160 Forest Drive Lot 38Dav
?016
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WARNING: THIS IS NOT A SURVEY
All data is provided as is withoult my or guarantee of any ldnd either expressed or implied Including but not limited to the
Impgedvaarantles of mmshmdability orrdness fora pMeualaruse. AN users 0 Davie Counlys GIS website shall hold harmless Me
County of Dante,North Carolina, its agents, consultants, contractors oremployees hon anyandaNdalmsoreausesofactiondueto
oraridngautoftheuseorinabilkyfouse eG datapmvidedbythiswebsie— -
Parcel Information..»
_
Parcel Number:
C714000001
Township:
Farmington
-- NCPIN Number:
5862869088
Municipality:
Account Number:
82522401
Census Tract:
37059-802
Listed Owner 1:
LANDY SCOTT
Voting Precinct:
SMITH GROVE
Mailing Address 1:
160 FOREST DRIVE
Planning Jurisdiction:
Davie County
City:
ADVANCE
Zoning Class: DAME COUNTY R-20
State:
NC
Zoning Overlay:
DAME COUNTY QD
Zip Code:
27006-9451
Voluntary Ag. District:
No
Legal Description:
LOT 38 CREEKWOOD ESTATES
Fire Response District:
SMITH GROVE
Assessed Acreage:
0.46
Elementary School Zone:
PINEBROOK
Deed Date:
3/2004
Middle School Zone:.
NORTH DAME
Deed Book/Page:
005420461
Soil Types:
GnB2
Plat Book:
0004
Flood Zone:
Plat Page:
171
Watershed Overlay:
DAVIE COUNTY
Building Value:
Outbuilding & Extra
Freatures Value:
Land Value:
Total Market Value:
Total Assessed Value:
[all
Davie County,
NC
All data is provided as is withoult my or guarantee of any ldnd either expressed or implied Including but not limited to the
Impgedvaarantles of mmshmdability orrdness fora pMeualaruse. AN users 0 Davie Counlys GIS website shall hold harmless Me
County of Dante,North Carolina, its agents, consultants, contractors oremployees hon anyandaNdalmsoreausesofactiondueto
oraridngautoftheuseorinabilkyfouse eG datapmvidedbythiswebsie— -
Pernuttee's �r DAVIE COUNTY HEALTH DEPARTMENT
Environmental Health Section
/ P.O. Box 848
PROPERTY INFORMATI#NLN-q
Directions to property:' r �/ % �,/ Mocksville, NC 27028 Subdivision Name:
�� r ✓ Phone #: 336-751-8760
/� �( 1f i r ✓...
AUTHORIZATION FOR Section: Z Lot: .
CC + WASTEWATER Tax Office PIN:#
OOZ[e 1 SYSTEM CONSTRUCTION /�O / �1
AUTHORIZATION NO: A Road Name,-&—es4 YJ r zip: c;ly�a
**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 I I of G.S. Chapter 130A, Wastewater Systems, Section .1900 Sewage Treatment and Disposal Systems)
/ ***NOTICE*** THIS AUTHORIZATION FOR WASTEWATER
n IS VALID FOR A PERIOD OF FIVE YEARS.
ENVIRONMENTAL HEALTH SPECIALIST DATE ISSUED
I
RESIDENTIAL SPECIFICATION: BUILDING TYPE -,I/—# 13EDROOMS .� # BATHS �_ # OCCUPANTS --e,'
GARBAGE DISPOSAL: Yes or No
COMMERCIAL SPECIFICATION: FACILITY TYPE # PEOPLE # PEOPLE/SHIFT # SEATS INDUSTRIAL WASTE: Yes or No
LOT SIZE TYPE WATER SUPPLY �15ESIGN WASTEWATER FLOW (GPD) 3�o NEW SITE REPAIR SITE
SYSTEM SPECIFICATIONS: TANK SIZE GAL.. PUMP TA �K / ,.,GAL. TRENCH WIDTH�4 ROCK DEPTH lam' LINEAR F�40
OTHER d C `I ( �Ve i c S , /- ",)
REQUIRED SITE MODIFICATIONS/CONDITIONS:
IMPROVEMENT PERMIT LAYOUT
,.0
lot,
F
11 FOR FINAL INSPECTION OF THIS SYSTEM PLEASE CALL BETWEEN 8:30 - 9:30 A.M. ON THE DAY OF INSTALLATION. TELEPHONE # IS (336) 751.8760. II
OPERATION PERMIT
AUTHORIZATION NO. G / OPERATION PERMIT BY:
SYSTE ,
-2q
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 02102 ntevis ) JW1W q :99140 'T/ I/'A in., ri7 Z:�-n
Pe'ttee s,%- - t 1 ,? a „f'• :DAVIE CPUNi HEALTH DEPAkTMENT
y ,'invironmental Health Section ' PROPERTY INFORMATION �k
P.O. Box 848
Director s to property: �� %'r" Mocksville, NC 27028 Subdivision Name:
Phone#:336-751-8760 / I
Section: ! Lot-
AUTHORIZATION FOR
WASTEWATER Tax Office PIN:#
SYSTEM CONSTRUCTION. // r
AUTHORIZATION NO: 00261'' A R� Name;/—Q%C'S l Zip:a
**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 FornVAuthorizaiionNumber should be presented to the Davie County Building Inspections
Office when applying for Building Permits. Ik
(Incompliance with Article I I of G.S. Chapter 130A, Wastewater Systems, Section .1900 Sewage Treatment and Disposal Systems)
***NOTICE*** THIS AUTHORIZATION FOR WASTEWATER CONSTRUCTION
-
- • ' " 'i�" �'- ( IS VALID FOR A PERIOD OF FIVE•YEARS.
