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118 Dutchman Creek RdDavie County, NC Tax Parcel Report ( p Thursday, September 29, 2016 5 { 5 � ` 112 4 4 I 5293 118 WARNING: THIS IS NOT A SURVEY Parcel Information Parcel Number: L700000024 Township: Fulton NCPIN Number: 5766589259 Municipality: Account Number: 17960000 Census Tract: 37059-804 Listed Owner 1: CORRELL DONALD C Voting Precinct: FULTON Mailing Address 1: 422 BECKTOWN ROAD Planning Jurisdiction: Davie County City: MOCKSVILLE Zoning Class: DAVIE COUNTY R -A State: NC Zoning Overlay: Zip Code: 27028-6607 Voluntary Ag. District: No Legal Description: HWY 801 Fire Response District: FORK Assessed Acreage: 1.55 Elementary School Zone: CORNATZER Deed Date: 1/2016 Middle School Zone: WILLIAM ELLIS Deed Book I Page: 010091175 Soil Types: PcB2,PcC2 Plat Book: Flood Zone: Plat Page: Watershed Overlay: DAVIE COUNTY Building Value: 14230.00 Outbuilding & Extra Freatures Value: 4500.00 Land Value: 23260.00 Total Market Value: 41990.00 Total Assessed Value: 41990.00 Davie County, NC All data is provided as Is wHhout warranty or guarantee of any ldnd either expressed or Implied including but not limited to the Implied warran es 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 or arising out of the use or Inability to use the GIS data provided by this website. L,ccs —Permittee's ;r r DAVIE COUNTY HEALTH DEPARTMENT Name: ' — Environmental Health Section PROPERTY INFORMATION P.O. Box 848, Directions to property: ry "i c- -it-), t `"� Mocksville,NC 27028 Subdivision Name: Tt.)V a� `Y,#.rt, C '>^t '✓I` 1t Vit ,.. Phone#:336-751-8760 Section: Lot: �' AUTHORIZATION FOR WASTEWATER Z 7 •�� !_r<1~ y Ta ice PIN:# - SYSTEM CONSTRUCTION AUTHORIZATION NO: �' A oad Name: "� **NOTE**This Authorization for Wastewater System Construction MUST BE ISSUED by the Davie County Environmental Health Section prior to issuance of any Building Permits.This Form/Authorization Number should be presented to the Davie County Building Inspections Office when applying for Building Permits.' (In compliance�yitEi cycle 1}"of G.S;Chaptteer 130A,Wastewater Systems,Section.1900 Sewage Treatment and Disposal Systems) ***NOTICE***THIS AUTHORIZATION FOR WASTEWATER CONSTRUCTION `r IS VALID FOR A PERIOD OF FIVE YEARS. ENVIRO �yEIVTAL�HEALTH SPE A>>IST DAT ISSUED l'' RESIDENTIAL SPECIFICATION:BUILDING TYPEb4" "#BEDROOMS #BATHS #OCCUPANTS GARBAGE DISPOSAL:Yes or No COMMERCIAL'SPECIFICATION: FACILITY TYPE #PEOPLE #PEOPLEISHIFT #SEATS INDUSTRIAL WASTE:Yes or No : LOT SIZE TYPE WATER SUPPLY i' DESIGN WASTEWATER FLOW(GPD) NEW SITE REPAIR SITE S SYSTEM SPECIFICATIONS: TANK SIZE GAL. PUMP TANK GAL. TRENCH WIDTH .ROCK DEPTH i2'+ LINEAR FT.711 -� OTHER REQUIRED SITE MODIFICATIONS%CONDITIONS: :��. JT�t-t- O� CVNTWIZi ka: a G�t-- IMPROVEMENT PERMIT LAYOUT ��-1 caA N-r I L: x (� t� i14n"1- Ve Q)Q Ll 160, ' x so fA 10 **CONTACT A REPRESENTATIVE OF THE DAVIE COUNTY HEALTH DEPARTMENT FOR FINAL INSPECTION OF THIS SYSTEM . BETWEEN 8:30 9:30:A.M.OR 100-):30 P.M.ON THE DAY OF INSTALLATION.TELEPHONE#IS(336)751=8760, OPERATION PERMIT �� SYSTEM INSTALLED BY: V AUTHORIZATION NO. O OPERATION PERMIT BY: DATE /lac **THE ISSUANCE OF THIS OPERATION PERMIT SHALL INDICATE THAT THE SYSTEM DESCRIBED ABOVE HAS BEEN INSTALLED IN COMPLIANCE WITH ARTICLE 11 OF G.S.CHAPTER 130A,SECTION.1900"SEWAGE TREATMENT AND DISPOSAL SYSTEMS",BUT,SHALL IN NOWAY BETAKEN ASA GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORILY FOR ANY GIVEN PERIOD OF TIME. DCHD 02102,(Revised) 54 :, Permittee s � DAVIE COUNTY HEALTH DEPAR 1V� NT Name. Environmental Health Section ' ; ` PROPERTY INFORMATION �, ... P.O. Box 848 t f c . �, DTrecfionsxo property: Mocksville, NC 27028 Subdivision Name: z pe Phone #: 336-751-8760 Section: Lot AUTHORIZATION FOR -_ ._ ... WASTEWATER ! T r � � e<� t. ?