL NOT BEGIN UNTIL IMPROVEMENTS PERMIT HAS BEEN ISSUED.
Home Phone '744' 51760
1. Permit Requested By Mm� i-��rtiJz�D �c DS,, )i JZ.. Business Phone _7 L 6• s'8S�
2. Address 9-6 - 1144 A).C. Z '7 a 1 -2-
3.
3. Property Owner if Different than Above AA^JA-0t- �o�es�i 99�' Z 36y
Address 'T. 73 -H.-,y 1D D�'/}� .IGT' X211 do
4. Permit To: a) Install ✓Alter Repair
b) Privy Conventional ✓ Other Type
Ground Absorption �j�
c) Sub-Division Sec. 'Lot No. 3 <foiZ p;v.4�'`J ZS'T!f 785-
5. System used to serve what type facility: House ✓ Mobile Home Business
Industry Other
b) Number of people
6. a}If house or mobile home, state size of home and number of rooms.
House Dimensions 4'0 X 30
Bed Rooms_ Bath Rooms 'Z Den w/Closet
b) If Business, Industry or Other, State: Number of persons served
What type business, etc.
Estimate amount of waste daily (24 hours)
7. Number and type of water-using fixtures:
commodes Z urinals +b garbage disposal
lavatory Z showers z- washing machine 1
dishwasher I sinks 1
8. a) Type water supply: Public Private ✓ Community
b) Has the water supply system been approved? Yes No
9. a) Property Dimensions Jr' A GR_.,3
b) Land area designated to building site
c) Sewage Disposal Contractor
10. Do you anticipate any additions or expansions of the facility this sewage system is intended to serve? A✓y
What type?
r
This is to certify that the information is correct to the best of my 0nowledge.
Date Owner ignatu
OWNER IS SOLELY RESPONSIBLE FOR COMPLIANCE WITH ALL STATE AND LOCAL LAWS
Allow 5 days for processing
Directions to property: G T-
6 j 70 �o l 7Z riR�7 . A)
oz,
i! *NOTE: Improvements Permits shall be valid for a period of 5
years from date issued. Improvements Permits are subject
to revocation, if site plans or the intended use change.
Effective October 1, 1989.
DCHD(6-62)
DAVIE COUNTY HEALTH DEPARTMENT
ENVIRONMENTAL HEALTH SECTION
SITE EVALUATION CONSENT FORM
1. Complete the form below and return to the Davie County Health Department.
2. Carefully follow the procedures as outlined in the enclosed "Information Bulletin."
NOTE: THE ABOVE MUST BE COMPLETED BEFORE A SANITARIAN WILL BE ABLE TO
BEGIN THE REQUESTED EVALUATION.
DETACH HERE AND RETURN TO: Davie County Health Department, Environmental
Health Section, P. O. Box 665, Mocksville, N.C. 27028
Davie County Health Department
Environmental Health Section
Site Evaluation Consent Form
LOCATION OF PROPERTY: DATE RECEIVED
/�� ✓S �; A (office use only)
yes no 1. 1 am the owner of the above described property.
ye no 2. 1 am not the owner of the above described property, however, I certify that I
have consent from ��z �NE �b� , owner to obtain a
owner's name
site evaluation by the Davie County Health Department for the purpose of
determining the suitability for a ground absorption sewage treatment and
disposal system.
no 3. 1 hereby give consent to the authorized representative of the Davie County
Health Department to enter upon the above described property and conduct all
testing procedures as necessary to determine its suitability for a ground
absorption sewage treatment and disposal system.
DATE SIGNATU E
4. 1 hereby authorize the Davie County Health Department to release site
evaluation results from the above described property to the following:
_ Owner only
— Owners designated representative
Anyone requesting results
Only those listed below
DATE SIGNATURE
DCHD(11/84)
DAVIE COUNTY HEALTH DEPARTMENT
Environmental Health Section.
P. O. Box 665
Mocksville, N.C. 27028
SOIL/SITE EVALUATION
Name Date
Address Lot Size
FACTORS AREA 1 AREA 2 AREA 3 AREA 4
1) Topography/Landscape Position S - S S
U ' U U
2) Soil Texture (12-36 in.) Sandy, S , _
Loamy, Clayey, (note 2:1 Clay)
U U U
3) Soil Structure (12-36 in.) S S S
Clayey Soils `"U
U U
4) Soil Depth (inches)
U "PGS U
5) Soil Drainage: Internal 49
U U U U
External S --h & 29
U U U
6) Restrictive Horizons
7) Available Space
PS PS PS PS
U U U U
8) Other (Specify) S S S S
PS PS PS PS
U U U UU
9) Site Classification - I .
U—UNSUITABLE S—SUITABLE PS—Provisionally Suitable
Recommendations/Comments:
Described by Title Date ` _
SITE DIAGRAM
x
DCHD(6.82)