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173 Ashley Lane, Lot 2 Davie County,NC Tax Parcel Report Tuesday, October 18, 2016 193 5, I 1 I I 5 t I I I 173 D W 2 r r Z 890 148 % ------------ r r r 1 r i WARNING: THIS IS NOT A SURVEY Parcel Information _ . Parcel Number: F50000000204 Township: Mocksviile NCPIN Number: 5831918845 Municipality: Account Number: 82527438 Census Tract: 37059-806 Listed Owner 1: DAUGHERTY STEPHEN P Voting Precinct: NORTH MOCKSVILLE COUNTY Mailing Address 1: 173 ASHLEY LANE Planning Jurisdiction: Davie County City: MOCKSVILLE Zoning Class: DAVIE COUNTY R-A State: NC Zoning Overlay: Zip Code: 27028-0000 Voluntary Ag.District: No Legal Description: LOT 2 ASHLEY PLACE Fire Response District: WILLIAM R.DAVIE Assessed Acreage: 4.96 Elementary School Zone: WILLIAM R DAVIE Deed Date: 12/2006 Middle School Zone: NORTH DAVIE Deed Book!Page: 006940456 Soil Types: MrC2,MrB2,GnB2 Plat Book: 0007 Flood Zone: Plat Page: 100 Watershed Overlay: DAVIE COUNTY Building Value: 229730.00 Outbuilding 8r Extra 13570.00 Freatures Value: Land Value: 35630.00 Total Market Value: 278930.00 Total Assessed Value: 278930.00 ,9 tmlAAll data Is provided as is without warranty or guarantee of any Idnd either expressed or Implied Including but not limited to the Davie County, Implied warranties of merchantability or Mness 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 rSpUN� NC or arising out of the use or Inability to use the GIS data provided by this website. DAVIE COUNTY HEALTH DEPARTMENT Environmental Health Section P.O.Boa 848/210 Hospital Street Mocksville,NC 27028 (336)751-8760 /n2 Account #: 990002908 Tax PIN/EH#: 05831`-91✓-8845 Billed To: Michael Dalton Subdivision Info: Ashley Place Lot#2 Reference Name: Location/Address: Ashley Lane-27028 Proposed Facility: Residence Property Size: 5 Acres ATC Number: 3578 AUTHORIZATION FOR WASTEWATER SYSTEM CONSTRUCTION **NOTE** This Authorization for Wastewater System Construction MUST BE ISSUED by the Davie County Environmental Health Section prior to issuance of any building permit(s). This Form/Authorization Number should be presented to the Davie County Building Inspections Office when applying for building permit(s)(in compliance with Article 11 of G.S.Chapter 130A,Wastewater Systems,Section.1900 Sewage Treatment and Disposal Systems). THIS AUTHORIZATION FOR WASTEWATE R VALI OR A PERIOD OF FIVE YEARS. Environmental Health Specialist's Signature: ate: 6 CERTIFICATE OF COMPLETION **NOTE** The issuance of this Certificate of Completion shall indicate the system described on Improvement/Operation Permit has been installed in compliance with Article 11 of G.S.Chapter 130A,Section.1900"Sewage Treatment and f. Disposal Systems,"but shall in NO WAY be taken as a guarantee that the system will function satisfactorily for any ,, given period of time. 33 f 10 Septic System Installed By: Environmental Health Specialist's Signature ate: DCHD 05/99(Revised) I I II 1 I I I � 7 I I r I 5. O l •I �Q I I � I 8845 !