1626 Underpass Road Lot 4Dav;A r.,,r„t.r 7 -,Tr
Tnvn+7 A 1D -"^*4
Parcel Number:
NCPIN Number:
Account Number:
Listed Owner 1:
Mailing Address 1:
City:
State:
Zip Code:
Legal Description:
Assessed Acreage:
Deed Date:
Deed Book / Page:
Plat Book:
Plat Page:
W AKlr 1A li: HIED LJ IN" 1 A o u 1C v Y. Y
Parcel Information
E8110B0002 Township: Shady Grove
5871956131 Municipality:
75353750 Census Tract: 37059-803
VOGLER DIANE BARNEY Voting Precinct: EAST SHADY GROVE
1626 UNDERPASS ROAD Planning Jurisdiction: Davie County
ADVANCE Zoning Class: DAVIE COUNTY R-20
NC Zoning Overlay:
27006-0000 Voluntary Ag. District:
LOT 4 GREENWOOD LAKE Fire Response District:
Building Value:
Land Value:
Total Assessed Value:
1.20 Elementary School Zone:
1/1988 Middle School Zone:
001410669 Soil Types:
0003 Flood Zone:
101 Watershed Overlay:
Outbuilding & Extra
Freatures Value:
Total Market Value:
ADVANCE
SHADY GROVE
WILLIAM ELLIS
GnB2
DAVIE COUNTY
No
161
All data is 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 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
NCor arising out of the use or Inability to use the GIS data provided by this webshe.
1l�
DAVIE COUNTY HEALTH DEPARTMENT Z lC�1aC��7�SS f06
r e(Septic Tank) Improvements Permit and Certificate of Completion
O(Gr` and Absorption Sewage Disposal System - G.S. Chapter 130 -Article 13C)
OWNER OR CONTRACTOR C 0 1, k �-
4A°nT��r� C,, DATE?- �/• �,�'" PERMIT
LOCATION C.N?
S.R. NO.
SUBDIVISION NAME x cn � l.n LOT NO. -S� SECTIONTOR BLOCK NO. 3
HOUSE
BUSINESS
NO. BEDROOMS 2 NO. BATHROOMS
GARBAGE DISPOSAL UNIT YES ❑ NO QI
AUTO. DISHWASHER YES NO ❑
AUTO. WASH. MACHINE YES 02" NO ❑
SITE SUITABLE YES ❑ NO ❑
SIZE OF TANK 4M gal. ?g54
NITRIFICATION FIELD 6 * Q sq. ft.
DEPTH OF STONE IN LINES: r 10
WATER SUPPLY: Individual Public ❑
House Trailer 800 Gal. 400 Sq. Ft.
Two Bedroom House 80 al. 60 c� Fr,
Three Bedroom House <'T00 Ga '00 SgFt
Four Bedroom House 1000 Gal. 'T700 Sq. Ft.
IMPROVEMENTS PERMIT BY -t`:4—r, /( ��l�%r1,tAd-,"- '-, 1, �r.
..-e �"�'�r�. � A INSTALLED BY
CERTIFICATE OF COMPLETION
By Date
(8/16/73) *Construction must co y with all other applicable State and local-egulations
LOT AREAlad
y a
Q
t,?
a
Davie County Health Department
�_V_ vii mental Health Section
.0 {'
Phone: (336) - 75 =
4 'S EP "2011
ENVIRO^,;VFNTA' !::D! TN
P.O. Box 848
210 Hospital Street
Courier # : 09-40-06
Mocksville, NC 27028
ON-SITE WASTEWATER CERTIFICATION FOR DWELLING
(Check One) Replacement Remodeling Reconnection
Fm: (336) - 751 - 8786
Name: hO tJil/Gt1 10/4%t✓� Phone Number (Home)
Mailing Address:_ _%'y U4t_W,4 � %/� G�NL� `1n —//9.? (Work)
- fid valve e , VL 2,700(l
Detailed
,700(-
Detailed Directions To Site: PWLI 15Y how
Property Address:
/ .)bP6x Z
Please Fill In The Following Information About The EXISTING Facility:
Name System Installed Under: Type Of Facility: X%7Jll IE
Date System Installed (Month/Date/Year): 11 7�, Number Of Bedrooms: Number Of People:
Is The Facility Currently Vacant? Yes No If Yes, For How Long?
Any Known Problems? Yes (9 If Yes, Explain:
Please Fill In The F bowing Information About The NEW Facility: jz1,0 ON t%ie bite.L 40c `j
Type Of Facility: it � 0/� `� rl� f'NP Number Of Bedrooms: Number of People
XRequested By:�lgllit; f 64/2 �/1,�%�� Date Requested:
(Signature)
For Environmental Health Office Use Only
pprove Disapproved
Comments:
Environmental Health Specialist
Date: y '-1--*,3 le --1
*The signing of this form by the Environmental Health Staff is in no way intended, nor should be taken as a guarantee
(extended or limited) that the on-site wastewater system will function properly for any given period of time.
Payment: Cash Check Money Order # AmountS /0,1.00 Date:
Paid By: 6 tU (% Received By:
Account #: g1yz Invoice #: 173 '