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1798 Davie Academy Rd Davie County, NC Tax Parcel Report Monday, September 26, 2016 �... ..�:,:•.A�.:Yom.. �e �•.-•W— SHADY KNOLL LN DORSE RD j DAU�yi CA'D��'�lY. �t ' z, L Lu �+ < �I rfj _j E �m WARNING: THIS IS NOT A SURVEY Parcel•Information, Parcel Number: J200000025 Township: Calahaln NCPIN Number: 5707696139 Municipality: Account Number: 73661000 Census Tract: 37059-801 Listed Owner 1: TOWELL JOSEPH H Voting Precinct: SOUTH CALAHALN Mailing Address 1: 1797 DAVIE ACADAMY RD Planning Jurisdiction: Davie County City: MOCKSVILLE Zoning Class: DAVIE COUNTY R-A State: NC Zoning Overlay: Zip Code: 27028-8205 Voluntary Ag.District: No Legal Description: 54.09 AC DAVIE ACADEMY RD Fire Response District: COUNTY LINE Assessed Acreage: 53.76 Elementary School Zone: COOLEEMEE Deed Date: 10/1996 Middle School Zone: SOUTH DAVIE Deed Book/Page: 001900805 Soil Types: ApB,WeC,RnC,CeB2,ChA Plat Book: Flood Zone: Plat Page: Watershed Overlay: DAVIE COUNTY Building Value: 709800.00 Outbuilding&Extra 59110.00 Freatures Value: Land Value: 328390.00 Total Market Value: 1097300.00 Total Assessed Value: 825550.00 All data is provided as is without warranty or guarantee of any kind either expressed or Implied Including but not limited to the °1 F Davie County, Implied warranties of merchantability or fitness for a particular use.All users of Davie County's GIS website shall hold harmless the County of Davis,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 website. N'Y.�ti+.�'"<��. a ""7i;r ii.,,r7:3, ,+ti'...--1'^ �.?1��n�J ��:��ot?�"{a�%j7`!'�"1`s'taY't„f a,�;'�.,� `.i;t?<}r,;�„ t;` "< ,. .w. • :Fti � ;,�•,,,-,may AUTHORIZATION NO: O 6 H.-7-�.'.DAVIE COUNTY HEALTH DEPARTMENT Environmental Health Section PROPERTY INFORMATION Permitiee's ..�- P.O.Box 848 Name:; 75e__76 6Mocksville,NC 27.028' Subdivision Name: ,` Phone#:704-634-8760 `Directions to'property: Section: Lot: AUTHORIZATION FOR r/ f - WASTEWATER SYSTEM CONSTRUCTION Tax Office PIN:# I Road Name- A! **NOTE**This Authorization for Wastewater System Construction MUST BE ISSUED by the Davie County Environmental Health Section prior• to issuance of any Building Permits.This Form/Authorization Number should be presented to.the Davie County Building Inspections Office when applying for Building Permits. (In compliance with Article 11 of G.S.Chapter 130A,Wastewater Systems,Section.1900 Sewage Treatment and Disposal Systems) ***NOTICE***THIS AUTHORIZATION FOR WASTEWATER CONSTRUCTION IS VALID FOR A PERIOD OF FIVE YEARS. ENVIRONMENTAL HEAL SPECIALIST, .,DATE ISSUED N� fi�vy. _�`;d s 3-ry vFY"-w;rs tF",E:' 'h � .9 �'�I:`T;i`i'j E t^fis i� fFT�F s.:ilk.^.. •.�.t �,c;., r.•r.++-�.re: .:41 ! G l i, , w.. i, r •.JTZ'- fs!� AVIS COUNTY HEALTH DEPT NT " 'IMPROVEMENT AND OPERATIOPEII TS PROPERTY INFORMATION P_ermitte 's° -y-- -�-� 'Name: = fir;` !�l %j . Subdivision Name: 4 ?Irect>ons to property: '%'-' Section: Lot: IMPROVEMENT } PERMIT Tax Office PIN:#. r � % qg , � Rad Name: �r i�f!