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217 Vanzant RdDavie Countv. NC Tax Parcel Report Friday. October 7. 201 E No r vt 9 1flJ6 F WARNING: THIS IS NOTA SURVEY All data is provided as is without warranty or guarantee of any kind either expressed or Implied Including but not limited to the Implied warranties of merchantability or fitness for a particular use. All users of Davie County's GIS website shall hold harmless the 7�7 Parcel Information UU1<1 Parcel Number: H2O0000044 Township: Calahaln NCPIN Number: 5719019996 Municipality: Account Number: 8302663 Census Tract: 37059-801 Listed Owner 1: GIBIETIS NICKOLAS Voting Precinct: NORTH CALAHALN Mailing Address 1: 217 VANZANT RD Planning Jurisdiction: Davie County City: MOCKSVILLE Zoning Class: DAVIE COUNTY R-A,R-20,H-B-S State: NC Zoning Overlay: Zip Code: 27028 Voluntary Ag. District: Legal Description: 13.413 AC VANZANT RD Fire Response District: CENTER Assessed Acreage: 13.54 Elementary School Zone: WILLIAM R DAVIE Deed Date: 10/2013 Middle School Zone: NORTH DAVIE Deed Book / Page: 009401009 Soil Types: PaD,ApB,PcC2,ChA,CeB2 Plat Book: Flood Zone: Plat Page: Watershed Overlay: DAVIE COUNTY Building Value: 311500.00 Outbuilding 8r Extra 4040.00 Freatures Value: Land Value: 91660.00 Total Market Value: 407200.00 Total Assessed Value: 407200.00 No r vt 9 1flJ6 F 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 Implied warranties of merchantability or fitness for a particular use. All users of Davie County's GIS website shall hold harmless the 7�7 County of Davie, North Carolina, Its agents, consultants, contractors or employees from any and all claims or causes of action due to UU1<1 1\ C or arising out of the use or Inability to use the GIS data provided by this website. r Account #: 989900079 Billed To: Ronald Jones Reference Name: Well Permit Proposed Facility: Residence Well Davie County Environmental Health P.O. Boz 848/210 Hospital Street Mocksville, NC 27028 (336)753-6780 / Fax (336)753-1680 WELL PERMIT Tax PIN%FH #: H2-000-00-044 Subdivision Info: LocationlAddress: 217 Vanzant Road -27028 Property Size: 13.54 Ac ATC Number: 0123 Actions of the employees of the Davie County EH Section shall in no way be taken as a guarantee that this well will produce water of any particular quantity or quality or for any amount of time. This permit is valid for a period of 5 years from the date of issuance. This permit may be revoked if it is determined that there has been a material change in any fact/circumstances upon which this permit was issued. Permit Type: New M Repair F1 Abandonment F-1 Proposed Well Location Diagram Certificate of Completion Diagram it Nto C L--/!rxG• V/`- C� J r Comments: Driller Certification #: Grout Inspected: Well Head Inspected: GPS Coordinates: EHS: Date: EHS: Date: W.P. 7-08 APPLICATION FOR PRIVATE WDLL PERMIT l Q� Davie County Environmental Health P.O. Box 848/210 Hospital Street 9 V�b Mocksville, NC 27028 so r1 (336)753,-6780 / Fax (336)753-1680 ***IMPORTANT*** THIS APPLICATION CANNOT BE PROCESSED UNLESS ALL OF THE REQUIRED INFORMATION IS PROVIDED. h APPLICANT INFORMATION Name 6n%ke-, Contact Person U ,Lte Address Home Phone 33y" �Y 'I DIP City/State/ZIP ,C 9-700(0 Business Phone 3316 - %Orf Name on Permit if Different than Above Mailing Address City/State/Zip PROPERTY INFORMATION *Date House/Facility Corners Flagged NOTE: A survey plat/or site Ian must accompany this application. Included: ❑ Site Plan ❑Plat (to scale) Owner's Name l V Phone Number 70V'- WA - q/88 Owner's Address aO S$ City/State/Zip ( / e. w a Property Address City /1i� t?i waw Lot Size L3. Sy &,C y,4 0 Tax PIN# 3 7 t 9 9 i&R t- 006 - bQ_ O Subdivision Name(if applicable) Section/Lot# T'i Directions To Site: J4u w- i� V IjAeot INAVAItte)9llski s)RUh1110101 Permit Type: New Well _ V_/Well Repair Well Abandonment Other (specify) Facility Type: Residential V Food Service Church Copnercial Other Are There Any Septic Systems Currently On The Site? YES NO V Do You Intend To Install A New Septic System On This Site? YES NO TERMS AND CONDITIONS: This application must be accompanied by a plat or site plan of the property that includes the existing and proposed property lines with dimensions, the specific location of the facility and any existing or future appurtenances, the location of any existing septic system, sewer lines, water lines, any existing water supplies and any surface waters. The applicant is responsible for identifying and marking the property lines and corners. The applicant is responsible for making the site accessible. By signing this application, the applicant signifies that they understand the terms and conditions and that they give permission for Davie County Environmental Health representatives to perform necessary field evaluations and procedures deemed necessary to determine the best location for a well. Signed Date 7/30/09 Site Revisit Charge Date(s): Client Notification Date: EHS: Account # Invoice # A01, RONNIE JONES CONSTRUCTION, INC. Custom Homes & Remodeling 185 Livengood Rd. Phone (336) 998-7206 Advance, NC 27006 (336) 909-1193 Applicant: Ronnie Jones Address: 142 Cedar Hill Lane City: Advance State/Zip: NC 27006 Phone #: (336) 909-1193 In "'A-ddress/Road #: CONSTRUCTION Vanzant Road AUTHORIZATION M srM 'w �° • �' Davie County Health Department Structure: 210 Hospital Street P.O. Box 848 # of Bedrooms: Mocksville NC 27028 # of People: Phone: 336-753-6780 Fax: 336-753-1680 Applicant: Ronnie Jones Address: 142 Cedar Hill Lane City: Advance State/Zip: NC 27006 Phone #: (336) 909-1193 In "'A-ddress/Road #: Subdivision: Vanzant Road Mocksville NC 27028 Structure: SINGLE FAMILY # of Bedrooms: 3 # of People: 3 *Water Supply: NEW WELL ,*Site Classification: PS Saprolite System? O Yes 9 No Design Flow: 3 6 0 Soil Application Rate: 0 3 For Office Use Only *CDP File Number 123017 - 1 County ID Number: 1-12-000-00-044 Evaluated For: NEW Township: PERMIT VALID UNTIL: 1 1/ 1 3/ a 0 1 8 Property Owner: Nickolas Gibieti0 Address: 18321 Dembridge Drive City: Davidson State/Zip: NC 28036 Phone #: (704) 402-4188 Phase: Lot: Directions Hwy 64 West from Mocksville Left on Vanzant Rd. Just before Lake Myers. Property on left Minimum Trench Depth: a 4 Inches Minimum Soil Cover: Inches Maximum Trench Depth: 3 6 Inches Maximum Soil Cover: Inches *System Classification/Description: *Distribution Type: TYPE II A. CONV SYSTEM (SINGLE-FAMILY OR 480 GPD OR LESS) S t. T k' *Proposed System: 25% REDUCTION Nitrification Field No. Drain Lines Total Trench Length: Trench Spacing: Trench Width: Aggregate Depth: I up Ic an . 1 0 0 0 Gallons 1 -Piece: O Yes ® No Pump Required: O Yes ®No O May Be Required Sq. ft. Pump Tank: Gallons 1 -Piece: O Yes O No GPM --vs-- ft. TDH _8Q Inches O.C. Dosing Volume: _ Gallons Feet O.C. O Inches O Feet Grease Trap: Gallons inches Pre -Treatment: O NSF OTS -1 O TS -II Septic Tank Installer Grade Level Required: 01011 OIII 01V Page 1 of 3 CDP Fite Number 123017 - 1 m /'Repair System *Site Classification: Ps Design Flow: 3 6 0 Soil Application Rate: 0 3 H2-000-00-044 County ID Number: ired:gYes ONO ONO, but has Available *System Classification/Description: TYPE II A. CONV SYSTEM (SINGLE-FAMILY OR 480 GPD OR LESS) *Proposed System: 25% REDUCTION Nitrification Field Sq. ft. No. Drain Lines ❑ Open Pump System Sheet Trench Spacing:_ O Inches O. _8Feet O.C. Trench Width:_ O Inches O Feet Aggregate Depth: inches Minimum Trench Depth: a 4 Inches Minimum Soil Cover: Inches Maximum Trench Depth: 3 6 Inches Maximum Soil Cover: Inches *Distribution Type: GRAVITY - SERIAL Total Trench Length: 3 0 0 ft Pump Required: OYes ®No O May Be Required Pre -Treatment: O NSF OTS -1 OTS -11 *Site Modifications No grading or construction activity is allowed in areas designated for system and repair without approval of Health Department. *Permit Conditions The issuance of this permit by the Health Department in no way guarantees the issuance of other permits. The permit holder is responsible for checking with appropriate governing bodies in meeting their requirements. This Authorization for Wastewater System Construction shall be valid for a person equal to the period of validity of the Improvement Permit, not to exceed five years, and may be issued at the same time the Improvement Permit issued (NCGS 130A -336(b)). If the installation has not been completed during the period of validity of the Construction Permit, the information submitted in the application for a permit or Construction Authorization is found to have been incorrect, falsified or changed, or the site is altered, the permit or Construction Authorization shall become invalid, and may be suspended or revoked (.1937(g)). The person owning or controlling the system shall be responsible for assuring compliance with the laws, rules, and permit conditions regarding system location, installation, operation, maintenance, monitoring, reporting and repair (1938(b)). Applicant/Legal Reps. Signature Required? O Yes ®No Applicant/Legal Reps. Signature? Date: *Issued By: 2244 - Daywalt, Andrew Date of Issue: 1 1 / 1 3 / a 0 1 3 Authorized State Agent: Malfunction Log OYes ® Hand Drawing O Import Drawing Total Time:(HH:MM) **Site Plan/Drawing attached.** 0 1 Hours 0 0 Minutes Page 2 of 3 S-8 - CA's issued - new t ► CONSTRUCTION AUTHORIZATION Davie County Health Department 210 Hospital Street P.O. Box 848 Mocksville NC 27028 Drawing Drawing Type: Construction Authorization CDP File Number: 123017 - 1 County File Number: H2-000-00-044 Date: 11/ 13 1 x 0 1 3 O Inch Scale: . O Block O N/A 3'Atcc; eat,�- Page 3 of 3 P1 P2 ' CONSTRUCTION AUTHORIZATION Davie County Health Department 210 Hospital Street CDP File Number: 123017-1 P.O. Box 848 H2-000-00-044 Mocksville NC 27028 County File Number: Date:.l 1,/ 13 /,2 0 13 Click below to import an image from an external location: Drawing Type: Construction Authorization Page 3 of 3 P1 P2