150 Shadybrook Road Section 1 Lot 2Davie County, NC Tax Parcel Report Tuesday, January 24, 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:
w
173 ! 205
191
� 173
165
)03
150
140 tI
O 12 2 _
11
157
vQ, '0
WARNING: THIS IS NOT A SURVEY
Parcel Information
J6050B0002
Township:
Fulton
5758901700
Municipality:
22888000
Census Tract:
37059-804
DYER JAMES HAROLD
Voting Precinct:
FULTON
150 SHADY BROOK ROAD
Planning Jurisdiction:
Davie County
MOCKSVILLE
Zoning Class: DAVIE COUNTY R-20
NC
Zoning Overlay:
27028-0000
Voluntary Ag. District:
No
LOT 2 HICKORY HILL SECTION 1
Fire Response District:
FORK
Land Value:
Total Assessed Value:
0.47 Elementary School Zone: CORNATZER
12/1975 Middle School Zone: WILLIAM ELLIS
000970184 Soil Types: GnB2,GnC2
0004 Flood Zone:
105 Watershed Overlay: DAVIE COUNTY
Outbuilding 8r Extra
Freatures Value:
Total Market Value:
1—&
All data Is provided as Is without warranty or guarantee of any kind either expressed or Implied Including but not limited to thDavie County, Implied warranties of merchantability or fitness for a particular use. All users of Davie Countys GIS website shall hold harmless the
County of Davie, North Carolina, Its agents, consultants, contractors or employees from any and all dalms or causes of action due to
NC or arising out of the use or Inability to use the GIS data provided by this webslte.
DAVIE COUNT' HULTH DEPARTMENT �Q �y i�(Glc"'
; ptic Tank) Improvements Permit and Certificate of Completion
(Ground Absorption Scwage Disposal System - G.S. Chapter 130 -Article 13C)
OWNER OR CONTRACTOR DATE PERMIT��,"
LOCATION �-^�; t i'isr. /�, is ;'}+�' ,,. r" ::, N� 4 6 3
SUBDIVISION NAME
S. R. NO.
LOT NO. + SECTION OR BLOCK NO.
HOUSEMOBILE HOME [_J BUSINESS C
NO. BED OOMS IV NO. BATHROOMS
GARBAGE DISPOSAL UNIT YES ❑ NO ,
AUTO. DISHWASHER YES NO ` ❑
AUTO. WASH. MACHINE YES NO ❑
SITE SUITABLE YES NO ❑
SIZE OF•TANK gah.
NITRIFICATION FIELD sq. ft.
DEPTH OF STONE IN LINES:
WATER SUPPLY: Individual,. ❑ Public {
IMPROVEMENTS PERMIT BYE. f•. G, �'�'�^
House Trailer 800 Gal. 400 Sq. Ft.
Two Bedroom House 800 Gal. 600 Sq. Ft.
Three Bedroom House0 Gall, 290_.4 ,—Ft,
Four Bedroom House p.1,0Ga1.,� r12QQ.„9q-,-,Zt.-,
TALLED BY / .T Gf ti
CERTIFICATE OF COMPLETION By Date
(8/16/73) *Construction must co ly with all other applicable State and local regulations
LOT AREA
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DAVIE COUNTY ENVIRONMENTAL HEALTH
P.O. Box 848/210 Hospital Street
Mocksville, NC 27028
• (336)753-6780 / Fax # (336)753-1680
REPAIR OPERATION PERMIT
Account #:
990005451
'fax PINIEH #:
5758-90-1700
Billed To:
Harold Dyer
Subdivision Info:
Hickory Hill Lot # 2
Deference Name:
REPAIR PERMIT
Location/Address:
150 Shadybrook Road -27028
Proposed Facility:
Residential Repair
Property Size:
0.478 Acre
ATGWT9 :ThRMance of this Operation Permit shall indicate the system described on the ATC 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.