� �., TaWffice PI t - SYSTEM CONSTRUCTION AUTHORIZATION NO:. 4.1 0 *''AAkoad Name:t;, 1 }?#�;,J tt��� �- r.-' •- **NOTE** This Authorization for Wastewater System Construction MUST BE ISSUED by the Davie County Environmental Health Section prior to issuance of any Building Permits. This Form/Authorization Number should be presented to the Davie County Building Inspections Office when applying for Building'Permits. (In compliance with Anjle 1 -of G ter 130A, Wastewater Systems, Section .1900 Sewage Treatment and Disposal Systems) a ***NOTICE*** THIS AUTHORIZATION FOR WASTEWATER CONSTRUCTION IS VALID FOR A PERIOD OF FIVE YEARS. ENVIRO TENTAMHEALTH SPECJALIST DATE ISSUED ; RESIDENTIAL SPECIFICATION: BUILDING TYPETV&k �� # BEDROOMS :S # BATHS t� # OCCUPANTS ('' GARBAGE DISPOSAL: Yes or No COMMERCIAL SPECIFICATION: FACILITY TYPE # PEOPLE # PEOPLE/SHIFT # SEATS INDUSTRIAL WASTE: Yes or No LOT SIZE TYPE WATER SUPPLY DESIGN WASTEWATER FLOW (GPD)'" NEW SITE REPAIR SITE ^`fit SYSTEM SPECIFICATIONS:TANK SIZE GAL. PUMP TANK GAL. TRENCH WIDTHS ROCK DEPTH i e2 LINEAR FT. OTHER ! '�l'j C T �`�7 TC' iii, l� LM }�C 1r3 {lt`✓�'�L �C i�� C r � REQUIRED SITE MODIFICATIONS/CONDITIONS: �%`� l �— QT `� (_£ 'f�+ t � +" l �1 ' `. ► �" C^" !^ t t= L Lw_ IMPROVEMENT PERMIT LAYOUT — e ; Ao E cr3x t t, 1 SLS C,>�- �wr.Zj VIA- ! tA 1 S� Af **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 THE DAY OF INSTALLATION. TELEPHONE #IS (336)751-8760. OPERATION PERMIT+ SYSTEM INSTALLED BY:.1� 1 r AUTHORIZATION NO. 9/0/ OPERATION PERMIT BY: DATE: *'THE ISSUANCE OF THIS OPERATION PERMIT SHALL INDICATE THAT THE SYSTEM DESCRIBED ABOVE HAS BEEN INSTALLED IN COMPLIANCE WITH ARTICLE 11 OF G.S. CHAPTER 130A, SECTION .1900 "SEWAGE TREATMENT AND DISPOSAL SYSTEMS", BUT SHALL IN NO WAY BE TAKEN AS A i-TTeD Am-rcv TueT Tuc cvcTRM WTT T PTTmr-rTnN cATTSFArT0RTT v PnR ANv rTvPm PPRT(nl 0P TTMP DAVIE COUNTY HEALTH DEPARTMENT Environmental Health Section y©V PO Box 848/210 Hospital Street Mocksville, NC 27028 Phone: (336)751-8760 ON-SITE WASTEWATER CERTIFICATION FOR DWELLING (Check One) REPLACEMENT V REMODELING ❑ RECONNECTION ❑ Name: l)[ r Na Z CC1"_2L1 Phone Number: q q<4 ` S (D a 3 (Home) Mailing • • • tit'.�!ltlil,r a a �.. - e � A • Detailed Directions To • • AL&' �� `` I •kq_ Ixaf o • • • • • • ► • ' ' a fir. f Property Address: tit `0kA1ehn-,Q _n C�(20 k QA Please Fill In The Following Information About The Existing Dwelling: Name System Installed Under: Type Of Dwelling:njuhjV' Date System Installed(Month/Day/Year): Number Of Bedrooms:_ -S Number Of People: Is The Dwelling Currently Vacant? Yes 0 No ❑ If Yes, For How Long? v l e Q k Any Known Problems? Yes ❑ No ;d If Yes, Explain: Please Fill In The Following Information About The New Dwelling: 3 aa- ?-Q, Type Of Dwelling: aq u (9y QN- lag i o ry Number Of Bedrooms: q Number Of People: t0 Requested By: Requested: t I - L1- 0�' k For Environmental Health Office Use Only 01 Approved ❑ Disappro Q rd-,ir a / sS uti'b i t l �O ja, %b oq)b"j`�� Environmental Health Specialist i �/ i\� / \ Date I/ I*The signing of this form by the Environmentail-Tealth Staff is inlv-w6y intended, nor should be taken as a euarantee(extended or limited) that the on-site wastewater system will function vroverly for anv given period of time. Payment: Cash ❑ Check ❑ Money Order ❑ # Amount: $ Date: Paid By: Received By: Account #:©� Invoice #: r51 .0.h 1/ '• A r i I DAVIE COUNTY HEALTH DEPARTMENT Environmental Health Section r PO Box 848/210 Hospital Street Mocksville