223 Brier Creek Road Lot 42Davie County, NC Tax Parcel Report 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 NOT A SURVEY
Parcel Information
H703OA0013 Township: Shady Grove
5769973044 Municipality:
39292000 Census Tract: 37059-804
IRELAND JACK G Voting Precinct: WEST SHADY GROVE
223 BRIER CREEK ROAD Planning Jurisdiction: Davie County
ADVANCE Zoning Class: DAVIE COUNTY R -A
Land Value:
Total Assessed Value:
NC Zoning Overlay:
27006-7152 Voluntary Ag. District:
No
LOT 42 GREEN BRIER ACRES Fire Response District:
ADVANCE
0.48 Elementary School Zone:
SHADY GROVE
/ Middle School Zone:
WILLIAM ELLIS
Soil Types:
EnB
0004 Flood Zone:
173 Watershed Overlay:
DAVIE COUNTY
Outbuilding & Extra
Freatures Value:
Total Market Value:
91.v r� All data Is provided as is without warranty or guarantee of any kind either expressed or Implied Including but not limited to the
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County of Davie, North Carolina, its agents, consultants, contractors or employees from any and all claims or causes of action due to
r'pU N� NC or arising out of the use or Inability to use the GIS data provided by this website.
CONSTRUCTION
AUTHORIZATION
Davie County Health Department
�4a yr.
1 210 Hospital Street
P.O. Box 848
Mocksville NC 27028
Phone: 336-753-6780 Fax: 336-753-1680 0 4/ a 9/ a 0 1 9
Applicant: Jackie Ireland Property Owner: Jackie Ireland
Address: 223 Brier Creek Rd Address: 223 Brier Creek Rd
City: Advance City: Advance
State/Zip: NC 27006 State/Zip: NC 27006
Phone #: Phone #:
/"Address/Road #:
223 Brier Creek Rd
Advance NC 27006
Structure: SINGLE FAMILY
# of Bedrooms: 3
# of People:
*Water Supply: NSA
Subdivision: Green Brier
Phase: Lot: 42
Directions
Hwy 64 East, turn left on Fork Bixby Rd. go almost to end,
turn left aftern passing Bailey's Chapel rd on right.
inches Pre -Treatment: O NSF OTS -1 OTS -II
Septic Tank Installer Grade Level Required: 01 OII 0111 01V
Page 1 of 3
Minimum Trench Depth:
a 4
Site Classification:
Provisionally Suitable
Inches
Minimum Soil Cover:
1 a
Saprolite System?
OYes CKNo
Inches
Design Flow:
3 6 0
Maximum Trench Depth:
3 6
Inches
Soil Application Rate:0
a
5
Maximum Soil Cover:
a 4
Inches
*System Classification/Description:
*Distribution Type:
TYPE II A. CONY SYSTEM (SINGLE-FAMILY
OR 480 GPD OR LESS)
Septic Tank:
Gallons
*Proposed System: 25% REDUCTION
1 -Piece:
O Yes
O No
Pump
Required: O Yes
(& No
O May Be Required
Nitrification Field
1 3
0
9 Sq. ft.
Pump Tank:
Gallons
No. Drain Lines3
1 -Piece:
OYes
(&No
Total Trench Length:
3 a 7
GPM
--vs--
ft. TDH
ft
Trench Spacing:Olnches
—
9
O.C.
®Feet 0. C. Dosing Volume:
_
Gallons
Trench Width:
3
RInches
Feet
_
Grease Trap:
Gallons
Aggregate Depth:
inches Pre -Treatment: O NSF OTS -1 OTS -II
Septic Tank Installer Grade Level Required: 01 OII 0111 01V
Page 1 of 3
CDP File Number 137709 - 1
*Site Classification:
Design Flow:
Soil Application Rate:
*System Classification/Description:
*Proposed System:
Nitrification Field
No. Drain Lines
Total Trench Length:
County ID Number: H7 -030 -AO -013
❑ Open Pump System Sheet
ireo: U T es V Ivo Vivo, out nas Hyallame apace
ft.
Sq. ft.
Trench Spacing:
Q Inches O.
— O Feet O.C.
