136 Vogler RdDavie Countv, NC
�
Ta�r ParrPl R Pnnrf
Tuesdav, October 11, 2016
Parcel Number:
NCPIN Number:
Account Number:
Listed Owner 1:
Mailing Address 1:
City:
State:
Zip Code:
Legal Description:
Assessed Acreage:
Deed Date:
Deed Book / Page:
Piat Book:
Plat Page:
Building Value:
Land Value:
Total Assessed Value:
WAK1VllVCT: "1'H15151VU'1' A SU1ZVI�Y
Parcel Information
F900000031 Tovmship: Shady Grove
5880569359 Municipality:
31319000 Census Tract: 37059-804
GRUBBS JOHNNIE M Voting Precinct: EAST SHADY GROVE
136 VOGLER ROAD Planning Jurisdiction: Davie County
ADVANCE Zoning Class: DAVIE COUNTY R-A
NC 2oning Overlay:
27006-7543 Voluntary Ag. District:
1.80 AC VOGLER RD LOT 7 HARTMAN Fire Response District:
1.58 Elementary School Zone:
11/1989 Middle School Zone:
001510412 Soil Types:
0005 Flood Zone:
017 Watershed Ove�lay:
123880.00 Outbuilding 8� Extra
Freatures Value:
29330.00 Total Market Value:
9" �`�' Davie County,
°��N�� NC
153250.00
No
ADVANCE
SHADY GROVE
WILLIAM ELLIS
Pc62,PcC2
DAVIE COUNTY
40.00
153250.00
�-
„�,�„�,�- �...+f w,` �-� '��;: �`'r�'S'� ', f�l:� ' �, .+...w' .. � r t . : .; 3 i �-�. �'t. . • � . - _ ` � ' . � `. . `:. . ,_-.., ._.t�, ,
. ,, � � , ' � �'1.., � %` ;+� � `��*.� �-� �
: .
AUTHORIZATION NO. '� � '�,�'A DAVIE COUNTY HEALTH DEPARTMENT ��----�,��---�..-- ._...,_ . . .
.� Environmental Health Section PROPERTY INF RMATION
Permittee's `\ ��, ,,,� <^ P.O. Box 848 /�y—�� �lU
Name: ``-' ��,��� �"' ��""�"'� ���� Mocksville, NC 27028 Subdivision Name.
� ���' Phone # 336-751-8760
Directions to property: �""'�.-�'.� �� Section: Lot:
AUTHORIZATION FOR
�� i:.: !�!,'1 S,� �:�:��!'�`;"� S� .'.t l.i�./� c, t..� WASTEWATER Tax Office P1N:# _
SYSTF.M CONSTRUCTION
v�; C--%l,,,�.,-TL � 1��- �'^� �-� Road Na�me: �Jf.�Li��- y'�'� Zip: l.r--��C..�.
**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.
(ln complianc � ith Article 1�3 of G.S. Chapter 130A, Wastewater Systems, Section .1900 Sewage Treatment and Disposal Systems)
l
�'` � ' ***NOTICE*** THIS AUTHORIZATION FOR WASTEWATER CONSTRUCTION
/i W�";:w� `2.-�-. ..-' ^,�iv ('t) IS VALID FOR A PERIOD OF FIVE YEARS.
, ENVIKO EAl -At'FiEALTH SPE�(J�LIST DATE ISSUED
, ,; , . , . ; . ,. ,., . .
.._ ,
' s . ' ,. .. 4 �,._ �,, i f , � R.' ' �.� ,;;,,_:
� „ ,� , �; : � , � `� �` ,`�,�`,�-� DAVIE COUNTY HEALTH DEPARTMENT - - -
-_' �,, r� •- TMPROVEMENT AND OPERATION PERMITS PROPERTY INF RMATION
, i Permittee's �� r - /�.y��% �� C'�i'U
. .. \(Llr.:�}�i ' _
�Name': �' ' � Subdivision Name: f `
S 4 '1; i'' '
Directions to property: {" µ' � Section: Lot:
Il�4PROVEMENT
E . , , ; t �, , . , : � - i :._ . r, � ; , - ` PERMIT Tax Office PIN:#
r�, � -.,,
.
