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WARNING: THIS IS NOT A SURVEY
All dm Is provided uis wlthoutwmraa�dy or guantee of any Idnd either expressed or impged Induding but not limited to the
Implied mmamies of merchardability orflmess for a particularuse. All uses of Davie County's GIS websiteshall hold harmless the
Countyof Davie, North Carolina, hsagents, censsitants, eorNadors or employeeshum any and all dams or causes of action due to
orarising out ofthe use or inability to use the Gla data provided by this webske
Parcel Number:
L4130A0030
Township:
Jerusalem
NCPIN Number.
5736626747
Municipality:
Account Number.
82519941
Census Tract
37059-807
Listed Owner 1:
SAWS LP
Voting Precinct:
COOLEEMEE
Mailing Address 1:
PO BOX 738
Planning Jurisdiction:
Davie County
City: COOLEEMEE
Zoning Class:
DAVIE COUNTY R -A
State:
NC
Zoning Overlay:
DAVIE COUNTY CZOD
Zip Code:
27014-0000
Voluntary Ag. District:
No
Legal Description:
LOT 7 DANIEL WEST
Fire Response District:
JERUSALEM
Assessed Acreage:
0.48 Elementary School Zone:
COOLEEMEE
Deed Date:
9/2010
Middle School Zone:
SOUTH DAVIE
Deed Book / Page:
008380476
Soil Types:
WeB,CeB2
Plat Book:
0005
Flood Zone:
Plat Page:
139
Watershed Overlay:
DAVIE COUNTY
Outbuilding & Extra
Building Value:
Freatures Value:
Land Value:
Total Market Value:
Total Assessed Value:
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Davie County,
NC -
All dm Is provided uis wlthoutwmraa�dy or guantee of any Idnd either expressed or impged Induding but not limited to the
Implied mmamies of merchardability orflmess for a particularuse. All uses of Davie County's GIS websiteshall hold harmless the
Countyof Davie, North Carolina, hsagents, censsitants, eorNadors or employeeshum any and all dams or causes of action due to
orarising out ofthe use or inability to use the Gla data provided by this webske
g�.. s ¢ fir# J
- ?reY -•C .a F3
DAME COUNTY HEALTx. F
H DEPARTMENT _ =
> T C k
ice--- c
IMRROVMENTS PERMIT AND_ CERTIFICATE OF COMPE3TlaN s _
DOTE Issued in-Compliance With G:S. of North Carolina Chapter 130-Article lac
K _Sewage Treatment and Disposal Rules-(1:0 NCAC 10A .1934_.1968) 3 �Perm�t Number-
Name is 3 A,u.: M _ r
Date ± �F 3
Location > , ,: € f -A. t f r�
�
Subdivision-Name_1_01'11r,\&� Lot No. ` Sec. .or Block No.
01
Lot Size v all House Mobile Home ��
_ Business —_ ' . Speculation
'-.-:No..-Bedrooms .`- _ No. Baths s '` _ No. in Family
Garbage:Disposal YES ❑ NO [.
Specifications for System:.
Auto Dish Washer` YES E NO,p,
Auto Wash Machine YES D^ NO ❑ t f. x
Type'-Water Supply Ln- ---
'This permit Void if sewage system described below is not installed within 36 months front-date of issue.
h
Improvements ermit b �
- p p _y
x
t
*Contact a representative of the Davie County Health Department for final inspecfion of this system between '8,31
9:30 A.M. or 1:004:3.0 P.M. on day of completion. Telephone Number: 704-634-5985-
Final
04-634-5985 Final Installation Diagram; System Installed by
71
.('' ifS c)
A - fit` f/'
Certificate of Completion i t l cILL -Date _
*The signing of;fhis certificate-shall=indicate that.the system described:.above has'been ialled iri drip ri'oeA tl
the=standards set forth-in-the above re ulation,.but'shall in NO way be taken as a guaranteemt a�t essy�ste vvi 14
unction "
93
satisfactorily for any given period of time - � i ? u
5
DAVIE COUNTY HEALTH DEPARTMENT
IMPROVEMENTS PERMIT AND CERTIFICATE OF COMPLETION
NOTE: Issued in Compliance with G.S. of North Carolina Chapter 130 Article 13c
Sewage Treatment and Disposal Rules (10 NCAC 10A .1934-.1968) Permit Number
Name A�rL 17 taW d. Date 1. - - c. , 4375
Location —i A 7 1, r4
Subdivision Name T_gd�t
Lot No. Sec. or Block No.
