109 East Valley View Rd Lot 22Davie County, NC Tax Parcel Report
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Thursday. January 5. 2017
All data b provided as Is without warranty or guarantee of any Idnd 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 webstte 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
NCor arWng out of the use or Inability to use the GIS data provided by this webstta.
WARNING: THIS IS NOT A SURVEY
Parcel Information
Parcel Number:
E8070B0007
Township: Shady Grove
NCPIN Number:
5871964601
Municipality:
Account Number:
42504500
Census Tract: 37059-803
Listed Owner 1:
KELLOGG TED G
Voting Precinct: EAST.SHADY GROVE
Mailing Address 1:
109 FAST VALLEY VIEW ROAD
Planning Jurisdiction: Davie County
City:
ADVANCE
Zoning Class: DAVIE COUNTY R-20
State:
NC
Zoning Overlay:
Zip Code:
27006-7620
Voluntary Ag. District: No
Legal Description:
LOT 22 3.78 ac GREENWOOD LAKE
Fire Response District: ADVANCE
Assessed Acreage:
3.77
Elementary School Zone: SHADY GROVE
Deed Date:
10/1998
Middle School Zone: WILLIAM ELLIS
Deed Book / Page:
002070119
Soil Types: GnB2,GaD,RvA,ChA,WATER
Plat Book:
0003
Flood Zone:
Plat Page:
053
Watershed Overlay: DAVIE COUNTY
Building Value:
Outbuilding & Extra
Freatures Value:
Land Value:
Total Market Value:
Total Assessed Value:
All data b provided as Is without warranty or guarantee of any Idnd 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 webstte 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
NCor arWng out of the use or Inability to use the GIS data provided by this webstta.
Permittee': _ -- DAVIE COUNTY HEALTH DEPARTMENT
, t
Name: Environmental Health Section_ PROPERTY'INFORMATION
P.O. Box 848
Directions to property: 1 Mocksville, NC 27028 Subdivision Name
Phone #: 336-751-8760
Section: Lot: 4—
f AUTHORIZATION FOR
WASTEWATER
SYSTEM CONSTRUCTION Tax Of ice PIN:#
Road Name: .1 , I`
AUTHORIZATION NO:
A
e-"•' G t 1 ij L� `�` Ztp
**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 Q 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.
ALS HEALTH SPECIALIST DATE ISS ED
RESIDENTIAL SPECIFICATION: BUILDING TYPE ` AX)5�# BEDROOMS`' # BATHS I. -
#OCCUPANTS I� GARBAGE DISPOSAL: Yes or No
COMMERCIAL SPECIFICATION: FACILITY TYJE # PEOPLE # PEOPLE/SHIFT'��// ,�,, jj�# SEATS INDUSTRIAL WASTE: Yes or No
� ! , - � NEW SITE REPAIR SITE +✓
LOT SIZE TYPE WATER SUPPLYt. � .r DESIGN WASTEWATER FLOW (GPD)'=--
SYSTEM SPECIFICATIONS: TANK SIZE GAL. PUMP TANK \ GAL. TRENCH WIDTHc— LPROCK DEPTH �' LINEAR FT. �UiD
OTHER t,..I �t 1r'i.:� �n 1
t t
'
REQUIRED SITE MODIFICATIONS/CONDITIONS: I ° a°�j�`��i`-^ � �'" 13�Lt L^ f }r" CILC,
IMPROVEMENT PERMIT LAYOUT
}, ��.,.y, C e..•ua*e:-�;:.7:R.an.e,x.r7 �`b�'''sc.. ��`�s
"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 (336)751-8760.
