318 Brier Creek RoadDavie County, NC Tax Parcel Report Tuesday, January 3, 2017
338
WARNING: THIS IS NOT A SURVEY
Parcel Information
Parcel Number:
H700000058
Township:
NCPIN Number:
5769769815
Municipality:
Account Number:
39623000
Census Tract:
Listed Owner 1:
JAMES CHRISTOPHER EDMUND
Voting Precinct:
Mailing Address 1:
318 BRIERCREEK ROAD
Planning Jurisdiction:
City: ADVANCE
Zoning Class:
State:
NC
Zoning Overlay:
319
_
73
to
7✓
D
Shady Grove
37059-804
WEST SHADY GROVE
Davie County
DAVIE COUNTY R -A
Zip Code: 27006-7153 Voluntary Ag. District: No
Legal Description: 2.23 AC OFF FORK BIXBY RD Fin: Response District: CORNATZER - DULIN,ADVANCE
Assessed Acreage: 2.23 Elementary School Zone: SHADY GROVE,CORNATZER
Deed Date: 10/1997 Middle School Zone: WILLIAM ELLIS
Deed Book / Page: 001980256 Soil Types: GnC2,EnB,MsC,ChA
Plat Book:
Flood Zone:
Plat Page:
Watershed Overlay: DAVIE COUNTY
Building Value:
Outbuilding & Extra
Freatures Value:
Land Value:
Total Market Value:
Total Assessed Value:
tl� 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
County of Davie, North Carolina, Its agents, consultants, contractors or employees from any and all claims or causes of action due to
SOU N'S� NCV or arising out of the use or Inability to use the GIS data provided by this website. N__�
AUTHORiZibN NO. IE COUNTY HEALTH DEPARTMEN _qq
Environmental Health Section 1.1 PROPE FORMATION
r:,.. ng� 1,�7 iy
Perms tee's% .,,. ,� P.O. Box 848 r
Name: '. Via:^A. i`�`'1 V!"" %t rtl"�>'1 Mocksville, NC 27028 SubdivisionName: y r'� y"N7 r'
� � Phone #: 704-634-8760
Directions to property: ��S/'i,�;! <% l"r� Section: �� Lot: "
AUTHORIZATION FOR j
WASTEWATER
Tax Office PIN:# Al -
SYSTEM CONSTRUCTION.
Road Name: A- e/j - = p:�
**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 Forrn/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.
a
ENVIRONMENTAL HEALTH SPECIALIST DATE ISSUED
--DAXIE COUNTY HEALTH DEPARTMEN
N?IMPROVEMENT AND OPERATION PERMIT§t PROP,f4jNFOF,.MATION
-Permltfee's f .w- 1$
Name: r.: ~!�-� r' r.,,r;'fi""r�4 " Subdivision Name:
Directions to property: ESection: Lot: ` A
IMPROVEMENT
V1. fl'
.. PERMIT Tax'bffice PIN:#
**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)
/-1 *..,, , --, J . (, r { "s•NU71(:I R"FwTrill Yr liMll-1.1 JUBJEUT'lU 1C6VUUA110N lb'
r� Jil
Vic' f �f'' rr f PLANS OR THE INTENDED USE CHANGE. YOUR WASTEWATER
ENVIRONMENTAL HEALTH SPECIALIST DATE ISSUED SYSTEM CONTRACTOR MUST SEE THIS PERMIT BEFORE
INSTALLING THE SYSTEM.
RESIDENTIAL SPECIFICATION: BUILDING TYPE I� s � # BEDROOMS 4? # BATHS V # OCCUPANTS GARBAGE DISPOSAL: Yes or No
COMMERCIAL SPECIFICATION: FACILITY TYPE- # PEOPLE # PEOPLE/SHIFT # SEATS INDUSTRIAL WASTE: Yes or No
LOT SIZE'x`��f �I� TYPE WATER SUPPLY r O DESIGN WASTEWATER FLOW (GPD) NEW SITE -111*1 REPAIR SITE i
SYSTEM SPECIFICATIONS: TANK SIZE ��� GAL. PUMP TANK GAL. TRENCH WIDTH ROCK DEPTH L:9— LINEAR FT. !oV
OTHER f ' (��/r�5�Lr`l , <? CLQ C .
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) 634-8760.
OPERATION PERMIT
BY:
9
AUTHORIZATION NO.'//� OPERATION PERMIT BY: r / 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)
Y
1
r
APPLICATION FOR, SITE EVALUATIONAMPROVEMENT P,
Davie County Health Department
Environmental Health Section
P.O. Box 848
Mocksville, NC 27028
(704) 634-8760
rov
ATC
****IMPORTANT**** THIS APPLICATION CANNOT BE PROCESSED UNLESS ALL
THE REQUIRED INFORMATION IS PROVIDED.
1. Name to be Billed(-' ) r 1 .9 'o � e- r -J (-L in e -S
Mailing Address l[ H e - m to e -A
City/State/Zip X770 (,'s61 C', 27 LZ Y
2. Name on Permit/ATC if Different than Above
Contact Person lJ�-� �1� '� ty) E -�
Home Phone z ,i -
Business
Business Phone 20 G 3 4 f� Q l
Mailing Address City/State/Zip
3. Application For: [ ] Site Evaluation Improvement Permit & ATC
4. System to Serve: [ ] House Mobile Home [ ] Business [ ] Industry [ ] Other .
I
5. If esidence: # People # Bedrooms—2,— # Bathrooms_ �q Dishwasher [ ] Garbage Disposal
JX�Washing Machine [ ] Basement/Plumbing [ ] Basement/No Plumbing
6. If Business/Other: Specify type # People #Sinks # Commodes
# Showers # Urinals # Water Coolers
I
If Foodservice: # Seats Estimated Water Usage (gallons per day)
7. Typle of water supply: County/City [ ] Well [ ] Community
8. Do you anticipate additions or expansions of the facility this system is intended to serve? [
If yes, what type?
[ ] Both
EI
]Yes KNo
0
PROPERTY INFORMATION REQUIRED: *** IMPORTANT ***,)&T OF THE PROPERTY MUST BE
SUBMITTED WITH THIS APPLICATION.
Property Dimensions: ! 2-3 H (- r WRITE DIRECTIONS (from Mocksvillee)) TO PROPERTY:
Tax Office PIN: # �! �D % - �� - �� 15 �n ��` O �_ . cn C" n R, Z. V' '\ i o L
Property Address: Road Damei, h F' ! N d� I i'.i j) ^ r h .) � i ; h �I � c� tc �--� �)�% t'i � r'
City/Zip <Lil t'. ('_- r\ n rn � I.,A
If in Subdivision provide information, as follows:
Name: ;
I ;
Section: Lot #:
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 from 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 U� f ► G A t' ;' kj < i m e- S to 6nduc all t sting pr ures a ecessary to determine the site suitability.
Al
DATE_ /y��G�; S / l SIGNATURE
I
Revised DCHD (06-96)
THIS AREA MAY BE USED FOR bRAIVINC YOUR SITE PLAN:
j�� 637.50 632.90
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