3722 Hwy 801 S Davie County, NC Tax Parcel Report Thursday, October 13, 201 t
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_ - WARNING: THIS IS NOT A SURVEY
Parcel Number: J800000019 Township: Fulton
NCPIN Number: __ 5778819064 Municipality:
Account Number: 44276000 Census Tract: 37059-804
Listed Owner 1: - LANIER JOE D Voting Precinct: FULTON
Mailing Address 1: 3722 NC HIGHWAY 801 SOUTH Planning Jurisdiction: Davie County
City: ADVANCE - Zoning Class: DAVIE COUNTY R-A
State: NC Zoning Overlay:
Zip Code: 27006-0000 Voluntary Ag.District: No
Legal Description: 5AC HWY 801 Fire Response District: FORK
Assessed Acreage: 4.96 Elementary School Zone: CORNATZER
Deed Date: 1/2013 Middle School Zone: WILLIAM ELLIS
Deed Book/Page: 2013E0008 Soil Types: PcB2,PcC2
Plat Book: Flood Zone:
Plat Page: Watershed Overlay: DAVIE COUNTY
Building Value: 223150.00 Outbuilding&Extra 15660.00
Freatures Value:
Land Value: 53630.00 Total Market Value: 292440.00
Total Assessed Value: 292440.00
9 C w1� Alldata is provided as Is without warranty or guarantee of any kind either expressed or implied Including but not limited to the
Davie County, Implied warranties of merchantability or fitness for a particular use.All users of Davie County's GIS website shall hold harmless the
County of Davie,North Carolina,Its agents,consultants,contractors or employees from any and all claims or causes of action due to
�oUry C� NC or arising out of the use or Inability to use the GIS data provided by this website.
APPLICATION FOR SITE EVALUATION/IMPROVEMENT PERMIT&ATC
-.-- ,._:_:_—__-.Davie County Environmental Health _.. . ---------.---------.---
P.O.Box 848/210 Hospital Street:
�p
j w j� Mocksville,NC 27028
(336)753-6780/Fax(336)753-1680
i�b ` on For: Site valuation/Improvement Permit ❑Authorization To Construct(ATC) ❑Both
?41Type of Application: New System ❑Repair to Existing System ❑Expansion/Modification of Existing System or Facility
***IMPORTANT***THIS APPLICATION CANNOT BE PROCESSED UNLESS ALL OF THE REQUIRED
INFORMATION IS PROVIDED. Refer to the INFORMATION BULLETIN for instructions.
APPLICANT INFORMATION
Name to be Billed a¢ 1Z, Contact Person -Jibe 414j.P N
Billing Address S Home Phone 33!�. qo 9-;1G 6 A
City/State/ZIP_� U e(ZC a /�/.C. ff'M Z, Business Phone
Name on Permit/ATC if Different than Above
Mailing Address City/State/Zip
PROPERTY INFORMATION *Date House/Facili Comers Flagged
NOTE: A survey plat or site plan must accompany this application. Included Site Plan ❑Plat(to scale)
(Permit is valid for 60 months with site plan,no expiration with complete plat.)
Owner's Name 1 XP -11aw a A,2 il le M- Phone Number
Owner's Address 'C e1 City/State/Zip G,aVa a ce �LDD G
Property Address 22.2_? JV Z 01' S' City��4�r CC.^'
Lot Size Tax # (�
Subdivision Name(if applicable) Section/Lot# t
Directions To Site: .2A,)-e
If the answer to any of the following questions is`yes",supporting documentation must be attached.
