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WARNING: THIS IS NOT A SURVEY
Parcel Information
Parcel Number:
1614OA0035
Township:
Shady Grove
NCPIN Number:
5758831161
Municipality:
Account Number:
9861000
Census Tract:
37059-804
Listed Owner 1:
BREWER JAMES M
Voting Precinct:
WEST SHADY GROVE
Mailing Address 1:
238 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 15 HICKORY HILL SECTION 2
Fire Response District:
CORNATZER - DULIN
Assessed Acreage:
1.92
Elementary School Zone: CORNATZER
Deed Date:
3/1989
Middle School Zone:
WILLIAM ELLIS
Deed Book / Page:
001470591
Soil Types:
GnB2,GnC2,GaD
Plat Book:
0005
Flood Zone:
Plat Page:
026
Watershed Overlay:
DAVIE COUNTY
Building Value:
Outbuilding & Extra
Freatures Value:
Land Value:
Total Market Value:
Total Assessed Value:
O h s��
Davie County,
All data is provided as Is without warranty or guarantee of any kind 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
rpC
NC
County of Davie, North Carolina, its agents, consultants, contractors or employees from any and all claims or causes of action due to
the use Inability to the GIS data by this website.
N t�
or arising out of or use provided
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
1 r
Name 1 vr,�i r°r.,>�r' /h ,��/,,, ; t4f?' 7" x /' �;' k bate No � � � -
Location-
-- �3g La, vie uJ
/ . -TA,c MrtP3s
Subdivision NameLot No. Sec. or Block No.
Lot Size s%! House =l Mobile Home — Business Speculation
No. Bedrooms"L% No. Baths No. in Family —,-Z—
Garbage Disposal YES ❑ NO [j" Specifications for System: �I
Auto Dish Washer YESNO ❑ / ��'/ a:`��
Auto Wash Machine YES NO ❑ _ f, , , 1
Type Water Supply
*This permit Void if sewage system described I
months from date of issue.
1
Improvements permit by — �l(/ / / -
*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: stem Installed by zz�?%r=A
Certificate of Completion 1��el Date 1 Ld
"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.
¢O
Jim
el
11 APPLICATION FOR SITE EVALUATION/IMPROVEMENTS PERMIT
avie County Health Department B
Environmental Health Section
�Q Jr P. O. Box 665 R�C,E1v
�/y �v� `�% Mocksville, N.C. 27028
�j CONSTRUCTION SHALL NOT BEGIN UNTIL IMPROVEMENTS PERMIT HAS BEEN ISSUED.
Home Phone
1. Permit Requested By e/9 1 �� /� Business Phone 91n� �-IDZ1
L#
s T;� ,�3 o iV c�
/ A7c��
3. Property Owner if Different than Above
MIM
Address
4. Permit To: a) Install v Alter Repair
b) Privy Conventional Cher Type
Ground Absorption
C) Sub -Division//,- Sec. Lot No. l�
5. System used to serve what typ facility: House Mobile Home Business
` Industry Other
b) Number of people
6. ay If house or mobile home, state size of ome and number of rooms.
House Dim s
Bed Roo s Bath Rooms 3 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 -3 washing machine
dishwasher sinks
8. a) Type water supply: Public l Private Community
b) Has the water supply system been approved? Yes2l-�'No
9. a) Property Dimensions % j ;)" 'e
b) Land area designated to building site /� ro �y 7--
c)
—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 corr ct to the beat of my knowledge.
Date Owner Signature
OWNER IS SOLELY RESPONSIBLE FOR COMPLIANCE WITH ALL STATE AND LOCAL LAWS
Dirnnfinnc fn r,rnncrfv
Allow 5 days for processing
DCHD (6-82)
13:7 -
•� DAVIE COUNTY HEALTH DEPARTMENT
Environmental Health Section
R O. Box 665
Mocksville, N.C. 27028
A SOIL/SITE EVALUATION
Address
R1
Date J%8'9
Lot Size Zt4e'
FAr.TORR ARFA 1 ARFA 9 AREA R APPA A
Topography/ Landscape Position
�
S
�
S
U
U
!) Soil Texture (12-36 in.) Sandy,
Loamy, Clayey, (note 2:1 Clay)01
S
`1T
U
{) Soil Structure (12-36 in.)
Clayey Soils
&P5
S --
c P,
U
U
) Soil Depth (inches)�
S^,
�
S
U
U
U
)Soil Drainage: Internal
-
tS�
'RAS)
I
S
Externalj�
®
P
tom'
U
4�
U
U
U
�) Restrictive Horizons
Available Space
S
U
(S
77"
S
1:11
S
41
►) Other (Specify)
S
PS
S
PS
S
PS
S
PS
U
U
U
i) Site Classification
6. J.
S
pUU
�• ),
��
U—UNSUITABLE S—SUITABLE PS— _Provisionally Suitable
Recommendations/Comments:
Described by J�'l� Title Date IT1Ira
SITE DIAGRAM d
ftocd r
,1.
DCHD (6-82)
Davie County Xealfii De artment
and dome .fealtfr len
9
210 HOSPITAL STREET/ P.O. BOX 665
MOCKSVILLE. N.C. 27028
PHONE: (704) 634-8985
March 2, 1989
Mr. Roy Potts
P. 0. Box 11
Advance, NC 27006
Re: Site Evaluation
Frank Bahnson
Hickory Hill II -Lot 15
Dear Mr. Potts:
On March 1, 1989, this office evaluated Lot 15/Section II in Hickory Hill.
On that date the soil was classified provisionally suitable; however, due
to the narrow width of the lot much planning will be necessary between the
builder and this office to insure adequate space for the proposed installation.
Before any permit can be :issued the house must be staked and property
lines marked.
If you have any questions, feel free to call.
Sincerely,
Robert B. Hall, Jr., R.S.
Environmental Health Section
RH/wd
Enclosure