249 Hidden Creek Drive Lot 19Davie County, NC Tax Parcel Report Thursday, January 26, 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 1S NOTA SURVEY
Parcel Information
E9150A0019
Township:
Farmington
5871471252
Municipality:
SHADY GROVE
8304809
Census Tract:
37059-803
HOCEVAR FRANK & ELLEN LIV TRST
Voting Precinct:
HILLSDALE
249 HIDDEN CREEK DRIVE
Planning Jurisdiction:
Davie County
Advance
Zoning Class: DAVIE COUNTY R-20-S,R-A
NC
Zoning Overlay:
DAVIE COUNTY QD
27006
Voluntary Ag. District:
No
Land Value:
Total Assessed Value:
LOT 19 HIDDEN CREEK
Fire Response District:
ADVANCE
0.91
Elementary School Zone:
SHADY GROVE
3/2015
Middle School Zone:
WILLIAM ELLIS
009820020
Soil Types:
Gn82
0005
Flood Zone:
179
Watershed Overlay:
DAVIE COUNTY
Outbuilding & Extra
Freatures Value:
Total Market Value:
9luvul�
Davie County,
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
NC
County of Davie, North Carolina, Its agents, consultants, contractors or employees from any and all claims or causes of action due to
or arising out of the use or Inability to use the GIS data provided by this website.
HEALTH .DEPARTMENT RELEASE
aK6 Davie County Health Department
r� 210 Hospital Street
P.O. Bax 848
Mocksville NC 27028
Phone: 336-753-6780 Fax: 336-753-1680
Applicant: Frank and Ellen Hocsvar
Address: 249 Hidden Creek Drive
City:
Advance
State2ip: NC
Phone #: (336) 940-3456
27006
r For Office Use Oniy
*CDP File Number 196021 -1
County ID Number:
Evaluated For: HDRNVWC
PERMIT VALID 0 8/ 1 7/ a 0 a 0
UNTIL:
r
erty Owner: Frank and Ellen Hocsvar
ess: 249 Hidden Creek Drive
City: Advance
State0p: NC 27006
\11P-1one #: (336) 940-3456
I,— Property Location & Site Information
Address Hidden Creek Drive Subdivision: Hidden Creek Phase: Lot 19
Road Advance NC 27006
SINGLE FAMILY Township:
*Structure: Directions
# of Bedrooms: 3 # of People: Hwy 158, left on Hwy 801 going North right on Hidden Creek Drive
'Water Supply: NIA
Basement: ❑ Yes D No
'Proposed Improvement:
Screened Porch
Type of Business:
Total sq. Footage: No. Of Employees:
Pump out septic tank, crush, and replace with a new 1,000 gallon tank that is to be placed a minimum of foot from the foundation.
This release in no way expresses or implies that the existing subsurface sewage treatment and disposal
system serving the site will continue to function for any period of time.
Applicant/Legal Reps. Signature Required? Oyes ONO
Applicant/Legal Reps. Signature; *Date: / /
*Issued By: 2140 -Nations, Robert
Authorized State Agent:
*Date of Issue: 0 8% 1 7/ 2 0 1 5
**Site Plan/Drawing attached.**
0 Hand Drawing 0Import Drawing
HEALTH DEPARTMENT RELEASE
Davie County Health Department CDP -File Number: 196021 -1
210 Hospital Street
P.O. Box 848 County File Number:
Mocksville NC 27028 Date: 08/ 1 7/ 2 0 1 5
Olnch
Scale: . OBiock = ft.
Drawing Type: Health Department Release ON/A
0
I
k
0.. �,
11
Page 2 of 2� -
. 4doo b4ald em".
Davie County Healtmnrpamnent ,
A836
� ityl ,wwronmental Health Section pAID
P.O. Box 848 Date;
C'Lejolved by! WNW
-7 210 Hospital Street '
Courier # :09-40-06
Mocksville, NC 27028
Phone: (336) - 753 - 6780 Fax: (336) - 753-1680
ON-SITE /•WASTEW ER CERTIF CATION
(Check One) Replaceme emodeling Reconnection
A
Name: / �N1C �l.U� d�/'VA � Phone Number � ' �Y O'J7.��/ (Home)
Mailing Address: oZw��/dzlt— V ' ow. I (Work)
Q%S&/I& 'e,'R%a6 Email Address:
Detailed Directions To Site: /U%Rrll0/✓ gal "Ro41 1,5,5, ��gGLTOrt/TO ��/��E/✓
Property Address: a7e6K119 i`(�
Please Fill In The Following Information About The EXISTI G Facility: �f
Name System Installed Under: LAA ,/t//y/L Avel'l% Type Of Facility: uSPi
67
Date System Installed (Month/Date/Year): `7 - /`/ '-
aa Number Of Bedrooms:_Number Of People: 4.71
Is The Facility Currently Vacant? Yes 6) If Yes, For How Long?
