209 Westridge Road Lot 223 DAVIE COUNTY ENVIRONMENTAL HEALTH
P.O. Box 848/210 Hospital Street
Mocksville, NC 27028
(336)753-6780 / Fax # (336)753-1680
REPAIR OPERATION PERMIT
Account #:
990005741
Tax PINIEH #:
5881-03-4908
Billed To:
Shirley Solomon
Subdivision Info:
Westridge 2 Lot # 22
Reference Name:
REPAIR PERMIT
Location/Addre-�s:
209 Westridge Rd -27006
Proposed Facility:
Residential Repair
IProperly Size:
. 0.50 Acres
ATC Number: 5813
**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 Tank Date Tank Size
Pump Tank Size
System Installed By: 1,a &V L� E.H. Specialist: 6��U�fDate:
GPS Coordinate:
DCHD 11/06 (Revised)
W-(Ms4cS Up -es S�C/
&-Ave&-d co /L -,PLV .
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 #: 990005741
Tax PINIEH #: 5881-03-4908
Billed To: Shirley Solomon Su€adivision. Info: Westridge 2 Lot # 22
Reference blame: REPAIR PERMIT Location!Addressi 209 Westridge Rd -27006
Proposed Facility- Residential Repair PropEMj .k 0045W air ❑Expansion
fi7C: U/9
a f6WH69rThiE644horization 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 chance.
Residential Specifications: # Bedrooms # Bathrooms # People Basement❑ Basement plumbing❑
Non -Residential Specifications: Facility Type # People # Seats
Square Footage(or Dimensions of Facility)_
Lot Size ��_ Type of Water Supply: XiCounty/City ❑Well ❑Community Well
System Specifications: Design Wastewater Flow (GPD) Tank Size j1 AL. Pump Tank GAL. p�
Trench Width � Max. Trench Depth Rock Depth JA Linear Ft. /�
Site Modifications/Conditions/Other: Q- GS i14114 0-f �bySl6te
Contact the Davie County Environmental Health Section for final inspection of this system between
R _30 0-30a . the da .-efinstallation. Telephone # (336)751-8760.
(Mh1�' Gi�2
Environmental Health
DCHD 11/06 (Revised)
Date: &Z7G f
DAVIE COUNTY HEALTH DEPARTMENT
(Septic Tank) Improvements Permit and Certificate of Completion
(Ground Absorption Sewage Disposal System - G.S. Chapter 130 -Article 13C)
OWNER OR CONTRACTORf;•,,,.,;rfj_ Ct; �.; � DATE PERMIT
LOCATION
-� N° 1677
S.R. NO.
SUBDIVISION NAMEla} �,{_�a� LOT NO. ,�:L SECTION OR BLOCK NO.
HOUSE [ter MOBILE HOME ❑ BUSINESS
NO. BEDROOMS J NO. BATHROOMS
GARBAGE DISPOSAL UNIT YES ❑ NO [5'*�
AUTO. DISHWASHER YES O3 NO ❑
AUTO. WASH. MACHINE YES Com" NO ❑
SITE SUITABLE YES NO ❑
SIZE OF TANK gal.
NITRIFICATION FIELD sq. ft.
DEPTH OF STONE IN LINES:
WATER SUPPLY: Individual ❑ Public [iT
IMPROVEMENTS PERMIT BYf
CERTIFICATE OF COMPLETION ~ By O
(8/16/73) *Construction must comply with all
LOT AREA
r
House Trailer
Two Bedroom House
Three Bedroom House
Four Bedroom House
INSTALLED BY
800
Gal.
400
Sq.
Ft.
800
Gal.
600
Sq.
Ft.
900
Gal.
900
Sq.
Ft.
1000
Gal.
1200
Sq.
Ft.
