235 Glenn Allen Rd Davie County,NC Tax Parcel Report Thursday, December 15, 2016
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WARNING: THIS IS NOT A SURVEY
Parcel Information _
Parcel Number: ;: ,-F70000000402 Township: Farmington
NCPIN Number: 5861318935 Municipality:
AccountNumber: 67846000 Census Tract: 37059-803
Listed Owner:1:• SMITH NATHAN F ; Voting Precinct: SMITH GROVE
Mailing Address 1: - 214 VINEYARD LANE.:-, Planning Jurisdiction: Davie County
City: MOCKSVILLE --. Zoning Class: DAVIE COUNTY R-A
State: - NC Zoning Overlay: DAVIE COUNTY QD
Zip Code: 27028-7444 Voluntary Ag.District: No
Legal Description: 3.59:AC OFF HOWARDTOWN Cl Fire Response District: SMITH GROVE
Assessed Acreage: 3.62 Elementary School Zone: PINEBROOK
Deed Date: -- :4/1994 Middle School Zone: NORTH DAVIE
Deed Book/Page: 001740039 Soil Types: MrC2,EnB,EnC,ChA
Plat Book: Flood Zone:
Plat Page: Watershed Overlay: DAVIE COUNTY
Building Value: Outbuilding&Extra
Freatures Value:
Land Value: Total Market Value:
Total Assessed Value:
O hI� 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
�O�p C NC or arising out of the use or Inability to use the GIS data provided by this website.
= • VOL DAVIE COUNTY HEALTH DEPARTMENT
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{ IMPROVEMENTS PERMIT AND CERTIFICATE OF COMPLETION
*NOTE: Issued in Compliance with G.S. of North Carolina Chapter 130 Article 13c
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Sewage Treatment and Disposal Rules (10 NCAC 10A .1934-.1968) Permit Number
Name � r\ ;� , _� > :. '\, =�1 Date N2
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Location ��;i ��� c� �� �;� v :i, t :_� `;
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Subdivision Name Lot No. Sec. or Block No.
Lot Size - J House Mobile Home_ _i-� Business Speculation
No. Bedrooms No. Baths No. in Family _
Garbage Disposal YES NO d Specifications for System:
Auto Dish Washer YES Ell NO
Auto Wash Machine YES p' NO p �!
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 bye+-�
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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.
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 (qy9) q fly
1. Permit Requested By In I'Ch a e. Business Phone (910) 99P- a8i�,3
2. Address /?- Rock fiTdvghcP NC Z7ooce
3. Property Owner if Different than Abover-
Address 9-- .2 Aim fo'c kyl lie, NG
4. Permit To: a) Install ✓Alter Repair
b) Privy Conventional--NZOther Type
Ground Absorption
c) Sub-Division &M Sec. Lot No.
5. System used to serve what type facility: House Mobile Home -- Business
Industry Other
b) Number of people
6. a}If house or mobile home, state size of home and number of rooms.
House Dimensions /;�" X z0 "
Bed Rooms 3 Bath Rooms g2 Den w/Closet /
b) If Business, Industry or Other, State: Number of persons served IvZd
What type business, etc
Estimate amount of waste daily (24 hours)
7. Number and type of water-using fixtures:
commodes .2— urinals garbage disposal
lavatory showers washing machine /
dishwasher 1 sinks -2
8. a) Type water supply: Public Private Community
b) Has the water supply system been approved? Yes No
9. a) Property Dimensions 3 S-0 3• a Sa- a,c-+-cs
b) Land area designated to building site &pproX i PM f�4t s4. ii..
c) Sewage Disposal Contractor /1v r _F�/�1S
10. Do you anticipate any additions or expansions of the facility this sewage system is intended to serve? n1d
What type?
This is to certify that the information is correct to the best of my knowledge.
2 2 A, 1
Date Owner Signature
OWNER IS SOLELY RESPONSIBLE FOR COMPLIANCE WITH ALL STATE AND LOCAL LAWS
Allow 5 days for processing
Directions to property:
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Oki /e �f pas �harfy I✓ills�
reS��egce ( 741'r & brick_ o,,,, Sic o� �
e �o c,�a,rcL�-o n
To r n l e f4 n 4-aelk, /2oe� . � ,e� c, �-'
DCHD(6-82)
J
` DAVIE COUNTY HEALTH DEPARTMENT
ENVIRONMENTAL HEALTH SECTION
SITE EVALUATION CONSENT FORM
1. Complete the form below and return to the Davie County Health Department.
2. Carefully follow the procedures as outlined in the enclosed "Information Bulletin."
NOTE: THE ABOVE MUST BE COMPLETED BEFORE A SANITARIAN WILL BE ABLE TO
BEGIN THE REQUESTED EVALUATION.
DETACH HERE AND RETURN TO: Davie County Health Department, Environmental
Health Section, P. 0. Box 665, Mocksville, N.C. 27028
Davie County Health Department
Environmental Health Section
Site Evaluation Consent Form
LOCATION OF PROPERTY: DATE RECEIVED
(office use only)
yes 0 1. 1 am the owner of the above described property.
no 2. 1 am not the owner of the above described property, however, I certify that I
have consent from E S ' �-- 1911&h , owner to obtain a
owner's name
site evaluation by the Davie County Health Department for the purpose of
determining the suitability for a ground absorption sewage treatment and
disposal system.
yes no 3. 1 hereby give consent to the authorized representative of the Davie County
Health Department to enter upon the above described property and conduct all
testing procedures as necessary to determine its suitability for a ground
absorption sewage treatment and disposal system.
DATE SIGNATURE
4. 1 hereby authorize the Davie County Health Department to release site
evaluation results from the above described property to the following:
— Owner only
— Owners designated representative
—Anyone requesting results
`-'fly those listed below
✓"L i
(F/.� x a&Aln�w
DATE SIGNATURE
DCHD(11/84)
J
DAVIE COUNTY HEALTH DEPARTMENT
Environmental Health Section.
R O. Box 665
Mocksville, N.C. 27028
SOIL/SITE EVALUATION
Name ��B�� �� Date
Address S '`+\ Lot Size 3
FACTORS AREA 1 AREA 2 AREA 3 AREA 4
1) Topography/Landscape Position S S 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) PS PS PS PS
U U U U
3) Soil Structure (12-36 in.) S S S S
Clayey Soils PS PS PS PS
U U U U
4) Soil Depth (inches) S S S S
PS PS PS PS
U U U U
5) Soil Drainage: Internal S S S S
PS PS PS PS
U U U U
External S S S S
PS PS 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 Q-1 � �4- Title Date
SITE DIAGRAM
DCHD(6-82)