268 Pine Valley Road Section 1 Lot 28Davie County, NC I Tax Parcel Report Tuesday, January 24, 2017
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WARNING: THIS IS NOT A SURVEY
Parcel Infonnation
Parcel Number:
J605000021
Township:
Fulton
NCPIN Number:
5758814570
Municipality:
Account Number:
59196500
Census Tract:
37059-804
Listed Owner 1:
RANDALL STANLEY E
Voting Precinct:
FULTON
Mailing Address 1:
268 PINE VALLEY ROAD
Planning Jurisdiction:
Davie County
City: MOCKSVILLE
Zoning Class: DAVIE COUNTY R -20,R -12-S
State:
NC
Zoning Overlay:
Zip Code:
27028-0000
Voluntary Ag. District:
No
Legal Description:
LOT 28 HICKORY HILL SECTION 1
Fire Response District:
FORK
Assessed Acreage:
0.82
Elementary School Zone:
CORNATZER
Deed Date:
2/1998
Middle School Zone:
WILLIAM ELLIS
Deed Book I Page:
002000694
Soil Types: Gnl32,WATER,MsD
Plat Book:
0004
Flood Zone:
Plat Page:
105
Watershed Overlay:
DAVIE COUNTY
Building Value: Outbuilding & Extra
Freatures Value:
Land Value: Total Market Value:
Total Assessed Value:
All data Is provided as Is without warranty or guarantee of any Idnd either expressed or Implied Including but not limited to the
Davie County, Implied warranties of merchantability or fitness for a particular use. All users of Davie County's GIS webslte &hall 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
NCor arising out of the use or Inability to use the GtS data provided by this website.
1A.
AUTHORIZATION NO: DAVIE COUNTY HEALTH DEPARTMENT 4000
2 0 3
Environmental Health Section PROPERTY INFORMATION
Permittee's f P.O. Box 848
Name: zz Mocksville, NC 27028 Subdivision Name: lhll-
/I ' Phone # 336-751-8760
Directions to property: C,
AUTHORIZATION FOR Section: I nt-
C- e 17Y5? ' a
WASTEWATER Tax 0 ce PIN:# f-4��e ��101 e4��
SYSTEM CONSTRUCTION
)f
V
x
Road Nam
**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 Forn-VAuthorization 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 CONSTRUCTION
"J , IS VALID FOR A PERIOD OF FIVE YEARS.
ENVIRONMENTAL HEALTH SPECIALIST DATE ISSUED
I)AVIE COUNTY HEALTH DEPARTMENT
IMPROVEMENT AND OPERATION PERMITS PROPERTY INFORMATION'
Name, Subdivision Name:
Directions'to property: Lot:
Section.
IMPROVEMENT 7Y fl 1- 611- e
PERMIT Tax 0 ice PIN:# Ar
I Name:
NOTE** This Improvement Permit DOES NOT authorize the construction or installation of a septic tank system or any' wastewater system. An
AUTHORIZATION FOR WASTEWATER SYSTEM CONSTRUCTION must be obtained from this Department prior to,the
constructionlinstallation 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)
***NOTICE*** THIS PERMIT IS SUBJECT TO REVOCATION IF SITE
P S OR THE INTENDED USE CHANGE. YOUR WASTEWATER
LAN
SYSTEM CONTRACTOR MUST SEE THIS PERMIT BEFORE
ENVIRONMENTAL HEALTH SPECIALIST bATt ISS JED
INSTALLING THE SYSTEM.
RESIDENTIAL SPECIFICATION: BUILDING TYPE # -BEDROOMS # BATHS # OCCUPANTS GARBAGE DISPOSAL: Yes or No
COMMERCIAL SPECIFICATION: FACILITY TYPE # PEOPLE # PEOPLEISHIFT # SEATS INDUSTRIAL WASTE: Yes or No
LOT SIZE TYPE WATER SUPPLY DESIGN WASTEWATER FLOW (GPD) d NEW SITE REPAIR SIM
SYSTEM SPECIFICATIONS: TANK SIZE ___---GAL. PUMP TANK -_—_—GAL. TRENCH WIDTH ROCK DEPTH _Z -Y— LINEAR FT.,286
OTHER
REQUIRED SITE MODIFICATIONS/CONDITIONS:
-H.Ifflf IRISER(S) TLG" FIHISHED MADE&
IMPROVEMENT PERMIT LAYOUT &APPROVED EFFLUE1j; q F
I old
e 7"
"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 THE DAY OF INSTALLATION. TELEPHONE # IS (336)751-8760.
OPERATION PERMIT
SYSTEM INSTALLED BY:
902=x V -
VD1.