Io
Any Known Problems? Yes If Yves, Explain:
Please Fill In The Following Inf rm tions/A,,bou/t The
�NlEW Facility:
Type Of Facility: 'Z %Ome m ba 1 ! & Y2L7 Number Of Bedrooms: Number of People
Pool Size: Garage Size: Other: c5kei '1lL% / ;/wrl & /(0 f 2- (10
Requested By: Date Requested: Q- 777/.-15'
(Signature)
For Environmental Health Office Use Only
Approved Disapproved
Environmental Health Specialist Date:
*The signing of this form by the Environmental Health Staff is in no way intended, nor should be taken as a guarantee
(extended or limited) that the on-site wastewater system will function properly for any given period of time.
Payment: Cash Check) Money Order # /0 & 2- Amount:$
Paid By: Received By:_
Account #: ! V Z Invoice #:
Date: X- /-
6AVIE COUNTY HEALTH DEPARTMENT
r� IMPROVEMENTS PERMIT AND CERTIFICATE OF COMPLETION
'NOTE: Issued in Compliance with G.S. of North Carolina Chapter 130 Article 13c
Se% age Treatment and D'sposV Rules (10 NCAC 10A .1934-. 8 Permit Number
Name _G,���lj
' Date `_
Location _= --- ------------ . t
Subdivision Name
Lot Size 4ti�_
House
Mobile Home -- Business
No. Bedrooms _—
No. Baths
No. in Family
Garbage Disposal
YES 0 NO Q
Specifications for System -
Auto Dish Washer
YES G':t NO r
Auto Wash Machine
YES Lj NO p
Type Water Supply
Speculation
/r
This permit Void if sewage system described below is ngt•installed within 36 months from date of issue.
Z
y
{
4
I � y
: i I
1-• 1 i
t
Improvements permit by – _
'Contact a representative of the Davie County Health Department for final inspection of this system between &30-
9:30 A.M. or 1:00.1:30 P.M. on day of completion. Telephone Number: 704-634-5985.
Final Installation Diagram:
Certificate of Completion — ���C Date
'The signing of this certificate shall indicate that the system described above ties been installed n co pliance with
the standards set forth in the above regulation, but shall in NO way be taken as a guarantee that the system will function
salisfactorily for anv oiven Deriod of time.
Building Sketch
RorrOw8i frank J. Hocevar
Non ACCt2SS 249 Hidden Creek Dr
C Advance COOOII Davie sn"r, NC %p COU 27806
-- -.___ .. ----- - ....................... -------..........................................................-_.
Lenuf Faimay Independent MgMept of VA
I
xa
Cofttroto Pi tip
5r,? cra Pi.
27.83'
' Master Raster
Brkfst Bedrm Bath
Area Den i ivif ire PCt,1111
Fit" f=loor
Kitchen 1,2:417 7", ;q Tl; v
Bath #2
i�
M
Foyer
1/2 Dining Bedrm Bedrm
Bath Room #2 #3
Porch
[rq.93 Ott,
Ou,"If y ________
13sa' toss• 25.83'
T
18•
m 2 Alt Garage
N 162.4 25. 1(1 it] W
25'
'"^'^t• ^* 6- -
Arty Cakataftsat Samary
Living Area
takr1ar6" Osts"
hmi H(xa
? I V; I4'.x:?t
35.75. 2583 = 923.42
2x4.08 - 8.16
42.91 x25.67 - 1088.65
12 x 18 = 215
13.58 x 6 _ 61.48
Tauri Lk xg Situ 4pcnsdoin
2318 S4 h
ftai.#rta{ Lea
Porch
64.98 Sq ft
6. 10.63 = 64.%
2 Alt Garage
524,25 SL it
25 x 24,8:3 .- 6X.75
4.5 a 7 3.5
Commte Pat"
553 64 ft
3ii.5 a 14 553
Form 80.86W-,W:IITOTAL" appraisal software by a la mote, irtc. - t -200 -ALA ON
M
-1
M .1 .— — 7fr—PKi;Effll
�..I!.E.; � Mj—L�H 1 0��-9
Plat Map
Borrower Frank.J. Hocavar
Proper Accf8SS 249 Hidden Crook Dr
Cis" Advance CGUIty Davie S'We NC 0 Core 27006
. . ..... . ...... ........ ......
-
Lender Fairway Indopondent MtgfDept of VA
4b -
All
1
Z9,
C% e PC
-0
04
C-
– iv
..........
