354 Brier Creek RoadDavie County, NC Tax Parcel keport .. Tuesday. January 3. 2017
WARNING: TIHS IS NOTA SURVEY
Parcel Information
005802 Shady Grove
Parcel Number:
H70000Township:
NCPIN Number:
5769768370
Municipality:
Account Number:
82531336
Census Tract:
Listed Owner 1:
DOSE CAROLE L
Voting Precinct:
Mailing Address 1:
354 BRIER CREEK ROAD
Planning Jurisdiction:
City:
ADVANCE
Zoning Class:
State:
Zip Code:
Legal Description:
Assessed Acreage:
Deed Date:
Deed Book / Page:
Plat Book:
Plat Page:
Building Value:
Land Value:
Total Assessed Value:
37059-804
WEST SHADY GROVE
Davie County
DAVIE COUNTY R -A
NC Zoning Overlay:
27006-0000 Voluntary Ag. District: No
3.58 AC W OFF FORK BIXBY Fire Response District: CORNATZER - DULIN,ADVANCE
3.58 Elementary School Zone: SHADY GROVE,CORNATZER
12/2009 Middle School Zone: WILLIAM ELLIS
008130617 Soil Types: MrB2,EnB,MsC,ChA
Davie County,
NC
Flood Zone:
Watershed Overlay: DAVIE COUNTY
Outbuilding & Extra
Freatures Value:
Total Market Value:
DAVIE COUNTY HEALTH DEPARTMENT'
` IMPROVEMENTS PERMIT AND CERTIFICATE OF COMPLETION
"NOTE: Issued in''Compliance with'G.S. of North Carolina Chapter 130 Article - 13c
Sewage Treatmen`and Disposal -Rules (10;NCAC 10A .1934-.1968) Permit Number'
Name. l'< Dateo��JXv� 3 8
Location
Subdivision- Name -- ". Lot No. Sec. or Block No.
Lot. Size �,T �a� House — Mobile Home _ Business Speculation
No: Bedrooms No. Baths- �No. "in''Family '
Garbage Disposal j : YES ❑ NO
Specifications or ,System:
Auto Dish Washer YES NO ❑ /
Auto Wash Machine YES N ❑ 1; l
Type. Water Supply i
ax,
--- ��
la, 4"4e
'This permit Void if sewage system described below is not installed within 36 months from date of issue.
f
:11mprovements permit by'-.
'Contact a representative'of the Davie County Health Department for final inspection of. this system between 8:30-
9:30 A: - A. '.M. on day of completion. Telephone Number: 704-634-5985.
ii100111
`Final Installation 'Diagram:-, System Install by f i
Certificate of Completion -Date % �J
"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-guararitee that the system will function .
satisfactorily for any given period of•time. h'
r APPLICATION FOR SITE EVALUATION/ IMPROVEMENTS PERMIT
Davie County Health Department A�(
Environmental Health Section P ,
P. O. Box 665
Mocksville, N.C. 27028
CONSTRUCTION SHALL NOT BEGIN UNTIL IMPROVEMENTS PERMIT HAS BEEN ISSUED.
I
Z1
Home Phone q/ (."f- ZS"b
1. Permit Requested By Leg /, i a JR0 lzoo ks Business Phone 9 / `�- 9 ZS=
2. Address 72 e 4- `/ 2,-ra n
3. Property Owner if Different than Above
Address
4. Permit To: a) Install� Alter Repair
b) Privy Conventional Other Type -5 a p-rs c- `rot A,
Ground Absorption
c) Sub -Division (5 iZe„V Ri21 MI Sec. Lot No.
5. System used to serve what type facility: House_ff:i'_`Mobite Home Business
IndustryOther
b) Number of people 2-
6.
6. a) If house or mobile home, state size of home and number of rooms.
House Dimensions 46'X 40
Bed Rooms 3 Bath Rooms Z )/i 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 3 urinals
lavatory
3
garbage disposal
showers Z washing machine I
dishwasher I sinks
8. a) Type water supply: Public Private P-1 Community
b) Has the water supply system been approved? Yes No
9. a) Property Dimensions 2-012 )C nn y R S o 3 S- /ge_rzex
b) Land area designated to building site .3 ovo .5'r,
c) Sewage Disposal Contractor b 1i V- Now �
10. Do you anticipate any additions or expansions of the facility this sewage system is intended to serve? u a
What type?
This is to certify that the information is correct to the best of my knowledge.
Date Owner Signature
OWNER IS SOLELY RESPONSIBLE FOR COMPLIANCE WITH ALL STATE AND LOCAL LAWS
Allow 5 days for processing
Directions to property:
0 LX
DCHD (6-82)