Date :� 'i 7 L
applicable State and local regulations
� �-G J !/ � /
Appn.sal Card
DAVIE COUNTY. NC
Page 1 of 1
8/24/20118:46:13 AM
ININGER JOHN DAVID & WININGERSANDRAS EB -110 -CO -010-01
09 WESTRIDGE RD
UNIQ ID 7427
2521065
D75 -P9
ID NO: 5881034908
COUNTY TAX,FIRE TAX CARD NO. 1 of 1
Reval Year: 2009 Tax Year: 2011
LOT 22 WESTRIDGE SECTION 2 1.000 LT
SRC= Inspection
raised by 19 on 04/23/2008 03207 UNDERPASS
TW -07
C- EX- AT- LAST ACTION 20100922
CONSTRUCTION DETAIL
MARKET VALUE
DEPRECIATION
CORRELATION OF VALUE
Foundation - 3
Eff. BASE
Standard 10.2600
Continuous Footing
5.0 USE MO Area UA RATE RCN EYB AYBCREDENCE
TO MARKET
Sub Floor System - 4
Plywood
8.00 01 1 01 12,1621 106 73.14 16037819831978 % GOOD 1 74.0
DEPR. BUILDING VALUE - CARD
118,68
DEPR. OB/XF VALUE - CARD
5,91
Exterior Walls - 15 TYPE: Single Family Residential Single Family Residential
MARKET LAND VALUE - CARD
33,75
Board Batten 12" Boardsd
31.0 STORIES: 1.0 Story
OTAL MARKET VALUE - CARD
158,34
Roofing Structure - 04
Hip
10.0
OTAL APPRAISED VALUE - CARD
158,34
Roofing Cover - 03
Asphalt or Composition Shingle
3.00
OTAL APPRAISED VALUE - PARCEL
158,34
Interior Wall Construction - 5
Drywall/Sheetrock 20.0
Interior Floor Cover - 08
OTAL PRESENT USE VALUE - PARCEL
Sheet Vinyl
6.00
OTAL VALUE DEFERRED - PARCEL
Interior Floor Cover - 14
OTAL TAXABLE VALUE - PARCEL
158,34
Carpet
0.0 +-11--+
PRIOR
Heating Fuel - 04
I +- - -16---+
3UILDING VALUE
BXF VALUE
108,73
Electrlc 1.00 8 I PTO I
+-10-+ I I
eating Type - 10
I BAS 1 1
ND VALUE
28,00
Heat Pump
4.00 1 6 6
PRESENT USE VALUE
it Conditioning Type - 03
1 1 I
EFERRED VALUE
entral
4.00 1 1 I
OTAL VALUE
136 73
Bedrooms/Bathrooms/Half-Bathrooms
1 + - - - 16 - - - +
- - 14--+
3/2/0 12.000 1
I I
Bedrooms
4
1
0
I
PERMIT
athrooms
I
I
CODE DATE NOTE NUMBER
AMOUNT
AS -2 FUS -0 LL -0
I
3
IBAS-3FUS-0LL-O
OTAL POINT VALUE
104.00 1
I
2
I
OUT: WTRSHD:
BUILDING ADJUSTMENTS
I
I
SALES DATA
ualit 3 AVG 1.000 1 +4+ 1
ha a Desi n 4 FACTOR 4
1 1.0500 I 3 F O P
I
FF.
INDICATE
Size 3 Size
+-12--+-1
1 0.970 1--+-10-+ 7
II
ECORD DATE
DEED
SALES
OTAL ADJUSTMENT FACTOR
F G D I +4 + - - - - - 26
1.02 1 1
- - - - - - +
TYPE
/
PRICE
BOOK PAGE M R
OTAL QUALITY INDEX
106 I I
0610 352 5005
WD
Q
V
3000
1 I
0583 617 11 00
WD
X
I I
15900
2 2
7 7
I I
I I
I I
HEATED AREA 1,860
II
NOTES
+----23-----+
WNER/DOGH **
/S COLD W ELL
SUBAREA
UNIT ORIG N.
