131 Spring Valley Lane Lot 7Dai.
?016
9hiv t8M n
data is provided as is without vwmnly or guardes
es of any kind either expressed or implied including but not limited to the
Davie County; Impliedwanam es of merchndablllty, orflt essfera particular use.ulusers or Davie Courdys GIS mirshe Mall hold handess the
County of Davie, North Carolina, ita agents, consultants, corMcton or employees from any and all dalms oruuses of action due to
NC or arising out otthe use orinabllity to use Me 619 data provided bythis webslte.
WARNING: THIS IS NOT A SURVEY
----Parc ffi; ormation
Parcel Number.
170000004305
Township:
Fulton
NCPIN Number:
5778161591
Municipality:
Account Number
82517388
Census Tract:
37059.804
Listed Owner 1:
TRIVETTE CANDY WILLIAMS
Voting Precinct:
FULTON
Mailing Address 1:
174 SPRING VALLEY LN
Planning Jurisdiction:
Davie County
City:
ADVANCE
Zoning Class: DAVIE COUNTY R -A
State:
NC
Zoning Overlay:
Zip Code:
27006-7054
Voluntary Ag. District:
No
Legal Description:
LOT 7 CARTERS COURT PHASE 11
Fire Response District:
FORK
Assessed Acreage:
0.98
Elementary School Zone:
CORNATZER
Deed Date:
32006
Middle School Zone:
WILLIAM ELLIS
Deed Book / Page:
006521011
Soil Types:
WeC,PcB2
Plat Book:
0007
Flood Zone:
Plat Page:
084
Watershed Overlay:
DAVIE COUNTY
Building Value:
55380.00
Outbuildi Va &extra
FreatLand
0.00'
Value:
16450.00
Total Market Value:
71830.00
Total Assessed Value:
71830.00
9hiv t8M n
data is provided as is without vwmnly or guardes
es of any kind either expressed or implied including but not limited to the
Davie County; Impliedwanam es of merchndablllty, orflt essfera particular use.ulusers or Davie Courdys GIS mirshe Mall hold handess the
County of Davie, North Carolina, ita agents, consultants, corMcton or employees from any and all dalms oruuses of action due to
NC or arising out otthe use orinabllity to use Me 619 data provided bythis webslte.
DAVIE COUNTY HEALTH DEPARTMENT
Environmental Health Section
P. O. Boa 848/210 Hospital Street
Mockwille, NC 27028
(336)751-8760 �et
7
IMPROVEMENT/OPERATION PERMIT (,
Account #: 990002642 Tax PIN/EH #: 5778-16-1591
Billed To: Jennifer Hellard Subdivision Info: Carter's Court Lot # 7
Reference Name: Location/Address: Williams Road -27006
Proposed Facility: Residence Property Size: see map
ATC Number: 3392
**NOTE** This Improvement/Operation Permit DOES NOT authorize the construction 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 (in compliance with
Article 11 of G.S. Chapter 130A, Wastewater Systems, Section .1900 Sewage Treatment and Disposal Systems). THIS
PERMIT IS SUBJECT TO REVOCATION IF SITE PLANS OR THE INTENDED USE CHANGE. YOUR
WASTEWATER SYSTEM CONTRACTOR MUST SEE THIS PERMIT BEFORE INSTALLING SYSTEM.
Residential Specification: Building Type ,4wi #People #Bedrooms �� #Baths
Dishwasher Garbage Disposal: ❑ Washing Machine Basement w/Plumbing: ❑ Basement/No Plumbing: ❑
Commercial Specification: Facility Type #People #People/Shift #Seats Industrial Waste: ❑
Lot Size Type Water Supply Design Wastewater Flow (GPD) 6 O Site: New Repair ❑
D
System Specifications: Tank Size GAL. Pump TarilS/DEh GAL. Trench Width Rock Depth " Linear Ft�
Other:
Required Site Modifications/Conditions:
IMPROVEMENT/OPERATION PERMIT LAYOUT - APPROVED EFFLUENT FILTER RISER(S) IF 6 " BELOW
FINISHED GRADE. ****NOTICE: Contact a representative of the Davie County Health Department for final inspection of this
system between 8:30 a.m. to 9:30 a.m. or 1:00 p.qi� to k.39 p.m. yrythe daylof instaQatiofi. Telephone # is (336)751-8760.****
Health Specialist's Signature: �/ Date: J Y
DCHD 05/99 (Revised) �%
DAVIE COUNTY HEALTH DEPARTMENT `yU
Environmental Health Section
P. O. Boa 848/210 Hospital Street
Mocksville, NC 27028
(336)751-8760
Account #: 990002642 Tax PIN/EH #: 5778-16-1591 '
Billed To: Jennifer Hellard Subdivision Info: Carter's Court Lot # 7
Reference Name: Location/Address: Williams Road -27006
rropuaeu raclmy. mubluunuu rrupeny aice. see map
ATC Number: 3392
AUTHORIZATION FOR WASTEWATER SYSTEM CONSTRUCTION
**NOTE** This Authorization for Wastewater System Construction MUST BE ISSUED by the Davie County Environmental
Health Section prior to issuance of any building permit(s). This Form/Authorization Number should be presented to
the Davie County Building Inspections Office when applying for building permit(s) (in compliance with Article 1 I of
G.S. Chapter 130A, Wastewater Systems, Section .1900 Sewage Treatment and Disposal Systems). THIS .
