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159 Old Mill RdDAVIE COUNTY ENVIRONMENTAL HEALTH Reference Name: Albert Poole Proposed Facility: Repair **NOTE** The issuance of this Operation Permit shall indicate the system described on the ATC 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. System Type: S.T. Manufacturer I(� Tank Date Tank Size Pump Tank Size System Installed By: "�� E.H. Specialist: e:�2©i/ GPS Coordinate: W� r C--60 &A 2 DCHD 11/06 (Revised) P.O. Box 848/210 Hospital Street Mocksville, NC 27028 (336)753-6780 / Fax # (336)753-1680 Z R' I -LZ JrD rl (JJ� ` REPAIR OPERATION PERMIT Account #: 990005762 Tax PIN/EH #: G8050B0015 Billed To: Albert Poole Subdivision Info: Address: 159 Old Mill Road Location/Address: 159 Old Mill Road -27006 City: Advance Property Size: 0.5 Reference Name: Albert Poole Proposed Facility: Repair **NOTE** The issuance of this Operation Permit shall indicate the system described on the ATC 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. System Type: S.T. Manufacturer I(� Tank Date Tank Size Pump Tank Size System Installed By: "�� E.H. Specialist: e:�2©i/ GPS Coordinate: W� r C--60 &A 2 DCHD 11/06 (Revised) DAVIE COUNTY ENVIRONMENTAL HEALTH P.O. Box 848/210 Hospital Street (Mocksville, NC 27028 (336)753-6780 / Fax # (336)753-1680 AUTHORIZATION FOR WASTEWATER SYSTEM CONSTRUCTION Account #: 990005762 Tax P1N,EH #: G8050B0015 Billed To: Albert Po6le Subdivision Info: Reference Name: Albert Poole LocationiAddress: 159 Old Mill Road -27006 Proposed Facility: Repair Properly Size: 0.5 Site Type: ❑NewRepair ❑Expansion ATC Number: 5828 **NOTE** This Authorization to Construct (ATC) MUST BE ISSUED by the Davie County Environmental Health Section prior to issuance of any building permit(s), (in compliance with Article 11 of G.S. Chapter 130A Wastewater Systems, Section .1900 Sewage Treatment and Disposal Systems). THIS AUTHORIZATION TO CONSTRUCT IS VALID FOR A PERIOD OF FIVE YEARS. This ATC is subject to revocation if site plans, plat or the intended use change. Residential Specifications: # Bedrooms # Bathrooms I # People Z Basement❑ Basement plumbing❑ Non -Residential Specifications: Facility Type # People # Seats_ Square Footage(or Dimensions of Facility) Lot Size Type of Water Supply: ACounty/City ❑Well ❑Community Well System Specifications: Design Wastewater Flow (GPD) ,2416) Tank SizeAL. Pump Tank `V GAL. Trench Width Max. Trench Depth I Cc Rock Depthk-Y?9 Linear Ft. Site Modifications/Conditions/Other: Contact the Davie County Environmental Health Section for final inspection of this system between 8:30 — 9:30a.m. on the day of installation. Telephone # (336)751-8760. Environmental Health SpecialisbUgAditDater DCHD 11/06 (Revised) DAVIE COUNTY ENVIRONMENTAL HEALTH SECTION J�APPLICATION FOR IMPROVEMENT PERMIT (REPAIR) r4 T DO I r PHONE NUMBER q0"q73_7 ADDRESS /✓`7 V" //l/jl K -U /UW1VL-C- _SUBDIVISION NAME PaLW� AA06 ogpalS TAX A1N ,5_ RCtb-31iOT# DIRECTIONS TO SITE c /1`T �(d I DATE SYSTEM INSTALLED 3 NAME SYSTEM INSTALLED UNDER TYPE FACILITY_//NUMBER BEDROOMS NUMBER PEOPLE SERVED TYPE WATER SUPPLY SPECIFY PROBLEM OCCURRING AW(*/16 644 DATE REQUESTED INFORMATION TAKEN BY This is to certify that the information 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. troa q12,6111 _Purn; - fa-,, 7-Z�'7q b,)L H --, Do�nj DAVIE COUNTY HEALTH DEPARTMENT (Septic Tank) Improvements Permit and Certificate of Completion (Ground Absorption SewagF Di sposaf,-,7Sy stem G.S. Chapter 130 -Article 13C) OWNER OR CONTRACTOR DATE PERMIT LOCATION S. R. NO. tmmE 1510 fd(Pi I I LOT NO. SECTION OR BLOCK NO. HOUSE MOBILE HOME LJ BUSINESS NO. BEDROOMS NO. BATHROOMS., GARBAGE