1999 Hwy 601SHEALTH DEPARTMENT RELEASE
dA Davie County Health Department
210 Hospital Street
P.O. Box 848
Mocksville NC 27028
Phone: 336-753-6780 Fax: 336-753-1680
Applicant: Brian and Lynn Wisecarver
Address: 1999 US Hwy 601 S.
City: Mocksville
State2ip: NC 27028
Phone 0: (704) 640-7110
t--� 1999 US �601, S" --I'
Address - - �
Road # Mocksville NC 27028
*Structure: SINGLE FAMILY
# of Bedrooms: 2 # of People:
*Water Supply: N/A
Basement: n Yes ❑ No
'Proposed improvement:
Out Building
For Office Use Only
*CDP File Number 121733 -1
L5-020-Aa014
County ID Number:
valuated For. HDR/WWC
PERMIT VALID 0 5 1 2 9/ 2 0 1 8
UNTIL:
Property Owner: Brian and Lynn Wisecarver
Address: 1999 US Hwy 601 S.
City: Mocksville
State2ip: NC 27028
Phone #:
Property Location & Site Information
Subdivision:
Township:
Directions
Hwy 601 South
(704) 640-7110
Phase: Lot
Type of Business:
Total sq. Footage: No_ Of Employees:
'Release Conditions
It is the responsibility of the owner to maintain a 5 foot minimum setback between the wastewater system and any part of the structure
foundation, including porches, decks, and any other appurtenances. If you are unsure as to the exact location of the septic system, please
It
a licensed installer or inspector locate the septic system for you. The local county health department in no way implies that the
proposed construction meets the required setbacks from the septic system unless otherwise noted. This release only shows that this
property has an approved wastewater system that appears to have met the permitting requirements at the time it was installed.
This release in noway expresses or implies that the existing subsurface sewage treatment and disposal
system serving the site will continue to function for any period of time.
Applicant/Legal Reps. Signature Required? Oyes C )No
Applicant/Legal Reps. Signature: *Date:,
*Issued By: 2244 - Daywalt, Andrew *Date of Issue:_ 0 5 2 9 1 2 0 1 3
Authorized State Agent:
**Site P landrawing attached.** Total Tlme:(HH:MM)
C3 Hand Drawing Olmport Drawing 0 1 Hours 0 0 Minutes
T
r �
his
O 'S
U�
Phone: (336) - 753 - 6780
Davie County .Health Department
Environmental Health Section
P.O. Box 848 INS
210 Hospital Street
Courier # : 09-40-06
Mocksville, NC 27028 _
Fax: (336) - 751- 8786
ON-SITE WASTEWATER CERTIFICATION FOR DWELLING
(Check One) Replacement Remodeling Reconnection���
Name: �/�� /1 � l l 11 t' " 7 s e -e,4, vt1z_, Phone Number (��i �7 / ��� (Home)
Mailing Address: /q.91 S Aj(Work)
Oak's di 6l e_A.16 Email
Detailed Directions To Site:
WE W
Please Fill In The Following Information About The EXISTING Facility:
Name System Installed Under: Type Of Facility:I/ SQ
Date System Installed (Month/Date/Year):T Number Of Bedrooms: Number Of People:
Is The Facility Currently Vacant? Yes CO If Yes, For How Long?
Any.Known Problems? Yes No If Yes, Explain:
Please Fill In The Following Inf. . rmation About The NEW Facility:
Type Of Facility: oWb Number Of Bedrooms: Number of People
'l Requested BDate Requested:
(Signature)
For Environmental Health Office Use Only
Approved Disapproved
Comments:
Environmental Health Specialist Date:
*The signing of this form by the Environmental Health Staff is in no way intended, nor should be taken as a guarantee
(extended or limited) that the on-site wastewater system will function properly for any given period of time.
Payment: .Cash Check Money Order # Amount:$ Date:
Paid By:
��r� Received By:
Account #: 6 Q IS �5 Invoice #:
0D?: 12 f-73 :3
All data Is provided as is without warranty or guarantee of any kind either expressed or implied Including but not limited to the Implied �' 'j,
q� r warranties of merchantability or fitness for a particular use. All users of Davie County's GIS website shall hold harmless the County of rC U 1;
10 Davie, North Carolina, Its agents, consultants, contractors or employees from any and all claims or causes of action due to or arising out of Printed. May 21, 2013
the use or inability to use the GIS data provided by this website.