IVO
AUTHORIZATION NO. OPERATION PERMIT DATE:7-7--9-9
**THE ISSUANCE OF THIS OPERATION PERMIT SHALL INDICA����DESCRIBED ABOVE HAS BEEN INSTALLED IN COMPLIANCE
WITH ARTICLE I I 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 05/96 (Revised)
DAVIE C�UNTY HEALTH DEPARTMENT
IMPROV FMENT AND 4ERATION PERMITS PROPERTY INFORMATION
PerinittCe s
N�me:
Subdivision Name:
Directions to property: Section:
IMPROVEMENT
PERMIT Tax 0 ice PIN:#
0 ZA
Road Name: EeA 7,0,�
**NOTE** This Improvement Permit DOES NOT authorize the construction or installation of a septic tank system or any wastewater system. An"
AUTHORIZATION FOR WASTEWATER SYSTEM CONSTRUCTION must be obtained fi-orn this Department prior to the
construction/installation of a system or the issuance of a building permit.
(In compliance with Article I I of G.S. Chapter 130A, Wastewater Systems, Section. 1900 Sewage Treatment and Disposal Systems)
***NOTICE*** THIS PERMIT IS SUBJECT TO REVOCATION 1[F SITE
PLANS OR THE INTENDED USE CHANGE. YOUR WASTEWATER
ENVIRONMENTAL HEALTH SPECIALIST bATE- ISS'OED SYSTEM CONTRACTOR MUST SEE THIS PERMIT' BEFORE
INSTALLING THE SYSTEM.
RESIDENTIAL SPECIFICATION: BUILDING TYPE # BERROOMS ?— # 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 11 DESIGN WASTEWATER FLOW (GPD) Jr d NEW SITE REPAIR SITE
SYSTEM SPECIFICATIONS: TANK SIZE __--GAL. PUMP TANK GAL. TRENCH WIDTH
ROCK DEPTH LINEAR Fr.
OTHER
REQUIRED SITE MODIFICATIONS/CONDITIONS:
IMPROVEMENT PERMIT LAYOUT APPROVED
--------------
7;
FIHISHED GRADE&
**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 THE DAY OF INSTALLATION. TELEPHONE # IS (336)751-8760.
OPERATION PERMIT
SYSTEM INSTALLED BY: ",-h
Z 0
oA
0
AUTHORIZATIONNO. OPERATION PERMITBY: 6--� DATE: Z--
DESCRI:BED ABOVE HAS BEEN INSTALLED IN COMPLIANCE
**THE ISSUANCE OF THIS OPERATION PERMIT SHALL INDICATE
WITH ARTICLE I I OF G.S. CHAPTER 130A, SECTION. 1900 "SEWAGE TREATMENT AND DISPOSAL SYSTEMS", #V
_WALL IN NO WAY BE TAKE, N AS A
GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORILY FOR ANY GIVEN PERIOD OF TIME.
DCHD 05196 (Revised)
DAVIE COUNTY HEALTH DEPARTMENT
(Septic Tank) Improvements Permit and Certificate of Completion
(Ground Absorption Sewage Disposal System G.S. Chapter 130 -Article 13C)
(OW:N�EP OR CONTRACTOR DATE -7t, PERMIT
LOCATION 884
S.R. NO.
SUBDIVISION NAME LOT NO. SECTION OR BLOCK NO. 0—
HOUSE MY MOBILE HOME BUSINESS El I
CERTIFICATE OF COHPLETION y qz DateS-- ),7 - 7 1�
(8/16/73) *Construction mu'st %omply with all other applicable State and local regulations
LOT AREA
n-�' _'�
cj� k' -j "-t 0
V
House Trailer 800 Gal.
400
Sq. Ft.
NO. BEDROOMS NO. BATHROOMS
Two Bedroom House 800 Gal.
600
Sq. Ft.
GARBAGE DISPOSAL UNIT YES UX NO
Three Bedroom House 900 Gal.
900
Sq. Ft.
AUTO. DISHWASHER YES EiT NO 0
Four Bedroom House 1000 Gal.
1200
Sq. Ft.
AUTO. WASH. MACHINE YES Mr NO [3
SITE SUITABLE YES [jX NO 0
oc'
SIZE OF TANK !,,o -10mgal.
C 41 at
NITRIFICATION FIELD sq. ft.
DEPTH OF STONE IN LINES: , -41, (ebeA a-,-, �9�
a
A , ��' *
WATER SUPPLY: Individual 0 Public
IMPROVEMENTS PERMIT BY
INSTALLED BY
CERTIFICATE OF COHPLETION y qz DateS-- ),7 - 7 1�
(8/16/73) *Construction mu'st %omply with all other applicable State and local regulations
LOT AREA
n-�' _'�
cj� k' -j "-t 0
V
A DAVIE COUNTY ENVIRONMENTAL HEALTH SECTION
APPLICATION FOR IMPROVEMENT PERMIT (REPAIR)
NAME 4 Ile, - 0 P/ N dal /j PHONE NUMBER
j
ADDRESS X.;7ellalln, SUBDIVISION NAME
LOT #
DIRECTIONS TO SITE
DATE SYSTEM INSTALLED NAME SYSTEM INSTALLED UNDER
TYPE FACILITY NUMBER BEDROOMS & -NUMBER PEOPLE SERVE
TYPE WATER SUPPLY -SPECIFY PROBLEM OCCURRING
DATE REQUESTED INFORMATION TAKEN BY
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. 1/93 e
1� # �191�1 Al &