211 Grady Ln (2) Davie County,NC Tax Parcel Report Thursday, February 23, 2017
WARNING: THIS IS NOT A SURVEY
77
Parcel Irifoimation
Parcel Number: K200000073 Township: Calahaln
NCPIN Number: 5707953600 Municipality:
Account Number: 13972500 Census Tract: 37059-801
Listed Owner 1: CARTNER DANNY WILLIAM Voting Precinct: SOUTH CALAHALN
Mailing Address 1: 211 GRADY LANE Planning Jurisdiction: Davie County
City: MOCKSVILLE Zoning Class: DAVIE COUNTY R-A
State: NC Zoning Overlay:
Zip Code: 27028-8262 Voluntary Ag.District: - No
Legal Description: 7.5 AC OFF DAVIE ACADEMY Fire Response District: COUNTY LINE
Assessed Acreage: 8.03 Elementary School Zone: COOLEEMEE
Deed Date: 8/1995 Middle School Zone: SOUTH DAVIE
Deed Book/Page: 001820350 Soil Types: AaA,RnC,ChA,CeB2
Plat Book: Flood Zone:
Plat Page: Watershed Overlay: DAVIE COUNTY
Building Value: 161740.00 Outbuilding&Extra 25930.00
Freatures Value:
Land Value: 44710.00 Total Market Value: 232380.00
Total Assessed Value: 232380.00
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 warrantles 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
�oUSi NC or arising out of the use or Inability to use the GIS data provided by this website.
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OPERATION PERMIT o
r ice se n v;
Davie County Health Department Number 219009-1
210 Hospital Street
P.O. Box 848 umber.
Mocksville NC 27028 r. REPAIR
Phone: 336-753-6780 Fax:336-753-1680
Applicant: Danny Cartner Property Owner Danny Cartner
Address: 211 Grady Lane Address: 211 Grady Lane
City: Mocksville Cky: Mocksville
State0l): NC 27028 State2ip: NC 27028
Phone#: (336)909-4027 phone#: (336)909-4027
Property Location & Site Information
Address/Road#: Subdivision: Phase: lot:
211 Grady Lane
Mocksville NC 27028 Directions
Structure: SINGLE FAMILY Davie Academy to Ridge Rd on the left. Long
#of Bedrooms: Driveway
#of People:
*Water Supply: NIA
*IP Issued by. 2140-Nations,Robert *System Classification/Description:
TYPE III G.OTHER NON-CONN.TRENCH SYSTEMS
*CA issued by: 2140.Nations,Robert
Saprolite System? QYes QNo
Design Flow: 3 6 0Distribution Type: GRAVITY-SERIAL Pump Required?
Q Yes G, to
Soil Application Rate: 0 . 3 *Pre Treatment:
Drain field
Nitrification Field 1 _ 2 _ 0 0 Sq.ft. *System Type: INFILTRATOR QUICK 4 STANDARD
(1"�
No. Drain Lines 3 Installer Donny Lakey
Total Trench Length: 3 0 0 ft. Certification#: 1108
Trench Spacing: 9 Inches O.C.
Feet O.C. *EH S: 2140-Nations,Robert
Trench Width: — 3 Qinches
Feet Date: 0 2 / 2 1 / 2 0 1 3
Aggregate Depth: inches
Minimum Trench Depth: 3 6 Inches
Minimum Sail Cover. 2 4 Inches Approval Status ,
Maximum Trench Depth: 3 6 ��, ® ApproyedC. sDtsapproved
Inches
s
Maximum Soil Cover.
2 4 Inches
t
CDP Fite Number 219009 - 1 Septic Tank County ID Number: '
Manufacturer. Let.
Long:
STB:
Gallons: Installer:
Date: / / Certification#:
'EHS:
'Filter Brand:
ST Marker. ❑ Yes ❑ No Date:
Reinforced Tank: ❑ Yes 1:1 No Approval Status
1 Piece Tank: ❑ Yes ❑ No
❑ Approved❑ Dlsapprovea-
Pump Tank
Manufacturer. Installer.
