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152 Oakbrook Drive Lot 11 Section 2Davie County, NC, Tax Parcel Report Wednesday, January 11, 2017 Parcel Number: NCPIN Number: Account Number: Listed Owner 1: Mailing Address 1: City: WINSTON SALEM WAKNnG: TH1h 1�i 1VUT A SUKVEY Parcel Information E8100B0014 Township: Shady Grove 5871844752 Municipality: 8304852 Census Tract: 37059-803 HEGE CURT SR Voting Precinct: EAST SHADY GROVE 4249 ALLISTAR ROAD Planning Jurisdiction: Davie County State: NC Zip Code: 27104 Legal Description: LOT 11 GREENWOOD LAKE SECTION TWO Assessed Acreage: 0.74 Deed Date: 3/2015 Deed Book / Page: 009830616 Plat Book: 0003 Plat Page: 088 Building Value: Land Value: Total Assessed Value: Zoning Class: DAVIE COUNTY R-20 Zoning Overlay: Voluntary Ag. District: No Fire Response District: ADVANCE Elementary School Zone: SHADY GROVE Middle School Zone: WILLIAM ELLIS Soil Types: GnB2 Flood Zone: Watershed Overlay: DAVIE COUNTY Outbuilding & Extra Freatures Value: Total Market Value: F -Al All data is provided as Is without warranty or guarantee of any ldnd either expressed or Implied Including but not "- ed to theDavie County, Implied warranties of merchantability or fitness for a particular use. All users of Davie County's GIS website shall hold harmlessthe County of Davie, North Carolina, its agents, consultants, contractors or employees from any and all claims or causes of action due to NCor arising out of the use or Inability to use the GIS data provided by this website. --__ Permittee's �f"j }� ,/ DAVIE COUNTY HEALTH DEPARTMENT �vL -.c: S Name: . ?'' ? �,.. /i .r> t�;y r' Environmental Health Section PROPERTY INFORMATION P.O. Box 848 J /� NrectionAo property /fS� ��1 2 r r r'/ Mocksville, NC 27028 Subdivision NameC�/ Phone #: 336-751-8760 Section:.- , 53`— '' S Lot: ,�✓ AUTHORIZATION NO: 7, -6 1 ' A AUTHORIZATION FOR WASTEWATER Tam _ffice PIN:# SYSTEM CONSTRUCTION - - (ad NamZ/1/'f"�/+ s"orc-' Zip: **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. (In compliance with Article 11 of G.S. Chapter 130A, Wastewater Systems, Section .1900 Sewage Treatment and Disposal Systems) z 'I +j ✓ ***NOTICE*** THIS AUTHORIZATION FOR WASTEWATER CONSTRUCTION IS VALID FOR A PERIOD OF FIVE YEARS. HEALTH SPECIALIST DATE ISSUED ? S RESIDENTIAL SPECIFICATION: BUILDING TYPE �� # BEllROOMS "� #BATHS �` ! #OCCUPANTS .GARBAGE DISPOSAL: Yes or No COMMERCIAL SPECIFICATION: FACILITY TYPE # PEOPLE # PEOPLE/SHIFT # SEATS INDUSTRIAL WASTE: Yes or No LOT SIZE TYPE WATER SUPPLY DESIGN WASTEWATER FLOW (GPD) NEW SITE REPAIR SITE i SYSTEM SPECIFICATIONS: TANK SIZE GAL. PUMP TANK GAL. TRENCH WIDTH ROCK DEPTH LINEAR FT. REQUIRED SITE MODIFICATIONS/CONDITIONS: **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 (336)751-8760. OPERATION PERMIT SYSTEM INSTALLED BY: Vde ojj. AUTHORIZATION N J OPERATION PERMIT BY: I / DATE: L �� **THE ISSUANCE OF THIS OPERATION PERMIT SHALL INDICATE THAT THE SYSTEM DESCRIBED ABOVE HAS BEEN INSTALLED IN COMPLIANCE WITH ARTICLE I I 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 02/02 (Revised) DATE SYSTEM INSTALLED NAME SYSTEM INSTALLED UNDER r* -1 ec S x"o J TYPE FACILITY NUMBER BEDROOMS NUMBER PEOPLE SERVED TYPE WATER SUPPLY �'�cc ^ `I-l� SPECIFY PROBLEM OCCURRING DATE REQUESTED �° o S INFORMATION TAKEN BY-49L— This is to certify that the information provided is correct to the best of my knowledge, and that I understand I am responsible for all charges incurred from this application. SIGNATURE OF OWNER OR AUTHORIZED AGENT Rev. 1193 R DAVIE COUNTY ENVIRONMENTAL HEALTH SECTION r APPLICATION FOR IMPROVEMENT PERMIT (REPAIR) c��+NAME 61_c'�q / o ^ 2 "� D o u,r. c� PHONE NUMBER ADDRESS D SUBDIVISION NAME C 1,e -e ^-',"ovc( LOT # 1/ DIRECTIONS TO SITE 0 4 -h1 �� ttF � ' is S Cokv►�t�.5 n - 'n. - '.