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181 Shadybrook Road Section 1 Lot 22Davie Countv, NC Tnsr PnrrPl RPnnrt 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: Land Value: Total Assessed Value: WARNING: THIS 1S NOTA SURVEY Davie County, Parcel Information J605000015 Township: Fulton 5758817061 Municipality: 6621040 Census Tract: 37059-804 BIGENHO THEODORE M Voting Precinct: FULTON 181 SHADYBROOK ROAD Planning Jurisdiction: Davie County MOCKSVILLE Zoning Class: DAVIE COUNTY R-20 NC Zoning Overlay: 27028-7405 Voluntary Ag. District: No LOT 22 HICKORY HILL SECTION 1 Fire Response District: FORK 0.79 Elementary School Zone: CORNATZER 4/1989 Middle School Zone: WILLIAM ELLIS 001480256 Soil Types: GnC2,GaD,WATER 0004 Flood Zone: 105 Watershed Overlay: DAVIE COUNTY Outbuilding & Extra Freatures Value: Total Market Value: OI nts�All Davie County, 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 claims or causes of action due to �OUt3'S4 NC or arising out of the use or Inability to use the GIS data provided by this website. 4 —7_� S ' DAVIE COUNTY HEALTH DEPARTMENT , W,�"Px = Environmental Health Section PROPERTY INFORMATION Y _ f P.O. Box 848 / Q,joctioris to property :✓ '' � ��/� r �'� ; r` Mocksville, NC 27028 Subdivision Name: ,&, Phone #: 336-751-8760, AUTHORIZATION FOR WASTEWATER SYSTEM CONSTRUCTION Section: J Lot: —,/ Tax Office PIN:# - 002555 . _ % , AUTHORIZATION NO: A Road Name:jf, .1r;=�. lr ,� Zip: , ?9 **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 FornVAuthorization 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. 3NVIRONMENTAL HEALTH SPEVIAI IST DATE ISSUED RESIDENTIAL SPECIFICATION: BUILDING TYPE # BEDROOMS --//— # BATHS' / # OCCUPANTS GARBAGE DISPOSAL: Yes or No COMMERCIAL SPECIFICATION: FACILITY TYPE # PEOPLE # PEOPLE/SHIFT # SEATS INDUSTRIAL WASTE: Yes or No r LOT SIZE TYPE WATER SUPPLY' DESIGN WASTEWATER FLOW (GPD) NEW SITE REPAIR SITE —/I , SYSTEM SPECIFICATIONS: TANK SIZE GAL. PUMP TANK GAL. TRENCH WIDTH, { /r ROCK DEPTHS LINEAR Fr OTHER REQUIRED SITE MODIFICATIONS/CONDITIONS: IMPROVEMENT PERMIT LAYOUT In f� c• �� s �} G�FL A✓ c FOR FINAL INSPECTION OF THIS SYSTEM PLEASE CALL BETWEEN 8:30 - 9:30_4.M. ON THE DAY OF INSTALLATION. TELEPHONE # IS (336) 751-8760. OPERATION PERMIT I SYSTEM,INSTALLED BY: I m � 1 �I 2 © S,0D6i&)14 0—"T L. A 141 18 �� AUTHORIZATION NO. Za, 4 OPERATION PERMIBY: 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. Cze & 3 -4 5'a DCHD 02/02 (Revised) 4,f Q fid 41-- S7 s6 -9/- DAVIE COUNTY ENVIRONMENTAL HEALTH SECTION APPLICATION FOR IMPROVEMENT PERMIT (REPAIR) -:Bi 58n A PHONE NUMBER 2Zff-7,—D SUBDIVISION NAME G a C_ /C C , LOT # z -- DIRECTIONS TO SITE DATE SYSTEM INSTALLED -7 NAME SYSTEM INSTALLED UNDER TYPE FACILITY NUMBER BEDROOMS NUMBER PEOPLE SERVED 2' TYPE WATER SUPPLY G SPECIFY PROBLEM OCCURRING "'tom / J`/ DATE REQUESTED o j FORMATION TAKEN BY This is to certify that the information provided is correct to the best of my knowledge, yAIrthat Ijundersta respons' le for all charges incurred from this application. SIGNATURE OF OWNER OR AUTHORIZED AG Rev. 1193 � N L6�$ L99b = e N ZL 08 o �z 89L0 S 6 LbLb 0981 r SZ 'Inc, 948£ 8 LZ8b �ssBC.: )N � z � o 0964 £ L L. ' �� oo� oo � oLss � � � b168 S `�� 8 906b o 8 epz �¢06 N « £409 ers $L60 Nco 6R 8801 N t ^ oo� • 80£ 6 Me� oo� pz z� «z lZl4 «`� y 4blL 14W Boz 00 !I 8418 09ZL ti s _' It T- " 4Zl£boz (vzs' (vov 6ZZ ls) t9 N lL£b ., L££E z cA l6£8 LZ£9 9Z££ tl46's " 01717L 0 tf` $ (voo' rya ^ bL 6Y� fD °1[ 2649 � Z148 � •� ~ �7 b� [ S 5 v„ZU917 L 4 No r 0" 1944 4942 L� • �� S « % a OL9Z _ZR 17994 69% �OILL a 9Lbi; OOL £8LL . raa O cv• ' 80LO �N 99 v g 90L4 11J ll8£ L05 v N VOL g` Z176£ F66 GZ6 W60 m o v v N l8ob s� w o� 190L ° 6170£ • eta 11 9ll ZL Zo 86Z6 E9 sD v LL£9 N/d 60£4 r N £ OL4b (tl88'4) L96L (vto,t) DAVIE COUNTY HEA TH DEPARTMENT