305 Farmington RdDavie County, NC Tax Parcel Report Monday. February 13. 2017
WA"11VU: '1'Hla 1N 1VUT A SURVEY
I
All data le provided as is without warranty or guarantee Of any kind either expressed or Implied Including but not limited to the
Davie County, implied warranllas of marchantabIlity or fitness for a particular use. All users of Davie County's GIS webslti shall hold harmless 1h
I Cou my of Davis, North Carolina, Its agents, con suhants, contractors or am playas& from any and all Claims or cauifi O1 Gallon due t0 d
e0613't NC or arising out of the use or Inability to use the GIS data provided by this weballe.
:Parcel Information `.;t
.':tT a
Parcel Number:
F500000031
Township:
Farmington
NCPIN Number:
5840670231
Municipality:
Account Number:
59012000
Census Tract:
37059-802
Listed Owner 1:
QUALITY OIL COMPANY LLC
Voting Precinct:
FARMINGTON
Mailing Address 1:
PO BOX 2736
Planning Jurisdiction:
Davie County
City: WINSTON SALEM
Zoning Class: DAVIE COUNTY H-B,I-2
State:
NC
Zoning Overlay:
DAVIE COUNTY QD
Zip Code:
27127-2736
Voluntary Ag. District:
No
Legal Description:
3.60 AC FARMINGTON RD
Fire Response District:
FARMINGTON
Assessed Acreage:
3.57
Elementary School Zone:
PINEBROOK
Deed Date:
612001
Middle School Zone:
NORTH DAVIE
Deed Book I Page:
003760349
Soil Types:
EnB
Plat Book:
Flood Zone:
Plat Page:
Watershed Overlay:
DAVIE COUNTY
Building Value:
45630.00
Outbuilding 8r Extra
5110.00
Freatures Value:
Land Value:
583160.00
Total Market Value:
633900.00
Total Assessed Value:
633900.00
I
All data le provided as is without warranty or guarantee Of any kind either expressed or Implied Including but not limited to the
Davie County, implied warranllas of marchantabIlity or fitness for a particular use. All users of Davie County's GIS webslti shall hold harmless 1h
I Cou my of Davis, North Carolina, Its agents, con suhants, contractors or am playas& from any and all Claims or cauifi O1 Gallon due t0 d
e0613't NC or arising out of the use or Inability to use the GIS data provided by this weballe.
A0
L
DAVIE COUNTY HEALTH DEPARTMENT %S 0
IMPROVEMENTS PERMIT AND CERTIFICATE OF COMPLETION
'NOTE: Issued in Compliance With Article II of G.S. Chapter 130a Permit Number
Sanitary Sewage S stems
Name�/� / - _ Date /(- /�-9Y N2 17
7 6 4 �d
Location
%r/ - _�a.do V,- �Za Pav�N .! C f
C� - �
Subdivision Name Lot No. Sec. or Block No.
Lot Size r/iC House Mobile Home — Business ` Industry
No. Bedrooms /V/ I/No. Baths No. in Family Assembly Other
Garbage Disposal . YES ❑ NO ❑ Specifications for System:
Auto Dish Washer YES ❑ NO ❑ rho 'U o
Auto Wash Ma^hine YES ❑ NO ❑ is
Type Water Supply _ %".35 ----
*This permit Void if sewage system described below is not installed within 5 years from date of issue.
This permit is subject to revocation if site plans or the intended use change. /
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.,
1:00-1:30 P.M. or 4:30-5:00 P.M. on day of completion. Telephone Number: 704-634-5985.
C74_
Final Installation Diagram:
System Installed by
N
pr?S eflG'� `A�l
Certificate of Completion - / .r �"Y Date 44 t
'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 functior
satisfactorily for any given period of time.
APPLICATION FOR SITE EVALUATION/IMPROVEMENT PERMIT & ATC
Davie County Environmental Health
P.O. Box 848/210 Hospital Street
Mocksville, NC 27028
(336)753-6780/ Fax (336)753-1680
Application: o 1 uation/Improvement Permit o Authorization To Construct (ATC) o Both
Type of Ap ation: oNew System oRepair to Existing System oExpansion/Modification of Existing System or Facility
***IMPORTANT*** THIS APPLICATION CANNOT BE PROCESSED UNLESS ALL OF THE REQUIRED
INFORMATION IS PROVIDED. Refer to the INFORMATION BULLETIN for instructions.
APPLICANT INFORMATION Nl( S&T -.%,
Name ra•r'.+-7,N cjr'a.. i2eact Sy I C Contact Person 6"r Lvh- olG�
.30: Fca/vi i�. inti IZ d Address 2-56 4%p6,-UQQ-bpme Phone
Mc -(,es l� '/V(- 2-70 2 c.
City/State/ZIP Business Phone -316 - 1�% -s 3o y
Email
Email:
Name on Permit/ATC if Different than
Above
Mailing Address
FKUPEK 1 Y 1NPUKMA I lUN
City/State/Zip
'Date House/t`acility Comers
NOTE: A survey plat or site plan must accompany this application. Included: o Site Plan
(Permit is valid for 60 months with site plan, no expiration with complete plat.)
Owner's Name 5 c t + wh , i e- I Phone 33&
Number
Owner's
Address Z 3 L Av7
City/State/Zip
Property Address City
Lot Size Tax PIN#
Subdivision Name(if applicable) Section/Lot#
Directions To Site: _
/) 4 /V 4 S ►4.. �q� 0 ti' 7- 1.P %' i u C' i u r s l — '/0
oPlat(to scale)
- vG(o- vS'�'Z
Al c Z 76 e�
If the answer to any of the following questions is "Yes",supporting documentation must be attached:
Are there any existing wastewater systems on the site?
_Yes _✓No
Does the site contain jurisdictional wetlands?
_Yes ✓No
Are there any easements or right-of-ways on the site?
/No
Is the site subject to approval by another public agency?
_Yes
_Yes ✓No
Will wastewater other than domestic sewage be generated?
Yes -No
IF RESIDENCE FILL OUT THE BOX BELOW
# People # Bedrooms # Bathrooms Garden Tub/Whirlpool oYes oNo
Basement: oYes oNo Basement Plumbing: oYes oNo
IF NON -RESIDENCE FILL OUT THE BOX BELOW
Type of FacilityBusiness iCc r,,-�i„ ,r,e- S1 -,z Total Square Footage of Building 1 S 1 Ft # People
# Sinks / # Commodes Z # Showers # Urinals _
Estimated Water Usage (gallons per day) (Attach documentation of similar facility water
consumption)
inspections to determine compliance with applicable laws and rules. 1 understand that 1 am responsible for the proper identification
and labeling of property lines and corners and locating and flagging or staking the house/facility location, proposed well location
and the location of any other amenities.
's
E
Property owner's or owner's legal representative signature
Date(s):
Client Notification Date:
EHS:
Date
�3�/Y77