19
20
Jim
3:
----------
001
MO. 00,
Form tIAP.PLAT — 'WinTY AL' appraisal SoNare by a la mode, inc. — I -WO-ALAN10DE
I �i
DAVIE COUNTY HEALTH DEPARTMENT
r� IMPROVEMENTS PERMIT AND CERTIFICATE OF COMPLETION
'NOTE: Issued in Compliance with G.S. of North Carolina Chapter 130 Article 13c
Sewage Treatment and D'sposV Rules (10 NCAC 10A .1934-.W8) Permit Number
NameDate
'
Location >" 94 14
Subdivision
Lot No. Sec.
Lot Size `=Agj House t-� Mobile Home _ Business _— Speculation _
No. Bedrooms --"L_ No. Baths No. in Family
Garbage Disposal YES ❑ NO ❑ Specifications for System -
Auto
Auto Dish Washer YES [h NO ❑
Auto Wash Machine YESstj 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:
dtio
l'
,kktt
Certificate of Completion —Date
jr V
"The signing of this certificate shall indicate that the system described above has been installed n corvpliance 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 anv given period of time. ,
,a..� � .,... �. - ......«�.�-w.-r._.......�,-..v..`-v--.•w... - .. ... ..� �....-1.Lw.. .. � 'v^ w.-... .^....,..-..-r-..n, p -w .. � s.. i� P'.., ..-. .:. s:...� .-.. �.. . .e -. -- ..
�. 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 Treatment and Disposal Rules (10 NCAC 10A .1934-.1968) j Permit Number
Name' '-r' r.� r` • ' ;:,', _ `� `' Date
Location!—
Subdivision Name -;'` rr ''r;,'/� -f' Lot No. ,/rSec. or Block No. r
Lot Size
House
r-� Mobile Home
— Business -- Speculation
No. Bedrooms ='
— No. Baths
-' ' ' No. in Family
- —
Garbage Disposal
YES ❑ NO
❑
Specifications for System:
Auto Dish Washer
YES (] NO
❑
1 - '--' ��'
'
Auto Wash Machine
YES h NO
❑
"`" ' +'�
Type Water Supply
l.°
*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 HeaIIth 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.
1 — --
Final Installation Diagram:
I
r�>
i
I�2rt
nstalled
Certificate
r -
of Completion �`�'� *='� Date ! __
'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.
�i APPLICATION FOR SITE EVALUATION/ IMPROVEMENTS PERMIT S10 O
f Davie County Health Department Q
Environmental Health Section
P. O. Box 665
Mocksville, N.C. 27028
CONSTRUCTION SHALL NOT BEGIN UNTIL IMPROVEMENTS PERMIT HAS BEEN ISSUED.
1. Permit Requested By J T -'f
2. Address 4810 SP1145
kl-
Home Phone 74 83 9S%
Business Phone %ZZ S-6 24
3. Property Owner if Different than Above 4/aT-.0 "/ % Ni�d d Eel CR ES
Address OF- cCFO / P I/A-4 C C
4. Permit To: a) Install Alter Repair
b) Privy Conventional Other Type
Ground Absorption q
c) Sub- Division s/OOe4eizeEI Sec. Lot No.
5. System used to serve what type facility: House X Mobile Home Business
Industry Other
b) Number of people 4 # Z
6. a) If house or mobile home, state size of home and number of rooms.
House Dimensions 24-00 Ib 34 X & 8 CO D,D L -SHA PE_)
Bed Rooms— Bath Rooms -Z 7 Den w/Closet A10
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 S showers �•
dishwasher sinks
8. a) Type water supply: Public v� Private Community
b) Has the water supply system been approve Yes '�No
9. a) Property Dimensions Fz-"N`z' .' 100 1 Q. 510 e ;.3 10'
garbage disposal
washing machine
I
/Rn
b) Land area designated to building site ! rA G
C) Sewage Disposal Contractor C • a• �AQ r1"(J�= 3"4 a e'9 Al %BSL
10. Do you anticipate any additions or expansions of the facility this sewage system is intended to serve?
What type?
This is to certify that the information is corre he est of my wled e.
3/ a --- - 4w�'
Efate Owner ignature
OWNER IS SOLELY RESPONSIBLE FOR COMPLIANCE ITH A STATE A �OCALLAWS
Allow 5 days for processing
Directions to property:
& L BURTON COMPANY
GENERAL CONTRACTOR
4810 SPILSBY LANE
WINSTON-SALEM. NC 27104
DCHD (6.82)
A
DAVIE COUNTY HEALTH DEPARTMENT
ENVIRONMENTAL HEALTH SECTION
SITE EVALUATION CONSENT FORM
1. Complete the form below and return to the Davie County Health Department.
2. Carefully follow the procedures as outlined in the enclosed "Information Bulletin."
NOTE: THE ABOVE MUST BE COMPLETED BEFORE A SANITARIAN WILL BE ABLE TO
BEGIN THE REQUESTED EVALUATION.
