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4078 Hwy 601SOPERATION PERMIT Davie County Health Department �f 210 Hospital Street 1r P.O. Box 848 , �, E' Mocksville NC 27028 Phone: 336-753-6780 Fax: 336-753-1680 Applicant: Frances Sanderson Address: 4078 US Hwy 601 S City: Mocksville State2ip: NC 27028 Phone #: Property Loca Address/Road #: Subdivision: 4078 US Hwy 601 S Mocksville NC 27028 Structure: MOBILE HOME # of Bedrooms: 1 # of People: 1 *Water Supply: PUBLIC 'IP Issued by. 2244 - Daywalt. Andrew *CA issued by: 2244 - Daywalt, Andrew Design Flow: 3 6 0 Soil Application Rate: 0 - 3 Nitrification Field No. Drain Lines Total Trench Length: Trench Spacing: Trench Width: Aggregate Depth: 'CDP File Number 120720-1 060000002901 County ID Number: Evaluated For. REPAIR �ownship: / Property owner: Frances Sanderson Address: 4078 US Hwy 601 S City: Mocksville State/Zip: NC 27028 )n & Site Information Phase: Directions Hwy 601 S. *System Classification/Description: Lot: SaproliteSystem? OYes ONo 'Distribution Type: GRAVITY -PARALLEL (eq. d -box) Pump Required? OYes ONo 'Pre_ Treatment: Drain field Sq. ft. 1 5 0 8• OInches O.C. Feet O.C. Inches - OFeet inches Minimum Trench Depth: Inches Minimum Soil Cover. Inches Maximum Trench Depth: Inches Maximum Soil Cover: Inches *System Type: INFILTRATOR OUICK 4 STANDARD Installer: Certification #: *EH S: 2244 - DaywalL Andrew Date: 0 4/ 0 3/.1 0 1 3 Approval Status 0 Approved O Disapproved CDP,File Number 120720 -1 Manufacturer. STB: Gallons: County ID Number: 060000002901 Tank Let. Long: Installer: Date: / / Certification #: Yes ❑ No RiserHeght: ❑ *EHS: *Filter Brand: NO (Min.6 in.) einforced Tank: ❑ Yes ❑ ST Marker. ❑ Yes ❑ NO Date: nforced Tank: ❑ Yes ❑ NO Approval Status 1 Piece Tank: ❑ Yes ❑ No ❑ Approved ❑ Disapproved Pump Tank Manufacturer. PT: Gallons: Installer: Certification #: THS: Date: / / RiserSealed ❑ Yes ❑ No RiserHeght: ❑ Yes ❑ NO (Min.6 in.) einforced Tank: ❑ Yes ❑ No iPiece Tank: ❑ Yes ❑ No Supp Pipe Size: inch diameter Pipe Length: feet *Schedule: Pressure Rated ❑ Yes ❑ No approved fittings ❑ Yes ❑ No Date: Approval Status ❑ Approved ❑ Disapproved Installer: Certification #: THS: Date: / / Approval Status ❑ Approved ❑ Disapproved Pump Type: Installer. / Dosing Volume: — Gal Certification #: Draw Down: Inches THS: *Chain: Date: Valves Accessible ❑ Yes ❑ No Flow Adjustment Valve ❑ Yes ❑ No Check -valve ❑ Yes ❑ NO Approval Status PVC unions ❑ Yes ❑ No ❑ Approved ❑ Disapproved Vent Hole ❑ Yes ❑ No Anti -siphon Hole ❑ Yes 0 No ,._ CDP•File Number 120720 -1 Electric Equipment County ID Number: 060000002901 NEMA 4X Box or Equivalent ❑ Yes ❑ No Installer: Box 12 inches Above Grade ❑ Yes ❑ No Certification #: Box Adj. To Pump Tank ❑ Yes ❑ No Conduit Sealed ❑ Yes ❑ No *EHS: Pump Manually Operable ❑ Yes ❑ No *Activation Method: Date* Alarm Audible El Yes ❑ No Approval Status ❑ Approved ❑ Disapproved Alarm Visible ❑ Yes ❑ No 2244 - Daywalt. Andrew *Operation Permit completed by: Authorized State Agent: Date of Issue: 0 4/ 0 3/ 2 0 1 3 This system has been installed in compliance with applicable NC General Statutes: Article 11, Chapter 130A, Rules for Sewage Treatment and Disposal, 15A NCAC 18A.1900 et. Seq., and all conditions of the Improvement