ENVIRONMENTAL HEALTH SPECIALIST DATE ISSUED
RESIDENTIAL SPECIFICATION: BUILDING TYPE - #;gEUROOMS #BATHS 7 # OCCUPANTS —4�,— GARBAGE DISPOSAL: Yes or No
COMMERCIAL SPECIFICATION: FACILITY TYPE ' !# PEOPLE # PEOPLE/SHIFT . # SEATS _ INDUSTRIAL WASTE: Yes or No
LOT SIZE TYPE WATER SUPPLY r'�, DESIGN WASTEWATER FLOW (GPD) ��NEW SITE REPAIR SITE_�'•�
SYSTEM SPECIFICATIONS: TANK SIZE GAL. PUMP TANK GAL. TRREENCH WIDTH G ROCK DEPTH rLINEAR FT�C.Q./
OTHER
60- r n Ve-1r;'SS
REQUIRED SITE MODIFICATIONS/CONDITIONS: ( -
FOR FINAL INSPECTION OF THIS SYSTEM PLEASE CALL BETWEEN 8:30 - 9:3,0 A.M. ON THE DAY OF INSTALLATION. TELEPHONE # IS (336) 751-8760.
OPERATION PERMIT SYSTEMI T LED Y: \ /l /� /''?
�2
/V�0�
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 I1 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 FU
NCTION SATISFACTORILY FOR ANY GIVEN PERIOD OF TIME.
DCHD 07/02 (Revised)il7/]'j-2SrI,G?
_71141 I/ n i no ... i'�i 7 4 f
DAVIE COUNTY ENVIRONMENTAL HEALTH SECTION
APPLICATION FOR IMPROVEMENT PERMIT (REPAIR)
NAME SC0/-{T {{--Z4ktCJV �J ,^�// PHONE NUMBER IW -0,576,_//.-' /J
ADDRESS �IYO YO/Pi� �JZ. Allfax/C2 /VC SUBDIVISION NAME dfee, .u/OQri'
h_ OZ 70'0& LOT # /
DIRECTIONS TO SITE &Nle% 6 (/► Jeri--
�l^�1t OGf S2 /l9lf
DATE SYSTEM INSTALLED NAME SYSTEM INSTALLED UNDER
TYPE FACILITY om—L NUMBER BEDROOMS NUMBER PEOPLE
/SERVED ((/
PE WATER SUPPLY O PECIFY PROBLEM OCCURRING NOS
/ 4 1, n //
DATE
This is to certify that the information provided is correct to the best of my
SIGNATURE OF OWNER OR AUTHORIZED AGENT
Rev. IM
TAKEN BY
do,ll -# ?k/ q
inmmed from this application.
DAVIE COUNTY HEALTH DEPARTMENT
(Septic Tank) Improvements Permit and Certificate of Completion
` `(Ground Absorption Sewage Disposal System - G.S. Chapter 130 -Article 13C)
OWNER OR CONTRACTOR DATE la -i - 35 PERMIT
LOCATION n 1 i a. . "r , 1\� t ry p
O 4
S.R. NO.
SUBDIVISION NAME C' ,.r , r,, ,;,,,_ �i 'y c._,tt s LOT NO. RNV SECTION OR BLOCK N0.
HOUSE (I MOBILE HOME 0 BUSINESS ❑
House Trailer 860 Gal. 400 Sq. Ft.
NO., BEDROOMS '.+ NO. BATHROOMS Two Bedroom House 800 Gal. 600 Sq. Ft.
GARBAGE DISPOSAL UNIT YES ❑ NO ❑ 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 ❑ ----s._,
SITE SUITABLE _ YES ❑ NO ❑
SIZE OF TANK gal.': 1 la .wk
NITRIFICATION FIELD sq. ft.
DEPTH OF STONE IN LINES:
WATER SUPPLY: Individual Q Public ❑
IMPROVEMENTS PERMIT BY Cis da INSTALLED BY
i
CERTIFICATE OF COMPLETION 67
By yy Date
(8/16/73) *Construotion must co ply'with'all other applicable State and local regulations
LOT AREA
z
t . DAVIE COUNTY HEALTH DEPARTMENT
(Septic Tank) Improvements Permit and Certificate of Completion
i
(Ground Absorption Sewage Disposal System - G.S. Chapter 130 -Article 13C)
OWNER OR CONTRACTOR n,, 1r, ,� ., �O %...•, I A„t DATE la -t - )N- PERMIT �y p
LOCATION C(o\ fur c,. 1\9. (O4
S.R. NO.
SUBDIVISION NAME { ,,t.,,,,_.,ti c .-2,,trs LOT NO. 3Y SECTION OR BLOCK NO.
NO. BEDROOMS .'.24
GARBAGE DISPOSAL UNIT
AUTO. DISHWASHER
AUTO. WASH. MACHINE
SITE SUITABLE
SIZE OF TANK
NITRIFICATION FIELD
NO. BATHROOMS
YES
❑
NO
❑
YES
❑
NO
❑
YES
❑
NO
❑
YES
❑
NO
❑
— gal.
Ft.
Four Bedroom House
DEPTH OF STONE IN LINES:
WATER SUPPLY: Individual
IMPROVEMENTS PERMIT BY R
By—
(8/16/73) *Construction must
LOT AREA
sq. ft.
Public ❑
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.
INSTALLED BY
Y`Ou"'�' Date of -/—/to
with all other applicable State and local regulations
neS�l� 1
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