Permittee's} DAVIE COUNTY HEALTH DEPARTMENT
r ,
,Name,,., t' /> rr 1� � Environmental Health Section PROPERTY INFORMATION
P.O. Box 848
Directions to property:" i'� t L/� C 3 %fin MOcksville; NC 27028 Subdivision .Name:
` ( Phone #: 336-751-8760
ection: Lot:
AUTHORIZATION. FOR
WASTEWATER f Tax Office PIN:#
SYSTEM CONSTRUCTION - -
AUTHORIZATIONNO: 2101 A (9D` MdlName:,llS SZip:27Q�
**NOTE** This Authorization for Wastewater System Construction MUST BE ISSUED by the Davie County Environmental Health Section prior
to issuance of any Building Permits. This Form/Authorization Number should be presented to the Davie CountyBuilding Inspections.:
Office when applying for Building Permits.
(Incompliance with Article 11 of G.S. Chapter 130A, Wastewater Systems, Section ,1900 Sewage Treatment and Disposal Systems)
***NOTICE*** THIS AUTHORIZATION FOR WASTEWATER CONSTRUCTION
.VALID FOR A PERIOD OF FIVE YEARS.
ENVIRONMENTAL HEALTH SP CIALIST DATE ISSUED
RESIDENTIAL SPECIFICATION: BUILDING TYPE # BEDROOMS # BATHS # OCCUPANTS GARBAGE DISPOSAL: Yes or No.
COMMERCIAL SPECIFICATION: FACILITY TYPE # PEOPLE # PEOPLE/SHIFT # SEATS INDUSTRIAL WASTE: Y6s or No
LOT SIZE TYPE WATER SUPPLY %� DESIGN WASTEWATER FLOW (GPD) NEW SITE REPAIR SITE !�
SYSTEM SPECIFICATIONS: TANK SIZE !%GAL. PUMP TANK GAL. TRENCH WIDTH y��KOCK DEPTH LINEAR FT J
OTHER
REQUIRED SITE MODIFICATIONS/CONDITIONS:
**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 THE DAY OF INSTALLATION. TELEPHONE # IS (336)751-8760;
OPERATION PERMIT p /
SYSTEM ALLED BY:
AUTHORIZATION NO. OPERATION PERMIT BY: DATE:
**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 DISPOSAL SYSTEMS", BUT SHALL IN NO BE TAKEN AS A
GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORILY FOR ANY GIVEN PERIOD OF TIME.
DCHD 02N2 (Revised)
NAME
ADDRESS
DAVIE COUNTY ENVIRONMENTAL HEALTH SECTION
APPLICATION FOR IMPROVEMENT PERMIT (REPAIR) U
, h PHONE NUMBER
/ SUBDIVISION NAME `
LOT #
DIRECTIONS TO SITE ,
DATE SYSTEM INSTALLED NAME SYSTEM INSTALLED UNDER
TYPE FACILITY Xol— NUMBER BEDROOMS NUMBER PEOPLE SERVED
TYPE WATER SUPPLY SPECIFY PROBLEM OCCURRING
DATE REQUESTED INFORMATION TAKEN BY 4
This is to certify that the information provided is correct to the best of my knowledge, and that I understand I am responsible for all charges incurred from this application.
SIGNATURE OF OWNER OR AUTHORIZED AGENT
Rev. 1N3 e
c�
Appraisal Card Page 1 of 1
ISECARVER BRIAN M WISECARVER LYNN A
Retum/Appeal Notes: LS -020 -AO -014
1999 S US HWY 601
UNIQ ID 21834
2528526
D328 -P16 ID NO: 5746170464
COUNTY TAX (100), FIRE TAX (100)
CARD NO. 1 of I
eval Year: 2013 Tax Year: 2013
.878 AC HWY 601 -
1.000 LT SRC- Owner
Appraised by 28 on 03/30/2009 05004 FAIRFIELD
TW -05 C- EX- AT- LAST ACTION 20110712
CONSTRUCTION DETAIL
- MARKET VALUE
DEPRECIATION CORRELATION OF VALUE
Foundation - 3
Eff. BASE
Standard 10.20000.
ontinuous Footing
5.0 US MO Area QUA RATE RCN EYB AYB REDENCE TO MARKET
ub Floor System - 4
0110112.0831106 74.20 156808199 198
8.0
% GOOD 80.0 )EPR. BUILDING VALUE - CARD
125,45
I lyood
xterior Walls - 10
TYPE: Single Family Residential
Single Family Residential EPR. OB/XF VALUE - CARD
5,72
ARKET LAND VALUE - CARD
22,00
Iuminum in I Siding
31.0 STORIES: 1 - 1.0 Story
rOTAL MARKET VALUE - CARD
153,17
xterior Walls - 21
ace Brick
0.0
oofing Structure - 03
TOTAL APPRAISED VALUE - CARD
153,17
able
8.0c
TOTAL APPRAISED VALUE - PARCEL
153,17
oofing Cover - 03
ksphalt or Composition Shingle
3.