Permit and Construction Authorization. This property is served by a sewage septic system. Rule .1961 requires that a Type septic system meet the following criteria: Minimum System Review ByThe Local Health Department: Management Entity: Minimum System InspectionlM aintenance Frequency By Certified Operator: Reporting Frequency By Certified Operator: Rule .1961 requires that a Type IV and V septic systems designed fora hometbusiness owner must maintain a valid contract with a public management entity with a certified operator or a private certified operator forthe life of the septic system. Rule .1961 requires that Type VI septic systems designed for a homelbusiness owner must maintain a valid contract with a public management entity with a certified operator for the life of the septic system. Rule. 1961 (2) (e) requires a contract shall be executed between the system owner and a management entity priorto the issuance of an Operation Permit fora system required to be maintained by public or private management entity, unless the system owner and certified operator are the same. The contract shall require specific requirements for maintenance and operation, responsibilities of the owner and systems operator, provisions that the contract shall be in effect for as long as the system is in use, and other requirements for the continued proper performance of the system. It shall also be a condition of the Operation Permit that subsequent owners of the systems execute such a contract. 4Hand Drawing Olmport Drawing **Site Plan/Drawing attached.** Total Tirne:(HH111A) Activity Code: S-19 204 - OP issued NEW Type 11 Quick 4 0 1 Hours 3 0 u mutes OPERATION PERMIT 120720-1 Davie County Health Department CDP File Number: 210 Hospital Street 060000002901 P.O. BoxsaB County File Number. Mocksville NC 27028 Date: Olnch Drawing DraWgg Type: Operation Permit Scale: , OON/A k LJ -4-L _ j Lel ! 1 _.1- — 1 Q -- f�- jj R 1 i III IIII t I j I j t t. y M • A pplint:ddress: CRY: State/Zip: Phone #: CONSTRUCTION AUTHORIZATION Davie County Health Department 210 Hospital Street P.O. Box 848 Mocksville NC 27028 For Office Use Onlv 'COP File Number 120720-1 County ID Number: 060000002901 Evaluated For: REPAIR Township: PERMIT VALID UNTIL: Phone: 336-753-6780 Fax: 336-753-1680 0 1/ 0 1/ 0 0 0 6 Frances Sanderson 4078 US Hwy 601 S Mocksville NC 27028 i Address/Road #: Site Classification: 4078 US Hwy 601 S Mocksville NC 27028 Structure: MOBILE HOME # of Bedrooms: 1 # of People: 1 'Water Supply: PUBLIC Subdivision: Property Owner. Frances Sanderson Address: 4078 US Hwy 601 S City: Mocksville State2ip: NC 27028 Phone #: Directions Hwy 601 S. ificatio Phase: Lot: �b�� Pagel of3 b/ Minimum Trench Depth: a 4 Site Classification: Inches Minimum Soil Cover. Saprolite System? QYes QNo Inches Design Flow: 3 6 0 Maximum Trench Depth: 3 6 Inches Soil Application Rate: 0 . 