System Type: S.T. Manufacturer Tank Date 7 /f &kank Size
Pump Tank Size
System Installed By: E.H. Specialist: ri te:
GPS Coordinate:
0
DCHD 11/06 (Revised)
DAVIE COUNTY ENVIRONMENTAL HEALTH
P.O. Box 848/210 Hospital Street
' Mocksville, NC 27028
(336)753-6780 / Fax 4 (336)753-1680
t
AUTHORIZATION FOR WASTEWATER SYSTEM CONSTRUCTION
Account #: 990005451 Tax PIN EH #: 5758-90-1700
Billed To: Harold Dyer Subdivision Info: Hickory Hill Lot # 2
Reference Blare: REPAIR PERMIT LocationlAddress: 150 Shadybrook Road -27028
Proposed Facility: Residential Repair Property Size: 0.478 Acre
Site Type: ❑New D(Repair ❑Expansion
ATC Number: 5744
**NOTE** This Authorization to Construct (ATC) MUST BE ISSUED by the Davie County Environmental
Health Section prior to -issuance of any building permit(s), (in compliance with Article 11 of G.S. Chapter 130A
Wastewater Systems, Section .1900 Sewage Treatment and Disposal Systems). THIS AUTHORIZATION TO
CONSTRUCT IS VALID FOR A PERIOD OF FIVE YEARS. This ATC is subject to revocation if site plans, plat
or the intended use change.
Residential Specifications: # Bedrooms # Bathrooms # People_ 7 Basement❑ Basement plumbing3
Non -Residential Specifications: Facility Type # People # Seats
Square Footage(or Dimensions of Facility)
Lot Size Type of Water Supply: (County/City ❑Well ❑Community Well
System Specifications: Design Wastewater Flow (GPD) Gy Tank Size GAL. Pump. Tank GAL.
Trench
i 1
Site Modifications/Conditions/Other:
Contact the Davie County Environmental Health Section for final inspection of this system between
Environmental Health Specialist
DCHD 11/06 (Revised)
**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 Pen -nits.
(In complia e,�ith Article I I 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.
ENVIRONMENTAL HEALTH SPECIALIST DATE ISSUED
RESIDENTIAL SPECIFICATION: BUILDING TYPE
# BEDROOMS
3 # BATHS �# OCCUPANTS
GARBAGE DISPOSAL: Yes or No
COMMERCIAL SPECIFICATION: FACILITY TYPE
Permittee', / ��/
DAVIE COUNTY
HEALTH DEPARTMENT
Environmental
Health Section
PROPERTY INFORMATION
Directions %'
P.O. Box 848
to property:
Mocksville, NC 27028
Subdivision Name:
Phone #: 336-751-8760
Z
Section: Lot:
�' rfAUTHORIZATION
1" r '', ,
FOR
WASTEWATER
Tax Office PIN:" - Q D
O
4► �'.1
� ±s�' �_.f� ,.� r
SYSTEM CONSTRUCTION
t. r�/`�•. "r %' �l G. rf..
"ic
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�j �C l •.l
AUTHORIZATION NO:
. - °. ,.�
Road Name:
Ztp
**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 Pen -nits.
(In complia e,�ith Article I I 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.
ENVIRONMENTAL HEALTH SPECIALIST DATE ISSUED
RESIDENTIAL SPECIFICATION: BUILDING TYPE
# BEDROOMS
3 # 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
SYSTEM SPECIFICATIONS: TANK SIZE ! r GAL.
REQUIRED SITE MODIFICATIONS/CONDITIONS:
IMPROVEMENT
_ DESIGN WASTEWATER FLOW (GPD) 36-0 NEW SITE REPAIR SITE
PUMP TANK I�// ' AL. TRENCH WIDTH L ROCK DEPTH4-LINEAR FT.
r7 ;
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. 1
OPERATION PERMIT
SYSTEM INSTALLED BY:
2
o16AUTHORIZATION NO. OPERATION PERMIT BY: �' 9%'' �' DATE: ✓/
"THE ISSUANCE OF THIS OPERATION PERMIT SHALL INDICATE THAT THE SYSTEM DESCRIBED ABOVE HAS BEEN INSTALLED IN COMPLIANCE
WITH ARTICLE I 1 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 O2tO2 (Revised) ilr5/w —1 r / If / 7;M
rdr/
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. 1
OPERATION PERMIT
SYSTEM INSTALLED BY:
2
o16AUTHORIZATION NO. OPERATION PERMIT BY: �' 9%'' �' DATE: ✓/
"THE ISSUANCE OF THIS OPERATION PERMIT SHALL INDICATE THAT THE SYSTEM DESCRIBED ABOVE HAS BEEN INSTALLED IN COMPLIANCE
WITH ARTICLE I 1 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 O2tO2 (Revised) ilr5/w —1 r / If / 7;M
P rmittee's % ,% �y DAVIE COUNTY HEALTH DEPARTMENT
Environmental Health Section PROPERTY INFORMATION
• .�..,'• .., �• {..: P.O. Box 848
Directions to property: Mocksville, NC 27028 Subdivision Name:
` Phone #: 336-751-8760
Section: Lot: z
/ AUTHORIZATION FOR
WASTEWATER Tax Office PIN:# - C/o
SYSTEM CONSTRUCTION
AUTHORIZATION NO: A j' Road Name r /f ` ` zip:' f c�
**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 Fonn/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)
;� r ✓• ,,r /rt ***NOTICE*** THIS AUTHORIZATION FOR WASTEWATER CONSTRUCTION
IS VALID FOR A PERIOD OF FIVE YEARS.
