1018 Underpass Rd Davie County,NC Tax Parcel Report Thursday, February 9, 2017
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WARNING: THIS IS NOT A SURVEY
Parcel Number: F80000013916 Township: Shady Grove
NCPIN Number: 5881510625 Municipality:
Account Number: 16618340 Census Tract: 37059-803
Listed Owner 1: COMER BOBBY KEITH Voting Precinct: EAST SHADY GROVE
Mailing Address 1: 1018 UNDERPASS ROAD Planning Jurisdiction: Davie County
City: ADVANCE Zoning Class: DAVIE COUNTY R-A
State: NC Zoning Overlay:
Zip Code: 27006-0000 Voluntary Ag.District: No
Legal Description: 12.19 AC UNDERPASS RD Fire Response District: ADVANCE
Assessed Acreage: 12.01 Elementary School Zone: SHADY GROVE
Deed Date: 3/1993 Middle School Zone: WILLIAM ELLIS
Deed Book/Page: 001670373 Soil Types: PaD,PcB2,PcC2,ChA,WATER
Plat Book: Flood Zone:
Plat Page: Watershed Overlay: DAVIE COUNTY
Building Value: 250550.00 Outbuilding&Extra 9410.00
Freatures Value:
Land Value: 114170.00 Total Market Value: 374130.00
Total Assessed Value: 374130.00
O Ayl�p 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
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County of Davie,North Carolina,Its agents,consultants,contractors or employees from any and all claims or causes of action due to
�OUp�t NC or arising out of the use or inability to use the GIS data provided by this website.
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4: DAVIE COUNTY HEALTH DEPARTMENT
IMPROVEMENTS PERMIT AND CERTIFICATE OF COMPLETION
*NOTE: Issued in Compliance with G.S. of North Carolina Chapter 130 Article 13c
//�tS__ewage Treatment and Disposal Rules (10�NCAC 10A .1934-.1968) �) Permit Number
Name,IIClP AZ / ,/l�ri.�-D1 fi�iY_{/ /,iii/%- �„ D ate '7-/�,� '', N2 5256
12
Location `/S'"�'' 7` o/ /,� v /�, -- ,.� =4�, �
Subdivision Name Lot No. Sec. or Block No.
Lot Size 'Ialz) House 1-<< Mobi� Home_ Business Speculation
No. Bedrooms No. Baths No.n Family _
Garbage Disposal YES N& Specifications for System:
Auto Dish Washer YES I NO p ""Lx
Auto Wash Machine YES NO ❑ rr
'
Type Water Supply
*This permit Void if sewage system described below is not installed within 36 months from date of issue.
i V -
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 by
Certificate of Completion Date O U
*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 �L
Environmental Health Section
P. O. Box 665 �®
Mocksville, N.C. 27028
CONSTRUCTION SHALL NOT BEGIN UNTIL IMPROVEMENTS PERMIT HAS BEEN ISSUED.
Home Pho a °S/�r,9�F -9/9S risi«cl
1. Permit Requested By M s CAI-IfOUA! —Sus/P Chkisrm"se v Business Phone-1
2. Address •t'Da 5 G wit�Qac.�a-ro , Nc -7-g170 oc -41
3. Property Owner if Different than Above SwSi e C'h.2i STI � �_ �� /'e 1T—
Address 40 q-54-b PeRtltfAIrate. Cuc�Q LV;N/sTont •-S,f/0,,, ,,AVC -2 7/4 f
4. Permit To: a Istall Alter Repair
b) Privy Conventional Other Type
Ground Absorption
c) Sub-Division Sec. Lot No.-
5.
o.5. System used to serve what type facility: House t-- Mobile Home Business
Industry Other sAjo)
b) Number of people s "`
6. ay If house or mobile home, statesize of home and number of rooms.
House Dimensions .? ���X 4 d +) X.
Bed Rooms Bath Rooms 3 Den w/Closet
b) If Business, Industry or Other, State:.Number of persons served
What type business, etc. W S�t SC STu
Estimate amount of waste daily (24,hours) ?
7. Number and type of water-using fixtures:
commodes * urinals garbage disposal I
lavatory — showers ��2 washing machine
dishwasher sinks
8. a) Type water supply: Public , Privateer Community
b) Has the water supply system been approved? Yes No
9. a) Property Dimensions i ;?- �/t�-
b) Land area designated to building site ?
c) Sewage Disposal Contractor g i C K MA e PV,+N C.Q , ALC•
10. Do you anticipate any additions or expansions of the facility this sewage system is intended to serve?
What type? Al D
This is to certify that the information is correct to the best of my knowledge.
