The URL can be used to link to this page

112 Wills Road Lot 22Appraisal Card Page 1 of 1 ------------ OLDING VIOLETS - RewrtVAppeal Notes: Pend: 0-000-00.143 12W619RD PIAT:00a5/0023 UNIQM2016 05262 - - D12tr M NO: 5862871173 - COIINTYTAX (100), FRE TAX (100) 1LC10( CMD NO. 1 o/ 1 - IYdr:2013Tax Year.2017 - LOT U CREEONOOD ESTATES SECTION 3 1.000 LT SRC=OispeCbn ralxtl by 19 an 05 01/2008 03301 Ot®CWOOD ESTATES TW -03 Q- M-15 EX- AT- IAS) ACTION 2015087 CONSTRUCTION Dur MARKET VALUE DEPRECIATION CORRELATION OF VAWE pp6p0Op _ 3FOBS FunDanal 0.000 moue TooU 5. LU. BASE —RCN [eaksxnre SmnEand 0.2400 O TToor System -4 8.0 s Ana UA EYB An ZREDENCZEM "WET eHOr Walk -09 01 011815125 %%XX 198419 %(DODlOOX GEM BUILDING VALUE -WTD ootl on MaadhMeT27.00TYPE: Sin9k Family ResMentlal Sin9k Family R®EenNal EPR-OBM VI E -GRD Wags -12 LAND VALUE -GRD an onC .te Blak 0. STYLE: B - Split Faye - AL MARKET VALUE -CARD ngS Ure-03 - Me 8.0 AL APPRALSED VALUE -GRD ngC T-03 - ALAPPIGTSEDVALUE-PARCEL gaCam mDn SR' k 3 -OK lerior Wall CansRuctlon 5 AL PRESEM USE VALUE- PARCEL elUsheetmrk 20.0 - -AL VALUE DEFERRED- PARCEL n[ubrFkar Cover -08 1LLTAYABIE VALDE-PARCEL Ree[Vin /laminate 6.0 - PRIOR ent Fba Cover -14 }. ___13_____+____23 _.__+ SOO. an0.0 URDRGVA11E IFBN IBFG I eating Fuel -04 I I I WVALUE kabla 1.0 1 I I MDVALUE 30,00 eatlngType-10 - I I I USE VALUE [ Pump 9.0 2 2 2 VALUE 6 6 6 AL VALUE - 130,68 Ir Con0iti0niig Typo -03 ntml CO I I I toomyeaNmonWHaN-BaNmoms - I 0 10.0 #____13 ---------- 23____} PERMIT a. OODE DATE NOTE NUMBER AMOUNT +--14--+ - -2 FUS - DLL - O IWDD I aftlerae. 1 ,1 IOM W HD: -2 MS-DLL- O - 4 4 - SAlF9 DATA N-BaMtoonts I I - FF. IMIDIM111 -OM15-011-0 MCOM ATE DEED SLUES IBAS #------32-------4 AGE TYPE PRICE M -O FUS -DLL -O i I 0995 009 7 01 WD Q 1 14500 AL POINTVALUE 6.00 I I 958 0631 5 01 WD I I BURDING ADT4TMENTS I 1 951 2 01 WD I I el 4 A&EVG .200 3 2 38 9 0 TO P I 10150 0 6 0390 139 11 001 WD 1 10300 Des10 4 FACTORS M .05 I I 3 11 Six .030 [ I A =UD MENTFACIOR 130 1 I TALQUALTNINDEX 12 1 I +--14--+-)-+-11-+6-+-•-4 HEATED AREA 1,862 4FOP 6 NOTES SyEAREA UNE) PRICE ORl6% GOND IDGi AYB lER ANN DEP RATE 6111 % COND OB/XF DEP VALU . RPL E ESCRIPTI 1N 1 ]0 11979119791 S51 1 01 TYPE 65 AREA % CS 10 ON PAVING 0 12 1 ALOB/1(FVAWE G 59 03 M S 04 P 03 DD 19 02 4- 2 Stay Si.glUl Stary REPLACE OouNa BALS 2,7 ALS I DING DIMENSIONS BAS=MM2WDO-N14W14514E146W14510WP+5 IN6 W)rv2W14$E14N1E11ME6N2EBN26$ PTR=N20 M-N126W23 FBM=W23526MN26$S26E23 820$. OINWR 71011 iGHEST - - ERAD IE LAND TOTAL D 867 115E LOLL IRON DEP1N/ WD COMD DMOTFS UNIT LAND UNT TOTAL ADlU51ED LAND OVERRIDE LAND E ODD! ZONING )AGE E SIZE MOD FACT RF AC LC TO Oi TYPE PRICE UNRS TYP ADJSI UMITPNCE VALUE VALUE NOl£S M 0100 210 0 1.0000 0 1.0000 PW 1.00 LT 1.00 AL MARKET LAND DATA AL PRESENT USE DATA Owm ... 