627 Hwy 801N (2)DAVIE COUNTY HEALTH DEPARTMENT ? 1
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)r / Permit Number
Name /r�'`"J�l��' ti�ill;?.��%f� Date
Location r' /J�'/ i 1J / ,�//1 /, y'/`f (,i✓ %r/ ✓ <�� r°! «• _. /i/�j;j
Subdivision Name
Lot No.
Sec. or Block No.
Lot Size ��' + �/ �� House I," Mobile Home Business Speculation
.No. Bedrooms 9 No. Baths No. in Family
Garbage Disposal YES [p NO 0 Specifications for System:
Auto Dish Washer YES TNO
Auto Wash Machine AYES NO
Type Water Supply ' r • _ ��`� ��` 1 / /
*This permit Void if sewage system described below is not installed within 36 months from date of issue.
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: 794-634-5985.
Final Installation Diagram:
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.
Name—
Address
` DAVIE COUNTY HEALTH DEPARTMENT
Environmental Health Section
P. O. Box 665
Mocksville, N.C. 27028
SOIL/SITE EVALUATION
FAr.TrIRS
ARFA 1
Date
Lot Size 13y�
ARFA 9 ARFA 3 ARFA A
6)
7
8
1) Topography/ Landscape Position S S
(Pry (15SJ PS PS
U U
?) Soil Texture (12-36 in.) Sandy, _ S S
Loamy, Clayey, (note 2:1 Clay) PS PS
ZT U U
1) Soil Structure (12-36 in.) S S
Clayey Soils C P� PS PS
U '1__ jjj U U
1) Soil Depth (inches) S S
PS PS
U U U
i)Soil Drainage: Internal S S S
PS PS PS
U U
External S S
PS PS
U U U
Restrictive Horizons
) Available Space S S
PS PS PS PS
U U U U
) Other (Specify) S S S S
PS PS PS PS
U U U U
9) Site Classification S
U—UNSU
Recommendations/ Comments: —d
S—SUITABLE / PS—Provisionally Suitable
Described by �,�Title Date
SITE DIAGRAM
DCHD (6-82)
r
U—UNSU
Recommendations/ Comments: —d
S—SUITABLE / PS—Provisionally Suitable
Described by �,�Title Date
SITE DIAGRAM
DCHD (6-82)
r
RECEIVED e'6AR' Z 5 1935
• - APPLICATION FOR SITE EVALUATION/ IMPROVEMENTS PERMIT
Davie County Health Department
Environmental Health Section
P. 0. Box 665
Mocksville, N.C. 27028
CONSTRUCTION SHALL NOT BEGIN UNTIL IMPROVEMENTS PERMIT HAS BEEN ISSUED.
Home Phone 94 r - 5:� 3
1. Permit Requested By kohpn- 'j• Za4/-e-Q t- Business Phone –
2. Address R • `/ /3 04 217 Ad yaM (e,, P G -2 70 a 6
3. Property Owner if Different than Above
Address &,q
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--)!!'–"'
ouse Mobile Home Business
IndustryOther
b) Number of people 2
6. a) If house or mobile home, state size of home and number of rooms.
House Dimensions
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 hou
7. Number and type of water -using fixtures:
commodes urinals garbage disposal
lavatory a showers . washing machine /
dishwasher l sinks 1
8. a) Type water supply: Public Vo' Private Community
b) Has the water supply system been approved? Yes No
9. a) Property Dimensions /00 x 3 LIS
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.
Date Owner Signature
OWNER IS SOLELY RESPONSIBLE FOR COMPLIANCE WITH ALL STATE AND LOCAL LAWS
Allow 5 days for processing
Directions to property:
ly�- 170A� -Mo'�e �-�
DCHD (6-82)
Parcel #: C714000014
Davie County, NC - Basic Estate Search
Basic Search Real Estate Search Tax Bill Search Sales Search 0
:View Property Record for this Parcel View Mao for this Parcel View Tax Bill Information
Parcel #: C714000014
Account #:82525594
Owner Information
Tax Codes
BXF•
ARNELL LESTER FRANKLIN& DARNELL RHONDA G
ADVLTAX - COUNTY T
0 000
30,00
27 NC HIGHWAY 801 NORTH
READVLTAX - FIRE TAX
ssessed:
DVANCE NC 27006
eferred:
Property Information
Township
Land (Units/Type): 1.000 LT
FARMINGTON
Address: 627 N NC HWY 801
Deed Information
Local Zoning
ate: 12/2005 Book: 00641 Page: 0903
lat Book: 0004 Page: 171
Legal Description
PIN
LOT 1 CREEKWOOD ESTATES
5862863706
Property Values
uildin :
148,93
BXF•
1,31
Land:
0 000
30,00
180 24
I
ssessed:
180,24
eferred:
Sales Information
No. Book Page Month Year Instrument Qual/UnQual Improved Price
1 00187 0493 05 1996 WD Unqualified Improved 120,000
2 00641 0903 12 2005 WD Unqualified Improved 0
View Property Record for this Parcel View Map 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,
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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=1463723 8/31/2016