DETACH HERE AND RETURN TO: Davie County Health Department, Environmental
Health Section, R O. Box 665, Mocksville, N.C. 27028
Davie County Health Department
Environmental Health Section
Site Evaluation Consent Form
LOCATION OF PROPERTY: DATE RECEIVED
L , (
ar 10) �i1D17r~� CREEK office use only)
yes no
yes no
es no
DCHD (11 /84)
1. 1 am the owner of the above described property.
2. 1 am not the owner of the above described property, however, I certify that I
3.
have consent from , owner to obtain a
owner's name
site evaluation by the Davie County Health Department for the purpose of
determining the suitability for a ground absorption sewage treatment and
disposal system.
hereby give consent to the authorized representative of the Davie County
Health Department to enter upon the above described property and conduct all
testing procedures as necessary to determine its suitability for a ground
absorption sewage treatment and disposal sys em.
_
Av& . -3
DATE
4. 1 hereby authorize the Davie Cou
evaluation results from the above described property to the following:
Owner only
Owners designated representative
Anyone requesting results
— Only those listed below
v .3
r�
DATE
S. L BURTON COMPANY
GENERAL CONTRACTOR
4810 SPILSBY LANE
Address
K
E
9)
DAVIE COUNTY HEALTH DEPARTMENT
Environmental Health Section.
P. O. Box 665
Mocksville, N.C. 27028
SOIL/SITE EVALUATION
Date
Lot Size
FACTORS AREA 1 AREA 2 AREA 3 ARFA d
1) Topography/ Landscape Position
S
S
S
S
PS
PS
PS
PS
U
U
U
U
?) Soil Texture (12-36 in.) Sandy,
S
S
S
S
Loamy, Clayey, (note 2:1 Clay)
PS
PS
PS
PS
U
U
U
U
!) Soil Structure (12-36 in.)
S
S
S
S
Clayey Soils
PS
PS
PS
PS
U
U
U
U
l) Soil Depth (inches)
S
S
S
S
PS
PS
PS
PS
U
U
U
U
i) Soil Drainage: Internal
S
S
S
S
PS
PS
PS
PS
U
U
U
U
External
S
S
S
S
PS
PS
PS
PS
U
U
U
U
�) Restrictive Horizons
Available Space
S
S
S
S
PS
PS
PS
PS
U
U
U
U
1) Other (Specify)
S
S
S
S
PS
PS
PS
PS
U
U
U
U
Site Classification
U—UNSUITABLE
Recommendations/Comments:
S—SUITABLE PS—Provisionally Suitable
Described by Title Date
SITE DIAGRAM
DCHD (6.82)
DAVIE COUNTY HEALTH DEPARTMENT
Environmental Health Section
P. O. Box 665
Mocksville, N.C. 27028
SOIL/SITE EVALUATION
Name � r' �-- < < P�` Date
Address Lot SizefOIX-10xlee"Iro
FACTORS AREA 1 AREA 2 AREA 3 AREA 4
Topography/ Landscape Position
S
S
P
PS
PS
U
U
U
!) Soil Texture (12-36 in.) Sandy,S
Loamy, Sj� , (note 2:1 Clay)
P
PS
S
PS
U
U
1) Soil Structure (12-36 in.)
Clayey SoilsPS
S
PS
S
PS
U
U
Soil Depth (inches)
-&
S
S
PS
PS
PS
PS
U
U
U
U
Soil Drainage: Internal�
S
PS
S
PS
p
CP
U
U
U
Externaly
(per
S
PS
S
PS
U
U
U
U
{) Restrictive Horizons
Available Space
SS
S
PS
S
PS
U
U
U
U
1) Other (Specify)
S
PS
S
PS
S
PS
S
PS
U
U�
U
U
1) Site Classification
/� ,
.r ,.
U—UNSUITABLE
Recommendations/Comments:
Described by /
SITE DIAGRAM
"Vw
b�-
DCHD (6.82)
S—SUITABLEr Provisional{y Suitable
Date
b�l
OFFICE OF THE OIRECTOR
ttbie (1�aun#� �ettl#� � epttr#men#
ttna dame �ettl#� �gent�
P. O. BOX 665
,ioc(ssbille, North Carolina 27028
May 2, 1988
Hubbard Realty
285 S. Stratford Rd.
Winston-Salem, NC 27103
Attn: Lilly Saad
Re: Sewage Disposal Installation
Hidden Creek/Lot 19 -Sec. 1
Dear Realtor:
The septic system was installed at the aforementioned address
on April 14, 1988• At the time of installation, the system met
the requirements of the North Carolina sewage disposal laws. As
of this date, the househas not been occupied. Therefore, the system
can be expected to function as designed.
Sincerely,
)KI
Robert B. Hall, Jr., R.S.
Environmental Health
RH/wd
TELEPHONE
17041 634.5095