NC 27028 Phone: (336)751-8760 -, ON-SITE WASTEWATER CERTIFICATION FOR DWELLING (Check One)' REPLACEMENT REMODELING ❑ RECONNECTION ❑ Name:_ Ury--� O iryc �C C Q_ l Phonel Number: (o 22, (Home) Mailing Address: 1 1 (1iC}111`Cl�1'.r(C t"P�Ic t��� (Work) Detailed Directions . To Site: (001 # CR,U (_'r S no (' n-) o le 4 1.o i n 5� b 1 cin i�,i�i�rrr�n �t<C�k f1..ci Property Address: l lb D(Ax Ck"'c1 C Pp '3L R Please Fill In The Following Information About The Existing Dwelling. Name System Installed Under: Type Of Dwelling: Sr914,d e. Date System Installed(Month/Day/Year): Number Of Bedrooms: Number Of People:__ Is The Dwelling Currently Vacant? Yes No 11'. If Yes, For How Long? u) P k Any Known Problems? Yes ❑ No �ff If Yes, Explain: Please Fill In The Following Information About The New Dwelling. 213 Type Of Dwelling: CA V Co 1 0 I A 1 10 F Number Of Bedrooms: Number Of People: ,i Requested By: Date Requested: I j - (4 - o : 1, (Signature) y For Enviro s ,. ental Health Office Use Only Approved ❑ Disapproved Comments: v�i`- f' C: 1 r ISS U�� i2 70 Environmental Health Specialist ' ,Date 1/lo lo 1W". . - K *The signing of this form by the Environmen ealth Staff is iri n y 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?$.' I LL.. Date: Paid By: Received By: ✓ c) ..Account #• � �O �• �'� Invoice #• b it DAVIE COUNTY HEALTH DEPARTMENT Environmental Health Section PO Box 848/210 Hospital Street Mocksville, NC 27028 Phone: (336)751-8760 ON-SITE WASTEWATER CERTIFICATION FOR DWELLING (Check One) REPLACEMENT*.-" REMODELING ❑ RECONNECTION ❑ Name: w A '-✓ Lv / r a/Phone Number: We / °"'4 (Home) Mailing Address: !/.2 1Z)tiyle,,4 ii4" �c�/L �S/- .S��D/ (Work) Detailed Directions To Site: G S%F- � .J^4e e. /ell. / s � G2'•�-{ N, R+, Property Address: Please Fill In The Following Information About The Existing Dwelling: Name System Installed Under: "-Zt r mLX Co t r c l 1 ^ ��`t 6 r rct 1 Type Of Dwelling: Date System Installed(Month/Day/Year): %'i/- 7e Number Of Bedrooms: � Number Of People: 4''-3 Is The Dwelling Currently Vacant? Yes G]INo ❑ If Yes, For How Long? 2 H t -C Any Known Problems? Yes 0 No;?*� If Yes, Explain: Please Fill In The Following Information About The New Dwelling.( 7114 tw100 Type Of Dwelling: 14• f��►-t-- Number Of Bedrooms: ?� Number Of People: —� Requested By:, For Environmental Health Office Use Only Requested: o2 - a2— ZOOy Approved R"" Disapproved ❑ Comments: 5ysl—a f'1 i5 b'DGC'?i )ATS. �O� . h 2 ��oc� w` 2 i.C, ���s CT Sllot)L-1) B -a t,)onfo itAt5—, sou Jc Ilan 1"0 2 Y"4p—, Environmental Health *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 0 # Amount: $ UU Date: C-�rj Paid By: :ld Received By: %� p Account #: Invoice #: �� U % • _ DAVIE COUNTY HEALTH DEPARTMENT /(Septic Tank) Improvements Permit and Certificate of Completion r : ,(Gr d Absor tion 77� e Disposal System G.S. Chapter 130 -Article 13C) / ,INER OR CONTRACTOR Z �, rr % DATE �.► ,j s _ �� y.- PERMIT LOCATION i +s wea/`J' : r�%e 11 ? 41 ` S. R. NO. SUBDIVISION NAME LOT NO. SECTION OR BLOCK NO. HOUSE ❑ MOBILE HOME BUSINESS ❑ NO. BEDROOMS NO. BATHROOMS Two Bedroom House 800 Gal. 00 Sq. Ft. GARBAGE DISPOSAL UNIT YES ❑ NO ❑ Three Bedroom House 900 Gal. 900 Sq. Ft. AUTO. DISHWASHER YES ❑ NO ❑ Four Bedroom House 1000 Gala 1200 Sq. Ft. AUTO. WASH. MACHINE YES ❑ NO ❑ SITE SUITABLE YES 0200' NO ❑ SIZE OF TANK Q ,^. gal. NITRIFICATION FIELD sq. ft. DEPTH OF STONE IN LINESs ~ WATER SUPPLY: Individual Public ❑ PERMIT BY �. �..i INSTALLED BYt IMPROVEMENTS '::��r-�.�,. CERTIFICATE OF COMPLETION By Date C,7 --.;2j —9 (8/16/73) *Construction must c y with all other applicable State and local regulations LOT AREA r-