11 . I ---IT .r. srs. 1 ___.._ n._____1J\nnnnnnl A9 I• I1Q/1y1IG Applicant: Violet S. Golding Address: 1046 Riverbend Drive CRY: Advance StatefLip: NC 27006 Phone #: e"Property Owner: Violet S. Golding Address: 1046 Riverbend Drive CRY: Advance State/Zip: NC 27006 Phi - Property " - OPERATION PERMIT Davie County Health Department 112 Wills Road 210 Hospital Street Advance NC 27006 P.O. Box 848 structure: SINGLE FAMILY_ Mocksville NC 27028 Phone: 336-753-6780 Fax: 336.753-1680 Applicant: Violet S. Golding Address: 1046 Riverbend Drive CRY: Advance StatefLip: NC 27006 Phone #: e"Property Owner: Violet S. Golding Address: 1046 Riverbend Drive CRY: Advance State/Zip: NC 27006 Phi - Property Location & Site Information Address/Road #: Subdivision: Creekwood Phase: 3 Lot: 22 112 Wills Road Advance NC 27006 Directions structure: SINGLE FAMILY_ 140 to Hwy 801 turn right going north. Wills Rd on right. - # of Bedrooms: _ # of People: aterSupply: N/A -*System *IP Issued by Classification/Description: - ' — — TYPE II A. CONY SYSTEM (SINGLE-FAMILY OR 480 GPD OR LESS) *CA issued by: 2140 -Nations, Robert SaproliteSystem? OYes iSNo - Design Flow: 3 6 0 *Distribution Type: GRAVITY -SERIAL Pump Required? OYes 00No Soil Application Rate: 0 3 *Pre Treatment: Drain field NQrificationHeld 1 2 0 0 Sq•ft• *System Type: INFILTRATOR QUICK 4 STANDARD No. Drain Lines a Installer: RandyM filer Total Trench Length: 2 5 0 ft. Certification #: Trench Spacing: — 9 Inches O.C. • Feet O.C. 'EHS: 2140 -Nations. Robert Trench Width: — 3 Inches gFeet 0 3/ 2 9/ 2 0 1 6 Date: Aggregate Depth: inches Minimum Trench Depth: 3 6 Inches Minimum Soil Cover a 4 Approval Status Inches Maximum Trench Depth :3 6 ® App[ovetl�'Disapprovetl Inches Maximum Soil Cover, 2 4 Inches CDP File Number 137469-2 Manufacturer. STB: Dosing Volume: Pump Tank Gallons: Manufacturer. Valves Accessible ❑ Yes Date: ❑ Yes PT: ❑ Yes PVC Unions 'Filter Brand: Certification #: ❑ Yes Gallons: ❑ Yes ST Marker. ❑ Yes ❑ No bforced Tank: ❑ Yes ❑ No 1 Piece Tank: ❑ Yes ❑ No County ID Number: ^C7-000-00.143 , otic Tank LaL Long: Installer. Certification #: 'EHS: Date: Pipe Size: inch diameter Pipe Length: feet *Schedule: Pressure Rated ❑ Yes ❑ No approved fittings ❑ Yes ❑ No Pump Type: Dosing Volume: Pump Tank Manufacturer. Valves Accessible ❑ Yes Installer. ❑ Yes PT: ❑ Yes PVC Unions ❑ Yes Certification #: ❑ Yes Gallons: ❑ Yes 'EHS: Date: / / Date: RiserSealed ❑ Yes ❑ No Riser Height: ❑ Yes _ ❑ No (Min.6 in.) Approval Status-': nforcedTank: El Yes ❑ No ❑ Approved❑o isapRroved ._ 1 Piece Tank: ❑ Yes _ __._ ❑ No Pipe Size: inch diameter Pipe Length: feet *Schedule: Pressure Rated ❑ Yes ❑ No approved fittings ❑ Yes ❑ No Pump Type: Dosing Volume: Draw Down: 'Chain: Valves Accessible ❑ Yes w Adjustment Valve ❑ Yes Check -valve ❑ Yes PVC Unions ❑ Yes Vent Hole ❑ Yes Anti -siphon Hole ❑ Yes Inches ❑ No ❑ No ❑ No ❑ No ❑ No ❑ No Installer. Gal Certification #: 'EHS: Date: / / Approval Status -. ,i`s ❑ Approved D Disapproved CDP File Number 137469=2 NEMA4X Box or Equivalent ❑ Yes Box 12 inches Above Grade ❑ Yes Box Adj. To Pump Tank ❑ Yes Conduit Sealed ❑ Yes Pump Manually Operable ❑ Yes 'Activation Method: Alarm Audible ❑ Yes Alarm Visible ❑ Yes 'Operation Permit completed Authorized State County ID Number: C7-000-00-143 y�•nunu[- ❑ No Installer. ❑ No Certification#: ❑ No ❑ No 'EHS: ❑ No Date: _ Approval Status [I No ❑'Approved ❑ Disapproved° ❑ No 2140 - Nations, Robert Date of Issue: 0 3/.1 9/ 2 0 1 6 Owner/Applicant Signature: - -. This system has been installed in compliance with applicable NC General Statutes: Article 11, Chapter 130A, Rules for, _ _.„_ Sewage -Treatment and Disposal, 15A NCAC 18A.1900 at. Seq., and all conditions of the Improvement Permit and Construction Authorization. This property is served by a TYPE II A sewage septic system. Rule .1961 requires that a Type TYPE u A septic system meet the following criteria: Minimum System Review ByThe Local Health Department: NIA Management Entity: OWNER --Minimum System Inspection/Maintenance Frequency By Certified Operator: NIA Reporting Frequency By Certified Operator. NJA Rule .1961 requires that a Type IV and V septic systems designed fora homelbusiness owner must maintain a valid contract with a public management entitywih a certified operatoror a private certified operator forthe life of the septic system. Rule .1961 requires that Type VI septic systems designed fora hometbusiness owner must maintain a valid contract with a public management entitywith a certified operator forthe life of the septic system. Rule. 1961 (2) (e) requires a contract shall be executed between the system owner and a management entity prior to the issuance of an Operation Permit for a system required to be maintained by a public or private management entity, unless the system ownerand certified operator are the same. The contract shall require specific requirements formaintenance and operation, responsibilities of the ownerand systems operator, provisions that the contract shall be in effect for as long as the system is in use, and other requirements for the continued proper performance of the system. It shall also be a condition of the Operation Permit that subsequent owners of the systems execute such a contract. @Hand Drawing Olmport Drawing **Site Plan/Drawing attached.** D OPERATION PERMIT Davie County Heafth Department 210 Hospital Street P.O. Box 848 Mocksville NC r , CDP Fite Number: 137469 - 2 . County File Number: C7-000-00.143 27028 Date: W W Q Inch Crnla• nRlnrle = ff g .. • . -- --- � --- ME MEMNON ME MOMMEMEN SNE NoMINIMv MEMMEMMEME . ■�■ E MEMEM.E.EMM■MO. M�� No NoMEMOMM a®M®■EN MEN ON MEMEMOMMEMEMEMEM NONE M ■M®®®® MEN No so ■�� MMOMM ■ 0 M0MEMO ONNEON ON M ■ NEON, �O N NE ME No� ®ONE MENS MEMO ■ MEMEMEME MEMOMMEM O� ■ M� vMEN MEN �0�' 0� M EMMINIMEMENOON v OEM MEi. ME 'IMMM■MEM � !iMMEM11 ■ ME■ ■■..■■■ ■.■■■■� r ■. MEN ::: :::::::::::::. .MEM I CONSTRUCTION ForofficeUseOniv AUTHORIZATION *CDP File Number ;137469-2 °"W`' Davie CountyHealth Department c7-ooaoo-fas p County ID Number: 210 Hospital Street Evaluated For. REPAIR 04 �. P.O. Box 848 Township: ,, Mocksville NC 27028 PERMIT VALID UNTIL: Phone: 336-753-6780 Fax: 336-753-1680 0 3/ 2 4/ 2 0 2 1 Applicant: Violet S. Golding Address: 1046 Riverbend Drive City: Advance State/Zip: NC Phone #: Prnnei Property Owner. Violet S. Golding Address: 1046 Riverbend Drive City: Advance 27006 State/Zip: NC Phone #: 27006 Address/Road #: Subdivision: Creekwood Phase: 3 Lot: 22 112 Wills Road Advance NC 27006 Directions Structure: SINGLE FAMILY 1-40 to Hwy 801 tum right going north. Wills Rd on right. # of Bedrooms: # of People: *Water Supply: WA Classification Saprolde System? Design Flow: Provisionally Suitable OYes @No 3 6 0 Soil Application Rate: 0 3 'System Classifieation/Description: TYPE II A CONY SYSTEM (SINGLE-FAMILY OR 480 GPD OR LESS) 'Proposed System: 25% REDUCTION Minimum Trench Depth: a 4 Inches Minimum Soil Cover 1 a Inches Maximum Trench Depth: 3 6 Inches Maximum Soil Cover. a 4 Inches `Distribution Type. GRAVITY -SERIAL Septic Tank: Gallons 1 -Piece: OYes ONo Pump Required: OYes ONo OMay Be Required Nitrification Field 1 a 0 0 Sq. ft. Pump Tank: Gallons No. Drain Lines 3 1 -Piece: OYes ONo Total Trench Length: 3 0 0 ft GPM—vs— ft. TDH Trench Spacing: — g 0Inches O.C. ®Feet O.C. DosingVolume: Volume: Gallons Trench Width:Inches 3 _ gFeet Grease Trap: Gallons Aggregate Depth: inches Pre Treatment: ONSF OTS -I OTS -II Septic Tank Installer Grade Level Required: 01 011 OIII OIV Dunn 1 of Q CDP File Number 137469-2 *Site Classification: Design Flow: Soil Application Rate: *System Classification/Description: *Proposed System: Nitrification Field No. Drain Lines Total Trench Length: ft County ID Number: C7-000-00-143 ❑ Open Pump System Sheet OYes ONO ONO, but has Available Space Trench Spacing:O Inches 0. — O Feet O.C. Trench Width: Inches Feet Aggregate Depth: inches Minimum Trench Depth: Inches Minimum Soil Cover. Inches Maximum Trench Depth: Inches Maximum Soil Cover. Inches Sq. ft. 'Distribution Type: Pump Required: Oyes ONo OMay Be Required Pre Treatment: ONSF OTS -1 OTS -II - 'Site Modifications No grading or construction activity is allowed in areas designated for system and repair without approval of Health Department. 'Permit Conditions The issuance of this permit bythe Health Department in no wayguarantees the issuance of other permits.The permit holder is responsible for checking with appropriate governing bodies in meeting their requirements. This Authorization for Wastewater System construction shall be valid for a person equal to the period of validity of the Improvement Permit not to exceed five years, and maybe Issued atthe sametime the Improvement Permit Issued (NCGS 130A -336(b)} If the installation has not been completed during the period of validity of the Construction Penni; the information submitted in the application for a permit or Constnrcdon Authorization is found to have been incorrect, falsified or changed, or the site is altered, the permit or construction Authorization shall become Invalid, and maybe suspended or revoked (.1937(g)). The person owning or controlling the system shall be responsible for assuring compliance with the laws, rules, and permit conditions regarding system location, Installation, operation, maintenanc% monitoring, reporting and repair (1938(b)). Applicant/Legal Reps. Signature Required? Oyes ONO Applicant/Legal Reps. Signature: Date: _ / / *Issued By: 2140 -Nations. Robed Date of Issue: 0 3/ a 4/ a 0 1 6 Authorized State Agent: function Log OYes `I ®Hand Drawing Olmport Drawing **Site Plan/Drawing attached.** Page 2 of 3 CONSTRUCTION AUTHORIZATION Davie County Health Department 210 Hospital Street P.O. Box 848 Mocksville NC 27028 Drawing Drawing Type: Construction Authorization CDP File Number: 137469 - 2 County File Number: C7-000-00-143 Date: 03/14/2016 W W Qlnch Scale: . . . QBlock QN/A ■■■MM■■.■■■■■■■■■■■.■■■■ M■■.■M.■■■.■■.■.■■■.■.■ ■■M■■■■■� ■■■■■■■■ ■■■■■■■ ■■■■■■. ■■■■■ ■■■■. ■ 0 No ■■■.■■■ ■ ■■■■■■■ ■■■■■ ■■■E■■■ ■ ■■■■■■■ ■■■■ ■■■■■■■ ■■■■■■■ ■■■■■■■ MMMMM®®■ ® MM ■■■ ■■ ■ ' 1 ■■■.■■■ .■■■■■■ ■■■■■■ _ ■■■■ ■■■■■ ■ I ■ ■■■■■■ MMM■M ■■■■ ■■E■ ■■M■ MOM■ ■.■■ ■■■■ ■■■■ ■■■■ ■■■■ mom ■■■■■ ■■■■■■ ■■. ■■■■■■ ■■■■■■ ■■ MMMMMMM ■■■■■■■■■■■ .■■■■■■■■■■■ ■.■■■■■■■■■■■ ■■.■■■■■.■■■■■■■■■ me ■■■ ` ■■■■■■■ ■■■■ MMM Cmmmmmmmmmmmimmm ■......ME MEMEM CONSTRUCTION AUTHORIZATION Davie County Health Department 210 Hospital Street CDP File Number: 137469 - 2 P.O. Box 848 C7-000.00.143 Mocksviile NC 27028 County File Number. Date: 03 / 24 /2016 Click below to Import an image from an external location: Drawing Type: Construction Authorization 1 ME 7o' ISM - -, o;w;,;mow 111 7— cP Dane CounVY�,,, ' County wX. DDa vieCounty,NC-GoMa x maps2.roktech.net/davie_gomaps/indexhtml-- —7�je E CD 20D --- — --- QM62 C> Q1"* 944 b.. 0700000143 L 4 r 3862871273 M..b.. 8305262 200 GOLDING VIOLETS O .j 393 Ad .�r #2. Mdm d. 2: 1046 RIVERSEND DRIVE O CD ADVANCE 213 KC27006 U... LOT 22 C UMOOO E ATE6 SE C'i DoCD �,� F,14- 0.50 1292 4200 m �04,70 Cd la, bY, loo 11 v "UWd.t 36- 6'51.10' U1/Lang I- ' DAVIE COUNTY HEALTH DEPARTMENT IMPROVEMENTS PERMIT AND CERTIFICATE OF COMPLETION `Note: Issued in Cpliancle with G.S. of North Carolina Chapter 130—Article 13c. Permit Number Name ^GU.�/fis �Ny 1�4./ciarLDate 6/LtZ-2 N9 2168 Subdivision Name l�a�dw-�1 Lot No. Sec. or.Block No. Lot Size House Mobile Home Business Speculation No. Bedrooms No. Baths 2- No. in Family Garbage Disposal YES ff'NO ❑ Specifications for System: Auto Dish Washer YES [NO❑ i 3 ,C 3 Auto Wash Machine YES a'NO C]5.5 -X , a Type Water Supply *This permit Void if sewage system described below isot in pled withi 36 months from date'of issue. mow; �c 5' 7jr /a/ Improvements permit by - (naj) *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 Certificate of Completion Q• 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. " 'DAVIE COUNTY HEALTH DEPARTMENT IMPROVEMENTS PERMIT AND CERTIFICATE OF COMPLETION *Note: Issued in Compliance with G.S. of North Carolina Chapter 130—Article 13c. L�� Permit Number Name % , C//, _S f7�% ham. l,:�r, j//� Date l6 Location Subdivision Name �s� ��'k J_4J Lot No. %• Sec or Block No Lot Size House Mobile Home _ Business, Speculation No. Bedrooms ? No. Baths No. in Family Garbage Disposal YES E]' NO ❑ Specifications for System: Auto Dish Washer YES [jam NO 0 , 7 /, r / _ Cry Auto Wash Machine YES .[j NO ❑ X3 �f Type Water Supply *This permit Void if sewage system described below is potinsfalled with' 36 months from date. of issue F . L X.S�:' S - �5 - �l %'��.eG,�. '.•.a�.n,-!. J:r.cG'.e•, 5- 1.21 f.2I 7 . 'L/,moi ,.•f^u,,.