3 Maximum Soil Cover: Inches 'System Classification/Description: `Distribution Type: GRAVITY - PARALLEL (eq. d -box) TYPE II A. CONY SYSTEM (SINGLE-FAMILY OR 480 GPD OR LESS) Septic Tank: _ Gallons 'Proposed System: 25% REDUCTION 1 -Piece: QYes QNo Pump Required: QYes QNo OMay Be Required Nitrification Field Sq. ft. Pump Tank: Gallons No. Drain Lines 1 -Piece: QYes ONo Total Trench Length: a 0 0 ft GPM—vs— ft. TDH Trench Spacing:— — OInches O.C. Feet O.C. Dosing Volume: Gallons — Trench Width: 3 6 a, Inches — OFeet Grease Trap: Gallons Aggregate Depth: inches Pre Treatment: ONSF OTS -1 OTS -11 Septic Tank Installer Grade Levet Required: 01 OII 0111 OIV �b�� Pagel of3 b/ CDP File Number 120720 -1 Repair System Require r System ification: Ps w: Soil Application Rate: *System Classification/Description: *Proposed System: Nitrification Field No. Drain Lines County ID Number: 60000002901 ❑ Open Pump System Sheet :OYes ONo ONo, but has Available Trench Spacing:Q Inches 0.1 ---8Feet O.C. Trench Width: Inches Feet Aggregate Depth: inches Minimum Trench Depth: Inches Minimum Soil Cover. Inches Maximum Trench Depth: Inches Maximum Soil Cover: Inches Sq. ft. *Distribution Type: Total Trench Length: ft Pump Required: OYes dNo OMay Be Required � Pre Treatment: ONSF OTS -1 OTS -II *Site Modifications No grading or construction activity is allowed in areas designated for system and repair without approval of Health Department. *Permit Conditions The issuance ofthis permit bythe Health Department in no wayguarantees the issuance of other permits.The permit holder is responsible for checking with appropriate governing bodies in meeting their requirements. This Authorization for Wastewater System Construction shall be valid for a person equal to the period of validity of the Improvement Permit, not to exceed five year:, and Maybe Issued at the sxnetime the Improvement Permit Issued (NCGS 130A -336(b)} If the Installation has not been completed during the period of validity of the Construction Permit, the Information submitted In the application for a permit or Construction Authorization Is found to have been Incorrect, falsified or changed, or the site Is altered, the penult or Construction Authorization shall become Invalid, and may be suspended or revoked (.1937(g)). The person owning or controlling the systen shall be responsible for assuring compliance with the laws, reties, and permit conditions regarding system location. Installation, operation, maintenance, monitoring, reporting and repair (1938(b)). Applicant/Legal Reps. Signature Required? Oyes ONo Applicant/Legal Reps. Signature- Date: *Issued By: 2244' Daywall. Andrew Date of Issue: 0 3 / Z 0 / a 0 1 3 Authorized State Agent: Malfunction Log Oyes 01 -land Drawing Olmport Drawing TotalTime:(HH:MM) **Site Plan/Drawing attached.** 0 1 Hours Idlnutes Page2of3 } • CONSTRUCTION AUTHORIZATION ' Davie County Health Department 210 Hospital Street P.O. Box 848 Mocksville NC 27028 Drawing Drawing Type: Construction Authorization CDP File Number: 120720 -1 County File Number. 060000002901 Date: 03/20/2013 Q Inch Scale: OBlock QN/A Pane 3 of 3 FTTT 1 _. f , , II e Li - s 1! r Fill qr Pane 3 of 3 DAVIE COUNTY ENVIRONMENTAL HEALTH SERVICE REQUEST APPLICATION IP/ATC OSWW REPAIR Name ��,u��s ��rs�13 Telephone Number Address 407Y US M � � Mailing Address (if different from above) Email Address: Subdivision Name Directions ///015 IMI (MA -X, LLyL r p(s. Date System Installed Type Facility Type Water supply _ U film Lot # 4!