4032 Hwy 158 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 #: 990006022 Tax PINIEH#: E60000007502'
Billed To: Mark Horvath Subdivision Info:
Reference Name: Repair Permit Location!Address: 4032 US'Highway 158-27028
Proposed Facility: Residential Repair Property Size: .58 Ac
ATG*I uotet*T ?Auance of this Operation Permit shall indicate the system described on the ATC has been installed
in compliance with Article 1 I 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: 06"S WTManufacturer k\A 06 Tank Date Tank Size /
Pump Tank Size Bedrooms
System Installed ByRaVIAV Ut&C SS Installer#: Dater
GPS Coordinate:
�'�nce (fes
j
Environmental Health Specialist: 161 A U A Date: E�
i
DCHD 11/06(Revised)
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 #: 990006022 Tax P€lel%EH M E60000007502
Billed To: Mark Horvath Subdivision Info:
Reference Name: Repair Permit Location/Address: 4032 US Highway 158-27028
Proposed Facility: Residential Repair Prope��9W ❑?�,�wA,Repair ❑Expansion
**NOTE**This Authorization to Construct(ATC)MUST BE ISSUED by the Davie County Environmental
ATReMnW&n 5991 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 change.
Residential Specifications: #Bedrooms #Bathrooms-a— People Basement❑ Basement plumbing❑
Non-Residential Specifications: Facility Type #People #Seats
Square Footage(or Dimensions of Facility)
Lot Size cl Type of Water Supply: XCounty/City ❑Well ❑Community Well
System Specifications: Design Wastewater Flow(GPD)-JrrO Tank Size_0jAr1q3AL.Pump Tank_�GAL.
Trench Width ��� Max. Trench Depth+` Rock Depth 10A Linear Ft. 11CO'. (9,5110
Site Modifications/Conditions/Other:
Contact the Davie County Environmental Heilth Section for final inspection of this system between
8:30-9:30a.m.on the day of installation. Telephone#(336)751-8760.
O
G
C/) 7,77
Environmental Health Specialist a Date: U
DCHD 11/06(Revised)
' DAVIE COUNTY ENVIRONMENTAL HEALTH SERVICE REQUEST
APPLICATION IP/ATC OSWW REPAIR
Name O-P k A ova j 1,1 Telephone Number
Address 4 D E 2 jos 1 W (l l 5'� /l��c.�s v�I I e N� Z-70Z e
Mailing Address (if different from above)
Email Address: 0 0
Subdivision Name Lot#
Direction b3Zei& ,Ci j h;
Oh A
Date System Installed Name System Installed Under
Type Facility 111 j&dP 0hj4 e Cj �e jnL Number Bedrooms_ Number People Served
Type Water Supply Specific Problem Occurring
S ilea✓
Date Re bested /- 30 -/ Info Taken By
THIS IS TO CERTIFY THAT THE INFORMATION PROVIDED IS CORRECT TO THE BEST OF MY
KNOWLEDGE,AND THAT I UNDERSTAND THAT I AM RESPONSIBLE FOR ALL CHARGES INCURRED
FROM THIS APPLICATION.
Signature of owner or Authorized Agent
Initial Fee Date REHS
Revisit Charge Date Reason
Revised 2-2011 n
M
" a' -"- DAVIE C-OUNTY ENVIRONMENTAL HEALTH SERVICE REQUEST
°.� . :• "
lo'
1APPLICATION IP/ATC OSWW REPAIRName /G �I��Ua-{ �) Telephone Number
�� address �{0Z-L ld s 114 V 15� 4,ock5 vj-1 I e Al(f Z-7O2 k
Mailing Address (if different from above)
Email Address: "0 0 "
Subdivision Name '' Lot# J
H Direction l ��Z
01,E - CA
Date System Installed Name System Installed Under
�1+6I dw(1( ��� Number Bedro
Type.Facility moms E Number People Served
Te Water Supply Specific,Problem Occurring
Date Requested fl 30 =1 Info Taken By
THIS IS TO CERTIFY THAT THE INFORMATION PROVIDED IS CORRECT TO THE BEST OF MY
KNOWLEDGE,AND THAT I UNDERSTAND THAT I AM RESPONSIBLE FOR ALL CHARGES INCURRED
FROM THIS APPLICATION.`
Signature of owner or Authorized Agent
Initial Fee Date REHS
Revisit Charge Date Reason
Revised 2-2011 �� � ~
j
Appra sal Card Page 1 of 1
DAVIE CO NTY NC 1/30/2013 2:27:48 PM
ORVATH MARK 3R HORVATH FELICIA Retum/Appeal Notes: E6-000-00-075-02
032 US Hr 158 UNIQ ID 6514
2528744 D139-P22 ID NO:5861050563 C
COUNTY TAX(100),FIRE TAX(100) CARD NO.1 of I
eval Year 013 Tax Year:2013 0.75 AC HWY 158 0.580 AC i SRC-Inspection
%ppralsed by 02 on 09/06/2007 03005 SMITH GROVE TW-03 C- EX-AT- LAST ACTION 20110712
CONSTRUCTION DETAIL MARKET VALUE DEPRECIATION CORRELATION OF VALUE C
oundation-3 Eg. BASE I Standard I 0.4500
ntinuous Footing 8-00 US MO Area UA RATE RCN EYB AYBCREDENCE TO MARKET
ub Floor System-4 oil 02 2 268 99 j42.S7b840N198NI98d %GOOD 1 55.0 DEPR.BUILDING VALUE-CARD 54,12
lywood I 11. DEPR.OB/XF VALUE-CARD 3,59
xterlor Walls-10 TYPE:Manufactured Home(Multi) Manufactured Home c
luminum n Siding32. MARKET LAND VALUE-CARD 16,93
STORIES:1-1.0 Story OTAL MARKET VALUE-CARD 74,64
oofing Structure-03 �.
