383 Hall Walker Ln Davie County,NC , . � Taa�Parcel Report �� � � (T Tuesday, October 4, 2016
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WARNING: TffiS IS NOT A SURVEY
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, Y . . ParcelInformation `
Parcel Number. C70000011605 Township: Farmington
NCPIN Number. 5872192046 Municipality: ,
Account Number: 82527517 Census Tract: 37059-802
Listed Owner 1: WOODRUFF DONNA M Voting Precinct: FARMWGTON
Mailing Address 1: 383 HALL WALKER LANE Planning Jurisdiction: BERMUDA RUN
City: ADVANCE Zoning Class: BERMUDA RUN OS
State: NC Zoning Overlay:
Zip Code: 27006-0000 Voluntary Ag.Distrlct: No
Legal Description: 2.000 AC OFF HWY 801 Fire Response District: SMITH GROVE
Assessed Acreage: 1.99 Elementary School2one: PINEBROOK
Deed Date: 7/2006 Middle School Zone: NORTH DAVIE
Deed Book/Page: 2006E0283 Soil Types: PcB2,PcC2,ChA
Plat Book: Flood Zone:
Plat Page: Watershed Ove�lay: BERMUDA RUN
Building Value: 75940.00 Outbuliding 8�Extra 34530.00
Freatures Value:
Land Value: 35400.00 Total Market Value: 145870.00
Total Assessed Value: 145870.00
91.�1�, All data Is pmvtded as is wRhout wartarrty or guanntee of any Idnd either exprcaaed or Implled ineluding but not Ilmtted to Me
Davie County� Imp11M wamMles of inerehaRability w fltness fw a particular usa All users ot Davle County's GIS webake shall hold harmiesa the
7�T CouMy of Davie,North Groflna,ks agerrts,conwltarrts,coritraactors w employees from any and aB dalms or wuses of actlon due to
n�U N'�� 1�� a,�s�ng out oT Me use or Inability to use the GIS data p�ovided by this webake.
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�� -AUTIit�RIZATIQN:,NO:. '� �Q,� DAVIE COUNTY HEALTH DEPARTMENT /�`� � ���
_ 4_•��:_�, -� `, � : Environmental Health Section� PROPERTY II�1FORMATION
Perm�ttee's ; �`� P.O.Box 848
` �/�'�"-°'j �i.��'<�' � Mocksville,NC 27028 Subdivision Name: """"�
Name: ' ��/�i4_
`� � ��Y Phone# 336-751-8760
Directions ro property: 1 '��� "'�" .��iC�� Section: -�-•— Lot: `"""°
: ; AUTHORIZATION FOR
f1/ � WASTEWATER /� ''')��� �
'f ����' ` �a/� .��. t'� ��!f11��� Tax Office PIN:#� D
SYSTEM CONSTRUCTION ��—f�-��
��/i d�' G h ���7-` . Road Name: �I ,f" Zip:�
**NOT'E**This Authorization for Wastewater System Consuuction 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 I 1 of G.S.Chapter 130A,Wastewater Systems,-Section�1900 Sewage Treatment and Disposal Systems)
***NOTICE***THIS AUTHORIZATION FOR WASTEWATER CONSTRUCTION
'` '�8~Q� IS VALm FOR A PERIOD OF FIVE YEARS. •
VI ONM NT L ALTH SPECIALIST" DATE ISSUED
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, q; !�����-a '� } TMPROVEMENT AND OPERATION PERMIT3. PROPERTY INFORMATION
' Pe�tteeys �" �-;"
Name:';��t :G ::..1 ti,�` *; ' e__<.4..� . ,, . � Subdivision Name: ..",�.,'
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Directions to property: _� '��'� "'"�'" ,�t: l - , , Section: -�-., Lot: ""'""""
, . / IlbIPROVEMENT '
.�, ''�.:. , _�'c,f ��',� r7 �;f��Gi.„�, PERNIIT i Tax Office PIN:#�? '' � _ c'" _ �� , .
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**NOTE**This Improvement Pemvt DOFS NOT authorize the construction or installation of a septic tank system or any wastewater system.An .
AUTHORIZATION FOR WASTEWATER SYSTEM CONSTRUGTION'must be obtained from this Department prior to the
construction/'installation of a system or the issuance of a building pernut.' ,
(In compliance with Article 11 of G.S.Chapter,130A,Wastewater Systems,Section.1900 Sewage Treatment and Disposal Systems)
�-�,'..�.-.., f �-�..;, : **sNOTICE**s THIS PERNIIT IS SUBJECf TO REVOCATION IF SiTE
,��:=� •I� !'��%.�'"s f,C��' �'�1;:°�"'��,,,,; PLANS OR THE INT'ENDED USE CHANGE.YOUR WASTEWATER
,EI�VIItO�L.�EALTH SPECIALIST. �.,DATE ISSUED �STEM CONTRACTOR MUST SEE THIS PERMTI'BEFORE .
,. INSTALLING THE SYSTEM. , . : , - .