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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Dvke C,¢RTP-t C,k�K
F'° L: S
DCHD(6-82) 712 Ace -�-�
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- 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. O. Box 665, Mocksville, N.C. 27028
Davie County Health Department
Environmental Health Section
Site Evaluation Consent Form
LOCATION OF PROPERTY: '4°'a CO ' DATE RECEIVED
�cdrup,ls�ct I BrT�p^^ R Ti (office use only)
yes no 1. 1 am the owner of the above described property.
Y36 no 2. 1 am not the owner of the above described property, however, I certify that I
have consent from Sus,¢N L• C'/YR/s%t�NseN 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 conductall
testing procedures as necessary to determine its suitability for a ground
absorption sewage treatment and disposal system.
O .
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
Only those listed below /
ATE
�f
ATE SIGNATURE
DCHD(11/84)
4
J.
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 wr :�/E_Xj�
d
1. Permit Request y Iq Z Itl Business Phone
2. Address i vD c
3. Property Owner if Different than Above
Address �"-
4. Permit To: a) Install Ater Repair 1 1
b) Privy Conventional Other Type
Ground Absorption
c) Sub-Division Sec. Lot No.
5. System used to serve what type facility: House Mobile Home Business
Industry Other
b) Number of people 1�
6. a) If house or mobile home, te/s'z of home and number of rooms.
House Dimensions
i
Bed Rooms Bath Rooms Den w/Closet
b) If Business, Industry or Other, State: Number of persons served
What type business, etc.
Estimate amount of waste daily (24 hours)
7. Number and type of water-using fixtures:
commodes urinals garbage disposal
lavatory showers washing machine
dishwasher sinks
8. a) Type water supply: Public Private Community
b) Has the water supply system been approved? Yes No
9. a) Property Dimensions a /--14-0_el i-e_S
b) Land area designated to building-site
c) Sewage Disposal Contractor
10. Do you anticipate any additions or expansions of the facility this sewage system is intended to serve?
What type?
This is to certify that the information is co r c to he best, k I g'
Date Owner Signature
OWNER IS SOLELY RESPONSIBLE FOR COMPLIANCE WITH ALL STATE AND LOCAL LAWS
Allow 5 days for processing
Directions to property:
d- >� e 70 V To lir >E/
Dw�Y
ocHo(6-e2)
t
c` DAVIE COUNTY HEALTH DEPARTMENT
Environmental Health Section.
P. O. Box 665
Mocksville, N.C. 27028
SOIL/SITE EVALUATION 1�
Name /`/-j Date T�� ✓/ ID
Address Lot Size
FACTORS AREA 1 AREA 2 AREA 3 AREA 4
1) Topography/Landscape Position S S
PS PS
U U
2) Soil Texture (12-36 in.) Sandy, S S
Loamy, Clayey, (note 2:1 Clay) P PS PS
U U
3) Soil Structure (12-36 in.) S S
Clayey SolisS PS PS
U U
4) Soil Depth (inches) l� S S
PS S PS PS
U U
5) Soil Drainage: Internal S S
S PS PS
l}� U U
External S S
pS PS PS PS
U U
6) Restrictive Horizons �j,�'?le
4
7) Available Space 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 S
U—UNSUITABLE
l S—SUITABLE PS—Provisionally Suitable
Recommendations/Comments:
Described byr Title Date jO
SITE DIAGRAM /
�v
Davie Coanfv Nealfli 7yenarfinenf
and Xovme Nealficy
210 HOSPITAL STREET/P.O. BOX 665
MOCKSVILLE, N.C. 27028
PHONE:(704)634.5985
April 18, 1988
Betty Potts Realty ,
Rt. 3, Box 320
Advance, NC 27006
Re: Site Evaluation
Underpass Road
Dear Ms. Potts:
On April 15, 1988, this office evaluated 2 sites on a 12 acre tract of
land that is located •on Underpass Road.
Both sites are classified provisionally suitable for the installation of
septic tank systems. Some rock was encountered along the ridge on both sites;
however, it should not present any problems.
If you have any questions, feel free to call.
Sincerely,
Robert B. Hall, Jr., R.S.
Environmental Health
RH/wd
Enclosure