�:' �'tt�:i **NOTE**This Improvement Permit DOES NOT authorize the construction or installation of aseptic tank system or any wastewater system.An AUTHORIZATION FOR WASTEWATER SYSTEM CONSTRUCTION must be obtained from this Department prior to the cons truction/installation of a system or the issuance of a building permit r- (In compliance with Article 11 of G.S.Chapter 130A,Wastewater Systems,Section.1900 Sewage Treatment and Disposal Systems) ***NOTICE***THIS PERMIT IS SUBJECT TO REVOCATION IF SITE PLANS OR THE INTENDED USE CHANGE.YOUR WASTEWATER ENVIRONMENTAL HEALTh SPECIALIST DATE ISSUED SYSTEM CONTRACTOR MUST SEE THIS PERMIT BEFORE INSTALLING THE SYSTEM. RESIDENTIAL SPECIFICATION:BUILDING TYPE 14 #BEDROOMS #BATHS_'� #OCCUPANTS,_ GARBAGE DISPOSAL:Yes or No COMMERCIAL SPECIFICATION: FACILITY TYPE #PEOPLE #PEOPLE/SHIFT #SEATS INDUSTRIAL WASTE:Yes or No LOT SIZE_ TYPE WATER SUPPLY DESIGN WASTEWATER FLOW(GPD) NEW SITE REPAIR SITE SYSTEM SPECIFICATIONS: TANK SIZE,��GAL. PUMP TANK GAL. TRENCH WIDTH ROCK DEPTH_/,; —'LINEAR Fr. i C� OTHER REQUIRED SITE MODIFICATIONS/CONDITIONS: IMPROVEMENT PERMIT LAYOUT l� **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 THE DAY OF INSTALLATION.TELEPHONE#IS(704)634-8760. OPERATION PERMIT SYSTEM INSTALLED BY: �— D'TjBXi'.S �oJs s-r i& DATt= Teo I d _ o cm x N AUTHORIZATION NO.()(OS v OPERATION PERMIT BY: DATE: 7 **THE ISSUANCE OF THIS OPERATION PERMIT SHALL INDICATE THAT THE SYSTEM DESCRIBED ABOVE HAS BEEN INSTALLED IN COMPLIANCE WITH ARTICLE 11 OF G.S.CHAPTER 130A,SECTION.1900"SEWAGE TREATMENT AND DISPOSAL SYSTEMS",BUT SHALL IN NO WAY BE TAKEN AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORILY FOR ANY GIVEN PERIOD OF TIME. DCHD 05/96(Revised) �w APPLICATION FOR SITE EVALUATIONAMPROVEMENT PERMIT& Davie County Health Department Environmental Health Section �l P O.Box 848 FEB 1 01997 Mocksville,NC 27028 O (704)634-8760 tt ****IMPORTANT**** THIS APPLICATION CANNOT BE PROCESSED ALL THE REQUIRED INFORMATION IS PROVIDED. 1. Name to be Billed �/ L Contact Person Mailing Address j�� `S Home Phone City/State/Zip `Ir l✓ �o �� OZ 7W G Business Phone 2. Name on Permit/ATC if Different than Above / h 01 Mailing Address �Z6 /`!P�'e✓/C&t) .4w City/State/Zip /✓/D L�s�/i/�_ 3. Application For: Site Evaluation ❑ Improvement Permit&ATC ❑ Both 4. System to Serve: XHous,e ❑ Mobile Home ❑ Business ❑ Industry ❑ Other 5. If Residence: # Pep le # Bedrooms # Bathrooms (� Dishwasher arbage Disposalhing Machine ❑ Basement/Plumbing ❑ Basement/No Plumbing 6. If Business/Other: Specify type # People # Sinks # Commodes # Showers # Urinals # Water Coolers If Foodservice: # Seats Estimated Water Usage(gallons per day) 7. Type of water supply: ❑ County/City ❑ Community 8. Do you anticipate additions or expansions of the facility this system is intended to serve? ❑ Yes 9 N o If yes,what type? PROPERTY INFORMATION REQUIRED: ***IMPORTANT***A PLAT OF THE PROPERTY MUST BE SUBMITTED WITH THIS APPLICATION. Property Dimensions: a C- 1 WRITE DIRECTIONS(from C� 1 Mocksville)TO PROPERTY- Tax Office PIN: # b —7 . n 1 Property Address: Road Name z Are 1 ,/� i /�i/ O i@ �7' C Gam, City/Zip '0 S v 1 1 /f io 1 If in Subdivision provide information,as follows: 1 A 1 Name: 1 I Section: Lot #• 1 1 1 This is to certify that the information provided is correct to the best of my knowledge.I understand that any permit(s)issued hereafter are subject to suspension or revocation,if the site plans or intended use change,or if the information submitted in this application is falsified or changed.I,also,understand that I am responsible for all charges incurred f in this application.I,hereby,give consent to the Authorized Representative of the Davie Count Health Department to ente n above described propert located in Davie County and owned byZ l co all testing procedures as necessary to determine the site suitability. DATE ;1-144—4V SIGNATU Revised DCHD(06-96) �• �,.y!"' ',�' .:�:" .,:y 4 b.,). tk 4?FY �^' ,n�"✓',':�F`—. � •�R.�'�71,� -(A�. }'{1 a`,�' 46Ac . / 11 75 •, / " d 4J 3AC, 10 4D 5p -.548 12 r L 13 2i -.• rr j 12Ac. est Al, M M .. nN 208.9cVa .5 tk 2:77AC :° 422AC.` ry0 � a F a 303 217.. ' .;,. �. :;. '. 3� . , y( -300'' ,e b ,'� 9i- 264 . .�, ' '. 31 "82' 'fir 26 m 38AcO 2°6Ac Fti. ' , s G 5 - i. 113 t N ' 32 i n 4.51 Ac ti J 4 R 1 N v NryrCV L ' n N E _ . 't � Y 14;'3 c : 8 •r, � id°7 � 174: 4.,.;- 1� Vie. sr '•. o � , , ti4Ac 3.1Rc DAVIE COUNTY HEALTH DEPARTMENT • Environmental Health Section SECTION LOT Soil/Site Evaluation APPLICANT'S NAME G/ DATE EVALUATED �/l L /?Z PROPOSED FACILITY PROPERTY SIZE '4' SUBDIVISION ROAD NAME ��U/p Aex Water Supply: On-Site Well Community Public Evaluation By: Auger Boring i / Pit Cut FACTORS 1 2 3 4 5 6 7 Landscape position L Slope% ol_ HORIZON I DEPTH Texture group Consistence Structure Mineralogy HORIZON II DEPTH t 1� Texture group Consistence Structure Mineralogy HORIZON III DEPTH Texture group Consistence Structure Mineralogy HORIZON IV DEPTH Texture group Consistence Structure Mineralogy SOIL WETNESS RESTRICTIVE HORIZON SAPROLITE CLASSIFICATION LONG-TERM ACCEPTANCE RATE i SITE CLASSIFICATION: EVALUATION BY: / G LONG-TERM ACCEPTANCE RATE: OTHER(S)PRESENT: REMARKS: LEGEND Landscape Position R-Ridge S-Shoulder L-Linear slope FS-Foot slope N-Nose slope CC-Concave slope CV-Convex slope T-Terrace FP-Flood plain H-Head slope Texture S-Sand LS-Loamy sand SL-'Sandy loam L-Loam SI-Silt SICL-Silty clay loam SIL-Silty loam CL-Clay loam SCL-Sandy clay loam SC-Sandy clay SIC-Silty clay C-Clay CONSISTENCE Moist VFR-Very friable FR-Friable FI-Firm VFI-Very firm EFI-Extremely firm Wet NS-Non sticky SS-Slightly sticky S-Sticky VS-Very Sticky NP-Non plastic SP-Slightly plastic P-Plastic VP-Very plastic Structure SC-Single grain M-Massive CR-Crumb GR-Granular ABK-Angular blocky SBK-Subangular blocky PL-Platy PR-Prismatic Mineralogy 1:1,2:1,Mixed Notes Horizon depth-In inches Depth of fill-In inches Restrictive horizon-Thickness and inches from land surface Saprolite-S(suitable),U(unsuitable) Soil wetness-Inches from land surface to free water or inches from land surface to soil colors with chroma 2 or less Classification-S(suitable),PS(provisionally