LL ...
�3s � � 4 '.. � q , � , �,� Road Name `d;..:.^ M.� �. ;- ZIP; �,_ �.
**NOTE** This Improvement Pernut DOFS NOT authorize the construction or installation of a septic tank system or any wastewater system. An
AUTHORIZATION FOR WASTEWATER SYSTEM CONSTRUGTION must be obtained frc�m this Departmeht prior to the
construction/installation of a system or the issuance of a building pernut.
(In compliance with Article 11 of G.S. Chapter 130A, Wastewater Systems, Section .1900 Sewage Treatment and Disposal Systems)
�" �' � ***NOTICE*** TFIIS PERNIIT IS SUBJECT TO REVOCATION IF SITE
�� �� '� ` PLANS OR Tf� INTENDED USE CHANGE. YOUR WASTEWATER
. __. _..; ,.,; . . .:.J'� : �,^ �?
ENVIRONMENTAL" HEALTH SPEGIALIST DATE EUSSI D SYSTEM CONTRACTOR MUST SEE THIS PERMIT BEFORE
, INSTALLING THE SYSTEM.
RESIDENTIAL SPECIFICATION: BUILDING TYPE I'I C�T`v # BEDROOMS � # BATHS Z. # OCCUPANTS `� GARBAGE DISPOSAL: Yes orrNo�
�..ri
COMMERCIAL SPECIFTCATION: FACILTI'Y TYPE # PEOPLE # PEOPLE/SHIF'f # SEATS INDUSTRIAL WAS'I'E: Yes or No
LOT SIZE 1� ��"�'-'�'1'YPE WATER SUPPLY��--V-- DESIGN WASTEWATER FLOW (GPD) CG'� NEW SITE REPAIR SITE •
SYSTEM SPECIFICATIONS: TANK SIZE GAL. PUMP TANK GAL. TRENCH WIDTH--r� ROCK DEPTH� �-, LINEAR FI'.< <'� I
OTHER
REQUIRED SITE MODIFICATIONS/CONDITIONS:
IMPROVEMENT PERMIT LAYOUT
�RfiPROVED E�FLll�t3T �IL7ER� ���YISLFR i�? IF �" �EL[7;�� FIidI�H�B GRAB��•
�
r
� •�,�'
' — i �,�,.--^ � p p' �.'�
i
i
�
�
J�'�
� a��
�_ �� r� �"N t 5 c.._i ,,.y I,-1_�S'►
� � � �
r �— ��y;���—, �,� c�
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 (704) 634-8760.
)t ){ l; Y.3i IC )S }: ).
I OPERATION PERMIT
�
�
1
�
�
C^
SYSTEM INSTALLED BY: '� � N�� V"H t'('AK.C'"'�
<
A'�
• ,p►�
�
OO`x� "Y
-----.l1„
,�.r- � J / .
—�. � o J
AUTHORIZATION NO. I�� '} OPERATION PE TE:
**THE ISSUANCE OF THIS OPERATION PERMIT SHALL INDICATE THAT THE SYSTEM DESCRIBED ABOVE HAS BEEN INSTALLED IN COMPLIANCE
WTTH 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 OS/96 (Revised)
0
���
i i+ �
,
, - .
,:
_ .;
; .. , . . . ' :: �. .. . .
.. , , , � . � ; . � �. .
