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134 Excalibur LnDAVIE COUNTY HEALTH DEPARTMENT SEPTIC TANK PERMIT ':'o. of Bedrooms Date^ '`his permit is granted to�Saru P �%�, l o , f e i tra tion of a septic tank at the residence of Neo Iri,f e Ec n a 12 ddre .Building Contractor �..Q Address Septic Tank Specifications: Length Width Depth Capacity % Gal. n C, Manufacturer's Name 2yllais ,-571a 6 i Address ITo. of lines—L width in. Total Length ft. No. of Sq. Ft. Type of filter material Total tons used „) / Minimum Requirements: House Traile Tank Cap. 80Sq. ft. line X00 Two-bedroom house 800. 00 Three-bedroom house 900 900 No one shall install a septic tank in Davie County without a permit from the Health Officer of his agent. Date of final approval Signed: Sanitarian I hereby certify that the above septic tank has been install991 according`t speci 'cations. Signed: / l� Septic Tank Contractor Notre: Make sketb�t of disposal system on back of sheet and mail to Health Center, Mocksville. OAF Davie County Health Department � �is t� Environmental Health Section �^ P.O. Box 848 o S„ 210 Hospital Street O U �'t Courier # : 09-40-06 1911 Mocksville, NC 27028 Phone: (336) - 753 - 6780. ON-SITE WASTEWATER CERTIFICATION Fax: (336) - 753-1680 (Check One) Replacement Remodeling Reconnection Name: VJ i4 g r+ c C L Phone Number Mailing Address: Email Address Detailed Directions To Site: j -( ! S - 0'4 c� I (Home) (Work) � keo Peara�e �a�ltoo.�o� C_ x,77 q L Property Address: � � �i(,� {� Edme-2 Please Fill In The Following Information About The EXISTING Facility: Name System Installed Under: �, Type Of Facility. Date System Installed (Month/Date/Year): to -Z' Number Of Bedrooms: L_Number Of People: Is The Facility Currently Vacant?o If Yes, For How Long?. Any Known Problems? Yes CN�o' Yes, Explain: Please Fill In The,,Following Information About The NEW Facili:/ ( -�Aoorns: Type Of Facility: �( ,t %' ; /S ummbfeer`Of�ef_Number of People Pool Size: , Garage Size: � Other: Requested By: y �(, A% GJ J )mak Date Requested: (Signature) For. Environmental Health Office Use Only pproved Disapproved Comments: Environmental Health Specialist. *The signing of this form by the Environmental Health Date: 41 I� I 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 Check Money Order # Amount:$ Date: Paid By: Received By: Account #: Invoice #: Nei t Appraisal Card DAVIE COUNTY, NC Page 1 of 1 •/Z /]0131Oe3f.�S0 •M ARNOLD BEATRICE Retum/ ppeal Notes: LS -070 -AO -006 134 EXCALIBUR LN UNIQ ID 21894 15672000 D329-PlO ID NO: 5746164693 COUNTY TAX (100), FIRE TAX (100) Elderly Exempt CARD NO. 1 of 1 eval Year: 2013 Tax Year: 2013 1 LOT EXCALIBUR LN 0.630 AC SRC- Inspection Appraised by 19 on 05/20/2008 05004 FAIRFIELD TW -05 C- EX- AT- LAST ACTION 20130320 CONSTRUCTION DETAIL MARKET VALUE DEPRECIATION CORRELATION OF VALUE Foundation - 3 i AP Additional 0.1500 ontinuous Footinq 5.00 Eff. BASE Ph slcal Standard 10.51000 ub Floor System - 4 Ilywood 8 0 USE MO AreaDUAL RATE RCN EYB AYB REDENCE TO MARKET xterior Walls - 10 01 01 1412 114 79.80 3287 111-111962 %GOOD 34.0 DEPR. BUILDING VALUE -CARD 11,180 TYPE: Single Family Residential Single Family Residential DEPR. OB/XF VALUE - CARD 1,60 MARKET LAND VALUE - CARD 10,17 luminum/Vin I Siding 29,00 oofing Structure - 03 able 8.0 STORIES: 1 - 1.0 Story TOTAL MARKET VALUE - CARD 22,95 oofing Cover - 03 s halt or Composition Shingle 3.0 TOTAL APPRAISED VALUE - CARD 22,95 nterlor Wall Construction - 5 D wall/Sheetrock 20.0 OTAL APPRAISED VALUE - PARCEL 22,95 nterlor Floor Cover - 08 heet Vinyl/Laminate 8.00 OTAL PRESENT USE VALUE - PARCEL 0 nterior Floor Cover - 09 line or Soft Woods 0.0 OTAL VALUE DEFERRED - PARCEL OTAL TAXABLE VALUE - PARCEL 22,95 eating Fuel -02 it Wood or Coal 0.00 PRIOR eating Type - 03 orced Air - Not Ducted 2.0 UILDING VALUE 12,32 BXF VALUE 2,05 ND VALUE 10,17 it Conditioning Type - 01 None 0.00 PRESENT USE VALUE DEFERRED VALUE Bedrooms/Bathrooms/Half-Bathrooms 1/0/0 O.00C OTAL VALUE 24,54C Bedrooms AS -IFUS -0 LL -0 lfice AS-0FUS-0LL-O +----------24-----------+ IBAS I I I PERMIT I I CODE I DATE I NOTE NUMBER AMOUNT I I 1 I 1 1 ROUT: WTRSHD: 6 6 SALES DATA I I OTAL POINT VALUE k3.00C BUILDING ADJUSTMENTS Uali 3 AVG1.000 ha a Desi 4 FACTOR 4 1.050 ize 1 3 1 Size 11.300 OTAL ADJUSTMENT FACTOR 1.37C OTAL QUALITY INDEX 114 1 I FF. INDICATE I I RECORD DATE DEED SALES I I BOOKAGE M R TYPE PRICE 1 1 0064 086 5 119611 WD I X I I +---10----+-----14------+ IFOP I I I 8a I I HEATED AREA 384 11 +---10----+ NOTES SUBAREA UNIT ORIG % ANN DEP % OB/XF DEPR. GS RPL ODEbOPAGE SCRIPTIO LT H NIT PRICE CON D BLDG# L/B AYB EYB RATE V COND VALUE RPORT 1 1 1 1 19 12 10.0 10 15.0 10 _ L L 198 199 199 5 199 S 4 82 4 77 TYPE AREA % CS 3 AS 38410 3064301 OP 60031 2234 rOTAL OB/XF VALUE 1,600 FIREPLACE 1 - None UBAREA 46 32,87 C0 BUILDING DIMENSIONS BAS=W24Sl6FOP=S8ElON8W10EE24N16 . ND INFORMATION HIGHEST THER ADJUSTMENTS LAND TOTAL NO BEST USE ZZNT,,TAG ON DEPTH/ LND Co.. ND NOTES ROA UNIT LAND UNT TOTAL ADJUSTED LAND LAND SE CODE TA DEPT SIZE MOD FACT RF AC LC TO OT TYPE PRICE UNITS TYP ADJST UNIT PRICE VALUE NOTES URAL AC 01204 0 2.7950 4 0.9800 02 +00 +00 +00 +00 RP 5,900.00 0.62 AC 2.73 16 160.1 1016 OTAL MARKET LAND DATA 0.62 10,17 OTAL PRESENT USE DATA http://maps.co. davie.nc.us/ITSNet/AppraisalCard. aspx?parcel=L507OA0006 4/2/2013