suitable),U(unsuitable) LTAR-Long-term acceptance rate-gal/day/ft2 DCHD(01-90) ■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■ ■■■■e■e■■■■■e■■■■■■■■■■■■■■■eee■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■ ■■■■■■e■■■■■ccc■■■eee■■■■■■■■■■■■■■■s■■■■■■■ccscccceeeeecccec■■■■■ ■■■■e■■■■e■■■■■■■■■■■cc■■■■■■■ecce■■■■■e■■ccec■e■■■■■■■■■see■■■■■■ MENNENMEMNON ®ii:Siiiiiiiiiiiiiiiimmmmmw e iiiiii ■■■■■■■■■■■■■■■■■■■■■■■■e�. ■■■■■■■■■■r■■■ec■e■■■e■■ccc■■�=scccee■■■■ ■■■■■■■■■■■■■■■■■■■■■■■■■■�■■■■■■■■■ell■■■■■■■■■■■■■■■■e■■■■■■■■■■■ ■■■■■■■■■■■■■■■■■■■■■■■■■s■■■■■■■■■e■■■■■■■■ee■■■■■■■■■■■,�■■■■eee■ ■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■i■r�■eee■■■ ■■■■■■■e■■■■■■■■■■■■■■■■■■■■■■■■e■■■■■■■■■■e■■e■■■■■■■■■■■eee■■■■■ ■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■ ■■etc■■e■■■■■�■■■■■■■■ee■■■■■■■■ ■■■■c■■■■ccc■■■■cc■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■cc■■c■■■■■ce■■■■ AvV o Health Department P8 t� Enviro tat Health Section1I Nh _ AUG 2 5 2010 .O. Box 848 mow:!•, 210 Hospital Street O U �'t L-iR-� r , , ,,tTH Cou ier# . 09-40-06 ville, NC 27028 Phone:(336)-753-6780 Fax:(336)-753-1680 ON-SITE WASTEWATER CERTIFICATION FOR DWELLING D�' A (Check One) Replacement Remodeling Reconnection Q Q cr Name: � Phone Number 90 r 1 l0 g (Home) Mailing Address: 11&0 &Zeg12QZ. Tfl-nd (Work) Ing-kS lI /lam /Va dg __70)9 Detailed Directions To Site: WN o e— ApadomqL �T OCM 14D QA1 Pfi4 Property Address: /7Qf' AALlie knAznydiddT Please Fill In The Following Information About The EXISTING Facility: Name System Installed Under: V u(�i �v u� f Type Of Facility: use Date System Installed(Month/Date/Year): R Number Of Bedrooms:^.�_ Number Of People: Is The Facility Currently Vacant? Yes & If Yes,For How Long? Any Known Problems? Yes No If Yes,Explain: ' Please Fill In The Following Information About The NEW Facility: Type Of Facility: G�U/t)6 h 4S� Number Of Bedrooms: Number o71n1W&9P_ eople i�nnn Pool Size: age e• Other: �a.XZZ SL�N,�'o011'1 A & (Requested By: ___jQDate Requested: ( ignatur _ For Environmental Health Office Use Only rovec isapproved Comments: Environmental Health Specialist Date: 2 O/D *The signing of this form by the Environmental Health Staff is in no way intended,nor should be taken as a guarantee (extended or limited)that the on-site wastewater system will function properly for any given period of time. Payment: Cash (Ch�eckMoney Order # 7i OS Amount:$ 06•/ 1bDate: - 3' Paid By: ,I ), L4 Received By: LaII/l Account#: �`f�� Invoice#: ��/Z? ZX 0 AUTHORIZATION NO: Q 6 5 S DAVIE COUNTY HEALTH DEPARTMENT Environmental Health Section PROPERTY INFORMATION ' Permittees% --- - -�� P.O.Box 848 Name:- f.