PT: Certification#:
Gallons: 'EHS:
Date: / / Date:
RiserSealed ❑ Yes O No
RiserHeight: ❑ Yes ❑ No (Min.6 in.)
' Approval Status]
einforced Tank: ❑ Yes O No 'to V6 0",Disapproved
1 Piece Tank: ❑ YeS ❑ No --
Supply Line
Pipe Size: inch diameter Installer
P
Pipe Length: feet Certification#:
'EHS:
"Schedule:
Pressure Rated ❑ Yes ❑ No Date:
Approved fittings ❑ Yes ❑ NO -;=Approval Status
❑ Approved❑ ,Disapproved
p Requirement
Pump Type: Installer.
Dosing Volume: — Gal Certification#:
Draw Down: 'EHS:
Inches
"Chain:
Date:
Valves Accessible ❑ Yes ❑ No
Flow Adjustment Valve ❑ Yes ❑ No
Check-valve ❑ Yes ❑ No Approva18tatus'
PVC unions C] Yes ❑ No ElApproved El Disapproved
Vent Hole ❑ Yes ❑ No
Anti-siphon Hole El Yes ❑ NO
CDP File Number 219009 - 'I County ID Number:
Electric Equipment
NEMAT4XBox or Equivalent ❑ Yes ❑ No Installer.
Box 12 Above Grade [3 Yes ❑ No
Certification#:
Boo Pump Tank ❑ Yes ❑ No
Conduit Sealed ❑ Yes ❑ NO *ENS:
Pump M an ually 0 perable ❑ Yes ❑ NO
*Activation Method: Date:
Approval Stafus.
Alarm Audible ❑ Yes ❑ No
Approved❑ Dsapproved �
Alarm Visible ❑ Yes ❑ No
2140-Nations.Robert
*Operation Permit completed by:
Authorized State A t: L Date of Issue. 0 2 / a 1 / 2 0 1 y
Owner/Applicant Signature:
This system has been installed in compliance with applicable NC General Statutes:Article 11, Chapter 130A, Rules for
Sewage Treatment and Disposal, 15A NCAC 18A.1900 et. Seq.,and all conditions of the Improvement Permit and
Construction Authorization.This property is served by a TYPE III G. sewage septic system.
Rule.1961 requires that a Type TYPE Ill G. septic system meet the following criteria:
Minimum System Review By The Local Health Department: NIA
Management Entity: OWNER
Minimum System Inspection/Maintenance Frequency By Certified Operator:
NIA
Reporting Frequency By Certified Operator. N/A
Rule.1961 requires that a Type IV and V septic systems designed fora home/business owner must maintain a valid contract
with a public management entitywith a certified operatoror a private certified operator forthe life of the septic system.
Rule .1961 requires that Type VI septic systems designed fora home/business owner must maintain a valid contract with a
public management entitywith a certified operator for the life of the septic system.
Rule. 1961 (2)(e)requires a contract shall be executed between the system owner and a management entry prior to the
issuance of an Operation Permit for a system required to be maintained by a public or private management entity, unless the
system ownerand certified operator are the same. The contract shall require specific requirements formaintenance and
operation, responsibilities of the owner and systems operator,provisions that the contract shall be in effect for as long as the
system is in use,and other requirements for the continued proper performance of the system. It shall also be a condition of
the Operation Permit that subsequent owners of the systems execute such a contract.
@Hand Drawing Olmport Drawing
**Site Plan/Drawing attached.**
OPERATION PERMIT
Davie County Health Department CDP File Number: 219009 - 1
210 Hospital Street
P.O.Box W County File Number:
Mocksville NC 27028 Date:
Olnch
Dira�yiin Scale: . OBlock
Drawing Type: Operation Permit ON/A
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CONSTRUCTION For office use Only
AUTHORIZATION 'CDP File Number 219009- 1
Davie County Health Department
County ID Number.
