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Davie County, NC
Information
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Parcel Number:
G8130A0001
Township:
Shady Grove
NCPIN Number.
5789276145
Municipality:
Account Number:
62527002
Census Tract:
37059-804
Listed Owner 1:
OSBORNE KENNETH D
Voting Precinct:
EAST SHADY GROVE
Mailing Address 1:
PO BOX 391
Planning Jurisdiction:
Davie County
City:
ADVANCE
Zoning Class:
DAVIE COUNTY R-20
State:
NC
Zoning Overlay:
Zip Code:
27006-0391
Voluntary Ag. District:
No
Legal Description:
0.745AC HY 801 POTTS TR 1WALNUT
Fire Response District:
ADVANCE
HILLS
Assessed Acreage:
0.72
Elementary School Zone:
SHADY GROVE
Deed Date:
11/2006
Middle School Zone:
WILLIAM ELLIS
Deed Book / Page:
2006E0347
Soil Types:
PcB2
Plat Book:
0009
Flood Zone:
X
Plat Page:
189
Watershed Overlay:
WS -IV -P
Building Value:
72670.00
Outbuilding & Extra
0.00
Freatures Value:
Land Value:
24960.00
Total Market Value:
97630.00
Total Assessed Value:
97630.00
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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
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causes of action due to or arising out of the use or inability to use the GIS data provided by this website.
NAME
Imp
DAVIE COUNTY ENVIRONMENTAL HEALTH SECTION _
APPLICATION FOR IMPROVEMENT PERMIT (REPAIR) �SJ
PO/ / � PHONE NUMBER
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'015' ��� SUBDIVISION NAME (�
LOT #
DIRECTIONS TO SITE
DATE SYSTEM INSTALLED NAME SYSTEM INSTALLED UNDERls
TYPE FACILITY O : Sa NUMBER BEDROOMS �`� NUMBER PEOPLE SERVED
TYPE WATER SUPPLY POA
SPECIFY PROBLEM OCCURRING l-` ��- • �
DATE REQUESTE4�,'� INFORMATION TAKEN BY (� �-
This is to certify that the information provided is correct to the best of my knowledge, and that I understand I am responsible for all ch incurred from this application.
SIGNATURE OF OWNER OR AUTHORIZED AGENT r
Rev. 1/93
,sF-„gi.r r- �7 a t�...s. �,.�+"'v- rte.: -+r -`'ri •aa..r. wrij�� �-»fir+- -i �-•, s--� y � --�;.� ,_ � � -,"., �t ,?'� .h., r , ��. .. .:e y.,-,
AUTHORIZA' 164 NO: DAVIE COUNTY HEALTH DEPARTMENT—
• I 1.r Environmental Health Section PROPERTY INFOR
Permittee's P.O.'Box 848
Name: Lt'a` �c-1 Is Mocksville, NC 27028 Subdivision Name:
{ ,, -Ip �4D1 .5 Phone # 336-751-8760
Directions to property: Section:Lot:
AUTHORIZATION FOR
1-lCtiJf>+� �i`yA�C4`. `v �2. Mt �'--? WASTEWATER Tax Office PIN:# -
SYSTEM CONSTRUCTION -
1 � Road Name: I IW V Zip: '17'70C)(0
**NOTE** This Authorization for Wastewater System Construction MUST BE ISSUED by the Davie County Environmental Health Sectionprior
to issuance of any Building -Permits. This Form/Authorization Number should be presented to the Davie County Building Inspections
Office when applyp'ng for Building Permits.
(In compliancVwith Arti ,le I llof G.S. Chapter 130A, Wastewater Systems, Section .1900 Sewage Treatment and Disposal Systems)
Aii / `, ' ,
***NOTICE*** THIS AUTHORIZATION FOR WASTEWATER CONSTRUCTION
:4-51a IS VALID FOR A PERIOD OF FIVE YEARS.
31 11' k`�F(EALTH SPECltIST DALE ISSUED
s+ DAVIE COUNTY HEALTH DEPARTMENT
t'4 IMPROVEMENT AND OPERATION PERMITS PROPERTY INFORMATION;
r
Ter nitfee s' _ coz
.;,.Name:. �''a' �' 4� 1 I Subdivision Name:
Directions to property: 1 }' 1- t' Section:
J IMPROVEMENT
PERMIT Tax Office PIN:#
�l_� "i �.( .�f• h^.,r�r� �* Road'Name: ��tAJti r4f.j
Lot:
Zip: ° 4'
**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 `5
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)
***NOTICE*** THIS PERMIT IS SUBJECT TO REVOCATION IF SITE
PLANS OR THE INTENDED USE CHANGE. YOUR WASTEWATER
ENVIRONMENTAI HEALTH SPECIALIST D ISSUED SYSTEM CONTRACTOR MUST SEE THIS PERMIT BEFORE
t . INSTALLING THE SYSTEM.
RESIDENTIAL SPECIFICATION: BUILDING TYPE ,# BEDROOMS — # BATHS # OCCUPANTS 1 GARBAGE DISPOSAL: Yes or No
COMMERCIAL SPECIFICATION: FACILITY TYPE # PEOPLE # PEOPLE/SHIFT # SEATS INDUSTRIAL WASTE: Yes or No
LOT SIZE TYPE WATER SUPPLY �✓v� DESIGN WASTEWATER FLOW (GPD) 3(-0 Q NEW SITE REPAIR SITE �✓ `/
SYSTEM SPECIFICATIONS: TANK SIZE GAL. PUMP TANK GAL. TRENCH WIDTH ` ROCK DEPTH LINEAR FT. 1
OTHER , aTuf
J
UTIp
REQUIRED SITE MODIFICATIONS/CONDITIONS: 4""' Nt%t J5�' `L -t-`^' t U
IMPROVEMENT PERMIT LAYOUT *APPROVED EFEFLI
'70`(41..
LE
1 1 k
tom.
t
ISE.R (S) IF 5" BEELCA FItIIShSD GRADE*
1
o'
"CONTACT A REPRESENTATIVE OF THE DAVIE COUNTY HEA4TH. DEPARTMENT FOR FINAL INSPECTION OF THIS SYSTEM
BETWEEN 8:30 - 9:30 A.M. OR 1:00 - 1:30 P.M. ON THE DAxi' OF INSTALLATION. TELEPHONE # IS (703))634�S760S Y.
(330)751-0760
OPERATION PERMIT
(�
Oct)YSTEM I TALLED
L 1r�% s1__J
X070
tj
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AUTHORIZATION NO. U� OPERATION PERMIT BY: DATE:
"THE ISSUANCE OF THIS OPERATION PERMIT SHALL INDICATE THAT 'THE DESCRIBED ABOVE H 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)