=� - ° �'1'✓r�� Mocksville,NC 27028 Subdivision Name: Phone#:704-634-8760 Directions to property: l_),4 ;,ail Section: Lot: AUTHORIZATION FOR WASTEWATER SYSTEM CONSTRUCTION Tax Office PIN:#�11 6 Road Name: 1�Yui , ? �J-zip- A **NOTE**This Authorization for Wastewater System Construction MUST BE ISSUED by the Davie County Environmental Health Section prior to issuance of any Building Permits.This Form/Authorization Number should be presented to the Davie County Building Inspections Office when applying for Building Pen-nits. (In compliance with Article 1 I of G.S.Chapter 130A,Wastewater Systems,Section.1900 Sewage Treatment and Disposal Systems) ***NOTICE***THIS AUTHORIZATION FOR WASTEWATER CONSTRUCTION IS VALID FOR A PERIOD OF FIVE YEARS. ENVIRONMENTAL HEAL SPECIALIST DATE ISSUED RESIDENTIAL SPECIFICATION:BUILDING TYPE w'#BEDROOMS_y'-#BATHS #OCCUPANTS., GARBAGE DISPOSAL:Yes or No COMMERCIAL SPECIFICATION: FACILITY TYPE #PEOPLE #PEOPLE/SHIFT #SEATS INDUSTRIAL WASTE:Yes or No LOT SIZETYPE WATER SUPPLY ��+° DESIGN WASTEWATER FLOW(GPD) ITE NEW S ✓' REPAIR SITE SYSTEM SPECIFICATIONS: TANK SIZE GAL. PUMP TANK GAL. TRENCH WIDTH _7'G ROCK DEPTH/ LINEAR FT. �!� A OTHER REQUIRED SITE MODIFICATIONS/CONDITIONS: IMPROVEMENT PERMIT LAYOUT a **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 THE DAY OF INSTALLATION.TELEPHONE#IS(704)634-8760. OPERATION PERMIT ��t' SYSTEM INSTALLED BY: D'IjvX►'.S NIL DAA.:. `Fev,�t Lill d 0. 0� 0 C x N AUTHORIZATION NO. OPERATION PERMIT BY: L DATE: Aq7 **THE ISSUANCE OF THIS OPERATION PERMIT SHALL INDICATE THAT THE SYSTEM DESCRIBED ABOVE HAS BEEN INSTALLED IN COMPLIANCE WITH ARTICLE I 1 OF G.S.CHAPTER 130A,SECTION.1900"SEWAGE TREATMENT AND DISPOSAL SYSTEMS",BUT SHALL IN NO WAY BE TAKEN AS Af GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORILY FOR ANY GIVEN PERIOD OF TIME. DCHD 05196(Revised) i GoMaps GIS Page 1 of 6 r F• 0. - -0,.� PSS Q - 13 \° 13 DORSE_RD�= f� 1 W 13 x k a to rte r ; I http://maps.co.davie.nc.us/GoMaps/map/map.cfm?CFID=4129&CFTOY.EN=61640881 8/30/2010 HEALTH.DEPARTMENT RELEASE For Office Use Only If *CDP File Number 120716-1 Davie County Health Department J200000025 210 Hospital Street County ID Number: P.O. Box 848 HDR/VMC '1<. •,w-�- Evaluated For: Mocksville NC 27028 Phone:336-753-6780 Fax:336-753-1680 PERMIT VALID 0 3 / 1 9 / 2 0 1 8 UNTIL: Applicant: Ken McDaniel Property Owner: Joe and Deborah Towell Address: 386 Howardtown Circle Address: 1797 Davie Academy Road City: Mocksville City: Mocksville State[Zip: NC 27028 State2ip: NC 27028 Phone#: (336)909-0869 Phone#: Property Location&Site Information CddressX797 Davie Academy Road Subdivision: Phase: Lot oad# Mocksville NC 27028 SINGLE FAMILYTownship: tructure: Directions #of Bedrooms: 5 #of people: 2 Hwy 64 W.Left onto Davie Academy Rd. *Water Supply: EXISTING WELL Type of Business: Basement: F]Yes F1No Total sq.Footage: No.Of Employees: *Proposed Improvement: Remodeling `Release Conditions This release in no way expresses or implies that the existing subsurface sewage treatment and disposal system serving the site will continue to function for any period of time. Applicant/Legal Reps.Signature Required? QYes 1@No Applicant/Legal Reps.Signature: *Date; j *Issued By: 2244-Daywalt,Andrew *Date of Issue:, 0 3 1 9 / 2 0 1 3 Authorized State Agent: **Site Plan/Drawing attached.** Total Time:(HH:MM) 0 1 Hogs Minutes GHand Drawing Olmport Drawing 1 ------------ MOM T MAL w NVVDP3917GH - •,••• aNl�dB!dJ�f„ � •.NN.tee..I.r.ws.ulu • ��L:1L.b16. -i •1 a �0 toy-/ / lip. 4 va 4p; / .