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192 Tifton Street Lot 239Davie County, NC , , . Tax Parcel Report Thursday, October 27, 2016 City: BERMUDA RUN State: NC Zip Code: 27006 Legal Description: LOT 239 BERMUDA RUN GOLF&COUNTRY Assessed Acreage: 0.61 Deed Date: Deed Book / Page: Plat Book: Plat Page: Building Value: Land Value: Total Assessed Value: 1/2014 009480718 0004 096 311740.00 75000.00 415360.00 Zoning Class: BERMUDA RUN CR WARNING: THIS 1S NOT A SURVEY Voluntary Ag. District: Parcel Information Fire Response District: CLEMMONS Parcel Number: D8060B0016 Township: Farmington NCPIN Number: 5882032363 Municipality: BERMUDA RUN Account Number: 8303087 Census Tract: 37059-803 Listed Owner 1: CARTER BRIAN ALEXANDER Voting Precinct: HILLSDALE Mailing Address 1: 192 TIFTON STREET Planning Jurisdiction: BERMUDA RUN City: BERMUDA RUN State: NC Zip Code: 27006 Legal Description: LOT 239 BERMUDA RUN GOLF&COUNTRY Assessed Acreage: 0.61 Deed Date: Deed Book / Page: Plat Book: Plat Page: Building Value: Land Value: Total Assessed Value: 1/2014 009480718 0004 096 311740.00 75000.00 415360.00 Zoning Class: BERMUDA RUN CR Zoning Overlay: Voluntary Ag. District: No Fire Response District: CLEMMONS Elementary School Zone: SHADY GROVE Middle School Zone: WILLIAM ELLIS Soil Types: Gn132 Flood Zone: Watershed Overlay: BERMUDA RUN Outbuilding & Extra 28620.00 Freatures Value: Total Market Value: 415360.00 161 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 Counq/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 NC or arising out of the use or Inability to use the GIS data provided by this websfle. 4 ♦ y.., Y �.y +_r � ys t.. 4 '`. .:. � �,.� }:'ry :':Y ; �� � .,I 1„� < :�,h .:� ,•'�,” � .. "Oy- X0 �\ t" DAVIE COUNTY HEALTH DEPARTMENT 'IMPROVEMENTS PERMIT AND . CERTIFICATE OF COMPLETION *NOTEAssued in Compliance With Article II of G.S. Chapter 130a Sanitary Sewage Systems Permit Number Name 19,9, !� Am,) -l/ Sad"/`/`/ »�f:� T Date /7 02 N2 6480 i �� Location A"/ Subdivision Name A Lot No. Sec. or Block No. Lot Size House I — Mobile Home Business Speculation No. Bedrooms No. Baths 3j� No. in Family_ Garbage Disposal YES NO ❑ ecifications for System: Auto Dish Washer YES NO EJ A, h r — idx�� XIII Auto Wash Ma:hine YES NO 171 / p 1 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. Improvements permit by *Contact a representative of the Davie County Health Department for final inspection of this system between 8:30- 9:30 A.M. or 1:00-1:30 P.M. on day of completion. Telephone Number 704-634-5985. Final Installation Diagram: �s System Installed by f -D yJ� s Certificate of Completion Yd & Date -7—/ 7 -12 '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 as a guarantee that the system will function satisfactorily for any given period of time. I f r o aI DAVIE COUNTY `HEALTH DEPARTMENT ,'—:.IMPROVEMENTS PERMIT AND . CERTIFICATE OF COMPLETION *NOTEAssued in Compliance With Article 11 of G.S. Chapter 130a Sanitary Sewage Systems Permit Number Name'�%��C.-iF/% art /f'>% ✓ Date N2' N2 F3 4 ,90 Location��,. -1 Subdivision Name ,�' �r i� Lot No. Sec. or Block No. Lot Size House Mobile Home _ Business Speculation No. Bedrooms No. Baths No. in Family Garbage Disposal YES NO ❑ Secifications for System: Auto Dish Washer. YES j NO E] ?aJS Auto Wash Ma^hine YES p NO ❑ 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. Improvements permit by *Contact a representative of the Davie County Health Department for final inspection of this system between 8:30- 9:30 A.M. or 1:00-1:30 P.M. on day of completion. Telephone Number 704-634-5985. _T_ Final Installation Diagram: System Installed by _ v� � Jf? r� s