• ,-iti-G �% � Improvements permit by *Contact a representative of the Davie County Health. Department for final inspection of this systembetween 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: n Lam. mei G24/ System Installed by r✓ ('/V'l' Certificate of Completion '-L f "" ``! Date 6//Y/ V '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: r" ~ °,' " • .1 ,DAVIE COUNTY HEALTH DEPARTMENT IMPROVEMENTS PERMIT AND CERTIFICATE OF COMPLETION `Note: Issued in C pliance with G.S. of North Carolina Chapter 130—Article 13c. Permit Number Name %. GU, 4-S /dc,I Date 613127 i ; `-: 21.68 Location Subdivision Name ctien/''�� / , i Lot No. a Sec. or Block No. Lot Size House. Mobile Home _ Business Speculation No. Bedrooms 3 No. Baths Garbage Disposal YES {]ANO [ Auto Dish Washer :' YES NO [ Auto Wash Machine YES NO [ Type Water Supply ,2— No. in Family *This permit Void if sewage system described below is pot i Ile Specifications for System: led with! 36 months from date. of issue. - ala Lva fit' �,� L I" �. �✓'�.(+� moi' �_.'. G:� ,J, Improvements permit by �) X10� *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 r 6 XPi - 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 betaken as a guarantee that the system will function satisfactorily for any given period of time. DAVIE COUNTY HEALTH DEPARTMENT (Septic Tank) Improvements Permit and Certificate.of Completion (Ground Absorptions Sewage Disposal System - G.S. Chapt�r 130 -Article 13C) OWNER 'OR CONTRACTOR ��7 i ; jll �� DC r�S DATE • G PERMIT LOCATION Seo!- r'l ?f/ANC� N° 1621 S. R. NO. SUBDIVISION NAME 1JOdO LOT NO. L Or «m2" SEG70N OR BLOCK NO .j= . HOUSE Q MOBILE HOME ❑ BUSINESS NO. BEDROOMS. ? NO. BATHROOMS. Z GARBAGE DISPOSAL UNIT YES L'T NO ❑ AUTO. DISHWASHER YES �/ NO ❑ AUTO. WASH. MACHINE YES ! i�c�'v3 xa� NO ❑ SITE SUITABLE YES O` NO ❑ SIZE OF TANK gala NITRIFICATION FIELD sq. ft. DEPTH OF STONE IN LINES: �'a+rTj 13� WATER SUPPLY: Individual ❑ ,Public ❑ IMPROVEMENTS PERMIT BY I/rL V l�ic� (8/16/73) *Construction 'LOT AREA - Date I X 2p comply with a other applicable State and local regula i -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. -. ! i�c�'v3 xa� INSTALLED BY Date I X 2p comply with a other applicable State and local regula i y-, DAVIE COUNTY HEALTH DEPARTMENT P. 0. BOX 57 Pi MOCKSVILLE,N. C. 27028 (704) 634-5985 / 9 Statement for Septic Tank Improvement Permits an/dd//or Site Evaluations -7 NAME / ((/iy�L / DATE ISSUED ADDRESS a / i Cie�/G ll PERMIT NO. a7/03 Explanation of charge AMOUNT -DUE S' SANITARIAN `PLEASE REMIT -THE ABOVE AMOUNT ON RECEIPT OF THIS STATEMENT. } ' �x1ItE . Tountu -�, MY[� �I1I1tP :�¢MI�Ij• �l$E1tC�J , .. .. ..' ..:.. P. O: BOX 57 �lllutksbille� �dnrilj,(Zlttrefintt 27D2$ OFf�ICE OF THE DI TOR _TELEPHONE- �1 - June ,.5, 1970 _ 7001, 634-5985 — Hubbard Reel ty" 429 Peters Creek parkyay tdinston 5a1em�;N.C. Re: Rent. H.ouse.,.Lot. .'' 22, Crcekwgod.III 4aviewCounty ,.Dear Sirs: On Mina 4,.;19799 ,a repair to the existing sewage disposa].'systam. 6as'completed on`the above mentioned location; I would like to Point out-the followIng, 16 an'effort°.to )ive'this sewgne system ao .a"chance functionproperly," 1. All'drains (gutter,basement, fpun clation') must. he divgrferl. from the new sy,,tem. 2. All water from_ the drivetuay must=be diverted away from-,new _system. 