218 Hidden Creek Drive Lot 10Davie County, NC
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Thursdav, January 26, 2017
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:
Building Value:
WARNING: THIS IS NOTA SURVEY
Parcel Information
E915OA0010
Township:
5871475680
Municipality:
8303591
Census Tract:
FORE JAMES R
Voting Precinct:
218 HIDDEN CREEK DRIVE
Planning Jurisdiction:
ADVANCE
Zoning Class:
NC
Zoning Overlay:
27006
Voluntary Ag. District:
LOT 10 HIDDEN CREEK
Fire Response District:
Land Value:
Total Assessed Value:
0.93 Elementary School Zone:
6/2014 Middle School Zone:
009591092 Soil Types:
0005 Flood Zone:
179 Watershed Overlay:
Outbuilding & Extra
Freatures Value:
Total Market Value:
Farmington
37059-803
HILLSDALE
Davie County
DAVIE COUNTY R -A
DAVIE COUNTY QD
ADVANCE
SHADY GROVE
WILLIAM ELLIS
Gn132
DAVIE COUNTY
7&J1
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DAVIE COUNTY HEALTH DEPARTMENT
IMPROVEMENTS PERMIT AND CERTIFICATE OF COMPLETION
*NOTE: Issued in Compliance with G.S. of North Carolina Chapter 130 Article 13c
Sewage Treatme Mcd Dlispos I Rules (10 NCAC 10A .1934-.1968) Permit Number
Name Date
Date—�7
Location
Subdivision Name
Lot Sizea V,' ,
1 '' House, Mobile Home
No. Bedrooms -5---
No. Baths �; No. in Family.
Garbage Disposal
YES NO p
Auto Dish Washer
YES NO 0
Auto Wash Machine
YES NO C]Type
Water Supply
A �.11n JU --
Business
Speculation
Specifications for System:
- qbd ' x '7> k 1�11 i
*This permit Void if sewage system described below is not installed within 36 months from date of issue.
*Contact a representative of the Davie County
9:30 A.M. or 1:00-1:30 P.M. on day of coml
Final Installation Diagram:
Improvements permit by
t for final inspection of this system between 8:30-
Number:
:30-
Number: 704-634-5965.
Installed by
de/
y 3 Z =
'go
De�K
Certificate of Completion _ Date �v
*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
satiMpintorily for anv niven nPriod of time.
_ ..tet
i• ^ - • DAVIE COUNTY HEALTH DEPARTMENT
IMPROVEMENTS PERMIT AND CERTIFICATE OF COMPLETION
*NOTE: Issued in Compliance with G.S. of North Carolina Chapter 130 Article 13c
Sewage Treatment and Disposal Rules (10 NCAC 10A .1934-.1968) Permit Number
r
Name ti ...� . _ Date r �.�
Location i \, , L; �, �•< t�., , a- _ _ l -
Subdivision Name Lot No. J
1 Sec. or Block No.
Lot Size House = t Mobile Home _ Business __ Speculation
No. Bedrooms No. Baths No, in Family
Garbage Disposal
Auto Dish Washer
Auto Wash Machine
Type Water Supply
YES d NO ❑
YES EI! NO ❑
YES J NO ❑
Specifications for System:
"This permit Void if sewage system described below is not installed within 36 months from date of issue.
Improvements permit by
"Contact a representative of the Davie County Health Plho
gar4ent for final inspection of this system between 8:30-
9:30 A.M. or 1:00-1:30 P.M. on day of completion. aNumber: 704-634-598 1. 5. --
Final Installation Diagram:
Installed by
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.
44-
-1
APPLICATION FOR SITE EVALUATION/ IMPROVEMENTS PERMIT
Davie County Health Department
Environmental Health Section
Mock. 0�. Box 27028 RECEIVED OCT 0 7 W7
CONSTRUCTION SHALL NOT BEGIN UNTIL IMPROVEMENTS PERMIT HAS BEEN ISSUED.
1. Permit Requested By
2. Address P. C).
3. Property Owner if Different than Above
Address tj - A
4. Permit To: a) Install ✓ Alter Repair
b) Privy Conventional ✓ Other Type
Ground Absorption
Home Phone _761— '5_ 5��- C-)
Business Phone 766
c) Sub -Division 111-DDcAJ e20,5X Sec. 1 Lot No. 1-
5. System used to serve what type facility: House -2!!L Mobile Home Business
Industry Other
b) Number of people u M K) )a(A3 0
6. a) If house or mobile home, state size of home and number of rooms.