OTAL PRESENT USE VALUE - PARCEL
nterior Wall Construction - 5
OTAL VALUE DEFERRED - PARCEL
)rywall/Sheetrock
20.0
OTAL TAXABLE VALUE - PARCEL
153,17
nterior Floor Cover - 12
PRIOR
ardwood
10.0
UILDING VALUE
129,86
nterior Floor Cover - 14
OBXF VALUE
9,51
:arpet
0.0c
LAND VALUE
22,00
eating Fuel - 04
PRESENT USE VALUE
lectric
1.0c
DEFERRED VALUE
eating Type - 10
TOTAL VALUE
161,37(
eat Pump
4.0
it Conditioning Type - 03
entral
4.0
drooms/Bathrooms/Half-Bathrooms
PERMIT
/2/0
10.00 + - - - 1 B - - - - + - - - - - 2 4 - - - - - - + CODE DATE NOTE NUMBER AMOUNT
drooms
I F E P I
I
AS - 2 FUS- 0 LL - 0
I I
I ROUT: WTRSHD:
I I
9 SALES DATA
throoms
2 2
I FF. INDICATE
AS -2 FUS-0LL-O
0 0
ECORD ATE DEED
+------26------+1111',0419�748
SALES
ffice
I I
I
IOOK AGE M R TYPE
PRICE
- O FUS - 0 LL- 0
I I
I I
I 00 WD Q I
488 85 61002
14200
OTAL POINT VALUE
104.00
+ - - - 1 B - - - - +
132496 100 WD Q I
13900
BUILDING ADJUSTMENTS
I B A S
172557 800 QC X I
uali 3 AVG
1.000 1
244140 1000 WD P I
9900
ha e,Desl 4 FACTOR 4
1.050 I -
6 5TD P I
11500
ize 3 Size
0.9700 1
1
OTAL ADJUSTMENT FACTOR
1.0210 5
1 .
I
OTAL QUALITY INDEX
106 1
1
1
+4+-------30--------+--------34--------+ HEATED AREA 2,146
GUOP 6
+-------30--------+
NOTES
D8 441 PG 540 (10-2-2002)
FROM: BANK ONE TR.
12.23AC TO HAROLD CARTER
FROM BENSON ROBERT JR ETU
SUBAREA
UNIT
PRIG % ANN DEP % OB/XF DEPR
TYPE GS AREA % RPL CS CODE ESCRIPTION LT H UNIT PRICE
COND LOG L/B AYB EYS RATE Ov COND
VALUE
S 1,784 10 13252103 RPORT 62 10.0
10 _ L 197 199 S 4
268EP
36 07 1869
r24
8 OL/VINYL 38 37.4
_ L 199 199 5 1
215OP
1 ORAGE 9 15.0
L 200 000 S3 61
87
18 02 333
3 - 1 Story
OTAL OB XF VALUE
-
5,715
2,25
IREPLACE Single
UBAREA
2,32 156,80
OTALS
-
UILDING DIMENSIONS BAS:W24FEP=W18S2OE18N20 S2OW18515E4UOP-S6E3ON6W30 E64N26W26N9 .
ND INFORMATION
.'.NEST
THER ADJUSTMENTS
TOTAL
'
NO BEST USE LOCAL FRO N
DEPTH /
LND
COND ND NOTES
OA
LAND UNIT LAND LINT
TOTAL
ADJUSTED LAND
LAND
SE CODE ZONING TAGE
DEPT SIZE
MOD
FACT RF AC LC TO OT
TYPE
PRICE UNITS TYP
ADJST
UNIT PRICE VALUE
NOTES
FR RES 0100 - 439
0 1.0000
0
1.00001
PW
1 22 000.0 1.00 LT
1 1.0001
22 000.0 2200 .840AC
OTAL MARKET LAND DATA
22,00
TOTAL PRESENT USE DATA 1 I I I- I
C
http://maps.co.davie.nc.us/ITSNet/AppraisalCard.aspx?parcel=L502OA0014 5/16/2013