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RESIDENTIAL SPECIFICATION:BUILDING TYPE,��` #BEDROOMS�#BATHS��#OCCUPANTS�_GARBAGE DISPOSALaQy�or No
COMMERCIAL SPECIFICATION: FACII.I1'Y TYPE #PEOPLE #PEOPLFJSHIFT #SEATS INDUSTRIAL WASTE:Yes or No
� LOT SIZE ,�r ' TYPE WATER SUPPLY�y�F--"DESIGN WASTEWATER FLOW(GPD)�_ NEW SITE � '� .
REPAIR STI'E ��
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SYSTEM SPECIFICATIONS: TANK SIZE ��GAL. PUMP TANK GAL. TRENCH WIDTHyJE� ROCK DEP'TH� LINEAR FT.� , '
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' OTHER ��, �
REQUIRED SITE MODIFICATIONS/CONDTTIONS:
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IMPROVEMENTPERMITLAYOUT, � jt-�p�OVEB E�FLUENT �IL�fER* �RISER(S) IF 6" BEL0�1 FINISHID GRAD��
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� •*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�'.M.ON THE DAY OF INSTALLATION.TELEPHONE#IS(704)634-�6��x H M H It
, t336)751-87 Q
OPERATION PERMIT ,.
SYSTEM INSTALLED BY:�,(Z��1�"���rl
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AUTHORIZATION NO.�/.�"SO! 1 OPERATION PERMIT BYc ' � � DATE:
**TI�ISSUANCE OF THIS OPERATION PERMTT SHALL INDICATE THAT T TEM DESCRIBED ABOVE HAS BEEN INSTALLED IN COMPLIANCE
WITH ARTICLE 11 OF G.S.CHAPTER 130A,SECI'ION:1900"SEWAGE TREATMENT AND DISPOSAL SYSTEMS",BUT SHALL IN NO WAY BE TAKEN AS A
GUARANTEE THAT THE SYSTEM WII.L FUNCTION SATISFACTORILY FOR ANY GIVEN PERIOD OF TIIvIE.
DCHD OS/96(Revised) �,
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� i �. 'Y-�o ; •l IMPROVEMENT AND OPERATION PERMITS PROPERTY INFORMATION ,
..'- Peimittee's ,r�',,1�1 ;
�1ame: �'"f 9 ' ��- ��� Subdivision Name: `""'""
Directions to property: �'� ;�4� '_`' ""`"�' �°'- � . Section: M-��- Lot: `"'°""
� ._ , Il1�PROVEMENT _
�• f a' ''* ,�,,��=f�����.� Il PERMIT Tax Office PIN:#.� ;�'�? -�t 1�'' f
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P: �'� ��
**NOTE**This Improvement Pemut DOES NOT authorize the construction or,installation of a septic tank system or any wastewater system.An '
AiJTHORiZATION FOR WASTEWATER SYSTEM CONSTRUCTION must be obtained fivm this Department prior to the
constiuction/'installation of a system or the issuance of a building pemut.
- (In compliance with Article 11 of G.S.Chapter 130A,Wastewater Systems,Section.1900 Sewage Treatment and Disposal Systems)
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�:�'j � �_ ***NOTICE***TFII.S PERMIT IS SUBJEGT TO REVOCATTON IF SITE
�. F,_�'-:*r+, �,_..-> � ::�, r' �:+, r-r ..; PLANS OR TI-IE IlVTENDED USE CHANGE.YOUR WASTEWATER
ENVIRONMENTAL HEALTH SPECIALIST DATE ISSUED SYSTEM CONTRACTOR MUST SEE THIS PERNIIT BEFORE
INSTALLING THE SYSTEM.
RESIDENTIAL SPECIFTCATION:BUILDING 1'YPF�� #BEDROOMS�_#BATHS�#OCCUPANTS�GARBAGE DISPOSAL�s or No
COMMERCIAL SPECIFICATION: FACILIT'Y TYPE #PEOPLE #PEOPLFJSHIFI' #SEATS INDUSTRIAL WASTE:Yes or No
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LOT SIZF�� '� TYPE WATER SUPPLY��� bESIGN WASTEWATER FLOW(GPD),� NEW SITE � REPAIR STfE r_
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SYSTEM SPECIFICATIONS: TANK SIZE 1�d GAL. PUMP TANK GAL. TRENCH WIDTH� ROCK DEP'TH� LINEAR FT.y�
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OTHER f� ! ���, -� � Z, _
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REQUIRED SITE MODIFICATIONS/CONDTfIONS: �>.- '
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IMPROVEMENTPERMITLAYOUT ' ��rOV�i} EFFLLIEIr,lT FILTER� �RISER�S> FF 6" i3�L.0:d �INISNEA GRAItE�
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""" "`*CONTACI'A REPRESENTATIVE OF THE DAVIE COUNTY HEALTH DEPARTMENT FOR FINAL INSPECTION OF ��S��x '� �
BETWEEN 8:30-9:30 A.M.OR 1:00-1:30 P.M.ON THE DAY OF INSTALLATION.TELEPHONE#IS(704)633? 6���T��—$Z L�
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OPERATION PERMIT •-
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' SYSTEM INSTALLED BY:��r�('��,., �. �/1I'1
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AUTHORIZATION NO.���OPERATION PERMIT BY: " c, DATE: ��iP���
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"'THE ISSUANCE OF THIS OPERATION PERMIT SHALL INDICATE THA�'x'fI�E_�-Y M DESCRIBED ABOVE HAS BEEN INSTALLED IN COMPLIANCE
WITH ARTICLE I 1 OF G.S.CHAP'TER 130A,SECI'ION.1900"SEW,�,GE TREA1'MENT AND DISPOSAL SYSTEMS",BUT SHALL IN NO WAY BE TAKEN AS A
GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACI'ORILY FOR ANY GIVEN PERIOD OF TIME.
