274 Baity Rd Davie County,NC Tax Parcel Report p I Monday, September 26, 2016
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WARNING: THIS IS NOT A SURVEY
Parcel Information
Parcel Number: C30000007206 Township: Clarksville
NCPIN Number: 5823305596 Municipality:
Account Number: 7252000 Census Tract: 37059-801
Listed Owner 1: BLAKLEY TONY ALEXANDER Voting Precinct: CLARKSVILLE
Mailing Address 1: 274 BAITY ROAD Planning Jurisdiction: Davie County
City: MOCKSVILLE Zoning Class: DAVIE COUNTY R-A
State: NC Zoning Overlay:
Zip Code: 27028-4612 Voluntary Ag.District: No
Legal Description: 2.122 AC BATTY RD P/O LOT E Fire Response District: WILLIAM R. DAVIE
Assessed Acreage: 2.12 Elementary School Zone: WILLIAM R DAVIE
Deed Date: 6/1984 Middle School Zone: NORTH DAVIE
Deed Book/Page: 0123-0386 Soil Types: MrC2,EnB,MsC
Plat Book: 10 Flood Zone:
Plat Page: 346 Watershed Overlay: DAVIE COUNTY
Building Value: 153430.00 Outbuilding&Extra 1260.00
Freatures Value:
Land Value: 24990.00 Total Market Value: 179680.00
Total Assessed Value: 179680.00
161 All data is provided as is without warranty or guarantee of any kind 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 website shall 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
NC 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 Trea_tment and Disposal Rules (10 NCAC 10A .1934-.1968) Permit Number
Name Date_ 4t 41 ', 4
Location
40,
ter.
Subdivision Name ` Lot No. Sec. or Block No.
Lot Size �2 House Mobile Home _ Business Speculation
No. Bedrooms No. Baths i No. in Family
Garbage Disposal YES ❑ NO ❑
Sp cific tions for System:
Auto Dish Washer YES ❑ NO ❑ �94F �
Auto Wash Machine YES ❑ NO ❑ 666
Type Water Supply _—
*This permit Void if sewage system described below is not installed within 36 months from date of issue.
rl
i
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
a 41 �17'0 L��
Certificate of Completion Date �1 �4
'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.
DAVIE COUNTY HEALTH DEPARTMENT
J '
Environmental Health Section
P. O. Box 665
Mocksville, N.C. 27028
SOIL/SITE EVALUATION
Name % Date /
Address / .0.� __ L/�<r�U��� Lot Size 6?
FACTORS AREA 1 AREA 2 AREA 3 AREA 4
1) Topography/Landscape Position � S
PS "
U
2) Soil Texture (12-36 in.) Sandy, S S S S
Loamy, Clayey, (note 2:1 Clay) PS P PS
U
3) Soil Structure (12-36 in) S S S S
Clayey Soils 5 P PS
U U U i U
4) Soil Depth (inches) S S S , � S
PS PS PS
U U
z
5) Soil Drainage: Internal SS'" S
PS WS PS
U U -
External S S S
PS• P.S
U
6) Restrictive Horizons `5D
7) Available Space S S S
PS PS =- PS
U U U
f Y::_ U
8) Other(Specify) i S S S $
PS PS PS PS
U U U U
9) Site Classification (�
U—UNSUITABLE S—SUITABLE —Provisionally Suitable
Recommendations/Comments:
Described by Title N Date
SITE DIAGRAM \
� � I
d �
DCHD(6-82)
• APPLICATION FOR SITE EVALUATION/IMPROVEMENTS PERMIT
'r Davie County Health Department
Environmental Health Section
R O. Box 665
Mocksville, N.C. 27028
CONSTRUCTION SHALL NOT BEGIN UNTIL IMPROVEMENTS PERMIT HAS BEEN ISSUED.
Home Phone qa)
1. Permit Reuested By Business Phone
2. Address ff
3. Property Owner if Different than Above
Address
4. Permit To: a) Install Alter Repair
b) Privy Conventional Other Type
Ground Absorption
c) Sub-DivisionSec. Lot No.
5. System used to serve what type facility: House Mobile Home—Business
IndustryOther
b) Number of people -3
6. a) If house or mobile home, state size of home and number of rooms.
House Dimensions 101 o C) `�i-t1 �•�
r �
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 sinks
8. a) Type water supply: Public Private ✓ Community
b) Has the water supply system been approved? YeSL No
9. a) Property Dimensions - -- 0 4&Lj;�'
b) Land area designated to building site Z
c) Sewage Disposal Contractor
10. Do you anticipate any additions or expansions of the facility this sewage system is intended to serve? lye
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
Allow 5 days for processing
Directions to property:
x,
D� x2
•
DCHD(6-82)
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 Trea ent and Disposal Rules (10 NCAC 10A .1934-.1968) Permit Number'
`Name > Date /�, _�%'� `!` `,; 4 .9 °►
u ;
Location
ILI
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 ❑ NO ❑ Sp cific tions for System:
Auto Dish Washer YES ❑ NO ❑ �(/ jl�� '
Auto Wash Machine YES NO
Type Water Supply
*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
Vol
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.
vC-ca luuu Uy
SITE DIAGRAM \ _
�n
Health Department
j it r�4,.- 1 JPS
Envi m- tal Health Section
.0. Box 848
MO d1ROAVIE�OUN� 210 Hospital Sheet
0rr tti, Courier# : 09-40-06 -�
Nlocksville, NC 27028
Phone:(336)-753-6780 trax:(336)-753-1680
ON-SITE WASTEWATER CERTIEMATION FOR DWELLING
(Check One) Replacement Qemode—Ifin-D Reconnection
Name: O' �of/l /1 r one Number 6'�;t /L
Mailing Address: 1C Q �G?�xSY `l0- g (Work)
Detailed Directions To Site: 62nmnSUc G j z- 6�L cl Al 1,146164fln4 Xe,
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s
Property Address: TU AJ6. &
Please Fill In The Following Information About The EXISTING Facility: 1 `
Name System Installed Under: �Y)<� (1L Type Of Facility: oe j(tyP_„t177l YY3YW�
Date System Installed(Month/Date/Year): `(/��7�� Number Of Bedrooms: Number Of People: a
Is The Facility Currently Vacant? YS ® If Yes,For How Long?
Any Known Problems? Yes Q If Yes,Explain:
Please Fill In The Following Information About The NEW Facility In ja%rt!/6d c
Type Of Facility:
cb -i^ yl� m Number of People
Requested By: K Date Requested:
(Sign tore)
For Environmental Health Office Use Only
Approved isapproved
Comments:
Environmental Health Specialist Date:
*The signing of this form by the Environmental Health Staff is in no way intended,nor should be taken as a guarantee
(extended or limited)that the on-site wastewater system will function properly for any given period of time.
Payment: Cash Check Money Order #. Amount:$ Date:
Paid By: Received By:
Account#: Invoice#: