1288 Hwy 64E ;;:�, -� x , ._. . . , _ , _
,, _ _ y , , -,s, , _ .. , . . . — .
F. ..
Y �� � DAVIE COUN�II"'I�ALTH DEPARTMENT �►��
.�:..�:� � I
� � � IMPROVEMENTS PERMIT AND CERTIFICATE OF COMPLETION
*NOTE: Isst�ed in Compliance with G.S. of North Carolina Chapter 130 Article 13c �
Sewage Treatment and Disposal Rules (10 NCAC 10A .1934-.1968) Pe�ttllt NUI11be1'
Name Noi�nan H. FSo�er, 3r. Date. 10-30-89 ' N0 ���J
L'ocation 64E. �-a�4- �";,�.u�... �"�,�.... �..l.��l ?a� s'��-K: r���
',
t.
— — y ,. �,•�,,� '
Subdivision Name Lot Na Sec. or Block,No.
' Lot Size Gv ="r,-��-Lr House �-�'� Mobile Home _ Business Speculation
No. Bedrooms -� No. Baths � Na in Family -3 _
�
Garbage Disposal YES p NO p�� 'Specifications for System: t o�3� �:.,� -� G.:.�.
Auto Dish Washer YES p! NO ,p ,,,, t�-� - ys,,, X ;x;�"�,,��x. �
Auto Wash Machine YES p� NO �❑ ;
Type Water Supply C.��.,;,,---_�..:,.� R` --
.�'�."`''. Zdt�,�
*This permit Void if sewage system de�� ow��C+,`n t installed within�months from date of issue.
r \
, . ' . , , �; . \ . . . . � , . . . . .
. � � . � . . .. . � . . `'� . . ..
. . . . . \ , . . . � . .
- � L�
� .
. ,
� - �..
..- �,
_-
„ r- ._ .- _
. - . . i� �� �� �.�.� 1 . . . . .. . � .
. . . . . . �../ � � � '�.. -.. _ . . � . . .
. , . . . ''.� � . � . . ' � .
E':\ S�To.:K
. ,�
� -
� . - � .
�
� . � . . . � . � - . . . . . . . . Nj , ,� . . . . . � . � - � � � . . . .
.. . � . � , . � . . r � . . . ' . � i � � � � . .
F,
. - �. . � � .. ._ � . � � . . ,1 {2 Lv_' y ��) . . , . , . � . : . . -
. . .. . � � . . � �_��--��- ,�' ' � � .. - � . � . . . . � . .. � . � .
�,-�'...�'` «r`� _
/ � � .
j ���
,�
I, /,
1 � �
�
� ,
�
------_�.�.� ' ,
� --_--- .�_...._�...._._..._......__._._..� _
�,..�,�----_.,,__.....�._..' �.� �� � --___.....�__
. Improvements permit by�-----�`„-,:. �,�
_ ,�
1
"Contact a representative of the Davie County Health Department for final inspection of this system between 8:�0-
;' 9:30 A:M. or 1:00-1:30 P.M. o�day� of completion. Telephone Number: 704-634-5985.
, _ , `°� .�..�- ;�
Final Installation Diagram: , }�y-' S—y'"�s`e` stalled by � ��"��- �-
�
r .. •
,..--.._.�:.- D , ;.;
. � ' , ,
a
, ., r� , a- [�O� .. . . :
�, . . _. .. � - ,s—
� . . .:. . ..` � ..r -� . . ._ _�.. .... � . � � F � . . , . � ' . . �� � � ..
. �,.. , . � ... .�. . � .. . � � . . .. . � ..
,f , . . _ . .. . . . � .
� .. . , . . � . . � � .. . . , � � � . .
. . . . . . . . , . � . . . �ti� , .
� . . . „ � . . � . . . . ... . '� . . . , . . . .. �. . . . .
- . � � . .: � . � .. �. . , ,"' '1 - +�., . . . . . . �. , . . . ' � , . � � . � � .
!
Certificate of Completion � ����� Date 1 � � � ' (l�
"The signing of this certificafe shall indicate that the system described above has been installed in compliance with
the standards set forth in the above regulation, but shaU in NO way be taken as a guarantee that the system will function
satisfactorily for any given period of time.
,
� APPLICATION FOR SITE EV'ALUATION/IMPROVEMENTS PERMIT
� '' Davie County Health Department
" � Environmental Health Section
� p. o. aox 665 E�E���p OCT 3 0 �
Mocksville, NC 27028. R
1 . Application/Permit Requested By ��/"/Y�c�� N �D�� r- JY _
� Mailing Address /� T � �O� ���sy�
Home Phone �-��' y -- L7 �/.j� Business Phon� � 3 y — �1_�_
2. Name on Permit if Different than Above
3. Property Owner if Different than Above
4. Application/Permit For: � General Evaluation �S/Tank Installa�.i�n
5. System to Serve: �Iouse � Mobile Home (� $usiness
(] Industry C Other � Unknown
6. If house, mobile home: Subdivision Sec. Lot�
No. of People � Dwelling Dimensions �� O 0
No. of B�drooms � �Basement/Plumbing
Na. of Bathrooms ,i`�_ � Basem�nt/No Plumbiny �
(,YWashing Machine 8/bishwasher � Garbag� D:�sp�sal '
7 . I.f business, industry, other: Specify type
No. of People Served No. of Sinks
No. of Commodes No. of Urinals
No. of Lavatories . , , Na. of Water Coalars
No. of Showers
b . Type of water supply : �Public � Private n Communi�:y
9 . Property Dimensions �j v � �C/Ll.o
10 . Sewage Dis.posal Contractor �����,p ���'�,
11 . Do you anticipate additions/ex ansions of the facility this system is
intended to serve? � Yes �o
If yes, what ty}�e?