. ' � , - ,;�
. , r - , ' � .. „�„ i ,`, ,� ;: k w..'..._
, d _,� �, . � , ' . "& % �'���,� � DAVIE COUNTY HEALTH DEPARTMENT f -
-_' ,..� . M, ' TMPROVEMENT AND OPERATION PERMITS PROPERTY INFORMATION
, � - Permittee's , , � � �..F � t ' f - %/-. ��, rJ
`Name: � � '� �� f t Subdivision Name:
Directions to property: : �� � �`` � y Section: Lot:
IMPROVEMENT
� , . . , ". PERNIIT
Tax Office PIN:#
� . 4 .. .. .. .
'�:' � ' � �.: ... � , Road Name � . �.. � Zip:
**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 CONSTRUCTTON must be obtained from this Departrnent prior to the
constiuction/'mstallation of a system or the issuance of a building pernut.
(In compliance with Article 11 of G.S. Chapter 130A, Wastewater Systems, Section .1900 Sewage Treatment and Disposal Systems)
if ***NOTICE*** THLS PERMIT IS SUBJECT TO REVOCATION IF SITE
, f.�J' ;.;� PLANS OR TI� INTENDED USE CHANGE. YOUR WASTEWATER
ENVIRONMENTAL HEALTH SPECIALIST DATE�ISSUED SYSTEM CONTRACTOR MUST SEE THIS PERMIT BEFORE
• INSTALLING THE SYSTEM.
RESIDENTIAL SPECIFICATION: BUILDING TYPE � �='��s # BEDROOMS � # BATHS .< # OCCUPANTS .`� GARBAGE DISPOSAL: Yes o�i�To
COMMERCIAL SPECIFICATION: FACILITY TYPE # PEOPLE # PEOPLElSHIFT # SEATS INDUSTRIAL WASTE: Yes or No
LOT SIZE�� �',�"��PE WATER SUPPLY�^��=-1-�-- DESIGN WASTEWATER FLOW (GPD)r' �Ce�=� NEW SITE REPAIR SITE �'
SYSTEM SPECIFICATIONS: TANK SIZE GAL. PUMP TANK GAL. TRENCH WIDTHw-x'�--' ROCK DEPTHI �� LINEAR FT.< <' �� ♦
REQUIRED SITE MODIFICATIONS/CONDITIONS:
IMPROVEMENT PERMIT LAYOUT
' �%��Fi'�ULD �=�l.!"':�lT �ILS�1�� �fth�:��;t�;� IF G" £ELt,'��a C=IF�JIS�-I�13 �aT2AIi��
•`3l� � _ _ �jt� f ;,x�'.
', � ,;,,.--�-� �,�o �-.-�.
� t I +
, �._„_......_ _ '§ � ! /
\ ? �'. .v
,� � —r � � � ; �
J
� ,..� � ; � � F �'� ,,.,,.,, C-� �,, t:. ��
�L c �w r� - ��.. ,�.-.�
_..�..
�j �' � f �.._ . .��``"' �
{-� �'`� ��
�$ / -, -..
y� r �-'� �., r(.. i r, � t r� �::--y
F /� ' —..����""'�.., �,/
i�..�,
i
�"h� ! y C...:1 �`.:: l-.C��?.`C"
�
**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 (704) 634-8760.
xxxxxsc�t�.n
I OPERATION PERMIT
�
�
�
y
c
�
C1
SYSTEM INSTALLED BY: � n N�� �N � rA� �.
�
,� (�`�.�
� ��
� x
� � _ ,I ,� �
��---._._ _ ,, ;
,
AUTHORIZATION NO. �� OPERATION PE � r� ?�TE: `� U v
�
**THE ISSUANCE OF THIS OPERATION PERMIT SHALL INDICATE THAT THE SYSTEM DESCRIBED ABOVE HAS BEEN INSTALLED IN COMPLIANCE
WITH ARTICLE 11 OF G.S. CHAP'TER 130A, SECTION .1900 "SEWAGE TREATMENT AND DISPOSAL SYSTEMS", BUT SHALL IN NO WAY BE TAKEN AS A
GUARANTEE THAT THE SYSTEM WII,L FUNCTION SATISFACTORILY FOR ANY GNEN PERIOD OF TIME.