/ Name System Installed Under Number Bedrooms Number People Served Specific Problem Occurring —11 /U45 4—it 8 bate Requested Info Taken By 00MVId, THIS IS TO CERTIFY THAT Tfilt INFORMATION PROVIDED IS CORRECT TO THE BEST OF MY KNOWLEDGE, AND THAT I UNDERSTAND THAT I AM RESPONSIBLE FOR ALL CHARGES INCURRED FROM THIS APPLICATION. Signature of owner or Authorized Agent Initial Fee Date Revisit Charge Date REHS _ Reason I� DAVIM COUNTY ENVIRONMENTAL HEALTH SERVICE REQUEST _. APPLICATION IP/ATC,OSWW REPAIR Named A �u C! �s `�� .I b fJ Telephone"Number b ��Z "Address 410 N; U.� 4 W q & 6 1�- Mailing Address (if different from above) Email Address: .,Subdivision Name Lot # ` Directionstoots, ✓ f Date System Installed Name System Installed Under. Type Facility - Number Be rboms " Number People Se e Type WateruPply Specific Problem Occurring _11 ate" Requested"h: n.. h� Info Taken By :THIS IS TO CERTIFY THAT TirkINFORMATION PROVIDED IS CORRECT TO THE BEST OF MY KNOWLEDGE;'AND THAT I UNDERSTAND THAT I AM RESPONSIBLE FOR ALL CHARGES INCURRED FROM THIS APPLICATION. Signature of owner or Authorized Agent " Initial Fee .Date REHS ^Y Revisit Charge Date Reason Revised 2-2011' - T' // U10 3co AUTHORIZATIQN NO: • Q 6 27 �DAVIE COUNTY HEALTH DEPARTMENT ANO' Environmental Health Section PROPERTY INFORMATION Perinittee'� P.O. Box 848 Name: "'� /� i /iF�! G iS l3 4 Mocksville, NC 27028 ,Subdivision Name: Phone #: 704-634=7. 8760 Directions to property: f _ Section: Lot: AUTHORIZATION FOR WASTEWATER Tax Office SYSTEM CONSTRUCTION � v 1 � Road Name: !n 6 1 S 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 Permits. (In compliance with Article 11 of G.S. Chapter 130A; Wastewater Systems, Section'.1900 Sewage Treatment and Disposal Systems) r / **NOTICE*** THIS AUTHORIZATION FOR WASTEWATER CONSTRUCTION * IS VALID FOR A PERIOD OF FIVE YEARS. ENVIRONMENTAL HEAL PECIALIST DATE ISSU L�y:'w -r. '..;{F'�•/i' "w'C ify wr-*y�.'�``.,�P`Ya�`�r. i.;�j ��+'�'?F,oroeS'+.'vt'[. h.:r'<-.•aF 7e a:tty, - {t'• +yx i"'«. Sy• .#i:.+•, Y'�••k:��,;. �x •''t`.C6`'r�`�."•�✓'` - � "-"awe �t .c'�' '• .. #.>»�!s �' .+I .� �"'r ~K , . DAVIE COUNTY HEALTH DEPARTMENT " IMPROVEMENT AND OPERATION PERMITS PROPERTY INFORMATION Nalrfe Subdivision Name: Directions to property:➢ Section: Lot: �, .. PERMIT* ° : ' IMPROVEMENT PERMIT Tax Office PIN:#.� r� I/-- = l 11 Road Na� �,; � �, Zip:-2-yd—!�`na ' **NOTE** This Improvement Permit DOES NOT authorize the construction or installation of a septic tank system or any wastewater system. An AUTHORIZATION FOR WASTEWATER SYSTEM CONSTRUCTION must be obtained from this Department prior to the construction/installation of a system or the issuance of a building permit. (In compliance with Article 11 of G.S. Chapter 130A, Wastewater Systems, Section .1900 Sewage Treatment and Disposal Systems) + d ***NOTICE*** THIS PERMIT IS SUBJECT TO REVOCATION IF SITE PIANS OR THE INTENDED USE CHANGE. YOUR WASTEWATER ENVIRONMENTAL HEALTH`SPECIALIST DATE ISSUEb SYSTEM CONTRACTOR MUST SEE THIS PERMIT BEFORE INSTALLING THE SYSTEM. RESIDENTIAL SPECIFICATION: BUILDING TYPE # 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 140 GAL: PUMP TANK GAL. TRENCH WIDTH l ROCK DEPTH? LINEAR FT. OTHER REQUIRED SITE MODIFICATIONS/CONDITIONS: **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. SYSTEM INSTALLED BY: ya Q AUTHORIZATION NO. �� OPERATION PERMIT BY..Ave DATE: <. **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) APPLICATION FOR SITE EVALUATIONAMPROVEMENT PERMIT Davie County Health Department Environmental Health Section tJ4 P. O. Box 848 Mocksville, NC 27028 (704) 634-8760 ****IMPORTANT**** THIS APPLICATION CANNOT BE PROCESSED UNLESS ALL THE REQUIRED INFORMATION RMATION IS PROVIDED. 