250 Lakeview Road Section 2 Lot 17Davie Counfy, NC' Tax Parcel Report Tuesday. January 17. 2017
WARNING: THIS 1S NOT A SURVEY
Parcel Information
Parcel Number:
1614OA0033
Township:
Shady Grove
NCPIN Number:
5758834188
Municipality:
Voluntary Ag. District: No
Account Number:
82527526
Census Tract:
37059-804
Listed Owner 1:
LOFFREDO JOHN MICHAEL
Voting Precinct:
WEST SHADY GROVE
Mailing Address 1:
250 LAKEVIEW ROAD
Planning Jurisdiction:
Davie County
City: MOCKSVILLE
Zoning Class: DAVIE COUNTY R-20
State:
NC
Zoning Overlay:
Zip Code:
27028-0000
Voluntary Ag. District: No
Legal Description:
LOT 17 HICKORY HILL SECTION 2
Fire Response District: CORNATZER - DULIN
Assessed Acreage:
1.74
Elementary School Zone: CORNATZER
Deed Date:
1/2007
Middle School Zone: WILLIAM ELLIS
Deed Book / Page:
006960863
Soil Types: GnB2,GnC2,GaD,WATER
Plat Book:
0005
Flood Zone:
Plat Page:
027
Watershed Overlay: DAVIE COUNTY
Building Value:
Outbuilding & Extra
Freatures Value:
Land Value:
Total Market Value:
Total Assessed Value:
Davie County,
All data is provided as is without warranty or guarantee of any Idnd either expressed or Implied Including but not limited to the
Implied warranties of merchantability or fitness for a particular use. All users of Davie County's GIS webahe shall hold harmless the
FA-
NCor
County of Davie, North Carolina, Its agents, consultants, contractors or employees from any and ail claims or causes of action due to
arising out of the use or Inability to use the GIS data provided by this website.
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_�� I_MPROUEMENES PERMIIT vAN,;;CERTIFICATE OF COMPLE�TI,ON ,.
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' -" *NOTE Issued 1n C mpJi.ance . rtY S o I b) rth Ca Chapter 130: Article 13c, E e ",
' �1° Sewage Treatment and Dispo I$Rules (1il0 NCAC 10'1934Oz. ;1968) ,. `Permi$t�Nwv>sber- E,-
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'Contact a.representative of the Davie County Health Department for final -inspection of this' system between 8 30�Y
9 30: A M =or 1 00 1 30 'P M ron daym of completion Tel
ephone.Number: 704-634-5985
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`The} signing of this certiflcate2shall"indicate that fi "e system described, aboues has been lristalled yin r.- , pli�an e wlith
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APPLICATION FOR SITE EVALUATION/ IMPROVEMENTS PERMIT
Davie County Health Department
Environmental Health Section
R 0. Box 665��C �V�O R
Mocksville, N.C. 27028 JIJ,U U
CONSTRUCTION SHALL NOT BEGIN UNTIL IMPROVEMENTS PERMIT HAS BEEN ISSUED.
Home Phone
1. Permit Requested By Snipes & Ferguson, Inc. Business Phone 998-7691
7 erlrlrncc P.O. Box 1681, Clemmons, NC 27021
3. Property Owner if Different than Above Mr 7 Mrs. Jim Brown
Arirlrncc Cooleemee, Nc 27014
4. Permit To: a) Install X Alter Repair
b) Privy Conventional X Other Type
Ground Absorption
c) Sub -Division Hickory Hill Sec. 2 Lot No. 17
5. System used to serve what type facility: House X Mobile Home Business
Industry Other
b) Number of people 3
6. a) If house or mobile home, state size of home and number of rooms.
House Dimensions 94' - 8" W X 74' (total depth)
Bed Rooms 4 Bath Rooms 02 Den w/Closet
b) If Business, Industry or Other, State: Number of persons served N/A
What type business, etc. N/A
Estimate amount of waste daily (24 hours) N/A
7. Number and type of water -using fixtures:
commodes 5 urinals -0-
lavatory 6 showers 3
dishwasher 1 sinks 5
garbage disposal -0-
washing machine 1
8. a) Type water supply: Public X Private Community
b) Has the water supply system been approved? Yes X No
9. a) Property Dimensions 83' frt. X 409' depth X approx. 210' rear
b) Land area designated to building site 1.75 ac
c) Sewage Disposal Contractor Not yet determined
10. Do you anticipate any additions or expansions of the facility this sewage system is intended to serve? No
What type? N/A
This is to certify that the information is correct to tA best of y k �
June 4, 1987
Date Og er Signat re
OWNER IS SOLELY RESPONSIBLE FOR COMPLI E WITH ALL STATli AN
Allow 5 days for processing
Directions to property:
Lakeview Road
Hickory Hill, Sec. 2
DCHD (6-82)
ledge.
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LAWS
- 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. O. Box 665, Mocksville, N.C. 27028
Davie County Health Department
Environmental Health Section
Site Evaluation Consent Form
LOCATION OF PROPERTY: DATE RECEIVED
Lot 17, hickory Hill Subdivision, (office use only)
Sec. 2
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 Mr. Jim Brown , 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.
es 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 suitabil' y for a ground
absorption sewage treatment and disposal syAtem. t 1
6-4-87 N I
DATE SIGNAT RE
Zrr�y H. erguso
4. 1 hereby authorize the Davie County Health Department release site
evaluation results from the above described property to the following:
— Owner only
Owners designated representative
Anyone requesting results
X Only those listed below
Mr. or Mrs. Jim Brown
Snipes & FerQuson, Inc.
6-4-87
DATE S
IGN R
ffLrryrH.
DCHD (11 /84)
Address
E
E
DAVIE COUNTY HEALTH DEPARTMENT
Environmental Health Section
R O. Box 665
Mocksville, N.C. 27028
SOIL/SITE EVALUATION
Date
Lot Size
FACTORS AREA l
AREA 2 AREA 3 AREA 4
Topography/ Landscape Position
S
S
S
PS
PS
PS
PS
U
U
U
U
!) Soil Texture (12-36 in.) Sandy,
S
S
S
S
Loamy, Clayey, (note 2:1 Clay)
- PS
PS
PS
PS
U
U
U
1) Soil Structure (12-36 in.)�
S
S
S
Clayey Soils
ckp
PS
PS
PS
U
U
U
U
Soil Depth (inches)
S
S
S
p
PS
PS
PS
U
U
U
U
Soil Drainage: Internal
S
S
S
5
I
PS
PS
U
U
U
U
External
S
S
S
S
CPQ^
PS
PS
PS
U
U
U
U
1) Restrictive Horizons
Available Space
S
S
S
S
PS
PS
PS
U
U
U
1) Other (Specify)
S
S
S
S
PS
PS
PS
PS
U
U
U
1) Site Classification
U—UNSUITABLE S—SUITABLE PS—Provisionally Suitable
Recommendations/ Comments:
Described by ` Title �� �-� Date
SITE DIAGRAM
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DCHD (6-82)
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