125 North Claybon Drive Lot 3Davie County, NC Tax Parcel Report Thursday, December 15, 2016
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9 h�rE, IW date Is provided as is without warranty or guarantee of any ldnd either Wressed or Implied Including but not limited to the
Davie County, imp..dm,.m. es of merchantability orfitness for a parlieularuse. All users of Davie Courdyc GIS website shall hold harmless the
County of Davis, North Carolina, its ag.L% consultants, contractors oremploye"fmm any and N dalms or "uses O ac lon due to
nDDN�; NC "arising outoftheuseorinabllnytousethe GIS data provided bythiswebshe.
WARNING: THIS IS NOT A SURVEY
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Parcel Information
�_�.
Parcel Number:
C7140A0003
Township:
Farmington
NCPIN Number:
5862965828
Municipality:
Account Number:
8307128
Census Tract:
37059-802
Listed Owner 1:
CHOPLIN COURTNEY R
Voting Precinct:
FARMINGTON
Mailing Address 1:
125 N CLAYBON DRIVE
Planning Jurisdiction:
Davie County
City:
ADVANCE
Zoning Class: DAVIE COUNTY R-20,1-2
State:
NC
Zoning Overlay: DAVIE COUNTY QD
Zip Code:
27006
Voluntary Ag. District:
No
Legal Description:
LOT 3 DAVIE GARDENS SECTION I
Fire Response District:
SMITH GROVE
Assessed Acreage:
0.46
Elementary School Zone:
PINEBROOK
Deed Date:
1112016
Middle School Zone:
NORTH DAVIE
Deed Book/Page:
010340594
Soil Types:
GnB2
Plat Book:
0003
Flood Zone:
Plat Page:
093
Watershed Overlay:
DAVIE COUNTY
Ouldin& Extra
Building Value:
Freaares Va ue:
Land Value:
Total Market Value:
Total Assessed Value:
9 h�rE, IW date Is provided as is without warranty or guarantee of any ldnd either Wressed or Implied Including but not limited to the
Davie County, imp..dm,.m. es of merchantability orfitness for a parlieularuse. All users of Davie Courdyc GIS website shall hold harmless the
County of Davis, North Carolina, its ag.L% consultants, contractors oremploye"fmm any and N dalms or "uses O ac lon due to
nDDN�; NC "arising outoftheuseorinabllnytousethe GIS data provided bythiswebshe.
DAVIE COUNTY HEALTH DEPARTMENT ��
IMPROVEMENTS PERMIT AND CERTIFICATE OF COMPLETION 17
'NOTE: Issuedf in Compliance with G.S. of North Carolina Chapter 130 Article 13c
Sewage Treat ntand Di s osal Rules (10 NCAC 10A.1934-.1968) Permit Number
Name Date Date // N2 5774
Lot Size 4W lfr0 House U� Mobile Home __ Business Speculation
.No. Bedrooms No. Baths No. in Family_
Garbage Disposal YESNO'[.� Specifications for System:
Auto Dish Washer YES ryn' Nt� .
- Auto Wash Machine YES T NO
__Type Water Supply �/
bo W
-'This permit Void if sewage system described below is not installed within 36•monthath
s from date Qf issue.
I
F
Improvements permit by /A/
'CBptact 'a representative of the Davie County Health Department for final inspection of this system between 8:30-
- - 9:30 A.V. or 1:00-1:30 P.M. on day of completion. Telephone Number: 704-634-5985.
Final, Installation Diagram:. System Installed by
U '
Certificate of Completion '/1' � - Date / 41
`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.
DAVIE COUNTY HEALTH DEPARTMENT
r�' IMPROVEMENTS. PERMIT AND CERTIFICATE OF COMPLETION
*NOTE: lssugp in Compliance with G.S. of North Carolina Chapter 130 Article .13c
Sewage Treatment and ,Disposal Rules (10 NCAC 10A .1934-.1968) Permit Number,
NameDate J/-/7- Zig N25774
Location /•v/Y rYQ/
Subdivision Name
Lot No: r2 Sec.
or Block No.
Lot Size
House t� Mobile Home - Business
Speculation
No. Bedrooms —cam
No. Baths 2 No.
in Family
Garbage Disposal
Auto Dish Washer
YES Er NO�[a�'i
for Specifications System:
p
YES N&_0ifl
�/
J
Auto Wash Machine
YES [jnNO ❑
c{��n/S/r�0
Cis
Type Water Supply
rn
--
(00
*This permit Void if sewage system described below is not installed within Wmonths from date of issue.
? Improvements permit by —
'CliQtactrepresentative of the Davie County Health Department for final inspection of this system between 8`.30-
j 9:30 A.P1 or 1:00-1:30 P.M. on day of "completion. Telephone Number: 704-634-5985. -
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. 0. Box 665
Mocksville, NC 27028.
