3282 Hwy 64E, ; .. . .,. : . ... . ..a.,. �.. . :. . .. . . .. . �. . .. .. _µ .� .. .. .
_ , �.,,.. . ,,. .. . _ _ _ _
�:, ��� h%�q� 3Z�Z u.s H�y
�_ w', -_ DAVIE COUNTY �HEALTH DEPARTMENT �(F� .
IMPRO.VEMENTS PERMIT AND CERTIFICATE OF COMPLETION
_,�;:"'�NOTE: Issued in Compliance with G.S. of North Carolina Chapter 130 Article 13c
i ��• . Sewage Treatment d Disposal Rules (10 NCAC 10A..1934-.1968) Permit Number
, , ,,, ~
Name - _ Date �; :�''��� '� a�ti� w�t&�
�� Locationy ;;"� ^,�"f�.i_ �,/ ���,���—��i��=—��� ; ����
.
�^ _ __ P�S �wY ��� �
Subdivision Name Lot No. Sec. or Biock No.
Lot Size House�=usc�— Mobile Home _ Business Speculation .
No. Bedrooms !/�;T- No. Baths —�_ No. in Family _
j
Garbage Disposal YES p NO Specifications for System: ,
Auto Dish Washer YES ❑ NO `�Y
,!r �" ) - , / -'� '`� �.� /t.�' �
Auto Wash Machine YES NO � � - �� ``' �" � f�
❑
-� r-- � �
Type Water SuPP�Y _-- <,. �%'��1,�'C/� �'
*This permit Void if sewage system described below is not installed within 36 months from date of issue.
,,.
F ... � ....,.., _ .�........,.,� . , � �
. �.....�.�-.-� ........�.-a..�.�..-...�...�.,�. .
� �
/I
. ! y , � . . . . .
. . � . � � f ( � . . ,� .
I�
. . 1 � � . . . � ' . . . .
i
. . . � . . . . . . ,
. . � , . , ' . ' �.,,,,...-- / _ � . .
/�.. .
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: System Installed by 'U��-�4" Ch��'N�
, {'....��.
•�r�a�.,.!�-�:.-�-- �
,��°
' .�� �r� ��G�,��
.__.._.___.. �� �3^'" �
� �_�y-� .
�
�v "
�
t'�
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.
� /
• J�5
' APPLICATION FOR SITE EVALUATION/IMPROVEMENTS PERMIT Jo'�
Davie County Health Department �fJ�
- Environmental Health Section
P. O. Box 665
' Mocksville, N.C. 27028
't
CONSTRUCTION SHALL NOT BEGIN UNTIL IMPROVEMENTS PERMIT HAS BEEN ISSUED.
Home Phone ����1�.�
1. Permit Requested ByS}�����f �•���`f�.f Business Phone
2. Address � � 2 �a� �3 �' a � � �
3. Property Owner if Different than Above
Address
4. Permit To: a) Install�Alter Repair
b) Privy Conventional Other Type
Ground Absorption
c) Sub-Division Sec. Lot No. �
5. System used to serve what type facility: House Mobile Home Business���
Industry Other
b) Number of people
6. a) If house or mobile home, state size of home and number of rooms.
House Dimensions
Bed Rooms Bath Rooms Den w/Closet
b) If Business, Industry or Other, State: Number of persons served �—�
What type business, etc.es�o�
Estimate amount of waste daily (24 hours)��
7. Number and type of water-using fixtures:
commodes � urinals garbage disposal
lavatory showers washing machine
dishwasher sinks �
8. a) Type water supply: Public�_Private Community
b) Has the water supply system been approved? Yes No f
9. a) Property Dimensions
b) Land area designated to building site
c) Sewage Disposal Contractor �ot/s
10. Do you anticipate any additions or expansions of the facility this sewage system is intended to serve? �`�
What type?
This is to certiiy that the information is correct to the best of my knowledge.
,�'_ ,��T��S -" ..�� � -S'
Date Owner Signa ure
OWNER IS SOLELY RESPONSIBLE FOR MPLIANCE WITH ALL STATE AND LOCAL LAWS
� Allow 5 days for processing
Directions to property:
/-�wy � S� ��s� o� /Lloe j��<<l�� , �-��s� `io�s� o�c. /`ffl� �
(J"2 '�o r� /`/w y �0 � , r�f7 �O!►'�(�
��
OCHD(6-82)
DAVIE COUNTY HEALTH DEPARTMENT
Environmental Health Section
P. O. Box 665
Mocksville, N.C. 27028
SOIL/SITE EVALUATION
Name ��1��� Date �����3'
v
Address Lot Size
FACTOR$ AREA 1 AREA 2 AREA 3 AREA 4
1) Topography/Landscape Position , S S S
�� PS PS PS
U U U U
2) Soil Texture (12-36 in.) Sandy, S S S
Loamy, Clayey, (note 2:1 Clay) � PS PS PS
� U U U
3) Soil Structure (12-36 in.) S S S S
Clayey Soils � PS PS PS
U U U
4) Soil Depth (inches) S S S S
� PS PS PS
U U U
5) Soil Drainage: Internal S S S
� PS PS PS
U U U
External S S S S
PS PS PS PS
� U U U
6) Restrictive Horizons
7) Available Space S S� S S
PS' PS PS PS
� U U U
8) Other (Specify) S S S S
pg PS PS PS
� U U U
9) Site Classification �
U—UNSUITABLE S—SUITABLE PS—Provisionaliy Suitable
Recommendations/Comments:
Described by Title Date
SITE DIAGRAM ��
��-
. Fo-..�' Z'
� �
DCHD(6-82)
Parcel#: J700000104 Page 1 of 1
v�'���
Davie County, NC - Basic Estate Search � � �:
. o U��S
- Davie County Web Site
Basic Search Real Estate Search Tax Bill Search Sales Search �
View Pro�ertv Record for this Parcel View Ma�for this Parcel View Tax Bill Information
Parcel#:J700000104 Account#:69482000
Owner Ioformation Tax Codes
PARKS)AMES L&SPARKS TAMARA W ADVLTAX-COUNTY T
282 HIGHWAY 64 EAST READVLTAX-FIRE TAX
DVANCE NC 27006
Pro e Information Townshi
nd(Units/Type): 1.390 AC FULTON
ddress: 3282 E US HWY 64
Deed I�formation Local 2onin
ate: 01/1900 Book: 00119 Page: 0815
lat Book: Pa e:
Le al Descri tion PIN
1.48 AC HWY 64 5777267971_
Pro e Values
uiidin : 77 04
BXF•
La�d: 23 91
Market: 100 95
ssessed: 100 95
Deferred•
Sales Information
No. Book Page Month Year Instrument Qual/UnQual Improved Price
_00119 A815 OL _. 1900 WD Un uai(fied Vacant 0
View Prouertv Record for this Parcel View Ma�for this Parcel View Tax Bill Information
«Return to Basic Search
All informatfon 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 af 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 lnternal use. Davie County,
its employees and agents make no warran .ty 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 inerchantability and fitness for a particu�ar use.
If.you have any questions about the data displayed on this website.please contact the Davie County Tax OfFice at j336) 753-6120.
1.5.9
http://maps.daviecountyna�ov/itsnet/View.aspx?nrid=1468605 6/21/2016