3."Water from the front yard must be diverted. A. Landscaping must be done order to divert the`iwater-frpm the' adjoining lot(*antlot). Unless 'these items are acted.: upon' and corrected properly, this sowans ,system•has little or no'chance-to"function correctly for any .given pericd of time:.': If this office ,can be'of further assistance,,nlease.feol:free to cv311 W us any',tzme, -` Joe h7andg, .Sanitarian Supervisor Davie County Haelth-gopartment cc, Mr. T W. Ellis " IT f� f e y.5 L`�Ml )+I ( V t y. �. —. / .. 'y ; .. i f „' J ice` lNIY � � / /t Yf T a j) 9 27h, DAVIE COUNTY HEALTH DEPARTMENT ,�— IMPROVEMENT AND OPERATIONI ERMITS PROPERTY INFORMATION Permittees Y Name t�'+�/ �� i ,'� Subdivision Name Drrechon§ to property: '►�tv",' h�` f Section:Lof: � IMPROVEMENT PERMIT . " Tax Office PIN:# IL— JoiA + ws Road'NX- WJLL� 2bZip;2—I **NOTE** This Improvement Permit DOES NOT.authomize the construction or installation of a septic tank system or any wastewater system. An.. AUTHORIZATIONTOR WASTEWATER SYSTEM CONSTRUCTION must be obtained from this Department prior to the cons 'trio ' stalla '6n of a system or the issuance of a building permit I (In p ' 9 p y Section. Sewage Treatment and Disposal Systems) c�om^�r " le 11 G.S.'Cha ter 130A, Wastewater Systems, ***NOTICE*** THIS PERMIT IS SUBJECT TO REVOCATION IF SITE PLANS OR THE INTENDED USE CHANGE. YOUR WASTEWATERENVIRON' HI SP CIALIS�J�ESSD SYSTEM CONTRACTOR MUST SEE THIS PERMIT BEFORE INSTALLING THE SYSTEM. RESIDENTIAL SPECIFIC ATION:BUILDING TYPE BEDROOMS _ #BATHS _'_ #OCCUPANTS_ GARBAGE DISPOSAL: Yes or No COMMERCIAL.SPECIRCATION: FACILITY TYPE. , .#PEOPLE '# PEOPLEISHIFT # SEATS INDUSTRIAL WASTE: Yes or No LOT SIZEt&AM-'TYPE WATER SUPPLY &(.ODESIGN WASTEWATER FLOW (GPD) NEW SITE REPAIR SITE v'.,. - _ C , a tl I t yam+ SYSTEM SPECIFICATIONS: TANK SIZE AL... PUMP TANK GAL. TRENCH WIDTH ROCKDEPTH24 LINEAR Fr.,5 . OTHER EM PAILIAO 14t3r- REQUIRED SITE MODIFICATIONS/CONDITIONS; "�� V� lill � '•T �rIX' IMPROVEMENT PERMIT LAYOUT *APPROVED.EFFLUENT FILTER* *RISER (S) IF 611_BELOW FINISHED SRADE*" .' f2 FpIIJJP: ��LpI 41 Qd **CONTAcr 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 THE DAY OF INSTALLATION. TELEPHONE # IS (MMMP - (336)751-8760 )�� 'w •i:0',!m yLn .: —. r �..,.-.�,..- .. � .,,..�x_„. n-.n-.�,;'` _?..•P+:i.... � M”, .C�.�•�I. DAVIE COUNTY HEALTH DEPARTMENT �-' " IMPROVEMENT AND OPERATION PERMITS PROPERTY INFORMATION Pe irfi ttae's ��j�� Name: ` i Subdivision Name: Directions to property: `� �1 i T c` Ci��) f Section: Lot:IMPROVEMENT` PERMIT Tax Office PIN:# 'ice euRoad N e:2 K i zip: **NOTE** This Improvement Permit DOES NOT authorize the construction or installation of a septic tank system or any wastewater system. An AUTHORIZATION FOR WASTEWATER SYSTEM CONSTRUCTION must be obtained from this Department prior to the constnictioNnstallation of a system or the issuance of a building permit. (In complia nce ivitfwA' icle 11 f G.S. Chapter 130A, Wastewater Systems, Section .1900 Sewage Treatment and Disposal Systems) ***NOTICE*** THIS PERMIT IS SUBJECT TO REVOCATION IF SITE PLANS OR THE INTENDED USE CHANGE. YOUR WASTEWATER ENVIRON 1 HE ' f6SP clAusT ATE IS ED SYSTEM