Certificate of Completion t ,j Date :2/7-/9 '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. A. . DAVIE COUNTHEALTH DEPARTMENT +�� y IMPROVOMENTS� PERMIT AND CERTIFICATE- OF•.COMPLETION. *NOTE:.Iss.uod in Compliance with �G.S: of North: Carolina Chapter 130 Article 13c Sewage Treatment and Dilspp6sal Rules '(10 NCAC,1OA .1934-.1968),, :� ( Permit .Number I� a -Name - i / AL. Date -VJ-:2 c,%Sc"�' Location - �� fes+ Subdivision Name I 141 -Al �) Lot No. Sec. or Block;No. it ' Lot Size Houde Mobile Home — Business Speculation_ • No. Bedrooms No. ;Bath j _ No. in Family - II r • 1 Garbage Disposal • YES_ Specifications for System: 1� pP Y Auto Dish Washer. YES NY...." Auto Wash Machine YES NIIIO p- ` . \ ,.,;u,Type-. Water SupplyX�X � 100 V, "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 Department for final inspection of this systerri between 8:30- ' _ 9:30 A.M. or 1:00-1:30 P.M. on day of,,completion. Telephone Number: 704-634-5985. ►� Final Instal ion Diagram: System Installed• by A%B� w%fit -��./,O�oe� o p � s�r�✓/«1 a ��`°'' `,,� �� s 70 4• &� ,A,r.. -o� %` /w Ao(e OA 149 • �0� �I II 00, Certificate.of Completion Date 'The signing .of'this certificate shall, indicate -that the system described above has •been 'installed inticom liance with - the standards. set forth in the above.r . gulation, but shall in NO way be taken.as a guarantee that the system will function = satisfactorily for any given period of tine: , APPLICATION FOR SITE EVALUATION/ IMPROVEMENTS PERMIT Davie County Health Department Z Q SID NO,Environmental Health Section R 0. Box 665 Mocksville, N.C. 27028 CONSTRUCTION SHALL NOT BEGIN UNTIL IMPROVEMENTS PERMIT HAS BEEN ISSUED. 1 Home Phone 1. Permit Requested Byt Y 'TLS ''�� Business"Phone 7L 6 - 5054, 2. Address P• b• I - /�lo�VS G Z 7 d/ Z 3. Property Owner if Different than Above Address 4. Permit To: a) Install.. Alter Repair - b) Privy Conventional-e!L'Other Type Ground Absorption c) Sub-DivisionB•MNP Sec. A& Lot No. 2_`.� 5. System used to serve what type facility: House ✓ Mobile Home Business IndustryOther b) Number of people uNiC 6. a) If house or mobile home, state size of home and number of rooms. House Dimensions Wj/ X 3 3 Bed Rooms 3 — Bath Rooms :7 �Z Den w/Closet - b) If Business, Industry or Other, State: Number of persons served — _4 A What type business, etc. / r'► Estimate amount of waste daily (24 hours) 6� M 7. Number and type of water -using fixtures: commodes urinals - ©" garbage disposal lavatory. showers �16 washing machine dishwasher sinks 1 8. a) Type water supply: PublicPrivate Community b) Has the water supply system been approved? Yeses No 9. a) Property Dimensions F- to • cS zG7 R 5. 2 S 3 R • 'QQ b) Land area designated to building site "Z-'?�0 sm Rr c) Sewage Disposal Contractor Af'9'cwr�� T.�.c. 10. Do you anticipate any additions or expansions of the facility this sewage system is intended to serve? 140 What type? This is to certify that the information is correct to the best of my kVwledge. Poo Date Owner ignature Nwel OWNER IS SOLELY RESPONSIBLE FOR COMPLIANCE WITH ALL STATE AND LOCAL LAWS Allow 5 days for processing ' Davie County Health Department Environmental Health Section Site Evaluation Consent Form LOCATION OF PROPERTY: DATE RECEIVED LaT -2-3 7-..,.J '5';—. (office use only) A 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 l 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. DATE SIGNATU E 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 y.A:o> DATE DCHD (11 /84) !p It Vt 19 rveVrd the properti, f1d' structures - or a . ceu r , xlely,:�ihown hereon that n6 rtrueture.10cal �itf? 1{ `p a)act�n f�tpelS of property, aad that no structure on adjacentpro1wrty:,, ekioschi 171, rnA . . . . . . . . . . m" ;009 7 ............ .......... 1! p•emiref 1! p•emiref • �tti�iP (1�,�un#� �E�Y#� �E�ttr#�nten# nub PnmE PEul#h Agenrg P. O. BOX 665 �>srkoille, �arfh ( aralina 271128 CONNIE L STAFFORD, BA, MPH TELEPHONE Health Director September 8, 1987 (704) 634.5985 .(704) 6345881 John L. McBride 391 Staffordshire Rd. Winston-Salem, NC 27104 Mr. McBride: -This letter is regarding Lot 239 in the Bermuda Run subdivision of Davie County. On May 5, 1987, this office evaluated said lot and found it provisionally suitable for a septic tank system; however, due to a power line that dissects the backside, space for installation may be a problem. Before any permit is issued the proposed house must be staked off and that immediate area evaluated. ' If you have any questions, feel free to call. Sincerely, Robert B. Hall, Jr., R.S. Environmental Health Enclosure RH/wd Name— Address FA r :TnP-Q DAVIE COUNTY HEALTH DEPARTMENT Environmental Health Section. P. O. Box 665 Mocksville, N.C. 27028 SOIL/SITE EVALUATION Date Lot Size ARFA 7 AREA 3 ARFA A ARFA 1 6) 8) I) Topography/ Landscape Position S S S / PS/ PS PS PS U U U ?) Soil Texture (12-36 in.) Sandy, S S S S Loamy, Clayey, (note 2:1 Clay) PS PS PS U U U 3) Soil Structure (12-36 in.) S S S Clayey Soils W PS PS PS U U U d) Soil Depth (inches) S S S PS PS PS PS U U U �) Soil Drainage: Internal S S S Pg PS PS PS U U U External S S S PS PS PS PS U U U Restrictive Horizons Available Space S S S PS PS PS U U U Other (Specify) S S S S PS PS PS PS U U U U 9) Site Classification U—UNSUITABLE Recommendations/ Comments: Described by _ SITE DIAGRAM DCHD (6.82) S—SUITABLE PS—Provisionally Suitable Title j Name— Address FA r :TnP-Q DAVIE COUNTY HEALTH DEPARTMENT Environmental Health Section. P. O. Box 665 Mocksville, N.C. 27028 SOIL/SITE EVALUATION Date Lot Size ARFA 7 AREA 3 ARFA A ARFA 1 6) 8) I) Topography/ Landscape Position S S S / PS/ PS PS PS U U U ?) Soil Texture (12-36 in.) Sandy, S S S S Loamy, Clayey, (note 2:1 Clay) PS PS PS U U U 3) Soil Structure (12-36 in.) S S S Clayey Soils W PS PS PS U U U d) Soil Depth (inches) S S S PS PS PS PS U U U �) Soil Drainage: Internal S S S Pg PS PS PS U U U External S S S PS PS PS PS U U U Restrictive Horizons Available Space S S S PS PS PS U U U Other (Specify) S S S S PS PS PS PS U U U U 9) Site Classification U—UNSUITABLE Recommendations/ Comments: Described by _ SITE DIAGRAM DCHD (6.82) S—SUITABLE PS—Provisionally Suitable Title U—UNSUITABLE Recommendations/ Comments: Described by _ SITE DIAGRAM DCHD (6.82) S—SUITABLE PS—Provisionally Suitable Title Davie County Nealtli De artment and .glome NealtFi deny 210 HOSPITAL STREET I P.O. BOX 885 MOCKSVILLE. N.C. 27028 PHONE: (704) 834-5985 Mike Atwood P. 0. Box 144 Clemmons, KC 27012 July 18, 1991 Re: Repair Permit 6480 Bermuda Run - Lot 239 Dear Mr. Atwood: This letter is regarding the septic tank repair done at the house located on Lot 239 in Bermuda Run. The system's premature failure was caused by a cut sprinkler line that flooded the septic system. Due to the lack of available repair area and the sprinkler system, this office feels that the only repair alternative is to install a pit at the ends of the 2 failing lines. If you have any questions, feel free to call. Sincerely; Robert B. Hall, Jr., R.S. Environmental Health Section RH/wd Enclosures A APPLICATION FOR SITE EVALUATION/ IMPROVEMENTS PERMIT Davie County Health Department Environmental Health Section P. O. Box 665 Mocksville, N.C. 27028 CONSTRUCTION SHALL NOT BEGIN UNTIL IMPROVEMENTS PERMIT HAS BEEN ISSUED. �,L / / _ Home Phone z�0.