DISPOSAL UNIT YES El NO ED AUTO. DISHWASHER YES C3 NO AUTO. WASH. MACHINE YES rl NO Et SITE SUITABLE YES 'CEf NO SIZE OF TANK gal. NITRIFICATION FIELD 00 sq. ft. DEPTH OF STONE IN LINES: / WATER SUPPLY: Individual Public ❑ IMPROVEMENTS PERMIT BY CERTIFICATE OF COMPLETION By (8/16/73) *Construction must o pV,,dth LOT AREA House Trailer 800 Gal. 400 Sq. Ft. Two Bedroom House 800 Gal. 600 Sq. Ft. Three Bedroom House 900 Gal. 900 Sq. Ft. Four Bedroom House 1000 Gal. 1200 Sq. Ft. INSTALLED BY Date 9-23 'e)V other applicable State and local regulationn AV— Appraisal Card View All Cards Next Card Page 1 of 1 newts rnllNw ur 7/26/2013 6-00-92 PM POOLE ALBERT M Retum/Appeal Notes: GB -050-80-015 159 OLD MILL RD UNIQ ID 11838 57476000 D427 -P28 ID NO: 5880316797 COUNTY TAX (100), FIRE TAX (100) CARD NO. 1 of 2 Reval Year: 2013 Tax Year: 2013 .50 AC OLD MILL RD 0.510 AC SRC= Inspection Appraised by 19 on 11/03/2008 07003 PEOPLES CREEK RD TW -07 C- EX- AT- LAST ACTION 20110712 CONSTRUCTION DETAIL MARKET VALUE DEPRECIATION CORRELATION OF VALUE Foundation - 3 Standard 0.3900 ontlnuous Footing5.0 MO Eff. Area UA BASE RATE RCN EYB REDENCE TO MARKET AYB US ub Floor System - 4 Ilywood 8.00 Oil 01 17751121 84.70 56431974197 % GOOD 1 61.0 )EPR. BUILDING VALUE - CARD 40,04 xterior Walls - 08 TYPE: Single Family Residential Single Family Residential EPR. OB/XF VALUE - CARD 4,54 asonite on Sheathing 29.00 11ARKET LAND VALUE - CARD 16,53 Roofing Structure - 03 STORIES: 1 - 1.0 Story rOTAL MARKET VALUE - CARD 61,11 able 8.0 Roofing Cover - 03 s halt or Composition Shingle 3.00 TOTAL APPRAISED VALUE - CARD 61,11 nterior Wall Construction - 5 TOTAL APPRAISED VALUE - PARCEL 115,13 D wall/Sheetrock 20.0 nterior Floor Cover - 08 TOTAL PRESENT USE VALUE -PARCEL heet Vin I/Laminate 6.0 TOTAL VALUE DEFERRED -PARCEL nterior Floor Cover - 14 TOTAL TAXABLE VALUE -PARCEL 115,13 Carpet 0.00 Heating Fuel - 04 PRIOR Electric 1.00 UILDING VALUE 97,82 Heating Type - 04 DBXF VALUE 10,69 Forced Air - Ducted 4.0 ND VALUE 16,53 Air Conditioning Type - 03 RESENT USE VALUE Central 4.00 DEFERRED VALUE Brooms/Bathrooms/Half-Bathrooms rOTAL VALUE 125,040 1/0 7.00 drooms -2FUS-0LL-O+______________31_-_____-_-____IBAS I throoms PERMIT [AS S - 1 FUS - 0 LL - 0 I I CODE DATE NOTE NUMBER AMOUNT oe I I I I ROUT: WTRSHD: TAL POINT VALUE fg5.00 I I BUILDING ADJUSTMENTS I I SALES DATA uall 3 AVG 1.000 I I FF. RECORD DATE DEED ha a/Desi 4 FACTOR4 1.050 2 2 Size 3 Size 1.210 5 5 I I BOOK PAGE M R TYPE /I/J.SI.DICATE ALES PRICE TOTAL ADJUSTMENT FACTOR 1.27( 1 I 0008810132 1 4 1197WD X i TOTAL QUALITY INDEX 121 1 1 I I I I I I I I HEATED AREA 775 I 1 NOTES +______________ 31______________+ ENANT SUBAREA LTH TH UNIT UNIT PRICE ORIG % COND BLDG#L/B ANN DEP AYB EYB RATE OVR % COND OB/XF DEPR. VALUE GS RPL ODE)ESCRIPTION L FENCE RPORT 0 20 0 20 30 400 10.45 10.00 100 10C _ _ L L 198 1984 55 196 1994 S3 43 1720 TYPE AREA% CS 6 BAS 77 1065643 3 FIREPLACE 1- None 59 METAL BLDG ORAGE 5 1 24 1 1,20 22 15.3C 40.0 10 10 _ _ L L 198 1993 S5 198 1983 S 0 1 0 89 UBAREA 1 OTALS 77 65.64 1 3TORAGE 1 16 19 4a.00 1 OC 1984 1988 S3 25 1920 OTAL OB/XF VALUE 4,536 UILDING DIMENSIONS BAS=W31S25E31N25$. ND INFORMATION IGHEST THER ADJUSTMENTS LAND TOTAL ND BEST USE LOCAL FRON DEPTH/ LND COND ND NOTES ROA UNIT LAND LINT TOTAL ADJUSTED LAND LAND SE CODE ZONING TAGE DEPT SIZE MOD FACT RF AC LC TO OT TYPE PRICE UNITS TYP ADJST UNIT PRICE VALUE NOTES URAL AC 0120 2: 0 2.9820 4 1.1000 +10 +10 -in +00 +00 PW 9,900.00 0.50 AC 3.28 32 472.0 1652 OTAL MARKET LAND DATA 0.509 16,530 OTAL PRESENT USE DATA http://maps.co.davie.nc.us/ITSNet/AppraisalCard.aspx?parcel=G8050B0015 7/26/2013