1615 Hwy 601S:'=+-'' , DAVIE COUNTY HEALTH DEPARTMENT
-IMPROVEMENTS PERMIT AND CERTIFICATE OF COMPLETION
j i t
*NOTE: Issued in Compliance with G.S. of North Carolina Chapter 130 Article 13c
Sewage Treatment and Disposal Rules (10 NCAC 10A .1934-.1968)
Name 41 �4 i'r � /142 r Date
Location �;✓ /=�'' � �lr �yJ :� �,.f:i,r, ��
Subdivision Name
Lot No
Permit Number
X46)413
Sec. or Block No.
Lot' Size g .2 Vl .L/ _ House Mobile Home _ Business Speculation
No. Bedrooms No. Baths ^2 No. in Family' 2 _
Garbage Disposal YES ❑ NO I;�-- Specifications for System:
Auto Dish Washer YES NO ❑ f� `�' ,, t.�
Auto Wash Machine YES [ NO ❑ ¢ _
Type Water Supply
*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 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:
N
System Installed by 4 �r
Certificate of Completion Date
*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.
RECEIVED MAY 0 7 1986
` APPLICATION FOR SITE EVALUATION/IMPROVEMENTS PERMIT
d r Davie County Health Department
Environmental Health Section
P. 0. Box 665
Mocksville, N.C. 27028
CONSTRUCTION SHALL NOT BEGIN UNTIL IMPROVEMENTS PERMIT HAS BEEN ISSUED.
Home Phone
1. Permit Requested B Via e/`S Business Phone
2. Address
3. Property Owner if Different than Above
Address
4. Permit To: a) Install_ke:0-"Alter Repair
b) Privy Conventional Other Type—
Ground
ype Ground Absorption
c) Sub -Division Sec. Lot No. ?
5. System used to serve what type facility: House Mobile Home Bs
2 IndustryOther
b) Number of people
6. a) If house or mobile home, state size of home and number of rooms.
House Dimensions
o vo
Bed Rooms Bath Rooms Den w/Closet
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 Z' urinals garbage disposal
lavatoryy showers washing machine /
dishwasher sinks
8. a) -Type water supply: Public Private Community '795 Aare.
b) Pias the water supply system been approved? Yes v"' -No
9. a)'Property Dimensions 1 19 - Z°' x I LS. �3 /a6./Z X �/. i��-?. X75 4o X Z gy2Y
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.
Date Owner Signature
OWNER IS SOLELY RESPONSIBLE FOR COMPLI NCE WITH ALL STATE AND LOCAL LAWS
Allow 5 days for processing
s to property:
797 `;rV 0-�' c-e�
M_
DCHD (6-82)
0
0
A.R. STEELE r 1
D.B.62 PG.293 ' _.,., • S �:Yrs� :' a i ,
3 j 62 • 460
. N 85.45'00" E•
` MILTON T. THOMP90N
o c ID.B. 108 PG 399
��fvo AREA 0.459 ACRE Esso• �y `
C O G O +'T 4e,.. 4
47-7
87.38' 35"E
118.34 i of
O 199 'r
;uo•*y,. A.O. ' STEELE
IA
o
Aq1110mv
� �. .
0 s S �• �a
01
► m 1
A �
i i/ � �W �� \ • �.ry ,...»»..tip
o d' Ll-l�p
i
f 'p 1 /•
I �■ 168123 89645'13" E--+�-; .275.35 TOl'AL r
C � � a 10612 g
r �
c toL� D Nei
O
1a �
.
Q
I �'o N 89`4 '13"F
29 29
if
O �q , ro �
J C� _.
70.00
a 210A2 - - - - -
1
N 89.08 3T ' W
(284.72TOTAL )
MICHAEL '
. J. YOURSCO
� -mac i �r<
D.B. 116 PG. B61 t�? ; }
60' r�.. R Q 1 K. 97 o?
R/W 1� x 7 W i}�'
�.
• ,� � , 7Y � '•� vat '` I,r?�i iN 't;+r:
,y r r +y + r I Aa �'•`" c ?
1 , ,
��;�J.�a �''�#yy-�t •: r, 1 �? u'H , ,i._ t a.. , '" , +,Y��I�t'�'Cgl
i�: 1, + a,1y >•:• r5 -i .J . • � +'y -, 1 a i .��(•����a �i�'t-t��s�'S,+,f � ..i: L ..�.x•ti.l�whn �•p:. .
2t"'kylti'{'� t..{, '•.E+.4r�rrt� y�y�" a �,. �. t�..w.: Q , } l�y.11SrF94`�5�*•i.�.«� kHr��iJ�• f,4 '2 �'i.a•%tF 5�.