, DCHD OS/96(Revised)
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� J APPUCATION FOR StTE tl►ALUATION/IMPROVFJNEM PERMIT& � � � � � M �
���^ Davie County Health Department ��'�"�
�� Environmenta/Hea/th Se�ion �
A � o� P.O. Boa 848/210 Hos ital Street � � ? � 2�0�
�!�"�����\1'��� Mocksville, NC p 27028 �
� (���' f (336)751-8760 ErJViROA,f;ENTAL F3EALTH �
� --�� DA41E COUNTY �
***Z1�QRTANT*** THI3 APPLICATION CANNOT HE PROCESSED UNLESS ALL THE REQUIRED
INFORMATION IS PROVIDED. Refer to the INEOR2+�,TION BULLETIN for instructions. �
1. Name to be Hilled (��� �� � S E/�7 N �-��W�1�� Contact Poraon � /T��
• Mailiaq 1►.ddress �% I �K� Wt'T�--K�(�. L-.� Some Phone �7���� �`�(�
City/3tata/ZIP ��J V��L,.L:. �� .�,�"I�V�p Buainesa Phone �.2-J�—�Z�(
2. Namo on Pormit/ATC i! Di!larestt than l►bove
Mailinq ]lddross CiLy/State/2ip
3. Application For: �'3ite Evalustioa � Improvement Permit/ATC fJ Hoth
a. Syetem to 8orvico: � House �Mobile Home 0 Business ❑ Industry Q Other
s. if Residence: 11 People � i 8edrooms 3 1i Bathrooms �
�Dishxaaher IY�Garbage Diaposal l�Washinq Machine Il Hasement/Plumbinq (I Haeament/No Plumbing
6. If Hu�inesa/Zndustry/Other: Spacily type � People M Sinks
� Commodea / 8hoxere � Urinale Y Water Coolera
IF FOODSERVICE: # Sests Estimated Water U9age (gallone per day)
7. Type of water supply: 0 CouAty/City �Well ❑ Community�
e. Do you anticipate additions or ezpansions of the facility this system is intended to serve? ❑Yes 1�(No
If yes,w6at type?
***I1�lPORTANT***CLIENTS MUST COMPLE7"ETHE REQUIRED PROPERTY INFORMATION REQUESTED
BELOW. Eit6er a PLAT or SITE PLAN MUST BESUBMI7TED by t6e client with TNIS APPLICATION.
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Property Dimeasions: ,� 0 3 /� y / S WRITE D[REGTIONS(trom Mocksville)to PROPERTY:
Taz Otlice PIN: # � • --/��1 y��Q �i�S� �)C��1S �I .Ty�
Property Address: Road Name ��� 1���L- �/t/������ �-1V �-.��'� � /=/�
City/Zip A�J���15/C C�/YG o2�D��, �1 l2T" /e?J�� �/9�~
If in a Subdivision provide inforwation,as follows: �,�D��/N 1/�'L ��y /�/J-
Name: C d /4"G�i��.s � T� .��� a� ��-'
Section: Block: Lot: Date Property Flagged: � Z �
This is to certify that t6e Information provided�S correct to t6e best of my knowledge. I understand that any permit(s)
issued hereafter are su6ject to suspension or revacation,if t6e site plans or intended use change,or if the information
submitted in this applicallon is falsified or c6anged I,a/so,understand lhat!am responsible jor all charges incurred jrom
thls applicadon. I,hereby,give consent to the Authorized Representative of the Davie County�Iealth De,,partment
to enter upon above described property located in Davie Couaty and owned by�LO Q.JJ� �T �fJ'J� /�d L✓�'J�
to conduct all testing procedures as necessary to determiae the site suitability.
DATE 3 /� y � SIGNATURE /�� !�V- C/�kl�/�
�—
TIiiS AREA MAY BE USED FOR DRAWING YOUR SITE PLAN(Include all of the following: Ezisting and proposed
proper;y lines and dimensions, structures, set6acks, and septic locations).
� �� Site Revisit Charge
i'�� Date(s):
Clieot Notificatioo Date:
EHS•
� /�'���� Account No. ��
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Revised DCHD(07/99) Invoice No. / �`