1. Application/Permit Requested By i/
Mailing Address) `f /d /)
Home Phone ` /!JoGd / Business Phone
2. Name on Permit if Different than Above
3. Property Owner if Different than Above
C-/
4. Application/Permit For:
General Evaluation
9/3'/Tank Installation
5. System to Serve:
(House
[]
Mobile.Home
0 Business
C] Industry G
Other
0 Unknown.
6. If house, mobile
home:� Subdivision
6 Sec. Lota�
No. of People
vCi
Dwelling
Dimensions
No, of Bedroom
7
Basement/Plumbing )( /
No. of Bathrooms
(Washing Machine
7
Dishwasher
Basement/No
Plumbing
U,-(:�arbage Disposal '
_
7. I.f business, industry, other: Specify type
No. of People Served
No. of Commodes`
No. of Lavatories.
No. of Showers
8. Type of water supply: Public
9. Property Dimensions
10. Sewage Disposal Cont
No. of Sinks
No. of Urinals
No. of Water Coolers
0 Private
0 Community
11. Do you anticipate additions/expansions of the facility this system is
intended to serve? [] Yes w,Ko
If yes, what type?
*NOTE: Improvements Permits shall be valid for a period of 5
years from date issued. Improvements Permits are subject
to revocation, if site plana or the intended use change.
Effective October 1, 1989.
This is to certify that the information provided is correct to the
best of my knowledge, and I understand I am responsible for all
charges in from this application.
D e Signature
Directions to Property:
DCHD (10-89)
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 PROP RTY: DATE RECEIVED
� � 2 (office use only)
es no 1. 1 am the owner of the above described property.
yes no 2. 1 am not the owner of the above described property, however, I certify that I
have consent from 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.
WAT 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
/�/�R� `•���A'u ,cam u ��C
DATE SIGNAT RE
DCHD (11 /84)
DAVIE COUNTY HEALTH DEPARTMENT
Environmental Health Section.
P. O. Box 665
Mocksville, N.C. 27028
SOIL/SITE EVALUATION
Name /SES Eef��N Date ;YZZ2AZ
Address /yfF}//f GA2D�n1S-n� Lot Size
FACT()R:R
AREA 1 AREA 2 AREA 3 ARFA d
1) Topography/ Landscape Position
9)
6P
PS
43)
PS
&F1
PS
a
PS
U
U
U
U
2) Soil Texture •(12-36 in.) Sandy,
Loamy, Clayey, 2:1 Clay)
S
(note
U
U
U
U
3) Soil Structure (12-36 in.)�
Clayey Soils
(PSS
S
S
U
U
U
l) Soil Depth (inches)
cps'
c2r
U
U
S) Soil Drainage: Internal ....... _
, S
P
P
U
U
U
External–
&>/
U
U
U
i) Restrictive Horizons
)Available Space
U
U
U
U
1) Other (Specify)
S
PS
S
PS
S
PS
S
PS
U
U
U
U
Site Classification
U—UNSUITABLE
Recommendations/Comments:
S—SUITABLE PS—Provisionally Suitable
Described by All Title
SITE DIAGRAM
X,
WHO )5.82)
Date_// /J_LYd`
V DAVIE COUNTY HEALTH DEPARTMENT
(Septic Tank) Improvements Permit and Certificate of Completion
(Ground Absorpt on,Sewpage DisposallSySystteem -.G.S. Chapter 130- rticle 13C)
OWNER _OR. CONTRACTOR .��,, �1 -+« 1/_� vire - _n n_ DATE -/ f'- PERMIT An1n�
LOCATION ?�^�/' T T Ct,Y.tw r�Fj6La g , N/�
S.R. NO.
SUBDIVISION NAME, (/Q t 01 LOT NO. ; SECTION OR BLOCK NO.
HOUSE Ml MOBILE HOME U BUSINESS.0
N0. B DROOMS NO. BATHROOMS
GARBAGE DISPOSAL UNIT YES ❑ NO ❑
AUTO. DISHWASHER YES ❑ NO ❑
AUTO. WASH. MACHINE YES_ ❑ NO ❑
SITE SUITABLE YES ❑ NO ❑
SIZE OF. TANK gal.
NITRIFICATION FIELD sq..ft.
DEPTH OF STONE IN LINES:
WATER SUPPLY: Individual' Public ❑
IMPROVEMENTS PERMIT BY F r.
CERTIFICATE OF COMPLETION B'_
y
(8/16/73) *Construction must.
LOT /AREA
House Trailer 800 Gal. 400 Sq. Ft.
Two Bedroom House800 Gal 600 5 Ft:
Three Bedroom House 900 al Sq. Ft
Four Bedroom House 1000 Gal.. 1200 Sq. Ft.
INSTALLED BY f 1'0S i i
Date
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i with all other applicable State and
locaY
fegul
ions
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