202 Lakeview Road Section 2 Lot 12Davie Countv, NC Tax Parcel Report Tuesday. January 17. 2017
WARNING: TMS 1S NO1' A SURVEY
Parcel Information
Parcel Number:
1614OA0038
Township:
Shady Grove
NCPIN Number:
5758736390
Municipality:
Fire Response District: CORNATZER - DULIN
Account Number:
82532026
Census Tract:
37059-804
Listed Owner 1:
DEQUENNE DAMON CHRISTOPHER
Voting Precinct:
WEST SHADY GROVE
Mailing Address 1:
202 LAKEVIEW ROAD
Planning Jurisdiction:
Davie County
City: MOCKSVILLE
Zoning Class: DAVIE COUNTY R-12-S,R-20
State: NC
Zoning Overlay:
Zip Code: 27028-0000
Voluntary Ag. District: No
Legal Description: LOT 12 HICKORY HILL SECTION 2
Fire Response District: CORNATZER - DULIN
Assessed Acreage: 1.45
Elementary School Zone: CORNATZER
Deed Date: 4/2014
Middle School Zone: WILLIAM ELLIS
Deed Book / Page: 009550553
Soil Types: GnC2,GaD,WATER
Plat Book: 0005
Flood Zone:
Plat Page: 026
Watershed Overlay: DAVIE COUNTY
Outbuilding & Extra
Building Value:
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 Ilmited to the
Davie County, Impliedwarranties of merchantability or fitness for a particular use. All users of Davie County's GIS websfte shall hold harmless the
County of Davie, North Carolina, Us agents, consuftants, contractors or employees from any and all claims or causes of action due to
nOUty,�� NC or arising out of the use or Inability to use the GIS data provided by this websfte.
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) Permit Number
N
Name f Z;:: % ,'- o Date'�,��'��'c_;
Location %ol�?D.2 L-ck���i 57f rd- 3'(034
. X38
Subdivision Name �"�'%% �' ! --
Lot No. Sec. or Block No.
Lot Size House 1Z Mobile Home _ Business -- Speculation
No. Bedrooms S" No. Baths r - Z No. in Family
Garbage Disposal YES O NO or Specifications for System:
Auto Dish Washer YES NO ❑
Auto Wash Machine YES NO C]
Type Water Supply
*This permit Void if sewage system described below is not installed within 36 months from date of issue.
t
y d
•J ,
f)J1r'/��,;
i1 JFr`�' V ,Ci l•
S , ,U !�
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: System Installed by
l
Certificate 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.
s�
',
Certificate 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.
�1
APPLICATION FOR SITE EVALUATION/ IMPROVEMENTS PERMIT
Davie County Health Department
Environmental Health Section
P. �c':'J��/G�11,,)!_
0. Box 665 yeD
Mocksville, N.C. 27028
CONSTRUCTION SHALL NOT BEGIN UNTIL IMPROVEMENTS PERMIT HAS BEEN ISSUED.
�/�j Home Phone
1. Permit Requested By 1411 17114-1 Business Phone Y T9 <F�� 7j-
2. Address -1 6�,. 9 7--
3. Property Owner if Different than Above _
Address
4. Permit To: a) Install Alter Repair �1
b) Privy Conventional ✓Other Type T7v L; --v (f- cc 'v kw0 C.'e
Ground Absorption
ITu 1v
c) Sub -Division /�rC �'c,z y M LL Sec. _ Lot No. Z j
5. System used to serve what type facility: House Mobile Home Business
Industry Other
b) Number of people
6. a) If house or mobile home, state size of home and number of rooms.
House Dimensions
Bed Rooms -3 Bath Rooms Z y� Den w/Closet
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 urinals garbage disposal
lavatory showers washing machine
dishwasher sinks
8. a) Type water supply: Public ✓ Private Community
b) Has the water supply system been approved? Yes No
9. a) Property Dimensions—
b) Land area designated to building site
c) Sewage Disposal Contractor
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 correct to the best of my knowledge.