� _ r O4 1. Permit Requested By O o In[ Business Phone W_ 2�9 3 0 2. Address 40 % 2'r 239 j'Za'cETdN' SM 8, BRX MPA aU V IV- C , 3. Property Owner if Different than Above Address 4. Permit To: a) Install Alter Repair b) Privy Conventional Other Type Ground Absorption c) Sub -Division Sec. Lot No. 23I 5. System used to serve what type facility: House Mobile Home Business Industry Other b) Number of people A 6. a) If house or mobile home, state size of home and number of rooms. imensions House Dimensions— Bed Rooms Bath Rooms Den w/Closet Bed b) If Business, Industry or Other, State: Number of persons served What type business, etc. Estimate amount of waste daily (24 hours) 7. Number and type of water -using fixtures: commodes urinals garbage disposal l lavatory showers washing machine dishwasher i sinks s 8. a) Type water supply: Public Private Community — b) Has the water supply system been approved? Yes No 9. a) Property Dimensions A'pAR oX /026'iC A60' b) Land area designated to building site c) 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. f -�k 0- 7 _: Date Owner Signature OWNER IS SOLELY RESPONSIBLE FOR COMPLIANCE WITH ALL STATE AND LOCAL LAWS Directions to property: Allow 5 days for processing "M DCHD (6-82) 3 -- _0 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 (office use only) BERMkDA ktto Ti�roK Si. L®T #�39 yes no 1. jam 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. ATE G NATORt 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 (:�)a ",-�4,t4ADATt 411Z SIGNATU DCHD (11 /84) certify that on f-_^ = =+ 19 7c`J, 1 surveyed the property shorn on this plat; that the properly lines and location of all structures are accurately shown hereon: that no structure located on this ,property encroachm an any adjacent street or property, and that sun• yrd " f no structure' on adjacent property encroaches on the premises A % .- ' 6 . , ,G 774), f PROPERTY OF LOT NO. _—£ MAP OF BLOCK NO. PUTT BOOK r' " PAGE _ 'M�! COUNTY, N. C. 46 ALE: t INCH K'[ET 27 JOB NO i'— .CLTl KA% MOYO ►1,Mf ! WIRT GV,�'s T�•�o �•..1.� .. i'-M14I 4 cBzWijc ( ountLi Pealth cB Apartment alit Pante Rcalth �Srnq P. O. BOX 665 f achsliifle, NoH4 ( aralinu 27028 CONNIE L. STAFFORD, BA, MPH TELEPHONE Health Director September 8, 1987 (704) 634-5985 (704) 634-5881 John L. McBride 391 Staffordshire Rd. Winston-Salem, NC 27104 Mr. McBride: This letter is regarding Lot 239 in the Bermuda Run subdivision of Davie County. On May 5, 1987, this office evaluated said lot and found it provisionally suitable for a septic tank system; however, due to a power line that dissects the backside, space for installation may be a problem.` Before any permit is issued the proposed house must be staked off and that immediate area evaluated. If you have any questions, feel free to call. Sincerely, . � �Z ;,i n c l r . x. Robert B. Hall, Jr., R.S. Environmental Health Enclosure RH/wd DAVIE COUNTY HEALTH DEPARTMENT Environmental Health Section R O. Box 665 Mocksville, N.C. 27028 SOIL/SITE EVALUATION '�" 0,!561 Name � cU Date : , Address Lot Size FAr:TOP.q ARFA 1 ARFA 9 ARFA 3 ARFA d Topography/ Landscape Position �-�-� PC S � S S PS S PS U U !) Soil Texture (12-36 in.) Sandy, Loamy, Clayey, (note 2:1 Clay) S PS S PS U U U U l) Soil Structure (12-36 in.) Clayey Soils SS PS PS S PS U S PS U Soil Depth (inches) S S S PS U S PS U �) Soil Drainage: Internal S S PS U U S PS U External S PS S PS U S PS U 1) Restrictive Horizons Available Space S !SD S PS U S PS U {) Other (Specify) S PS S PS S PS S PS U U U U 1) Site Classification U—UNSUITABLE S—SUITABLE PS—Provisionally Suitable Recommendations/Comments: e Described by _ SITE DIAGRAM DCHD (6-82) Title Date iS'