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147 Coyette LnImprovements 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: 0 9 rr System Installed by - �V7 to Q 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. 1 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 {� f Name C, ti, c�, \�� :. �� _ Date �� - ! �� P '1194 Location CIL" 'Name Subdivision Lot No. Sec. or Block No. a.- Lot Size - House Mobile Home _ Business Speculation �� No. Bedrooms __ No. Baths No. in Family Garbage Disposal YES p NO p Specifications for System. Auto Dish Washer YES Er NO Auto Wash Machine YES NO [] �. (.W Type Water Supply *This permit Void if sewage system described below is not installed within 36 months from date of issue. C_ 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: 0 9 rr System Installed by - �V7 to Q 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. 1 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: 0 9 rr System Installed by - �V7 to Q 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. APPLICATION FOR SITE EVALUATION/IMPROVEMENTS PERMIT Davie County Health Department 0 5 Environmental Health Section t:com Q Mpy P. 0. Box 665 RG G Mocksville, N.C. 27028 CONSTRUCTION SHALL NOT BEGIN UNTIL IMPROVEMENTS PERMIT HAS BEEN ISSUED. Home Phoneqyvr 1. Permit Requested By Business Phone (03 �4- '914/0 1 2. Address 3. Property Owner if Different than Above Y� Address 4. Permit To: a) Instal l__LZAlter Repair i b) Privy Conventional Other Type Ground Absorption 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, state size of home nd number of rooms. House Dimensions /'%00 SC, -. Bed Rooms_ Bath Rooms a— Den w/Closet �. b) If Bulsiness, Industry or Other, State: Number of persons served What type business, etc. Estimate amount of waste daily (24 hours) 7. Numbell and type of water -using fixtures: commodes urinals garbage lavatory showers 2 washing m , dishwasher sinks 8. a) Type' water supply: Public Private Community b) Has the water supply system been approved? Yes No_�L 9. a) Prop;IDimensions i 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? What type? This is to certify that the information is correct to the best of my knowledge. Date Owne ignature OWNER IS SOLELY RESPONSIBLE FOR COMPLIANCE WITH ALL STATE AND LOCAL LAWS Allow 5 days for processing r OT Directions to property: � �(,�, kQ r 1f a CY, . oz:, DCHD (6-82) 1�oa� o ' ems La DAVIE COUNTY HEALTH DEPARTMENT Environmental Health Section. P. 0. Box 665 Mocksville, N.C. 27028 SOIL/SITE EVALUATION Name,e v\"t') \ e `kJ Date S 1 U Address S ca X'"N si Lot Size' c FACTORS ARFYf 1 \ ARFC**-� ARFA 3 ARFo d 1) Topography/ Landscape Position S S C:&i- U PS U PS U ?) Soil Texture (12-36 in.) Sandy, Loamy, Clayey, (note 2:1 Clay) S <:fl� S PS S PS U U U i) Soil Structure (12-36 in.) Clayey S PS S PS S PS Soils U U U g Soil Depth (inlches) PS _ S PS S PS U U U i) Soil Drainage Internal S PS S PS U U U External pS S PS S PS U U U i) Restrictive Horizons Available Space S S PS S PS U U U U 1) Other (Specify) S PS S S S PS S PS U U 1) Site Classification U—UNSUITABLE S—S nTAE3LE PS— ro isionaliy Suitable Recommendations/Comments: Described by - Title Date. � 0 - SITE DIAGRAM o DCHD (6-82) G n SO V Q Davie County, NC Tax Parcel Report Tuesday, September 27, 2016 PB7-PG124 5 7 151 100 --- 141 . ....... 140r - N . ..... ...... ..... ...... .............. 163 1477 a CD -ij --CN 27 EN LO w 3792 7 LO 9! 5722 7-- 87,,Q2 co A CV CV —031- 109 105 1597 13 Davie County, NC WARNING: THIS IS NOT A SURVEY causes of action due to or arising out of the use or inability to use the GIS data provided by this website. Parceflnforthation. Parcel Number G90000001601 Township: Shady Grove NCPIN Number 5789966752 Municipality: Account 953000 Census Tract: 37059-804 Listed Owner 11 ALLEN KEVIN WAYNE Voting Precinct: EAST SHADY GROVE Mailing Address 1: 147 COYETTE LANE Planning Jurisdiction: Davis County City: ADVANCE Zoning Class: DAME COUNTY R -A State: NC Zoning Overlay: Zip Code: 27006-0000 Voluntary Ag. District: No Legal Description: 0.78 AC WOFF PEOPLES CRK Fire Response District: ADVANCE Assessed Acreage: 0.74 Elementary School Zone: SHADY GROVE Deed Date: 4/1988 Middle School Zone: WILLIAM ELLIS Deed Book I Page: 001420810 Soil Types: Pc132,PcC2 Plat Book: Flood Zone: x Plat Page: Watershed Overlay: WS -IV -P Building Value:'' 154220.00 Outbuilding 8, Extra 0.00 Freatures Value:' Land Value: 18000.00 Total Market Value: 172220.00 'I Total Assessed Value: 172220.00 Davie County, NC All data is provided as is without warranty or guarantee of any kind either expressed or implied including but not limited to the Implied warranties of merchantability or fitness for a particular use. All users of Davie County's GIS website, shall hold harmless the County of Davie, North Carolina, its agents, consultants, contractors or employees from any and all claims or causes of action due to or arising out of the use or inability to use the GIS data provided by this website.