ENVIRONMENTAL HEALTH SPECIALIST DATE ISSUED
RESIDENTIAL SPECIFICATION: BUILDING TYPE # BEDROOMS # BATHS # OCCUPANTS GARBAGE DISPOSAL: Yes or No
COMMERCIAL SPECIFICATION: FACILITY TYPE # PEOPLE # PEOPLE/SHIFT/` # SEATS C INDUSTRIAL WASTE: Yes or No
LOT SIZE TYPE WATER SUPPLY (� DF�SIGN WASTEWATER FLOW (GPD) . 31�G" �1A7W' SITE REPAIR SITE
SYSTEM SPECIFICATIONS: TANK SIZE * r 'GA/PUMP TANK �I1GAL. TRENCH WIDTH 1 ROCK DEPTH `4 'LINEAR FT.
OTHER (�
4 l
REQUIRED SITE MODIFICATIONS/CONDITIONS:
IMPROVEMENT
a I
r ..
�� .
ICJ
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.
OPERATION PERMIT
SYSTEM INSTALLED BY:
"i
a 9 `12-
Cy' OPERATION PERMIT BY: / a /_� l ��
AUTHORIZATION NO. � OPER DATE: ,...� -
**THE ISSUANCE OF THIS OPERATION PERMIT SHALL INDICATE THAT THE SYSTEM DESCRIBED ABOVE HAS BEEN INSTALLED IN COMPLIANCE
WITH ARTICLE 1 I OF G.S. CHAPTERT130A, 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.
»CHo OM2 (Revised)5q5-1�N 0, � ZZ9
eaff h'e-(dt&- (q&0 Da� Udiwl(5 /,abl has Am,
DAVIE COUNTY ENVIRONMENTAL HEALTH SECTION / /�!!
APPLICATION FOR IMPROVEMENT PERMIT (REPAIR) 6fi, % T 0-1736%*
ADDR
DIRECTIONS TO
_ PHONE NUMBER 'W yI&I
'," SUBDIVISION NAME
LOT #
:51 /16el pxs- ear v
e a er655
-e !
IF ,
DATE SYSTEM INSTALLED /175 NAME SYSTEM INSTALLED UNDER
TYPE FACILITY NUMBER BEDROOMS NUMBER PEOPLE SERVED
TYPE WATER SUPPLY u`7 SPECIFY PROBLEM OCCURRING Q�P��/U/V� OVCi
'p_11.
�I . Gt �`�f Irl �q l IU
DATE REQUESTED 94'16 INFORMATION TAKEN BY
wmpt"'
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
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DAVIE COUNTY HEALTH DEPARTMENT
(Septic Tank) Improvements Permit and Certificate of Completion
(Ground Absorption Swage Disposal System G.S. Chapter 130 -Article 13C)
OWNER OR CONTRACTOR AA"; ri, DATE 5- PERMIT
N? 463
LOCATION
U/ S.R. NO.
SUBDIVISION NAME LOT NO. SECTION OR BLOCK NO.
I . 1* (-11'
HOUSE
HOME LJ BUSINESS LJ
NO. BED40OMS 141
NO. BATHROOMS
GARBAGE DISPOSAL UNIT
YES ❑
NO
AUTO. DISHWASHER
YES
NO
❑
AUTO. WASH. MACHINE
YES
NO
❑
SITE SUITABLE
YES' �
NO
[3
SIZE OF'TANK
gaf.
NITRIFICATION FIELD sq* ft.
DEPTH OF STONE IN LINES:
House Trailer . 800 Gal. 400 Sq. Ft.
Two Bedroom House 800 Gal. 600 Sq. Ft.
Three Bedroom House 9-QkjGa,,00_$
_q, F, t
Four Bedroom House PzCLQ'-Ga-lS _6
WATER SUPPLY: Individual,. 0 Public t9
IMPROVEMENTS PERMIT BY f NSTALLED BY
CERTIFICATE OF COMPLETION
By Date ----$--/9
(8/16/73) *Construction must coWly with all other applicable State and local regulations
LOT AREA
. ...........