542 Will Boone RdDavie Countv. NC ry Tax Parcel Renort Tuesdav, October 11, 2016
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Parcel Information
Parcel Number: K500000066 Township:
NCPIN Number: 5747813008 Municipality:
Account Number: 36802000 Census Tract:
Listed Owner 1: HOOSE CHARLES V Voting Precinct:
Mailing Address 1: 542 WILL BOONE ROAD Planning Jurisdiction:
City: MOCKSVILLE Zoning Class:
State: NC Zoning Overlay:
Zip Code: 2702&0000 Voluntary Ag. District:
Legal Description: .776 AC WILL BOONE RD Fire Response District:
Assessed Acreage: 0.77 Elementary School Zone:
Deed Date: / Middle School Zone:
Deed Book / Page: Soit Types:
Plat Book: Flood Zone:
Plat Page: Watershed Overlay:
Building Value:
Land Value:
Total Assessed Value:
�°"�f�' Davie County,
�o— �,� NC
23310.00 Outbuilding 8� Extra
Freatures Value:
12830.00 Total Market Value:
38020.00
Jerusalem
37059-807
JERUSALEM
Davie County
DAVIE COUNTY R-A
JERUSALEM
CORNATZER
WILLIAM ELLIS
PaD,Ce62
DAVIE COUNTY
1880.00
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� � ` � ' , DAVIE COUNTY HEALTH DEPARTMENT
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�����'� , IMPROVEMENTS PERMIT AND CERTIFICATE OF COMPLETION , �
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"NOTE: Issued in Compliance witti G.S. of North Carolina Chapter 130 Article 13c �
Sewage Treatment and Disposal Rules (10 NCAC 10A .1934-.1968) Permit Number
Name f .�i1.�/.�r ��i rF' Date �/// ��'� ��°• ��r:�3
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Location /��/. � /i��� ✓l'/�r... 6�'�// �`-�Y /�����.i�' �
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' Subdivision Name �Z �� �� ���'�C6l�No. Sec. or Block No.
Lot Size If�r'1� House Mobile Home ��� Business Speculation
No. Bedrooms � No. Baths�_ No. in Family_�_
� Garbage Disposal YES •p NO pf Specifications for System:
Auto Dish Washer YES p NO ❑ �,�,� ����� ��
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Auto Wash Machine YES F NO �] J~
6] y ir
� Type Water Supply � _ �x���/��-.�
' 'This permit Void if sewage system scrib d below is not installed within 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 by �s�`�- �;//A,zD
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; 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. �
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DAVIE COUNTY HEALTH DEPARTMENT
� Environmentai Health Section
' P. O. Box 665
Mocksviile, N.C. 27028
SOIL/SITE EVALUATION
Address
1) Topography/Landscape Position
2) Soil Texture (12-36 in.) Sandy,
Loamy, Clayey, (note 2:1 Clay)
3) Soil Structure (12-36 in.)
Clayey Soils
4) Soil Depth (inches)
5) Soil Drainage: Internal
External
6) Restrictive Horizons
7) Available Space
8) Other (Specify)
9) Site Classification
U—UNSUITABLE
Recommendations/Comments:
AREA 1
S�LI
,C�'�
U
� S .
U
��
U
�
U
�i�
'U
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PS
U
S
PS
U
S—SUITABLE
Described by -���a�� Title
SITE DIAGRAM
DCHO (6-62)
Date .
Lot Si
AREA 2
PS
0
U
PS
"'Q
�U
PS
U
�
PS
U
S
PS
U
S
PS
U
S
PS
U
S
US
S
PS
U
S
PS
U
S
PS
U
PS
U
S
PS
U
,`' r 1
PS—Provisionaliy Suitable
AREA 4
S
PS
U
PS
U
S
US
S
PS
U
S
US
S
PS
U
PS
U
S
PS
U
0
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�� APPLICATION FOR SITE EVALUATION/IMPROVEMENTS PERMIT
' Davie County Health Department
Environmental Health Section ��C����D QUG
P. 0. Box 665 !� �3�,�
Mocksville, N.C. 27028
CONSTRUCTION SHALL NOT BEGIN UNTIL IMPROVEMENTS PERMIT HAS BEEN ISSUED.
1. Permit Requested By ���-� LE S U o S�
2. Address �T � � �x �� � �6�5 �� / �
3. Property Owner if Different than Above
Address
4. Permit To: a) Install� Alter Repair
b) Privy Conventional� Other Type
Ground Absorption
Home Phone �1 � � �` �� -�
Business Phone
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, � te size.�o� me 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.
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 �"' - '� u.)c��-
9. a) Property Dimensions
b) Land area designated to building site
c) Sewage Disposal Contractor �' S% --h (.(J��l �a4 ►2.1>
10. Do you anticipate any additions or expansions of the facility this sewage system is intended to serve?
What type?
This is to certify that the information is correc to the best of my knowledge.
�— l ^ � � � �
te Owner Signature
OWNER IS SOLELY RESPONSIBLE FOR COMPLIANCE WITH ALL STATE AND LOCAL LAWS
Allow 5 days for processing
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Directions to property:
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