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1878 Hwy 801SDavie County, NC' Tax Parcel Report Tuesday, September 27, 2016 Avg 1 Davie County, NC WARNING: THIS IS NOT A SURVEY erl[nfcmqgtl§ Parcel Number: G800000023 Township: Shady Grove NCPIN Number: 5880125194 Municipality: Account Number: 62802500 Census Tract: 37059-803 Listed Owner 1: S & G INVESTMENTS INC Voting Precinct: EAST SHADY GROVE Mailing Address 1: Po BOX 150 Planning Jurisdiction: Davie County City: KURE BEACH Zoning Class: DAVIE COUNTY R-A,R-20,H-B State: NC Zoning Overlay: Zip Code: 28449-0000 Voluntary Ag. District: No Legal Description: 4.449 AC HWY 801 Fire Response District: ADVANCE Assessed Acreage: 3.89 Elementary School Zone: SHADY GROVE Dead Date: 1/1900 Middle School Zone: WILLIAM ELLIS Dead Book I Page: 001280630 Soil Types: WeC,WeB,PcB2 Plat Book: Flood Zone: x Plat Page: Watershed Overlay: Building Value: 114240.00 Outbuilding & Extra 3670.00 Freatures Value: Land Value: 253400.00 Total Market Value: 371310.00 Total Assessed Value: 371310.00 Avg 1 Davie County, NC 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 4;>�s j� Environmental Health Section . P.O. Box 848 0 ~ 210 Hospital Street Courier # : 09-40-06 1911 Mocksville, NC 27028 Phone: (336) - 753 -6780 ON-SITE WASTEWA ER IFS .CATION Fax: (336) - 753-1680 (Check One) Replacement emodeling Reconnection Name: - �'1 % �Yf �� Phone Number % �r t�� (Home) Mailing Address: IMAM 111AN� nn (Work) e(2V 6 Email Address: Detailed Directions To Site: 4,pl(ll! 6124SS ie/ Property Add ess: 97Y. &OOODO L 3 QK Please Fill I he Following Information About e ING Facility: (� CI Name System Installed Under: t Type Of Facility: lbv 4,;-1W S�d2c. Date System Installed (Month/Date/Year): Number Of Bedrooms: / Number Of People: Is The Facility Currently Vacant? Yes No If Yes, For How Long? Any Known Problems? Yes No If Yes, Explain: Please Fill In The Following Information About The NEW Facility: Type Of Facility: Viol 1 �fi?!/L, C okl 2,:�)W Number Of Bedrooms: - Pool Size: Garage Size: Other: Number of People, kequested By:_"! "`-- Date Requested: For Environmental Health Office Use Only Approve Disapproved Comments: Environmental Health Specialist (� �/'`'(,( lit) "/�i(�� Date: ��,��c�U/� *The signing of this form by the Environmental Health Staff is in no way intendcd, 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:$ Date: Paid By: Received By: Account #: Invoice #: **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 Article 11 of G.S. Chapter 130A, Wastewater Systems, Section .1900 Sewage Treatment and Disposal Systems) ***NOTICE*** THIS AUTHORIZATION FOR WASTEWATER CONSTRUCTION IS VALID FOR A PERIOD OF FIVE YEARS. F EN�VIAONMENTAAL H HSE LIST DATE ISSUED RESIDENTIAL SPECIFICATION: BUII DING' TYP ,D�L9/ ` #BEDROOMS #BATHS #OCCUPANTS GARBAGE DISPOSAL: Yes or No COMMERCIAL SPECIFICATION: FACILITY TYPE # PEOPLE # PEOPLE/SHIFT # SEATS INDUSTRIAL WASTE: Yes or Nc LOT SIZE TYPE WATER SUPPLY 1 r DESIGN WASTEWATER FLOW (GPD) NEW SITE REPAIR SITE SYSTEM SPECIFICATIONS: TANK SIZE GAL. PUMP TANK GAL. TRENCH WIDTH ROCK DEPTH LINEAR FT,M OTHER f ! %y C?ZG` REQUIRED SITE MODIFICATIONS/CONDITIONS: **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 (704) 6348760. OPERATION PERMIT \1 'STEM INSTALLED BY: ULt AUTHORIZATION NO. 1 OPERATION PEMI.&a-leDATE: L **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 GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORILY FOR ANY GIVEN PERIOD OF TIME. DCHD 05/96 (Revised) ...:u,,•, —m. ,r..,.w °y: ! iY'i'ut,Y,�r.'aif'�,5 S",r.•Yv.«m �."F'„;;fio,,,.»`�^,eta*.r 3..%y -rro •.s>s:,. ' ''".i"-ST�•t;•.•. AUTHTI'ON NO:1154 Ub DAVIE COUNTY HEALTH DEPARTMENT . Environmental Health Section PROPERTY INFORMATION Permit e'sP.O. (''' Box 848 Name:SIZ .. / Mocksville, NC.27028 Subdivision Name: ' Phone #: 704-634-8766 Directions to property: Section: Lot: AUTHORIZATION FOR WASTEWATER SYSTEM CONSTRUCTION Tax Office P N:# - - Rnarl Name• :�t��l AAVdm7i -f ?7i9n/ **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 Article 11 of G.S. Chapter 130A, Wastewater Systems, Section .1900 Sewage Treatment and Disposal Systems) ***NOTICE*** THIS AUTHORIZATION FOR WASTEWATER CONSTRUCTION IS VALID FOR A PERIOD OF FIVE YEARS. F EN�VIAONMENTAAL H HSE LIST DATE ISSUED RESIDENTIAL SPECIFICATION: BUII DING' TYP ,D�L9/ ` #BEDROOMS #BATHS #OCCUPANTS GARBAGE DISPOSAL: Yes or No COMMERCIAL SPECIFICATION: FACILITY TYPE # PEOPLE # PEOPLE/SHIFT # SEATS INDUSTRIAL WASTE: Yes or Nc LOT SIZE TYPE WATER SUPPLY 1 r DESIGN WASTEWATER FLOW (GPD) NEW SITE REPAIR SITE SYSTEM SPECIFICATIONS: TANK SIZE GAL. PUMP TANK GAL. TRENCH WIDTH ROCK DEPTH LINEAR FT,M OTHER f ! %y C?ZG` REQUIRED SITE MODIFICATIONS/CONDITIONS: **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 (704) 6348760. OPERATION PERMIT \1 'STEM INSTALLED BY: ULt AUTHORIZATION NO. 1 OPERATION PEMI.&a-leDATE: L **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 GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORILY FOR ANY GIVEN PERIOD OF TIME. DCHD 05/96 (Revised) + ^�. ':.L Pl ' xv:-�,. n.i�w.,,.t..Ei i� W`+H+:.is� �•ritY+a—rW-��. —vY � " Y . �..a �'.�� . .:, AUTHORIZ„AT.ION NO: r DAVIE COUNTY HEALTH DEPARTMENT: Environmental Health Section PROPERTY INFORMATION "Permittee's [' P.O. Box 848 Name: J+ �OL'�PQL� Mocksville, NC 27028 Subdivision Name: Phone #:,704-634-8760 rop Directions to perty: 1 Section: Lot: 4 / / AUTHORIZATION FOR ,r* / WASTEWATER Tax Office P N:# - SYSTEM CONSTRUCTION Y Road Name: �2/�%1Zip:lo **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 Article I l of