203 Lakeview Road Section 2 Lot 45Davie County, NC ITax Parcel Report Tuesday, January 17, 2017
Zip Code: 27028-0000 Voluntary Ag. District:
Legal Description: LOT 45 HICKORY HILL SECTION 2 Fire Response District:
Assessed Acreage: 0.80 Elementary School Zone:
Deed Date:
Deed Book / Page:
Plat Book:
Plat Page:
Building Value:
Land Value:
Total Assessed Value:
8/2003 Middle School Zone:
005090038 Soil Types:
0005 Flood Zone:
026 Watershed Overlay:
Outbuilding & Extra
Freatures Value:
Total Market Value:
No
CORNATZER - DULIN
CORNATZER
WILLIAM ELLIS
GnB2,GnC2
DAVIE COUNTY
9 t.tA
WARNING:
THIS 1S NOT A SURVEY
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NC
Parcel Information
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Parcel Number:
16140A0005
Township:
Shady Grove
NCPIN Number:
5758738617
Municipality:
Account Number:
82521395
Census Tract:
37059-804
Listed Owner 1: POORE JANICE MARIE
Voting Precinct:
WEST SHADY GROVE
Mailing Address 1:
203 LAKEVIEW ROAD
Planning Jurisdiction:
Davie County
City: MOCKSVILLE
Zoning Class:
DAVIE COUNTY R-20
State:
NC
Zoning Overlay:
Zip Code: 27028-0000 Voluntary Ag. District:
Legal Description: LOT 45 HICKORY HILL SECTION 2 Fire Response District:
Assessed Acreage: 0.80 Elementary School Zone:
Deed Date:
Deed Book / Page:
Plat Book:
Plat Page:
Building Value:
Land Value:
Total Assessed Value:
8/2003 Middle School Zone:
005090038 Soil Types:
0005 Flood Zone:
026 Watershed Overlay:
Outbuilding & Extra
Freatures Value:
Total Market Value:
No
CORNATZER - DULIN
CORNATZER
WILLIAM ELLIS
GnB2,GnC2
DAVIE COUNTY
9 t.tA
Davie County,
All 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
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NC
County of Davie, North Carolina, Its agents, consultants, contractors or employees from any and all claims or causes of action due to
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or arising out of the use or Inability to use the GIS data provided by this website.
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
Name l4wj4.11�_1 fX L. Date -2
Location
Subdivision Name
Lot No. - Sec. or Block No
Lot Size _ House Mobile Home __ Business __ Speculation
No. Bedrooms — No. Baths_ No. in Family__
Garbage Disposal YES p NO �,]i- Specifications for System:
Auto Dish Washer YES NO Q %
Auto Wash Machine YES NO
Type Water Supply
*This permit Void if sewage system described below is not installed within 36 months from date of issue.
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 -'-
c
Certifi ate of Completion_` s� Date
'The signing of this certificate shall in icate th It the system described above has been installed in compliance with
the standards set forth in the above re ulation ut shall in NO way be taken as a guarantee that the system will function
satisfactorily for any given period of time.
APPLICATION FOR SITE EVALUATION/ IMPROVEMENTS PERMIT �`-
Davie County Health Department �S
Environmental Health Section
P. O. Box 665 V _ v
Mocksville, N.C. 27028
CONSTRUCTION SHALL NOT BEGIN UNTIL IMPROVEMENTS PERMIT HAS BEEN ISSUED.
Home Phone
1. Permit Requested By /Ji6V Business Phone lG
Je-Y!{ 74-7
2. Address tfDt 3 1?0_u" Z- r✓I,r,G/CS cr jLLC /t1,�Z7o 7-
3.
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 Axecxx 14, J_L Sec. ' Lot No. -.14-6c
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 Bath Rooms 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 f 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.
e /fi�L
Date Owner Signa ure
OWNER IS SOLELY RESPONSIBLE FOR COMPLIANCE WITH ALL STATE AND LOCAL LAWS
Allow 5 days for processing
Directions to property: ^ o\\
DCHD (6-82)
z DAVIE COUNTY HEALTH DEPARTMENT
Environmental Health Section
R O. Box 665
Mocksville, N.C. 27028
SOIL/SITE EVALUATION
Name—\\�-y `\ V O C Date - o 7
Address ,�j ��' Lot Size A
E
F
E
FerTnRC ARR01 AREA`S—) AREA 3 AREA 4
Topography/ Landscape Position
PS
in
S
PS
S
PS
U
U
!) Soil Texture (12-36 in.) Sandy,
S
PS
S
PS
Loamy, Clayey, (note 2:1 Clay)
U
U
U
U
I) Soil Structure (12-36 in.)
Clayey
C:k
nPS
S
PS
S
PS
Soils
U
U
U
U
Soil Depth (inches)S
S
S
PS
S
PS
U
U
U
U
Soil Drainage: Internal
Ps!)
S
PS
S
PS
External
PS
S
PS
S
PS
U
U
U
U
i) Restrictive Horizons
') Available Space
Cp
PS
S
PS
S
PS
U
U
U
!) Other (Specify)
S
PS
S
PS
S
PS
S
PS
U
U
U
U
1) Site Classification
U—UNSUITABLE S—SUITABLE PS—Provisionally Suitable
Recommendations/ Comments:
Described by �— Title
--� Date
SITE DIAGRAM
DCHD (6-82)
�tti�ie fl�oun#� �ettl#� �e�ttr#men#
ttnb (Rome 'Wealth '�lsenrg
P. O. BOX 665
'Ruclisbille, �qorth (garolina 27928
CONNIE L. STAFFORD, BA. MPH
Health Director
Hickory Hill Dev. Co.
Rt. 3, Box 92
Mocksville, NC 27028
Dear Developer:
June 11, 1987
Re: Site Evaluation
Hickory Hill II/Lot 45
On June 11, 1987, as you requested a representative from
this office visited your site and found the soil provisionally
suitable for the installation of a ground absorption sewage system.
If you have any questions, please feel free to contact this
office.
Sincerely,
0MaMal-
RRWTMWM��
Charles Little, R.S.
Environmental Health
Enclosure
CL/wd
TELEPHONE
(704) 634-5985
(704) 634-5861