House Dimensions 6- 1 X 9
Bed Rooms —3 Bath Rooms z- Den w/Closet O
b) If Business, Industry or Other, State: Number of persons served N, H
What type business, etc. to - A
Estimate amount of waste daily (24 hours) N'
7. Number and type of water -using fixtures:
commodes
lavatory
urinals O
showers
dishwasher sinks f
garbage disposal
washing machine I
8. a) Type water supply: Public Private Community
b) Has the water supply system been approved? Yes Y' No
9. a) Property Dimensions /5d IK 2 _V5
b) Land area designated to building site Ila 4
c) Sewage Disposal Contractor py- AF' F
10. Do you anticipate any additions or expansions of the facility this sewage system is intended to serve? y� S
What type?
This is to certify that the information is correct to the best of my kno dge.
Date Owner Si ature
OWNER IS SOLELY RESPONSIBLE FOR COMPLIANCE WITH ALL STATE AND LOCAL LAWS
Allow 5 days for processing
Directions to property:
DCHD (6-82)
119
IN
Davie County Health Department
•+ - c Environmental Health Section
• Site Evaluation Consent Form
LOCATION OF PROPERTY: DATE RECEIVED
/"
jD � f D��� C � (office use only)
yes 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.
E5ATIZ SIGNAT
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
WE SIGNA
DCHD (11 /84)
0
Soro
GRAVEL
.........
NO ..mopo
cr
ZO
Zz.
0
Soro
GRAVEL
DAVIE COUNTY HEALTH DEPARTMENT
Environmental Health Section
P. 0. Box 665
Mocksville, N.C. 27028
SOIL/SITE EVALUATION
Name\� �� Date o
Address S ��' Lot Size 1 )5
E
FACTORS AREA 1 AREA 2 AREA 3 AREA A
1) Topography/ Landscape Position
S
S
PS
1�
PS
PS
U
U
U
?) Soil Texture (12-36 in.) Sandy,
Loamy, Clayey, (note 2:1 Clay)
ck,
S
S
PS
S
PS
U
U
U
U
i) Soil Structure (12-36 in.)
Clayey Soils
S
(T�)'
dp
S
PS
S
PS
U
U
U
U
q Soil Depth (inches)
SSS
(a)
A�
PS
S
PS
U
U
U
U
i) Soil Drainage: Internal
S
S
(:k:�
P
PS
PS
U
U
U
External
S
S
A
CPP
PS
PS
U
U
U
U
i) Restrictive Horizons
�
Available Space
PS
S
(�
S
PS
S
PS
U
U-
U
U
1) Other (Specify)
S
PS
S
PS
S
PS
U
U
U
1) Site Classification
C
J
U—UNSUITABLE
Recommendations/Comments:
Described by
SITE DIAGRAM
DCHD (6-82)
S—SUITABLEPS— rovisionally Suitable
Title - Date — ^�
ED
r4\-
rDavie County NealtI De artment
n
and .dome .7�ealtFr ye cy
210 HOSPITAL STREET/ P.O. BOX 665
MOCKSVILLE, N.C. 27028
PHONE: (704) 634-5985
September 21, 1988
Hubbard Realty
Attn: Cindy Dorman
285 S. Stratford Rd.
Winston-Salem, NC 27103
Re: Sewage System Installation
Mike Atwood
Hidden Creek
Sec. 1/Lot 10
Dear Realtor:
The septic tank system that serves this residence was designed,
inspected and approved by this office on February 10, 1988.
With proper maintenance and use it should function properly.
Sincerely,
�/�
Robert B. Hall, Jr., R.S.
Environmental Health Section
RH/wd
Name
Address
FACTORS
DAVIE COUNTY HEALTH DEPARTMENT
Environmental Health Section
P. 0. Box 665
Mocksville, N.C. 27028
Z7 SOIL/SITE EVALUATION
AREA 1 AREA 2
Date
Lot Size
AREA 3 AREA 4
) Topography/ Landscape Position
�)
3)
4)
5)
�)
8)
9)
S
S
S
PS/
PS
PS
U
U
U
Soil Texture (12-36 in.) Sandy,
Loamy, CIS a,(note 2:1 Clay)
PS
PS
S
PS
S
PS
U
U
Soil Structure (12-36 in.)
Clayey Soils
PS
PS
S
PS
S
PS
U
U
Soil Depth (inches) ,'
�55
S
S
PS
PS
PS
PS
U
U
U
U
Soil Drainage: Internal
S
S
(h
P5
PS
PS
U
U
U
External
da,
S
(ff�
S
PS
S
PS
U
U
U
U
Restrictive Horizons
Available Space
S.
��j
S
S
PS
��T
PS
PS
Other (Specify)
S
S
S
S
PS
PS
PS
PS
U
U
U
/�U
U�• S•
Site Classification
U—UNSUITABLE S—SUITABLE PS—Provisionally Suitable
Recommendations/Comments: o
Described byTitle ��/� Date
SITE DIAGRAM
DCHD J6 82)
96f