� 117NOt N Mi]tOr • / / / � , � to •IY Rt1yryN I ( L'�'s� ald uwww WAM I � ., OW44vr r{ --------- br0lRNiuw.-w¢MmN..wl'.wltw.wrlonaaNt topL.pw.•�rtb -tiYew.rorrpp��..f��.....-N-.�n•^a -�s�� ••••_••-••• • •�- — +v-Maiw�w�4V IIQIOYJNY.+.—J��YI. 4•f161. aa?-- Tj'a YTf9�'�kV -3y-.y-pty,wryu�ova No _�ul. R '.maum _.�pyr•4•YY.�o�1 Iwavwtaoaaaro+t almccavuu>arvmtwDaDssVa afa0 oxxmrca�ilnr tY•.t .Yn t rin�t. la.at �I ... 1 baa - • • _ w a. . ^1ffC6iaYLi�.�u6'ldt-"��'+ 1 APPLICATION FOR SITE EVALUATION/IMPROVEMENT PERMIT&ATC Davie County Environmental Health P.O.Box 848/210 Hospital Street Mocksville,NC 27028 (336)753-6780/Fax(336)753-1680 Application For: O Site Evaluation(Improvement Permit W<uthofl ation To Construct(ATC) O Both Type of Application: ❑New System ORepair to Existing System ❑Expansion/Modification of Existing System or Facility •*•WORTANT•••THIS APPLICATION CANNOTBE PROCESSED UNLESS ALL OF THE REQUIRED INFORMATION IS PROVIDED. Refer to the INFORMATION BULLETIN for instructions. APPLICANT INFORMATION Name to be Billed Contact Person Billing AddressC Home Phone City/State/ZIP. Busincss Phone 33 Name on Permit/ATC if Different than Above Mailing Address City/State/Zip PROPERTY INFORMATION 'Date HouseNacility Corners Flagged NOTE: A survey plat or site plan must accompany this application Included:ErSitc Plan OPlat(to scale) (Permit is valid for months with site Ian,no expiration with complete plat.) Owner's Nam 'M W FPLC. Phone Number Owner's Address City/State/Zip SAD t PropertyAddress City Lot Size SM, .!T47 Tar PIN# Subdivision Name(if applicable) Sectio ot# Dircc ions To Sitc: L If the answer to any of the following quer-ons is•yes",Jupporting documm jmon must be attached. Are there any existing wastewater systems on the site? Fres ONO Does the site contain jurisdictional wetlands? []Yes pwo Are there any easements or right-of-ways on the site? Oyes wlo Is the site subject to approval by another public agency? Oyes 1l 4 o Will wastewater other than domestic sewage be generated? Oyes I,Z1Qo IF RESIDENCE FILL OUT THE BOX BELOW #People #Bedrooms .5•• - #Bathrooms Garden Tub/Whirlpool 611es ONo Basement: es ❑No Basement Plumbing: ❑Ycs [Ko-. IF NON-RESIDENCE FILL OUT THE BOX BELOW Type of Facility/Business Total Square Footage of Building #People #Sinks #Commodes #Showers #Urinals Estimated Water Usage(gallons per day) (Attach documentation of sirru'lar facility water consumption) FOODSERVICE ONLY: #Seats Type system requested: ❑Conventional OAccepted ❑Innovative OAIttc/cnmlive OOther exi Water Supply Type:O County/City Water 0 New Well sting Well O Community Well Do you anticipate additions or expansions of the facilitylhis system is intended to serve?P/Yes 0 No If yes,what type? "1"Wd ( This is to certify that the information provided on this application is true and correct to the best of my knowledge. I understand that any permit(s)or ATC(s)issued hereafter are subject to suspension or revocation if the site is altered,the intended use changes,or