OPERATION PERMIT
4 L..t 0�S CO`>> ALL- W A
I r, F-Oi JQ - 01k. ` QaQ\34C
PO V"w o 1,46 6 -W IP2 A TrA,12P
SYSTEM INSTALLED BY:61c
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AUTHORIZATION NO. OPERATION PERMIT BY: DATE:
"THE ISSUANCE OF THIS OPERATION PERMIT SHALL INDICATE THAT TH SY BED A VE AS BEEN INSTALLED IN COMPLIANCE
WITH ARTICLE 11 OF G.S. CHAPTER 130A, SECTION .1900 "SEWAGE TREATMENT D DISPOSAL SY ', BUT SHALL IN NOWAY BETAKEN ASA
GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORILY FOR ANY GIVEN PERIOD OF TIME. Q'
DCHD 02/02 (Revised)
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NAME
ADDRESS_
_t�
DAVIE COUNTY ENVIRONMENTAL HEALTH SECTION
APP KATION FOR IMPROVEMENT PERMIT (REPAIR)
aC�CS✓cll�-
Lz,'is� 17 z
d PHONE NUMBER
SUBDIVISION NAM L',
LOT #
z a
DIRECTIONS TO SITE l y 4-a 1 f 41� �y
A)— D �/t_J ,V Ask,J
"�+� a { r
DATE SYSTEM INSTALLED 7 Go's NAME SYSTEM INSTALLED UNDER
TYPE FACILITY NUMBER BEDROOMS_ :3 1 NUMBER PEOPLE SERVED
TYPE WATER SUPPLY . ��/ SPECIFY PROBLEM OCCURRING
DATE REQUESTED 5 (0 ` y% INFORMATION TAKEN BY -.
o
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 charges incurred from this application.
SIGNATURE OF OWNER OR AUTHORIZED AGENT
Rev. 1193
`d�-
Road Name: .V:
**NOTE** This Authorization for Wastewater System Construction MUST BE ISSUED by the Davie County Envirofitii ntal HeWtlr SectiW.prior
oto
to issuance of any Building Permits. This Form/Authorization Number should be presented to the Davie Cot Buil4liiigInspections
Office when applying for Building Permits. v
(In compliance with Article 11 of G.S. Chapter 130A, Wastewater Systems, Section .1900 Sewage Treatment and Disposal Syste' nsj'
% ***NOTICE*** THIS AUTHORIZATION FOR WASTE WATE CONSTRUCTION
�' IS VALID FORA PERIOD OF FIVE- AR.
ENVIRONMENTAL HEALTH SPECIALIST DATE ISSUED
AUTHOI.%:ZATION NO: 1495 DAVIE COUNTY HEALTH DEPARTMENT
•
Environmental Health Section
PROPERTY`INFORMATION
Permittee's
Name: '
f
e'-1,11,
P.O. Box 848
-
- —
Mocksville, NC 27028
Subdivision Name: r
Directions to
;-
i' s%!�pf'tl�
Phone #: 704-634-8760
��l
Section: '" D Lw
property:
,.j - , 115
} _
AUTHORIZATION FOR
WASTEWATER
-� -
SYSTEM CONSTRUCTION
Tax Office PIN:#
`d�-
Road Name: .V:
**NOTE** This Authorization for Wastewater System Construction MUST BE ISSUED by the Davie County Envirofitii ntal HeWtlr SectiW.prior
oto
to issuance of any Building Permits. This Form/Authorization Number should be presented to the Davie Cot Buil4liiigInspections
Office when applying for Building Permits. v
(In compliance with Article 11 of G.S. Chapter 130A, Wastewater Systems, Section .1900 Sewage Treatment and Disposal Syste' nsj'
% ***NOTICE*** THIS AUTHORIZATION FOR WASTE WATE CONSTRUCTION
�' IS VALID FORA PERIOD OF FIVE- AR.
ENVIRONMENTAL HEALTH SPECIALIST DATE ISSUED
DAVIE COUNTY HEALTH DEPART
iVIENT „( ,a /'.,<. <. • r
" IMPROVEMENT AND OPERATION PERMITS PROPERTY INFORMATION
PerAitteels
Name: ;,:`x % ,/ i ! l ` {` Subdivision Name1"i��?��r'`((1C1/1�
Directions to property: ` Section -'
- IMPROVEMENT
PERMIT
Tax Office PIN:#
Mot
Road Name: 14 4.'` A Gip.
**NOTE** This Improvement Permit DOES NOT authorize the constriction or installation of a septic tank system or any wastewater system\An
AUTHORIZATION FOR WASTEWATER SYSTEM CONSTRUCTION must be obtained from this Dep"entiriotto the -.
construction/installation of a system or the issuance of a building permit. '
(In compliance with Article 1 I of G.S. Chapter 130A, Wastewater Systems, Section. 1900 Sewage Treatment and Disposal Systems) L }
***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 THISPERMITBEFORE
INSTALLING TIM SYSTEM.
