174 Green Brier Acres Lot 40Davie County. NC
Tax Pnrnel R Pnnrt
Tuesday. January 3. 2017
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:
Plat Book:
Plat Page:
Building Value:
WARNING: THIS IS NOTA SURVEY
Parcel Information
H703OA0015 Township: Shady Grove
5769963809 Municipality:
82524796 Census Tract: 37059-804
IRELAND JO ANN Voting Precinct: WEST SHADY GROVE
174 AUSTINE LANE Planning Jurisdiction: Davie County
ADVANCE Zoning Class: DAVIE COUNTY R -A
NC Zoning Overlay:
27006-7138 Voluntary Ag. District:
LOT 40 GREEN BRIER ACRES Fin: Response District:
Land Value:
Total Assessed Value:
0.48 Elementary School Zone:
5/2005 Middle School Zone:
2005EO150 Soil Types:
0004 Flood Zone:
173 Watershed Overlay:
Outbuilding & Extra
Freatures Value:
Total Market Value:
ADVANCE
SHADY GROVE
WILLIAM ELLIS
GnB2,EnB
DAVIE COUNTY
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aCounty of Davie, North Carolina, its agents, consultants, contractors or employees from any and all dalms or causes of action due to i
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NC or arising out of the use or Inability to use the GIS data provided by this websIte.
3; 36
DAVIE COUNTY HEALTH DEPARTMENT
IMPROVEMENTS PERMIT ANDi CERTIFICATE OF COMPLETION
*Note: Issued- in Compliance with.G.S. of North Carolina Chapter 130—Article 13c.
Permit',!kumber
Name E, lay'. � 1J e ict.• c� ii Date �' _g 3 {� Rl a�
`t
Location '- ' •
*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 day of completion. Telephone Number: 704-634-5985.
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Final Installation Dia`gra�m'.: fi Syst m In tailed by �m 2ri1�
_J1
i1
i �►
Certificate of Completion Date 3 a
5
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
satisfactorily for any given period of time.
Subdivision Name hRfeti.br;w.
Lot No. �o Sec. or Block No.
Lot Size 100')(2661 House
Mobile Home ✓ Business Speculation
No. Bedrooms No. Baths
No. in Family a -
Garbage Disposal YES pNO 2r
Specifications for System: X100 mal- 7 4
Auto Dish Washer .:; 0' NO`
YES
A, ..
:. Auto Wash Machine ; YES e NOfl
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co:,
S�S�rt- n� sl.a,���- na �Ip�•
Type Water Supply CoU�
•r,�s-�
rrsPT ckr o jeL•
��- Cw.�ac•4- �.1:.s aFF�e�e �';fi quv
*This if -system -described below is installed 36 from date; issue. GF �f J �
permit :Void, sewage
not within. months of
SSt►� ho �e^;appr�A^^c�
- •
i Q
I ��
`a .ter 4' �•
i;
Improvements permit by Y -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 day of completion. Telephone Number: 704-634-5985.
�; F f•
Final Installation Dia`gra�m'.: fi Syst m In tailed by �m 2ri1�
_J1
i1
i �►
Certificate of Completion Date 3 a
5
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
satisfactorily for any given period of time.
j I ,
DAVIE COUNTY HEALTH DEPARTMENT
Environmental Health Section
R O. Box 665
Mocksville, N.C. 27028
SOIL/SITE EVALUATION
Name
-L����
Date
S
PS
PS
PS
Address
U
Lot Size
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FAr:Tr1RQ APPA 1 AREA 9 AREA 3 AREA 4
Topography/ Landscape Position
S
PS
PS
PS
PS
U
U
U
U
!) Soil Texture (12-36 in.) Sandy,
Loamy, Clayey, (note 2:1 Clay)
S
(fN;l
S
PS
S
(it:::>
S
PS
U
(:ip
U
U
i) Soil Structure (12-36 in.)
Clayey Soils
S
S
PS
S
C�
S
PS
U
U
U
Soil Depth (inches)
(:5/
S
S
PS
U
PS
PS
U
PS
U
) Soil Drainage: Internal
S
S
S
S
PS
U
t
cl%)
U
External
�
PS
S
�PS
S
PS
U
U
U
i) Restrictive Horizons
/
Available Space
S
U
S.
S
<
S
PS
�
U
1) Other (Specify)
S
PS
S
PS
S
PS
S
PS
U
U
U
U
I) Site Classification
U—UNSUITABLE
Recommendations/ Comments:
Described by
SITE DIAGRAM
DCHD (6-82)
S—SUITABLE PS—Provisionally Suitable
.1
Date
4 , .
APPLICATION FOR SITE EVALUATION/ IMPROVEMENTS PERMIT
Davie County Health Department
Environmental Health Section
P. 0. Box 665
Mocksville, N.C. 27028
CONSTRUCTION SHALL NOT BEGIN UNTIL IMPROVEMENTS PERMIT HAS BEEN ISSUED. �
Home Phone � Q
1. Permit Reques d By � • r e,/7 -n- Business Phone
2. Address t9 - � / ? C� g�, /4g!Z ��- C.>, 2 7 0 0
3. Property Owner if Different than Above
Address
4. Permit To: a) Install Alter Repair
b) Privy ✓ Conventional Other Type
Ground Absorption
c) Sub -Division Bew1h-Z'A Y Sec. Lot No.
5. System used to serve what type facility: House Mobile Homes
IndustryOther
b) Number of people '�?' .
6. a) If house or mobile home,
7state size of home and number of rooms.
f
House Dimensions 'Z • x I 5;Z
Bed Rooms Bath Rooms 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
lavatory
urinals
showers
garbage disposal
washing machine %
dishwasher / sinks
8. a) Type water supply: Public 1Z Private Community
b) Has the water supply system been approved? Yes Z No
9. a) Property Dimensions
b) Land area designated to building site /
c) Sewage Disposal Contractor I f � h AV 3 1716-r _P?
10. Do you anticipate any additions or expansions of the facility this sewage system is intended to serve?�
What type?
This is to certify that the information is correct to the best of my know edge.
g s
Date Owner ignature
OWNER IS SOLELY RESPONSIBLE FOR COMPLIANCE WITH ALL STATE AND LOCAL LAWS
Allow 5 days for processing
Directions to property:
0 e9
t�
ox,ni -e - 1#
L�� �- zle
DCHD (6-82)