Are there any existing wastewater systems on the site? rfll�es❑No
• Does the site contain jurisdictional wetlands? ❑YesoNo
Are there any easements or right-of-ways on the site? j,2'1'es❑No
Is the site subject to approval by another public agency? ❑Yesopo
Will wastewater other than domestic sewage be generated? OYesk2110
IF RESIDENCE FILL OUT THE BOX BELOW
#People J9r #Bedrooms L #Bathrooms arden Tub/Whirlpool❑Yes
Basement:❑Yes Basement Plumbing: ❑Yes o
IF NON-RESIDENCE FILL OUT THE BOX BELOW
Type of Facility tSxsiaess-S72,orq 5'VArn4 nZotal Square Footage of Building 6 8 G #People :I
#Sinks-•;— #Commodes J #Showers_ 6 #Urinals 0
Estimated Water Usage(gallons per day) g (Attach documentation of similar facility water consumption)
FOODSERVICE ONLY: #Seats
Type system requested: ❑Conventional ❑Accepted wf-ovative ❑Alternative []Other
Water Supply Type:❑County/City Water ❑New Well pgl�xisting Well ❑Community Well
Do you anticipate additions or expansions of the facility this system is intended to serve?❑Yes wergo .
If yes,what type?
This is to certify that the information provided on this application is true and correct to the best of my knowledge. I understand
that any permit(s)or ATC(s)issued hereafter are subject to suspension or revocation if the site is altered,the intended use
changes,or if the information submitted in this application is falsified or changed I hereby grant right of entryto the AuthoSized
Representative of the Davie County Health Department to conduct necessary inspections to determine compliance with applicable
laws d rules. I understand tat I am responsible for the proper identification and labeling of property lines and comers and
g the house/facility location,proposed well location and the location of any other amenities.
locating nd fl"or stay,
Pr owner's or owner's legal representative signature Site Revisit Charge
Date(s):
Client Notification Date:
Date EHS:
Sign given ❑Yes❑No Account#
Revised 11/06 Invoice#
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Davie COUNTY
210 Hospital Street
P.O. Box 848
Mocksville NC 27028 TEL: 336-753-6780 FAX: 336-753-1680 Request ID: 51389
REQUEST FOR SERVICE/COMPLAINT INVESTIGATION REPORT
REQUEST DATE: 09/12/2014 TAKEN BY:
SECTION: N/A TYPE:
PROPERTY NUMBER: 122197 ASSIGNED TO: Nations, Robert
ESTABLISHMENT NUMBER:
PERSON OR PREMISES TO SEE: OWNER: Joe D. Lanier
Joe D. Lanier 3722 NC Hwy 801 S
3722 NC Hwy 801 S. Advance , 27006
Advance NC, 27006
REQUESTED BY: Neighbors HOME:
WORK:
Cell:
CONDITION REPORTED:Need to make sure installed correctly that it doesn't contaminate ajoining
properties. Behind existing builder, Upper building with attached shed
COMMENTS:
RECORD OF INVESTIGATION
DATE: HR/MT: COMMENTS
EHS:
EHS #:
ACT CODE:
DATE: HR/MT: COMMENTS
EHS:
EHS #:
ACT CODE:
DATE: HR/MT: COMMENTS
EHS:
EHS #:
ACT CODE:
DATE: HR/MT: COMMENTS
EHS:
EHS #:
ACT CODE:
DATE: HR/MT: COMMENTS
EHS:
EHS #:
ACT CODE:
Next Inspection Date: Status of Complaint: OPEN Resolved Date:
Complaintant Contacted:
ji a
DAVIE COUNTY HEALTH DEPARTMENT
Environmental Health Section
Soil/Site Evaluation
APPLICANT NT FO A N R INFORMATION
I � �
► } Joe Dean Lanier fi Tax PIN• 5778-8179064 ,.
3722 NC Hwy 801 S
4336;909-265,0 `4.96 Acres
I
Water Supply: On- ite Well Community Public
j Evaluation By: Aug r Boring Pit qut
FACTORS 1 2 3 1 5 6 7 I
i
Landscape position ( I 1
Slope% ( I
HORIZON I DEPTH ' I
Texture groupI
Consistence
Structure J
i
Mineralogy !
HORIZON H DEPTH I
Texture group
Consistence
Structure r i
Mineralogy ! }
HORIZON III DEPTH
Texture groupi I I
Consistence ( }
Structure
Mineralogy { i
HORIZON IV DEPTH
Texture groupI I !
Consistence ► I I
Structure
Mineralogyf i
SOIL WETNESS l
RESTRICTIVE HORIZON
SAPROLITE I I E
CLASSIFICATION }
LONG-TERM ACCEPTANCE RATE ! I I
SITE CLASSIFICATION: EVALUATI N BY:
LONG-TERM ACCEPTANCE RATE: OTHER(S)PRESENT:
REMARKS:
LEGEND '
Landscape Position
i
R-Ridge S-Shoulder L-Linear slope FS-Foot slope N-Nose slope'
CC-Concave slope CV- onvex slope' T-Terrace FP-Flood plain H Head slo
Texture i
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 }
1 CONSISTENCE
Moist `
VFR-Very friable FR-Fable FI-Firm VFI Very firm EFI-Extremely firm 4
NS-Non sticky SS-Slightly sticky S-Sticky VS -Very Sticky j
I NP-Non plastic SP-Slightly plastic P-Plastic VP-Very plastic
1
Structure ;
SC-Single grain M-Masisive CR-Crumb GR-Granular ABK-Angular blocky
SBK -Subangular blocky L-Platy PR-Prismatic
i a
f �
Mineralogy
1:1,2:1,Mixed
Notes 1
Horizon depth-In inches j 4
Depth of fill -In inches
Restrictive horizon-Thickness and inches from land surface E
Saprolite-S(suitable),U(unsuitable) i
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)
DAVIE COUNTY HE RTMENT 372Z�(/j/y �(I` �•
f _ (Septic Tank) ImproveK
` ermit and Certific of Com' pletion
(Gro Sewage pisal System - G.S `Cha ter 130-Ar icl'e"ITG)OWNER OR CONTRACTORs �. gkj,*C(- DATE ;'" ' PERMIT
b.� ...... [��T
+- . 226
LOCATION
�. S.R. NO.
SUBDIVISION;NAME LOT.NOG, SECTION OR BLOCK NO.
HOUSE MOBILE HOME tj BUSINESS ❑
House Trailer 800 Gal. 400 Sq. Ft.:'
NO. BER OMS NO. BATHROOMS Two Bedroom House 800 Gal. 600 Sq. Ft.
GARBAGE DISPOSAL UNIT YES .b , NO ❑ Three Bedroom House 900 Gal. 900 Sq. Ft.
AUTO. DISHWASHER YES " NO ❑ Four Bedroom House 1000 Gall 1200 Sq. Ft
AUTO. WASH. MACHINE YES NO ❑ C`t+� �vi �uf .11t'Gst� /S + ,�,
SITE 'SUITABLE YES NO ❑
SIZE `OF. TANK TC, gra 1.
NITRIFICATION FIELD sq. ft.
DEPTH OF STONE IN LINES:
WATER.SUPPLY: Individual Public ❑*' / P
IMPROVEMENTS.PERMIT: BY 1 ,� '�" .; INSTALLED BY l ��
CERTIFICATE OF COMPLETION By Date G-�-
.(8/16/73) *Construction must Com y with all other applicable State and local regulations
LOT AREA 4Yrs 1 41busc' f{ CY4`A
w �• s
Appraisal Card Page 1 of 1
DAME COUNTY NC 6/27/2013 2:18:12 PM
NIER 30E D LANIER MARGARET Retum/Appeal Notes: 38-000-00-019
722 S NC HWY 801 UNIQ ID 19905
276000 D355-P16 ID NO:5778819064
COUNTY TAX(100),FIRE TAX(100) CARD NO.I of 1
eval Year:2013 Tax Year:2013 SAC HWY 801 4.980 AC SRC-Inspection
kipprafsed by 07 on 07/05/2007 04001 FULTON TW-04 C- EX-AT- LAST ACTION 20110725
CONSTRUCTION DETAIL MARKET VALUE DEPRECIATION CORRELATION OF VALUE
• Z
oundatlon-3 Eff. BASE Standard 0.2900 m
ontinuous Footing5.0
ub Floor System-4 US MO Area UA RATE RCN IEYBIAYB CREDENCE TO MARKET
I ood 8.0 01 01 3647 121 84.70 314301198 197 %GOOD 1 71.0 DEPR.BUILDING VALUE-CARD 223,1S �m
• xterior Walls-21 TYPE:Single Family Residential Single Family Residential DEPIL OB/XF VALUE-CARD 12,06
ace Brick 34.00 MARKET LAND VALUE-CARD 53,63
00fing Structure-03 STORIES:2-1.5 Stories TOTAL MARKET VALUE-CARD 288,84
able 8.0
oofing Cover-03
kSphalt or Composition Shingle 3.00 TOTAL APPRAISED VALUE-CARD 288,84
nterlor Wall Construction-5 TOTAL APPRAISED VALUE-PARCEL 288,84
)rywall/Sheetrock 20.0
nterior Floor Cover-08
heet Vinyl/Laminate 6.00 TOTAL PRESENT USE VALUE-PARCEL
nterlor Floor Cover-14OTAL VALUE DEFERRED-PARCEL
:arpet 0.0
OTAL TAXABLE VALUE-PARCEL 288,84
eating Fuel-04 PRIOR
Electric 1.0 UILDING VALUE 251,29
eating Type-10 BXF VALUE 14,22
eat Pum 4.0 AND VALUE 52,89
Ir Conditioning Type-03 RESENT USE VALUE
entral 4.0 DEFERRED VALUE
rooms/Bathrooms/Half-Bathrooms TOTAL VALUE 318,40(
//0 16.00
rooms 7
AS-4 FUS-0LL-0
throoms
AS-3 FUS-0 LL-0 PERMIT
fflce CODE DATE NOTE NUMBER AMOUNT
+--30---+ o
OTAL POINT VALUE 109.00 I F U S I p
BUILDING ADJUSTMENTS 2 2 OUT:WTRSHD: o
0 0 SALES DATA
ize 3 Size 0.880 +--30---+ o
uall 4 ABAVG 1.200 FF. INDICATE
RECORD DATE DEED SALES
ha a Desi 4 FACTOR 4 1.050 7 F O P 7 OOK PAGE M R TYPE / / PRICE
OTAL ADJUSTMENT FACTOR 1.11 +-22-+--30---+-21-+ +---37---+---36---+ 0091 909 11197 WD X I
OT
QUALITY INDEX 123 I B A S I I F B M I S U G I
3 3 3 3 3
0 0 0 0 0
I I I I I
+-22-+--30---+-21-+ +---37---+---36---+ HEATED AREA 3,900
7FOP7
+--30---+ NOTES
TS 1+2
SUBAREA UNIT ORI
G% ANN DEP % OB/XF DEP
TYPE GS AREA % RPL CS ODE DESCRIPTIO LTH H NIT PRICE GOND LDGP!1. B AYB EYB RATE V GOND VALUE
5
2,19 t.4423.,
24 HED 2 3 60 5.1 30 _ L 198 198 S
UG 1 08 2 ARAGE 3 2 72 25.0 L 00 00 S 6 1206
BM 1,11( OTAL OB XF VALUE 12 06OP 42 5 60
REPLACE 5-Two or 5,40
more
UBAREA
OTALS 5,40 14,30
UILDING DIMENSIONS BAS=W2IFOP-W30N7E30S7$W52 S30E22FOP=S7E30N7W30$E5lN30$PTR-N20 FUS-N20W3OS2OE30$S20EIS FBM=E37BUG=E36S30W36N30
530W37N30 W15 .