Lot Size
House
Mobile Home --- Business -- Speculation
No. Bedrooms
No.
Baths
f%
No. in Family 2
Garbage Disposal
YES
❑ NOD,
Specifications for System: , „•• ; • • 4.
Auto Dish Washer
YES
❑ NO
p -
.,
Auto Wash Machine
YES
p- NO
•❑
° ` `
Type Water Supply
-
_-
1
*This permit Void if sewage system described below is not installed within 36 months from date of issue.
Improvements permit by
v
*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
[.c
-/L
7�, �n c.✓.
Certificate of Completion �) �1� - ,G., —Date
*The signing of this certificate shall indicate that the system described above has been installed incompliance 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.
DAVIE COUNTY HEALTH DEPARTMENT
Environmental Health Section
P. O. Box 665
Mocksville, N.C. 27028
SOIL/SITE EVALUATION
Name 4a�/C/ //UiSY i/zh. / Date
Address Lot Size 4=02(-
FAr.T(]RC AREA 1 AREA 2 AREA 3 AREA 4
Topography/ Landscape Position
3)
d)
5)
6)
S
S
S
PS
PS
PS
PS
U
U
U
!) Soil Texture (12-36 in.) Sandy,
}R'
PS
Loamy, Clayey, (note 2:1 Clay)
,
C�r�/
PS
PS
U
U
U
Soil Structure (12-36 in.)
S
S
S
Clayey Soils
PS
PS
PS
U
U
U
Soil Depth (inches)
S
S
S
S
iGGsl
PS
PS
PS
U
U
U
Soil Drainage: Internal
S
S
S
PS
PS
PS
U
U
U
U
External
S
S
S
PS
PS
PS
U
U
U
Restrictive Horizons
)Available Space
SS
PS
S
PS
S
PS
U
U
U
3) Other (Specify)
S
S
S
S
PS
PS
PS
PS
U
U
U
U
3) Site Classification
�,-,
U—UNSUITABLE
Recommendations /Comments: a
S—SUITABLE PS—Provisionally Suitable
Described by :Zze�// Title Date
SITE DIAGRAM
/ vl
DCHD (8-82)
APPLICATION FOR SITE EVALUATION/ IMPROVEMENTS PERMIT
Davie County Health Department
Environmental Health Section
R 0. Box 665
Mocksville, N.C. 27028
CONSTRUCTION SHALL NOT BEGIN UNTIL IMPROVEMENTS PERMIT HAS BEEN ISSUED,
1. Permit F
2. Address
3. Property Owner if
Address
Home Phone o 3 6
By - a - .�„-u,_ . nBusiness ^Phone
than
4. Permit To: a) Install'! Alter— Repair
b) Privy '!Conventional— Other Type—
Ground Absorption
c) Sub -Division Sec. Lot No. �y
5. System used to serve what type facility: House— Mobile Home— usiness—
Industry— Other
b)Number of people 2-
6. a) If house or mobile home, state size of home and number of rooms.
House Dimensions /5Z //
Bed Rooms cZ Bath Rooms I/ZDen w/Closet
b) If Business, Industry or Other, State: Number of persons served
What type business, etc.
Estimate amount of waste daily (24 1
7. Number and type of water -using fixtures:
commodes (
lavatory —
showers
garbage disposal
washing machine
dishwasher sinksy
8. a) Type water supply: Public LPrivate Community
b) Has the water supply system been approved? Yes -=::f No-
9.
es-=::fNo-
9. a) Property Dimensions '-�
b) Land area designated to building site
c) Sewage Disposal Contractor
10. Do you anticipate any additions or expansions of the facility this sewage system is intended to serve? A�a
What type?
This is to certify that the information is correct to the best of my knowledge.
d�� lga�o
Date Owner Signature
OWNER IS SOLELY RESPONSIBLE FOR COMPLIANCE WITH ALL STATE AND LOCAL LAWS
Allow 5 days for processing
Directions to property:
16 193E
DCHD (6-82)