G.S. Chapter 130A, Wastewater Systems, Section .1900 Sewage Treatment and Disposal Systems) I***NOTICE*** THIS AUTHORIZATION FOR WASTEWATER CONSTRUCTION IS VALID FOR A PERIOD OF FIVE YEARS. '.ENVI O MENTAL HEALTH SPECIALIST DATE ISSUED : s 'F - ,A. VSi'a '.,• i SP# DAVIE COUNTY HEALTH DEPARTMENT • IMPROVEMENT AND OPERATION PERMITS PROPERTY INFORMATION Permittee's ,r Name:"'xit Subdivision Name: Directions to roe%'f' '' p p rty: Section: Lot: IMPROVEMENT �PERNM Tax Office P N:# - - Road Name: **NOTE** This Improvement Permit DOES NOT authorize the construction or installation 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 11 of G.S. Chapter 130A, Wastewater Systems, Section .1900 Sewage Treatment and Disposal Systems) 41 ***NOTICE*** THIS PERMIT IS SUBJECT TO REVOCATION IF SITE PLANS OR THE INTENDED USE CHANGE. YOUR WASTEWATER ENVIROTiMENTAL HEALTH SPECIALIST DATE ISSUED SYSTEM CONTRACTOR MUST SEE THIS PERMIT BEFORE INSTALLING THE SYSTEM. RESIDENTIAL SPECIFICATION: BUILDING TYPT3 �1 ` # BEDROOMS ` # BATHS / # OCCUPANTS eC GARBAGE DISPOSAL: Yes or No COMMERCIAL SPECIFICATION: FACILITY TYPE # PEOPLE # PEOPLE/SHIFT # SEATS INDUSTRIAL WASTE: Yes or No LOT SIZE TYPE WATER SUPPLY L_ DESIGN WASTEWATER FLOW (GPD), NEW SITE REPAIR SITE SYSTEM SPECIFICATIONS: TANK SIZE GAL PUMP TANK GAL. TRENCH WIDTH l ROCK DEPTH 0/y LINEAR FrAng OTHER . 7yy-og'v� REQUIRED SITE MODIFICATIONS/CONDITIONS: IMPROVEMENT PERMIT LAYOUT II "CONTACT A REPRESENTATIVE OF THE DAVIE COUNTY HEALTH DEPARTMENT FOR FINAL INSPECTION OF THIS SYSTEM II BETWEEN 8:30 - 9:30 A.M. OR 1:00 - 1:30 P.M. ON THE DAY OF INSTALLATION. TELEPHONE # IS (704) 6348760. OPERATION 0 INSTALLED BY: F AUTHORIZATION NO. 1(5 y 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 GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORILY FOR ANY GIVEN PERIOD OF TIME. DCHD 05/96 (Revised) 4s'lr^'t .. �y : +. ,,, . , _. as h �a+'r-'sA-':M•^+w-• "•��. i-+ -'4-D.`J.+y -, .. c _ ., `] /+ DAVIE COUNTY HEALTH DEPARTMENT IMPROVEMENT AND OPERATION PERMITS. PROPERTY INFORMATION fi Permitt6e's -Name: �4a "t +t'''�► 70e� Subdivision Name: Directions'to property: e •+. Section: Lot: P - IMPROVEMENT .PERMIT Tax Office P N:# - - Road Name: © ID:, **NOTE** This Improvement Permit DOES NOT authorize the construction or installation 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 11 of G.S. Chapter 130A, Wastewater Systems, Section .1900 Sewage Treatment and Disposal Systems) ***NOTICE*** THIS PERMIT IS SUBJECT TO REVOCATION IF SITE PLANS OR THE INTENDED USE CHANGE. YOUR WASTEWATER ENVIRONMENTAL HEALTH SPECIALIST DATE ISSUED SYSTEM CONTRACTOR MUST SEE THIS PERMIT BEFORE ti ) INSTALLING THE SYSTEM. RESIDENTIAL SPECIFICATION: BUILDING TYP94 V # BEDROOMS # BATHS �� # OCCUPANTS *;7, GARBAGE DISPOSAL: Yes or No COMMERCIAL SPECIFICATION: FACILITY TYPE # PEOPLE # PEOPLE/SHIFT # SEATS INDUSTRIAL WASTE: Yes or No ` LOT SIZE TYPE WATER SUPPLY r� DESIGN WASTEWATER FLOW (GPD) _F&NEW SITE'•'REPAIR SITE SYSTEM SPECIFICATIONS: TANK SIZE GAL. PUMP TANK GAL. TRENCH WIDTH - -N ROCK DEPTH - J LINEAR FT OTHER REQUIRED SITE MODIFICATIONS/CONDITIONS: �x **CONTACT; A REPRI;6aT_ ;NTATIVE 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 (704) 634-8760. OPERATION PERMIT - Q YSTEM INSTALLED BY: � + AUTHORIZATION NO. OPERATION PERMIT BY: Gtr/C/ 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 GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORILY FOR ANY GIVEN PERIOD OF TIME. DCHD 05/96 (Revised) DAVIE COUNTY ENVIRONMENTAL HEALTH SECTION WORKSHEETFORSEPTIC SYSTEM REPAIR PERMIT NAME S r De / L+ PHONE NUMBER ADDRESS / �m�?PD SUBDIVISION NAME A)Z6 DIRECTIONS TO SITE DATE SYSTEM INSTALLED NAME SYSTEM INSTALLED UNDER SPECIFY PROBLEMS OCCURRING SUBDIVISION LOT # 4 DATE REQUESTED INFORMATION TAKEN BY AUTHOWZATION NO: 115 4 DAVIE COUNTY HEALTH DEPARTMENT Environmental Health Section PROPERTY INFORMATION Permittee's P.O. Box 848 Name: Efi r W gd:s Mocksville, NC 27028 Subdivision Name: -^ Phone #: 704-634-8760 Directions to property: AUTHORIZATION FOR " r WASTEWATER SYSTEM CONSTRUCTION Section: Lot: Tax Office PIN:# - Road Na e:d P_A1fi jV: 70 **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 Fonn/Authorization Number should be presented to the Davie County Building Inspections Office when applying for Building Permits. (In compliance with Article 11 of G.S. Chapter 130A, Wastewater Systems, Section .1900 Sewage Treatment and Disposal Systems) ' ✓ ' ' ***NOTICE*** THIS AUTHORIZATION FOR WASTEWATER CONSTRUCTION IS VALID FOR A PERIOD OF FIVE YEARS. ENVIRO MENTAL HEALTH SPECIALIST DATE ISSUED RESIDENTIAL SPECIFICATION: BUILDING TYPE Oit l/' # BEDROOMS —# BATHS # OCCUPANTS GARBAGE DISPOSAL: Yes or No COMMERCIAL SPECIFICATION: FACILITY TYPE # PEOPLE # PEOPLE/SHIFT � � # SEATS INDUSTRIAL WASTE: Yes or No LOT SIZE TYPE WATER SUPPLY / D DESIGN WASTEWATER FLOW (GPD)26—11) NEW SITE REPAIR SITE L/ r SYSTEM SPECIFICATIONS: TANK SIZE GAL. PUMP TANK GAL. TRENCH WIDTH SG' ROCK DEPTH 0199 LINEAR FT,i rt D 1;3"p OTHER ` r� A/, REQUIRED SITE MODIFICATIONS/CONDITIONS: IMPROVEMENT PERMIT LAYOUT rat;, tw c� OPERATION "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 (704) 634-8760. INSTALLED BY: F �_I L AUTHORIZATION NO. �� OPERATION PERMIT BY: 4 el DATE: "THE ISSUANCE OF THIS OPERATION PERMIT SHALL INDICATE THAT THE SYSTEM DESCRIBED ABOVE HAS BEEN INSTALLED IN COMPLIANCE WITH ARTICLE I 1 OF G.S. CHAPTER 130A, SECTION .1900 "SEWAGE TREATMENT AND DISPOSAL SYSTEMS", BUT SHALL IN NO WAY BE TAKEN AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORILY FOR ANY GIVEN PERIOD OF TIME. DCHD 05/96 (Revised)