ANN DEP % OB/XF DEPR,
GS
SCRIPTION LTH THUNIT PRICE COND
BLDG#L/B AYB EYB
RATE V GOND
VALUE
5 5
158
TYPE AREA % RPL CSRN 12 1 192 15.0 _ L 198 199
BAS 1 86 10 136040FENCE 250 10.45
A4ED
L 198$128
S
FGD 621 4 2040 N PAVING 10 15 1 50 4.0
_ L 19999
S 5
300
FOP 2 3 731 2 18 432 5.1
_ L 001 001
S 6
132
PTO 25 05 951 OTAL OB/XF VALUE
5,906
FIREPLACE 3 2,25
USAREA I
I
OTALS 1,7651160,378
BUILDING DIMENSIONS BAS=W30 PTO=NI6EI6S16W16$ N20W1158W10S40 FGD=W12S27E23N27W11 E21 FOP=S4E4N7W4S3$ N3E4S7E26N32$.
LA NO INFORMATION
HIGHEST
OTHERADJIUSTMENTS
TOTAL
NO BEST USE
LOCAL
FRON
DEPTH /
LND
COND
ND NOTES
ROA
LAND UNIT LAND UNT
TOTAL
ADJUSTED LAND LAND
SE CODE
ZONING
TAGE
DEPTH
SIZE
MOD
FACT
RF AC LC TO OT
TYPE
PRICE UNITS TYP
ADJST
UNIT PRICE VALUE NOTES
FR RES 0100
0
0
1.0000
0
0.9000
37,500.0 1.000 LT
0.90
33,750.00 3375
TOPO
OTAL MARKET LAND DATA
33,75
El
OTAL PRESENT USE DATA
http://maps.co.davie.nc.us/ITSNet/AppraisalCard.aspx?parcel=E81 I 00001001 8/24/2011
DAVIE COUNTY HEALTH DEPARTMENT
(Septic Tank) Improvements Permit and Certificate of Completion
(Ground Absorption Sewage Disposal System - G.S. Chapter 130 -Article 13C)
OWNER OR CONTRACTOR :�;,,. , t,F d._ �!' t- • • �ti R DATE r? ! 7 PERMIT
LOCATION lr ? 1677
S.R. NO.
SUBDIVISION NAME its �_.:,i� T LOT NO. SECTION OR BLOCK NO.
HOUSE [;�" MOBILE HOME p BUSINESS ❑
NO. BEDROOMS J NO. BATHROOMS Z -
GARBAGE DISPOSAL UNIT YES ❑ NO 3.
AUTO. DISHWASHER YES NO ❑
AUTO. WASH. MACHINE YES Com" NO ❑
SITE SUITABLE YES NO ❑
SIZE OF TANK b gal.
NITRIFICATION FIELD sq. ft.
DEPTH OF STONE IN LINES:
WATER SUPPLY: Individual ❑ Public
IMPROVEMENTS PERMIT BY
CERTIFICATE OF COMPLETION
By
(8/16/73) *Construction must comply wi
LOT AREA
all
House Trailer
Two Bedroom House
Three Bedroom House
Four Bedroom House
INSTALLED BY
800
Gal.
400
Sq.
Ft.
800
Gal.
600
Sq.
Ft.
900
Gal.
900
Sq.
Ft.
1000
Gal.
1200
Sq.
Ft.
Date -1 ) 7
applicable State and local regulations
�fOI
j v
1 //7�- J �l
' 4
DAVIE COUNTY HEALTH DEPARTMENT
R. 0. BOX 57
I40CKSVILLE, N. C. 27028
(704) 634-5985
Statement for Septic Tank Improvement Permits
and/or Site Evaluations
NAME DATE ISSUED %�
i
ADDRESS- PERMIT NO. i
Explanation of charge
AMOUNT DUE
SANITARIAN
. �1'.ct••• c1��
PLEASE REMIT THE ABOVE AMOUNT ON RECEIPT OF THIS STATEMENT.