Date Owner Si ature
OWNER IS SOLELY.RESPONSIBLE FOR COMPLIANCE WITH ALL STATE AND LOCAL LAWS
Allow 5 days for processing
Directions to property:
DCHD (6-82)
'4
,4,�
DAVIE COUNTY HEALTH DEPARTMENT
Environmental Health Section
P. O. Box 665
Mocksville, N.C. 27028
SOIL/SITE EVALUATION
Name Date 3 40%-,�
Address Lot Size /-I�? X?97'�'
FACTORS ARFA 1 ARFA 9 ARFA 3 AREA A
1) Topography/ Landscape Position
S
U
S
(j
`tom
S
PS
U
S
PS
U
?) Soil Texture (12-36 in.) Sandy,
Loamy, Clayey, (note 2:1 Clay)
S
P
S
PS
S
PS
4f
U
U
3) Soil Structure (12-36 in.),S-n
Clayey Soils
4PPS
S
17
S
S
PS
U
U
U
I) Soil Depth (inches)
S
S
PS
S
PS
U
U
U
i) Soil Drainage: Internal
S
S
PS
S
PS
U
U
External
S
PS
PS
"tT
U
U
i) Restrictive Horizons
Available Space
S
g
PS
S
PS
S
PS
U
U
1) Other (Specify)
S
PS
U
S
PS
U
S
PS
U
S
PS
U
1) Site Classification
P, f
S"
U—UNSUITABLE S—SUITABLE PS—Provisionally Suitable
Recommendations/ Comments: 409 ✓ .wvo�-/ 'o
4r,01 'Of
Described by Title ��'� Date 3 ��
SITE DIAGRAM
UCHD (6.82)
Davie County Xealtl f Department, ;�
and dame Nealtfren <'
9 cY
210 HOSPITAL STREET / P.O. BOX 665
MOCKSVILLE, N.C. 27028
PHONE: (704) 634-5985
Hickory Hill Development Co.
Route 3, Box 92
Mocksville, NC 27028
March 18, 1988
Re: Site Evaluation
Hickory Hill/Sec. 2 -Lot 12
Dear Mr. Ward:
On March 17, 1988, this office evaluated Lot 12 in Hickory Hill,
Section II. On that date the lot was classified provisionally suitable for
a septic tank system; however, the system must go on the front of the lot to
maintain separation from the lake.
Sincerely,
AW-A46V �)
Robert B. Hall, Jr., R.S.
Environmental Health
RH/wd
Enclosure
9
11
APPLICATION FOR SITE EVALUATION/ IMPROVEMENTS PERMIT
Davie County Health Department
Environmental Health Section
P. O. Box 665
Mocksville, N.C. 27028
CONSTRUCTION SHALL NOT BEGIN UNTIL IMPROVEMENTS PERMIT HAS BEEN ISSUED.
Home Phone 7q FL' y-7 �7 �-
1. Permit Reque ted By Business Phone
2. Address M UTA_ ,4 lU L
3. Property Owner if Different than Above
Address
4. Permit To: a) Install Alter Repair
b) Privy Conventional Other Type
Ground Absorption
c) Sub -Division Sec. Lot No. Z
5. System used to serve what type fac ity: House Mobile Home Business
—
Industry— Industry Other
b) Number of people
6. ap If house or mobile home, state size of home and number of rooms. ` 1
House Dimensions 3
Bed Rooms �*� Rooms— Den w/Closet—�
b) If Business, Industryor 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 urinals garbage disposal
lavatory s showers 3 washing machine
dishwasher / sinks
8. a) Type water supply: Public Private Community
b) Has the water supply system been approved? Yes No
9. a) Property Dimensions Asa' X 30D' &-P-,c"ZX,
b) Land area designated to building site % 7a
c) Sewage Disposal Contractor fi /.Em' C/111 '_#__
10. Do you anticipate any additions or expansions of the facility this sewage system is intended to serve? A-17)
What type?
This is to certify that the information is correct to the best of my knowledge.
Date Owner Signature
OWNER IS SOLELY RESPONSIBLE FOR COMPLIANCE WITH ALL STATE AND LOCAL LAWS
Directions to property:
DCHD (6.82)
Allow 5 days for processing
t • Davie County Nealtlr De ar ent
and .�fome .�fealtF Aen
y c y
210 HOSPITAL STREET/ P.O. BOX 885
MOCKSVILLE. N.C. 27028
PHONE: (704) 834-5985
September 22, 1988
Richard Short
Rt. 3, Box 91-1
Mocksville, NC 27028
Dear Mr. Short:
This letter is regarding the house built by you on Lot 12, Sec. 2 of
Hickory Hill in Davie County.
The lot was evaluated on March 17, 1988, and at that time was approved;
however, no permit was issued.
On September 12, 1988, the system was installed without the appropriate
permit; due to this fact, the system was placed in a less suitable location
with one line having five step downs. The system installed was for a three
bedroom house.
Please make a point to obtain the required permit in the future before any
construction starts. Your cooperation is appreciated.
Sincerely,
0e.f.
Robert B. Hall, Jr., R.S.
Environmental Health Section
RH/wd
Enclosures
r