1. Name to be Billed l -1,'ZZ„erv; ��.uOl �Aj5o Contact Person Mailing Address G 4�1O C • CitR a N s C LRC 4 l iai Home Phone 46312— City/State/Zip Mae. i3%Z PROPERTY INFORMATION REQUIRED: *** IMPORTANT *** A PLAT OF THE PROPERTY MUST BE SUBMITTED WITH THIS APPLICATION. Property Dimensions: � WRITE DIRECTIONS from 1 Mocksville) TO PROPERTY: Tax Office PIN: # Jt' 7 5 — _ 1.3 Property Address: Road Name City/zip I 1 IfinSubdivision provide information, as follows: Name: 2441c5 6 -0 Al �'� Lot #• �'� 1 L./ Section 1 �J 1 This is to certify that the information provided is correct to the best of my knowledge. I understa that any perms s) issued hereafterr. L;--PIl 9&7;' L 4 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 from this application. I, hereby, give consent to the Authorized Representative of the Davie County Heald and owned by L771e _-5 q t'v as necessary to determ ne the site suitability. DATE Ne — �?V SIGNATURE Revised DCHD (06-96) Department to enter upon above described property located in Davie County to conduct all testing procedures c City/State/ZipMae. Business Phone �4�f•�f.S2.1L 2. Name on Permit/ATC if Different than Above Mailing Address City/State/Zip 3. Application For: ' Site Evaluation ❑ Improvement Permit & ATC Both 4. System to Serve: ❑ House Mobile Home ❑ Business ❑ Industry ❑ Other 5. If Residence: # People t # Bedrooms ,} _ # Bathrooms 2— Dishwasher ❑ Garbage Disposal ❑ Dishwasher Washing 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 ❑ Well ❑ Community 8. Do you anticipate additions or expansions of the facility this system is intended to serve? ❑ Yes No If yes, what type? PROPERTY INFORMATION REQUIRED: *** IMPORTANT *** A PLAT OF THE PROPERTY MUST BE SUBMITTED WITH THIS APPLICATION. Property Dimensions: � WRITE DIRECTIONS from 1 Mocksville) TO PROPERTY: Tax Office PIN: # Jt' 7 5 — _ 1.3 Property Address: Road Name City/zip I 1 IfinSubdivision provide information, as follows: Name: 2441c5 6 -0 Al �'� Lot #• �'� 1 L./ Section 1 �J 1 This is to certify that the information provided is correct to the best of my knowledge. I understa that any perms s) issued hereafterr. L;--PIl 9&7;' L 4 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 from this application. I, hereby, give consent to the Authorized Representative of the Davie County Heald and owned by L771e _-5 q t'v as necessary to determ ne the site suitability. DATE Ne — �?V SIGNATURE Revised DCHD (06-96) Department to enter upon above described property located in Davie County to conduct all testing procedures c r. Parcel 28.01 Dona B. Harris and Catherin D. Johnson I D.B. 123 — 039 v ov .. c 0 N _ S 88°45'50"E NIP S 88°45'50"E JEIP. _ NIP 836.28' c np.1 226.18' E ,�� F,�] X 1 o v t qj W - N Nd O 30' occeso eaxment 0 0 5.000 .. d.) Acres (by dm 3 IP o I _ 303.80' Point in cl N 88633'50"W Parcel 35.1 6 Q E CO ` N �E c _ a Ct v I • 3 c C Parcel 29 1 _ • 