ND INFORMATION
IGHEST THERADJUSTMENTS LAND TOTAL
NO BEST USE LOCAL FROM DEPTH/ LND GOND NO
NOTES OA UNIT LAND UNT TOTAL ADJUSTED LAND LAND
SE CODE ZONING TAGE EPT SIZE MOD FAR RF AC LC TO OT TYPE PRICE UNITS TYP ADJST UNIT PRICE VALUE NOTES
URAL AC 0120 233 1 0 1.3010 4 11.1500 FOI+16+00+00+00 PW 7 200.0 4.979 AC 1 1.494 11 5363
OTAL MARKET LAND DATA 4.979 5363
OTAL PRESENT USE DATA
http://maps.co.davie.nc.us/ITSNet/AppraisalCard.aspx?parcel=J800000019 6/27/2013
Davie COUNTY
210 Hospital Street
P.O. Bdx 848
Mocksville NC 27028 TEL: 336-753-6780 FA%: 336-753-1680 Request ID: 50802
REQUEST FOR SERVICE/COMPLAINT INVESTIGATION REPORT
REQUEST DATE: 08/21/2014 TARN BY: Bonnie
SECTION: N/A TYPE:
PROPERTY NUMBER: 122197 ASSIGNED TO: Nations, Robert
ESTABLISHMENT NUMBER:
PERSON OR PREMISES TO SEE: OWNER: Joe D. Lanier
Joe D. Lanier 3722 NC Hwy 801 S
3722 NC Hwy 801 S. Advance , 27006
Advance NC, 27006
REQUESTED BY: Caller HOME:
WORK:
Cell:
CONDITION REPORTED:Call in ? if a permit for septic had been pulled
COMMENTS:
RECORD OF INVESTIGATION
DATE: HR/MT: COMMENTS
EHS:
EHS #:
ACT CODE:
DATE: HR/MT: COMMENTS
EHS:
EHS #:
ACT CODE:
DATE: HR/MT: COMMENTS
EHS:
EHS #:
ACT CODE:
DATE: HR/MT: COMMENTS
EHS:
EHS #:
ACT CODE:
DATE: HR/MT: COMMENTS
EHS:
EHS #:
ACT CODE:
Next Inspection Date: Status of Complaint: OPEN Resolved Date:
Complaintant Contacted: NO
40aP beryl& a I A[)
• - Davie County Health Department
"his l� Environmental Health Section • ;,
P.O. Box 8481
L , ,5 210 Hospital Street
O ZT I`1'S Courier# : 09-40-06 •
Mocksville, NC 27028
Phone:(336)-753-6780 Fax:(336)-751-8786
ON-SITE WASTEWATER CERTIFICATION FOI��
(Check One) Replacement . Remodeling jN
ction
i Name:.- }- Phone umber —9AT—A� e)
Mailing Address:4S k)
d1Z6rr10:& •`. Email --�
Detailed Directions To Site: M!r l (f�' q 10/7
ON
Property Address: �t/1/!-P
J�_000- )0 -vl9
Please Fill In The Following Information.About The EXISTING Facility:
Name System Installed Under: ��. r1 /•e�. Type Of Facility: j�
Date System Installed(Month/Date/Year): /9 V Number Of Bedrooms: Number Of People:��
Is The Facility Currently Vacant? Yes No If Yes,For How Long?
Any.Known Problems? Yes No. If Yes,Explain:
Please Fill In The Following Information About The NEW Facility:
Type Of Facil' a Csi Number Of Bedrooms: Number of People
Requested By: Date Requested:
'gnature)
For Environmental Health Office Use Only
nents.:
�D-issapproved/ / -/ .
r Pa 'IZG(/` A6Wj t/Le 4-6 ft A74 Py
Environmental Health Specialist Date: '71 tol(3
*The signing of this form by the Environmental Health aff is in no way intended,nor should be taken as a guarantee
(extended or limited)that the on-site wastewater system will function properly for any given period of time.
Payme Cash Check Money Order # Amount.V/00-00 41
n Date:
Paid By: ��'J�( _ Received By:
Account#:- [ Invoice#:
o —A I22 �R�
Davie County,NC - GoMaps Advanced Page 1 of 1
Davie toun�,
40 n
Latitude;361 V 14,39' Longitude;-8013716,52'
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—`]1}k[,` All data is provided as is without warranty or guarantee of any kind either expressed or Implied Including but not limited to the Implied
,w +'Y. warranties of merchantability or fitness for a particular use.All users of Davie County's GIS webslte shell hold harmless Ne County of GU HS
/j/` Dane,North Carolina,Xeagens,consultants,contractors or employees from any and all claims or causes of action duo to or arising out of printed:Jun 27, 2 13
r the use or Inability to use the GIS data provided by this websge.
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