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425 Hwy 801N Davie County, NC Tax Parcel Report 6 Wednesday, September 28, 201( ........................................................................................................................................--l-1-............................ .................. ....................... .......................................................................................................................... .....................------------ WARNING: THIS IS NOT A SURVEY Parcel Information Parcel Number: D70000022701 Township: Farmington NCPIN Number: 5872058618 Municipality: Account Number: 66948000 Census Tract: 37059-802 Listed Owner 1: SMITH DAVID L Voting Precinct: SMITH GROVE Mailing Address 1: PO BOX 2251 Planning Jurisdiction: BERMUDA RUN City: ADVANCE Zoning Class: BERMUDA RUN CM State: NC Zoning Overlay: Zip Code: 27006-0000 Voluntary Ag. District: No Legal Description: 1.00 AC S OFF HWY 801 Fire Response District: SMITH GROVE Assessed Acreage: 1.00 Elementary School Zone: PINEBROOK Deed Date: 10/1990 Middle School Zone: NORTH DAVIE Deed Book/Page: 001560746 Soil Types: PcB2 Plat Book: Flood Zone: Plat Page: Watershed Overlay: BERMUDA RUN Building Value: 98890.00 Outbuilding&Extra 0.00 Freatures Value: Land Value: 109550.00 Total Market Value: 208440.00 Total Assessed Value: 208440.00 l.v♦ All data Is provided as Is without warranty or guarantee of any kind either expressed or Implied including but not limited to the 9 p' Davie County, 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 ��UN�� NC or arising out of the use or Inability to use the GIS data provided by this website. DAVIE COUNTY HEALTH DEPARTMENT a: 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 1.. if, J�7 Date N2 5 l E r Location �'�!/ ,;�=�"` `. i%' r.` ' �'�' zl Subdivision Name Lot No. Sec. or Block No. Lot Size f /' ' House Mobile Home _ Business __ Speculation No. Bedrooms ,--JNo. Baths- No. in Family Garbage Disposal YES ❑ NO p' Specifications for Syster is Auto Dish Washer YESNO Auto Wash Machine YES p NO -❑ Type Water Supply •j _ __S'f ii �, �.- *This permit Void if sewage system described below is not installed within 36 months from date of issue. ............ f 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 F �-1 Sao J 16 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. r APPLICATION FOR SITE EVALUATION/IMPROVEMENTS PERMIT Davie County Health Department Environmental Health SectionC P. 0. Box 665 ECE'1VEO NOVO 3 Mocksville, N.C. 27028 l CONSTRUCTION SHALL NOT BEGIN UNTIL IMPROVEMENTS PERMIT HAS BEEN ISSUED. t-- - Home Phone 1. Permit Requested LSL I I Busines Phone L 2. Address �7C4 3. Property O ner if Differe than bove Q Address 4. Permit To: a) Install Alter Repair b) Privy Conventional t/Other Type Ground Absorption c) Sub-DivisionSec. Lot No. 5. System used to serve what type facility: House Mobile Home Business Industry Other b) Number of people 6. ar If house or mobile home, state size o ome and number of rooms. House Dimensi s 6 Bed Rooms _Bath Room 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 ofZr-using fixtures: commodes urinals garbage disposal lavatory 0? showers__ washing machine dishwasher sinks 8. a) Type water supply: Public ' Private Community—u b) Has the water supply system een approved? Yes No�— 9. a) Property Dimensions�� 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. CA) 1 q Z _.._ Date 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 Lc-'54 -/b gel �-pVc j 4W110JV_ l/,O 6rn - q ror"b rcv DCHD(6-82) DAVIE COUNTY HEALTH DEPARTMENT ENVIRONMENTAL HEALTH SECTION SITE EVALUATION CONSENT FORM 1. Complete the form below and return to the Davie County Health Department. 2. Carefully follow the procedures as outlined in the enclosed "Information Bulletin." NOTE: THE ABOVE MUST BE COMPLETED BEFORE A SANITARIAN WILL BE ABLE TO BEGIN THE REQUESTED EVALUATION. DETACH HERE AND RETURN TO: Davie County Health Department, Environmental Health Section, P. O. Box 665, Mocksville, N.C. 27028 Davie County Health Department Environmental Health Section Site Evaluation Consent Form LOCATION OF PROPERTY: DATE RECEIVED 14LOL q0[-ntarHenQ5 A&rrb WTI r. (office use only) yes (S) 1. 1 am the owner of the above described property. yes no 2. 1 am not the owner of4he above descrilred property, however, I certify that I have consent from Aowner to obtain a owner's name site evaluation by the Davie County Health Department for the purpose of determining the suitability for a ground absorption sewage treatment and disposal system. yes no 3. 1 hereby give consent to the authorized representative of the Davie County Health Department to enter upon the above described property and conductall testing procedures as necessary to determine its suitability for a ground absorption sewage treatment and disposal system. DATE OSIdNATURE 4. 1 hereby authorize the Davie County Health Department to release site evaluation results from the above described property to the following: Owner only — Owners designated representative Anyone requesting results Only those listed below -2-0 -SS' 0S - DATE SIGNATURE DCHD(11/84) �(,csTl�I rid �`7�-�I'-���1 (y ) 7 S-a3V DAVIE COUNTY HEALTH DEPARTMENT Environmental Health Section P. 0. Box 665 Mocksville, N.C. 27028 SOIL/SITE EVALUATION Name Date XxAmy Address Lot Size FACTORS AREA 1 AREA 2 AREA 3 AREA 4 1) Topography/Landscape Position S� S S S PS PS U U 2) Soil Texture (12-36 in.) Sandy, S S S Loamy, Clayey, (note 2:1 Clay) (c PS PS 'U U U U 3) Soil Structure (12-36 in.) S S S S Clayey Soils <±�) PS PS PS U U U 4) Soil Depth (inches) S , S S © /PS 1 PS PS U � U U 5) Soil Drainage: Internal S S S S 4P PS PS U U External S Ttl. S S PS PS PS U U 6) Restrictive Horizons 7) Available Space } S S PS PS PS PS U U U U 8) Other (Specify) S S S S PS PS PS PS U U U U 9) Site Classification r-51- '�0- 5- U—UNSUITABLE S—SUITABLE PS—Provisionally Suitable Recommendations/Comments: T Described by 7w/z Title Date SITE DIAGRAM DCHD(6-82)