837.95' NIP c (n Parcel 31 c Q I 6I I N 89°58'55"W o c N NIP .r• ^ 0 60' m a I . _ C4 E 30' c Parcel 31 ,.John __.. A. Spillman eta[ D.B. 427 — 399 • DAVIE COUNTY HEALTH DEPARTMENT Environmental Health Section SECTION LOT Soil/Site Evaluation APPLICANT'S NAME PROPOSED FACILITY SUBDIVISION Water Supply: On -Site Well Community_ Evaluation By: Auger Boring t/ Pit DATE EVALUATED 1—'12-4 PROPERTY SIZE ROAD NAME/ ( J Public t Cut FACTORS 1 2 3 4 5 6 7 Landscape position 2—Slope % _ HORIZON I DEPTH Texture group Consistence Structure Mineralogy HORIZON II DEPTH `Q Texture groupf Consistence Structure _ /e 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 , SITE CLASSIFICATION: LONG-TERM ACCEPTANCE RATE: REMARKS: DCHD (O1-90) EVALUATION BY: OTHER(S) PRESENT: 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 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 ii ■■■■■N■■E■■s■E■■■E■E■■■■■■■EEE■■■■■■■■■■■■■■■■■■■■■■■ ■■■■■■■■■■■■■eO■■■■■O■■eO■■■Mee■■■■■■■■■■■■■■■■■■■■■■ ■■eee■■■■■■■■■■■■■■■e■■■■■■■■■■■EEE■EE■EEOOeeeee■■■■■ ■O■■■■■eee■ee■■■eee■■■■�■■■■■■■■■EM■E■■E��■■■■E■E■■EE■ ■eee■■ecce■■■■EE■■■■EE■�,■■■■■■�■■■■■■■■r�■■■■■■■■■■■■ ■■■■■■■■■■■■■■■■■■■■■■■ri�E■■■■EEee■■■■E■e�O■■■EON■■■■ ■eO■■e■■eee■■eee■eee■■■��■■i:::ee:::o::i■e■■■■■■■■■■■ ■■■■■E■■■■■■■E■■■NOO■e■■■■■■Mee■■■■■eeO■■O■■■■■■eee■■ ■■■■■■e■■■■eMee■■■■■eee■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■ ■■■■■■■■■■■■■■■■■■■■■■OEOeeeeee■■■E■eeee■eeeeO■■■■■e■ ■■eee■■■■■■■■■��■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■EE■■Ee■ ■e■e■■■e■■O■e■eee■■■■ee■■eeeeeeE■■■eee■■■■■■■■■■■■■■■ ■■■■eON■ONe■■■■■■■■■■■■■■■■■■■ ■■■■■eee■■■■■■■■eee■■ ■■■■■■eeeE■■■■■■■■■■■■■■■■■Mee■■■■■■Mee■■■■■■■■Mee■■■ ■e■■eee■■e■E■■E■■■■■E■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■ ■■■■■■■■■e■■■■■■■■■ee■■Eee►�ee■e►�■■■■Mee■■■■ ■■■o■■■e■■■■■e■■■■■■ ■ee■Oa■■E��■e■■e■■Mee■ ■■Mee■eee■■■■■■ONOEE�iE■■■■s�■■■■■e■■Ea■■■■■ ■■eeO■e■■■eee■■OOOt■■E■■■■■■►�■■■►�■■■■■■■■■■ ■■■■■■■■■■■■■■■■■E■■■■■s■■■■��eee�■■■■eee■■■ ■■■■■■■■■■■■■eee■■■■E■■■OOME■�■eee■■■e■■■■ ii ME ME ME ME ME ■■■■■■ ■■■■■■ ■■■ NONE ■E■■■■ li■■►o■■ limon■■ NINERIO■ ■FINEW ■uE■rJ ■m■■rfi ■■MEMO■ ■NOME■■ ■■■E■■■ ■■EEO■■ ■■■■■■■ ■■■E■■■ ■■■■■■■ ■EEE■E■ ■E■■■E■ ■E■■E■■ ■EEE■■■ ■■■E■E■ ■E■■EM■ ■OM■■M■ ■■■■ME■ ■E■■■E■ ■■■■■■■ ■Oe■■■■ ■E■■E■■ ■■■■■■■ ■■■■E■■ ■N■■■E■ ■E■■■E■ ■■■■■■■ ■■■■■■■ ,Appriisaj Card.. Page 1 of 1 7 nn nm> >,aa -to oro ANDERSON WILLIAM C REV TRUST SANDERSON FRANCES K REV TRUST Return/Appeal Notes: 06-000-00-029-01 078 S US HWY 601 UNIQ ID 24416 2523188 - D334 -P23 ID NO: 5754139963 COUNTY TAX (100), FIRE TAX (100) CARD NO. 1 of I eval Year: 2013 Tax Year: 2013 5.000 AC OFF HWY 601 5.000 AC SRC- Inspection raised by 02 on 04121/2008 05002 WEST JERUSALEM TW -05 C- EX- AT- LAST ACTION 20120925 CONSTRUCTION DETAIL MARKET VALUE - DEPRECIATION CORRELATION OF VALUE oundation - 3 ER BASE Standard 0.5600 ntinuous Footin 8.0 US MO Area UA RATE RCN EYB JJ AYB - REDENCE TO MARKET 03102 1,7441 93 134.41k0011119921199GOOD 1 44.0 EPR. BUILDING VALUE - CARD 26,41C ub Floor System - 4 ood 11.0c TYPE: Mobile Home (Single Wide) Manufactured Home EPR. OB/XF VALUE - CARD 4,50 Merior Walls - 10 ARKET LAND VALUE - CARD 29,74 luminum n 1 Siding 32.0 STORIES: 1 - 1.0 Story rOTAL MARKET VALUE - CARD 60,65 