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104 Hickory Tree Road Lot 20Davie Countv, NC Tax Parcel Report Thursday, January 12, 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 I Page: Plat Book: Plat Page: Building Value: WAICPI1111lT: IMO In AV -1 A 311,11(vzY Parcel Information J701 OA0021 Township: Fulton 5768322927 Municipality: 82533127 Census Tract: 37059-804 HOLLIFIELD BRENDA C Voting Precinct: FULTON 104 HICKORY TREE ROAD Planning Jurisdiction: Davie County MOCKSVILLE Zoning Class: DAVIE COUNTY R-20 Land Value: Total Assessed Value: NC 27028-7122 LOT 20 HICKORY TREE SECTION ONE 0.67 12/2011 008770259 0004 170 Zoning Overlay: Voluntary Ag. District: No Fin; Response District: FORK Elementary School Zone: CORNATZER Middle School Zone: WILLIAM ELLIS Soil Types: GnB2 Flood Zone: Watershed Overlay: DAVIE COUNTY Outbuilding & Extra Freatures Value: Total Market Value: rO Davie County, NC All data is provided as is without warranty or guarantee of any Idnd either expressed or Implied including but not limited to the Implied warranties of merchantability or fitness for a particular use. All users of Davie County's GIS website shall hold harmless the County of Davie, North Carolina, its agents, consultants, contractors or employees from any and all daims or causes of action due to or arising out of the use or Inability to use the GIS data provided by this w ebsfte. ti . W.t�..d�. ivMt.v''-.,-:.:r,e'7 :. fit. •. ir;,,.: '; r .- � . _ .. .y .... .. .. - - > - .Av,. TION NO: 1 J DAVIE COUNTY HEALTH DEPARTMENT Environmental Health Section PROPERTY INFORMATION Permittee's � �/J / P.O. Box 848 Name: .� rs �C /7 �// r' Mocksville, NC 27028 Subdivision Name: . Phone # 336-751-8760 Directions to property: c�' Section: Lot: -20 / AUTHORIZATION FOR '//1'/' WASTEWATER Tax Office PIN:# - SYSTEM CONSTRUCTION — Road Name: Zip: °2.2 **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) ***NOTICE*** THIS AUTHORIZATION FOR WASTEWATER CONSTRUCTION IS VALID FOR A PERIOD OF FIVE YEARS. TIRO MENTAL HEALTH SPECIALIST DATE ISSUED A+� 4-w:�_ DAVIE COUNTY HEALTH DEPARTMENT IMPROVEMENT AND OPERATION PERMITS PROPERTY INFORMATION Permittje s /' w Name: — ,n ,f; �''f /'... Subdivision Name: Directions to property:. SO ection: Lot: IMPROVEMENT PERMIT Tax Office PIN:# - - Road Name: Zip:'/` -e **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 CONSTRUCTION must be obtained from this Department prior to the construction/installation of a system or the issuance of a building permit. (Incompliance with Article 11 of G.S. Chapter 130A, Wastewater Systems, Section .1900 Sewage Treatment and Disposal Systems) ***Nn'rFrF*** 7MR PFRMiT IC CiTRTF.rT Tn Rv.vnvATTnN iv CiTF: - �' `jR r' - ;; PLANS OR THE INTENDED USE CHANGE. YOUR WASTEWATER ENV O MENTAL H HEALTH SPECIALIST DATE ISSUED SYSTEM CONTRACTOR MUST SEE THIS PERMIT BEFORE INSTALLING THE SYSTEM. RESIDENTIAL SPECIFICATION: BUILDING TYPE _ # BEDROOMS—J' # BATHS _ _ # OCCUPANTS GARBAGE DISPOSAL: Yes or No COMMERCIAL SPECIFICATION: FACILITY TYPE # PEOPLE # PEOPLE/SHIFI'# SEATS INDUSTRIAL WASTE: Yes or No LOT SIZE TYPE WATER SUPPLY DESIGN WASTEWATER FLOW (GPD) ,6 / 1 NEW SITE.—REPAIR SITE SYSTEM SPECIFICATIONS: TANK SIZE GAL. PUMP TANK GAL. TRENCH WIDTH �(� /ROCK DEPTH a"7 LINEAR FT�_�� REQUIRED SITE MODIFICATIONS/CONDITIONS: IMPROVEMENT PERMIT LAY6 `PROVED EFFLUENT FILTER* *RIB `R(S) IF C� F " 13ELOU FINISHED GRADE* "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. TELEPHONINP49NMJ 16M760. (336)751—x760 OPERATION PERMIT SYSTEM INSTALLED BY: t - n AUTHORIZATION NO. & OPERATION PERMIT BY: DATE: "THE ISSUANCE OF THIS OPERATION PERMIT SHALL INDICATE THAT THE SYSTEM DESCRIBED ABOVE HAS BEEN INSTALLED IN COMPLIANCE WITH 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 05/96 (Revised) '49 DAVIE COUNTY HEALTH DEPARTMENT �-IMPROVEMENTS PERMIT AND CERTIFICATE OF COMPLETION *Note: Issued in Compliance with G.S. of North Carolina Chapter 130—Article 13c. Name ' c'� n K, 0— Location Date /D -.5-,�-( Permit Nur, Subdivision Name Lot No. Sec. or Block No. Lot Size House Mobile Home _ Business Speculation No. Bedrooms No. Baths No. in Family Garbage Disposal YES p NO p Specifications for, Sptem: Auto Dish Washer YES 0 NO ❑ 61-1dd P V-' ' Auto Wash Machine YES NO ♦] Type Water Supply *This permit Void if sewage system described below is not installed within 36 months from date of issue. Improvements permit by *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. Final Installation Diagram: System Installed by X-3 n Q 1 a � Certificate of Completion & Date Lb' 7 -el *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. DAME COUNTY HEALTH DEPARTMENT ENVIRONMENTAL HEALTH SECTION PO Box 848/210 Hospital Street Courier #09-40-06 Mocksville, NC 27028 Phone #: (336)751-8760 January 29,2002 Jane Whitlock Howard Realty 330 S. Salisbury Street Mocksville, NC 27028 Re: Sewage System Check Rich Allred -Owner Hickory Tree lot # 20 Dear Ms.Whitlock: As requested, a representative from this office visited the aforementioned site on January 29, 2002 . At the time of the visit a final inspection of the sewage system was done on repair order # 1691 A ( copy attached ). Please be aware that the above statement is in no way intended, nor should be taken as a guarantee (extended or limited) that the sewage system will function properly for any given period of time. Please advise should this office be of further assistance. Sincerely, Aea & gk�WA. Robert B. Hall, Jr. , R.S. Environmental Health Specialist Enclosure(s) RBH: df DAVIE COUNTY HEALTH DEPARTMENT IMPROVEMENTS PERMIT AND CERTIFICATE OF COMPLETION *Note' Issued in. Compliance with G.S., of North Carolina Chapter 130—Article 13c. -Permit Number:' Date 10' 527"/ Name. Location Subdivision Name.2P Lot No. Sec. or Block No. Lot Size House Mobile Home Business Speculation No. Bedrooms No. BathsNo. in Family Garbage Disposal YES E], NO' `0 Specifications for System:. Auto Dish -Washer YES E;] NO Auto Wash Machine YES NO �E] > Type -Water Supply. *Jf *This permit Void, if sewage system described below is not installed within 36 months from date of issue. Certificate of Completion liz *The signing of this certificate shall indicate that the system described the standards set forth inthe 'above regulation, b,ut's.hall in NO way be t, satisfactorily for any given period of time; Date ve has been installed in compliance with as a guarantee that the system will function