AUTHORIZATION FOR WASTEWATER CONSTRUCTION IS VALID FOR A PERIOD OF FIVE
/YEARS.
Environmental Health Specialist's Signature: & Date:
CERTIFICATE OF COMPLETION
E** The issuance of this Certificate of Completion shall indicate the system described on Improvement/Operation Permit
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.
7�y
lD 2 %.rt �✓ i2�
Septic System Installed B
rironmental Health Specialist's Signature : -4� - Date: CS X111 ��
DCHD 05/99 (Revised)
D E C 2ORTANT***
LICATION FOR SITE EVALUATION/IMPROVEMFM PERMIT & ATC
Davie County Health Department
EnvironmentaiHealth secY`ion
MARP.O. Box 848/210 Hospital Street
Mocksville, * NC 27028'}ice
E"RO(336) 751-8760 C.1�
COUNTY
SS APPLICATION CANNOT BE PROCESSED UNLESS ALL THE REQUIRED
.INFORMATION IS PROVIDED. Refer to the INFORMATION BULLETIN for instructions. -
1. Name to be Billed Contact Person(Ck Y
;Mailing Address 1/ •1.. - Home Phone I p I -A ..33
City/Stats/ZIP 10 (1, �(, (�Jl ��f NIC. UZ Business Phone
- 2. Name on Permit/ATC if Different than Above - --
Mailing Address - City/State/zip -
3. Application For: .0 Site Evaluation %'Kmprovement Permit/ATC, "❑ Both
4. System to service: ❑ House . ar Mobile Home - ❑ Business ❑ - Industry ❑ Other -
--5., I£. Residence: # People Bedrooms _`�_ -# Bathrooms_ ,
GI/Dishwasher ❑ Garbage Disposal 1"ashing Machine ❑ Basement/Plumbing ❑ Basement/No Plumbing
6. If Business/industry/Other: Specify type #.People # Sinks
# Commodes # Showers - #,Urinals # Water Coolers
IF FOODSERVICE: # Seats/ Estimated Water Usage (gallons per day) - -
7. Typeo£-water supply:. 6 County/City - ❑ Well ❑ Community "
a. Do you anticipate additions or expansions of the facility this system is intended to serve? ❑ Yes ."o
If yes, what type?
***IMPORTANT*** CLIENTS MUST COMPLETETHE REQUIRED PROPERTY INFORMATION REQUESTED -
BELOW. Either a PLAT or SITE PLAN MUST BESUBMITTED by the client with THIS APPLICATION.
Property Dimensions:. �a1
e-� � o-(9 - WRITE DIRECTIONS (from Mocksville) to PROPERTY:
Tax Office PIN:1,,1p IIS Q lsll l Aou 22T rd La;t,8�� lurr) "
Property Ad dress: Road Name lAJ&,q Y\`s2oa I I Psi tsrk-Vna-&xbg elo aboL+
T
City/zip r\ A 2 `) 3 }t� rill �-e ,S - -Q Y p (. l2% c }v
If in a Subdivision provide information, as follows: L ,11 ,G !.,7(d .&D Ila rn d c - on
Name: e"l L4 -He djri ckyp ) "
I Rel 0+1 Ie�.,�I �{ ey�� moble. k%rm
pe911 ty nagged• c� r, ve-
Section: Block: Lot: Date Pio i v rn �n I — O
This is to certify that the information provided is correct to the best of my knowledge. I undo Land &at any permit(s)
issued hereafter are subject to suspension or revocation, if the site plans or intended use change, or if the information .: -,
submitted in this application is falsified or changed. I, also, understand diet I mn responsible for all charges incurred from
this application.I, hereby, give consent to the Authorized Representative of the I iie Coq ty He th Depart(�ent
to enter upon above described property located in Davie County and owned by ! IP..YII1 1- �a v 1
to conduct all testing procedures as necessary to determine the site suitability.
DATE SIGNATURE
THIS AREA MAY BE USED FOR DRAWING YOUR SITE PLAN (Include all of the following: Existing and proposed
.1'�, property lines and dimensions, structures, setbacks, and septic locations).