oofing Structure - 03 able 9.0 oofing Cover - 03 TOTAL APPRAISED VALUE - CARD 60,65 halt or Composition Shingle 5.0c OTAL APPRAISED VALUE - PARCEL 60,65 nterior Wall Construction - 5 OTAL PRESENT USE VALUE -PARCEL rywall/Sheetrock 28. nterlor Floor Cover - 08 heet Vinyl/Laminate 7.Ot TOTAL VALUE DEFERRED - PARCEL OTAL TAXABLE VALUE - PARCEL 60,65 nterior Floor Cover - 14 et 0.0 PRIOR eating Fuel - 04 UILDING VALUE 20,98 lectrtc 1.0c BXF VALUE 4,50 AND VALUE 29,74 eatIng Type - 04 orced Air - Ducted 5.0 RESENT USE VALUE 3EFERRED VALUE it Conditioning Type - 02 all Unit 3.0 +----20 ----+ I W D D I I I OTAL VALUE 55.22( rooms/Bathrooms/Half-Bathrooms 1 110 0.00C I I rooms -1FUS -0U.-0 8 8 I I PERMIT CODE I DATE I NOTE I NUMBER AMOUNT throoms AS - I FUS - 0 LL - 0 1 1 I I B A S I 1 1 I 1 2 2 4 4 OTAL POINT VALUE 1ID9.DOqI BUILDING ADJUSTMENTS OUT: WTRSHD: Ual 1 3 1 AVG 1.000 - SALES DATA hape/Desigid 3 1 FACTOR 3 1.000 FF. ECORD ATE DEED TYPE 01 INDICATE SALES PRICE Ize 3 Size 0.850 OTAL ADJUSTMENT FACTOR 0-85C OOK AGE R 565 192 8 WD E I OTAL QUALITY INDEX 9 I I 1 - I 0192 895 2 199 WD U V 3500 1 I I 1 +-----22-----}-----22 ----------- 22...... IFOP I g g HEATED AREA 1,584 I I NOTES . } .. - - - 22 ...... W IS PP SUBAREA UNIT T NIT PRIG! ORIG % GOND LDG B AYB EYB ANN DEP RATE 64 % OB/XF DEP GOND VALU GS RPL ODE ESCRIPTIO SITE 1 01 01 11 4,5-.001 01 1 L 12n Sol 1 10 450 TYPE AREA % CS 8 JMH 1,58 10 5450 OTAL OB/XF VALUE 4,50C oP v a 240 DD 36 2 309 IREPLACE 1 - None UBAREA 2,12 60,01 - OTALS UILDING DIMENSIONS BAS -W23 WDD-Nl8W20Sl8E20 W43S24E22 FOP-S8E22N8W22 E44N24 NO INFORMATION IGHESTTHERAD]USTMENTS LAND TOTAL i ND BEST USE LOCAL I FRON DEPTH / LIN. COND ND NOTES OA UNIT LAND LINT TOTAL ADJUSTED LAND LAND SE ' CODE ZONING TAGE EPT SIZE MOD FACT 5F AC LC TO OTTYPE PRICE UNITS TYP AD3ST UNIT PRICE VALUE NOTES H HOMES IT 0201 0 0 1.3000 4 0.7500 10 -15 +00 +00 +00 PD 6,100. c 5.00C AC 0.971 5,947.50 2973 OTAL MARKET LAND DATA 5.00C 29,74C OTAL PRESENT USE DATA O 0 r http://maps.co.davie.nc.us/ITSNet/AppraisalCard.aspx?parcel=060000002901 2/28/2013 Parcel #: 060000002901 Davie County, NC - Basic Estate Search Basic Search Real Estate Search Tax Bill Search Sales Search View Prooerty Record for this Parcel View Mao for this Parcel View Tax Bill Information! Parcel #: 060000002901 Account #:82523188 Owner Information Tax Codes [ANDERSON WILLIAM C REV TRUST& SANDERSON FRANCES K REV TRU ADVLTAX - COUNTY TA 8 US HIGHWAY 601 SOUTH READVLTAX - FIRE TAXCKSVILLE NC 27028 29,74 Property Information Township land (Units/Type): 5.000 AC JERUSALEM [Address: 4078 S US HWY 601 Deed Information Local tonin Date: 08/2004 Book: 00565 Page: 0192 Plat Book: Page: Le al Description PIN 5.000 AC OFF HWY 601 5754139963 Property Values Building: 26,41 BXF: 4,50 Land: 29,74 Market: 60 65 ssessed: 60 65 Deferred: Sales Information No. Book Page Month Year Instrument Qual/UnQual Improved Price L 00192 0895 02 1997 WD Unqualified Vacant 35,000 00565 0192 08 2004 WD Unqualified Improved 0 View Property Record for this Parcel View Mao for this Parcel View Tax Bill Information 1<< Return to Basic Search Page 1 of 1 06; 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.daviecountyne.gov/itsnet/View.aspx?prid=1465546 7/29/2016