1372 Cornatzer Rd Davie County,NC Tux Parcel Report Wednesday, October 12, 2016
ILL 1364 WARNING: THIS IS NOT A SURVEY
Parcel Iufuzmuuyu
Parcel Number: H700000007 Township: Shady Grove
Nop|NNumboc 5708231870 Municipality:
Account Number: 17450000 Census Tract: 37059-804
Listed Owner 1: CORNATZGRBAPTIST CHURCH Voting Precinct: WEST SHADY GROVE
Mailing Address 1: 1372 CORNATZER ROAD Planning Jurisdiction: Davie County
City: K8OCKGV|LLE Zoning Class: DAV|ECOUNTY R+A.R' U
State: NC Zoning Overlay:
Zip Code: 27028-0000 Voluntary Ag.District: No
Legal Description: 2.S5ACCORNATZER&RALPH Fire Response District: CORNATZER'DUL|N
Assessed Acreage: 225 Elementary School Zone: CORNArIER
Deed Date: / Middle School Zone: VNLLiAMELL|O
Deed Book/Page: Soil Types: GnB2
Plat Book: Flood Zone:
Plat Page: Watershed Overlay: DAV|ECOVNTY
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Building Value: 610410.00 Fro�umoOutbuilding—Extra
0.00
Land Value: 42900.00 Total Market Value: 653310.00
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Total Assessed Value: 653310.00
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DAVIE COUNTY HEALTH DEPARTPENT SEPTIC TANK PERMIT
No of Bedrooms j1!447'LrC-A Date
This permit is grante4 to f;arboo Ell/s for the installation of a septic tank
at the residence of (nrhq er , nl;rl` ur<�i Address 3, ltjocks a;//c.,a. C',
Building Contractor Address
Septic Tank Specifications: Length Width Depth Capacity Gal. O O
Manufacturer Is .Name Address 3
No of lines_ width 3eAn. Total Length ` /ooft. No. of Sq. t. 3
Type of filter material Total tons used
Minimum Requirements: House Trailer Tank Cap. 800 Sq. ft. line 400
Two-cbedroom house, 800 600
Three-bedroom house 900 900
No one shall install a septic tank in Davie County without a permit from the Health
Officer or his agent.
Date of final approval Signed:
Sanitarian
I hereby certify that the above septic tank has been installed according to
specifications.
Signed:
Septic Ta Contract
Note: Make sketch of disposal system on back of sheet and mail to Health Center,
Mocksville.
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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 .19/34-.1968) Permit Number
.Name �r?N/� 7`t 41- 6Ai�itS f• Ci kylZc �� Date �! � Yy �.� r•
' �WK 3 ;i70
Location
Subdivision Name Lot No. Sec. or Block No.
G��vrrc ti
Lot Size House Mobile Home _ .Busiae s Speculation
No. Bedrooms No. Baths ?_ No. in Family _
Garbage Disposal YES NO
g p � Specifications for System: /Uov
Auto Dish Washer YES ❑ NO ❑
Auto Wash Machine YES E) NO F-11�v`x x /$
S iZ�N
,LJ .!S a'n Or C viv c rT t rL.
Type Water Supply
'This permit Void if sewage system described below is not installed within 36 months from date of issue.
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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'S C, T`�-� Uv«
S
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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.
DAVIE COUNTY HEALTH DEPARTMENT
Environmental Health Section
R O. Box 665
Mocksville, N.C. 27028
SOIL/SITE EVALUATION I/
Name (2Z(W A,77-s4,- SA-PT75T CK u 2.C/-( Date
Address �bv� 9 �° Lot Size
FACTORS AREA 1 AREA 2 AREA 3 AREA 4
1) Topography/Landscape Position (�b (i_�> S S
PS PS PS PS
U U U U
2) Soil Texture (12-36 in.) Sandy, S S S S
Loamy, Clayey, (note 2:1 Clay) 1�v CZS--> PS PS
U U U U
3) Soil Structure (12-36 in.) S S S S
Clayey Soils cn <3M> PS PS
U U U U
4) Soil Depth (inches) S SPS PS
�_..._-
U U U U
5) Soil Drainage: Internal S S S S
� PS PS
U U U U
External SS S
(3-NS & PS PS
U U U U
6) Restrictive Horizons
7) Available Space S S. S S
PS PS PS PS
U U U U
8) Other (Specify) S S S S
PS PS PS PS
U U U U
9) Site Classification
U—UNSUITABLE S—SUITABLE PS—Provisionally Suitable
Recommendations/Comments:
Described by � Title ��°`'�'` "'�"�"' Date ' 6,SITE DIAGRAM
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4
DCHD(6-82)
21
APPLICATION FOR SITE EVALUATION/IMPROVEMENTS PERMIT
Davie County Health Department
Environmental Health Section
P. O. Box 665
Mocksville, N.C. 27028
CONSTRUCTION SHALL NOT BEGIN UNTIL IMPROVEMENTS PERMIT HAS BEEN ISSUED.
Home Phone 998-8403
1. Permit Requested By Cornatzer Baptist Church Business Phone 998-4399
2. Address Route 3 Box 404 Mocksville, NC 27028
3. Property Owner if Different than Above
Address
4. Permit To: a) Installer Alter Repair
b) Privy Conventional Ll Other Type
Ground Absorption
c) Sub-Division Sec. Lot No.
5. System used to serve what type facility: House Mobile Home Business
IndustryOther fleWl y 9h#,,0'k ,>WS iP
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 j garbage disposal
lavatory showers washing machine
dishwasher sinks
8. a) Type water supply: Public—Private Community
b) Has the water supply system been approved? Yes ✓ No
9. a) Property Dimensions 6e X Joe
b) Land area designated to building site FIP.Ph'o,?f , �.1/
c) Sewage Disposal Contractor
10. Do you anticipate any additions or expansions of the facility this sewage system is intended to serve? IV4
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:
DCHD(6-82)