if the information submitted in this application is falsified or changed I hereby grant right of entry to the Authorized Representative of the Davie County Health Department to conduct necessary inspections to determine compliance with applicable laws and rules. I understand that I am responsible for the proper identification and labeling of property lines and comers and locating and flagging or staking the houselfacility location,proposed well location and the location of any other amenities. Property owner's or owner's legal representative signature. Site Revisit Charge r/��• Dates) r Client Notification Date: Dau EIIS• Sign given ❑Yes ONo Account# Revised 11/06 Invoice# F '. . •�J�9 2 �' j�� 2 oav �b/fly I 1NObJ ♦ AUTHORIZATION NO: 0 6 5 8 DAVIE COUNTY HEALTH DEPARTMENT Environmental Health Section PROPERTY INFORMATION -Pemu ee's 1�' --�-� Tw�f� _ P.O.Box 848 Name: ^/D !O Mocksville,NC 27028 Subdivision Name: Phone#:704-634-8760 Directions.to property:�.IFI:�%� ��i� - - Section: Lot: AUTHOR17A.TION FOR WASTEWATER Tax Office PIT: SYSTEM CONSTRUCTION PAVII, Ro d N e: 1�1 t°, C **NOTE**Ibis Authorization for Wastewater System Construction MUST BE-ISSUED by the Davie County Environmental Health Section prior to issuance of any Building Permits.This Fom-dAuthorization Number should be presented to the Davie County Building Inspections Office when applying for Building Permits. . (In compliance with Article 11 of G.S.Chapter 130A,Wastewater Systems,Section.1900 Sewage Treatment and Disposal Systems) ***NOTICE***THIS AUTHORIZATION FOR WASTEWATER CONSTRUCTION ' IS VALID FOR A PERIOD OF FIVE YEARS. ENVIRO liEAL SPECIALIST DATE ISSUED RESIDENTIAL SPECIFICATION-BUILDING TYPE :, J #BEDROOMS'—Cr—:#BATHS #OCCUPANTS.;_�GARBAGE DISPOSAL.Yes or No COMMERCIAL SPECIFICATION: FACILITY TYPE #PEOPLE ' #PEOPLEISFHFT #SEATS INDUSTRIAL WASTE:Yes or No LOT SIZE TYPE WATER SUPPLY A/// DESIGN WASTEWATER FLOW(GPD) 45�_NEW SITE !/ REPAIR SITE SYSTEM SPECIFICATIONS: TANK SIZE,IL.GAL. PUMP TANK GAL. TRENCH WIDTH ROCK DEPTH LINEAR FT._�� REQUIRED SITE MODIFICATIONS/CONDITIONS: IMPROVEMENT PERMIT LAYOUT 1 • C . **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 THE DAY OF INSTALLATION.TELEPHONE#IS(704)634-8760. OPERATION PERMIT SYSTEM INSTALLED BY: Appraisal Card Page 1 of 1 View All Cards Next Card 0 DAVIE COUNTY NC 3119/2013 4:28:07 PM DWELL 3OSEPH H TOWELL DEBORAH M Retum/Appeal Notes: 32-000-00-025 1797 DAVIE ACADEMY RD UNIQ ID 17726 3661000 D67-P6 ID NO:5707696139 O COUNTY TAX(100),FIRE TAX(100) CARD NO.1 of 3 � Revel Year:2013 Tax Year:2013 54.09 AC DAVIE ACADEMY RD 54.100 AC SRC-Inspection r Appraised by 01 on 04/14/2008 01003 DAVIE ACADEMY TW-01 C- EX-AT- LAST ACTION 20120322 r CONSTRUCTION DETAIL MARKET VALUE DEPRECIATION CORRELATION OF VALUE p oundation-3E0 BASE Standard 0.1600 m ontinuous Footing5.00USE MO Area QUA RATE RCN EYB AYB REDENCE TO MARKET S ub Floor System-4 Ilywood all 01101 14,8181172 120.40587338 199 199 %GOOD 1 84.0 EPR.BUILDING VALUE-CARD 493,36C Merior Walls-21 TYPE:Single Family Residential Single Family Residential