able 9.00
oofing Cover-03 TOTAL APPRAISED VALUE-CARD 74,64
halt or Composition Shingle S. TOTAL APPRAISED VALUE-PARCEL 74,64
nterlor Wall Construction-5
)rywall/Sheetrock 28.00 TOTAL PRESENT USE VALUE-PARCEL
nterior Floor Cover-08 I OTAL VALUE DEFERRED-PARCEL
heet Vinyl/Laminate 7.00 TOTAL TAXABLE VALUE-PARCEL 74,64
nterior Floor Cover-14
t 0.0 PRIOR
:arpeeatlng Fuel-04 BUILDING VALUE 65,50
BXF VALUE 4,55
lectric 1.
ND VALUE 16,93
eating Type-10
eat Pum 5.0 +------26-------+-------30-------------
RESENT USE VALUE
I W D D I F E P I EFERRED VALUE
Ir Conditioning Type-03 I I I OTAL VALUE 86,980
entral 5. 1 1 I
3edrooms/Bathrooms/Half-Bathrooms 1 1 1
20 0.00C 6 6 �i 6
Brooms I I I i I PERMIT
AS-3 FUS-0 LL-0 I I i I CODE DATE NOTE NUMBER AMOUNT i
throoms1 +---+---_3426_______+-------30--i-----+
AS-2 FUS-DLL-O 1 I
I I OUT:WTRSHD:
OTAL POINT VALUE 111.00 1 I SALES DATA gym•,
BUILDING ADJUSTMENTS 4 1 FF. INDICATE o
ize 3 Size 0.850 1 :� 1 ECORD ATE DEED SALES
uali 3 AVG "000' SEAS `� 8 OOKIPAGEIMOtYR I TYPE PRICE c
ha a Desi 4 FACTOR 1 1.050 ++ 1 0731 3250 9 2007 WD Q I 84500 C
OTAL ADJUSTMENT FACTOR - 0.89C I I 0723 794 7 2007 WD P I 3800
OTAL QUALM INDEX gs 9 I 0699 3218 2 2007 TO P I 4900
I 1 0148 212 4 1989 WO X V o
+----21-----+5-+-10----------267'-"'-+ ni
IUOP I
I I
1 1 '
1 2 HEATED AREA 2,270
' I I
I +---17----+ I NOTES
09LISTING-WOOD FENCE
SUBAREA UNIT ORI G% ANN DEP % OB/XF DEPR
RPL ODE ESCRIPTIO T NIT PRICE GOND LDG B AYB EYB RATE V GOND VALUE
TYPE GS AREA % CS 1 ORAGE 1 2 28 15.0 10 _ L 194 19 S 4 185
AS 1 79 1 7620 S OOD FENCE 13 15.9 _ 001001 S 8 173
EP 48 07 143 OTAL OB XF VALUE 3,593
OP 19 03 246
DD 41 02 442
2-Pre
IREPLACE Fabricated 1,00
UBAREA 2,88 98,40 r
OTALS 't
UILDING DIMENSIONS FEP=W30WDD-W26N16E26S16$N16E30SI6$BAS=W64S14WIS5E1S9E21 UOP=S11 E17N 12W2S IWION IWSS I$N I ESS IE ION IE2S IE26N28$.
ND INFORMATION
IGHEST i AD3USTMENTS LAND, TOTAL
NO BEST USE LOCAL FRON DEPTH/ LND CONDrTHER
ND NOTES OA UNIT LAND UNT TOTAL ADJUSTED LAND LAND
SE CODE ZONING TACE EPT SIZE MOD FACTRF AC LC TO OT TYPE PRICE'- UNITS TYP ADJST UNIT PRICE VALUE NOTES
H HOMESIT 0201 124 0 2.8620 4 1.2000+10+10+00+00+00 PW 8,50MC 0.580 AC 1 3.434 29 189.0 1693
OTAL MARKET LAND DATA 0.580 16,93
OTAL PRESENT USE DATA
II
1 !
http://m aps.co.davie.nc.us/ITSNet/AppraisalCard.aspx?parcel�E60000007502 1/30/2013
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` 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�lr a`�`'�� 2—L-1 ��1'A Date �� '`� N2 5532
Location . �, •:���_ 1' e r``( c� � ,� ,� �° 11 c;� �`.