�
_l�,i
(� *NOTEs Iaaprovement8 Permita shall be valid for a period oE 5
II Years from date issued. Improvements Permits are sub�ect ';
�! to revocation, if site plans or the intended uae chanqe.
i Effective October 1, 1989. _��
. � This is to certify that the information pravided is correct to the
best of my knowledge, and I understand I am rssponsible for all
� charges incurred from this application.
� /a 30./ � y _ �
ate � Signa ure
UirEctions to PropQrty :
�( �,�j '
DCHD (10-89)
�� ,'
'�
,� �
...� DAVIE COUNTY HEALTH DEPARTMENT
Environmental Hea�th Section. �
P. O. Box 665
Mocksville, N.C. 27028
� SOIL/SITE EVALUATION
Name Na�e•r►�., �e�►.c.. Date �'3a -�9
Address �'1' �a �'?r 9 - l.ot Size 6l' a�'�'=-
/1l0l.�.
FACTOR$ AREA 1 AREA 2 AREA 3 AREA 4
1) Topography/Landscape Position � � � �
PS PS PS PS
U U U U
2) Soil Texture (12-36 in.) Sandy, S S S S
Loamy, Clayey, (note 2:1 Clay) �,1��- � `� � �
� U U U
3) Soil Structure (12-36 in.) S S S S
Clayey Soils � � �� �
� U U U
4) Soil Depth (inches) c� � � � 1
�4��} pg PS PS PS
. � U U U
5) Soil Drainage: Internal , S S S S
...�.e�� � �� � ..
� u u u
External 67 � � ��
PS PS PS PS
. � U U U
6) Restrictive Horizons
�✓/,���„ �y/.a��'� o�/.�., �„/,g��,�
7) Avaiiable Space C� � � � .
Go au,�,� PS . PS PS PS
� U U U
8) Other (Specify) S S S S
PS PS PS PS
� U U U
9) Site Classification �S � P� PS
U—UNSUITABLE S—SUITABLE �rovisionaliy Suitable
Recommendations/Comments: _ �Y ��k-�-��(°'� � �'-`� � `F' p�� °�"'-'" ` ''`�-`- s'�`f`'`' '�"� �'`"^'
Iw. l.i:... S��r..�..�1-w.. i 3 o.p pr f`•�.
Described by�'�-9''� �S' Title ��-�� Date �� �J ��
SITE DIAGRAM �
� 3 �Z
� ._,_." _--- ---
. � �
. � � ,�,,,e..'�'t"-"'Y ,
.- �, ��
� __�� ------- �''---'
/ .
. ��
. / .
/
/
' , .
I l
I I .
_ _ _
F
UCHD(6-82)
Parcel#: J500000017 Page 1 of 1
o�`�r�
Davie County, NC - Basic Estate Search �ov���.
. Davie County Web Site
' Basic Search Real Estate Search Tax Bill Search Sales Search �
�
Vlew Prooertv Record for this Parcel View Ma�for this Parcel View Tax Bill Information
Parcel#:7500000017 Account#:8144000
Owner Information Tax Codes
GER NORMAN HAROLD]R ADVLTAX-COUNTY T
1288 US HIGHWAY 64 EAST FIREADVLTAX-FIRE TAX
MOCKSVILLE NC 27028
Pro e Intormation Townshi
Land(Units/Type): 24.200 AC MOCKSVILLE
ddress: 1288 E US HWY 64
Deed Information Local Zonin
Date: 01/1998 Book: 1988E Page: 0118
lat Book: Pa e:
Le al Descri tion PIN
27.984 AC US HWY 64 5747894269
Pro e Values
Bulldin : 314 22
BXF: 23 08
Land: 134 33
Market: 471 63
essed• 374 82
eferred• 96 81
Sales Information
No. Book Paye Month Year Instrument Qual/UnQual Improved Price
00127 0285 08 1985 WD Unqualified Vacant 0
1988E 0118 OS 1998 WL Un ualified Im roved 0
View Pro�ertv Record for this Parcel View Mao for thls Parcei View Tax Bill Informatfon
«Return to Basic Search
All information on this site is prepared for the fnventory of reai 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 notifled that the aforementioned public information sources should be
consulted for verification of the information. All information contained herefn 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, 1n fact or in law, including wfthout timitation the implied warranties of inerchantability 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/itsnetNiew.aspx?prid=1479320 6/22/2016