EPR.OB/XF VALUE-CARD 59,11 ace Brick 34.00 41ARKET LAND VALUE-CARD 328,39 oo0ng Structure-04 STORIES:6-A Frame rOTAL MARKET VALUE-CARD 880,86 -lip 10.0 oo0ng Cover-03 ksphaft or Composition Shingle 3.00 TOTAL APPRAISED VALUE-CARD 880,860 nterlor Wall Construction-6 TOTAL APPRAISED VALUE-PARCEL 1,007,99 ustom Interior 32.0 nterlor Floor Cover-12 TOTAL PRESENT USE VALUE-PARCEL 736,24 ardwood 10.0 nterlor Floor Cover-14 TOTAL VALUE DEFERRED-PARCEL 271,75 TOTAL TAXABLE VALUE-PARCEL 736,24 :arpet 0.0c eating Fuel-04 PRIOR lectric 1.0c UILDING VALUE 690,24 eating Type-10 BXF VALUE 64,53 eat Pum 4.0 +--22_-+ IFUS +-22--+13-+ ND VALUE 318,59 Ur Conditioning Type-03 1 I RESENT USE VALUE 48,31 entral 4.00 I I DEFERRED VALUE 270,28 drooms/Bathrooms/Half-Bathrooms I I OTAL VALUE 1,073,36( /4/1 19.00 S 3 rooms 0 2 AS-1FUS-SLL-O I T athrooms I 110+11+12-+ AS-1 FUS-3 LL-0 I 0 PERMIT ry alf-Bathrooms +--24--+ CODE DATE NOTE NUMBER AMOUNT o 0 AS-I FUS-OLL-O o OTAL POINT VALUE 130.00 1-22--4--22--+ ' 3PTO 8 I +--24--+ OUT:WTRSHD: Q BUILDING ADJUSTMENTS +I1+11+ 1 IUBM 1 0 ize 3 Size 0.870 I B A S 6 3 1 1 SALES DATA 1 +FOP +10+16-+ 1 1+ 119010805 F' INDICATE wall 5 CUSTM 1.450 CORD ATE DEED SALES ha Dest 4 FACTOR 4 1.050 S 1 3 0 16+ 1 2 +11+ OK AGEM R TYPE PRICE 00TAL ADJUSTMENT FACTOR 1.32 2 F O P 1+ I 1 30 199 WD V 15900 OTAL QUALITY INDEX 17 +6+--23--+ 0 1 1 IFGD 1 +11+ +12+ I 1 1 2 3 1 3 110+5++12+ HEATED AREA 4,606 I O +FOP+ +--23--+ NOTES VBXF-NV HSE.NV 2 LISTING 40X80 STG W/B SUBAREA UNIT ORIG% ANN DEP % OB/XF DEPFL GS CODE ESCRIPTIO LTH H NIT PRICE GOND BLDG* B AYB EYB RATE OV COND VALUE TYPE AREA %RPL CS 9 ABLE 41 59 2,419 30.00 100 _ L 1976199 S3 58 42091 5 2.201001272947 S DOD FENCE 0 0 300 8.70 100 _ L 199 1999 S5 30 78 GD 52 2865 4 HED 4 2 1,18 S.1 30 _ L 199 199 S 3 181 OP 19710351 830 P PAVING 1,10 9,90 3.0 1 _ L 199 199 S 3 891 5 2 33 9 25344 4 HE 3 8 2 40 5.1 L 00 00 5 4 550 O 2861DO51 168 OTAL OB XF VALUE 59,111 BM 62 2d 1505 REPLACE 5-Massive 72S UBAREA 6,2 87,33 OTALS UILDING DIMENSIONS BAS-W16N3W10N13W22PT0=NSW22S13E22N8$S8FOP-W11S6E11N6ZS6W11N6W11S1SFOP=W6512E6N12SS12FGD=S23E23N23W23 E23S13ElOS3FOP=S4E11N4W3N3W5S3W3SE3N3ESS3E3N3E12NIIEllN10E3N11SPTR=N25FUS=N50E22SSE22S3E13S32W12S3W11N3W10SIOW24=525;PTR=E25S20 BM=E12N11EIIN10E1N11W24S32 W25N20 . NO INFORMATION IGHEST THERAD3USTMENTS LAND TOTAL NO BEST USE LOCAL FRON DEPTH/ LND COND ND NOTES OA UNIT LAND i�id ADJUSTED LAND LAND SE CODE ZONING TAGE EPT SIZE MOD FACT RF AC LC TO OT TYPE PRICE UNITS UNIT PRICE VALUE NOTES URAL AC 0120 1062 0 0.8310 4 1.0900 01+20+00-30+00 PW 6,700.0 54.09 6,070.2C 32839 OTALMARKET LAND DATA S4.D99 328,3L9.1 L HOMSTTE 5000 0 0 1.0000 5 2.5000 6,700.00 2.000 AC 2.500 16 750.0 3350 GRI 11 5210 0 0 1.0000 5 1.0000 590. 15.87 AC 1.00 590.0 93 GRI III 5310 0 1+1 1.0000 5 1.0000 385. 19.341 AC 1.00 385.0 744 RSTI 6110 0 1.0000 5 11.00001 415.0 12.20 AC I.00 4.5.0 506 RSTII 6210 0 0 1.0000 5 1.0000 270.0 4.67 AC 1.00 210.0 126 OTAL PRESENT USE DATA 54.09 5664 http://maps.co.davie.nc.us/ITSNet/AppraisalCard.aspx?parcel=J200000025 3/19/2013