224 Liberty Rd � /
Davie County,NC Tax Parcel Report ��'a b Tuesday, October 4, 2016
WARNING: TffiS IS NOT A SURVEY
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ParcelInformation _ ;
Parcel Number: L50000002802 Township: Jerusalem
NCPIN Number: 5746036463 Municipality:
Account Number. 82532079 Census Tract: 37059-807
Listed Owner 1: HAYES INVESTMENT PROP,LI.P Voting Precinct: COOLEEMEE
Mailing Address 1: 223 LIBERTY ROAD Planning Jurisdiction: Davie County
City: MOCKSVILLE Zoning Class: DAVIE COUNTY R-A
State: NC Zoning OveNay: DAVIE COUNTY CZOD
Zip Code: 27028-0000 Voluntary Ag.District No
Legal Descriptlon: .59 AC OFF LIBERTY RD Fire Response District: JERUSALEM
Assessed Acreage: 0.58 Elementary School Zone: COOLEEMEE
Deed Date: 4/2013 Middle School 2one: SOUTH DAVIE
Deed Book/Page: 009230541 Soil Types: CeB2
Plat Book: Flood Zone:
Plat Page: Watershed Overlay: DAVIE COUNTY
Building Value: 148370.00 Outbuilding 8�Extra 710.00
Freatures Value:
Land Value: 7460.00 Total Market Value: 156540.00
Total Assessed Value: 156540.00
9�m�A All data Is provided as Is wHhout vramMy or guaraMee of any Idnd dtlter e�cpressed or Implled includtny but not IlmRed to the
Davie County� Implled wamMies ot merchaMabllity or fkness for�particular use.M users ot Davie CouM�/s GIS website shall hold hartnless the
CouMy of Davie,No►th Carolina,lts ageMs,conaultaMs,wntradon or cmployees hom any�nd a6 daims or causes ot aW on due to
�pU N'�'� NC or arising out M the use or Inabitity to uu the GIS data provlded by thts website.
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,�j�- 4' , " DAVIE COUNTY HEALTH DEPARTMENT .
.�;U' � - - — - � IMPROVEMENTS PERMIT AND CERTIFICATE OF COMPLETION
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' "NOTE::Issued in Compliance with G.S. of North Carolina Chapter 130 Article 13c
-• - Sewage Treatment and Disposal Rules (10 NCAC 10A .1934-.isss) Permit Number
Name �r.'J�.��l ��i» .l�•�fi�r'' ��"'..����% :,�``i_,S ' �' Date N� �� ��:;
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LOC8tI0f1 C;l,%/;./! ��ua i,f"r' /r' .�i f � i✓�/ _.+.�. �`t t� l( !� �✓/ �i.> (�
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Subdivision Name � � � � Lot'No. Sec. or Block No.
Lot Size ��S�r^J� House fr'� Mobile Home _ Business ' Speculation
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No. Bedrooms � =�` No. Baths� No. in Family ��
Garbage Disposal YES p NO p- �
Specific�tions for System:
Auto Dish Washer YES NO ❑ //,'� � '�,� ,,,,,/ s' ,,.�
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Auto Wash Machine YES NO �p ����,�� �/��-�; �� �� f`��%`
Type Water Supply � _
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'This permit Void if sewage system described below is not installed withi�36 months from date of issue.
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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.
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Final Installation Diagram: ,� System Installed 6y__�l�r.f/C-�'j ��1�'�r�
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Certificate of Com letion —"= Date r-����
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"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.
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` � � + APPLICATION FOR SITE EVALUATION/IMPROVEMENTS PERMIT
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Davie County Health Department ����C�
Environmental Health Section �
P. O. Box 665
Mocksville, N.C. 27028 �
CONSTRUCTION SHALL NOT BEGIN UNTIL IMPROVEMENTS PERMIT HAS BEEN ISSUED.
��i� ��l/�' /)'/�/`� ��/�ome Phone���y�'��'� �
1. Permit Requ ted By ���/�� ri� Business Phone
2. Address 1 S� • � �-
3. Property Owner if Different than Above
Address
4. Permit To: a) Install A etl r Repair
b) Privy Conventional�her Type
Ground Absorption
' c) Sub-Division Sec. Lot No.
5. System used to serve what type facility: House�(vlobile Home Business
Industry Other
b) Number of people -� �
6. a7 If house or mobile home, state size of home and number of rooms.
House Dimensions I
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 dai�y (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�.e�.�Private Community
b) Has the water supply system been approved? Yes�
9. a) Property Dimensions ���X����
b) Land area designated to building site
c) Sewage Disposal Contractor l��J�'Dw�
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.
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Date Owner Sig.ature
OWNER IS SOLELY RESPONSIBLE FOR COMPLIANCE WITH ALL STATE AND �OCAL LAWS
Allow 5 days for processing
. Directions to property:
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'"^� pAVIE COUNTY HEALTH DEPARTMENT
� Environmental Health Section
, P. O. Box 665
• Mocksville, N.C. 27028
SOIL/SITE EVALUATION
Name � Date �/�/��
Address Lot Size� �'
FACTOR$ AREA 1 AREA 2 AREA 3 AREA 4
1) Topography/Landscape Position � S � S
U ZT U �
2) Soil Texture (12-36 in.) Sandy, �., S �
Loamy, Clayey, (note 2:1 Clay) PS � � �'�'S)'
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3) Soil Structure (12-36 in.) -
Clayey Soils � PS S
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4) Soii Depth (inches) S
P PS � �i�PS ..
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U U 't7
5) Soil Drainage: Internal S S S,.., S
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External S S
. PS _. .� PS
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6) Restrictive Horizons
7) Available Space S , � � � ,
� S
U U U
8) Other (Specify) S S S S
pg PS PS PS
U � � . �
9) Site Classification
U—UNSUITABLE 8—SUITABLE PS�,Provisionally Suitable
Recommendations/Comments: �
Described by ��•%l/� Title �>� Date �
SITE DIAGRAM
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� � � AVIE COUNTY ENVIRONMENTAL H H SECTION
- �, . Q¢ APPUCATION FOR IMPROVEMENT MIT(REPAIR)
NAME 1-�-� I�OB//✓,S ONE NUMBER ���-�f'lo��
ADDRESS a� � �I I���t �\��-- - SUBDIVISION NAME —
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/��D(�.�CS ✓J�I���/Y� �n `7ao� d LOT# . —
DIRECTIONS TO SITE (oD�� ,�'�. �I �er�"��c�• �, �a I I O(�-� r�-�p �yl.�
DATE SYSTEM INSTALLED NAME SYSTEM INSTALLED UNDER �f"
TYPE FACILITY NUMBER BEDROOMS � NUMBER PEOPLE SERVED �
TYPE WATER SUPPLY SPECIFY PROBLEM OCCURRING L�/�-� �`Dz�
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� DATE R�ESTED � - -��,_INFORMATION TAKEN B�� ��_ ,
This is to certify that the intormation provided is correct to the best of my knowledge,and that I understand I am responsible for all charges incurred from this application.
SIGNATURE OF OWNER OR AUTHORIZED AGENT
Rev.1/93 �i����"j�f�L �uC/� 1C�� � C� � � (/✓��
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