•n I y 506 Printed:Dec 11 , 2014 All data is provided as is without warranty or guarantee of any kind either expressed or implied including but not limited to the 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 or arising out of the use or inability to use the GIS data provided by this website. DAVIE COUNTY HEALTH DEPARTMENT Environmental Health Section / • , r P.O.Boz 848/210 Hospital Street C / Mocksville,NC 27028 (336)751-8760 IMPROVEMENT/OPERATION PERMIT Account #: 990002908 Tax PIN/EH M #5831-91-8845 Billed To: Michael Dalton Subdivision Info: Ashley Place Lot#2 Reference Name: Location/Address: Ashley Lane-27028 Proposed Facility: Residence Property Size: 5 Acres ATC Number: 3578 **NOTE** This Improvement/Operation Permit DOES NOT authorize the construction of a septic tank system or any wastewater system. An AUTHORIZATION FOR WASTEWATER SYSTEM CONSTRUCTION must be obtained from this Department prior to the construction/installation of a system or the issuance of a building permit(in compliance with Article 1 l of G.S.Chapter 130A,Wastewater Systems, Section.1900 Sewage Treatment and Disposal Systems). THIS PERMIT IS SUBJECT TO REVOCATION IF SITE PLANS OR THE INTENDED USE CHANGE. YOUR WASTEWATER SYSTEM CONTRACTOR MUST SEE THIS PERMIT BEFORE INSTALLING SYSTEM. Residential Specification: Building Type HWSZ- #People #Bedrooms 3 #Baths 2 •S Dishwasher: M/' Garbage Disposal: ❑ Washing Machine: Basement w/Plumbing: ❑ Basement/No Plumbing: ❑ Commercial Specification: Facility Type #People #People/Shift #Seats Industrial Waste: ❑ Lot Size -5' KCS Type Water Supply OELL-- Design Wastewater Flow(GPD) S�aO Site: New 12/ Repair❑ System Specifications: Tank Size 'LOGAL. Pump Tank GAL. Trench Width Rock Depth 12-' Linear Ft. (OCX� Other: l_1•J 'T p r" . r Required Site Modifications/Conditions: ' tJSTl�L.1l, t'_�� C_O•?1 0�2 S tF IMPROVEMENT/OPERATION PERMIT LAYOUT- APPROVED EFFLUENT FILTER RISERS) IF 6"BELOW FINISHED GRADE. ****NOTICE: Contact a representative of the Davie County Health Department for final inspection of this system between 8:30 a.m.to 9:30 a.m.or 1:00 p.m.to 1:30 p.m.on the day of installation. Telephone#is(336)751-8760.**** d. Z -� A o sd� Environmental Health Spe list's Signature: Date: DCHD 05/99(Revised) - i ((�� np U LIGATION FOR SITE EVALUATION/IMPROVEMENT PERMIT&ATC DE C t5 WE I ni Davie County Health Department EnVftnlnenta/Hea/th Section P.O. Box 848/210 Hospital Street SEP "' 8 2003 Mocksville, NC 27028 (336)751-8760 f. ii ** THIt APPLICATION CANNOT BE PROCESSED UNLESS ALL THE.REQUIRED DED./ Refer to the INFORMATION BULLETIN for instructions. 1. Name to be Billed CFV,) Contact Person Mailing Address 4/1 � 6),- r Home Phone 7S7-d A'S' City/State/ZIP Business Phone 2. Name on Permit/ATC if Different than Above Mailing Address City/State/Zip 3. Application For: ❑ Site Evaluation >91improvement Permit/ATC ❑ Both` 4. system to Servicer House ❑ Mobile Home ❑ Business ❑ Industry ❑ Other 5. Type system requested: Conventional ❑ conventional modified ❑ innovative 6. If Residence: # People 3 # Bedrooms �_ # Bathrooms I- Dishwasher ❑Garbage Disposal Washing Machine ❑Basement/Plumbing ❑Basement/No Plumbing 7. . . If Business/Industry /Other: verify type # People # Sinks # Commodes # Showers # Urinals # Water Coolers IF FOODSERVICE: # Seats Estimated Water Usage (gallons per day) S. Type of water supply: ❑ County/City Well ❑ Community 9. Do you anticipate additions or expansions of the facility this system is intended to serve? ❑Yes 1L6N0 If yes,what type? ***IMPORTANT***CLIENTS MUST COMPLETE THE REQUIRED PROPERTY INFORMATION REQUESTED BELOW. Either a PLAT or SITE PLAN MUST BE SUBMITTED by the client witli THIS APPLICATION. Property Dimensions.: Sw �,JA WRITE DIRECTIONS(from Mocksville)to PROPERTY: Tax Office PIN: # SU 3/9/d y$S S- 1/S /SS «fir eo,,za ewey, Property Address: Road Name-4S/4Z-,142,4e 44,66- O"ro .