��.. w•'�� :7K � _.mfr •� i7
i ' //
OFFICE OF THE DIRECTOR
pavie (gonntg Pealt4 Department
anb Pome Pe0t4 �genrg
P. O. BOX 665
C"Rucksilille, �Karth (Qurolina z7oz8
May 23, 1986
Ms. Julia C. Howard
Davie Builders Inc.
330 South Salisbury Street
Mocksville, NC 27028
Ms. Howard:
TELEPHONE
(7041 634-5985
As per your request a representative from this office visited your site
on May 22, 1986 in order to determine the"soil/site suitability for the
installation of.a ground absorption sewage system. Unfortunately, due to the
following reason we were unable to conduct the evaluation. Please notify
this office as soon as the item or items below have been completed. Upon noti=
fication, this office will place your application back in the active file and
again be placed on our work schedule.
The sitesneed to have the location of the proposed houses staked off.
The sites are on 601 South and I feel there will be a problem with the
site on which the tower is located.
Sincerely,
Robert B. Hall, Jr. R. S.
Environmental Health
r
Name
Address
DAVIE COUNTY HEALTH DEPARTMENT
Environmental Health Section
R 0. Box 665
Mocksville, N.C. 27028
SOIL/SITE EVALUATION
–� Date Z6F
Lot Size
FACTnRS ARFA 1 ARFA ? ARFA 3 ARFA d
5
6)
8)
1) Topography/ Landscape Position S S S S
PS PS
U U
?) Soil Texture (12-36 in.) Sandy, S S S S
Loamy, Clayey, (note 2:1 Clay) PS PS
U U U U
!) Soil Structure (12-36 in.) S S S
Clayey Soils t� PS PS `
UU U
d) Soil Depth (inches)' S S
PS PS
U U U
) Soil Drainage: Internal S S S
PS PS
U U U
External S S
S PS PS
U U U
Restrictive Horizons
j Available Space S S.S S
CEP PS PS
U U U
Other (Specify) S S S S
PS PS PS PS
U U U
9) Site Classification
U—UNSUITABLE S—SUITABLE PS—Provisionally Suitable
Recommendations/Comments:
Described by —
SITE DIAGRAM
koil- "I
DCHD (8.82)
Title �./ Date
� s
�- . ,e
�'z v
U—UNSUITABLE S—SUITABLE PS—Provisionally Suitable
Recommendations/Comments:
Described by —
SITE DIAGRAM
koil- "I
DCHD (8.82)
Title �./ Date
� s
�- . ,e
�'z v
Parcel #: K510OA002001
Davie County, NC - Basic Estate Search
Basic Search Real Estate Search Tax Bill Search Sales Search
View Property Record for this Parcel View Map for this Parcel View Tax Bill Information
Parcel #: K510OA002001 Account #:14952630
Owner Information
Building:
Tax Codes
BXF•
HAPPELL TERESA A
Land:
ADVLTAX - COUNTY T
Market:
15 SOUTH MAIN STREET
ssessed:
FIREADVLTAX - FIRE TAX
Deferred:
OCKSVILLE NC 27028
Vacant
3,500
Property Information
00184 0612 12 1995 WD
Township
Land (Units/Type): 0.780 AC
67,000
JERUSALEM
ddress: 1615 S US HWY 601
Deed Information
Local tonin
Pate: 12/1995 Book: 00184 Page: 0612
Plat Book: 0005 Page: 144
Legal Description
PIN
1.78 AC HWY 601 LOT 4
5747120493
Property Values
Building:
59,5801
BXF•
Price
Land:
14 22
Market:
7380
ssessed:
73 80
Deferred:
Qualified
Sales Information
No.
Book Page Month Year Instrument
Qual/UnQual
Improved
Price
1
00139 0015 07 1987 WD
Unqualified
Improved
41,000
Z
00132 0598 06 1986 WD
Qualified
Vacant
3,500
3
00184 0612 12 1995 WD
Qualified
Improved
67,000
View Properly Record for this Parcel View Map for this Parcel View Tax Bill Information
« Return to Basic Search
Page 1 of 1
oNYr,z
00-S
Davie County Web Site
All information on this site is prepared for the inventory of real property found within Davie County. All data is compiled from recorded deeds,
plats, and other public records and data. Users of this data are hereby notified that the aforementioned public information sources should be
consulted for verification of the information. All Information contained herein was created for the Davie County's Internal use. Davie County,
its employees and agents make no warranty as to the correctness or accuracy of the Information set forth on this site whether express or
Implied, In fact or in law, including without limitation the implied warranties of merchantability and fitness for a particular use.
If you have any questions about the data displayed on this website please contact the Davie County Tax Office at (336) 753-6120.
1.5.9
http://maps.daviecountync.gov/itsnet/View.aspx?prid=1474613 7/19/2016