268 Hidden Creek Drive Lot 14Davie County, NC Tax Parcel Report Thursday. 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 I Page:
Plat Book:
Plat Page:
Building Value:
WAKNMG: 11-11IS IS INU-1- A SUKVEY
Parcel Infonnation
E9150AD014
Township:
5871379732
Municipality:
15884500
Census Tract:
CLEVENGER JERRY E
Voting Precinct:
268 HIDDEN CREEK DRIVE
Planning Jurisdiction:
ADVANCE
Zoning Class:
NC
Zoning Overlay:
27006-0000
Voluntary Ag. District:
LOT 14 HIDDEN CREEK
Fire Response District:
1. ju
Elementary School Zone:
Land Value:
Total Assessed Value:
4/1988 Middle School Zone:
001430022 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
WILLtAM ELLIS
GnB2,GnC2,ChA
DAVIE COUNTY
No
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County of Davie, North Carolina, Its agents, consultants, contractors or employees from any and all claims or causes of action due to
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DAVIE COUNTY HEALTH DEPA
IMPROVEMENTS PERMIT AND CERTIFICAI
'NOTE"' 6'wi'th&S.-of Nort C
1§sued in CoMplianc h arolin6 Chapter 130 A
Sewage Treatment.and Disposal Rules (10 NCAC 10A .1934-1�
N e k" A"Y/-�/-, r 'i 2A/
am te
/7
Locatiort
17e,
Subdivision Name Lot No.
TMENT
OF COMPLETION
cle 13c
3) Permit Number
B 8 4
Sec. or
APPLICATION FOR SITE EVALUATION/ IMPROVEMENTS PERMIT
Davie County Health Department
Environmental Health Section
R 0. Box 665
Mocksville, N.C. 27028
CONSTRUCTION SHALL NOT BEGIN UNTIL IMPROVEMENTS PERMIT HAS BEEN ISSUED.
-7(
Home Phone
1. Permit Requested By Business Phone
2. Address -2 1 10 C-Ln,Ak," wi�(4221 --s"a I-Af - C'
3. Property Owner if Different than Above
Address
4. Permit To: a) InstaILLZ_ Alter— Repair
b) Privy— Conventional— Other Type—
Ground Ab orptio�n
c) Sub -Division 0254 �"ec. Lot No.
5. System used to serve what type facility: House fX Mobile Home— Bu'siness
Industry— Other
b) Number of people 4,
6. a) If house or mobile home, state size of home and number of rooms.
House Dimensions /0
Bed Rooms Bath Rooms -2- Den w/Closet
b) If Business, Industry or Other, State: Number of persons served
What type business, etc.
Estimate amount of waste daily (24 hou
7. Number and type of water -using fixtures
commodes 3
lavatory - i:,h
dishwasher
urinal
showers
sinks
garbage disposal
washing machine
8. a) Type water supply: Public 1'� Private ___Community
b) Has the water supply system been approvedl'? Yes No
9. a) Property Dimensions
b) Land area designated to building site
e&Wc) Sewage Disposal Contractor
10. Do you anticipate any additions or expansions of the facility this sewage system is intended to serve?
What type?
This is to certify that the information is correct to the best of my knowledge.
f7h/ k k,�9,4
/ - /D at e Owner Sidn�ture
OWNER IS SOLELY RESPONSIBLE FOR COMPLIANCE WITH ALL STATE AND LOCAL LAWS
Allow 5 days for processing
Directions to property:
eJ W
A 7,4 54 1- e-�_0+1
DCHD (6-82)
9Z--)
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. 0. Box 665, Mocksville, N.C. 27028
Davie County Health Department
Environmental Health Section
Site Evaluation Consent Form
LOCATION OF PROPERTY: DATE RECEIVED
(office use only)
no 1. 1 am the owner of thE above described property.
tsl)
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 Cou nty Health Department for the purpose of
determining the suitability for a ground absorption sewage treatment and
disposal system.
no
3. 1 hereby give consent to the authorized representative of the Davie County
Health Departmentto enter upon the above described propertyand conductall
testing procedures as necessary to determine its suitability for a ground
absorption sewage treatment and disposal system.
7 h t lex-? k=
16ATt 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
DATO SIGNATURE
DCHD (11 /84)
Name—
Address
2
3
4
5
6
7
8
9
FArTOPR
DAVIE COUNTY HEALTH DEPARTMENT
Environmental Health Section
R 0. Box 665
Mocksville, N.C. 27028
SOIL/SITE EVALUATION
APFA I APFA 9
Date /?(0
Lot Size 31"Sec�'W-o
AAFAR APFA A
) Topography/ Landscape Position
&�
S
S
PS
S
PS
U
U
U
U
) Soil Texture (12-36 in.) Sandy,
Loamy, C
,14.qy, (note 2:1 Clay)
S
S
PS
S
PS
U
U
U
U
) Soil Structure (12-36 in.)
Clayey Soils
S
<S7�
S
PS
S
PS
U
U
U
U
) Soil Depth (inches) 14
PS
S
PS
S
PS
S
U
U
U
U
) Soil Drainage: Internal
S
d5?
S
S
PS
S
PS
U
U
U
U
External
S
(�?
S
C19)
S
PS
S
PS
U
U
U
U
Restrictive Horizons
Available Space
PS
PS
S
PS
S
PS
U
U
U
U
Other (Specify)
S
PS
S
PS
S
PS
S
PS
U
U
U
U
Site Classification
U—UNSUITABLE S—SUITABLE PS—Provisionally Suitable
Recommendations/ Comments: 7-4,-,al4d�f
Described by Title Date
SITE DIAGRAM
sa b
DCHD 16-82)
Ddiie Coz(n�v Nedltk De artment
and Noine Aealtlf 7yaienq
210 HOSPITAL STREET/ P.O. BOX 665
MOCKSVILLE, N.C. 27028
PHONE: (704) 634-5985
April 11, 1988
Hubbard Realty
Attn: Jeff & Jody
285 S. Stratford St.
Winston-Salem, NC 27103
Re: Sewage System Installation
Hidden Creek/Sec. 1 -Lot 14
Dear Realtor:
The septic tank system that serves this residence was designed,
inspected and approved by this office on April 11, 1988.
With proper maintenance and use it should function properly.
Sincerely,
Robert B. Hall, Jr., R.S.
Environmental Health
RH/wd