[� City/Zip_/LL�'fff—kink ?K eMd- fj CW 9--)WX114W 444 7t1 r?i&fs o`. If in a Subdivision provide information,as follows: ,daf elL Z. 3 'lvaer 46,f — oma, Name: �,•J � ,ds#,(eV le�eo?�� �,r ea, Section: Block: Lot: Date home corners flagged: 12 —0 This is to certify that the information provided is correct to the best of my knowledge. I understand that any permit(s) issued hereafter are subject to suspension or revocation,if the site plans or intended use change,or if the information submitted in this application is falsified or changed. I,also,understand that I am responsible for all charges incurred fi•oln this application. I,hereby,give consent to the Authorized Representative of the Davie County Health Department to enter upon above described property located in Davie County and owned by to conduct all testing procedures as necessary to determine the site suitability. DATE I/-, SIGNATURE ?` THIS AREA MAYBE USED FOR DRAWING YOUR SITE PLAN(Include all of the following: Existing and proposed property lines and dimensions, structures, setbacks, and septic locations). pC a Site Revisit Charge Client Notification Date: EHS: Sign given / Account No. 0 / { M Revised DCHD( /03 C Invoice No. i/ 1, M777!r777777r--,7,7MW-T nXV) !F,! �-,�,� "7,��,,�,,M-"'777,77M,"M W-11 ---7- `-`*%"17-1"'-,---- - '---- ; YMNI�PRAWN, 11=11w�.---�"",-,­............: �12W - , , SM//,��"/ ,�, / '- , /,I �/" ,�,,��,�,�,,��,,I"ff,,'���,�,��,�'; ,��;,,'- , ,- ,- �" - ``�`//W,&1'1'11"�,�� "', ", , ,�,�, '11- ,,,""M", , I I I 1'�11'1,1',, ', ,�,-,/�- " '1�1`1110?11 �111 11",�/,/�/IAXMRI 401n, i-/, , ""I�rlll " f I 1-�"","----7--- , , , - I , �//n` ,�,//," ,�,P/"�/, ,/A/ /,A�, "� , �r , -m///,n�, ; I/ �`, I - W- , " " "115 " �", 111T ,-� , // � ,,, - , -�",�,,,A,,q,;,,1-- , , I/ -� "n'/�" ��111//11 'I""""?, �,;�/n�//// I /0 ///-� / -": ;1, 11, ...� - - "I , ,.� , �,m- "//,/ � �1� I p �­ � ; , � , I I - I, I /,"///,�� I �// W/;/", -111 , , , ,, - , I ,, 11 ,,/ -�, ,, /-I I ,/";"�- �" -::, , , , �/ ,',,,' P", vpytn,��l?"",�v�,,���g,,�,,,�,,,,, �,,,,,,-"-",-',,',�""",�"", �-',w ,� I , ,/�,,- "- , , �:,," -, ,/"/ �I _ , - - ,11 I ", ::;:,, , "' , 638 , � , ,/"/ , '�,�" :,: ,,,, " , ","'-, " � , ,,,, _ -,��,/- _��, ` :�/',- / ""I"111 , " ;", : ,�"/,,/� �/, I ` " I , , I � /", I/11/� ""' ,/ �','11'�,,/ :,""""', , I I ,M I "//, , / 11 / 1- 1 -1 nv,"�'- '_/"", , I I I � , ,�"'11'e�':' , - " , / I I , �,��' �- �- , , I , I , " / ,�'-/ ,/� el , , , , '', / / -///�,/"/`�/,- ''-/,��/,// ��/"":,//: -/;,�,"Z:;:',-, , ", /I "" I n/9",", ,, ,-g - 'nal/I 1 an " 1-111,11,11 '' I /, -�M /, / /Iam/ , / ""' 1, -/--, - I 11 -- , j ��:`-/ � /-/"",/,�,�"/",,"/, , -'�',"',�,-"" , - , 1, / ,//�--, , I n" , , - - I �/,/"/,/1Q'//�, I �1�/,I I '/",�,,,�,"" /��- �;", ,--K�/�//��- I-111 ��,�SIAWII 11 - 1- /,/"Ah"s , al",1, , , / i,�, , - " , :,;,/"","'W1/I / , ��, -- , -I-,/;IV I ///,//�-',,,,, �/;/ 0 no ,/;, ", "I'll, " ,-',I/ A/ I ,I, 1 "/////,///r��/��""",,/",,;�7 , � ,,/,/6�//,N&-�,�,,, ,/,�-//,Ahm- , 1, ,,,,"'' , ,-AA V"�?41p� `/ "", � �""", 1, I , N/1 //,/" , , � // '' /, C'�//"-"�� ,v M-R 1 A " , ," , , , 1219 K- / �, � , ,, 1/'-�/ ,/"' ,/,//,/"','/", /, , I I , � " - , "I","/"/,/,/,I/ , I Ed ,, , ; I I ,/ / IS / " I I -',�/;, "" I , / , "'?," , , �,//" - , " / //,// ,"too! sw//,",�/,", ,// / , `/ "'' "''/,/, I, , "/ I I "',//"''//", - ,:,", :" "- - �,/, I , ,, ,I/ , , %/ � -""I'' /",/,/-/ , , I ,/ '11-1- 1/11/1, , // ," / ,, I I 01, /' '/ 1�1 // I,/,/,/ ,,,,, , ," / ,&//// -1/ - I // "1111-I , - ," n -//,�/,, 11-11/11`1//�11/11'/",//,/,�"/ / , - .../ 111`--/ ", - ,,, / / ,/ , - � I I'll - / /// /, �' : -//'�,,,/,,,'/,,',,/' �'':'' I'll ',�,I"1'�,/'111- ,� I ,,,,, , - I "1/1 , ,�- �, ,/,�,� A , I ,�1�1,1// , �,'i�",� , I-/ -// ,�` :;,,""',,/,,//",�"%:,,:: ,/, � ,,,,,� ,, , -/, , -�m,�/,:,/,////11/1 � - , �///1'1/1/111/ M11",1�' / I xlll//""-/�, 1t,/,/,///,/, - - ,-,/�,/,1�1'/', /I"" , I , - ,,, , , / - �"-- , , I -, , , ��,`�`/"',//�/R/ / , /I/ /, , "/,/, ` , , , , , , ` ,, , /// , , , ,/ I I ,I -, , ,,,,,,, I I I I I ",/, /' , , '/, '- , I I�'/,"' 1 - , 11 I -- 1;I I -��" /, , , , I I I I I I I I I I �'- � - - - , " - 1� - , I , -1 I I I , - , "/ - , , , �: - �1��I �J " I I I ,� I / : -/, I ,",/�//- I /;// 11 ­ / , - � `� I I I , I " , , - , , I I I 1� I , , _ ��,/'- , I I ��/',""::;,, � ;',,,��//""',�////"_ � ,,�`,,/-; /, ,,, -�- � ��", // %"I 'oil /, �/,�', I , , , "� ,///o,/'-';' ': /,/", 11 I , A " / , , , '0� - , " I/ I , , �' /, / , "-1'��/1, , ,� �, I I 1'��I" , ,�,"',", " / I ,�,-� , I - - ,/, /, �',',-�",`//','/n�',',' ,/;,j,,//,A//1U`, , ,�-I'�iil � "I"",/,"', / - �, /",/"",/" , - ,/"/'' �,/,/,�,��/,, I I - � ,, , , / , / " "I'M11 - I /',/"', � �" , `�',1,,/:; I " / / , H / 11"- I , / , 0 �� �;` , , /,/ I/-111 , & ,,,",,,,,',,',/,//"/�////,///�'�,// / -;,�"/""",," � � /, 'g//�//,/,�",/,;",,,, �", , "11/�/ " '-1 I? 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Phone:(396)-i33-6780 - Fax:(335)-753-1680 ON-SITE WAS,TFWATER CERT.IP`LCATION (Check One) Replacement Remodeling Reconnection Name: Phone 33 S t 7-a-4� (home) .Mailing AYidress: 1-7 3 q Sp►1 ccs L/41— ^—y----_(Work) Email A ddress• r _ D Directions To Site: — l I tf -_ --V `// 6�/Y'a, Property address• Please> ill in The Following Information About TbeE.'YCS2MVPFa�c�tY� LOA, J�� Name SS•stem Instaued Under: ^oi'1 •�' 1) 2 D tType Of F`acility:_, Date Sysiem Installed(D4onthOate[Year): (,`5— O ,lumber Of Bedroorrs;__ Number Of People: Is The Facility Currently Vacant? Yes No If Yes,For How Long? _ Any Kn I m Problems? Yes No If Yes,Expla*.n: 1 Please Fill In The Followw' Information about The MW Facility: Type O IFacility: ! I N �G X _ Namber Of F3edrooms: Number of People Pool Si Garage Size- — Other:`_r — XRequestld By: f-- 6"� - A. Date Reouested: (Signature) For Environmenial Healfe Office Use Only Approl !$approved ` Comrue ts -1 ����--f_ �r' / r1'j Environmental Health Specialist _ _ — — _D ate i j The sig:rirg of this fornz by the Environmental Health Staff is is no wad•intended,nor should betaken as a guarantee j I(extended or limited)that the on-site wastewater system will 5 nrticn property for ary given pericd of tin, e. l Pa merit: Cass. Check k1c, e"y Order _�p 12 _---;Aaioua::S �z� �Q�11D IQ—f Dater 2 Paid 8�:� Q-}C—1, 15.. - - -- -Received B>':_�v !"/► TTi[�GII _ �__. Account H.. �t� i i