�Lv DATE SYSTEM INSTALLED NAME SYSTEM INSTALLED UNDER r* -1 ec S x"o J TYPE FACILITY NUMBER BEDROOMS NUMBER PEOPLE SERVED TYPE WATER SUPPLY �'�cc ^ `I-l� SPECIFY PROBLEM OCCURRING DATE REQUESTED �° o S INFORMATION TAKEN BY-49L— This is to certify that the information provided is correct to the best of my knowledge, and that I understand I am responsible for all charges incurred from this application. SIGNATURE OF OWNER OR AUTHORIZED AGENT Rev. 1193 DAVIE COUNTY HEALTH DEPARTMENT (Septic Tank) Improvements Permit and Certificate of Completion • (Ground Absorpt on "Sewage D sposal S stem)- G.S. Chapter 130 -Article 13C) •, CONER AOR COIw OR (,u ,� DATEya7 Z& PERMIT LOCATION l ��i �WhwbL N9 17 01 S.R. NO. SUBDIVISION NAME �'� fi`t:%_t.r �� y�.:� r:/�. LOT NO. _ �� SECTION OR BLOCK NO HOUSE ©' MOBILE HOME ❑ BUSINESS ❑ NO. BEDROOMS NO. BATHROOMS 2— GARBAGE GARBAGE DISPOSAL UNIT YES ❑ NO (� AUTO. DISHWASHER YES NO ❑ AUTO. WASH. MACHINE YES NO ❑ SITE SUITABLE YES NO ❑ SIZE OF TANK gal. NITRIFICATION FIELD sq. ft. DEPTH OF STONE IN LINES: ,,, WATER SUPPLY: Individual ❑ cPublic�, ❑ In . itf IMPROVEMENTS PERMIT BY House Trailer 800 Gal. 400 Sq. Ft. Two Bedroom House 800 Gal. 600 Sq. Ft. Three Bedroom House 900 Gal. 900 Sq. Ft. Four Bedroom House 1000 Gal. 1200 Sq. Ft. laoo . o ra(:3 �.Y .2 Y INSTALLED BY CERTIFICATE OF COMPLETION By ,�� ����� Date 41 y d (8/16/73) *Construction must comply with all other applicable State and local regulations LOT AREA L DAVIE COUNTY HEALTH DEPARTMENT (Septic Tank) Improvements Permit and Certificate of Completion (Ground A++►b��sorpt on 'Sewage D s osal S stem - G.S. Chapter.l 0 -Article 13C) OWNER OR C0!►TRACTOR (,t.� .-� DATE PERMIT LOCATION (Qa Kb%c)j ` •� N° 17 81 S.R. NO. SUBDIVISION NAME LOT N0. �l SECTION OR BLOC Jam' HOUSE MOBILE HOME U BUSINESS ❑ BATHROOMS 1 2 '�a-- House Trailer 800 Gal. 400 Sq. Ft. N0. BEDROOMS NO. Two Bedroom House 800 Gal. 600 Sq. Ft. GARBAGE DISPOSAL UNIT YES ❑ NO 2' Three Bedroom House 900 Gal. 900 Sq. Ft. AUTO. DISHWASHER YES NO ❑ Four Bedroom House 1000 Gal. 1200 Sq. Ft. AUTO. WASH. MACHINE YES NO ❑ SITE SUITABLE YES NO ❑ /C.a a .mac SIZE OF TANK gal. �X3 NITRIFICATION FIELD sq. ft. -4 y `zy DEPTH OF STONE IN LINES: c� WATER SUPPLY: Individual ❑ ��,�,, �Publi ❑ IMPROVEMENTS PERMIT BY INSTALLED INSTALLED BY CERTIFICATE OF COMPLETION C±IV.y By �/1J Date (8/16/73) *Construction must comply with all other applicable State and local regulations LOT AREA �r�x�xis%0 DAVIE COUNTY HEALTH DEPARTMENT _ ��✓/ P. 0. Box 57 MOCKSVILLE, N. C. 27028 179 (704) 634-59851 Statement for Septic Tank Improvement Permits I and/or Site Evaluations NAME -1/- 71 DATE ISSUED 4 )Y ADDRESS Explana PERMIT NO. AMOUNT DUE S• � SANITARIAN4, i lb PLEASE REMIT THE ABOVE AMOUNT ON RECEIPT OF THIS STA EHENT. DAVIE COUNTY HEALTH DEPT. PERK TEST RECORDS DATE'L NAME LOCATION FINDINGS: HOLE N0.1 HOLE NO.2 HOLE NO. 3 LOT DIAGRAM COMMENTS ,a",C c� all BY0. dcJ .,