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639 Fork Bixby Rd101 Davie County, NC WARNING: THIS IS NOT A SURVEY harmless the County of Davie, North Carolina, its agents, consultants, contractors or employees from any and all claims or Parcel Number: 1700000101 Township: Fulton NCPIN Number: 5778256442 Municipality: Account Number: 82518221 Census Tract: 37059-804 Listed Owner 1: ALLRED JAMES RICHARD Voting Precinct: FULTON Mailing Address 1: 639 FORK BIXBY ROAD Planning Jurisdiction: Davie County City: ADVANCE Zoning Class: DAVIE COUNTY R-20 State: NC Zoning Overlay: Zip Code: 27006-0000 Voluntary Ag. District: No Legal Description: 3.000 AC FORK BIXBY RD Fire Response District: FORK Assessed Acreage: 2.72 Elementary School Zone: CORNATZER Deed Date: 2/2002 Middle School Zone: WILLIAM ELLIS Deed Book/Page: 004070797 Soil Types: WeC,PcB2 Plat Book: Flood Zone: X Plat Page: Watershed Overlay: - Building Value: 196660.00 Outbuilding & Extra 500.00 Freatures Value: Land Value: 35050.00 Total Market Value: 232210.00 Total Assessed Value: 232210.00 101 Davie County, NC l 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. DAVIE COUNTY HEALTH DEPARTMENT IMPROVEMENTS PERMIT AND CERTIFICATE OF COMPLETION *NOTE:issued in Compliance with G.S. of North Carolina Chapter 130 Article 13c iSewage Treatment and Disposal Rules (10 NCAC 10A .1934-./1968) Permit Number Name/r� /ice' r % F� /,` %% 7` '��� Date N2Location _ - _ Subdivision Name Lot No. Sec. or Block No. Lot Size /' .-"% - House Mobile Home Business Speculation No. Bedrooms `_s' No. Baths o?, No. in Family Garbage Disposal YES ❑ NO .per Specifications for System: , Auto Dish Washer YES Q NO ❑ ,, �3(� .=✓� �`—' Auto Wash Machine YES [D NO -❑ Type Water Supply ? _ Al ,. *This permit Void if sewage system described below is not installed within 36 months from date of issue. k . 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 G� Ry w i � r Certificate of Completion _� ��� Date i *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 I� Environmental Health Section P. 0. Box 665 Mocksville, N.C. 27028 CONSTRUCTION SHALL NOT BEGIN UNTIL IMPROVEMENTS PERMIT HAS BEEN ISSUED. I Home Phone �%%�%M %d /�/ �-// 1. Permit Req ted B / 1M_ _Business Phone 2. Address / h 3. Property Owner if Different than Above Address 4. Permi To: a) Install Alter Repair b) Privy Conventional Other Type Ground Absorption c) Sub -Division Sec. Lot No. 5. System used to serve what type facility: House Mobile Homes Industry Other b) Number of people :7- 6. aJ if house or mobile home, state size of home and number of rooms. House Dimensions 1 -'VX 749 Bed Rooms Z 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 J-1 lavatory dishwasher urinals showers -Z sinks �— 8. a) Type water supply: Public— Private Community b) Has the water supply system been approved?' es No 9. a) Property Dimensions 4QpeoX 3e0 X /,t00r 66ed, b) Land area designated to building site c) Sewage Disposal Contractor 10. Do you antic What type? mow, �t� 7 Aj, Fv garbage disposal washing machine l This is to certify that the information is correct to the best of my knowledge. Ca �a Date Owner Signature OWNER IS SOLELY RESPONSIBLE FOR COMPLIANCE WITH ALL STATE AND LOCAL LAWS Allow 5 days for processing ns to property: 1E�4* 6A1 T�s2k ,::fAU2(:!A 1 31101n l leS ),O26Pe,11 r , �I111Ew d. lei e,:/ aN /e ,c ) DCHD (6-82) DAVIE COUNTY HEALTH DEPARTMENT Environmental Health Section, P. O. Box 665 Mocksville, N.C. 27028 SOIL/SITE EVALUATION Name C �/a Gt ��/ m,0 Date Address Lot Size Fer.TnRC APPA 1 ARFA 7 ARFA R AREA A 1) Topography/ Landscape Position S&S S �p U U U 2) Soil Texture (12-36 in.) Sandy, Loamy, Clayey, (note 2:1 Clay) S P S dp U PS U 3) Soil Structure (12-36 in.) Clayey Soils SCdpS..,, Com' Com'' �j U U U I) Soil Depth (inches) ,,,�S) Ai) U U i) Soil Drainage: Internal SS q(S) External © � C) S) PS U S U PS U PS U i) Restrictive Horizons Available Space PS PS PS PS U U U U 1) Other (Specify) S PS S PS S PS S PS U U U U 1) Site Classification U—UNSUITABLE S—SUITABLE PS_ Provisionally Suitable Recommendations/Comments: Described by �Z6'// Title SITE DIAGRAM �q DCHD (6.82) X —5 Date" kpAy-