210 Hospital Street Evaluated For REPAIR
P.O. Box 848 Township:
Mocksville NC 27028 PERMIT VALID UNTIL:
Phone:336-753-6780 Fax:336-753-1680 0 1 / 1 8 / a 0 2 a
Applicant: Danny Cartner Property Owner. Danny Cartner
Address: 211 Grady Lane Address: 211 Grady Lane
City: Mocksville City: Mocksville
State2ip: NC 27028 State2ip: NC 27028
Phone#: (336)909.4027 Phone#: (336)9094027
Property Location & Site Information
r
ad #: Subdivision: Phase: Lot:
y Lane
e NC 27028 Directions
Structure: SINGLE FAMILY Davie Academy to Ridge Rd on the left. Long Driveway
of Bedrooms:
#of People:
xWater Supply: wA
System Specifications
Minimum Trench Depth: 3 6
rDesign
assification: Provisionally Suitable Inches
e System? QYes QNo Minimum Soil Cover. a 4 Inches
Flow: 3 6 0 Maximum Trench Depth: 3 6 Inches
SoilMaximum Soil Cover:
Application Rate: 0 3 a 4 Inches
'System Classification/Description: 'Distribution Type: GRAVITY-SERIAL
TYPE III G.OTHER NON-CONY.TRENCH SYSTEMS Septic Tank:
Gallons
'Proposed System: 251/1a REDUCTION 1-Piece: QYes QNo
Pump Required: QYes QNo QMay Be Required
N ilrification Field 1 2 0 0
Sq. ft. Pump Tank: Gallons
No. Drain Lines 3 1-Piece: QYes QNo
Total Trench Length: 3 0 0 }t GPM—vs— ft. TDH
Trench Spacing: _ 9 Onches
e t O.C.C Dosing Volume: _ Gallons
Trench Width: Inches
— 3 8Feet Grease Trap: Gallons
Aggregate Depth: inches
Pre Treatment: QNSF OTS-1 OTS-II
Septic Tank Installer Grade Level Required: 01 Oil OIII OIV
Dann i of Q
CDP File Number 210009 - 1 County ID Number.
❑ Open Pump System Sheet
Repair System Required:®Yes ONO ONo, but has Available Space
rDesign
System Inches 0. .
Trench Spacing: 9
ification: Provisionally Suitable — Feet O.C.
Trench Width; Inches
w: 3 6 0 - . �Feet
Soil Application Rate: 0 - 3 Aggregate Depth: ,
inches
Minimum Trench Depth: 3 6
'System Classification/Description: Inches
TYPE III G.OTHER NON-COW.TRENCH SYSTEMS Minimum Soil Cover. a 4 Inches
Maximum Trench Depth: 3 6 Inches
'Proposed System: 25%REDUCTION -
Nitrification Field 1 a 0 0 Sq.ft. Maximum Soil Cover: a 4 Inches
No. Drain Lines 3 'Distribution Type: GRAVITY-SERIAL
Total Trench Length: 3 � � � Pump Required: Oyes C7No OMay Be Required
Pre Treatment: ONSF OTS-I OTS-II
*Site Modifications
No grading or construction activity is allowed in areas designated for system and repair without approval of Health Department.
*Permit Conditions
The issuance of this permit bythe Health Department in no way guarantees the issuance of other permits.The permit holder
is responsible for checking with appropriate governing bodies in meeting their requirements. ;
This Authorization for Wastewater system Construction shall be valid fora person equal to the period of valldlty of the improvement Permit not
to exceed five years,and may be Issued at the same time the Improvement Permit Issued(NCGS 130A-336(b)}If the installation has not been
completed during the period of validity of the Construction Permit the Information submitted In the application fora permit or Construction
Authorization is found to have been Incorrect,falsified or changed,or the site Is altered,the permit orConstruction Authorization shall become
Invalid,and may be suspended or revoked(.1937(8)).The person owning or controlling the system shall be responsible for assuring compliance
with the laws,rules,and permit conditions regarding system location,Installation,operation,maintenance,monitoring,reporting and repair
(1938(b)).
