122 Country Circle Lot 26Davie County, NC Tax Parcel Report Tuesdav, November 29. 2016
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Parcel Information
Parcel Number. E814OA0026 Township: Shady Grove
NCPIN Number:
5881128229
Municipality:
Account Number:
82524514
Census Tract:
37059-803
Listed Owner 1:
REICHARD KEITH R
Voting Precinct:
EAST SHADY GROVE
Mailing Address 1:
122 COUNTRY CIRCLE
Planning Jurisdiction:
Davie County
City:
ADVANCE
Zoning Class:
DAVIE COUNTY R -A
State:
NC
Zoning Overlay:
Zip Code:
27006-7456
Voluntary Ag. District:
No
Legal Description:
LOT 26 COUNTRYSIDE SECTION 2
Fire Response District:
ADVANCE
Assessed Acreage:
1.50
Elementary School Zone:
SHADY GROVE
Deed Date:
5/2005
Middle School Zone:
WILLIAM ELLIS
Deed Book / Page:
006100336
Soil Types:
Se13,GnI32
Plat Book:
0006
Flood Zone:
Plat Page:
014
Watershed Overlay:
DAVIE COUNTY
Building Value:
Outbuilding & Extra
Freatures Value:
Land Value:
Total Market Value:
Total Assessed Value:
91 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. Ali users of Davie County: GIS websRe &hall hold harmless the
�O Nr County of Davie, North Carolina, Its agents, consultants, contractors or employees from any and all claims or causes of action due to
1. or anteing out of the use or Inability to use the GIS data provided by this website.
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` �q�'” DAVIE COUNTY HEALTH DEPARTMENT
IMPROVEMENTS PERMIT AND CERTIFICATE OF COMPLETION 3 06
*NOTE: Issued in Compliance With Article II of G.S. Chapter 130a
Sanijory She aqq Systems �� ��� ,1, .. c� Permit Number
�N
Name Date No 7139
_
Location
Subdivision Name
" d " ' 7 Lot No. Sec. or Block No.
i
Lot Size House Mobile Home _ Business -- Speculation
No. Bedrooms No. Baths z No. in Family _
Garbage Disposal YESNO Q Spe&ifncations . for
Auto Dish Washer YES ❑ NO ❑ t °'
Auto Wash Ma thine YES NOpS;
ED)w T!
Type Water Supply __—
'This permit Void if sewage system described below is not installed within 5 years from date of issue.
This permit is subject to revocation if site plans or the intended use change.
'Contact a representative of the Dapie Cou
9:30 A.M. or 1:00-1:30 P.M. on d, yl of tc
Final Installation Diagram:
Improvements permit by
Health Department for final inspection of this system between 8:30-
letion. Telephone Number 704-634-5985.
System Installed/ by
r'il' �t
r -
Certificate of Completion al 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.
r APPLICATION FOR SITE EVALUATION/IMPROVEMENTS PERMIT A
Davie County Health Department APR Q } 5
Environmental Health Section
P. O. Box 665 --
Mocksville, NC 27028----
1. Application/Permit Requested By�\�iyr�m Y—N
Mailing Address\Ao �w nuc,�trb Q�ke QA c kp-rx."NYY\Z.()C . �'lQla
Home Phone Business Phone
2. Name on Permit if Different than Above
3. Application/Permit for: ❑ General Evaluation [Septic Tank Installation
4. System to Serve:ouse ❑ Mobile Home ❑ Place of Public Assembly
❑ Business ❑ Industry El Other ElUnknown
5. If house, mobile home: Subdivision 0oy� Sr d e Section Lot #
No. of People
No. of Bedrooms 7
No. of Bathrooms a ?
Dwelling Dimensions
6. If business, industry, place of public assembly, other: Specify type
No. of People Served
No. of Commodes
No. of Lavatories
No. of Showers
7. Type of water supply: 2 Public
No. of Sinks
No. of Urinals
No. of Water Coolers
Water Usage Figures
❑ Private
❑ Basement/Plumbing
—❑/BasemenUNo Plumbing
Ir Washing Machine
C7,'Dishwasher
Garbage Disposal
8. Property Dimensions Sewage Disposal Contractor
9. Do you anticipate additions/expansion of the facility this sytem is intended to serve? ❑ Yes No
If yes, what type?
❑ Community
*NOTE: Improvements Permits shall be valid for a period of 5 years from date issued. Improvements Permits are subject to
revocation, if site plans or the intended use change. Effective October 1, 1989.
Directions to Property:-<io �o $Q - �4I�e �C° ��� SO '{� �✓t dei tSS
_ fid"wr
f
This is to certify that the information provided is correct to the
incurred from this application.
11 -115 --
DATE
my knowledge, and I understand I am responsible for all charges
SIGNATURE
CONSENT FOR SITE EVALUATION TO BE DONE ON ABOVE DESCRIBED PROPERTY
MUST CHECK ONE: 1. I OWN the property. ❑ 2. 1 DO NOT OWN the property.
If you checked Box #2, the rest of this form MUST be completed by the owner or a person authorized by the owner:
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.
to conduct all testing procedures as necessary to determine said site's suitability for a ground absorption sewage treatment
and disposal system.
DATE SIGNATURE
DCHD (12-90)