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138 Harness Lni J •� ,� 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 v "IN _—Lt. Date --Ib N2 3" 4 n Location�� Subdivision Name Lot No. Sec. or Block No. Lot Size House Mobile Home _ Busirless Speculation No. Bedrooms . Noa Baths No. in'Family Garbage Disposal YES p NO4 Specifications for System: ., Auto Dish Washer: YES: ❑ NO to, Auto Wash Machine YESNO Type Water Supply _ *This permit Void if sewage system described below is not installed within 36 months from date of issue. y ------------ Improvements --- 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 Certificate of Completion Date 5-% !g 4 *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. t f APPLICATION FOR SITE EVALUATION/ IMPROVEMENTS PERMIT Davie County Health Department Environmental Health Section ccG�w�Q 0 P. O. Box 665 Mocksville, N.C. 27028 CONSTRUCTION SHALL NOT BEGIN UNTIL IMPROVEMENTS PERMIT HAS BEEN ISSUED. �J// a �L ^ 1 j Home Phone ` �� S/ Z 1. Permit Requ sted B V� �' �� 2.Business Phone 2. Address y ✓ N E -9 oU O -q V L C Al. C, ;;:-21 3. Property Owner if Different than Above Address 4. Permit 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 Homed Business IndustryOther b) Number of people 6. ay If house or mobile home, state size �h of home and number of rooms. House Dimensions l� %,(S�(191 t. 9O Bed Rooms_ 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 lavatory dishwasher urinals showers cinkc garbage disposal washing machine , 8. a) Type water supply: Public—' Private Community CS O U IV 7-V 7- W el T>- i_ b) Has the water supply system been approved? Yes No // 9. a) Property Dimensions '5_ A r ---ST b) Land area designated to building site c) Sewage Disposal Contractor (To R Al A % a F R_ 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 informatio is correct to the best of now e. XL0aA_.,_coT,,. Dat Owner Signature OWNER IS SOLELY RESPONSIBLE FOR COMPLIANCE WITH ALL STATE AND LOCAL LAWS Allow 5 days for processing Directions to property: I Q/U 6o/ gollic, —(-o(-ATH 7kt) U Rd S OcooLzE-mFic -- f AsT 9.; 9+a 3fid c� s --- ► taw DCHD (6-82) A -t R6_- q o y , 4 r 1 Name 'Address — FACTORS DAVIE COUNTY HEALTH DEPARTMENT Environmental Health Section P. O. Box 665 Mocksville, N.C. 27028 _ SOIL/SITE EVALUATION e, ARIFA I AREA 9 Date © c6 g Lot Size b AREA 3 AREA d 1) Topography/ Landscape PositionS (:::N U -(�B U PS U S PS U �) Soil Texture (12-36 in.) Sandy, Loamy, Clayey, (note 2:1 Clay) U S S PS U S PS U 1) Soil Structure (12-36 in.) Clayey Soils P PS S PS U S PS U 1) Soil Depth (inches) U U S PS U S PS U i) Soil Drainage: Internal pS S S PS U S PS U External PS S PS U S PS U 1) Restrictive Horizons------� Available SpaceS S U U S PS U S PS U 1) Other (Specify) S PS PS S PS U S PS U 1) Site Classification U—UNSUITABLE /� qq S—SUITABLE PS—Pr visionally Suitable Recommendations/ Comments: Described by Title Date SITE DIAGRAM DCHD (6-82) "E / C .�Y N 01°40'17"E NO3'12'11"E N04'S3'12"E NO7°09 15" /'-+• / Np3'15'14"W-mo—� 187, 77 119, 74 99 51 99,79 157.00 nail 8 cap In N 42'23�00'E tree stump 60.00 N 0% O � O O O A O D r EEto O (P m N lJ 0� %D D O r O Z - (A U O N A N N l.! D S 88 v0 • � �9 sy. K F .S / .108 / LOT 39 GS >JY L Tl'FTEROW ( --TIFY THAT fIrVCFR AREA = 6.111 ACRES 1134.37 S 00' 09' 3 6" W ` AREA= 5.00 ACRES 982-24 S 03.30' 19"E f� 9q0 p0 510. 21.33'E W. A. ELLIS, ET AL DB. 103 PG. 746 O O P r� j TC ..r REVISION TOLA+S or wbo6c' B Parcel #: M506OA000103 Davie County, NC - Basic Estate Search Basic Search Real Estate Search Tax Bill Search Sales Search 0 'View Property Record for this Parcel View Man for - this Parcel View Tax Bill Information :4 Parcel #: M5060A000103 Account #: 27539880 Owner Information "din : Tax Codes BXF: FRANCO MIGUEL A JR Land: ADVLTAX - COUNTY T Market: 175 NC HIGHWAY 801 essed• FIREADVLTAX - FIRE TAX IlDeferred: OODLEAF NC 27054 Property Information Township Land (Units/Type): 6.380 JERUSALEM [Address, 138 HARNESS LN Deed Information Local tonin ate: 05/1995 Book: 00180 Page: 0442 Plat Book: Page- a e:Le al Description Legal PIN FF HWY 801 5745496440 Property Values "din : CCC BXF: 4,50 Land: 42,30 Market: 46 80 essed• 46,80C IlDeferred: Sales Information No. Book Page Month Year Instrument Qual/UnQual Improved Price 1 00145 .0611 10 1988 WD Qualified Vacant 16,000 2 00180 0442 05 1995 WD Qualified Vacant 4,000 View Property Record for this Parcel View Map for this Parcel View Tax Bill Information « Return to Basic Search Page 1 of 1 oN�1F tovt,�, Davie County Web Site All information on this site is prepared for the inventory of real property found within Davie County. All data is compiled from recorded deeds, plats, and otherpublic records and data. Users of this data are hereby notified that the aforementioned.public information sources should be consulted for verification of the information. All information contained herein was created for the Davie County's internal use. Davie County, Its employees and agents make no warranty as to the correctness or accuracy of the information set forth on this site whether express or Implied, in fact or In law, Including without limitation the implied warranties of merchantability and fitness for a particular use. If you have any questions about the data displayed on this website please contact the Davie County Tax Office at (336) 753-6120. 1.5.9 http://maps.daviecountync.gov/itsnettView.aspx?prid=1460141 8/25/2016