Applicantfl.egal Reps.Signature Required? Oyes ONO
Applicant/Legal Reps. Signature* Date:
'Issued By:
2140-Nations.Robert Date of Issue: 0 1 / 1 8 / 2 0 1 3
- - _ - - - - - ------
Authorized State Agent: Malfunction Log OYes
Hand Drawing Olmport Drawing
**Site Plan/Drawing attached.**
Page 2 of 3
CONSTRUCTION AUTHORIZATION
Davie County Health Department CDP File Number: 219009 - 1
210 Hospital Street
P.O.Box 848 County File Number:
Mocksville NC 27028 Date: 0 1 / 1 8 2 0 1 7
Q Inch
Drawing Drawing Type: Construction Authorization Scale: Qelocrt
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Davie COUNTY
210 Hospital Street
P.O. Box 848
Mocksville - NC 27028 TEL: '336-753-6780 FAx: 336-753-1680 Request ID: 71437
- REQUEST FOR SERVICE/COMPLAINT INVESTIGATION REPORT
REQUEST DATE: 12/28/2016 TAKEN BY:
SECTION: N/A TYPE:
PROPERTY NUMBER: 219009 ASSIGNED TO: Nations, Robert
ESTABLISHMENT NUMBER:
PERSON OR PREMISES TO SEE: OWNER: Danny Cartner
Danny Cartner ' 211 Grady Lane
211 Grady Lane _ Mocksville , 27028
Mocksville NC, 27028
(336) 909-4027
REQUESTED BY "'Danny; Cartner HOME: 336 409-3883
211 Grady Lane WORK:
Cell:
Mocksville NC 27028
Additional Information:
CONDITION REPORTED:Pumped, lines full, needing new line
COMMENTS:
RECORD OF ACTIVITIES
DATE: HR/MT: COMMENTS
EHS:
EHS #:
ACT CODE:
DATE:. HR/MT: COMMENTS
EHS:
EHS #:
ACT CODE:
DATE: HR/MT: COMMENTS
EHS:
EHS #:
ACT CODE:
DATE: HR/MT: COMMENTS
EHS:
EHS #:
ACT CODE:
DATE: HR/MT: COMMENTS
EHS:
EHS #:
ACT CODE:
Next Inspection Date: Status of Complaint: OPEN Resolved Date:
Complaintant Contacted: NO
DAVIE COUNTY ENVIRONMENTAL HEALTH SERVICE REQUEST
APPLICATION IP/ATC OSWW REPAIR p—
Name �f�/(/1C! Telephone Number 3
Address C5? 19i
Mailing Address (if different from above)
Email Address:
Subdivision Name Lot# 44 F cad
Di tions S .IDA v�`�- 5�- i G
Date System Installed Name System Installed Under
Type Facility . Number Bedrooms Number People Served
Type Water Supply Specific Problem Occurring fmiy
r
Date Requested Info Taken By
THIS IS TO CERTIFY THAT THE INFORMATION PROVIDED IS CORRECT TO THE BEST OF MY
KNOWLEDGE,AND THAT I UNDERSTAND THAT I AM RESPONSIBLE FOR ALL CHARGES INCURRED
FROM THIS APPLICATION.
Signature of owner or Authorized Agent
Initial Fee Date REHS
Revisit Charge Date Reason
Revised 2-2011
DAVIE COUNTY ENVIRONMENTAL HEALTH.SERVICE REQUEST
APPLICATION IP/ATC OSWW REPAIR' a
Name %' IJAY K/ 011124varz— Tel hone Number 3 ,
Address o? t
Mailing Address (if different from above) 1 a
Email Address:
Subdivision Name , . , . r` . ..
Lot#
Directions els-f .6,q Vi�. ?5�
�. .5 ;
Date System Installed �q T S "I Name System Ins lied Under IV91- ;
Type Facility Number bedrooms Number People Served
Type Water Supp4
y l ti,,Specific Problem Occurring
Date Requested Info Taken By a:
} THIS IS TO CERTIFY THAT THE INFORMATION PROVI ED IS CORRECT TO THE BEST OF MY
KNOWLEDGE,AND TH,4I UNDERSTAND THAT I AM RESPONSIBLE FOR ALL CHARGES INCURRED
FROM THIS APPLICAT ---""
.: 'Signature o wfier or Authorized Age/n
Initial f ee7a{e O REHS
Revisit.Charge �Da Reason
Reviseh-2011 r