DCHD OS/96 (Revised)
r a.
\�
�„�..��,. • l µ f v �( u � 4
. , �.�^.r �P . � � .
w"�"`=:..' . ' 'DAVIE COUNTY. NEALTH`DEPARTMENT.,.:... � � . � Ia�i�� , ~,
--;,,�`"-, ::.��. �
�"`��" , IMPROVEMENTS PERMIT AND CERTIFICATE OF� COMPLETION • �
. . • , , , , �. ,, , -
. '. 'NOTE: Issued in Compliance With Article II of G.S. Chapter 130a � � `�� � �' .
� San�tary Sewage Syst ms �* ` Permit Number .
N�� . � c� �� �� �,�> �� ��_�'. V 1�.��� S D a t e 3_ 3 �� J � N0 '�' 9(� 5
Location r�� � c� �� �. �:. � �� �� �ae1 � � V `�+i�c.:�a � �� .�.. � U � 1.,� . � ,
Y� << �= t `, . V f � �v J �i�� C�J C.. @ F`y 1 � �l : i K� � • ! �'ti : � n ' :i`'�+✓�� ^+�. —1 ; �. .` .
' �,�,,, -v.,F;� 1- • ' , , ,,,• ,, ' + , ,. _ �,�,' . , v..: .; • .
� Subdivision Name Lot Na� Sec.�or Biock No.'
, , t� r, , . � . . .. �
� •,r�'l.�.r,s�w , ... �:
Lot� Size � ._f ' ��House' ti"� � Mobile Home ._ � -;Bus�ness � ''industry � �` . �
. -- : � t,, ; ' ' � �. .,.. �.:, : .
:'�.. _
"No. Bedrooms"� .No. Baths _� _—No. in Family: � � wPubifc�Assembly ��Other • .
A i� ';
� � .,Garbege Disposal �� YE8 C] '; N0�'p'' � �a ., =�SpecitiCations fot.. Syste �,,,;;;� �'.�� .
�, , : Auto::Dish Washer .�,,; YES �' �„�JO ❑ t, , � .`f pU C� .C�,� c�...�,: `' ����,: �" �'+' �1`�` �.
Auto Wash M8^hine, k�YES � N�D ['].. �;``t,.:� . M .. _� "ti:, 4 �� i �a. �`#. �-
` , � " ��• ,_,, UU '�S, " � �( I'�,� 51��,; .� � .
� � ¢�YPe Weter Supply _. �� �--: - — -- �' : :v - - ,
fi 4R9� , ,,, .� : �:t,: , r ty ,.:. , , ; .,� � ' _. ; .
�'�1'his pe`rmit Vofd if sewage system described below is not installed within 5 y�ars Irom:,datetofil§sUe��,� ��� `;
'� ���Thi� pe�mit fs sub'ect to revocallon if site lans �r the intended use chen e '` ` • '�
1 ,
� ,, P 9 :r "3,� � � , �+ -
',�� .: ' ' � �; :� , � ,,, ; h .,' - : . .' , � .
%ATTENTION �: ,YOUR SEPTIC SYSTEM CONTRACTOR MUST SEETHIS PERMIT�LAYOUT BEFORE (NSTAWNQ THIS � '
�! �� _ � � � � SYSTEM. �,, . . " - -�-�-!� .. � r .
��'•.} e�f .,�.� . � , �.J . � 4. . ` 4... 5. � „��j . — i ..
r >
'� � i��,., •
,,1 . � � . ' � �. . i, . . ....... _ ,. . , t .. . . .
, �..._,
„�� 1� ..; .' '; . . . .....,. � ' . ' ' ' �: ' � '� � �.. � . . .. . , . • �
'� , . . ' . . . - ' . . . . .. � r�� �.I� ... . �.�,� t, ��,r . . . ' . � . . ' I.