CONTRACTOR MUST SEE THIS PERMIT BEFORE INSTALLING THE SYSTEM. RESIDENTIAL SPECIFICAT19N: BUILDING TYPE lima# BEDROOMS _ # BATHS # OCCUPANTS --%_ GARBAGE DISPOSAL: Yes or No COMMERCIAL SPECIFICATION: FACILITY TYPE, # PEOPLE # PEOPLE(SHIFT. # SEATS,_ INDUSTRIA[, WASTE: Yes or No LOT SIZE/ TYPE WATERSUPPLYD'ESf�GN WASTEWATER FLOW (GPD)NEW SITE- REPAIRSITELZ� I , . it tt 0 SYSTEM SPECIFICATIONS TANK SIZE, -_GAL. PUMP TANK GAL. TRENCH WIDTH ROCK DEPTH2E LINEAR FT2L REQUIRED SITE MODIFICATIONS/CONDITIONS: �"6't-`<a�e lrr.c.ry1 ryA1Y` t'-(.7"Ir+4LY'411 'frbK`rJ IY4�1"1�A/P+t: i7_�" IMPROVEMENT PERMIT LAYOUT.y.66R FILTER* TSI. 1IF,' 6",1 IIELOW;FINISHED GRADE* A /F-�sTi06 - **CONTACT A REPRESENTATIVE OF THE DAVIE COUNTY HEALTH DEPARTMENT FOR FINAL INSPECTION OF THI`�J$�SYSTEM BETWEEN 8:30 - 9:30 A.M. OR 1:00 - 1:30 P.M. ON THE DAY OF INSTALLATION. TELEPHONE # IS A1M1 avbb. ,� 1 36 751-8760 OPERATION PERMIT SYSTEM AUTHORIZATION NO. —&LP OPERATION PERMIT BY: F //y7/f DATE: zo 'z7 I **THE ISSUANCE OF THIS OPERATION PERMIT SHALL INDICATE THAT THE SYSTEM DESCRIBED ABOVE HAS BEEN INSTALLED IN COMPLIANCE - WITH ARTICLE 11 OF G.S. CHAPTER 130A, SECTION .1900 "SEWAGE TREATMENT AND DISPOSALSYSTEMS", BUT SHALL' IN NO WAY BE TAKEN AS A J GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORILY FOR ANY GIVEN PERIOD OF TIME. DCHD 05/96 (Revised) ACcfi:. dy DAVIE COUNTY HEALTH DEPARTMENT IMPROVEMENTS PERMIT AND CERTIFICATE OF COMPLETION Note: Issued in C�rgplJanc �e with G.S. of North Carolina Chapter 130—Article 13c. KKee _ Permit Number Name % w. L/4 -S /dGsL Date 6/s`�7 N9 2168 Location Subdivision Name, i r Lot No. Sec. or Block No. Lot Size House Mobile Home _ Business - Speculation No. Bedrooms '� No. Baths Z No. in Family_ Garbage Disposal YES ff-�NO ❑ Auto Dish Washer YES [EI'NO ❑ Auto Wash Machine YES n NO ❑ Type Water Supply _— 'This permit Void if sewage system described below is pot tie 5 Specifications for Sys em: 11 ed mow. e/s G - s14 s 4 A. ' � r 36 months from date of issue. GZ.G( LVr-LGGt �[U'— �LGv-C .Le R�� U-4rv\1VV 517i 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. Final Installation Diagram: System Installed by�� i1oiL� lliz� ww� era . Certificate of Completion Q- / Date x/1/7/ 'The signing of this certificate shall indicate that ttie-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. DAVIE COUNTY HEALTH DEPARTMENT (Septic Tank) Improvements Permit and Certificate of Completion (Groun&Absorption Sewage Disposal System - G.S. Chapter, 130 Article 13C) OWNER OR CONTRACTOR Y. r% / u ! i DATE %%1G% PERMIT LOCATION i ;'r v is 1� ? 1621 S.R. NO. SUBDIVISION NAME LOT NO. L [ r SECTION OR BLOCK NO. !-I NO. BEDROOMS NO. BATHROOMS Z GARBAGE DISPOSAL _UNIT YES C'JNO ❑ AUTO. DISHWASHER YES 0 NO ❑ AUTO. WASH. MACHINE YES E' NO ❑ SITE SUITABLE YES El' NO ❑ . SIZE OF TANK gal. NITRIFICATION FIELD sq. ft. DEPTH OF STONE IN LINES: ' J,✓ WATER SUPPLY: Individual ❑ Public ❑ IMPROVEMENTS PERMIT BY lick:.;. ru'-c!��J (8/16/73) *Construction LOT AREA House Trailer 800 Gala '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. f� INSTALLED BY f 4 z comply with ak'1/other applicable State and local i