Subdivision Name �Q3Z " uv ! Lot No. Sec. or Block No.
Lot Size 3 r
��,-�;�_ House Mobile Home Business Speculation
No. Bedrooms _ No. Baths — No. in Family
Garbage Disposal YES p NO [31/
Sp cific tions far System: -,
Auto Dish Washer YES Q' NO p d_G9 --
� 01C
Auto Wash Machine YES p NO C]
Type Water Supply e
fid, x 3 X �{
'This permit Void if sewage system described below is not installed within 36 months from date of issue.
\ `V
I>>
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: ystern Installed by
��o hyo $ID
Certificate of CompletionDate
'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.
• AP•PLIC&ION FOR SITE EVALUATION/IMPROVEMENTS PERMIT
Davie County Health Department 1 •�
Environmental Health Section Ed APR
P. O. Box 66511
Mocksville, N.C. 27028 REM
CONSTRUCTION SHALL NOT BEGIN UNTIL IMPROVEMENTS PERMIT HAS BEEN ISSUED.
Home Phone
1. Permit Requested By A 1 Business Phone
2. Address lai Soh Cel D 2• d :ate - N_ C. Z7 -)-Ci
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 Homel..cBusiness
IndustryOther
b) Number of people
6. aj If house or mobile home, state size of home and number of rooms.
House Dimensions 00-6 Le W:p c
Bed Rooms 3 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 urinals garbage disposal
lavatory showers washing machine �—
dishwasher t/ sinks
8. a) Type water supply: Public ✓ Private - Community
b) Has the water supply system been approved? Yes—L----No-
9.
No9. a) Property Dimensions ;✓4
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? we)
What type?
This is to certify that the information is correct to the best of my knowledge.
Date Owner Sign ture
OWNER IS SOLELY RESPONSIBLE FOR COMPLIANCE WITH ALL STATE AND LOCAL LAWS
Allow 5 days for processing
Directions to property:
o w g r
a w �r Cl
8 4D d a �v� IZ 4h: S s: d o & T /
S N
DCHD(6-82)
0
DAVIE COUNTY HEALTH DEPARTMENT
Environmental Health Section.
R O. Box 665
Mocksville, N.C. 27028
SOIL/SITE EVALUATION q
Name �--`�� Date ' t
3
Address S �� Lot Size y
FACTORS ARE AR 2 ARE ARE
32�
1) Topography/Landscape Position S
PS -
U U
2) Soil Texture (12-36 in.) Sandy, S S
Loamy, Clayey, (note 2:1 Clay)
3) Soil Structure (12-36 in.) S
Clayey Soils PS` PS
U
4) Soil Depth (inches) S
PS PS
U
5) Soil Drainage: Internal S
PS PS PS
U
External S
PS <::r>
U
6) Restrictive Horizons z�
7) Available Space ® S'
Kw
PS PS PS PS
U U U U
8) Other (Specify) S S S S
PS PS PS PS
U U U c
9) Site Classification
U—UNSUITABLE S—SUITABLE PS—Provisionally Suitable p
Recommendations/Comments: °\
Described by �"" Title _ Date
SITE DIAGRAM
. g.
DCHD(6-82)
Parcel#: E60000007502 Page 1 of 1
oA�r�
Davie County, NC - Basic Estate SearchC,
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View Property Record for this Parcel View Mao for this Parcel View Tax Bill Information
Parcel#: E60000007502 Account#: 82528744
Owner Information Tax Codes
HORVATH MARK 3R&HORVATH FEUCIA ADVLTAX-COUNTY T
032 US HWY 158 mEADVLTAX-FIRE TAX
MOCKSVILLE NC 27028
Property Information :9 Townshi
nd(Units/Type): 0.580 AC FARMINGTON
ddress: 4032 US HWY 158
Deed Information Local Zoning
Date: 09/2007 Book: 00731 Page: 0250
Plat Book: Page:
Le al Description PIN
75 AC HWY 158 5861050563
Property Values
uildin 5412
BXF• 3,59
nd: 16,93
arket: 74,64
000111
ssessed: 74,64
Deferred:
Sales Information
No. Book Page Month Year Instrument Qual/UnQual Improved Price
00148 0212 04 1989 WD Unqualified Vacant 0
00699 0218 02 2007 TD Unqualified Improved 49,000
00723 0794 07 2007 WD Unqualified Improved 38,000
00731 0250 09 2007 WD Qualified Improved 84,500
View Property Record for this Parcel View Mao for this Parcel View Tax Bill Information
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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 other public 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/itsnet/View.aspx?prid=1479660 6/15/2016