1.�.. � . . - � Ey . . . ��' - � ' , , . . ' .}`4 .
— , -. •` ... : ... ,.� � ,
� . , ..J � . ' , . �. .. i j _ . .. � . _ � . . ' - . . . �
. � ' �"�' �,�' lJ � � , . � i
,i
,. •, � . , _ . . . , „
� �'_''�� . r . � � . �- _ � �
. i� . � � .. � . � :
� `�----_' �,' _ .. . � _
.. . � . . . � ��J• . . � . � � � . . .., , . _ . . , . . . . .
� � � . � � .. .. � .� . �. .. ` � . . . . �, . .
. ' i"(� � , . ' . . . . � . . . . . � � _ L'
L
a�4,� t . w ���' � r . .... , . . .., . � 4.
/� . . . ' ��"� ���\y , .� • . � a ,.: � "�i�' . . � , ' � . .
_ . �`'` � ,. ,.. (�°��� ;�.`�_. �,,���. .
� �1— .
, Improvements permit by —_ �
`Contact a representative of the Davie Counry Health Department tor final inspection of this system between 8:30-9:30 A.M:, ' �
1:00-1:30 P.M. or 4:30-5:00 P.M. on day o( compietion: Telephone Number; 704-634•69861 'g f(o0 •
' Final Installation Diagram: �1 �'�"' ��'' System installed by _- C�,�V��,9� '
. ' .. y a �� .
,. � „
• �. , .
� . . , ,
' �.
. ,. . . _ „
_ , : ,,.
� .
' ��' � U S � ' , , , �''�"'� , ,�t `,.
. g' � . . - � r• � iiS
� ' ; "•,� �� . . . .
. �
�
• , , / � " i . f -. ,., . � , �i. .� . . .. . . „ .'�� . . .
, . , . . . . � a � � ,. . .,. . , ' �I� � "� � .
V. , . . • 1 .. . . � . . . . . . � .
. . O . � ��+Y�y , . . . ,. . . . . . . .
� � r
. ' � 'J ♦ f . , . . � . .. . . . , � , , . � , ' . . ' � .
� o ��."' .... , n�.� . . ' ; , �,
i� 2 , „� v ..
;
�� J N I w. ;� .t � , , 1 �
L ~ C�: Fa��� �. .��� � b-_��� g 5 •=
Certiticate of Completion Date , _
'The signing ot this certiiicate shall indic�e that the system described above has been installed in compliance with�
the standards sef torth in the above regulation, bui st�all•iq NO way be taken as a guerantee that the system will tunction
satisfactorily tor any given period of time. � t �; ' . � �
� ,
NAM
� DAVIE COUNTY ENVIRONMENTAL HEALTH SECTION
APPLICATION FOR IMPROVEMENT PERMIT (REPAIR)
� I v�V �`� PHONE NUMBER l� 0 r� � I
ADDRESS I` lC.� �(iC�J�-�� �� U�-1J �� SUBDIVISION NAME
DIRECTIONS TO
il
TE Ud �lO v
or) �C�� ��J _ � J�
O ,.1
LOT #
5 ti � �, � �►� ;���- F � �� ��� �r
DATE SYSTEM INSTALLED �� ` NAME SYSTEM INSTALLED UNDER 5�'''��
` �
TYPE FACILITY �`���SQ% NUMBER BEDROOMS � � NUMBER PEOPLE SERVED �
TYPE WATER SUPPLY I�Cu- SPECIFY PROBLEM OCCURRING SI����C�C
1 �.� � � -rA � �, �1 r�
DATE REQUESTED� �� INFORMATION TAKEN BY,
This is to certify that the information provided is correet to the best o} my knowledge, and that I understand I am responsible for all charges i�curred from this application.
SIGNATURE OF OWNER OR AUTHORIZED AGENT
Rev. 1/93
/'i.y� f�9� -��/-0/09� �c��1�93 �� ���d