RESIDENTIAL SPECIFICATION: BUILDING TYPE /71 # BEDROOMS Y # 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. DESIGN WASTEWATER FLOW (GPD)"Y �y NEW SITE REPAIR SITE G---��
SYSTEM SPECIFICATIONS: TANK SIZE GAL. PUMP TANK GAL. TRENCH WIDTH--5L/;'ROCK DEPTH � LINEAR FT:99de
OTHER
REQUIRED SITE MODIFICATIONS/CONDITIONS:
IMPROVEMENT PERMIT LAYOUT O -�
Ao11,45
I
"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
SYSTEM INSTALLED BY:
X225
AUTHORIZATION NO. OPERATION PERMIT BY: :.: ft -� 1 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) .
r
DAVIE COUNTY HEALTH DEPARTMENT-'
IMPROVEMENT AND OPERATION PERMITS PROPERTY INFORMATION
Perl ttee's f _
Name:
•' Subdivision Name:!"'
' Directions to property: Y.r''�f •�oy'• ^ . Y. Section:d!.•�_ Lot:
r' IMPROVEMENT
f' PERMIT Tax Office PIN:# -
a
R ad e.t✓ ry r L '
.f
**NOTE** This Improvement Permit DOES NOT authorize the construction or installation of a septic tank system or any wastewater sys7.,
AUTHORIZATION FOR WASTEWATER SYSTEM CONSTRUCTION must be obtained from this Department prior,to th
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)
r , ***NOTICE*** TILS 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 PERMITBEFORE
�'{INSTALLING THE SYSTEM.
RESIDENTIAL SPECIFICATION: BUILDING TYPE # BEDROOMS —y— # BATHS 0. # OCCUPANTS .r GARBAGE DISPOSAL -Yes or No
COMMERCIAL SPECIFICATION: FACILITY TYPE # PEOPLE # PEOPLE/SHIFT # SEATS INDUSTRIAL WASTE:. Yes pr' No
1
LOT SIZE TYPE WATER SUPPLY DESIGN WASTEWATER FLOW (GPD)'Y� NEW SITE REPAIR SITE
SYSTEM SPECIFICATIONS: TANK SIZE GAL. PUMP TANK GAL. TRENCH WIDTH—�6 ROCK DEPTH / (7 LINEAR Fr':
OTHER
i
REQUIRED SITE MODIFICATIONS/CONDITIONS:
IMPRO/VEMENT PERMIT
�LAYOUT
/
Vis ' AZI;
**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
j ! ...
SYSTEM INSTALLED BY:
i r
` 7 ,
AUTHORIZATION NO. OPERATION PERMIT BY: DATE: • . 6
**THE ISSUANCE OF THIS_ OPERATION PERMIT SHALL INDICATE THAT THE YSTEM DESCRCBE'ABOV$ HAS BEEN INSTALLED Ilk COMPLIANCE
WITH ARTICLE 11 OF G.S. CHAPTER 130A, SECTION .1900 "SEWAGE TREATMENT.AND DISPOSAL SYSTEMS", BUT SHALL IN NOWAY BE TAKEN AS A
GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORILY FOR ANY GIVEN PERIOD OF TIME.
DCHD 05/96 (Revised) i
r,
DAVIE COUNTY ENVIRONMENTAL HEALTH SECTION
WORKSHEET FOR SEPTIC SYSTEM REPAIR PERMIT
NAME ra ///,I PHONE NUMBER
ADDRESS ;l1s G �,�9/ G i 6,, d SUBDIVISION NAME_(,�C?P.ol�itX.i
SUBDIVISION LOT #_Z11W1-1S'- 1 /t
DIRECTIONS TO SITE
DATE SYSTEM INSTA
NAME SYSTEM INSTALLED UNDER c�
SPECIFY PROBLEMS OCCURRING
DATE REQUESTE
NFORMATION TAKEN BY
AA9, �o /444/, -5