Trench Width:
Q Inches
_ Q Feet
Aggregate Depth:
inches
Minimum Trench Depth:
Inches
Minimum Soil Cover:
Inches
Maximum Trench Depth:
Inches
Maximum Soil Cover:
Inches
*Distribution Type:
Pump Required: OYes O 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 130A336(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? OYes ONO
Applicant/Legal Reps. Signatures Date:
*Issued By: 2140- Nations, R ert Date of Issue: 0 4 / a 9 / a 0 1 4
Authorized State Agent: Malfunction Log Oyes
(9 Hand Drawing O Import Drawing
**Site Plan/Drawing attached.**
Page 2 of 3
Characters
Remaining
750
Characfore
Remaining
2000
CONSTRUCTION AUTHORIZATION
Davie County Health Department
210 Hospital Street
P.O. Box 848
Mocksville NC 27028
Drawing Drawing Type: Construction Authorization
It
u
CDP File Number: 137709 - 1
County File Number: H7 -030-A0-013
Date: 04/.19 1 a 0 1 4
O Inch
Scale: 0 Block = ft.
O N/A
J
L
Page 3 of 3 P1 P2
CONSTRUCTION AUTHORIZATION
Davie County Health Department
210 Hospital Street
P.O. Box 848
Mocksville NC 27028
CDP File Number: 137709 - 1
County File Number: H7-030-Ao-013
Date: .0.4. / 2 9/. 0 14
Click below to import an image from an external location: Drawing Type: Construction Authorization
Page 3 of 3
P1 P2
DAVIE COUNTY HEALTH DEPARTMENT
kaepuc ianK) improvements rermit ana t ertutcate of %-ompieuon
(Ground Absorption Sewage Disposal System - G.S. Chapter 130 -Article 13C)
OWNER OR CONTRACTORCrJl.� �{'Q/ �f c2gyt e DATE44
PERMIT
LOCATION N? 1270
S.R. NO.
SUBDIVISION NAME r c✓l; yre '✓',`,J.: Y`, �C LOT No. ter%. SECTION OR BLOCK NO. _
HOUSE ❑ MOBILE HOME ❑ BUSINESS
NO. BEDROOMS .�' NO. BATHROOMS ,
GARBAGE DISPOSAL UNIT YES ❑ NO Er -
AUTO. DISHWASHER YES ❑ NO Q
AUTO. WASH. MACHINE YES El NO ❑
SITE SUITABLE YES ❑ NO ❑
SIZE OF TANK 2s3p gal.
NITRIFICATION FIELD o o sq. ft.
DEPTH OF STONE IN LINES:-!L_?ef
11
WATER SUPPLY: Individual ❑ Public
IMPROVEMENTS PERMIT BY
House Trailer
800 Gal. 400 Sq. Ft.
Two Bedroom House 800 Gal. 600 Sq. Ft.
Three Bedroom House �-610`-r-al. " 7 =OS q. Ft.
Four Bedroom House
000 Ga 200 Sq. Ft.
j
47
INSTALLED BY
C'�tP S�JL,-O
CERTIFICATE OF COMPLETION By Date %VI 77
(8/16/73) *Construction must com y with all other applicable State and local regulations
I
LOT AREA
S
t i
► DAVIE COUNTY HEALTH DEPT.
PERK TEST RECORDS
DATE
NAME
LOCATION�; /Ir
lT�cY �/a c
!0I. -A
FINDINGS: HOLE N0.1 ig C2 13
HOLE NO.2
HOLE 110. 3 1p g L
COMMENTS
� O
(A)
BY 1 <
I
IOT DIAGRAM
• . _ DAVIE COUNTY ENVIRONMENTAL HEALTH SERVICE REQUEST
APPLICATION IP/ATC OSWW REPAIR
jilivl %e-
Name L (� t�'Q /$ Telephone Number 30
Address
Mailing Address (if different from above)
Email Address: Q 0 -0 13
Subdivision Name ���N` �� �1 lL �. �� Lot # ` 47/
Directions U L 4 t -E Ci 12d, N -q
✓�-
Date System Installed 7 — Name System Installed Under
Type Facility Number Bedrooms_ Number People Served
Type Water Supply Specific Problem Occurring
Date Requested — Info Taken By
THIS IS TO CERTIFY THAT THE INFORMATION PROVIDED IS CORRECT TO THE BEST OF MY
KNOWLEDGE, AND THAT I UNDERSTAND THAT I AM RESPONSIBLE FOR ALL CHARGES INCURRED
FROM THIS APPLICATION.
Signature of owner or Authorized Agent
Initial Fee Date REHS
Revisit Charge Date Reason
Revised 2-2011
I3 7707
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